C4 lab work

Do you have any idea what labs were ordered initially? It's hard to know why he's interested in the C4 without knowing why you had labs done to begin with.

I know he ordered a few but the only one I know he ordered for sure the first time was the C3

Again, without knowing why you went to the dr (original complaint) it's impossible to guess why he's ordering certain tests. Here's a general description of why complement assays are ordered



Do any of those situations apply to the reason you were at the dr's?

If it helps any...it was my Gastroenterologist that ordered the tests...he also ordered a CT with contrast...a endoscopy and a colonoscopy...my syptoms have been going on for about 7 years but have become even worse in the last year...I have flair ups of lower abdominal and back pain...my belly bloats to the point of looking pregnant....I have joint pain...sometimes sharp chest pains....and Im tired ALL the time...even after nine hours of sleep. I also have reynauds so my feet are always cold and purple.

I really dont know if any of those apply because he hasnt discussed it with me...I went to my first appointment told him my complaints he ordered the test...and after he recieved the first round of lab work results he ordered the C4 I have not yet been diagnosed with anything nor has he talked about what he thinks it can be....I just read about that test and became worried about what it could mean and am not getting any answers when calling his office...everyone acts like they have no clue:(

Yeah, I hear you. It's frustrating as hell when you're trying to get information out of the system and no one will talk to you - especially when you're waiting over a weekend. The only one who is going to explain the results to you is your dr. If you get some new tests ordered explain to whoever is asking you to come in for more tests that you aren't having any more tests until you get an update on the results of what's already out there. They're YOUR results and you have a right to know what they are and to have them explained to you in language you can understand. It's possible that the C4 was ordered the first time (along with the C3) and that the results came back inconclusive or they had a problem with the sample used for the test. It may not be a new order, but a retest order. I have no idea, but I'd call the office on Monday, let them know that you're worried and ask that the dr call you back with an update as soon as possible.

We have some folks here with autoimmune disorders that may be able to relate something specific about your symptoms. Your original question of why he ordered a C4 as a second pass can only be answered by your dr. I'd guess it was a re-order rather than a new order but he's going to have to explain that to you. Maybe some of our folks who have AI diseases will drop by and chat with you.

it was a new order for sure...but I appreciate your time and advice thank you!

Hi Loren31 - Welcome to A2K...

<thanku Flying Squrrrl JPB - here...>

hmmmmm Loren... to be honest, I'm not sure what a C4 test is... are you in USA? Perhaps the tests are called by different names there. I'm in the UK and I have blood tests done each month but no C4's. CRP and a zillion others - but really unsure how to advise you about that particular test.

So, from my experience only over last 20+ years: I have SLE, RA, Raynaud's plus the possible, but not likely, onset of Chron's - plus a few other little lovelies too. <Yes, yes, if I were a horse, they'd shoot me > However, talking about your specific problems - well - first up the joint pain is likely caused by inflammation (that may sound a little obvious) - with the array of tests that can be done, including very simple ones like ESR and PV - that can show if there is 'activity' going on in your body.

Specifically for SLE -
http://en.wikipedia.org/wiki/Systemic_lupus_erythematosus

and RA
http://en.wikipedia.org/wiki/Rheumatoid_arthritis

it all sounds very scary when you start to read up on things that you may or may not have... really scary... but you have to remember that you will most likely not have all the symptoms...




ok... the endoscopy and colonoscopy - that could be to determine or rule out a whole other diagnosis. The colonoscopy will let the doc see whether you have any ulcers in your colon, they can take biopsies (don't worry, you will have sedation and it doesn't hurt at all) ... with SLE, you can have apthous ulcers in your colon which can be also be indicative of Chron's - diet is a huge factor with Chron's and there are a few threads on A2K that discuss Chron's. I had these procedures done in Feb this year - and it was a lot easier than I thought it was going to be (again, another poster has written about this and I can find the link if you want to read thru it). The endoscopy can also see if you have stomach ulcers (or heliobacterium) which can cause the bloating etc - or they could determine (by ruling out other things) that you have irritable bowel syndrome - again, diet factors in that greatly. IBS can cause huge abdominal swelling - and yes, it's horrible, painful and you can look as tho your pregnant - this can come and go depending on how you moderate your diet and also, stress levels.

Lower back pain... can't assist in that department - that's about the only place I have not suffered any joint problem with - but I do know from other posters how terribly painful it can be.

If you can/wish to, can you tell me if you are on any medications? With joint pain, often NSAIDS are prescribed - for me - they caused more problems - 3 stomach ulcers with Naproxen (Naprosyn) and ibuprofen... but for many people, they can give immense relief. I've been on immunosupressants (methotrexate) for 14 years-ish - that works for me much better. Do you take any pain killers for your joint pain?

Chest pains... can't help with that one either.

The good thing is - the doctor is taking your symptoms seriously by ordering these tests and I really would advise that the only 'real advice' you should take on why they have ordered the tests and what the possible diagnoses could be, is from the doctor who is treating you.

The worst symptom I struggle with, is fatigue. That just knocks me down and takes me out on a regular basis. The only thing that can be done about it - is rest, when needed, rest rest rest.


Keep talking if you need to have a vent.

It is invariably harder to 'not know' what is wrong than it is to deal with with what they/you 'know' to be wrong. I hope you can talk with your doctor for reassurance as soon as possible - reading up on possible diagnoses can send you spiralling and can churn your tummy up too making the symptoms worse.

You've had your symptoms for a number of years now so you are used to dealing with the daily onset - try and think that when the doctor explains or determines a diagnosis, that that is the signpost to getting the help you need to try and combat any disease. You can and will do that - once you know what you have to battle with - you find it in yourself to deal with it.

Vent away Loren - I don't know if what I've said could be help or a hindrance to you - but please know that you're not alone feeling crahp and, tho that doesn't make it any easier for you, there's usually someone around to listen if you need to have a shout. Enjoy your good days as best you can - I do understand that unpredicatably of these symptoms is a pain in the bahookie... you never know if the next day is going to be a good one or a bad one - but I will say, it's really, really not all doom and gloom if you have SLE, despite it being a nasty... trying to keep a positive focus DOES make a difference - (well, for me it does).

<disclaimer - I'm not medical at all... just an experienced loud and fairly-informed patient >


ps: if ya knew how many times JPB and a couple others got PM's from me saying "dayum, it's the immaculate conception again, I look pregnant..." - ha... dontya just loathe that!!!!!>

Izzie....

Thank you for your kind words....sometimes its nice to know I'm not alone as it seems alot more often I am finding those around me to roll their eyes "oh, Loren doesn't feel good again!" and it can be very frustrating! This feels like it has been an on going battle, going from one specialist to the next. It seems either the doctors each give me a differnt diagnosis with treatment never working or they simply say they have no idea what is wrong. All I know is that I am very tired of feeling this way and praying to god someone figures something out and get me on the road to feeling better. Currently I am on colace, prilosec, a chewable gas relief med and bentyl all of which bring me very little relief if any. I was on tylenol with codine for my back pain ( I can't really handle anything stronger unless they are pumping it through an IV) but I stopped taking that as it just seemed to cause more problems then good. My doctors have tried altering my diet in different ways depending on there current "guess" as to what could be the problem but diet changes don't seem to change the way things go. I have two small children with endless energy and their own array of health issues and our life is pretty "go, go, go" right now and I find myself struggling to keep up most days or unfairly cranky because I simply don't feel good and am in pain. Its gotten to a point where it not only affects me but my loved ones as well...which just makes it all that more frustrating to have no answers. Hopefully all these tests will show the doctor something otherwise I will probably be pushed off onto another specialist. Again...thank you for your kind words and information....I'm feeling a little more calm about it now!

Hey Loren

It is very difficult, especially with a young family.

I would recommend you get these enterology tests done -(these could come back negative and inidcating IBS - which isn't wholly helpful because it does mean a change in eating habits, dealing with stress etc... this could be caused by the fact you have a lot of pain to deal with i.e. your joints, back pain etc, and especially the fatigue.

If the enterologist does not come up with a definitive dx, then ask him to refer you to a rheumatologist (you call them immunologists in the USA). Ask specifically for the ESR and PV tests which will indicate "itis" - inflammation going on somewhere - ie arthritis, SLE, ulceritis - anything with an 'itis' going on with the parameters we've talked about here.

RA/SLE - specific test - Rheumatoid factor (you can have RA without the factor) and anti-DNA and antiRNA tests. There are important. The C4 test you were talking about may include the usual tests I have here - CRP (reactive protein), AST (Liver Function Test) and ALK (alk phospate) - these are strong indicators for inflammatory arthritis type symptons and connective tissue disease, incorporating SLE. Also the base RBC, WBC neutrophils, eosinophils etc. (bog standard blood tests). The first mentioned are very specific tests and "pretty routine" - all they need to do is take a few extra vials (mine are 8 at a time).

Other than that, I would really push for reassurance about the chest pains... that would be my priority if I were you... You haven't described the pain, could these be anxiety pains... worrying about what's wrong. Whatever it is, you need to see someone soon about that.



with your diet and bloating - try cutting down on your carbs - bread, pasta, cereals with wheat, bread... that sort of thing... dairy produce... try maybe for a couple weeks and see if it makes a difference. Carbs make a huge difference to IBS if that what it could be. (sorry if this comes over as preaching - don't mean it to sound that way)

I'm here a lot of the time and there are many posters with experience in various symptoms to glean information from. Just talk when you wish to.

Don't accept the doctor saying "don't know what the answers are"... you have quite specific symptoms that sound all too familiar... so try and push them - have a list of questions to ask them and be strong, look them direct in the face and wait for them to answer. Maybe if your partner/hubby can go with and he can "back up what you're sayng" to the doc and to basically, hold your hand - give you a little strenght. If not, a friend. Anyone who you are comfortable with and supported by to accompany you and who can also ask questions if you are struggling to say what happens when you get sick- it's sometimes better when there is a back up so it doesn't sound like your whole body is falling apart and being whiney - someone independent can tell it like it is to the doc.

I know too well the looks I get when I am always sick... in fact, people are so bored of my umpteenth surgeries etc, it's now easier not to discuss it (tho I whine with folk here). Somehow, you have to find a place inside your head that says - "unless you are well, you cannot look after the kids to the best of your ability, the way you wish to and it's hard for partner/hubby too" - therefore YOU must be well, you must put your health needs first, so you can then do everything/some things that are expected of you as partner/mom/daughter/sister/ etc.... TAKE CARE OF YOU FIRST -then you will be stronger for them.

Do remain calm - and if you wanna talk... carry on. Also, I know I said it before - but keep a positive focus that this will not beat you - do all that you can when you can, and when the fatigue cracks you - no matter what - you have to rest. OK.... give it a go until you see the doctor (it may seem selfish and believe me, with kids and partner, the guilt you feel is the worst - BUT YOU MUST NOT LET IT!


Sending you strength and best healing wishes. Take care.

Small quibble, Iz. I ran a clinical lab and later was supe in a research lab for the rheumatology department at a university in the US, and much of the work we did could be described as immunology. The docs were, as a generalization, rheumatologists, some also phDs in this and that, one a researching orthopedist, one a hematologist as well. But the board certs were primarily in rheumatology.

Later I worked at a major clinical lab for immunology - the owner was a rheumatologist and phD.
I am behind the times on the laboratory aspects, so I have no useful comments on present days testing.


I'm glad Loren has had a chance to talk with both JPB and Izzie. Good smart women.

I suppose I could be wrong, heaven forfend, re board certs in immunology. I'm quibbling from my days of yore.

Thanks for clarifying that Osso. Yep, in Boston I was with a rheumatologist and when we moved to CA I was transferred to an immunologist at Stanford Uni - mainly coz I was real sick then but also undergoing IVF treatment in San Jose.

Yep yep, you're quite correct. Rheums can and should be able to do all the tests I said above for sure, if they deem it necessary. That's who, if she can get the referral, whom she should aks to see.

Grazie - hope you had a lovely day Osso. x