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Victoria, Chiropractor
Category: Health
Satisfied Customers: 590
Experience:  25 years overall experience in health care from hospital-based intensive care to private practice
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I am awaiting a blood test to come back and it was taken ...

Customer Question

I am awaiting a blood test to come back and it was taken on 18th April. Surely it shoujld be back by now. I have Raynauds and my ESR rate came back abnormal (border line). What exactly does this mean? So the hospital repeated all my blood tests but this particular one has been atthe Queens Medical Centre since 18th April. I am wondering why they are taking so long.
Submitted: 9 years ago.
Category: Health
Expert:  Victoria replied 9 years ago.

ESR =erythrocyte sedimentation rate. Erthyrocytes are red blood cells. This test measures the degree of red blood cell "settling" in a sample of blood during a specified period of time, in other words, it looks at how quickly or slowly the red blood cells fall to the bottom of tube of blood. Red blood cells are heavier than the serous or liquid part of the blood and the blood sample is mixed with an anticoagulant to prevent clumping of the cells right away, but the sample must be tested within 2 hours..

The ESR is a very sensitive test as an early indicator of inflammatory disease when other chemical and physical signs may still be normal, however it is a nonspecific test. This means that it can pick up on an inflammatory process very early on in its course, but is unable to tell you the specific reason for the inflammation. ESR is elevated in inflammatory disorders such as rheumatoid arthritis, vasculitis(inflammation of the blood vessels, malignancy and infectious processes. Because the test is nonspecific, when positive, other test must be done to look for the specific source. When borderline, doctors often wait a little while and repeat the test, but perhaps your symptoms or some other test results were suspicious for a particular diagnosis and further testing was initiated based on more than just your ESR. Most likely the battery of tests you had done fell into one or more of these categories: rule in or out various autoimmune diseases and/or infections such as Epstein-Barr Virus and/or some type of malignancy(cancer) such as multiple myeloma. Highly specialized tests that require special equipment found in very few labs around the country, involving multi-step testing or DNA sequencing could potentially take several weeks before the results were back, but most likely the blood samples were lost, mislabeled or improperly handled such that the test results were invalid and were just thrown away. When it became obvious that there was no record of your blood results to be found, the blood work was repeated afresh.

Warmest regards,

Victoria and 2 other Health Specialists are ready to help you
Customer: replied 9 years ago.
Epstein-bar Virus - what exactly is this? Also what is multiple myeloma?

I have a feeling that my problem is Lupus. The consultant mentioned this a couple of times. My symtoms are the butterfly rash, my nose feels as though something is creeping about at the back of it. My ears feel as though they are running and ache all the time. I have a continuous headache. My skin is now covered with a sort of netting look which the consultant actually said. I am not losing weight. Thank you for going to the trouble to look into this for me.

Actually my own GP took a few blood tests, 2 came back ok but the 3rd one was the faulty one. He sent me to see a consultant who repeated all the tests. Here again one has not yet been returned, this is the one I spoke of in my original question. I hope it is not something bad. I have been feeling unwell for ages.
Expert:  Victoria replied 9 years ago.
Hello again,

You may very well be right and if not lupus some other autoimmune type disease. The butterfly rash points strong to lupus.

Epstein-Bar Virus is a very common virus that most of us are exposed to without long term consequences. It is the offending agent in mononucleosis with which you are probably familiar. The virus has been implicated in chronic fatigue syndrome and other nonspecific type illness that are difficult to explain. Multiple myeloma is a type of bone cancer. I was merely citing them as examples in the categories of things for which you might test in conjunction with a positive ESR. I did not mean to imply that you might have any of these particular diseases. I was just explaining what the ESR test reflected and various types of problems it might indicate for which more specific tests would be needed. The specific tests would be guided by your clinical picture of which I had no knowledge except that you had Raynaud's which may or may not have a connection to why one's ESR was elevated. An autoimmune connection is certainly possible, including lupus and scleroderma. A borderline ESR could just be indicative of having had a bout of the flu or food poisoning. Try not to worry and wait for the test results before jumping to any conclusions. Easy for me to say - right?

Warmest regards,