Connected Rheumatology

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Archives for September 2021

Why everyone asks if you are depressed

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I’m not depressed!

And besides, wouldn’t you be if you were in pain all the time?

I know this conversation all too well. It is a conversation that takes longer than the 15 minutes we are given with our doctors. Why do doctors keep bringing this up? We worry that talking about our emotional state could label us. Doctos will assume it’s all in our head and our concerns and symptoms will no longer be taken seriously. These concerns are valid as I’ve, unfortunately, seen issues go unchecked in patients where too many assumptions were made. But despite this real concern, we shouldn’t dismiss the opportunity to investigate the way emotions may be impacting our symptoms.

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Get to know the anti-centromere antibody

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The anti-centromere antibody rarely comes up in casual conversation. Even doctors are easily confounded by this antibody. Doctors can give confusing or mixed messages regarding a centromere antibody result and this can send even the most levelheaded into a tailspin.

What is a centromere?

We might need to return to high school biology to answer this. Stick with me as we do a quick refresher.  The centromere is a piece of DNA that attaches to chromatids to form a chromosome. (!!!) We all have 46 chromosomes or 23 pairs. (Think of “23 and me”) The chromosome is a structure that houses all our DNA. We find this structure in the nucleus of our cells, making, by definition, the centromere antibody an anti-nuclear antibody, or ANA. The anti-centromere antibody, thus, can be positive in those with a positive ANA result. Remember, the ANA blood test is a general, non-specific anti-nuclear antibody blood test while the anti-centromere antibody test is a more specific type of ANA. This then would make a positive centromere antibody result with a negative ANA, very unlikely.

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Sjogren’s Syndrome: know the facts

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You’ve been waiting for this appointment for months. Your mind races as you wait for your name to be called. This all started when you made an appointment with your doctor on your dentist’s recommendations. You had more cavities than usual and your dentist recommended you get checked for an autoimmune condition. An autoimmune condition? Really? Sure, you have been tired the last few months, but life is busy and who isn’t tired these days? Your doctor did some tests and said you have rheumatoid arthritis. WHAT? You are given a copy of your labs, the name of rheumatologist and told to take Advil.

The four-month wait for the rheumatology appointment gives you plenty of time to investigate your labs, and to your dismay, you find you are ANA positive. Dr. Google immediately informs you that you likely have lupus. Let the spiraling commence. Why didn’t my doctor mention this? How could this happen? Am I going to die?

They call your name and usher you back. Blood pressure is a little elevated – not surprising given what you are bracing yourself to hear. Waiting again. Finally, the doctor arrives. She looks over your labs, does a physical, and says “You don’t have lupus or RA.” A wave of relief washes over you. Your future suddenly becomes clear again. “But you have Sjogren’s Syndrome.”

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