So my rheumy who got caught with his pants down around his ankles for missing the osteoporosis diagnosis, decided two months ago that he would suddenly start to test me after being under his care for 16 months, said he would be doing specialized blood tests for osteoporosis. I thought he should have pulled the tests that day before he sharply raised my MTX on a very slight change.
Anyway, I go to the lab for my usual one week early blood draw and sometimes a urinalysis. I thought before I left to go to the bathroom one more time, but decided not to in case it was going to be a urinalysis test time too.
So I get there and this is exactly what the check in person said as she handed me the cup: You were told this has to be your second urination of the day, right? I decided that was the weirdest question I have ever been asked in my life. Let's see, I called the lab last Thursday to move up my time because of work, and they said only the doctor's office can change your appointment. So I left three messages Thurs, Fri and Monday with no response. And now, once again, I am to be a mindreader and know that the urinalysis is the second pee of the day.
I told her she was in luck. Morons.
Don't you hate it when they don't call you back???? Do they think we call them to chat or what???
Hugs
Cathy and Angy...I am having the same problems with my Dr.s office.It gets better - I just researched second pee of the day and it says NPO or nothing by mouth after midnight. I took all my meds and had breakfast and coffee. Morons. you should have told the lab tech 'urine luck!'Pip
JSNY, what were they testing the urine for? I have never heard of 2nd urineThey are testing your urine for osteoporosis?
My OB was the one that detected the fact that I have osteopenia after my first bone density scan. I'd been seeing an RD (3 different ones to be exact) for at least 10 years by then but it was my OB that detected it.
I thought that was slightly strange myself.....but I guess while being treated for RA osteoporosis or the beginning stages as osteopenia aren't a concern to them? I don't know. I know I'm young but after being treated for RA for so many years I think it should have been routine to have been screened early on and to closely monitor this due to all of the meds. My OB said the fact that I've already entered menopause at such an early age is definately a factor (Also the reason for the bone density test) but chances are better that the long term RA treatments (Including Predisone) is the most likely culprit in my case.
Hummm... yep morons is right.
Monitor therapeutic response in patients with metabolic bone disorders
Predict future bone mineral density (BMD)
Predict therapeutic response prior to initiation of antiresorptive therapy
Detect bone metastasis in patients with various malignancies
Clinical Background
Osteopenia and osteoporosis are characterized by low bone mineral density (BMD) leading to bone fractures that may result in either full recovery or chronic pain, disability and even death. Healthy levels of BMD are maintained by a balance between bone resorption and bone formation. N-telopeptide (NTx), the amino-terminal cross-linked peptide of type I collagen, is released during bone resorption and has been correlated with BMD T-scores.1 Multiple studies have shown that NTx not only correlates inversely with BMD response to therapy, but also is an early marker or predictor of BMD response. Thus, therapeutic response can be determined within 3 to 6 months of therapy rather than 1 to 2 years.2-4 Studies have also demonstrated that elevated pretreatment NTx values predict positive response to therapies such as hormone replacement therapy in postmenopausal women.4,5 In patients with malignancies, elevated levels of NTx may indicate bone metastases.6-8
The above clinical utility was established based on urinary measurements; however, initial studies based on serum indicate similar utility.9-12 Additional studies are required for confirmation.
Individuals Suitable For Testing
Individuals who are about to begin antiresorptive therapy
Individuals who are currently receiving antiresorptive therapy
Individuals with suspected bone metastasis
Specimen Requirements
1.0 mL refrigerated serum (0.3 mL minimum)Collect baseline specimen immediately prior to initiating therapy; collect subsequent specimens at the same time of day for optimal results when monitoring therapy.
2nd Morning Urine: 2 mL refrigerated urine (1 mL minimum)
Collect the second morning void; mix well and aliquot into a sterile screw cap container; store and ship refrigerated without preservatives.
24-Hour Urine: 2 mL refrigerated aliquot of a 24-hour urine collection (1 mL minimum)
Refrigerate during collection; do not use preservatives; record total 24-hour volume on the vial and request form.
I am going to use the ur-ine luck line when I see him next week. I read it was also a test for liver problems, and I have been on MTX for 16 months, but my labs have really been good, low, not way off the map. I pulled that 150 RA initially, then a high B12, and very high amlyase and lipase when I had the severe acute pancreatitis, and well the thyroid of 71 or so, but my autoimmune labs really aren't that high. I will report on the Ur-ineator next week. As the wheel of health churns, these are the days of our lives, in Gene-ral Hospital, Autoimmune la la land. The Stepford Patient.