Met With Gi Today, Tests Ordered For Tomorrow

[AlysounRI]

Hi All:

I am going in for blood tests and my endoscopy tomorrow morning.

I met with the GI doc. this morning.

I have a whole scrip of bloodtests to take.

Some I know, some I can't tell what they are.

Here is the list:

Albumin,

Ceruloplasmin (seems to test for copper),

HepB Ag, Hep B Ab (I know what these are, these are due to my elevated liver levels).

Antismooth muscle Ab.

HepBe Ab, HepBe Ag (how are these different from above?),

Hep C Ab (see above),

AnA,

AmA,

Ferritin (yes, I am low on iron, I know this one),

Spep Hg,

IgA level,

HepBC IgC,

CBC w/dica(?),

B12 (yes, I know this one, too)

573.2, 564.1 ( don't know if these numbers mean anything)

Now what I don't see is a TtG test ordered.

Or might this have another name on the scrip?

I did like the doctor, he wasn't dismissive of anything I had to tell him, and he has diagnosed several people in the local celiac support group I have visited. So he certainly know what celiac is all about. I am in RI and this doctors name is Theodore Palumbo.

He asked me about the vitamins I take, if I was a vegetarian (I'm not), and about the protein in my diet. There are a lot of liver level tests because the last time I had bloodwork done my liver levels were high and the urine tests indicated some crystals in my urine (kidney stones??).

Can anyone help me to decipher what these blood tests are testing for other than the obvious? Your help is very much appreciated.

~Allison

[nora-n]

hi, maybe the 573.2, 564.1 are the ttg tests???

elevated liver numbers are typical for celiac.

The IgA test is for total IgA, to see if the ttg IgA or antigliadin IgA are valid

Ferritin typically is low in celiac, so is b-12 and vitamin D. But not neccessary all of them at hte same time...

[Wolicki]

I looked up those two codes on Quest Diagnostics. They are for Hepatitis B and IBS.

Looks like he did not order most of the tests in the standard celiac panel. Someone else can chime in with the full panel names, as I always forget one

[Wolicki]

Here ya go. I looked it up. These are the tests:

Tissue Transglutaminase (tTG) Antibody, IgA

[AlysounRI]

Thank you Nora and Wolicki.

I'll be sure and ask him about the blood tests tomorrow.

So the IgA level test is one of the tests for celiac but the others that you listed are not there, right?

I am so confused. I'll ask him about the tTG and the IgG test tomorrow before the local anesthesia sets in and I'll print out this little topic from the forum. Could there be a second round of these things if the IgA test turns out to have elevated levels, is this was his thinking is maybe? But I will ask him about this tomorrow.

I knew that liver levels being high might be an indication for celiac but I didn't know that there were so many kinds of Hepetitis strains!!

~Allison

[Roda]

hi, maybe the 573.2, 564.1 are the ttg tests???

elevated liver numbers are typical for celiac.

The IgA test is for total IgA, to see if the ttg IgA or antigliadin IgA are valid

Ferritin typically is low in celiac, so is b-12 and vitamin D. But not neccessary all of them at hte same time...

Those numbers are ICD 9 codes. That is what they use for medical billing. Here is exactly what they mean.

Open Original Shared Link

Open Original Shared Link

Also there are several strains of hepatitis. Hep A and B there are vaccinations for Hep C there is not. Here is a link describing the strains of hepatitis.

Open Original Shared Link

[AlysounRI]

Thank you Roda.

So it seems to be that, this doctor also being a liver specialist, wants to rule out any of the Hep. strains first, do the IgA test and the endoscopy. Maybe they left the tTg test of the scrip or they want to do the endo. first.

I'll be sure to ask tomorrow morning. I am hoping that test will be done.

Ah, the subtle poetry of medical billing codes ...

~Allison

[Roda]

Thank you Roda.

So it seems to be that, this doctor also being a liver specialist, wants to rule out any of the Hep. strains first, do the IgA test and the endoscopy. Maybe they left the tTg test of the scrip or they want to do the endo. first.

I'll be sure to ask tomorrow morning. I am hoping that test will be done.

Ah, the subtle poetry of medical billing codes ...

~Allison

Your welcome. Ask the doctor how many biopsies they are going to take in the small bowel. A good sampling should include at least 6 all from different areas. Good luck and I hope you get some answers. I'm going for a repeat EGD next Tues.

[nora-n]

The IGA test by itself is not a celiac test.

The celiac tests are:

the main one nowadays is Ttg IgA

but often they also run the others, since some people only have one of them positive. And the antigliadin test may be the first one to turn positive in early celiac.

antigliadin IgA

EMA

and there is this now deamidated gliadin test

and some have the IgG versions done too

[AlysounRI]

The IGA test by itself is not a celiac test.

Grrrrrr, this may be an oversight then.

I'll be sure to mention it tomorrow.

And, thanks, Roda, I will be sure to ask how many samples they are going to take from the small intestine.

It's going to be a long, complicated day tomorrow, I think.

I will let you know how it all turns out.

And what he says about the missing celiac panel tests.

~Allison

[ravenwoodglass]

Are you already gluten free or have you been? I am wondering if you are if the doctor realizes the tests would be a waste of time and money and that is the reason he didn't order them. He may also feel that since the rate of false negatives is high the endo might be the way to go.

[AlysounRI]

Are you already gluten free or have you been? I am wondering if you are if the doctor realizes the tests would be a waste of time and money and that is the reason he didn't order them. He may also feel that since the rate of false negatives is high the endo might be the way to go.

Raven, I mentioned to him that I had done a three week elim. of gluten in Feb. But that I had been back on it (and how) since the beginning of the Month of March (this month). It was my impression that he wanted to do the endoscopy right away as a first thing. I don't know yet.

But I am going to ask him more questions tomorrow before I go into <scary music>conscious sedation</scary music> ...

Thank you for your comment and your question,

The is forum is so helpful.

~Allison

[ravenwoodglass]

Raven, I mentioned to him that I had done a three week elim. of gluten in Feb. But that I had been back on it (and how) since the beginning of the Month of March (this month). It was my impression that he wanted to do the endoscopy right away as a first thing. I don't know yet.

But I am going to ask him more questions tomorrow before I go into <scary music>conscious sedation</scary music> ...

Thank you for your comment and your question,

The is forum is so helpful.

~Allison

Asking him about that does seem a good plan. Try not to worry about tommorrow if you can. The test isn't bad and although you will have conscious sedation that doesn't mean that you will feel or remember anything. If your really nervous mention that to them when you get to the procedure, if there is a long wait they might give you something to relax you.

[AlysounRI]

Asking him about that does seem a good plan. Try not to worry about tommorrow if you can. The test isn't bad and although you will have conscious sedation that doesn't mean that you will feel or remember anything. If your really nervous mention that to them when you get to the procedure, if there is a long wait they might give you something to relax you.

Thanks Raven. I will.

I'm not too much of the nervous type at all.

I'll roll with it.

It's just a relief that this day has come really and that soon I can get off the gluten, you know ...

~Allison