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Arthritis Testing Overview:

In order to gauge your current state of health, our clinic will often request copies of your last two years of medical testing and will often recommend further testing as needed.  Our clinic does request some testing that is and not commonly performed in more "mainstream" medical clinics.  24-hour heavy metal testing with provoking agent, neurotransmitter analysis, food sensitivity testing, comprehensive stool testing and Candida antigen testing are commonly recommended by our medical staff.   Some of these are discussed in detail in the links in this section.

What to Expect on Your First Visit:

First office visits typically last 45-60 minutes.  Your doctor will review your intake form with you and gather a detailed medical history.  A partial physical exam is usually performed and medical records are often requested from your primary care physician and/or other doctors.  Specialty laboratory testing may be recommended.  Most clients are offered an initial protocol consisting of nutritional supplementation, dietary and life style recommendations.

First Visit: Blood Test

To assess and identify kidney, liver, blood sugar and other key factors such as blood cholesterols. The results are explained to the patient, giving him/her a fuller understanding of the blood chemistry, so that they may take control.

Patients are required to fast for 14 hours before the test. Water may be drunk freely, but not tea, coffee, juices or other beverages. Appointments are normally arranged for mid-morning so that food and drink can be consumed up to 8pm the previous evening. On the day of the appointment, any prescribed medication should be taken with water as normal.

Patients are recommended to bring food to eat after the blood sample has been taken. Diabetics should advise the clinic, and separate arrangements will be made.

First Visit: Urine Analysis

To establish exactly how the kidneys are functioning. Patients are required to collect urine over a period of 24 hours. This should be as near the date of the blood test as possible, but must not include the 14 hours fasting period prior to the appointment.

A recommended timetable is that the first urine of the day should be excluded, than all subsequent urine for the next 24 hours collected in clean plastic containers. (If collection starts at 8am, this process must be followed until 8am the following day.) Eg. Appointment 10am Friday, fasting commences Thursday 8pm. Urine collection starts Wednesday 8am. until Thursday 8am.

Containers should be clearly labeled with the patient’s names and brought to the clinic at the time of their appointment.

First Visit: Resting ECG for Doctors Report

The electrocardiograph (ECG) determines the condition of the heart and measures its actions and the pulse.

The doctor in charge reports any findings in his medical notes.

Specific Arthritis Testing:

While often referred to as if it were a single disease, arthritis is actually an umbrella term used for a group of more than 100 medical conditions that collectively affect nearly 46 million adults and 300,000 children in America alone. While the most common form of arthritis -- osteoarthritis (OA) -- is most prevalent in people over 60, arthritis in its various forms can start as early as infancy.

The common thread among these 100-plus conditions  is that they all affect the musculoskeletal system and specifically the joints - where two or more bones meet. Arthritis-related joint problems include pain, stiffness, inflammation and damage to joint cartilage (the tough, smooth tissue that covers the ends of the bones, enabling them to glide against one another) and surrounding structures. Such damage can lead to joint weakness, instability and visible deformities that, depending on the location of joint involvement, can interfere with the most basic daily tasks.

What is the Rheumatoid Factor Test?

The Rheumatoid Factor test is used to measure the amount of the autoantibody rheumatoid factor (RF) in the blood by drawing approximately 7ml of blood sample from a vein on your arm. The rheumatoid factor is an autoantibody that binds to other antibodies, causing the body’s immune system to attack the tissues. This results to inflammation processes in the body.

Indications and Contraindications

The Rheumatoid Factor test is used to diagnose the following conditions:

• Rheumatoid Arthritis
• Rheumatoid lung disease
• Autoimmune diseases (scleroderma, SLE, Sjögren’s Syndrome)
• Chronic viral infection
• Tuberculosis
• Renal disease
• Syphilis

You may not be able to get tested or get an accurate result for rheumatoid factor if you:

• Are over 65 years of age
• Have high amounts of fat in the blood
• Have received multiple vaccinations and transfusions

How do you prepare for the Rheumatoid Factor Test?

No special preparation such as fasting or sedation is required before the test. However, notify your physician if you are taking medications as it may be necessary for you to stop taking them before getting tested.

How does it feel? How long will it take?

The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You may feel nothing at all from the needle while your blood is being drawn, or you may feel a quick sting or pinch depending on your sensitivity to pain. A 7-ml venous blood sample is drawn which lasts for a few minutes.

Expected effects after the test:

Normally, there are no major effects after the test. Commonly, patients may feel a little sore and slight bleeding may occur on the needle site. Bruising or swelling may occur. 

Special instructions after the test:

Cover the needle site with a clean and dry bandage for 24 hours. Constantly check for signs of infection. To minimize swelling and bruising, apply warm compress several times a day.

Interpretation of Results:

Results of the Rheumatoid Factor test may be available approximately 2 days after the testing.

Normal Findings (Negative):  A negative test result indicates that you do not have rheumatoid arthritis. However, if RA is suspected due to the presence of symptoms, the test may be repeated.

Method	Normal Value
Agglutination	Less than 1:80 titer
Nephelometric	Less than 60 U/ml

High values of RF indicate (positive) that you have rheumatoid arthritis. In some cases, people with high RF levels do not have rheumatoid arthritis but may develop it later on. A positive Rheumatoid Factor test may also indicate that you may have the following conditions:

• Myositis
• Endocarditis
• Sarcoidosis
• Lupus
• Scleroderma
• Chronic hepatitis
• Chronic viral infection

Notes:

Rheumatoid arthritis is diagnosed by using the results from the Rheumatoid Factor test, the patient’s medical history and physical examination. Elderly patients oftentimes test false-positive for the rheumatoid factor test.

The Right Diagnosis and Treatment for Arthritis

Once the comprehensive review is completed for each patient, our doctors and our team of medical professionals will evaluate your diagnosis. At this point, our doctors will spend one on one time with you to interpret and explain your results. Together you will explore your goals and discuss your treatment plan options. These treatment plans can be implemented using multiple modalities such as medications, hormones, diet, supplements, behavior and lifestyle changes, and alternative therapies. Our doctors will prescribe a preventative and comprehensive treatment plan that is tailored to your needs and fits into your lifestyle.

Patients Medical’s  Personal Approach to Arthritis

Our doctors and our team at Patients Medical will regularly monitor your progress and track the effectiveness of your program making adjustments if necessary. Our goal is to support you and advise you every step of the way.

We work in conjunction with your existing doctors. Any gaps between specialists are filled to ensure we support your overall health and well-being. While we treat serious medical conditions such as Alzheimer’s, Diabetes, Parkinson’s, Multiple Sclerosis, anxiety, depression, and heart disease; the primary objective of our staff is prevention and early detection of disease.

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, NYC, New York, NY 10017.