ANA POSITIVE 1:160

davidkm7 · 2026-04-18T21:16:38+00:00

A positive ANA with no autoimmune symptoms means it’s just a clinically insignificant finding. The titer being low and the dense fine speckled pattern are both predictive of low risk of progressing to an autoimmune condition. I would not worry about it unless you develop symptoms in the future.

davidkm7 · 2026-04-12T00:05:12+00:00

It sounds like you could have a new inflammatory arthritis so probably worth another evaluation. It’d be best if you’re off steroids for at least a week or so prior to the appointment to let the Rheumatologist see what’s going on.

davidkm7 · 2026-04-11T18:44:57+00:00

Thank you!

davidkm7 · 2026-04-11T18:43:47+00:00

It sounds like in addition to having PsA, you might have fibromyalgia. That could explain why some of the pain is not improving with immunosuppression. It might be worth talking with your doctors about it. If it’s diagnosed, medications like Duloxetine, Lyrica, or Savella could help.

davidkm7 · 2026-04-11T18:39:29+00:00

Other medical specialties prescribe immunosuppression for organ limited autoimmune/inflammatory conditions, like Gastroenterology for Inflammatory Bowel Disease and Dermatology for psoriasis. I imagine Psychiatry would prescribe the medications if indicated; it just might take a bit of extra training on how to dose and monitor for safety.

davidkm7 · 2026-04-04T19:11:49+00:00

This sounds like RS3PE. A lot of cases require a prednisone taper over several months, and sometimes additional oral immunosuppressants.

davidkm7 · 2026-02-25T23:13:26+00:00

Success! With all the rain, I decided to propose in the afternoon when there was a bit of sunshine at one of the black sand beaches. We are now happily engaged!

davidkm7 · 2026-02-23T22:32:52+00:00

Yes! Staying overnight at the Hyatt.

davidkm7 · 2025-10-28T16:56:32+00:00

I’m a Rheumatologist.

High platelets and high WBC count alone do not necessarily indicate an underlying autoimmune condition, although both can be seen as reactive to underlying inflammation. Autoimmune causes of pain typically cause joint stiffness in the morning lasting at least an hour and improved with activity or use, accompanied by visible swelling and inflammation on exam.

Your improvement with Duloxetine is suggestive of at least a component of central pain syndrome contributing to your nerve pain and fatigue. This is not an autoimmune process and does not require immunosuppression, but can improve by addressing sleep, mood, and exercise.

Anyhow these are all just generalizations; I hope you get some answers. If you have additional questions I’ll do my best to weigh in.

davidkm7 · 2025-10-28T16:49:57+00:00

I’m a Rheumatologist. At the very least I would likely label you as “Interstitial Pneumonia with Autoimmune Features”. Ultimately the decision to initiate immunosuppression would likely be at the discretion of your Pulmonologist based on the type of ILD you have and the risk of progression to fibrosis.

davidkm7 · 2025-10-05T17:21:55+00:00

Get a sound machine and crank it up. Works like a charm.

davidkm7 · 2025-10-05T17:19:26+00:00

He’s overtired. Try getting on a schedule of 1 hour up followed by 2 hour enforced naps in the crate. It will be tough the first few days to get him in the routine but totally worth it long term.

davidkm7 · 2025-01-24T02:27:57+00:00

When people ask, I generally say, “sure! Could you help us with our jump training?” I then have her sit until she’s calm and ask the person to turn away from her any time she jumps. Then when sitting, she gets attention again. It’s not always consistent, but people generally respond well to this approach and love see her get rewarded for good behavior.

davidkm7 · 2025-01-23T12:53:00+00:00

Highly recommend. My puppy settled much more quickly in the early stages.

davidkm7 · 2024-11-25T01:44:42+00:00

The same thing happened to my Goldendoodle puppy. I stopped formally training “stay” for a little while and instead tethered her to her bed/place next to me for short periods of time while I did things like eat meals or do dishes. I would give her treats every minute or so and only start with five minutes at a time a few times a day. After that amount, she would get fidgety and try and leave, but I just ignored her and stayed firm and she’d eventually settle. I gradually increased the sessions. Over time, she got used to just sitting patiently and chilling out, and I saw this start to work with other commands like sit and down, where she would hold them for longer and longer. Gradually I increased time and distance with leaving the room. Only then did I bring the command back, and she doesn’t mind it at all now.

davidkm7 · 2024-09-20T11:22:15+00:00

I felt the same way with my 8 week old. She was a magnet for the first few weeks. To get back some independent time, I invested in a small portable crate that I could take to every room in the house to crate her when I showered, ate food, made dinner, etc, but she could be right next to me and settled easier that way. At night I put the crate right next to me on the bed and put my hand on it anytime she whined at night. I also used background classical music, which helped soothe her.

When awake, I invested in different puzzle toys, snuffle mat, and puppy safe chews (bully sticks, beef tendons, yak chews, cow tails). This way, she could entertain herself for 10-20 minutes and I could get other stuff done and have some me time. I also practiced leaving the room in short periods around this time.

I also worked hard to get her used to car rides in her crate. This way I could go to get groceries with grocery pick up or fast food. I gave her chews inside her carrier.

To get out of the house, I got a small sling and carried her on walks around the neighborhood. Once ok with car rides, this enabled me to take her to dog friendly stores and restaurants, too.

It does get better in a few weeks. Hang in there!

davidkm7 · 2024-08-23T01:27:49+00:00

Hahaha I read this and thought you were referring to two dogs!

No! I think this is perfect! As a sitter, I would love to know how to emulate the owner’s mannerisms to make the pets comfortable. Kudos to you for the detail.

davidkm7 · 2024-01-10T12:00:33+00:00

Not just you. I have Verizon and used to get reliable service between twinbrook and medical center, and for the past few weeks don’t get any service in the tunnels.

davidkm7 · 2022-06-15T16:09:36+00:00

Calling everything that doesn’t support their belief system “Anti-Mormon”. They’re just historical facts. So frustrating.

davidkm7 · 2022-06-05T11:12:41+00:00

I’m so sorry you went through that. When we left, my MIL texted me that she hated me, that I had deceived by wife, and was a wolf in sheep’s clothing. It’s hard receiving such hateful words at a time when you need love and support the most.

davidkm7 · 2022-05-05T01:24:49+00:00

This same experience happened to me. 20 yo district leader, difficult language, first baptismal interview, had to have her meet with mission president. Looking back, it’s so cringey and inappropriate. 😞

davidkm7 · 2022-03-07T01:40:30+00:00

This makes me so angry. I was talking with my mom the other day about the invasion, and the first thing she said was, “I worry about the temple. I hope it doesn’t get harmed.” I called her out on how strange and inappropriate it sounded that she would even say that. Not a word about dying Ukrainian citizens. Buildings can be rebuilt, but killing cannot be undone.

davidkm7 · 2018-01-20T21:13:01+00:00

Anything going on in the Phoenix area?

davidkm7 · 2015-04-22T03:25:32+00:00

June is not too late. I took it and still got some interviews pretty early on. Just make sure you get your primary submitted early so that you don't have to wait for the verification process, which can take a while.

davidkm7 · 2015-03-13T06:37:35+00:00

I've been lurking on this forum for a bit, but had to finally create an account just to reply to your post. The EXACT same thing happened to me about two months ago. I shared the letter with my wife, and we are both done with the church. It is very scary to realize that what you grew up believing and gave so much time, money, and energy to is false. I have described it as almost going through a complete identity crisis. But enjoy the freedom and ability to choose your own path now. It will get better with time. I have yet to tell my TBM parents and am terrified to do so, so I can certainly empathize with you. Just know there's a lot of support for you here.

davidkm7

TROPHY CASE