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How to get lab tests done through Quest ~before~ possibly seeing a CFS doctor?

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by Chziime, Sep 21, 2015.

  1. Chziime

    Chziime

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    Hi,

    Since April, I have had a sudden bout of mild cardiomyopathy, and I have some associated symptoms such as exercise intolerance. A couple professionals have told me that it may have been caused by a virus, being so sudden - and I WAS very sick the week before my first episode. I'm interested in getting the viral tests (and associated co-infections, maybe candida, etc - basically whatever Enlander recommends), and if something pops up, seeing a specialist like Dr. Enlander, since he has the reduced rate if you talk through Skype.

    My insurance (Qualcare) uses Quest, could they provide reliable results for these sort of labs? It may be my only option, as funds are extremely limited. Would insurance even cover these sorts of tests, especially without a diagnosis? Maybe I can use Cardiomyopathy as a diagnosis?

    Thank you for any advice!
     
  2. minkeygirl

    minkeygirl But I Look So Good.

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    Left Coast
    I get my labs done by quest and my medicare HMO pays for them.

    I've never had a problem getting labs done and I've asked for some crazy stuff. And many labs are a fact finding mission anyway. If your doc will order them it shouldn't be a problem.
     
  3. halcyon

    halcyon Senior Member

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    I can't speak about the other cardiotropic viruses (i.e. adenovirus, CMV, parvovirus, etc) but for enteroviruses, Quest cannot directly do a test that will be accurate at this stage. Their test (that they send off to Focus Diagnostics) is designed to detect acute infections only. There is only a single lab in the US that does the tests that you need at this point, ARUP labs. Quest is able to send blood off to them, I'm just not sure exactly how you accomplish this. The tests that you need are the echovirus and coxsackie B antibody test panels. Perhaps if you contact Quest they can tell you how your doctor can order these for you.
     
  4. Chziime

    Chziime

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    Ah... I contacted ARUP, as there isn't really a contact e-mail for Quest, and I do not feel like making phone calls :)

    I really don't want to open up a can of worms here and obsess about testing, as I do have a history of hypochondria, but I still feel like I need some more answers. Where do people here usually draw the line? I ~did~ get cardiomyopathy, and in a one week period, went from heavy weight lifting to barely being able to go up stairs, along with extreme anxiety. There were a few medicinal/supplemental confounding variables, and I have had a few "dizzy/faint" episodes before it all started, but it all seemed like such a strong shift.
     
  5. halcyon

    halcyon Senior Member

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    Understood, but I don't think it's unreasonable to get testing for these viruses, especially if you got cardiomyopathy suddenly after a viral illness. Enteroviruses are heavily associated with both ME and cardiomyopathy/myopericarditis.
     
  6. Chziime

    Chziime

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    How would this ARUP lab test http://ltd.aruplab.com/Tests/Pub/0060055

    differ from this? http://www.questdiagnostics.com/testcenter/BUOrderInfo.action?tc=7656X&labCode=QTE

    Does "Serum" mean that it's in the blood, meaning it is only acute? Quest has a second option that does not include "serum."

    So far I am thinking of looking into (according to Enlander's recs):
    -Epstein-Barr Antibodies
    -CMV Antibodies (IGM)
    -TSH (was high - 7 - last I tested)
    -M. Pneumoniae (IGG, M), EIA
    -Coxsackie B (1-6) AB
    -Respiratory Allergy Profile Reg I
    -Lyme Disease, DNA, PCR, BLD
    -IL2, IL6, IL10
    -Candida AB
    -Babesia Microti
    -CMV AB (IGG)
    -Echovirus
    -E. Chaffenensis
    -Food Allergy Profile
    -Parvovirus B19 AB (IGG, M)
    -Vitamin B12, Serum
    -HV6 (IGG, IGM)
    -Methylmalonic/Homocystein
    -Natural Killer Cell Function
    -Lupus Profile
    -Carnitine, FRAC, SER
    -Gliadin AB (IGG, IGA)
    -HSV 1/2 (IGG)
    Adenovirus

    Is anything here superfluous? And, am I missing a virus for cardiomyopathy?
     
  7. halcyon

    halcyon Senior Member

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    These assays are performed using different methods. The ARUP test uses a microneutralization method and the Quest/Focus test uses complement fixation. In chronic enterovirus infections this complement fixation assay does not work for some reason, but overall neutralizing antibody levels are highly elevated. I've had both of these tests, the Quest/Focus test came back totally negative and the ARUP test came back highly elevated.

    Seems pretty reasonable.
     
    Last edited: Sep 21, 2015
  8. Chziime

    Chziime

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    Thank you very much for your help.

    To get the lab requests, I am somewhat hesitant to ask my physician. Last I mentioned virus testing, he implied that it isn't really possible. Is there a specialist whom I can visit, or should I just suck it up and ask my physician?
     
  9. halcyon

    halcyon Senior Member

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    It's worth a shot. Why not just get an appointment with Dr. Enlander? I'm sure he would order all of these tests for you.
     
  10. Chziime

    Chziime

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    If I consulted with Enlander, I'd pay $300 for a phone/Skype consult in which he'd order tests, and THEN would have to have another one going over the results. I'm trying to save money - and if all of my viral tests come back negative, I probably won't even pursue a new doctor.

    I am currently in contact with ARUP Labs to find out information about the collection portion of it.
     

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