Hi, I Have Check My Blood Work To See If

Brief Answer:
Wait a couple of weeks

Detailed Answer:
Hello, I'm Dr. Branch, thanks for using Ask a Doctor. As you likely already know, ESR and CRP are acute phase reactants that are markers for inflammation in the body. They are fairly nonspecific, which means many different causes of inflammation can cause them to increase, including infections, autoimmune diseases, and even atherosclerosis, though very high levels are more associated with bacterial infections.

CRP reacts more quickly to inflammation than ESR, and will normalize 3-7 days after resolution of the cause for the inflammation, while ESR takes up to several weeks. So to get a clear picture of how your inflammation is changing, whatever the cause, I would suggest waiting a couple weeks for ESR, along with CRP if you want to check them together.

I hope that helps, please let me know if you have any questions about any of that, and I would be glad to discuss it with you further.

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Brief Answer:
Wait a couple of weeks

Detailed Answer:
Hello, I'm Dr. Branch, thanks for using Ask a Doctor. As you likely already know, ESR and CRP are acute phase reactants that are markers for inflammation in the body. They are fairly nonspecific, which means many different causes of inflammation can cause them to increase, including infections, autoimmune diseases, and even atherosclerosis, though very high levels are more associated with bacterial infections.

CRP reacts more quickly to inflammation than ESR, and will normalize 3-7 days after resolution of the cause for the inflammation, while ESR takes up to several weeks. So to get a clear picture of how your inflammation is changing, whatever the cause, I would suggest waiting a couple weeks for ESR, along with CRP if you want to check them together.

I hope that helps, please let me know if you have any questions about any of that, and I would be glad to discuss it with you further.

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Brief Answer:
I would not rely on ESR or CRP

Detailed Answer:
If you are trying to determine if you are having an exacerbation of bronchiectasis, I would not rely on the ESR or CRP, as it is determined mainly on symptoms rather than any laboratory features. If you are having more, thicker sputum, with shortness of breath, chest pain, or blood in the sputum, those would be signs of an exacerbation, and you should be treated with antibiotics, which if there are no oral antibiotics that treat the pseudomonas you have, you will need to be admitted and given IV antibiotics. Inhaled bronchodilators and steroids may also be given if there is any evidence of bronchoconstriction, such as wheezing.

I can understand your frustration that it sounds like the ER doesn't feel like you need to be admitted for treatment. But I doubt that your ESR or CRP results will be what convinces them you need to be treated. It may be that if you go back because you are not getting better, they will reconsider you for admission, seeing that you don't have any other choice.

I hope that helps, if I am not understanding something about your situation, please feel free to explain and I would be glad to help any way I can.

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Brief Answer:
I would not rely on ESR or CRP

Detailed Answer:
If you are trying to determine if you are having an exacerbation of bronchiectasis, I would not rely on the ESR or CRP, as it is determined mainly on symptoms rather than any laboratory features. If you are having more, thicker sputum, with shortness of breath, chest pain, or blood in the sputum, those would be signs of an exacerbation, and you should be treated with antibiotics, which if there are no oral antibiotics that treat the pseudomonas you have, you will need to be admitted and given IV antibiotics. Inhaled bronchodilators and steroids may also be given if there is any evidence of bronchoconstriction, such as wheezing.

I can understand your frustration that it sounds like the ER doesn't feel like you need to be admitted for treatment. But I doubt that your ESR or CRP results will be what convinces them you need to be treated. It may be that if you go back because you are not getting better, they will reconsider you for admission, seeing that you don't have any other choice.

I hope that helps, if I am not understanding something about your situation, please feel free to explain and I would be glad to help any way I can.

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Brief Answer:
Please see below

Detailed Answer:
Ok, I think I understand better now. They are saying that if your CRP and ESR are normal, then it is very unlikely you are having any exacerbation. But that doesn't mean if your CRP and ESR were high, they would necessarily admit you.

I can understand your frustration. The only thing I would suggest is if you are not getting better, going back and emphasizing you have blood in your sputum. If you are having shortness of breath or increased sputum, be sure to emphasize that as well. Hopefully if you go again, they will take a closer look and listen more carefully to you, and prescribe the antibiotic if you need it.

Let me know if you have any other questions or if there is anything else I can help with, I would be glad to do so.

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Brief Answer:
Please see below

Detailed Answer:
Ok, I think I understand better now. They are saying that if your CRP and ESR are normal, then it is very unlikely you are having any exacerbation. But that doesn't mean if your CRP and ESR were high, they would necessarily admit you.

I can understand your frustration. The only thing I would suggest is if you are not getting better, going back and emphasizing you have blood in your sputum. If you are having shortness of breath or increased sputum, be sure to emphasize that as well. Hopefully if you go again, they will take a closer look and listen more carefully to you, and prescribe the antibiotic if you need it.

Let me know if you have any other questions or if there is anything else I can help with, I would be glad to do so.

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Brief Answer:
It won't be the main thing

Detailed Answer:
ESR and CRP won't be the main thing they look at in determining whether you have an exercabation of your bronchiectasis; if they are elevated, it may be a factor in their decision, but they may say, with bronchiectasis, it is expected that you will always have elevated ESR and CRP. They were likely just using those results as evidence that they could clearly show you to justify their decision, but really the decision should have more to do with your symptoms than with these tests. Doing these tests wouldn't even be necessary in evaluating someone with a possible bronchiectasis exacerbation. So I would just encourage you to not focus too much on these tests, they likely just mentioned them in passing in order to convince you they had good reason to not treat you.

Again, if your ESR and CRP are elevated, that might be a factor in their decision, but it should not be the major factor; rather, your symptoms should be the main thing.

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Brief Answer:
It won't be the main thing

Detailed Answer:
ESR and CRP won't be the main thing they look at in determining whether you have an exercabation of your bronchiectasis; if they are elevated, it may be a factor in their decision, but they may say, with bronchiectasis, it is expected that you will always have elevated ESR and CRP. They were likely just using those results as evidence that they could clearly show you to justify their decision, but really the decision should have more to do with your symptoms than with these tests. Doing these tests wouldn't even be necessary in evaluating someone with a possible bronchiectasis exacerbation. So I would just encourage you to not focus too much on these tests, they likely just mentioned them in passing in order to convince you they had good reason to not treat you.

Again, if your ESR and CRP are elevated, that might be a factor in their decision, but it should not be the major factor; rather, your symptoms should be the main thing.

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