High Sed Rate Positive ANA hx Osteoporosis

[carliec]

I have recently been extremely fatigued and have had multiple arthralgia's, red/raised rash on my forearms/under my arms that comes and goes, a very tender right breast with a lump that comes and goes under my arm and in my groin.  I just "don't feel well", and also have noted "night sweats".  I am a very busy Wife/Mother of 3 teens,  work 40 + hours a week, volunteer at church, and am involved with the kids activities at school.  About 3 years ago I tested positive for Lyme and also had a + ANA, but other than the + Lyme further testing showed no other cause.   I was treated with antibiotics for about 2 years for the lyme, and I have not been taking them for about a year.  I had really felt pretty well over the past year or so.   I figured the fatigue and "general feeling of being unwell" was just stress and just being overtired.  I went to the Doctor last week and he ordered some labwork.  The result came back with a Sed Rate of 68 which he said was quite high.  Last year I had the same test and it was 4.  He asked me to come back into the office for a follow-up to make a plan of action.  He had ordered a Comprehensive Metabolic Panel....Most of the results were in the "middle" except for some that were on the "lower" / "higher" end of normal in my opinion.  Is that anything to consider? or could those results mean something.....CBC/W/PLATELET:  WBC 5.8 normal is 4.8-10.8,  RBC 4.40 normal is 4.20-5.40, HCT 37 normal 37-47, DIFFERENTIAL:  POLY 58 normal 55-75, MONO 6 normal is 4-12, BASO 1 normal is 0-1, and again ESR 68 normal is 0-20 (mine a year ago was 4).  I'm 40 years old and have a history of Osteoporosis/Osteopenia, and I had a total hysterectomy at the age of 28 for endometreosis.  I do not/have not ever taken estrogen replacement.  I did have Aredia/Forteo injections for the treatment of the osteoporosis.   The lump/mass is my breast was found to be "prominent glandular" tissue....no sign of mass/calcification...the "lump" under my arm and in my right groin come and go.  My ribs under my arm (upper part) of my ribcage is very tender.  My doctor wants to refer me to a rheumatologist, but I would just as soon have him order more tests and if necessary I could see rheumatology.  What would/should Dr. C order for further tests?