Tuesday, June 21, 2005

Spinning, Spinning, Spinning in Circles!

I'm so dizzy and tired of chasing numbers! It's an obsession with me, too, following lab values. I have an Excel spreadsheet dedicated to tracking Anthony's lab values. And to be REALLY anal, I have graphs that show the trends in each of the important labs. Hey, I've got to have SOMETHING to do to feel important!

Anyway, I noticed (and subsequently choked over the fact) that Anthony's liver functions more than doubled from June 11th to today's draw. This is NOT good news. It could mean one of two things:
1. Anthony's starting a new round of rejection. Rejection could require an in-patient stay with IV steroids. ARGH!
2. Anthony's liver is responding to the immune system fighting the infection he's had.

The reason I'm worried about the rejection is because we recently cut Anthony's Prograf dose in HALF. Why would we do that you ask? Well, because the level had gone out of his normal range, and it was hindering his ability to fight the infection. We want him at the lowest possible dose of Prograf to maintain proper liver function and infection fighting ability, but we don't want it to go so low that he goes into rejection. And rejection is very probable with the dose being cut in half.

We're not going to raise his Prograf dose back up, though. Why the HECK NOT? Because rejection is "easy to fix" and he still needs to fight this infection quickly. Plus since his last Prograf level read 3.5, he's still within his normal range for the Prograf. We redrew that level today, but won't know the result until Thursday, I think. I'm going to be on pins and needles waiting for that! So we won't change the dose any until we get that Prograf level back.

We'll redraw labs again on Friday morning, and if I can find a way to get the blood to Children's Hospital (an hour from us) before 11:00am, we'll get THAT Prograf level back the same day. There's no lab here at home that runs the Prograf level. We had previously been sending it to Omaha for evaluation, but since our insurance deductible etc resets on July 1, I'm not really willing to pay the out-of-network fees if I can have the blood run at Children's (an in-network hospital). The switch is going to throw things off a bit, but I can be (sort of) patient.

For those who are interested, Anthony's labs below are from Saturday June 11 and today:

Liver Functions
AST: 27 to 82 (normal 0-46)
ALT: 18 to 43 (normal 0-56)
The other liver functions didn't move outside of the normal range for Anthony. The AST and ALT aren't TERRIBLY high, but to change that much that fast makes me nervous.

CBC (and these are all normal!)
WBC: 9.40 to 8.50
Hct: 30.0 to 31.4
Hgb: 10.1 to 10.5

Anthony's kidney functions, which are monitored because the Prograf is filtered through the kidneys, are all fine. His albumin is normal, too.

So while I don't feel that Anthony's in rejection yet, I'm nervous that he could be heading in that direction. Please keep him in your prayers for continued healing with this infection and for NO REJECTION!

I'll update again on Friday when I have new numbers and a clearer idea of what we're dealing with.

Love, Laurie, Mark and Anthony
Coming up in Anthony-land:
Wednesday: A return to day care!
Friday: MORE labs (Cheri, come back!!!)


Sarah said...

praying that this is not rejection! Stay strong little guy.

Anonymous said...

Hope the doctor's records are as good as yours Laurie - sounds like you're on top of it. Praying for Anthony that all goes well for him and that the number game comes out in Anthony's favor. He's been through alot but together with the help of the Lord, if there are more hurdles - we'll jump them one at a time. Love to all

Andree said...

Anonymous is Andree - I don't think I know how to use this comment publishing stuff too well :)

cheri said...

Sorry I missed you! I will be there Friday-just fighting a sinus infection. Keep your chin up--no rejection-just fighting this infection. Hug the little man for me.