Tuesday, January 11, 2011

Round III, 1/11/11: As always, good news- bad news

In his favorite hospital place, the Play Atrium
Let's start with the good.  We are coming home soon...again!
Can't we just end there?

The bad news is we are coming home soon because Sage's body is rejecting the IV drugs so badly that it would do him permanent harm to continue treatment. Technically speaking, his eosiniphil levels are at a.1, which is again in the range of moderate DRESS Syndrome, which causes multi system failure.
I wish it could all be good news, just for once.

So, as with everything Murphy has touched with his damn laws, all the docs are admitting they were wrong, but will never accept defeat.  It's probably the amikacin now responsible for the rash, and the rest of the drugs in the slurry just activated it (that's what Mom thinks)  The Docs still don't know, so we are going with mom on this one.  His levels are higher now, even then when the rash was at it's worst.  Docs are worried about long term damage.  The new-new-new-new plan is to stop the amikacin immediately, monitor his eosiniphil levels for signs of reduction for 24-48 hours, pull the picc line out and send us home before the weekend.  Then we wait.  That's the worst part for Type-A CF Parents.

Bitter sweet to say the least.

He will probably be able to return to School and basketball Feb 1st.
Of course there is always a catch.  A BIG catch.
The docs did an abcessus culture at his last bronchoscopy, which takes 8 weeks to find the final results.  We have a 50/50 shot.
50% that Sage got just enough antibiotics to eradicate the abcessus, or at least send it into remission to not bother us for a few years.
50% that his culture will still come back positive for abcessus. 

If it is positive, we will have lost round III.  They will readmit us to the hospital, this time for an "extended admission" (longer than a month) to slowly start him back on all the meds once again...basically start his treatment all over...but instead of 6+ weeks, it would be much longer in the hospital and he will not be able to come home on IV's, due to the potential for DRESS reactions.

Playing DS in the bathtub?  Really?
It's hard.  I am learning the ART of Medicine. His CF Doc said today that I should seriously think about medical school.  It had crossed my mind.

Sage has a rare genetic disease, with an extremely rare infection, which is even more rare in children.  There is very little study, no standard of care, no sure fire treatment.  The positive is that the head doc that is treating Sage in the abcessus in conjunction with his Cf doc, has written one of the only existing studies of abcessus in children, with and without CF.  So, if there is anyone who can help, it's this guy.
He did say that even without treatment for a few weeks, abcessus is very slow growing, and therefore will not develop resistance if we stopped the antibiotics too soon. This was kind of good news and made me feel better about all this on and off antibiotics mess.

Hey, we are still doing the happy dance over here...all the way down the ped.'s hallway!  Not under the circumstances that we would have hoped for, but at least we are bound for Home Sweet Home...for now....waiting for the next rock that CF wants to throw at our glass house. (I hope this post was not pre-mature)

Of course, as soon as I wrote this, Sage's rash is starting to pop up.... again!   I will have to wait till the morning to see if this changes things....again.
xoxo  Mommy

Skyline View of Chapel Hill NC From the Play Atrium


  1. Ugh! So sorry he couldn't tolerate the meds. Have they thought about nebulized Amikacin for him? It does not impact the body with side effects like IV's do. Some people at NIH being treat for abscessus with only nebulized Amikacin have been able to eradicate it. I was on it for 3 months and I am not alternating months. Just a thought... It would get him the drug with far less toxicity.

  2. With all of your knowledge you should co author the next article written on abscessus in children. You should also get to bypass medical school since you've been living it for the last many years.

  3. really hope you guys can go home soon. Like Dorothy on the Wizard of Oz says "there's no place like home".