Wednesday, September 06, 2006

More conversations, more answers?

Hi everyone:

Patty came through plasmapheresis with flying colors -- enough so that doctors are talking about letting her do future rounds (once a month) as an outpatient. Of course, we know nothing about outcomes as yet, but at least the process went fine. She is eating a hearty lunch of soup, fruit and bread as I write this. Patty will undergo a second round of plasmapheresis on Friday, and then will be hit with another dose of IVIG.

Patty's PRA was tested based on a blood draw late in her hospitalization last week. Her antibodies had not dropped. The cardiologist is hopeful that the combination of plasmapheresis and IVIG will be enough to start to move the numbers down; another PRA test will be taken shortly. Doctors have speculated that Patty is experiencing something of a "double whammy" -- where her antibodies are not only attacking the cells of strangers (as the PRA test shows), but also her own cells (hence, the rashes.) This is somewhat of a mystery doctors hope to solve.

Rheumatologists shared with us that all but one of the tests for systemic lupus have been completed, and thus far the results have been negative. This is good news, in a sense, because it means that the form of lupus Patty has is more manageable with topical treatments. However, a diagnosis of systemic lupus might have provided some answers as to why all of this has happened to Patty. Here's the other wrinkle, though -- because Patty has been on cytoxan for some time, and cytoxan is a treatment for lupus, it's possible that Patty has some form of systemic lupus but it may have not been measurable because the cytoxan may have driven it back. The bottom line here is that we continue to have more questions than answers. Ultimately, though, the approach they would take to address the lupus is the approach they're already using to address the antibodies -- with doses of cytoxan.

We don't expect to hear much more today. I'll be sure to provide an update when we learn more.


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