Monday, August 2, 2010

Update on Nick 8/2/10

Nick's oncologist called this evening with the pathology results from the biopsies.

I have mentioned before that the pathologist would be testing for several different things.

The tests for any kind of fungal infection and micro bacterial infection were NEGATIVE. Praise God!

This was a very real concern for us. It is not uncommon for transplant patients to become exposed to some kind of fungus or micro bacteria that would cause problems similar to Nick's. People with normal immune systems are able to fight of these invaders without any ill effects.

There were also tests run that determined the structure of Nick's lymph system. These tests showed that the lymph structure is NORMAL. Praise God!

Another test showed that the EBV (Epstein Barr Virus) is still present in some of the cells that make up blood cells. The amount of the EBV present is not much more than what is likely present in anyone that has had previous exposure. Another praise. We are always watching the EBV levels. The PTLD/lymphoma that Nick was diagnosed with began from an EBV exposure. The levels help the doctor know exactly how active the EBV is in Nick's body.

The doctor said that overall the pathology is not impressive.

The tests also showed that the lymph tissue samples taken did not indicate classical EBV driven PTLD lymphoma. This is another praise. When the oncologist and the pathologist compared the current results to the pathology results from 4 years ago, they determined that it is completely different this time. These results indicate that we are dealing with a chronic EBV infection that often knocks out the B cell portion of the white blood cells and is sometimes associated with giant lymph nodes (such as the ones in the pelvic region where Nick's mass is at).

Now for the best news of all.

Nick's oncologist said that he believes that the PTLD/lymphoma is in REMISSION!!!!!!!! Hallelujah! Praise God!

Nick is cancer free! I can barely grasp the reality of this news. This is the first time in 6 1/2 years that no one in our house has had cancer. No chemo.

Ok...(trying to remember to breathe)...Nick's diagnosis is EBV driven immunodeficiency. It is likely caused by a chronic EBV infection constantly attacking Nick's B cells. The best course of action right now will be to continue to treat Nick with the IVIG. The oncologist is doubling the dose of IVIG that Nick will be receiving in the hopes that it will fully replace what Nick is missing and give him more immune protection longer. The usual dose of IVIG is about 300 mg. Last month, Nick received 350 mg. A bit of an increase, but not a lot.

On Thursday, Nick will likely be receiving around 800 mg of IVIG. This will basically replace all of the immune globulin in Nick's body. It sounds aggressive. It is aggressive. It is not something that the doctor is approaching lightly. Anytime IVIG is given, the patient is at risk for an allergic reaction. This risk increases with the increase in the dosage. I will confess that this worries me. I know it is what is best for Nick, but the allergic reaction is frightening. The nurses are prepared for it. The one time Nick had a reaction it was very mild and was gotten under control quickly. This time I'm worried.

Please pray for us on Thursday. Pray that Nick's body will handle this treatment without any ill effects or allergic reactions. Pray that I can handle the stress of just watching and waiting for several hours.

Thank you all for the thoughts and prayers. It is so wonderful to be able to write an update with such wonderful news and praises.

I will update again sometime Thursday or Friday. I will also update on Facebook throughout the day.

We continue to work to remain...

In His Grip,

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