Lovely lovely lovely lovely day!

We are back from Children's. The blood draw was swift and relatively (for me, anyway) painless. We walked in and Cana (Conna? Kana?) one of our fave phlebotomists (sad, really, when you have a 'fave phlebotomist') was behind the desk.

"You!" I said, pointing. "You! Kana (Cona? Khanna?) have to draw Jack's blood! .....please." {Always remember to say "please." }

She did. It was fast. One stick and she even got a half-smile out of him (between screams) after the deed was done. And it all happened right on time - during his cyclosporine trough. Woo Hoo!

We got the results just now and the ALT and AST are elevated still but they are down a few points. But here's the exciting part. Because they got the true cyclosporine level today for the first time in 4 weeks, they can determine that it is too high. 100 points too high, actually. And having a cyclosporine level that is too high can cause your ALT and AST to be elevated. They have now lowered his cyclo dose and I am hoping that next week's labs will find us on our way to normal liver enzyme numbers.

Of course, there is also the fact that his direct bili is up .1 points. They don't seem to be the least bit concerned about that but bili is my enemy. It is also the name of an ex-boyfriend who was a bit of a jerk. So I really don't like it. I'm not sure if bili goes up when the cyclo is too high. But it is barely up and probably means nothing. It's just my job to obsess over every little thing. It's a special gift.

Also - just to increase your general knowledge of pediatric liver transplant, although "rejection" sounds terrible as something that could happen (could actually BE happening to Jack if it turns out the high cyclo is not the cause of the elevated numbers) it really isn't that big of a deal. Infection would be much worse. About 60% of pediatric transplant patients have some rejection of the new organ within the first 3 months. It just means that the immunosuppression isn't high enough. If they were to discover it, he would be in-patient for 3 days while recieving heavy boluses of steroids (3 total) and then he would be released. Rejection doesn't do permanent damage to the organ unless they don't catch it for a long time. It can also be a good thing because it shows that the immunosuppression isn't too high. You do NOT want the immunosuppression to be too high as that would increase the risk of infections and, like I said, those can be much MUCH worse.

So, there you go. I thought I would mention it because every time I say "rejection" people gasp and say "Oh my GOD!" and, really, it's not as scary as all that. It just sounds really bad. I mean, there are better ways to spend your time than rejecting an organ....I can think of 12 right off the top of my head without even trying...but we don't see his new liver as being in any kind of lasting danger right now. That's my public service announcement about organ rejection. I wish a rainbow would appear and that music would play. THE MORE YOU KNOW...