Saturday, November 15, 2014

Every Cloud Has A Silver Lining- (biopsy results)

Mason and I checked in yesterday at 7 am to same day surgery for his heart biopsy. Silly boy was super excited to be there! It's like a home away from home for him where lots of nurses and doctors know him, he gets fun prizes, and  he can order any food or drink that he wants..... maybe his view of a fun time is just a bit distorted, but I'll take the good attitude any day! He happily went into the cath lab for his biopsy, until he remembered I'd be leaving once he was almost asleep, he then got just a little nervous. But, he is certainly one brave boy!

After his biopsy we stayed in a post-op room for his monthly IVIg infusion. It was a long day and we didn't get back home until after midnight, but it's always nice to get everything done in one day. 

We got the results from Mason's biopsy last night while we were still there. It sadly wasn't the results we'd been praying and hoping for. Apparently that stormy rejection cloud has made a return. It has been lingering over Mason off and on for the last year and a half. In June, the last time he had a biopsy, it was just a very slight mild rejection. Now, it is still mild, but worse than it was. It's about the same in severity as it was in October and March of 2013, For those who understand the way Primary's transplant team scores there biopsies it is a C2 V3 ISHLT 1R pAMR2. His rejection is mainly antibody mediated. Which it usually is with Mason! 

The plan of action right now is going back up on the high doses of steroids (prednisone), which I definitely have a love hate relationship with. They can do wonderful things such as getting rid of the bad antibodies fighting against Mason's special heart, but at the same time turn my cute little happy guy into a restless grumpy pants! I know prednisone hurts his little tummy too, because today he's had trouble just keeping all his meds down. But, the worse side effect of all is how much more it suppresses his immune system. I believe it's about 50% more than his normal suppression! 

So I have a decision to make about whether to send him to school or not right now. It is a fine line decision! We got him his heart so he could enjoy life right?! But I also have to decide how far I go with protecting his fragile life from all the germs and sickness that could take his life. Errr! The transplant team has left it up to me! It get harder the older he gets, because he now realizes what he's missing out on. And, he absolutely loves school!!!

I will be talking to the team again on Wednesday to discuss the rest of Mason's plan. They want to get back his DSA results (blood work that checks for donor specific antibodies) back to to see if they are higher or lower than the last time we checked (which was in June). This will help them decide how long they will keep Mason on the higher doses of prednisone and if they need to add another anti -rejection med (Retuximab) to his treatment routine. So I'll probably wait until then to decide how much of an 'at home lock down' I need to keep Mason on! 

After I got the biopsy results last night I spent quite some time pondering about "what is the silver lining in all this?" First and foremost, Mason is happy and thriving! He loves life! The rejection also could be much much worse! He already experienced severe rejection four and a half years ago soon after his transplant. We've been there, done that... and I will take this lingering mild rejection over that any day anytime! Additionally, his heart function remains great and his heart pressures were good and normal yesterday. Amazingly his special heart continues to handle the antibody rejection. Hopefully his heart can just remain resilient! That is my prayer through all of this, that we can control this mild rejection allowing Mason to continue enjoying life. We are also grateful for great doctors who are knowledgeable and experienced. It is because of them and our Heavenly Father that I can find the silver lining in this storm cloud... there's always hope that we will get through it!

Someone recently asked me if all of the rejection that Mason has experienced since his transplant is normal. I believe it is not necessarily normal, but always possible. We went into Mason's transplant knowing rejection was a great possibility for him. He had a very high antibody count before transplant. He received some IVIg treatments at Stanford prior to transplant which lowered his antibody count about 30%. This widened his donor pool significantly, and he got his heart after being on the transplant list only 4 weeks! 

Although, we knew that there was the chance of the donor heart reintroducing some of the antibodies the IVIg treatments had wiped out, which would then caused rejection. And that's exactly what happened! We for sure saw this with his severe rejection in the beginning. Aggressive treatments and medicine made his new heart happy, wiping out most of the bad antibodies. But, overtime the antibodies continue to slowly return and fight his heart again, even through his daily anti-rejection meds and his monthly IVIg treatments. 

On the flip side, we could have chosen to avoid all of the antibodies Mason had ever had, even those that the pre-transplant IVIg treatments had gotten rid of, when the docs at Stanford were trying to find him a heart match. And then maybe he wouldn't ever have experienced all this rejection. But, Mason was too sick and weak to wait for that! Avoiding all of those antibodies would have extremely narrowed his donor pool, most likely making the wait for a new heart too long for Miracle Mason to have survived! So again, what's the silver lining of this rejection? Mason is still with us, and loving life!

"Even if you cannot always see that silver lining on your clouds, 
God can, for He is the very source of the light you seek."
~Jeffrey R Holland

Thank you for your continued support, love, and prayers. Please pray with us at this time that Mason can conquer the rejection once again. Love to all!!!

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