Sunday, July 6, 2014
We saw the immunologist and really liked him. He was calming and although Anna wouldn't have anything to do with him at first, she was laughing with him by the end of the appointment. He ordered a bunch more labs. Some of them were repeats. They showed a lower IgA, continued neutropenia (low neutrophils which are a type of white blood cell) and that she does have immunity to measles. She still did not show immunity to tetanus, haemophilus influenzae, or strep pneumoniae. The process is to re-immunize her with DTaP and Pneumovax (which we did that day) and then wait 4 weeks and have the titers redrawn. We have about 10 more days before the redraw. Those results will determine where we go from here. It will either mean prophylactic antibiotics every other day (or 3X a week) if the vaccines take or IVIG once every 3 weeks or SCIG every week (our choice) if the vaccines don't take. The IVIG and SCIG are immunoglobulins that are either given IV or SC (subcutaneous). They are the part of the blood that contains the antibodies that she's missing (if the vaccines don't take). The IgA cannot be replaced because it's half life is so short but protecting for the other things will help her to stay well anyway. So we are in a holding pattern again. So far she has been off of antibiotics for 2 weeks again and things have been ok. I pray this streak continues!