Wednesday, September 06, 2006
Camping!
It was doubtful down to the last minute, but Jacob is actually sleeping under the stars in Big Basin Redwoods with his class tonight. They'll be gone until friday.
Tuesday, all of the docs convened to discuss the results of Jacob's bronchoscopy: neuro-oncology, pulmonology, bone marrow transplant and they even pulled in the infectious disease team.
Drum roll...They did NOT find aspergillis! Instead they found a bacterium, pseudomonas. When I went to look it up, I found it described as "the epitome of an opportunistic pathogen of humans." Anyway, its much preferable to the fungus: the treatment is shorter, far less toxic, and more likely to actually work. They prescribed an oral antibiotic, cipro, together with an inhaled drug, tobramycin that has been shown to be extremely effective against pseudomonas. Yay!
Nothing is ever simple however. For some reason, Blue Cross got it into its mind that it just wasn't going to authorize the tobramycin. No one could tell us why. Especially after they authorized the nebulizer machine to administer it. It took truly heroic efforts on the parts of Jacob's nurse practitioner and the heme-onc case manager at Packard to storm the castle. We still don't actually have the medicine, but the infectious disease guys finally said, "oh, just let him go camping as long as he's taking the Cipro!"
Then Jacob had to decide if he felt well enough to go. He'd missed the bus by that time, but I was able to drive him up there this afternoon.
Next week they are going to tackle the issue of whether or not to treat the aspergillis. My fingers are crossed that they will decide not to; that it was just contamination in the specimen, since the sinus CT was clear.
In all fairness, I have to say that this was an aberation - in general, Blue Cross has been phenomenally supportive and timely.
I stupidly forgot to get a picture of Jacob at the camp site, but here is a picture of the park from the web:
It really looks like that.
Tuesday, all of the docs convened to discuss the results of Jacob's bronchoscopy: neuro-oncology, pulmonology, bone marrow transplant and they even pulled in the infectious disease team.
Drum roll...They did NOT find aspergillis! Instead they found a bacterium, pseudomonas. When I went to look it up, I found it described as "the epitome of an opportunistic pathogen of humans." Anyway, its much preferable to the fungus: the treatment is shorter, far less toxic, and more likely to actually work. They prescribed an oral antibiotic, cipro, together with an inhaled drug, tobramycin that has been shown to be extremely effective against pseudomonas. Yay!
Nothing is ever simple however. For some reason, Blue Cross got it into its mind that it just wasn't going to authorize the tobramycin. No one could tell us why. Especially after they authorized the nebulizer machine to administer it. It took truly heroic efforts on the parts of Jacob's nurse practitioner and the heme-onc case manager at Packard to storm the castle. We still don't actually have the medicine, but the infectious disease guys finally said, "oh, just let him go camping as long as he's taking the Cipro!"
Then Jacob had to decide if he felt well enough to go. He'd missed the bus by that time, but I was able to drive him up there this afternoon.
Next week they are going to tackle the issue of whether or not to treat the aspergillis. My fingers are crossed that they will decide not to; that it was just contamination in the specimen, since the sinus CT was clear.
In all fairness, I have to say that this was an aberation - in general, Blue Cross has been phenomenally supportive and timely.
I stupidly forgot to get a picture of Jacob at the camp site, but here is a picture of the park from the web:
It really looks like that.
# posted by Ann @ 11:02 PM 
