An Update & Request for Prayer: October 13, 2009

I just returned from my appointment with my Infectious Disease specialist in Indianapolis. He believes I still have an active fungal infection. My temperature was 99.5 when I was checked today (my normal temperature is around 97.5). I told him that Sunday evening I began with some greenish sinus drainage and that has continued through today. I have a minor, dry cough and continued fatigue and pain.

I had discontinued the Amphotericin intranasal washes on Friday after 3 weeks. He recommended that I resume that for an additional two weeks. He also wants to swap out Posaconazole for Voriconazole (V-FEND). This is another very expensive medication that requires special insurance authorization.

I ran a drug interaction check on this with my other drugs. I know there are some warnings with Voriconazole and they are numerous (cardiac and hematological - serious concerns). Also, it said that combining Cipro with Voriconazole increases these cardiac risks. And Voriconazole increases the level of steroids (which I take daily).

If we decide to move forward with Voriconazole, we will have to set outside of the ER and take the first dose as they do not want me in the hospital for desensitization or to observe for allergic reactions, yet I need to be nearby medical assistance. I am looking at the two fungal sensitivities that I have received thus far - Voriconazole is the number one choice on one of the sensitivities. However, on the other sensitivity report, Voriconazole is the worst choice but Posaconazole (that I am taking) has activity against the infection. Perhaps flipping a coin to select the drug would be a good plan.

He also recommended another sinus CT after 1 week of Voriconazole. Then a return visit with him in 2 weeks. I believe he is quite concerned and I was upset knowing despite our best efforts - oral, IV and intranasal antifungals - that I remain with an infection and temperature. He felt all of the enlarged nodes that have emerged and I told him that tomorrow we are checking an LDH level to exclude Richter's transformation - he said an ongoing fungal infection could be contributing to the enlarging lymph nodes and spleen.

I ordered and received an herbal antifungal formula that I am going to try. I figure it cannot hurt anything. Please pray for my doctors to have clear guidance regarding the medication choices. I have fought fungal infections since late February. Thank you for your continued prayers!