Our little Karis (see posts on intestinal transplant patient) has gone into rejection and has contracted a virus. They cannot fight the infection because the drugs would be opposed to the anti-rejection drugs. Her life is hanging in the balance. Please pray fervently! Please ask anyone you know to stop and pray now. Terri

FAther, We ask that you hear our cry right now. Master touch this little body and give wisdom to those who are treating here. Amen

I am praying for Karis.

Dear Family, she made it through the night! Thank you so very much for your faithfulness. Please continue to pray. Our God is faithful to hear and to answer the prayers of those who put their trust in Him. Below is a note from Karis' momma. <3 lots, Terri

Latest Update:

Tuesday, 05-oct-2004

4:00 AM EST: I just called the hospital and learned that Karis has been stable all night and the pain in her legs is less. She's handling the Thymoglobulin well. Praise God! I'll be heading over there soon. May God give each one of you a wonderful day.

Lord,
Karis is in desperate need of you right now. Her little frame is calling out to you father. I ask that you heal her body, you remove this virus that has attacked her. We know that you allowed your son to die for us and you said by his stripes we your children are healed - this goes for Karis. We trust and believe that you are working in every organsm, in every cell. We praise you for the peace and the restoration that you are giving her. I thank you for the victory in advance.
Last but not least Father God, I ask that you give Karis parents peace, please bring your heavenly angels down and surrond them with your unconditional love, give them strength during this difficult time. Yet they trust in what you are doing and the healing in Karis body. In Jesus name.......AMEN!

Your sister in Christ,
Nicole (NB)
XOXOXOOX

I will be praying for your precious daughter

Thank you family for your time and efforts in prayer for Karis~please continue to pray. I know it is only by the Hand of God that she is still alive. They are now trying to treat the virus; but, the drugs are in conflict with the anti-rejection drugs, so they will have to be careful to monitor her for problems. Our God is able and willing to restore her to health. We must stand firm together before Him until we see His deliverance. He will not fail.

Here's an update from her mom at noon today.

Latest Update:

Tuesday, 05-oct-2004

12:00 NOON EST: Karis is doing much better. When I walked in this morning she was awake and smiled at me, and since then she has sat in a chair for a few minutes while we changed her bed, watched an old black-and-white movie with subtitles (a very silly one), worked some on her crochet, conversed for awhile with several different people, went through the poking and prodding morning rounds routine, and listened to me read to her for a few minutes before falling asleep again.

She received a book and a personal letter from Joni Eareckson Tada today; that was very fun! Joni, if you're reading this, thank you!!

She's still taking the Dilaudid pretty regularly, but the pain in her legs has lessened, and that is very encouraging. Because she handled the Thymo well, she'll probably be able to return to 7 North later this afternoon. First, they're giving her first dose of Rituximab, the drug chosen to fight the EBV, here in the ICU so they can monitor her closely and make sure there are no adverse reactions. At present she's taking 25 different medications, many of them IV: quite a juggling act for the nurses!

Dr. Sindhi just told us she can start having clear liquids. Overall, things are going very well! Thank God with us.

I never know quite how much detail to write: some might want to know everything, which would be difficult, and for others, what I have written may be too much. Karis wants to thank you for praying for her yesterday, when things seemed a little scary for awhile. The battle's not over, but it's wonderful for her to feel so much better.

Terri -

Give Karis our love and tell her that we have not stopped praying for her.

She is remarkable; and God is unstoppable.

Howard

Family, another crisis has been overcome. Our God is faithful and will complete that which He has begun. Thank you for your continued prayers. <3 Terri

This is the latest from Karis' momma:

Latest Update:

Wednesday, 06-oct-2004

11:00 AM EST: Karis' blood pressure seems to be stabilized again so pretty soon we'll be trekking back up to 7 North. The doctors think the interaction of so many strong drugs is what caused her high blood pressure, so they're giving her a "rest day," holding off for 24 hours on the Thymo and a few other drugs. When they start again tomorrow they're going to give lower doses per day and compensate by extending the therapy a few extra days. Prograf is down to 26, so almost back to where they want it. They are also letting Karis eat a little bit today. Thank God with us that the leg pain seems to be gone!!


6:30 AM EST: Karis is being taken back to ICU with blood pressure of 196/78.

Tuesday, 05-oct-2004

12:00 MIDNIGHT EST: Please don't stop praying yet!

I just received an e-mail asking the following question, and I thought it might be worth an attempt at clarifying for everybody: "Just wondering--does the fact that the crisis has passed and that Karis is dong much better mean she is no longer rejecting the new intestine?

"Response: NO, it doesn't mean that at all. We still have a big battle ahead, in regard to both parts of our deadly duo, the rejection and the infection.

The "crisis that has passed" is the one that took Karis to the ICU--her blood pressure bottoming out. Over the time that she was in ICU, she stabilized enough to come back to the transplant floor. But she's still taking a ton of medications and will be for several days yet.

You may remember that we came back to the hospital a week ago because of "mild to moderate" rejection, which they thought they were treating effectively with six days of high-dose steroids and higher levels of Prograf. We found out Monday that steroid treatment wasn't enough, so now they're using more potent medicines, but won't even reevaluate until after five days on these meds. It will take at least that long to see appreciable improvement in her endoscopy and biopsies. Likewise with the infection: The infectious diseases doctor told me today there is no point in doing another titer (measure of the virus level in her body) until after a week of treatment with the medication they have selected.(The Prograf, by the way, reached toxic levels today: 42, when the goal is 18-20. Just two days ago it was 16.6. It's still proving tricky to discover the right dose for each day, given a number of different variables like how much she's eating and how well her intestine is absorbing. The toxicity affects her kidneys and complicates the task of keeping her fluids and electrolytes in balance.)

An example of how resolving these problems takes time: To effectively deal with her first episode of rejection, Karis required ten days of OKT3, one of the strongest of the "big guns" available. They're not using OKT3 this time because it's too dangerous to use again so soon, but Thymo has lots of difficult side effects as well. It wasn't until a few days into the OKT3 treatment that Karis started bleeding a lot from her intestine, and that went on for a couple of days. In other words, the damage from the rejection got worse before it got better, even after treatment was started. We haven't necessarily seen the worst yet of either the rejection or the infection.

Karis is feeling better for two principal reasons, neither of which have directly to do with the "deadly duo": transfusions of blood and platelets, which have restored some energy, and the reduced pain in her legs. In fact, she now has more tummy pain and sore throat pain than she did yesterday (or else she just didn't notice, since her legs hurt so much). Both the rejection and the infection are still potentially life-threatening if not kept under control and effectively treated.

Even as I'm writing this, Karis is having blood pressure problems with her second dose of Thymo, but too-high blood pressure this time, keeping the nurse very busy and consulting the doctor on call. One of the biggest practical differences between being in the ICU as opposed to being on the floor is the amount of attention the nurse can give. In the ICU, believe it or not, Karis had two nurses dedicated full time just to her, as well as at least one doctor constantly on duty right in the room. On the floor, each nurse cares for three patients, and the doctor on call covers not only Children's Hospital transplant patients but the next door adult hospital as well. So we're pushing the limits for staying on the floor tonight, with the constant monitoring required and the complexity of Karis' medication schedule. If she gets into more serious blood pressure (or other) trouble as the Thymo administration continues, she'll have to return to ICU, because on the floor the nurse just doesn't have the luxury of devoting the attention to Karis that she might need.

I'm not saying this to mean that I'm expecting Karis to get into trouble again, but just to illustrate that her situation still requires vigilance. I'm staying here with her tonight for that reason.

Sorry if, in my joy at seeing her better, I've given the wrong impression, that this thing is resolved. Far from it. But that doesn't deny our relief at having the immediate crisis yesterday relieved.

If you're still with me through all this long explanation, my congratulations! Hope it helps. (See how difficult it is to know how much detail to try to communicate?!)

Soteria,

Sorry I've been away.

Father God,

I pray that you manifest you healing powers to help Karis overcome the UNCERTAIN CIRCUMSTANCES AT HAND. Only you father can mold and mend her body. Please enter her body with your healing powers. We ask in the name above all names to bring victory. In Jesus Name! Amen!


I will continue to lift her up daily.