Friday, January 18, 2008

I reply to Dr. Foster

I want to give all this communication to our Pediatric Rheumatologist to get his feedback on the conversation. I like the questions Dr. Foster asked. Dr. Wong said go on MTX, which i had already said we were on. I responded to Dr. Foster with:

Dear Dr. Foster,
Thank you so much for your quick response. We appreciate & value your thoughts! My husband & I are very much in this fight to win for Charlotte & appreciate you being on our side of the battle lines! In answer to your questions:

Our daughter has not taken an eye test. When our ophthalmologist looked into her eyes, she said she isn’t a full 20/20, but that’s “normal for her age” & that was at 26 months.

At our last appt, the severity was +2-3 in the left eye & +2 in the right. Charlotte has not been happy about the slit lamp exam, but has done it every time, sitting on my lap since her 1st appt in November. She understands that is what she needs to do. This degree of inflammation has remained constant since 11.14, although the right eye has shown slight variance, not enough to make a difference as we understand it.

You mention that (we need) “to put out the fire quickly” & that 1st attempt would be intravenous SoluMedrol. Is that the shot in the eye? Our Pediatric Rheumatologist mentioned that form of treatment months ago when we were first diagnosed.

But on timing: In your estimation, knowing that we have been at this level of inflammation since November 14th, would you say that the Pred Forte topical treatment is not going to cut it no matter how long we continue? And we are on pred forte orally now as well (12 days), and heading into week 3 of MTX. Should the pred forte orally & topically be given a chance with the MTX & if so how long? Or does it appear that Pred Forte orally/topically isn’t going to be the solution if we have been on it for the amount of time we have.

I know that our ophthalmologist is VERY willing to work with you as a member of our team. I would love to hear your feedback & also share this with our Ped. Rheumatologist Dr. Kingsbury so he understands what we would like to do in moving forward with our action plan for Charlotte.

Thank you Dr. Foster!
Best, Erika Cox

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