[Ryan Jay]

Hey everyone,

I'm back to work now. Yay! I feel pretty good, but I have a question for you guys. It seems like my therapeutic level of cyclosporine is above the toxicity levels that are acceptable to my doctors.

For example:

Lab 1. (With 300 mgs of CSA daily)

Trough: 130
Billirubin: 1.8
Creatinine: 1.2

CBCs

HGB: 10.8
HCT: 31
PLT: 67
WBC: 3.3
ANCs: 1600

(This with all lines having dropped slightly after my labs two weeks prior)


Lab 2. Two weeks later (After my doctor boosted the CSA to 400 mgs daily)

Trough: 280
Billirubin: 2.3
Creatinine: 1.5

CBCs

HGB: 11.8
HCT: 34
PLT: 76
WBC: 3.8
ANCs: 2200

Anyway, we've gone back and forth splitting the difference between 300-400 mgs. and we are still teetertottering. Closer to 400, the counts go up, but the toxicity gets too high...closer to 300, the toxicity drops but the counts drift down, albeit slightly. I'm drinking water and everything, but has anyone else experienced this? I feel like I am tacking into the wind.