Cole Reynolds Update

For the last week I have been telling people with cautious optimism that Cole's endoscopy yielded the best possible outcome--no inflammation. Dr. Russo believed this to be the case, and so did we. Unfortunately, the visual evidence was not corroborated by the biopsy results. The esophagus is still inflammed. A normal esophagus has around 5 eosinophils ("Eos") per high powered field ("HPF"). Anything above 15 Eos per HPF is abnormal and cause for alarm. In April, Cole presented with 60 Eos per HPF in the upper esophagus and 35 Eos per HPF in the lower esophagus. Last week, Cole presented with 40 Eos per HPF in the upper esophagus and 24 Eos per HPF in the lower esophagus. Obviously, regardless of what we thought we knew based on the visual evidence, Cole has not improved. This explains, in part, why Cole continues to vomit daily and why he is not interested in food. The fact that we have been able to sustain weight over the last month of vomiting is nothing short of a miracle.

We have been instructed by Dr. Russo to restart Cole on Flovent, a topical steroid that is administered orally via an inhaler (the idea is to swallow it rather than breathe it into your lungs). The hope is that this will reduce the inflammation and the number of Eos to acceptable levels. Because Cole had been practically elemental (no food other than his elemental formula) prior to the endoscopy, Dr. Russo's suspicion is that this eosinophilic esophagitis has less to do with food and more to do with something else. That something else can be environmental allergens or an autoimmune reaction of the body for unexplained reasons. We have also been told that to the extent that Cole wants to eat "real" food, we are permitted to give him anything that is not dairy, soy, wheat, eggs, nuts/peanuts or fish/shellfish. This is as far as we are for next steps at the moment, Joel and I suspect that another endoscopy is in our future in two or three months.

If you would like to pray with us, please pray for the following:

1. a complete healing of Cole;



2. no more inflammation in Cole's esophagus;



3. no more vomiting period;



4. increased appetite;



5. an oral acceptance with the Elecare;



6. no need for the nasogastric tube;



7. strength for Joel and me; and



8. wisdom for Joel, me, Dr. Russo and any other doctor who treats Cole.