What the dr said...

Ryan had an appointment with Dr. Johnson, his infectious disease specialist yesterday. He went over the lab work Ryan had done last week, and ran down the list of "normal" valley fever symptoms. Other than extreme fatigue, and weight loss his list of symptoms is looking pretty good. The tiredness is the last thing to go, so that could be a while, but Dr. J says Ryan should be recovered enough by baseball season to actually play. and that has been Ryan's biggest concern... well that and the fact his clothes are pretty much just hanging on his bones right now, (he is down about 20 pounds between when he had a physical done in May and now). Ryan also asked why the skin on his hands and legs gets a purplish tinge sometimes.  It's some long medical word, and it will go away at some point, along with everything else.
There is a whole list of stuff they test for when they do the blood panel. Some of it has to do with the medication he is taking, it can affect his liver function, so they have to keep an eye on that, they also check the level of the actual medication in his blood for toxicity. Then they do a cocci titer, which I had to come home and look up, because that's what I do. Here is what it means; A titer is a test to find how much dilution is required for a patient’s blood serum not to show any Valley Fever antibodies. When a blood sample is taken, the serum (the clear part of the blood with white and red blood cells taken out) is mixed with a saline solution and then tested. If the VF test is positive (shows that cocci antibodies are still there) it is diluted by half again. This happens again and again until the cocci test is negative, meaning the serum is so diluted that no antibodies can be found. A titer that is written as “1:8” is read as “one to eight.” To say someone has a titer of 1:8 means the mixture could be considered to be one part serum and eight parts solution before the test could become negative. A titer is considered lower when it is less diluted (1:4 is lower than 1:8) and higher when it uses more solution (1:128 is higher than 1:32). Medical sources routinely consider titers of 1:8 and above to be serious. Dissemination is especially common above 1:16. Patients with high titers and dissemination are usually treated with antifungal medication. A low titer can mean the immune system isn’t reacting strongly (either due to immune problems or the VF attack wasn’t as severe as it could have been) and a high titer can mean the immune system was reacting very strongly (indicating that the VF infection was severe or the immune system just produced many Coccidioides antibodies). Regardless of one’s immune health, these antibodies are actually useless to help the body fight the disease. They are helpful in diagnosis because the antibodies are easier to spot in the blood than the fungus itself. They measure from 1:2 up to 1:512. His titer count is 1:64. He will keep taking his medicine and go back in 6 weeks.