Devin's been off since returning to school after Christmas break... he's had some good days... some bad days... and some bizarre days... he has been flat and very sleepy!  Constipation has been a HUGE issue and one that we are working to try and figure out!  This week has been a rough week for Devin.  He has come home from school every day but Monday and Friday... and slept non-stop! (he wakes up every morning and wants to go.  I don't want you to think I send him off sick)  When they called me on Thursday a light bulb went off.. could this be his liver??  He just does not look right.. his color is off, he looks so tired even though he is sleeping 16 hours a day!!, and he is just not himself!!!  I'm a slow one!! who desperately wants to deny theirs an issue!! because issues always come with set backs and torture for Devin.

We drew labs Friday AM and boy were we shocked!!! His Liver enzymes were VERY elevated..      AST >500 (normal 5-40)   ALT > 1000 (normal 7-56).  Of course this sent red flags flying to both the DC team and the NJ team.  We immediately drew more blood and did an INR and Ammonia level to try and sort this mystery out.  Devin has absolutely NO signs of illness!! NONE!!!! No change in medications or dosage!!  Just sleeping all the time!!  So why is his poor Liver struggling so much!  ???
I heard from the nurse practitioner in DC yesterday who gave me the orders for more blood... Then I went off to work and the heard form the other nurse practitioner in DC who asked "what is going on" AAHH!! After talking to her we agreed that it was best to come up with a plan... if this then that!! for the weekend!! Now for any of you that have ever had medical issues when you hear from a center 3 times in one day it gets slightly alarming!!!  Not to mention I had received a message for my local GI doctor that we needed to talk... and received my second call from her at 9:30 last night...

 Well his INR was 1.1 (normal 1-2).. Thank God!!   BUT, his ammonia level was 118 (normal 10-40).. GGRRR!!! this could be the problem... but WHY!!!!  We gave him stuff to make him poop and we will be doing labs again this morning and I am sure again tomorrow morning... and Monday morning!!  If his numbers continue to climb or do not come down he will need a Liver biopsy next week!!!

Please pray this all resolves!!!!