Long story short, it looks like Gavin’s numbers are okay as far the hematology is concerned. Where the problem lies is that REMS, the governing body that makes the rules about what the minimum requirements are in order to have Clozapine dispensed is very, very conservative. It’s completely understandable but there does seem to be a disconnect somewhere.
I’m pretty sure Gavin’s ANC has to be over 3.0 in order to get a refill released. This is a very serious medication and so they’re not playing games.
Having said that, the doctor explained that Gavin could safely take Clozapine at a 1.5 or possibly even lower. The hospital standard he showed me says 1.5 is the minimum requirement for use of Clozapine.
There’s a disconnect somewhere or perhaps REMS is simply extra cautious when dispensing Clozapine outside of a hospital environment. I don’t know but my curiosity is going to have me call our pharmacy in the morning and double check the standard.
When all was said and done, the hematologist’s information lined up almost exactly with what Gavin’s prescribing psychiatrist says and that’s certainly a comfort.
We left with the recommendation that if Clozapine is the only antipsychotic that works for Gavin, continue using it. He feels Gavin’s numbers are fine and he’s closely monitored anyway. We just have to be careful.
Frankly, he said he was more concerned about Gavin’s platelet count dropping but since it’s come back up, we’re just going to keep an eye on things.
Once again, I’m so grateful for Akron Children’s Hospital. The new doctor was amazing and the staff everywhere throughout the hospital is always incredibly kind. ☺
We got out of the appointment and home in time to pick the boys up from school. I called Lizze’s Mom and canceled, thanking her for being willing to help out…☺
Finally, there is something else that happened and I eluded to it in the opening paragraphs of this post. I’ve decided that I want to try and make that a teaching moment. In order to do that, I really need to dedicate a separate post to it.