Just heard back from the Chief of Allergy:
Hello Mr. Brooks,
Since our visit, I've been gathering more information on the lymphocyte toxicity testing.
I reviewed this with our immunology laboratory who confirmed there is no academic immunology lab in the US that does lymphocyte toxicity testing for drugs. It is not done anywhere here.
I corresponded with Dr. Shear who felt that Dr. Rieder who is the director of the Drug Safety Lab, Robarts Research Institute was excellent and a reputable laboratory. He didn't know though whether they had a validated version of the assay for Trileptal and Cymbalta.
I corresponded with Dr. Rieder the director of the laboratory. He felt they could test for Trileptal since it is an aromatic compound, but testing to Cymbalta would be very experimental. He is having his technician send the protocol. He asked for advance notice/scheduling as they are the only lab in North America with this capacity. I inquired about cost and he is getting back to me on that also.
So at this point, I am waiting the protocol from the tech. I envision these problems:
1. The need for a control being sent also. This is because the test itself is highly sensitive and the transport of the blood can cause changes in the cells that will alter the outcome. Without having a control sent from the same place and going through the same handling, it is difficult to interpret results.
2. Coverage of the test.
3. The experimental nature of the Cymbalta testing.
I expect to hear back from them later today and can update you. It may be easier to have this done at a later date and sent from a different office where the control etc can also be obtained. Our lab will not be able to do this.
Can't ask for a more thoughtful and thorough reply. But ... looks like this isn't going to happen. Not here, at least.
I think I'm going to try to make a plan to fly out of here, this weekend.
This morning, Internal Medicine wrapped up with me. In terms of getting sick so often, and having had multiple serious drug reactions, she said I'm "just not lucky."
In terms of moving forward .... with regard to meds ... she tends to agree with Dr. Volchek: try to be lucky in the future, and avoid meds.
If the lab really can't confidently test both drugs .... well ... it's nowhere near as valuable.
Not sure what I'm going to do, but ... I don't have any more clinic appointments -- just a dinner reservation at Pescara, early this evening. After that, I'll check into logistics.
Ciao for now .... as always .... from ... The Gulag.