Tomorrow is a big day for us. Gavin is scheduled for an endoscopy, a procedure we refer to as a 'scope', to check the status of his disease. When it comes to Eosinophilic Esophagitis, or EoE, what you really want to know is how many eosinophils (a certain type of white blood cell) are present in the esophagus. A scope is the only way to find out.

Here is my non-medical explanation of how I understand this procedure...

Gavin will be put to sleep, and his GI doctor will go into his esophagus and take both pictures and samples. The pictures are the only immediate feedback we will get tomorrow, but can be very misleading when it comes to EoE. The truth lies in the samples, or biopsies, which are sent to a lab. At the lab, a stain is added, which makes the eosinophils dark and easy to see. A pathologist will count how many eosinophils are present per high power field (HPF) for each biopsy, and reports the number back to the doctor, and then to us. A healthy esophagus has 0 eosinophils. An active case of EoE is typically 15 or more eosinophils per HPF. This is Gavin's scope history:

Scope 1: September 2010 - 59 eosinophils - diagnosed with Eosinophilic Esophagitis.
Decided to try treatment with topical steroids only, no change to diet

Scope 2: May 2011 - 53 eosinophils - steroid treatment alone is not a success
Changed type of steroid and removed dairy and soy from diet

Scope 3: September 2011 - 0 eosinophils - current treatment a success
Decided to keep going with current treatment and allow his esophagus to heal

It has been almost 2 years since that glorious scope with 0 eosinophils, and I'm terrified of what this one will bring. Best case scenario would be another clean scope, and we would be able to decide if we want to try and remove the steroids or add a food back into his diet. Worst case scenario would be anything else. Okay, I'm being a little dramatic, and if you read this far into my post, you probably know me well enough to expect it. Kidding aside, I'm very afraid right now. This disease is so unpredictable that it is impossible to prepare yourself, and that to me is the scariest part. I don't want my baby to lose any more foods, or even have to go another day with the ones he currently lives without, but the bottom line is I just want him to be healthy enough to enjoy his childhood. The procedure tomorrow has its own risks, those of anesthesia, and the risk of a perforation (tear) in his esophagus. For now, I'll just focus on getting through tomorrow, enduring the long wait for the magic number, and then moving forward from there. Deep breath...