Another rousing day at the clinic

The scheduling department got a little carried away with the later appointments this week. Scheduled me for 2:30, 3:00 and even 3:30. The 2:30 appointment finally ended at 9:30pm at the hospital. The clinic closes at 7 and there wasn't time to pour Ambizone, platelets and blood into me between 2:30 and 7. So I got the Ambizone and platelets, then went to the hospital to get the blood.

So the next day I got the appointments rescheduled and had to take what was left. Friday morning, today was 7:30. (sleepy sigh) However it looks like I will be finished by noon so that's a lot of day left.

I've been trying to decide how to deal with the gardens in my yard. Yesterday I decided that hiring a pro might be the right way to go. I can't go out there and get my hands dirty. There seems to be a lot of stuff that didn't make it through last season, and I would like to make some changes in the looks of them. So I'll get some advice and some work done. I hope.

Conor was to visit this weekend but he has a cold so won't be coming. Janice is coming to stay though so a change of pace. Walt is on his way back to Kansas and so is his furniture. They arrive the first of next week.

Conor and Annie send me daily pics of Harrison who is now 4 1/2 months old. He rolled over this week and I got a video of that! Here is my current favorite picture.

My lungs feel better, sound better. It looks like I will still be waiting for a few more weeks before we start planning the transplant. Meanwhile, I hang out. I'm getting better at waiting. Better at being taken care of--it's hard for us independent types to be cared for.

Cathi

My DeVore cousins

Monday morning. When I don't feel great, it's like any monday morning when I was working. Ugh and blah.

But I logged in today to talk about my DeVore cousins who have contributed much blood and sweat to getting my house rid of all dangers. Dennis, Sara's husband, helped demolish the bathroom, as did Walt's buddy Jeff. Sara and my niece, Margaret, ripped up the carpet from the basement. And hauled it out to the street to be picked up. Then Sara came back and helped Margaret with the cleaning in the basement. Last week Jason, Carol's son, helped Walt rip out the remainder of the paneling and wood from the basement walls and sweep away the dry mold. These are the jobs nobody wants to do and the DeVores pitched in and did them. THANK YOU! (I hope Dennis's back is okay now.)

They all send encouraging emails and many comments on the blog. They have visited and they just remind me who I am. Even though I am isolated, they act pretty normal about it. I get links to bluegrass downloads from the Winfield festival that we attend every year. And I just really appreciate that I'm still included.

Meanwhile life goes on. Daily clinic visits which are in the afternoons now. I actually drove myself to the clinic on Saturday but then had to have Benedryl to get a platelets transfusion so called for a driver to get me home. Mom and Dad are really good about it. I get dropped off at the clinic about half the time now, and I like that. Gives me a little time to catch up, and nap if I want.

Peggy took me to the clinic yesterday and we talked a little bit about what I should be doing with this waiting time. Sometimes I think I should be creating something momentous and meaningful that will outlive me. Other times (and this is what I prefer) I think I just need to keep my business going and my real life intact so I can step back in when I'm well. Peggy reminded me that the same questions apply to everyone. None of us really know how much time we have; and we have to choose every day the best thing we should be doing.

So outside of wishing for more energy, which I didn't even have before I got AML, I'm fine. My white cell count bobbles around but isn't so low that I'm scared. I like that it goes up sometimes as much as it goes down. I'm getting a lot of transfusions of blood and platelets which is normal for my situation.

Cathi

Time Flies

Time flies when you're having fun. I can't believe it's been a week since I wrote here. A week of the same clinic visits every day. I did get permission to eat out one more time since my friend Diane was here from Houston.

I took Vidaza shots, 2 per day, for 7 days. Out of those 14 shots, 3 sites developed very sore knots. I feel lucky. I lost a few meals, didn't feel great for a few days, but overall, survived in good form. Today I feel pretty good. My clothes reflect the tender tummy, and I would like to have more energy, but I have no pain so I'll be grateful.

On Monday an order was issued for 30 more days of Ambizone. I had a depressed reaction. Not really blue, just 30 more days. My days seemed to be consumed by clinic visits and nothing else was happening. Since February 1st I've been in the hospital or the clinic every single day.

I had the bright idea to change the time to noon giving me the mornings to accomplish something. That has worked out well. Now, instead of 4 piles of paper on the floor of my bedroom, there are about a dozen. I'm not sure how productive this is but I feel better.

I am uneasy now about my counts dropping with this pneumonia still lurking. I want the doctors to reassure me that I won't get sick. Instead they ask me if I want to see the psychiatrist. This dude showed up in my hospital room one day, uninvited, with a colleague and proceeded to 'counsel' me and ask a bunch of idiot questions. I promptly disinvited him, told him I had nothing to say, ran him out, and still have a bill for $400 or so.

Anyway, I am taking two oral antibiotics. I take an anti-viral medication. I go to the clinic daily for an anti-fungal medicine. And I keep clean. Following all the rules for dietary restrictions and isolation. That's the best I can do. And keep busy.

Seems like I had lots of other stuff to say, but tonight you get just the facts I guess.
Cathi

Holding pattern

Home from my daily clinic visit. 5pm. I go in about 10 every weekday and get home anywhere from 3 to 5. There are lots of variables. How many patients; how many nurses; how fast the pharmacy is; whether I need blood or platelets; etc etc.

I've been getting shots of Vidaza, the chemo drug to keep MDS/leukemia in remission. Two shots in my belly. The shots are painful going in and my stomach feels like someone has been punching me. Ironically, the Vidaza shots don't bruise, but there are bruises left from the neupogen shots: I do look like I've been through the wringer somewhere.

I feel not so great this week. The chemo works on me. I can control the nausea with a cocktail of drugs, one of which is Ativan. Ativan is mainly an anti-anxiety drug but it works well in cancer patients to control nausea. However, it makes me sleepy so I can't drive and I feel kind of cloudy much of the time.

Nurse Practitioner Julie came in today and said "Honestly, if I didn't know your history I would not question a thing about you." So my lungs sound totally normal but the left one looks bad on an x-ray. This has been the case more often than not since I've been sick. Sounds good, looks bad. ugh.

I gather I could be in this holding pattern for several weeks or even months. The lung heals slowly. And that's what we're waiting for. No more dinners out as the ANC count dropped to under 1. Some of the liver enzymes are still high. And those are the facts. My joints hurt when I move. I'm trying to minimize movement...ha ha.

I don't have a good rhythm for my days. It's hard to get started on a project at 3 or 5 in the afternoon. However, Peggy took me to the clinic on Sunday and we spent several hours ordering clothes for me. So I will soon have a new wardrobe; a treat anytime, but especially in my situation. Finally, just for grins, a picture of the night out with the girls.

Driving Privileges!

Yesterday Dr. Aljitawi told me "I don't have a problem with you driving." so today I drove to the clinic. Accompanied by Mom...not alone yet. But perhaps in the near future. Of course I can't really go anywhere except the clinic.

I am feeling good, and according to everyone around me, looking good. I've gained 10# now which I think is plenty. The bone marrow biopsy has nothing terrible in it, even though I don't have the complete results yet.

So the new plan is to start "consolidation" chemo-therapy on Monday. This will be a less toxic chemo and is intended to keep the Leukemia in remission. I get a shot every day for a week (during which I am warned about upchucking) then 2 or 3 weeks off then a week of shots again. We are hoping to buy time with this plan for my lung to finish healing. The pneumonia this time only affected my left lung; the right one still looks clear.

The liver counts continue to improve. Since the caspo fungan was stopped. This is also why I feel better. Which I stress each time I see a provider. "I feel really good without the caspo!" Yesterday Dr. Aljitawi said perhaps I would not have to take it again if the lung gets better without it. Music to my ears.

My white cell count and absolute neutrophil count have been up permitting me a little more freedom. I've been eating out at restaurants and whooping it up. I had a jolly night with some girlfriends this week that was a second wind. The dinner was interrupted once for me to be disconnected from the potassium pump I had slung over my shoulder. Janet and I went out to her car which was parked square in front of the restaurant door, got in the back seat, and went to work. I got my arm out of my sweater and she went to unscrew the PICC line connection. But she had some trouble so turned round in the seat with her back to windshield and front to me and leaned over to get more traction on the connection. Who KNOWS what passersby thought? and who cares? We got the business done and went back in to enjoy a hot drink after the meal.

The counts will drop when I start the chemo next week so I'll be back to the neutropenic diet and more restrictions. I have been fortunate to enjoy the meals being provided by my Troop 91 friends and my mother appreciates them even more.

No time line has been set up yet. The BMT doctors would like to get me healthy enough to undergo a full bone marrow transplant. So that's the goal. Slowly. I'm not even writing surely because who knows what might happen next. I'm thinking I have caught a break and will heal nicely.

Cathi

One day stay

First things first. My friend, Janet, is here from England for the week and has been loyally ferrying me to the clinic daily and hanging about for the long hours I am there. Though she has found a good massage therapist at Woodside and has snuck over there a time or two. We are having a good time catching up and just spending time together. She has whomped me at all the games we've played and claims it is because she plays Mah Jongg. So something else for me to learn.

We are staying at Mom's house because the latest work on my house (pulling up the basement carpet) revealed a lot of mold and mildew in the basement, result of an apparent leak. So theories and fixes are being tossed about for that problem. Meanwhile the house is spotless and ready...sigh.

Walt is coming to town today. He has finally bought a house in Overland Park and now will be spending more time in KC. The family won't move until April when ski season in New Hampshire is over.

Last week my niece, Margaret, was here and worked like the dickens on my house, besides keeping me company. She bought me a lot of green stuff to wear on St Patrick's Day, which kept the hospital staff amused. They might have laughed even more if they had seen the knickers covered with clover!

I am in the hospital this morning, thankfully just overnight. Dr. Aljitawi sent me here yesterday from the clinic for what looked like a pneumothorax (pocket of air under a lung.) I've been on 100% oxygen since I arrived but I slept good. Dr. Ganguly just came in and reported that there is no pneumothorax and I can go home after the treatment I need today. I still have a little bit of pain which gave rise to all this, but presumably it will go away soon.

The CT Scan also showed slight improvement in the pneumonia. Pneumonia is just so slow to heal. I should be specific, FUNGAL Pneumonia is slow to heal.

I have been feeling good and that helps my spirits tremendously. They stopped one of the anti-fungal drugs because my liver is inflamed and life without it is better. No nausea, less fatigue. I've eaten enough to gain a couple of pounds!

I appreciate the comments on my blog. I reread them constantly. They are important to me. I guess they remind me of my life and the people who love me, all the people praying and cheering for me. So keep adding comments! and silly jokes too.

Cathi

Recovering at home

Life out of the hospital is nice in spite of the long hours at the clinic. Last night I slept straight through til 6 this morning without waking up....or being woke up. The bed here is better and nobody cares what my blood pressure is at midnight.

I am still at Mom & Dad's house because turns out there is more to do at my house before I can live there. The bathroom remodel is finished but the vents needs to be cleaned again. Then the very old carpet in the basement needs to come out, and the vents cleaned after that. And of course the house has to be cleaned again after all this other commotion. But we have a plan so it will get finished.

Medically the plan is to ride out the next 30 days using the time to get ready for a transplant. I'll visit the clinic daily for the anti-fungal drugs. Sometime in the next week or so I will start a mild chemo-therapy to prevent the recurrence of leukemia, and then be ready for a transplant.

I feel pretty good. Much better than when I went in the hospital last week. I don't have a lot of energy but I expect that will come over the next few days. I'd like to wake up and think "today I want to get this and this done." Right now I just wake up and think "today I have to eat 1800 calories and 90 g. of protein."

Eating is easier when I'm not upchucking. Plenty of meat for protein, and at least one protein shake to get close to the 90. My first goal is to stop losing, then start gaining.

Feeling better has improved my confidence too. I believe I can recover from all these things...pneumonia, leukemia, or whatever other infection gets thrown my way. I can't do it alone; I need my friends and family and my faith. But eventually I'll be on the outside again, living a new life.

Cathi

Day after St Pat's

I am scheduled to leave the hospital today. Based on the results of the lung CT scan yesterday. The scan showed the pneumonia reduced by about half in my lung but still not gone (I'm not sure "gone" really happens.) The doctors are changing all the antibiotics to oral pills so I am not so tied to the IV pole. However, the anti-fungal medicine is still IV so I'll be going to the clinic every day to get those. The infectious disease doctor wants the drugs delivered daily for a month then repeat the CT scan.

It would be nice to actually have a month to recover. However, as my body proceeds through these ups and downs the original diseased bone marrow becomes more strange and perhaps stronger and leaves less time to recover and make decisions. The doctors expected to have the full results of the bone marrow biopsy sometime yesterday afternoon. I have not heard and probably will not til the end of this week or first of next week.

I feel much much better. I haven't vomited for several days nor run a fever. I can't seem to eat enough calories to satisfy the nutritionist but it feels like all I do is eat. Food isn't particularly appealing either, especially hospital food. I'm looking forward to getting home to some regular food. I am not neutropenic so I can eat more things, like salad, which will be nice. But I will still be drinking protein shakes to get the calorie and protein counts up. The goal is 1800 calories and 90 grams of protein.

Mentally I'm still not at the top of my game. I'm scared and I wish I didn't have to deal with this. I know the doctors are going to lay out some choices in the next week or so and I'm going to have to choose. The options and risks change each time I get sick and have a setback.

I'm trying to keep the horizon short... living in today. I will be redecorating my room with my "real life" pictures including new pics of the grandbaby. And I will be leaning on my friends and family for support. Looking for people who believe I can get well and convince me of it.

Cathi

It's a Mad, Mad, Mad, Mad World

Back at the hospital Cathi is in a new room. Room 4101, albeit a tiny room it is a relief after the long days at the clinic that were starting very early and ending late. It's also a wee bit less frustrating as most folks at the clinic are getting well. Noticeably better.

No results from the marrow biopsy performed on Thursday. (Cathi) 'Personally I think this means they didn't find what they here hoping for or expecting.' So more consults with more docs. Maybe we will know on tuesday.

They did performa a bronchoscopy, however, which revealed a staph infection in the upper left lobe. Now yet another change of antibiotics. Which hopefully will be followed by dramatic upturns in Cathi's well being.

Then they performed a thoracentesis (drain placed in the chest cavity) to draw fluid out of Cathi's pulmonary cavity which was collapsing the lung slightly. The pain was immediately better after the procedure, and appears to be improving still.

From Cathi
My head is improving. Distracting movies and comforting friends and family. I need to be reminded who I am and what I'm capable of doing. E.g. Setting a goal and reaching for it. That I have banked years of good wishes for everyone and I need to withdraw for myself now.

Mostly I am tired. I don't have the same energy I had last summer. And I am mad. Mad about spending 9 months in a bedroom. Mad about having the pneumonia complication. Mad about the failed transplant and the gall bladder. I'm ready to walk out in the world in street clothes and see my friends and family.

I do have some WBCs though: 1.5. And some neutrophils backing them up. So more things to try to hit this ever moving target.
C.Maynard. fumbling from the Blackberry

A Fever! I know it's off to the hospital I go.....

That used to be a catchy little tune back when Conor had enough hair to actually style it. Young MC is now old and relegated to bad jokes for VH1 and Cathi has now adopted Conor's youthful short spiked hair style. But that was the tune on Monday night. Cathi and Lori left 7:30am Monday morning for a day at the out patient spa for KU med cancer patients. After lots of tests and two units of plasma Cathi came home at about 6:30pm not feeling rejuvenated so she just sat down to warm up. That lasted for as long as any normal person can take the smell of fried Salmon patties. So it was back upstairs to the room.

After a bit she had a fever of 100.9. So a couple of Tylenol some rest and the fever is gone?? Right? Wrong!
'I know it's off the hospital I go...' So Walt went to take Cathi to the hospital for a check up, & Lori went to console Walt who had an offer accepted on a house Monday that he just realized he did not like. The entourage arrived at destination before the paparazzi could amass to greet them, so they went to ward 41 with closed doors, then ward 41 with open doors, then finally to ward 42 with Ola the nurse. Gotta stay on the down low with Ola the nurse.

The hospital took cultures, administered an IV of antibiotic, which took about an hour to get it all figured out and actually started. Lori went home early and Cathi & Walt grabbed some shut eye and were finished by 12:30am. The drive home was uneventful and the two went to bed with Cathi's cough causing a stir every couple of hours.

Tuesday 7:30am Cathi and her Mom were off the clinic again for a blood work & a cat scan of the lungs. Janice came up to spend a couple days of hooky at Cathi's side, and spent the day at the spa together with her as they marched around for the cscan & then the results. "What the pneumonia is worse in the Cat Scan?
I know it's off the hospital I go..."

So that is about the best of the past two days. Janice took Cathi back to the hospital BMT ward in room 4101 to be treated by the yellow coats. She received two units of plasma on Monday, had a cough, and what goes down, must come back up. All of this to end up back in 'The Ward'. So the song ends in a little diddy and happiness. So where is the happy ending. Robin.

Cathi is like a regular celebrity each time she goes into the 4th floor. So many of the nurses stop to say hi "Great to see you, but sorry to see you here" They chat as if they were friends from another engagement and then it's off to the next stop and next a new nurse around the corner. Ah but Robin, Robin is an event each time that leaves a smile and a stronger Cathi. So it was great that Robin was there to help her and spend some time to lift her up.

Robin was working the hospital when Cathi arrived and really had a nice chat with her and picked her back up. Robin always has that charm that lifts Cathi up. Cathi's close of the day was a text that read "Am very tired but spirits better. Pep talk by Robin helpful."

Not so up to date, Weekend Update

Another day at the clinic. Another dollar.
Each day Cathi has plugged along to the clinic visits. Friday & Sunday her friend Peggy took her to the clinic. Saturday & Monday it was her mother who attended with her. Most of the time she is coming home with the IV bag giving medications to treat the fungal pneumonia. One day it clicked off at 3:15am, and another fortunately it was just before bed.

Her current residence is in the upstairs bedroom at her Mom & Dad's house. She is very reliant and grateful for care from her parents. She does well to make it up and down the stairs even after all that time at the hospital. Her food and energy intake has not been what it has been in the past. Much of the time the food comes back as fast as it when down or even faster a few times. Some of the medications are creating a haze which makes it hard for her to focus on her recovery and health. But true to herself she is marching according to her doctors orders & keeps on working to put food down.

Brant Tidwell and some scouts (his son) came by on Saturday and did some yard cleanup & trimming to spruce up the house. Cathi drove by it later in the day and was so pleased to see the work & how nice the bushes looked. She had forgotten about the request made to the scouts a while ago. Cathi sends a big thanks for trimming the bushes and the yard work.

Work begun on her house this weekend to get it ready for her to live in it again. The demo crew (Walt, Dennis, Jeff, & Mike) gutted the guest bathroom to remove the molded items and clean it in preparation for the builder to start on Monday. The builder did check in and started on Monday, but a there is a little misdirection on the work instructions. 'I wonder how Cathi would have handled this?' But anything worth doing is worth doing twice. So work should be completed by the end of the week. After another round of sterilization she should be ready to move into the house. Ready, but a little timid after the last time that resulted in a rush to the hospital.

There is little progress on a timeline for the transplant as the focus has been to rid the lungs of the fungal pneumonia. The transplant is still eminent and they plan to do a bone marrow biopsy later in the week to check the status of the latest shot of her brothers cells that she received while in the hospital.

Cathi's spirits are not where they were or need to be. She needs to see a positive bone marrow biopsy and a date for the transplant. Each day the lungs continue to sound better, but each day little bumps keep happening. She had did not feel well on Sunday after the clinic visit that ended at noon. After staying in bed for the rest of the day, she had a fever in the evening and it was decided that needed to back to the hospital. After a few hours at the hospital she did come back home and had a clinic visit that was uneventful on Sunday.

Once again, "home"

I got out of the hospital yesterday, not exactly free of all hospital commitments, but able to spend time in my own bed and my own place. Which is still Mom and Dad's upstairs bedroom.

Getting up the stairs is tougher than it was 32 days ago, but I can do it unaided. I don't try to do it carrying anything. I am really glad to be home because I had begun to notice daily the loss of strength. and that is why I am out. To get strong. To eat and put some weight on. Get healthy.

I'm still having trouble keeping food down which I have since I went in the hospital Feb 1st. I'm eating something that resembles 3 meals a day, to a cow or sheep perhaps. little bits all day long. It's tricky to know if the last meal is processed before I start eating the next one. But the bin is never far away.

Long days at the clinic to receive two pole anti-fungal drugs aimed at the pneumonia. Since the DLI I've had extraordinary growth in WBCs and neutrophils. This is great and is just what we hoped would happen. I'd like to see the same best possible outcome from the bone marrow biopsy next week.

and now I find myself drifting off to sleep while writing even though I'm watching that stimulating show "My Name is Earl?"

In your prayers please include my attitude thank you.

Cathi

2nd mini transplant - looking good

Day 26, +38 since Chemo
Cathi received her brother's wbc's with little incident on Tuesday. Beth the transplant specialist had two giant syringes that were full of Walt's wbc's with the bone marrow stem cells attached to the wbc's and injected them right into the pic line. Each syringe took quite a bit of time to insert. Remember this was done to help increase Cathi's own wbc production to get her healthier to accept a full bone marrow transplant at a later date with fresh cells from her donor.
So this week saw a boost in her wbc count going up to .5 from the transplant. It is expected that the wbc count will go back down before her marrow will get production online and get improved wbc production. This will likely take 10-14 days before solid increases in wbc's will be maintained. In the meantime her wbc will likely go up and down.
Cathi is still not eating on a regular basis and has trouble keeping food down. Just in the past day she has seen some improvement on this and is now requesting Starbucks coffee brought in the morning with the paper. She is also working to venture beyond the hospital neutropenic menu to get some food that tastes better. All good signs of solid recovery.

A new Day, A new dose of Cathi's donor

Day 22 in the Hospital, +38 since Chemo
The weekend is over, the boys have gone home, and a new plan. There was one plan Saturday, another Sunday, and yet another on Monday. Here is the approach moving forward.

Sunday morning Mcguirk came in to say that Cathi looked good and her lungs sounded the same. He did decide that he wanted a CAT scan of her lungs on Monday or Tuesday to confirm it clinically. This was to see things clearing up in order to prepare for another transplant, a mini-transplant like before.

He viewed the mini-transplant as a potential solution since her body is not ready to go through the rigors of a full-blown transplant & the chemotherapy preparation. But since the WBCs are stubbornly not regrowing, it’s an option he feels will give the desired results. As you look back in the September blog posts to see what the process was but essentially it’s a very quick ramp-up & preparation period followed by the transplant. The difference in a mini-transplant is the prep does not kill off the host marrow and blood the way it does on a full-blown process.

Prior to moving forward, Mcguirk wanted to seek the advice of some Seattle colleagues as they have the most experience with these mini-transplants. So the Dr's do have consultations. Cathi and a lot of us use discussion boards for troubleshooting IT issues. The medical community benefits from these and other collaboration relationships in ways many of us had not even thought of! He said based on what he finds for his answers, he’d decide when to schedule the min-transplant and what modifications to the previous procedures may be required.
That was Sunday

Monday he came in with an update on the pneumonia and a new plan. The infectious disease doctor finally has resolution on what type of pneumonia it is – fungal pneumonia. Mcguirk said, ‘Acts, looks, and talks like a duck. It’s a duck.’ This one of the primary causes of mortality in leukemia patients…hence another plan with quicker impact and results.

The plan is two-pronged in Dr Mcguirk's terminology. As opposed to Conor's ‘two-phased’ approach. So here are the details:
- Infuse the leftover cells from Walt on Tuesday, remember he gave an extra 130ml in Sept. These wbc's are put in to help Cathi with some WBCs to fight off the pneumonia, and improve her health and lap times at the hospital. Remember Dr Ganguly would say 'You have your brothers blood, you should feel 10 years younger. This may lead to Cathi getting out of the hospital in 7 – 10 days (Mar 3-6). But then Cathi's brother was always an unknown... so no way to know for sure, as history has shown us the two together only tend to last 90 days. Not doing the chemo treatment before opens the door for a greater risk of graft Vs. host disease.
- Then a full-blown transplant in about a month, when Cathi has fully recovered. That would include the total body irradiation, (Chemo + radiation) that would squash all marrow prior to a transplant. Cathi would also infuse fresh cells from the donor. Fresh cells increases success rates by about 10% & there will be no more of Walt on file at the hospital to use.

It is a good plan. It will strengthen her ability to ward off the pneumonia on her own, or with a little help from her brother so to speak. And with all we have done at the hospital, a plan that is sure to change as conditions change and improve. We shall see. There is even a chance, very slight, but a chance, that the infusion tomorrow would ‘take’, and that’d be it. But that is kind of like a lottery ticket, people do win them, but it is generally somebody else, with odds at seven digits.

So here is the 'marching orders' as Cathi would say, for the rest of us:
-Hope and pray the infusion tomorrow takes care of the pneumonia. Cards & posts
-Hope and pray the infusion ends up being the solution. There is always hope! If it is not the solution, then it is support for recovery and then on to the full transplant in about a month’s time, and for that transplant to work.