Dr. Costanzo visit

Hi everyone:

All the photos I was taking of Patty this morning were unflattering, so we decided to try a somewhat different approach--hence, the picture you see here. The mask was crafted around my enormous melon, so Patty's mouth is actually in the nose area somewhere.

Patty had an appointment with Dr. Costanzo yesterday afternoon. The doc agrees that the Rituxan/Cytoxan combo may not be working in reducing the panel reactive antibodies (PRA), but feels it is important to keep trying other options (rather than simply waiting and hoping for a perfect heart.) Dr. Costanzo thinks that total lymphoid irradiation (TLI) is the next logical choice. As always, we heard that this treatment is "generally well tolerated." We shall see...

Dr. Costanzo also noted that Patty's difficulty in tolerating Cytoxan and CellCept presents some interesting challenges after a transplant, because one or the other is typically part of the protocol. Instead, she may have to use one of the "old" immunosuppressive drugs. I am feeling nervous on Patty's behalf, because I don't want her to go through the whole process of transplantation only to find that the drugs she needs post-transplant only make her miserable.

Much to Patty's disappointment, Dr. Costanzo advised Patty against riding on roller coasters or other thrill rides. The issue is not one of fear or excitement being harmful, but a worry about sudden changes in blood pressure that could lead to other hardships. So, if we end up at Six Flags at some point, Patty will be joining me in the observer role.

We're still waiting on news about Colin's passport. The waiting is agony.

Love,
Brian