Fancy dinners

I got my AFP test results back today... Now, it doesn't confirm that I don't have ovarian cancer, but it's a good sign that it is not... or at least that it is not far advanced (in my expert opinion). Prior to my transplant, my AFP tumor marker tests were up in the hundreds, (normal level for an adult is under 20) however, today my markers are at 4.5! YA BABY!! They were definitely elevated due to my failing liver! Hopefully I will get more (professional) details at tomorrows appointment to set my mind at ease.
Today, I also realized just how different I have become since before my sickness started taking over my life. Now - no offense to "advanced aging" people, but if you haven't noticed... they tend to be feisty and have more of a "I don't give a damn" attitude. You can tell this by their driving, I really think they don't even bother looking behind them when they are backing up... they're just like, "I'm comin' out!" and then there is the way they dress, either complete comfort or dressed like you may never see their wardrobe again. (in every color of the rainbow and wearing every accessory they own.) tehehee... I say this with love and now understanding. I mean really, who cares!! Live it up... enjoy! Carpe Diem...
I read recently, a woman who in her last years said that her only regret was not making enough mistakes... She led a cautious life. Ate to many beans and not enough ice cream. She would have had more real troubles, but less imaginary ones... --I think of all my stories that bring laughter, like the time me and my cousin went out dancing and got lost on the way home... somehow we ended up on an airport runway. It still cracks us up. Mistakes, adventures, silliness, and bravery make up most of my best moments... and that is what I want -- A life full of moments! In order to do that, you have to be adventurous, not give a damn, and by all means have an open mind. Even in the hospital after my transplant, I realized that my first long hospital stay, I had kept my door closed always, but this time, I left it open - inviting people and experiences in. (simple thing, but I think it says a lot)
Last night, Jason and I were invited out to dinner (which I could have played it safe, who knows... I could get sick or sleepy while out) but we went, I overdressed, and had a great time. To tell you the truth, not only was the company and food great, but it was by far the fanciest dinner we had ever gone to. Which of course I did not mention there, in fear of sounding a bit like a hick.(Thank God River wasn't there... he takes his shoes off everywhere, including all restaurants. tehehee) This was obviously NOT their first fancy dinner. The dessert alone cost as much as what I try to normally order my entree at... but it was gooooood! However, after we got home I thought about it; and even though I would have had a coronary if Jason and I had paid for that meal prior to this experience, It was something that I now think everyone should experience -- at least once. It was such a treat. I personally am a food lover anyway, but to experience such rich, beautifully prepared food was definitely one of my moments.
And to our friends, if you are reading this (and I hope that you aren't. tehehe)... Thank you so much for a lovely dinner... Now give me a goody bag or all of your secrets and inner-workings will be blogged. (Just kidding - really)    

Just a lil Thank YOU!!

I'm just sitting here getting my Magnificent Magnesium drip again... waiting for my tacos (tehehe) and reading my latest comments from my friends (old and new) and family and wanted to give you all a huge THANK YOU! For all of your support, love, and laughs. It really helps, more then you know! Hopefully I will be able to repay the favor some day. Love and prayers are being sent your way, and for all of us that are fighting battles... Lets keep the faith. We can do it!!

Good News / Bad News

The good news is, My liver is not in rejection, nor is there any of the Hep C virus present in my new liver (yet). Sally is a happy camper, and I will be going home tonight (after more magnesium, of course)
Now the not so good news. While doing my MRCP (which is similar to an MRI) The doctors noticed a mass, a possible cyst on my ovary. (Which I have had before and are quite common) They wanted to investigate. So this afternoon, I was sent down for a pelvic ultrasound (the "invasive" kind... and I'll just leave it at that) When I asked if I could see the cyst, my tech said she wasn't so sure it was a cyst... she wasn't quite sure what it was. "Oh, oh" I thought... I watched her spend a lot of time on the left ovary, and then as I was ready to be wheeled back to my room, she did the dreaded shoulder tap. (Not good) On the way back, I started thinking of all the things it could be... maybe just a clump of scar tissue from when I had my partial hysterectomy? But my mind kept going back to my AFP levels. Just before my transplant, my AFP tumor marker began raising, which doctors automatically attributed to my Hep C/Cirrhosis.... Besides, who would have Ovarian cancer at my age, on top of a failing liver?
My nurse coordinator came in soon after I got back from the test, and I asked her, could it be scar tissue? Good thinking, but no, It is a complex mass. (darn, to easy) At that point I asked about the AFP levels prior to my transplant... and as I am typing this right now, a lab tech is leaving my room. He just drew blood to check on the AFP levels now, post transplant. (They should be back under 20, I believe, since Sally is doing great!) If they are still elevated and in the hundreds like they were before, I'd say we have a problem, but I am no doctor. I did get told I was Doctor Sher's favorite patient for being so proactive, and knowing about this... But right now I'm kind of kicking myself for not being a little more proactive earlier. I had thought about it before, because I have been having some pain in that area, a sort of tightness. But wouldn't my primary doctor have thought about it too? Of course this is the same doctor that kept prescribing me anti-depressants for my decompensated cirrhosis, and never once followed up on any of the symptoms like constant vomiting and edema/ascites.
Any ways,no point in crying over spilled milk now. They want follow up done by a gynecologist within 1 week. It could be Cystic neoplasm, a dilated fallopian tube, or a follicular cyst. However, if these AFP levels are still on the rise, that is going to be a very bad sign that is not the latter two.
I do believe that it can't just be coincidence that they happen to see this now, so whatever it is... I know I'll get through it like I have all the other things... but coooooooooooome on!! Give me a break here. hehee. (Big sigh) I'll keep you all posted, but I doubt I'll get out of this without at least a few more invasive tests and another biopsied organ.

          ...you can go ahead and print that out and blow it up. teheheheee (I would... but my luck I would end up with some head trauma too.)

It's 9:00, do you know where your meds are?

 As soon as my urgent sounding phone rings at 9:00 AM and PM I make my "blaaaah" face and then frantically jump up to grab a Gogurt (or whatever I have on hand) so that I can take my medi-cocktail. Right now, it is an ever changing combo, and definitely feels like two more complete meals. It is also slightly embarrassing if we happen to be out and about at the time my (The alarm itself is a big "HEY, LOOK AT ME")... but, I learned real fast to keep my next dose of meds with me if I go anywhere. You never know where your day may take you, and it sucks having to cut it short to go home and pop your pills... and I don't think a cop would let me slide if I said I was speeding home to take my pills on time. hehehee. Yes, I do know the importance of these pills (and my fungal jungle juice too) ...It really is a big responsibility taking care of someone elses liver!
Since my liver numbers are not dropping like they should be, my combination is pretty much changing every time I have my labs drawn, which is, right now, every Monday, Wednesday, and Friday. This last Friday when I went to check in for my labs, my registration said "labs and biopsy" (Double Gulp) but after getting my lab results back, my counts had not gone up (or down :() so that meant no biopsy again, at least for this week. Sally and I were very happy! I am still very concerned about my HCV, and why Sally is not improving much anymore, but I will try hard not to worry about it until I know more. I'll just continue to try my hardest to keep my new liver happy and healthy... and try to keep my constantly changing meds straight. Luckily, (and I hate to be mean, but...) my nurse coordinator was "let go" this week. I was having some real trouble with her, not only was she very difficult for me to understand (you should have heard us on the phone every time my meds changed... Kind of important information to get lost in translation), but she was also not very helpful, and well... sometimes plain rude. (Not to mention, she forgot about me at least twice while I was waiting for my results so that I could go home... the last time adding a total of 4 hours to my wait at USC.) I was sick to my stomach having to go in there Friday, and asking if I could change my coordinator. (Though I admit, I am VERY proud of myself for doing it) God knows I hate confrontation, but as soon as I (quietly) said it out loud, I received a smile and 4 great words "She's no longer here" Problem solved... and I had nothing to do with it, (I think) And just to say, she is the only one I've had problems with at USC. But  I digress. Muwahahahaa. --Back to my meds... Soon, hopefully we will get them regular and later, start slowly removing some of them. They do have side effects, some causing skin cancer, kidney problems, ulcers/bowel problems, diabetes, high blood-pressure, balding, Roid-rage, moon face... just to name a few (and these are the common ones, I believe it is something like 75% of transplant patients get skin cancer) Needless to say, I'm keeping my sunscreen near the door, and am on the look out for a cute umbrella with UV protection.

Below is my list of meds... and being that it is Saturday night, it is also part of my new routine to prepare my pills for the week. (whoa nelly, I'm party animal!!) hehee.

• Prograf (Immunosuppressant) Side effects include insomnia, tremors, headache, high blod pressure, high blood sugar, hair loss.
• Cellcept (Immunosuppressant) Side effects include diarrhea, nausea, abdominal discomfort, and changes in blood cells count.
• Prednisone (Immunosuppressant) Side effects include stomach ulcers, huger, weight gain, swelling, moon-face, high blood sugar, acne, mood swings, bone weakening, and cataracts.
• Pepcid (Antacid) protects from all the above anti-rejection meds, especially the Prednisone.
• Bactrim (Anti-Bacterial) Side effects include nausea, diarrhea, and rash
• Nystatin (Anti-fungal) ...I call this my jungle fungal juice. Side effects include skin irritation, acne, skin streaking, unusual hair growth, and dryness.
• Valcyte (Anti-viral) Side effects include diarrhea, constipation, nausea, headaches, and dizziness.
• Magnesium-Oxide (Mineral) Side effect (just the normal one) is diarrhea.
• Prozac (Anti-depressant) ...I've got nothing but love for my prozac. tehehee

I have to say that so far (at least for me) none of the side-effects have been half as bad as how bad it was prior to my transplant... have I mentioned I STILL haven't thrown up since the morning of my surgery... (Not sure I'll ever get over that!! So amazing)

By the way, do you like my temporary tattoo? tehehe, as soon as I can, I'll have one much more permanent. (shhhhh, don't tell my docs - jk, I go to a very professional and STERILE artist.) And don't worry, I will tell my docs myself... they are only there to help.

What's goin' on now!?!

Hey guy and gals, I have been trying to write this update since last weeks blood tests, and have just decided to be honest without the fluff. Last week for the first time, they brought up the "R" word, which is common (and scary enough) for us transplant patients, but what I was mostly concerned about, was the thought that my Hepatitis C could be coming back strong (which the doctors have been telling me not to worry about that yet since day 1 post transplant... until yesterday) This weeks appointment, my levels had raised again slightly which began to raise a red flag, that maaaaaybe it is time to start worrying about it for me. Hepatitis C will always come back to invade the new liver post transplant, but one can only hope that it will cause little or no damage to this new gift, or at least take another 30 years or longer to destroy it completely. However, this is not always the case. Studies show that in some cases, HCV will come back with a vengeance and cause cirrhosis and liver failure with in 5 years post transplant. (That puts me at about 35 years old... River at 9) To which I was told by a doctor, "That is better then the 1 - 2 years we gave you prior to your transplant" (True, but so NOT what I wanted to hear.)

So tomorrow, I will have labs again, and will most likely be admitted for more tests, including a biopsy on Thursday. (which I am actually happy that they will be going through the neck artery, down to my liver to pull the sample - I may be weird, but it sounds less invasive to me) This will tell us if it is rejection or my Hepatitis C that is causing elevated counts. ~~I have no idea which one I'm supposed to be praying for... except that maybe it's just a fluke, and the counts will just start dropping again? But if not, something will need to be done.
The treatments for these two things are opposite of each other. For rejection, they will need to raise my anti-rejection medications, for HCV, they will need to try to lower the anti-rejection meds as much as possible to slow the progression of the Hep... however, they need to be careful, because lowering it to much will cause a rejection episode... it's all about balancing the necessary evil.
They are also trying to figure out why my Magnesium is still dropping so much. Supposedly it is normal for a few weeks after surgery... but not this far out. The main way Magnesium is lost, is through urine... so (it doesn't seem like a good idea to me, but I'll go with it) they want me to raise my salt intake... the theory being that I will retain water, not pee as much, and keep what magnesium I absorb in, instead of losing it to the fishies.) We'll see how that goes... but I'm not holding my breath on not needing an infusion anytime soon.
I am trying to control myself, trying to take it easy, which I messed up on today by picking up River to put him in his room... it was quick - I realized it as soon as I did it... but it did hurt, so I definitely need to still heal some. I also noticed that my main bald spot has gotten slightly bigger, but at least it is coming out a little slower then I originally thought, and a lot slower then it did when I was on the Peg-intron treatment (Those were serious clumps... and let me just add, when you are sick, losing hair and taking a shower, it is best to keep your puke bucket with you because you do NOT want to clean that mess out of your drain. blaahhh) Not that I have had to worry about that since my transplant... I haven't thrown up since the morning of my surgery!! So besides waiting for the outcome of tomorrow... everything is going pretty good!!

A lil more on Perez... I think I'm a boxing fan now.

Just a few more pictures...(I stole from Melissa) :)

 Photo report: Perez-Campos

Photos and report by Rocco Morales
Before an enthusiastic crowd at the open air Pico Rivera Sports Arena, NABO super featherweight titlist, Eloy Perez, proved that he is amongst the elite in his division by totally overwhelming the solid Derrick Campos. In a scheduled 8 round non-title contest, Perez used his lightning fast jab to set the tempo of the fight and keep Campos at the end of his punches. This strategy worked to perfection for as Campos only knew one direction, and that was straight forward, causing him to eat jab after jab from Perez.

Photos: Rocco Morales

Click the photo to go to the next photo

The best moment of the fight for Campos came at the end of the second round when he threw numerous punches after the bell had sounded to end the round. Other than that, however, it was all Perez.
By the fourth round, Perez had worn down Campos enough with the jab to start sitting down on his other punches and began landing his right cross nearly at will, puffing up Campos face considerably. Perez, who entered this fight with just 4 knockouts in 19 career fights, appeared to be a much more effective puncher than that statistic would indicate.
By the beginning of the fifth round, Campos looked to be a beaten fighter but, nonetheless, came out and gave it his all. Campos’ effort, however, was in vain, as Perez was just too fast and too strong. Midway through the round, the referee hovered nearby keeping a very close eye on Campos who appeared to be in major trouble.
Perez unleashed one final assault and Campos had no answer for it, leading the referee to waive off the fight, much to the chagrin of Campos, at 2:02 of the fifth round. In what would be his 29th professional fight, Campos was stopped for the first time of his career by the world class Perez.
With the victory, Perez improves to (18-0-2, 5 KOs) while Campos drops to
(20-9, 11 KOs). Perez, just 23 years old and currently ranked #3 in the world by the WBO, appears to have a very bright future.

1 month POST Transplant

Whooo hoooo!! Yesterday was my 1 month anniversary (I know, I'm like a teenager again, celebrating my 1 month) tehehee... Can't help it, I'm so proud!! And to top it off, I had a GREAT night out, thanks to my friend Melissa and Garcia Boxing (and my mom for watching River) We went to the Eloy "Prince" Perez fight, and watched him TKO Campos is the 5th round. Now I must admit, usually I am more of a lover then a fighter, but even I was screaming (well, kind of...I don't really have any stomach muscles right now) for my man sporting a HUGE green ribbon for Organ Donation and kickin' some serious butt! I had taken some green ribbons for my friends to wear, but was almost in tears (Couldn't cry, cuz I didn't want my mascara to run on the tele') when Perez's team came out with green ribbons everywhere! How in the world did I manage that you're wondering... Well, I have amazing friends of course!! Garcia Boxing (who trains Perez) is no stranger to the shortage of organ donors. Max Garcia is the dad to a life-long friend of mine, Melissa, and 2 years ago, he was fighting for his life, waiting for a kidney. Like Nancy, Max had a living angel -- Angela, who donated one of her kidneys so that he could live... and living he is doing!! Lookin' GOOOOD!! I felt like a Princess, getting special treatment, even when I hugged Eloy and congratulated him on his victory, he did the same, insisting that my fight was a tougher one. (of course I puffed out my chest and did a little 1, 2 move. hehee) and today, I feel like I took a few punches to the body, but I wouldn't trade it for the world. It was another amazing night that I would never have experienced otherwise.

Even Sugar Shane Mosley was in the "green" spirit last night!! We got the word out to some people who didn't even know what the green ribbon represented when they first got to that fight last night, which was my main goal! We did good! It made me all the more anxious to get my organization up and running... I know, I need to finish recovering first, but I have so many new friends that are still in desperate need of organs, so I need to get on it, and fast!! I also know that in many cases, HCV returns and can destroy my new liver within 5 years... which means, well, I may have to do this all again... and it is my goal to not need a living donor the next time, because there will be no waiting list! It's a big demand, which would require just about everyone to become an organ donor, but call me hopelessly optamistic, because I think we can do it! ...It all starts with awareness, and that only takes me and YOU. So lets see what we can do! Even the smallest pebble will cause a ripple effect.

The BIG "R"!!!

  That's Rejection... (not Ricki) Though neither one of us are to be feared, I'm not to be taken as serious as the big R. heheee... 
Why am I even mentioning the R word, bad ju-ju!!! (nope, I don't believe in that... just ask my surgeon, who after the 5th or 20th time of me mentioning my previous DIC episode before my transplant, finally looked over at me and said straight out... "Shhh, don't mention that word again, we don't talk about that in the hospital" ...Like I was the CRAZY one) Anywho, yesterday was my clinic day, and I knew it was going to be a long one because I needed my magnesium fix. The last few weeks I have been getting infusions twice a week, but this was the first time I had gone 7 whole days without it... and I was feeling it. By Sunday night, I felt like I could pass out at any second from exhaustion. However, when they did my lab work, they also found that my ALT and AST levels had slightly raised, which can mean rejection...
So, what's the plan? More hospitalization? Another liver transplant?? Possibly, but not likely... Most likely, they will just need to change up my anti-rejection meds... Ok, not "just" but they have been doing this for years now, and have gotten pretty good at it, so I trust completely that they know what they are doing and will get my body behaving nicely to Sally again. 
So last night, my nurse called me back and told me to raise my Prograf .5mg and come back on Wednesday morning to see if the counts have gone down any. If not, then... well we will take it from there, but most likely I'll be getting more USC tacos (and you know how I likes me some tacos) ...I'll keep you posted.
Below is some information on rejection (for us liver patients, different organs have different signs). It is the word that any of us transplant patients dread to hear, for fear of losing our precious gift. However, it is more common then I thought, and if caught on time, can be treated successfully. Whoo hoo!!

Rejection

The body's immune system protects a person from infection by recognizing certain foreign substances, such as bacteria and viruses, and destroying them. Unfortunately, the immune system recognizes a new liver as a foreign substance also. Rejection is an attempt by the immune system to attack the transplanted liver and destroy it. To prevent rejection from occurring, a recovering patient must take immunosuppressive medications, as prescribed, for the rest of his life.
In spite of all precautions, rejection episodes can occur. Up to 75% of all liver-transplant recipients will have at least one rejection episode, even though these people are taking immunosuppressants. The first episode often occurs within 2 months of surgery. Rejections are usually controlled by changing the dosages of immunosuppressive medications or temporarily adding a new one.
If detected early, most rejection episodes can be treated successfully. A patient should be alert to the signs and symptoms of rejection and inform his transplant team promptly if he has the following.

• fatigue
• fever
• abdominal pain or tenderness
• dark yellow/orange urine
• clay-colored stools

A patient may not have any symptoms, but his liver-function tests may be abnormal, suggesting that rejection is occurring. This is why maintaining a strict appointment schedule with the transplant team is critical. When rejection is suspected, it is usually confirmed by a liver biopsy. Based on the results, the transplant team will decide the best treatment. As with all transplant patients, a patient may have biopsies at regular intervals to monitor his liver function.

I've got the FEVER... Cabin fever that is.

Wow, mentally I feel like I have been out of the hospital for months... though, my physical "feelings" reminds me that it has only been about 3 weeks since my transplant. Still no driving, no lifting my son, bending over is still quite painful, and with all these bruises, I look like a serious domestic violence case. Actually, the last time I was getting my Magnesium infusion one of the nurses asked me if I was in a violent relationship... I said "Yes, but only with you nurses" heheheee.
Since this is my 6th surgery, I thought for sure I would be used to it, but I guess it is something you never really get used to - being dependent on others... I can't even open my windows, well... I'm not supposed to, but you try living in Southern California in summer and your husband forgets to open the windows before he leaves for his 12 hour day.
Speaking of my husband... Please pray for him. He is running around so much, he looks like a chicken with his head cut off. Being that he is "free-lance" if he doesn't work, he doesn't get paid and probably would be let go real fast, but since he is the only one bringing in any real income... he has to work, which means that pretty much a few days after my surgery, River and I were pawned off on my poor mom. Which isn't so bad, for the two of us at least, except sometimes I feel like a kid again... and there is a reason kids leave home at 18. hehehee. I will be happy when I can stand on my own two feet again! ...I think Jason has lost weight, we aren't eating properly, and no offense to my husband, because the fact that he has started cooking dinner for us in the first place is VERY impressive, but I am getting a little tired of broiled chicken, green beans, and white rice (sometimes he broils fish instead - same seasoning so it starts to all just taste like Ficken) heheee, it's actually very good, but we have it 3 to 4 times a week, soooo ya! I have started cooking a few side dishes this week... Spanish Rice, Gnocci's (Ok, I used the Gnocci's Jason's Grandma made and sent up, but I made the sauce) and I think by next week, I'll be able to cook a full meal without sitting down or taking a pain pill (which don't really work anyways - stupid glorified Tylenol) Not this week though. My ribs are one of the main things that bothers me. (In order to put Sally in, they had to separate and hold my ribs apart) ...Bra's are really tricky right now - I know, TMI Ricki, TMI!! Back to Jason, He also has to do all the grocery shopping, cleaning the kitty litter box (forever now, since I cannot be near animal feces with my new liver... awe, darn!) and, he has to deal with ME on STEROIDS, can you say ROID-RAGE. I am on an emotional roller coaster, and not used to being this tightly wound. One little thing can get my blood boiling, but hopefully my doses will be lowered soon. This will help the balding too, yup... one more side effect from anti-rejection meds. I swear, luckily I am not vein, and happen to be a fan of Sinead O'Connor, tehehee, but again... My poor husband.
Sometimes bad thoughts come into my head. I wonder if I made the right choice, or was I selfish and cheated my death? Was this Gods plan, or did I force the hand? Am I really someone who deserved this gift when so many others are still suffering and dying? Is my Hep C going to come back with a vengeance to rectify my fate?

Don't worry, these thoughts ARE normal! They disappear just as quickly as they came, and honestly, I do believe that it is mostly due to the medicine and cabin fever... maybe a little bit of fear too, the devil tries to get in there, but I am confident - and MOST of the time, I am just plain happy to be alive and not puking! :) OH, and here is a little article (one of many) just to prove I'm normal.
http://www.hepatitis.va.gov/vahep?page=trans-03-02 I will admit that for me, it is all about keeping my mind busy, which isn't to hard with a wild 4 year old running circles around me and asking questions about everything under the sun. Staying connected to the outside world helps too, even if it is just by writing or facebook and twitter, although sometimes I do have to force myself to do these things too. Hopefully soon I will be right as rain, and can focus on what I really want to do, a program to help transplant patients, mentally and financially. Don't laugh, I think it helps that I in fact need help... with BOTH of these things. hahaha. I do have knowledge to share though... This ain't my first rodeo!
Whoooooooooo hoooooooooo! LIFE, live it then give it!!

Weren't you just here?!?

Sometimes you wanna go where everybody knows your name... Unfortunately for me, that would be the hospital. tehehee. The statistics are high for returning into the hospital after transplant, (20 - 70% of patients experience rejection, not to mention the risk of infection due to the anti-rejection meds and the possibility of bile leaks. I am actually doing pretty dang good so far, if I do say so myself. However, I still get my fair share of the hospital. I have "clinic" every Monday, and up until today, I had to (well Jason or Lee had to) make the drive to USC so I could have labs done on Thursdays too -- always resulting in me needing more magnesium. Not to mention the extra trip we made last weekend when I noticed some redness and oozing at my incision site, which in combination with a high white blood cell count (meaning possible infection) caused them to admit me for another night... of course, some more Magnesium and -- more tacos! The culprit of my magnesium continuously dropping below normal is the Prograf - one of the three anti-rejection medications I take. I start to notice I am pooped out, shakey and weak. The IV infusions do the trick, but only seem to last about 2 days and then I start to fade back into that ol' familiar feeling again...Which I was feeling early this morning, pre appointment.
I went in and got my normal hugs and hello's at the lab and then the tx clinic, but again I was sentenced to 2-4  hours of being tethered down to my pal flo. (yes, that's my I.V. machines name.) So I am also becoming known at the "Evaluation clinic", which is where I've been going twice a week to get my magnesium... they even ordered me lunch today  -- more tacos :) I also met a nurse who was at the Donate Life walk in May (Which is pretty impressive for her to remember... I still can't do that without my H.E.) but I digress... The real news is, I got my staples out today!! I am now foreign object freeeeeeee, well except for my new healthy liver, but I don't really consider Sally foreign anyways. They also lowered my Prednisone, which is another of my anti-rejection medication that is also a steroid, and YES, it gives me ROID-RAGE, so my family is happier today too! Yup, things are definitely looking up and after my infusions I feel better and more awake then I have in almost 10 years! Ahhh, to be what the lucky ones call "normal"!!