[Lisa V]

Vera, it would be impossible to read Mark's entire journal in a night! It's nearly three years worth of entries, some quite lengthy and detailed, and almost daily during the main part of the process. It's particularly hard when you know how it's going to end, his words take on a bittersweet resonance that was surely not intended at the time. Still, it's worth reading for two reasons: first, because everyone who takes the time to share their insights on this process with the rest of us helps us in our understanding of the road we may find ourselves walking down at some point, and second, because Mark is simply worth getting to know, and his passing doesn't change that.

Having followed his progress over the least several years, I can tell you that he had exhausted several other options (ATG, Campath, androgen therapy, nutritional changes, etc.) before coming to the reluctant conclusion that transplant was his only remaining hope. It was a very difficult decision for him to make, and he was not shy about sharing his innermost feelings with the rest of us on the Aplastic Central forum. He was fortunate to have a very good MUD available and was still just under the 40 yr. old marker, so he psyched himself up and went for it!

The actual transplant took place in June 2007, and despite a rollercoaster ride of complications, his life seemed to be returning to normal and he was lucky enough to be able to finally meet his donor, with whom he felt an almost fraternal bond. That was a joy to read about! Unfortunately he had a recurring problem with BOOP, a type of lung GVHD, which eventually forced him to rely on oxygen 24/7. In addition, he had already survived one battle with sepsis.

I'm not sure what brought on the second round of sepsis. He had been feeling "off" and his counts were down, but his doctor initially told him the tests were negative for sepsis or anything serious. That didn't last, however. He became not only septic but was also suffering from kidney failure, liver upset and C. difficile in his gut. Not a good combination, and low Hgb apparently wasn't helping his heart any either. Oddly enough, the lung issues that had been plaguing him seemed not to be part of the equation here.

Anyway, I'm not qualified to analyze any of this, I only bring it up because I think it's important to understand that even with a successful transplant it's possible to have severe complications more than 2 years later. Hopefully this will help people who are considering BMT to realize what a major, long-term process this is. Not to discourage anyone, but an informed decision is always the best one.

RIP Mark, we'll miss you!