On August 22 Jim experienced shortness of breathe. Tried an extra water pill since that worked before. Later that day we headed to the ER since he continued uncomfortable. He was admitted to the cardiac floor for diuretics and monitoring the Drs felt fluid overload. By morning not much had changed and the on call cardiologist came in stating he felt something else was going on and Jim would do best. At St. Likes. Full to capacity he was not transferred until 8/24. His transplant cardiologist was concerned of a blockage. That caused the changes to his heart seen that morning on echo,. The right side of his heart is not moving And the muscle weakened. He was scheduled for a heart catheterization later that day. It was found that he has many small blockages. Too many to fix but clearly not the cause. His heart pressures were extremely high meaning too much fluid. Continue diuretics agressively. By the next day the doctors decided his body is making antibodies attacking the heart. Rejection. Not the typical rejection seen. During early transplant. Saturday 8/26 plasmaphoresis was started to filter blood removing plasma that contains the antibodies. This is followed with a dose of chemo to kill any bad cells left. He is to complete 4 cycles of this in a 12 day block. In the mean time his kidneys are not working well so he was started on continuous dialysis. That continued til noon on Monday 8/29. This morning still no marked urine production so. Dialysis restarted but 3 hrs few times a week . hoping that if heart function improves so will kidneys. Once the treatment is completed they will do another cardiac Cath and re assess heart function, today 8/30/16 jim signed consents for plan b. If This does not work they have started the work up for a heart kidney transplant. If testing Works out and a committee feels he is a candidate he will go on the list. Higher risks second time around. Jim's spirits remain good. He is always a trooper.