It's been a long day.  We started at 930 with the first appointment and left after 500.   But we saw three doctors and she had an echo.  We didn't learn much new information but confirmed what we already new.  Her kidney function is slightly decreasing and her pulmonary artery pressures are continuing to inch up.  Her estimated pressures from the echo was 76 and the right side of her heart is on the border between moderately to severely enlarged.  The discussion es today centered around what to do next.  The Drs want to add a new PH medicine which is super expensive and has to be approved by insurance along with at some point starting plasmapheresis again to calm the underlying disease.  They are checking a bunch of labs to make sure they weren't missing anything.  So we are waiting on approval and labs to be checked to determine the next course of action.

God continues to be good by supplying the best Drs.  Pray for wisdom for the Drs and insurance approval.  

Matt