I have friends here that care, other readers please ignore.
We were at Mayo Monday and Wednesday.
We now have a course of action and treatment.
Diagnosis is 99% sure that Mary's disease is primary light-chain amyloidosis involving her heart and gut. The 1% doubt that will be resolved with lab results not yet available concerns the particular form of the disease but it's really a matter of i-dotting and t-crossing confirmation of other diagnostic results.
This is an incurable disease, a form of cancer. It's akin to leukemia in that it involves white blood cells, different in that it involves different white cells.
It's rare, 8 people per million rare. Nobody knows more about it than Mayo. It is a very difficult disease to treat because it has many dimensions and manifestations, and interactions with other issues like cardiac, gastrointestinal and all other organs though Mary's issues at present are cardiac and GI.
Because there is clearly cardiac involvement and damage, sudden death by heart failure is more probable than for a person without such damage. We agree that sudden death by heart failure or whatever purely beats the hell out of a lingering death fraught with pain. Neither of us wants to survive the other. We've been teammates since forever. We each and both are a bit selfish in not wanting to be a grieving survivor, and we share a sense of humor about that. It's a bad idea to piss my Mary off, but she does appreciate a good joke.
We think we have top-notch professionals in hemotology, oncology and cardiology on Mary's team.
An initial chemotherapy regimen has been defined, which Mary will begin immedately. Meanwhile, the cardiologists will try to manage the conflicting issues of low blood pressure (hence seriously diminished physical capacity) vs edema, vs side effects from the chemo.
Mary's sense of humor is undiminished.
The cardiologist of late appointment today, upon first encounter with Mary, noted discoloration of her nose. What up with that? I paraphrase, the cardiologist was Indian, not Afro. Anyway, Mar noted that a fellow patient in an aside in the waiting room said "I sure hope you're having a better day than I am." The guy was 79 and we think that he received some very bad news about either himself or his wife but probably himself (the self-centered asshole!) I'd noticed the despair in this man when he plopped into a chair in the waiting area but I didn't observe the interaction between him and Mary. Mary had cried a bit for him so her nose was red.
Why do I love her so?
We noted this evening that Rochester is 90 minutes bed-to-bed. That's an easy commute. We'll probably be doing that with some frequency.