Time is moving on. As we try and coordinate this we aren't feeling any great sense of urgency on anyone's part, so we're not overly concerned. Although maybe we should have been.

Jackie and I found that doctors (or at least good doctors) are so busy that most of the sense of urgency in your treatment must come from you. Doctors today are very event driven. You are in their attention span when you are in front of them -- for an office visit or in an emergency -- their attention is all yours. But it drops considerably when you are not in front of them. So make your case continuously.

And so we went to get the second opinion. This doctor ran his office very differently -- he really empowered his nurses. The nurse came in and spent a considerable amount of time with us -- getting history, talking about chemo reactions, nausea control and lots of other things. This is not to say that direct doctor interaction is bad, but again, it's hard to get a lot of attention from a good established doctor.

Finally, the doctor comes in. He agrees with all the options presented so far, and adds another, an autologous bone marrow transplant (ABMT). Well, so much for being experts, here was something new for us to learn about. In the second opinion the doctor wasn't very hopeful about Jackie's chances, and while he wasn't predicting imminent death, he suggested that an ABMT was the only potential cure. He did have two cautionary notes. The first was that it was aggressive and therefore dangerous. The second was that not all insurance companies would pay for them, some insurance companies considered them experimental. He said that they are expensive -- in the $150,000 to $200,000 range. That's a lot of money.