[Lisa V]

David, one of the things about having SAA is that you don't have the luxury (or agony) of a "watch and wait" period. As soon as my husband was diagnosed, he was treated, BAM! Blood tests a year or so earlier had been all normal.

I wasn't aware of it at the time, but having MAA really is a different sort of scenario, for better or for worse. Waiting is frustrating, and at first I didn't understand why doctors would not give ATG at the first sign of pancytopenia. Now I get it; it's because ATG doesn't necessarily return you to full normal counts. Often it just puts you back into the MAA category. As long as you are not requiring transfusions it's considered a success. Still, I think there are some doctors who are experimenting with giving ATG for MAA, just to see if it can turn it around before it becomes SAA. I don't know what the results have been, but it might be something to research.

Basically, if you are considering trying any alternative or "non-standard" treatments, now would be a good time to try them, when you don't have so much at stake. Some people have shown varying degrees of improvement following strict nutritional guidelines, Chinese herbal remedies, etc. If you wait until your counts are so low you're being transfused, however, the chances of any lifestyle changes bringing about a sudden dramatic turnaround seem pretty slim. At that point, you have to start looking at the big guns: ATG, BMT, hy-cy, etc.

This would also be a good time to research all of your options, so that when you do get there you know what you're getting into and can make informed decisions. It might be good to find out if you have a sibling match, although some doctors seem to put this off until absolutely necessary, probably because testing is very expensive. If you think you may be going that route, it couldn't hurt to make some financial preparations too if you can. Just a thought.