@hello1234, Dr. Mour says and notes he wants hubby to be seen again in 2 weeks. I had to call our nurse coordinator to tell her that because the video conferencing was not yet ordered. But like you had mentioned earlier, perhaps it's Mayo's protocol to meet with with patient directly when they're going to be introducing a new med cocktail.
One thing that may make a difference is we do not know who the provider will be, may not be Dr. Mour again which means a different provider may have a different opinion. The nurse coordinator says the Mayo providers rotate in and out, one week doing out patient clinic, and other in-patient. Hoping whoever we get that they will stay consistent in their decision making regarding med changes.
Regarding home hemo, hubby opted not to get a fistula because we had a hunch that hubby may get a call from Mayo soon. And sure enough about 8 months after Mayo eval they called to say they had a kidney for him. He had a Central Venous Catheter and we had to keep it pristinely clean to avoid infections. Used a special dressing for the CVC, special precautions had to be taken when showering, then dressing the CVC after. After done showering it was 20 minutes of cleaning/dressing the CVC, cleaning the wings and the lumens with alcohol, cleaning the skin around the CVC with Except, wrapping the lumens with gauze and dress it with flexible netting, etc. It was a lot of work and must follow protocols to keep it sanitary! My hubby was on home hemo for about 2 years and never ever got an infection from using CVC. However, the Mayo staff does encourage CVCs because they are prone to infections( if not properly taken care of), but it did make giving home hemo dialysis easier because it was plug and go. Also, the dialysis center was more lenient in letting us use the CVC because we were doing home hemo, thus less germs than in-center. My hubby said when he got dialysis at Mayo, that the dialysis staff liked the way I dressed his CVC!! And when he was scheduled to had his CVC removed after transplant, the two nurses who removed it said I met the gold standard in caring for the CVC!! I think they had expected to see something gross come out but the all the parts of the CVC was as good as new. And, it was the only CVC he ever had, he didn't have to replace it because it was still working well even after 2 years!! I was prepared to learn about different cannulation methods had our dialysis center insisted upon it but I guess they didn't push us because we never had any issues with infections and my husband was showing good clearance in his labs!

@hello1234,

Regarding the appointment in 2 weeks - like you, my initial thought was why would you need a video appointment to start Sirolimus? You make a good point so I'm going to ask the nurse to see if it's really necessary to have the video appointment when they're already reviewing weekly labs.
Question: when you have an appointment with your transplant team, are you sometimes assigned to a PA, not getting an MD depending on availability?