Anne’s greatest concern was that her Raynaud’s would progress to systemic scleroderma. Historically, treatment has been supportive. Intubation with a “woody” neck is often more than problematic. Systemic sclerosis impacts the heart and gastrointestinal tract. On an EKG, Anne was diagnosed as having a total heart block. A biventricular pacemaker was inserted. Dr.. Broussard put Anne on CAR-T Therapy. Anne’s T cells were collected and modified to destroy B cells that create autoimmune antibodies. CAR-T stands for chimeric antigen receptors. CAR-T treatment stops or slows down the progression of scleroderma. Her hands would never be normal. Anne’s disease progressed to her lungs over time with pulmonary hypertension, after four years on the faculty. The pulmonary hypertension team at Tulane became involved and started treatment.