Tuesday, November 22, 2011

Normal? (Gulp)

Isis is licking off Indiana's breakfast.

Things are going shockingly well here. Life, in Indiana's mind, is back to normal. (With the exception of bandage changes--she does hate those) She is feeling good, eating well, getting around probably slightly better than normal (but still having trouble getting up). Maybe she knows she has a hole in her back. I know she knows she has a bandage on it. Indy has always hated wearing anything, be it bandages or clothes. This is why I walked into the hallway last night to find her fast asleep with her bandage pulled off and all the honey licked off. Booger.

Months and months ago, my family and I decided to spend the Thanksgiving holiday at my parents' cabin on a lake in central Illinois. Jim and I try to take the dogs there 2-3 times a year, to relax, and to get a change of scenery. It's kind of my happy place, a place that represents togetherness and family, and a lack of stress. We've never spent a holiday down there, but have been talking about it since my aunt died in 2009. Holidays in our own homes bring back too many memories, not that memories are bad. But the loss is still fresh enough that recreating the holidays, but without one of the essential parts, is just too painful. We knew we'd enjoy the holiday more by creating something new.

Our plans were thrown into question last week when Indiana got sick. We weren't sure if we'd still be able to go. But with Indiana's miraculous upswing, and the fact that her illness and our treatment of it wouldn't require an emergency vet visit, we realized we'd be safe to keep our plans.

The bandages are going with. So are all the medicines and treatments that are keeping her alive and healthy. But so are my parents, and their dog, and our best friends, and their dog. (And yes, for those keeping track, that's 6 adults and 4 dogs, all in a 900 square-foot, 2-bedroom cabin). And we'll be creating memories: new, happy memories.

Life throws you curve balls. Life is hard. Sometimes life sucks. But we soldier on. What was once normal no longer is, but we adapt and create a new normal.

This may be our last Thanksgiving with Indiana, but we don't want to dwell on the sadness of that. Instead, we'll be thankful to spend this holiday with her, making new memories and filling the time with love.

Monday, November 21, 2011

Keep on Keepin' On

So much fighting spirit!

Big developments over the weekend: the skin over the tumor fell off Sunday morning, and most of the tumor did too.  There's just a tiny bit left.  (And I haven't looked at it yet this morning, so, who knows?)  The last time I looked at it, which was last night, the mass was maybe the size of half a mushed-up kiwi.  (Does that make sense?  It does to me.)  And this is down from its large grapefruit size on Tuesday. 

I am astonished.

What we are left with now is a large, gaping wound.  It's probably 4 inches in diameter, so, I guess, fairly big.  But without flappy skin and a large tumor, it's actually pretty easy to clean.  Nolvasan, Manuka honey, bandage.  Repeat, repeat, repeat. 

I started a website to post pictures of the progress of the tumor.  Because of this experimental drug we're using, I wanted to keep track of the tumor's death.  I also wanted to keep track of how well the tumor responds to the Manuka honey, because I've heard it can do amazing things.  Anyway, I set up the page but haven't made the link public other than to mention it, once, on Facebook.  (If any of you want access, let me know, and I'll share it privately)  I'm not one to hide who I am or what I'm going through.  I blog about what's going on, and I post VERY frequent updates to Facebook to share with 215 of my closest friends.  But the pictures?  I was afraid to show that.  I still am.  I'm secure in what I'm doing, in the treatment choices that Jim and I have made.  But I'm fragile, people.  I'm an artiste.  We don't like being questioned or, God forbid, disagreed with.  What if the pictures got out and people didn't understand?  What if they thought I was letting my dog suffer?  That I was allowing her to be in pain?

I know what we're doing is right.  Indiana tells me every day, and, believe me, I'm looking for her response.  But I'm getting through this by sheer will and the love and support of more friends and family than I can count.  (How did I end up with so many wonderful animal people in my life?  I am overwhelmed!)  But I don't have room for negativity or disharmony right now.  If people think I'm wrong (and thankfully, no one has expressed that view to me), I don't want to know.  Which is why I'm keeping the photos semi-private for now.  Maybe I'll get brave later.  Who knows.

Back on track to the tumor, and, more importantly, the dog:  tumor = small/almost gone; hole left = kinda huge; dog = eating well, bright and perky, and completely kick-ass. 

Oh, how I love her so.

Friday, November 18, 2011

Hope, or, When Will I Learn

The Princess and The Papa

Cancer is always a roller coaster.  I learned that five and a half years ago, and, it seems, it's still true today. 

Though Indiana's been feeling pretty good, despite the soon-to-be-gaping hole in her back, it's always hard to tell what's going on inside a body.  Bleeding?  Organ failure?  Other tumors?  Plus, when you open up a large wound on the body of a living organism, other organisms, i.e. bacteria, want to live there.  So despite the fact the the tumor itself is not going to kill Indiana, secondary infection might.

In my head, and, well, in my eyes--this tumor looks nasty--I've been wondering how much time we have left, and this is the consummate question for any parent dealing with cancer.  How much time do we have?  I've known forever that this is variable, and often dogs can do much better than their stated prognosis; I've seen it many times.  But when it's your own pet, all previous knowledge is lost.  Advice you've given to others over the course of almost six years?  Out the door.  Suddenly, you're back to square one, turning to your support system for help.  You can't remember anything, and you're scared all over again. 

So after speaking with both of our vets over the last few days, I had a really unclear picture of where Indiana is headed.  What's going to take her, in the end?  Systemic infection?  Kidney failure?  Anemia?  And how quickly?  Any day?  Any week?  Any month? 

During a visit with our primary vet today, we discussed wound care and put a plan in place for keeping infection at bay.  The tumor will be losing its protective skin any time now, which isn't necessarily a bad thing.  We want the whole darn thing to slough off.  Gross, I know, but it's our best chance for survival.  But it opens up a huge wound--I'm anticipating about 4" in diameter--which will be difficult, though not impossible, to keep free of infection.  Twice-daily debridement with Nolvasan, followed by a healthy slathering of Manuka honey, and thrice-daily bandage changes are the plan.  This doesn't sound like a lot of work on paper, but I understand that wound care is terribly time-consuming.  Essentially, I'm clearing my schedule for the near future to deal with this. 

The best part?  My vet told us to expect an open wound for at least two months.  My reaction?  "We have two months?" I seriously didn't think she'd last that long.  Apparently, if we keep her free of infection, she definitely could still be with us.  I was floored.  And thrilled.

I know that our time with our girl is limited.  I know that at any time things could change.  I know that keeping the wound from becoming infected will be harder than it sounds.  But I am up for the challenge.  And so is Indiana.  How could I ever have doubted that?

Thursday, November 17, 2011

Continuing the Fight

Can't tell she's sick, huh?

Indiana has cancer. 

She's actually had it--well, we've known about it--for over a year.  At the time, it was a tiny little dot on her back.  Like a tiny grape under her skin.  Biopsy came back as an unspecified sarcoma.  The prognosis seemed good, as these types of cancer tend only to metastasize locally.  We opted to leave it alone.  Consults with both a kidney specialist and a cardiologist left us uneasy.  Anaesthesia is hard on the body.  What would it do to a 12-year old dog with a heart arrhythmia and kidney disease?  In consulting with an anaesthesiologist, the best she could tell me was that Indy had only a "slightly higher" risk of death from anaesthesia.  I didn't find that comforting.  In the presence of a localized, small tumor, it seemed prudent to avoid that path that potentially lead to instant death.

Now, 13 months later,  I am of course questioning that decision.  I knew where leaving the tumor alone could lead.  Did  I choose this for Indiana?  Did I give her cancer? 

A good friend said some very comforting words the other day.  She told me that at that juncture, where we had to make a decision, we were given two bad choices.  There wasn't a good, clear choice.  I didn't pass up a good choice and choose a bad one.  I chose the path that, while it might not end somewhere good, was a happier path with a quality of life.  But honestly, neither path had a happy ending.

Knowing all of this, I still struggle.  As parents, as good parents, we should always question our own decisions, to learn and to make sure we're always thinking of our pet's best interest.  It doesn't mean I won't feel guilt along the way, even if I know in my heart I did the right thing.  We want our pets to feel happy, to always protect them.  That's not always easy or even possible. 

We've been through a lot with Indiana in the last five and a half years.  She has proven herself to be a fighter, and indeed, even in this dark, scary time, she continues to fight.  Her eyes tell me so.  But it breaks my heart to see the open wound on her back, the hair shaved away.  I probably will never see it grow back.  As the blood oozes out of the holes in the tumor, the smell of death and decay oozes along with it, turning my stomach.  I am sick at not only the mass of deadly cells on her back but also at my own weakness.  I shouldn't be afraid of the blood, of the smell, of the torn skin.  But I am.  It gets harder every day, and I have to talk myself through removing the bandages in the morning, unsure of what I'll find.  I am angry at my weakness.  I am ashamed.

It's also hard to come to terms with the fact that we are in an endgame.  What parent doesn't want their child to live forever, even if we know they can't? 

This morning, when Jim and I awoke and walked into the living room, Indiana was lying on her bed, very still.  Jim approached her first, and as I got closer, I saw she was breathing but not moving.  We looked at each other, fear and heartache in our eyes.  We tried to rouse her, and she was slow to do so.  Was this her time?  Was this the end?  No, it wasn't.  Indiana was simply sleeping peacefully, exhausted after a busy day prior.  She eventually woke, and over the course of several hours, she walked outside, sat in the grass to survey her kingdom, and ate a hearty breakfast with much aplumb.  She even took her pills. 

Were we overreacting?  Sure.  But we also both know that our time is limited more than ever before.  I can't think about that much, because I know my heart will break into a thousand pieces if I do.  My coping mechanism?  Making Indiana's life perfect.  Jim and I are completely focused on creating a happy, peaceful home, free from stress.  Making the most of every day.  Of every moment. 

Some things in my life will have to go.  If it causes me stress, it has to go.  I can't bring that into my home.  I know that will make some people in my life unhappy.  But I am fortunate to know a huge number of animal lovers, who understand what I'm dealing with.  And ultimately, I don't care.  I have to make decisions that I can live with.  I alone have to deal with the consequences of my actions.  When Indy is gone, I need to make sure I can do that.  I will look back on my decisions and question them, dissect them.  Some will be good and some will not.  But I have to know that I gave all I had to her, that I fought just as hard as she, that when it came down to it, I gave her everything I had to give, as she has done for me every day of her life. 

We are down, but we are not out.

Wednesday, November 16, 2011

A Lazy Copy and Paste of My Facebook Update

I just got back with Indiana from a vet appointment with another vet. I ran into a friend who used to be Indy's vet over the weekend. (She only stopped being our bet because she moved away). Long story short, she saw my posts about Indiana's tumor and offered to give Indiana injections of a drug she is starting a trial on. It is pretty cool and seems like it could have fantastic implications for both humans and animals. Anyway, we went up to the suburbs to start the first of four weekly injections.

The trip was actually pretty great because (1) my good friend and personal vet tech Amanda went with us, (2) Indy had eaten well just before we left and was feeling really good, (3) another friend, who is a Reiki Master, was our vet tech, and we go to chat with her while Indy got Reiki, and (4) my vet friend is amazing.

She believes that Indy's tumor is just that--all new tumor growth. The quick advancement could mean that the tumor has become aggressive. She told me that Jim and I should begin to prepare...which I think we have already started to do anyway.

The tumor opened up some last night, causing an open wound and thus some bleeding. If we can keep it under control, the bleeding shouldn't be a big deal. If we can stop the tumor from growing, we should be able to minimize the risk of infection, which is our biggest long-term worry. I realize that wound care will be a part of the rest of her life. This is a bigger deal for me than for her. I know she's ready for a fight, and so am I.

I am hopeful that this new drug can help reduce tumor inflammation but will also help her arthritis. Indy is alert and happy and is able to walk and eat with gusto. I know our time is limited, and this is hard to wrap my mind around. I apologize in advance for being a bad friend/daughter/employee/mother to my other animals as I move into this new chapter with Indiana. I know I'm going to struggle for a while.

Thanks to everyone who has expressed their concern, love, and support thus far. It means so much. Truly, it does. Indy, Jim, and I are so fortunate to have so many people in our lives who are willing to help and support us.

Indy is a tough girl who has cheated death more than once. We're not writing her off yet.

Tuesday, November 15, 2011

Trial and Errors

As many of my friends know, we're going through a rough patch with Indiana right now. Her cancerous tumor, known to us for over a year, and stable for at least six months, ballooned over the weekend. Friday morning, when I left for a weekend veterinary conference, the tumor was as it always is, able to fit in the palm of my hand. When I returned home Sunday night, the tumor was as large as my hand.

I was stunned. How could this mass, a sarcoma not known for aggressive growth, increase in size so rapidly?

I scrambled to find a way to protect it until morning, when I could take her in to the vet. The mass has always had a thin spot, where the layers of skin are weaker, more fragile. I knew that if the mass kept growing, the tumor would rupture in that spot.

Thanks to some friends, we got the mass protected and put a plan into place, should the tumor break open over night. It didn't though. I was able to get in to see the new vet in our practice, as my regular vet no longer works Mondays.

We've known for a while that there is a hematoma around the tumor--basically a capsule of blood caused by trauma. How much of the mass was blood and how much cancerous tissue, we've never known.

My first instinct when I saw this growing tumor was that much of it had to be blood. How could a sarcoma, not known for being aggressive, grow so exponentially? For over an hour, our vet tried to extract blood from the mass, wanting to provide Indiana's poor stretched skin some relief, wanting to provide relief to me, my panic and desperation evident. But no blood would come. No relief.

Our options: surgery, which we decided against a year ago, due to both the size of the tumor and Indiana's delicate health status, or letting it go, treating with a Chinese herb to reduce the blood. I felt there was a third option: debulking the mass under local anaesthetic, something Indiana has allowed on the past. I'll be calling my vet this morning to discuss this option, as the vet I saw yesterday, young and new to my medically-challenging dog, wasn't eager to take this treatment path.

The tumor continued to grow yesterday, and while I think it might be slightly larger this morning, the growth seems to have slowed, thanks to the Yunnan Paiyao we've been giving her. Indy slept poorly last night, wandering a lot, and this morning we found her against the wall, unable to get up on her own, urine leaking as soon as we lifted her up. Her legs aren't working today. This could be due to exhaustion, or even the UTI I am fairly certain she just developed. Or something worse, though I am hoping with all my heart that it is not.

I can't help but feel that I sent her down this path, knowing a year ago that this is where my choice could lead. I had hoped that it would not. I was naive. I still think we made he right choice. Surgery could kill her. But I still feel responsible for her current state. That's hard to live with.

For now, I am doing at least twice-daily bandage changes. Miraculously, her skin didn't split over night, as I expected it to. I am trying to keep her comfortable and to lift her back legs for her so she can go outside. Puppy urine pads can help in the in-between times, and grooming bath wipes can help clean her up. Thankfully I have all these supplies already.

I'll be calling the vet at 9am sharp to update them. Beyond that, I just don't know. I will do what has to be done. Though Jim had to leave for work, we briefly discussed a sleep plan so that Indy wouldn't have to be left alone. I anticipate little sleep in my future. That's okay.

And I'll not leave her side. The rest of the world will still be there when this crisis has passed. I belong with Indy right now, which is exactly where I want to be.