February 26, 2008

Timing is Everything

When I look into my sweet little girl’s eyes, I know that she is ready. Her body simply won’t work for her anymore. She’s unsteady on her feet; she can’t make it up the stairs; she won’t eat; she stumbles and falls as she strains to pee. This morning she sat by the arbor gate, as is to wait for someone to come and take her. I think she is waiting for Kay, or angels, or maybe both.

The other children are subdued. Lucy is clinging, and Gracie has taken to sleeping in Nala’s spot. Even Max is acting like he knows something is up. CatBreath is complaining more loudly than ever, and puked and pooped on her bed and our windowseat (wait, she does that anyway).

I’m not going to take Nala to work with me today. Better for her to rest, and perhaps Molly and Luis will visit her in her dreams, and let her know that everything will be alright.

February 26, 2008

Green Lane Park

When I got home from work today, Nala couldn’t get up from where I left her in the morning. Her rear leg was swollen, and she had no strength. Beverly got her to drink some water, and Kay carried her outside and set her down to pee, which she did for a long, long time. Lori arrived home, and we sat with her in the living room. She settled on Kay’s lap, and did manage to raise her head for a few treats—some whipped cream, some pizza crusts, even an M&M.  Kay played the cymbals for her (she even managed a few joyful barks), and we indulged her in a demo of indoor red ball (she judged our performance from Kay’s lap). Mostly she sat, staring off into space as we waited for Dr. Walski to arrive.

With a sedative to lull her to sleep before the final injection, embraced in the arms of her three moms, the process was peaceful, gentle, and loving. I closed my eyes, and there she was, my vibrant and full of life little girl, running ahead of me on the trail through Green Lane Park towards a little bridge, and just as she got there, turning around to me, tail wagging, full of joyful exuberance. I wanted so much to call her back to me, but held myself back, even as she looked at me to say, “Come on Mommy, hurry up!” And I knew I had to let her run ahead, and that she’d be alright; she had no fear. And with a smile she turned and ran ahead, worlds to explore.

Goodbye, sweet angel girl. I promised I would walk with you up to the bridge, and let you go. Now go play in the sunshine…chase smells and sounds through brush and trails… run bold and free…go find Molly and dive into the water…chase balls and play drums…try out your new wings. You and I won’t get lost, or separated, because I’m right here, and our souls will always be connected.

February 24, 2008

Drumming with the Stars

Nala is slowing down, and I have a feeling that she has begun the final leg of her journey here. Lori says she’s holding out a little longer to see me start my new job in 2 weeks, to know that I’m going to be ok.  Today we took a little walk…maybe 100 yards to the end of the road, but a half an hour with her slower pace, and we talked about how all the things she’s loved about life—playing all sorts of games, and feeling loved and secure, and going on adventures and meeting new people, and interesting smells, treats and presents, all the joys of the past 11 years will be a million times more intense and beautiful and endless when she crosses over the rainbow. Not since we brought her home from the hospital in November, have I felt her attention as much on the other side as here.

Although her knee is nearly healed, she walks slowly and her breathing is heavier. She’s less interested in eating, (hopefully not due to my cooking), and I’m finding it necessary to spoon feed her more often than before. When we got home from our walk and she climbed onto the couch in the living room, she stayed put even though I left for the study, with the rest of the pack in tow. Lori covered her with a blanket, and she is sleeping now. Perhaps she is dreaming of Molly and Luis and red balls which fly across the sky in a glorious celestial soccer match, or grooving to a heavenly drumbeat, leaping high above crashing cymbals in an ecstasy of rhythm and dance.

February 25, 2008

Triple Time

I know this about myself: When it comes to the kids, I have a tendency to allow my fears to run wild, so that inwardly, based on whatever little information I have about their medical or emotional condition, I am worrying about the worst possible scenarios and outwardly, I battle a rising stress that comes from this fear and sense of powerlessness.

What I want for myself, and for Nala, is to stay grounded in the knowing that everything that is happening is in divine order, and that no matter how awful it seems, I have the wisdom and strength to face it.  I’m fully aware that it is not helping Nala to know that her Mommy is feeling so overwhelmed and afraid for her and her suffering. But it is so hard to project a calm strength when inwardly, my heart feels like it is about to break.

Last night, Lori noticed blood in Nala’s urine, and I saw this today as well. She’s also been panting a lot—last night in the living room, and later in bed.  She wouldn’t eat breakfast, so I spoon fed her from a can of sardines and she managed to get those down. She’s moving like an old lady—she nearly fell off the bed, and hobbled outside to pee, and since I carried her up into the kitchen, she hasn’t moved from her bed. Unless Dr. Walski has another miracle up her sleeve, it seems the clock is ticking faster. Or perhaps, the clock is ticking at the same rate, but as the end of her time draws nearer, my perception is of ticking in triple time.  

January 17, 2008

How ex-cruciating!

Nala has strained the cruciate ligament in her right knee. This is her story:

“I was just finishing up another great jam session for my band, Bebe and the Breaths, Comeback Tour. We’re going with a clean new sound--simple percussion and vocals—and we’re ready to rock! But just as I was ending my last number,  I miscalculated the downward velocity of my leap high above the cymbals, and my knee took the fall. Now Luna, the manager, wants to choreograph Gracie and Goose so the show can still go on. Fat chance!”

According to her Mom Kay, “Nala was running to catch a high fly ball over center field, while the rest of the team stood helplessly by. Morgaine was so busy watching Nala she forgot to watch the ball; Gracie went charging after a squirrel thinking it was a ball; Bradshaw forgot what game he was playing and tried to tackle Morgaine; Lucy and Max were distracted by the hot dog vendor, and Rex was tired and wanted to go home. It was all up to Nala. Eyes steady and focused, she charged down the center line and leapt 20  feet in the air, catching the ball as the crowd cheered wildly. Unfortunately, her descent was impeded by Gracie’s sudden dart into center field after a nuthatch she mistook for the ball, and Nala’s knee took the hit. With a 6-8 week recovery time ahead, there’s little hope that the team will pull it together for the remainder of the season.

This is Mom Lori’s recounting of what happened. “I had just left the house to plaster a 500 sq ft Bucks County kitchen showroom to showcase 15 different applications of Italian plaster. Nala was peeing over by the rose bush at the wrought iron gate, and when she saw me she began wagging her tail in greeting. As she struggled to rise hastily from her awkward position, she let out a sudden yelp and hobbled over to me. I helped her back into the house, where Mommy Donnamarie immediately created a sterile environment, and with flashlight, magnifying glass, tweezers, and healthy treats as rewards, removed the tiny rose thorn from the pad of her foot that had caused her distress.”

I’m Goose and this is my story. “Nala was crouching to pee and she got up too fast. She pulled her ligament and now her knee hurts. I cleaned her ears to make her feel better, and she said I could eat her dinner from now on. And Mommy said that I could go to work with her and Nala, where there are nice people with food.”

February 15, 2008

It’s been a long month for Nala. More than the cancer, I think the knee injury has aged her. Unable to play ball or her other favorite games, she’s displaying a timidity and neediness that is quite unlike her initial response to the cancer.  It’s so sad to watch her defer to the other dogs.  Bored, she’s sleeping more.  Having taken a few spills going up the stairs, she’s become fearful and whines for me to carry her up to bed at night.  (Thank goodness I can manage her 50 pounds, but perhaps that’s just the mommy endorphins at work.)  

On the other hand, she still displays the same joy when I take her to work and when we go for walks, which we’ve just started to do again. And I think that gradually the knee is healing; now we need to reestablish her self-confidence. We may need to send her to sports camp at her Mom Kay’s in Manchester, to help her get past the hesitancy that her injury, and perhaps my babying, engendered.

December 28, 2007

It’s not going well. Yesterday, at her acupuncture appointment, Dr. Walski counseled me that Nala most likely has only 2 or at most 3 months left. I think that somehow I have this fixed 6 month timeframe in the back of my head, as if the clock really isn’t ticking and she always has 6 months from the present moment. She said that the pain and discomfort that Nala seems to be experiencing now could just as likely be caused by the cancer as by a urinary tract infection. I guess I’ve wanted to make the cancer a non-issue, as if all the nutritional, medical and emotional support could be holding the cancer at bay, leaving only a set of more easily managed symptoms to contend with. And it might well be that she has developed a resistance to the antibiotics, and that by supplementing the Baytril with another antibiotic, her infection will be controlled and symptoms relieved for a time, till she develops a resistance to the next course of medication. In this game of trying to cheat time and destiny, even short term strategies have their place.

So we wait for the new urine culture to return, and hope that somehow the acupuncture will help manage the pain. But I know in my heart that what is happening is not good. Nala’s whining is more insistent, her need to go out and pee more frequent, and as much as I try to distract her with her favorite activities, her joy is momentary and fleeting.

We’ve played drums and red ball and tennis ball, I’ve given her extra snacks of turkey meat and sardines, and finally resorted to half a rimadyl for pain. Last night it was valium—the only thing that seemed to relieve her pain also knocked her out.  Is this what it will come to? If she is so inconsolable now, how much worse will it be when I return to work after the holidays?

This is not the quality of life I want for her. On the other hand, she is able to pee in a stream, her appetite is great, and she is still so bright and playful, delighted to engage in her favorite activities. Where is the line between prolonging life and compassionate termination? How do we know when it is really time to let go? Everyone says she’ll tell us, and I want so much to believe that. But what if she doesn’t tell me, or worse still, doesn’t ever want to leave this world, even if she must? We may be the witnesses to destiny’s unfolding, but we are also the ones who must make decisions she cannot make for herself. The enormity of this responsibility shakes me to the depths of my being.  

January 5, 2008

The Medicine Shoppe

The results of the urine culture came back last week, confirming the presence of a different bacteria resistant to the antibiotics that Nala was taking previously. A new, more expensive antibiotic was prescribed, which we’ll keep her on permanently, so that hopefully the bacteria won’t ever get a chance to overcome its effects. We also have to continue to keep her immune system as strong as possible, to prevent other infections from taking hold.

Deciding how much medication to buy gets a bit tricky. Sometimes we measure time along with hope, as if both will take us though the coming months or perhaps even seasons. Sometimes we measure hope in weeks, and time in days.  We take a long walk together, as we did on New Year’s Day, and it seems like Nala can keep on going forever, drinking in the beautiful windswept winter with all her senses. Other days she goes off by herself to the bed in the corner and softly cries, or spends such a long time straining every muscle on her body to pee out just a few drops, as the wind howls and rattles across the brittle lawn.

Dr. Walski dispensed a 3 month supply, but promised to take back whatever we didn’t use if that would be the case. Today we drove to the Medicine Shoppe to refill another one of her prescriptions, which was dispensed in a 30 day supply. With a leap of faith, I asked the pharmacist to double the quantity.  Today, our measure of hope is half full.

December 24, 2007

Tinsel Tails

Christmas Eve was here at last, and the children waited patiently by their stockings, stuffed full with wondrous surprises. Rather than attempt to distribute presents at one time, knowing full well that Max would immediately hoard them all, we let in one dog at a time, and individually dispensed a present or two. They were happy to receive tasty treats and rawhide bones, which they carried off to far corners of the house to gnaw in peace, although Nala chose to remain on the living room couch, with nary a nibble.   Something wasn't quite right for her. We retrieved a large, soft present from beneath the tree and placed it on the sofa. "Open it, honey" we gently urged. Nala made a few requisite sniffs and looking at us with sad eyes, seemed to mutter, "It's clothing, isn't it?" We opened the package to reveal the warm and utterly fashionable sweater I had just finished knitting or her, and she tolerantly allowed us to put it on and make a fuss, but this was clearly not on her Christmas list.

There was only one option left, and we took it. "Close your eyes, sweetie" Lori nuzzled against Nala, blocking her view of the basement. I retrieved the high hat cymbal that we'd saved from her drum set, unable to bring ourselves to throw away although we had stopped her playing years ago out of concern for her arthritis. That afternoon I had done my best to clean off the tarnish and grime, and now I placed it in the living room before her.

"Look Nala, it's your drums!" Lori whispered. Nala looked up, completely nonplussed. Years after we stopped playing them for her, it was fun to get a rise by saying the "d-word." It wasn't till we took the cymbal out to the patio, and closed the door on the other dogs, that she began to believe that yes, we were really going to allow her to play again.

The tap of the cymbal sent shivers down her spine, and soon she was barking and jumping to the beat as if her band, Bebe and the Breaths, had never broken up after Molly's tragic death (Official cause of death: bloat, most likely brought on by kibble overdose). Just as animated and syncopated as she was years ago, Nala jumped and sang and wagged her whole body with joy, jumping to Mommy's erratic beat. It was not even 5 minutes, but at last, it was Christmas, and it was magic.

December 26, 2007

The Itch You Can't Scratch

Nala's urinary tract infection has returned. Despite the new course of antibiotics, which provided a few days of relief, she is uncomfortable again. I can tell by the way she whines to me, firmly insistent that I take notice, and paws at my head, trying to draw me in closer.  She was clingy with Lori yesterday at Christmas brunch, and she is following me like my shadow today. She also smells faintly like pee, the way an incontinent person smells when they need to change their Depends. That's how it starts. Then she needs to go out more often, and the stream is shorter, the dribbles longer. And she is both restless, and lethargic.

Serious illness and infirmity has a way of reducing the fullness of life to the most basic of bodily functions. As caregivers, we clean up the messes and talk to the doctors and try to provide comfort, but ultimately we can only bear loving witness as the process, whether of healing or of disease, follows its own course. CatBreath, nearing 20, and her spells of leaning over her perch on the back of my computer monitor, to puke or to poop, unable to make it over to the litter box, or just not caring in that moment, screaming in her loudest Siamese that she is uncomfortable; Nala, hunched over in the cold, struggling to pee past the burn.  We want so desperately to succor and nurture and most of all, believe in the power of love to heal all wounds; we try valiantly to stay one step ahead--or at least keep pace--with the process, but sometimes it feels like we're just chasing our tails. Then, a new medication or therapeutic session or just some stubborn life force kicks in, and symptoms are relieved and we think we've succeeded in managing the problem, but the control is illusory.   It's very humbling.   Without control, all that is left is faith.

December 8, 2007

It’s My Party and I’ll Sleep if I Want To

Today was the much anticipated the celebration for Nala’s 11^th birthday.  She took me for a walk, actually a jog, to the Schoolhouse development where she ran through the lots with a look of utter joy on her face. We returned home an abundance of gourmet dog treats from Aunt Beverly, along with a feast of veggies, fruit and pizza. Friends Diane, Cindy, Judith and Kay joined our Stone Cottage family in the celebration, which included a pick up game of Red Ball, and reading of birthday wishes from afar in the living room. Although she managed to sleep through much of the indoor portion of her party, she was surrounded by love and attention, which made us all very happy.

I’ve been noticing a subtle shift in energy as well as how much pee she can get out at a time. During her walk, she stopped to strain more often than she had last week, and her renewed buoyancy after the acupuncture treatment has begun to wear off. Still, she was able to play hard, take her challenges in stride, and thoroughly enjoy the moment, which is really what living is all about.

December 22, 2007

Puppy Love

Sometimes it’s almost easy to forget that Nala has cancer. Something seems to be working.

Maybe it’s the healthy food I’m making her. Aside from the tiny amount of dry kibbles I mix in to give it some crunch, her meals are fit for human consumption. And they don’t taste bad either. Other than the fact that turkey or chicken is a primary ingredient, they’d probably do us a world of good, being rich in antioxidants, fresh veggies and legumes, and organic, whole foods.

It could be the energy work—the acupuncture seems to boost her energy and lift her spirits, and she’s been much more playful since beginning treatments. And last week, we took her to The Gentle Spirit for healing touch, and in the 20 minutes or so that Lori and I sat on the mat with her for her session, it was as though we were in the presence of a puppy. She rolled over onto her back for Jennifer, positioned her paws or legs so that Jennifer could find all the right energy meridians (interestingly, she led Jennifer right from the bladder, where she started, to her lungs), and made little puppy noises and playful movements, and then decided almost abruptly after 20 minutes that the session was done and it was time to explore the office. 

Treating the recurrent urinary tract infections is probably the single most important thing we are doing for her medically.  When she has a UTI, she struggles to pee and her pain and discomfort is visceral; when the antibiotics kick in, she is a much happier dog. It is hard to know if the other meds—the piroxicam to reduce inflammation and hopefully tumor size, the Misoprostol to protect her stomach from the piroxicam, the prazosin to relax her bladder—are all playing a role in her well-being. We can only hope so.

The tumor and lesions are hidden, their workings mysterious. Whether they are furtively multiplying as fast as they can, or struggling to maintain their ranks after each onslaught of good food, energy and love, we’ll never know. But we have our girl back, as playful, confident and content as we could hope for.

The veil of darkness is lifting; the longest night is shifting towards light.

December 2

Overnight, the first snowfall frosted the pines with powdered sugar that spilled over grass and fence post and pond. Like children eager to run out and play, Nala, Max, Gracie and Goose charged through the yard, all snowy noses, wagging tails and smiles. We played some red ball, kicking up drifts of white as the ball skidded back and forth between us. When we came back into the warm living room, Nala crawled up onto my lap and fell asleep in my arms in front of the fire. All thoughts of reading or knitting were quickly replaced with the gentle rhythm of petting her, and her quiet breathing.  It was a moment for simply being.

December 3

The Pincushion

This afternoon Nala went to our local vet, Meadowbrook Animal Hospital, for her first acupuncture treatment. Dr. Walski has had success treating other cancer patients, helping restore their energy and improve their quality of life. Today we were calling on the big guns of the alternative treatment world.

 
It was determined that Nala’s chi needed more yang, and a treatment was designed to reduce pain and balance her energies. As Nala pressed her head against me, one might have taken her response to be one of embarrassment for looking like a little pincushion, as much as her usual veterinary-induced timidity.

 
She seemed happy to rest at home, till hearing something outside, she shot up out of her chair, began barking wildly and suddenly, darted after a tennis ball and retrieved it with a sparkle in her eye we haven’t seen in months. She truly seemed to be energized and happy. Being a pincushion has its perks.

November 23

We awoke to a bitterly cold Friday, yet Nala was more steady on her feet and alert than she had been since returning home. She was happy to eat left over Thanksgiving turkey, and she led my eyes to her leash making it quite clear what she wanted. But it was so cold, and I didn't know where we had stored her sweaters and coats; she never really liked to wear them anyway. Gracie's red coat hung on a peg by the door, her parchment thin greyhound skin needing more protection from the elements than the others required. Nala and I conspired to borrow Gracie's coat and lock the others in the living room, then slipped out the kitchen. To the sound of Max's frantic barking, we were off! I nearly had to jog to keep pace with her, and she clearly was capable of far greater speed than her Mommy. We headed down towards the old schoolhouse and up into the still unsold development of "Schoolhouse Farms." There, I took her off leash, and she happily explored the empty lots and spec homes. And then, miraculously, she bent over, and pooped. A nice long, perfectly formed, steamy poop. My heart leapt; I praised her and we danced with each other in circles in the empty field. This is a dog who doesn't want to die.

November 30, 2007

Some of our days are good days, grounded and strong. Other days are not. I guess that’s how it’s going to be from now on.

I took Nala into the office with me. She wasn’t nearly as bright eyed and energetic today as she’d been on previous occasions, although she did have her moments of really perking up to say hello to new people and supervising the general activities. The signs are subtle, but I notice the difference. Tonight she tried to go right upstairs to bed after dinner, but I encouraged her to stay downstairs with us, although she sought places far from the center of activity, and slept, her breathing heavy, but regular. I restlessly prepared a new "super health-freak" stew for her, hoping that the holistic supplements would be better portioned within a larger batch of food, and found myself giving into despair. Instead of feeling strong and grounded, I felt weak and desperate…please don’t leave me, I pleaded. Please get better! Please may this help you… I stirred into the stew. I felt so tired, but tried to comfort myself with assurances that I would be there for us both. It isn’t easy to hold your own sobbing heart, but she is teaching me how.

November 21, 2007

It's been 2 days since learning that Nala has cancer of the urethra, that has also spread to her lungs. Day by day, I watch her closely, look into her eyes, and try to listen, deeply, to what she us telling me.

When we left the hospital at Penn Vet, and took the promised walk through campus, she nearly pulled me along as she trotted, alert and bright-eyed, even chasing after a few squirrels. We walked down to College Green and she gave the Button a good, long sniff, and we jogged around the big statue of Ben Franklin in front of College Hall (She was unimpressed). As I told her of my student days, she sniffed out their memories, as if she would conjure their forms from muddy blades of grass or pavement corners. She struggled to pee, too, barely pushing out half the amount she had struggled to relieve herself of before her stay in the hospital. Her eyes pleaded for help, yet just as surely, she stood up and was ready to take on the next whiff of passing students, pile of leaves, or scampering squirrel.  One of my few regrets in not having children was to not have a daughter go to Penn.  Funny how the universe delivers on our wishes.

The ride home-- 2 hours in steady traffic-- was long and hard; the incessant sniffing by Max, Goose and Gracie upon our arrival, slightly annoying. Still, I believe she was happy to be home, with me and Lori, even her siblings, and just too overwhelmed by the lingering effects of the anesthesia and diagnostic procedures to take in the enormity of all that had happened.  Yet we all knew.

November 22