Thursday, April 8, 2010

BENIGN HEMATOMA!!!!



















I got Alec's biopsy results (BENIGN HEMATOMA!!!!) yesterday, and it was hands-down the best day of my life. Yesterday simply was not long enough, though, so today is also the best day. And probably tomorrow too. And the day after that. It's a miracle. There are just no words. But there IS champagne. And that is what I am doing now. But first I wanted to share the incredibly happy news and also say THANK YOU to everyone who spared kind words, good thoughts, positive energy, well wishes and/or prayers for Alec over the last several days. I just know IT WORKED and I straight up love you even if I have never met you. On behalf of me and Alec, thank you so much. We are so lucky. I can't stop saying thank you out loud. I still think I am in shock. I have never been in shock from happiness and relief before. It is interesting and wonderful. I can't describe it. I wish I could share a glass of champagne with you - although I only have one champagne flute, so yours will have to be served in a jar ;) - but I lift my glass in spirit. I have never had a better reason to celebrate. I propose a toast to hope and love and faith in things not seen. Thank you, thank you, thank you. I hope your evening is as beautiful as mine.

Sunday, April 4, 2010

Hoping for the best.



Alec in the van after getting sprung from the emergency hospital...let's go home!



Nap time! When we arrived home, Alec whined fussily for about 15 minutes and then passed right out. Adorably, he is using his cube toy as a pillow.



After two days in the emergency hospital, Alec is finally home! He is doing well post-operatively. The last couple days he was being monitored for heart ayrrhthmias (very common after splenectomies, apparently – if the irregularities had persisted he would have been put on heart medication, but he did not need it). They were also monitoring his red blood cell count and warned me he might need a transfusion after surgery because of how much blood he lost. However, we were lucky and he did not need that either. Finally, they wanted to make sure he was eating well (and not vomiting) and doing okay on his oral pain meds before releasing him. Although he was picky when the staff fed him, he ate heartily for me when I visited him yesterday and he kept it all down so I got the green light to bring him home this morning. I am so happy he is home with me!

When he saw me, Alec began to whine excitedly (he is a very whiny little boy). Because they brought him out the side door directly into the parking lot, and not into the exam room where we had had our visits, I think he knew he was going home. I was nervous about lifting him into the van but that went okay. He has staples in his abdomen and I had to alter the way I normally lift him in and out of the van. I am hoping to not have to transport him while he is healing. The staples have to stay in for two weeks, and he is on pain medication, but nothing else for now. He has activity restrictions due to the staples and his incision, but basically these are the same restrictions he already has because of his back (plus very short walks for now). I was so worried they might hurt his back inadvertently in the hospital. Each time I talked to a new tech or doctor: “And you know about his disability, right?...Okay, just checking!” They were all great and assured me they were being very careful and that there was a big sign on his kennel alerting staff to his back issue.

I look for good news where I can find it, and upon discharge I was happy to learn the final bill was less than the estimate they had given me (because he did not need the blood transfusion or have other complications). The total was $3,887 and I have one credit card that is still within a 6-month introductory period with 0% APR (I actually got it in Feb. to pay for Alec's new rehab treatments in Corvallis – the ones that unfortunately did not work!). This credit card has a $5,000 limit, and with the $1,000 for the rehab treatments from last month, I still had just enough room to put this bill on it, which is good because my other two credit cards are not in introductory periods and have high APR’s (I originally got both of those for Kobi’s chemotherapy treatments a few years ago and now retain them for emergencies, aka vet bills). Not that I will be able to pay this off in 4 months, but I am glad the interest will not kick in right away!

Of course, we are not out of the woods. Today's bill is truly the least of my worries. Alec’s spleen and the grapefruit sized mass that had ruptured, along with a biopsy of his liver, were sent to the lab and I will not learn the results until next week – they said probably Wed. or Thurs. They told me the regular statistics are 60-70% chance it is malignant, but given his age (9) and breed, the chances is higher. Not the greatest odds, but I am hoping for the best: a benign hematoma. If it is malignant, we will have to begin chemotherapy right away, as this is an aggressive type of cancer. So there is a lot more potentially coming down the pike at us, financially and health-wise, the latter of course and without saying always being the most important, but I am scared about hitting the limit on all my cards eventually (it happens fast; I was credit card debt free only a month ago!). But I will cross that bridge when I come to it. Step...by...step. I am trying to keep my thoughts positive.

For now, he is home! He was so cute when I brought him inside. He lay down on his bed and whined softly for about 15 minutes (I think he was just “telling me all about it,” if you know what I mean). I assured him I was very sorry for leaving him at the hospital for two days but that it was for the best, etc. He even let me cuddle him a bit! Usually my attempts to cuddle him elicit escape attempts, but I think he did not mind being babied a little as I listened and sympathized. It was the cutest whine; I am no dog translator, but I think the meaning was transparent: “I am happy to be home but I did not like being in that hospital at all!” Then suddenly he just fell asleep – passed right out on his bed (yes, he is breathing! Of course I checked!), and now his little paws are twitching as he is probably dreaming about his stay in the ICU. Poor little guy is tuckered out. He went from whine, whine, whine to fast asleep in 30 seconds. I hope he continues to sleep and rest. I know he did a lot of sleeping in the hospital, but I think being home in one’s own bed is different.

We have been fortunate so far. His surgery was a success and his surrounding organs looked good. There were no masses on his lungs (they x-rayed those before surgery). He has recovered amazingly well from surgery so far (knocking on wood!). And dogs can live just fine without their spleens, in case you were wondering. Finally, when it happened, I was here with him and brought him in very soon after noticing he was acting strangely (thanks again to Daniela, the wonderful receptionist at my regular vet, who when I called strongly advised me not to wait). This could easily have happened next weekend when I was at a work conference on the east coast. I had planned for a couple friends to take turns watching him, but I doubt they would have been as alarmed as I was by his sudden lethargy; they probably would have thought he was just depressed that I was gone. They obviously don’t know him as well as I do, and likely would not have realized how strange his behavior was or that it was an emergency situation. I almost didn’t (and if you have been reading this blog you know I am borderline obsessive about observing Alec, just because of all he has been through). He could have easily bled to death if much more time had gone by. So if this was going to happen, we have been lucky so far.

I just need our luck to hold out a little longer. I appreciate all the well wishes and support. It really means a lot. If you could do me a little favor and make a wish for a benign hematoma for Alec, I would be so grateful. I know so many people are pulling for him and thinking good thoughts and it helps so much.

And now…I wait. Love is not easy. It holds the potential for the greatest joy but also the deepest pain. The hardest part about truly loving someone, at least for me, is the intense desire to protect them from harm. You try to do everything in your power to keep them safe, but still there are things you cannot control. That's where the hope comes in.

Friday, April 2, 2010

Not this.

This morning when I woke up, I noticed Alec had vomited a little in the night, or maybe that morning. I had given him a CET chew (dental rawhide chewy thingy) the night before, which I have given him many times. There was a chunk of this along with some food in the vomit. I thought maybe he had an upset tummy because he ate the whole thing before bed (sometimes he chews them over the course of a few days, but not always). When we got up he went right to his water bowl and started drinking...and drinking...and drinking. Finally I called him away before he could drain the whole (big) bowl and took him outside where he urinated and defecated like normal, but he did not want to walk - not normal - and just stood there obviously wanting to come back inside. He seemed weak and was acting strange. I brought him inside, thinking again maybe just a little upset tummy. He went straight into his "little house" (his kennel) and showed no interest in breakfast - very unusual. It crossed my mind he might have some of the chewy hung up inside but I (mistakenly, it turns out) thought he could not be blocked if he had peed and pooped. I called his regular vet and they were booked of course, but Daniella at the front desk (who is wonderful) told me if it was a blockage I would not want to wait; she recommended I take him to the emergency clinic. Even though it turned out not to be a blockage, this was very good advice.

As luck would have it, my annual performance review at work was scheduled for that morning. I was going to take Alec in as soon as it was over. When my boss called at 9:30 am, however, she could tell immediately something was wrong (I have neither poker face, nor poker voice, nor poker anything) and she suggested we reschedule and thank god she did. I took him in right after that and he was so weak by the time we got to the emergency clinic. There were dogs in the lobby and he did not even respond (again, highly unusual) and he laid down while I was at the front desk checking in...also unusual for this normally anxious boy. He was weak and lethargic and clearly did not want to walk. What was wrong with him?

After the front desk called for triage, a tech came out to the lobby. He asked me some questions about things Alec might have gotten into. I assured him Alec was rarely out of my sight, and he was not the scavenger type dog anyway - never has been (that was my dear Kobi - totally different story). I asked, but was not allowed to come back with him. I waited. Someone came and told me they were doing an ultrasound to see if he was blocked. An hour or so later the doctor came out to the lobby to call me back. She did not have a poker face either. My heart sank as the panic rose.

She said Alec was bleeding internally - a lot. There was a mass on his spleen, and it had ruptured. There was no blockage; it wasn't the rawhide chewy I gave him. She said I could not have known ahead of time (as I pleaded, "what signs did I miss?? I watch him so closely!"). She told me there are usually no clinical signs for splenic masses until they rupture. She said cancer of the spleen is common in German shepherds but there is a chance it could be a benign hematoma. As remote as this chance may be, it is what I am hoping for.

The only option was surgery to remove the spleen. They recommended x-rays first to be sure there were no tumors on his lungs, in which case surgery might be futile. They brought him to me in the exam room and I said good-bye to him before the x-rays (he was alert but weak...although he walked in on his own, we had to drag him back across the slippery floor on the blanket because he did not want to walk) and waited another hour. The doctor came out to tell me his chest x-rays were clear. Hurdle one. Then he went into surgery. I came back home as there was nothing I could do and waited by the phone. Three hours later the surgeon called to tell me he had come out of surgery okay and was stable. Hurdle two. She had removed his spleen, which had a grapefruit sized mass on it. They sent his whole spleen out to the lab, and I won't know until next Wednesday or Thursday if it is definitely cancer. Again, if you are reading this, BENIGN HEMATOMA is what we are hoping for!!! Alec has beaten the odds before. He has been through so much. I know life isn't fair, but he deserves a break. The estimate for today was $6,300. If it is cancer, chemotherapy will be an option. And of course, one I will take. The prognosis is only 2-6 months without chemo.

Of course I asked, if it IS cancer (please no!!!!), is there a possibility it was all removed when his spleen was taken out? The surgeon told me no; because of the vascular nature of the spleen, with so much blood passing through (unlike some random leg muscle for example) there is the potential that the rest of his cells have been "showered." He would require chemo.

He came out of surgery three hours ago. The surgeon said I could visit in five. I will be heading to the hospital soon. I am writing this to take my mind off things, to keep from drinking too much whiskey. I just poured myself a finger when I learned he made it through surgery okay. I don't know what to do with myself. I am trying so hard to think good thoughts, but my brain is crazy with worry and anxiety. I don't want to let the bad thoughts in. Whiskey helps. But I can't drink too much because I need to drive to the hospital later.

He will be monitored overnight, his heart, his blood levels, etc. If everything looks good tomorrow I can bring him home. Or it may not be until Sunday. As luck would have it, I am traveling to the east coast for work next weekend. I don't think I will be able to stick to the original plan of having friends watch him now. The emergency clinic does medical boarding. I got a quote: $630 for 72 hours. This might be my only option. I was nervous enough leaving him before this...I can't imagine leaving now without him being monitored 24/7.

In keeping with my previous post about bedside manner, the ER doctor who first spoke to us, Maree Doolan, was wonderful. She was so compassionate and really caring and spent time talking with me until I was out of questions. I did not feel rushed. This is a special skill; its easy for busy vets to inadvertently make you feel hurried. This is also what I love about Kristin Sulis, our regular vet at Mt Tabor Veterinary Care (and her wonderful staff). Our neurologist back in California, Lisa Tieber, shared this quality. I have had lots of experiences with vets and if they could all be like this, it would be great. Dr. Doolan even called to check in after the surgeon had already called with an update. Those of you who have been in similar situations know how much that means...not a perfunctory call, but genuine. One can tell the difference, and it made a difference to me.

Quick note about my previous posts: the laser and VOM therapies I wrote about last time had no effect; Alec did not show any improvements. I was holding off writing that update, for obvious reasons I guess. But I am glad I tried. If only it hadn't been so expensive for nothing to come of it. The doctor was so hopeful at the outset; she was really disappointed he had not improved. Oh well. All of that matters little now. I just need him to get better. Benign hematoma, benign hematoma...and no complications. Please say it with me. Please let him be okay.


I just took this photo a few days ago during a stroll along the river front.