Sep 21, 2010

Fade to color

I haven't been that inspired to write about Castor's and my experiences lately. It seems that this ordeal has faded into the background quite a bit. A good thing, for sure. Still, I don't want to get complacent and stop being grateful for time with my boy. Hasn't happened yet.

The fact is that Castor's mostly adjusted to tripawd life. And me to it. Now, it's time for me to readjust to my life. Certainly, that entails spending lots of time at home with him; fortunately, I work from home 90% of the time. However, I also have begun to leave the house more regularly to work nearby.

Many say to me that Castor's lucky to have me, that I'm doing everything I can for him. I believe that and appreciate the thoughts. I know that I have handled these transitions really well. My veterinary background, including our friends still in the business of saving animals, my fortunate work situation, and my immense support system are to thank.

I started worrying that I was also tapping into my survival instincts of long-ago. You know those people who "thrive" in crazy, stressful situations? Children who grow up in alcoholic homes can become unfeeling, controlling perfectionists who seem to have unimaginable situations under control, when really they are just sweeping the floor to spite the people shitting in the house. Or something like that. I don't think that's what I'm doing now though.

I am not in denial. And certainly, I've been feeling a lot. Am I a bit controlling? Well, honestly, yes. Especially with regards the boy. (And how to brew tea, how to clean the bathroom, where to keep the blankets, ... Yep, there's lots to let go still!) However, progress has been made. Lots of it.

This time around, I seem to be not losing it or clinging to it, but rather focusing more deeply, with an almost intuitive sense for how to navigate the chaos. Now, I am staying present for the ups and the downs.

Speaking of vertical movements
The stairs are an obstacle best overcome by two people. With Rob's help, Castor travels up and down our stairs with ease. Rob's shoulder on the other hand...Well, Castor takes the last four steps in one big leap. I'm working on changing that, but he doesn't seem to understand. Hitting bottom probably never felt so soft.

Here's us taking him up and down. It might not be too clear, but sometimes he's just pawing at the ground. Usually I use the Walkabout rather than just carrying his rear.

We're casually looking for a new place to live sans stairs; however, most places are not nearly as fabulous, small, crappy, more expensive, in less desirable areas, or most commonly, still have stairs. Also, we love our landlord, Dr. Color.

The only real problem currently is that it requires two people, one strong enough to carry most of Cas's weight. He seems to carry 80-95% of his weight in his front legs now, especially going down stairs. He attempted a handstand the other day, floating his back leg of the stair for a couple of seconds. That's my little yoga doggie (Dogi??).

Getting the house in order
We have finished making the house tripawd friendly. They tend to slip a bit more than on four paws, so we had to sufficiently cover the hardwood floors. I discovered a new use for yoga mats. We bought a couple to place over random slippery floors. Bonus: walking on cushy yoga mats feels awesome too.

I also found a cheap-ish way to raise his food and water bowls. I bought two seven-gallon buckets, and Rob cut big holes in the lids to hold stainless steel bowls. The bowls fit snugly, and although the buckets are not so attractive, that will soon be fixed too. I found a pleasing fabric to place over them. I just have to sew them up a bit. Sweetness.

I still want to buy him these ridiculous(ly cute?) socks for wearing in the house, but I've thus far resisted the sweet, consumptiony urges emanating from deep within my bowels. Useful? Probably. Needed? Not really. My mom did get him some Ruff Wear booties though, for outdoor trips.

I have just begun to let Cas stay home alone too. Sure, for only an hour or less, but I'm easing into it. The I only time I left him alone, for an hour, after we were back in San Francisco, he licked his suture enough to cause that tiny infection. Since his suture is healed and no infection lingers, it's safe now. (Go Clavamox!)

Why so somber?
I'm used to Castor being remarkable for his beauty and sweetness, but not for what he's lacking. I completely forget that seeing a dog hopping around, missing a leg, especially one as big as Castor, is arresting. Then someone at the park puts on their pouty face and asks, "Aw. What happened?" That's actually not so common, thankfully.

I welcome people's reactions and questions. I would much rather talk to people about such things. Awkwardness, discomfort, and pain often come from silence. (Another lesson from my adventures in childhood.) Fortunately, most people are willing to ask questions and many don't seem altogether unfamiliar with tripawds.

Still, it's a tad jarring when people seem sad about his new architecture. To me, he's Castor. He's not different at all. Certainly not diminished in any way. Clearly, things about him are different, but I don't even think of him as having had four legs. Difficult to explain, I guess. (Or I'm just failing at an easy task? Either way.)

Do you ever feel a sense of loss when thinking about the times you didn't have hair under your arms? Maybe it's like that. You don't even think about it, right? I really don't mind shaving.

Perhaps that's a weird analogy. Be that as it may, the only "Aw, I really miss ..." moments I've had have been thinking of our hour long walks up the hilly neighborhood. No biggie.

Speaking of hair, Castor's hair is growing back. (Like that transition?)

I must say I adore his little nub. Before if I ever wanted to stop Castor in his tracks, I would just rub his inner thigh. He would stop immediately. He loves it. Now, if I rub the inside of his left hip, he lifts his little nub out. It's adorable!

So there you have it. Castor can do no wrong in my eyes. That's unconditional love.

Partner yoga
I've started Castor's stretching and strengthening routines. I'm still figuring out the details, and we're starting off slowly. After we go out for a short but exhausting walk/run in the afternoon, I have him do two to three squats, i.e., have him sit and stand. I have Rob hold his walkabout harness to help ease his rear's descent, if need be. He's doing great. I reward him with carrots, of course.

After that, I have him lay down on his left side, so I can start by stretching his right rear leg. I am reading The Healthy Way to Stretch Your Dog, a book about...well, can you guess? Since it's important to stretch when the muscles are warm, I want to work the back hip first.

From there, I stretch his right shoulder and elbow. The I get him to flip over. (That's the hardest part!) It's not a great to flip Danes over their backs, so I have him sit up to change sides. Anyway, he's so good about it all. I'll put up some videos of specific stretches once we've seen the physical therapist at Davis. Then I'll know I'm not screwing it up. =)

After our first session, he got super playful. Enjoy this cuteness!

Go get 'em!
Oh, yeah. Cas is back to playing. He fell once and almost a few times, but he's getting it. He's running after dogs, running after Rob, and tossing sticks around. So cute.

The most popular comment pre-amp was, "you got a saddle for that thing?" (Nope, you aren't the first one to think of that. ha!) The number one comment now is, "it's only been three weeks?!" If you are facing the amputation question, it has been my experience that they figure it out. These creatures are so unbelievably resilient. You will be amazed. Certainly, if your loved one faces other challenges - arthritis, other compromised limbs, etc. - then it might not be so easy, but Castor's near blind and totally rocking it on three!

He's been feeling so good for the past week and a half. The chemotherapy didn't cause any side effects that I noticed. The night after he seemed a bit uneasy. I thought he might be nauseated. No diarrhea, no vomiting, and no missing meals though. By day four, the Carboplatin should be out of his system too.

For the first three to four days we had to be careful with his urine, i.e., avoid getting on our skin. The problem with that is whatever gets on his skin will inevitably get on mine. (He sleeps in my bed.) So, I had to try to keep it off him. The problem with that? He pees on cement at least once daily, and it splatters like crazy.

You should have seen me trying to get a pee pad under him outside. I followed him around in circles, hunched over, pee pad in hands. Just as he'd start to squat, I'd toss the pad down, he'd hear it, look back at me with indignation and start walking around again. It took about four times on average.

Too bad for you, there's no video - maybe next round. It was hilarious.

We were all happy to leave day four behind us. Without any notable problems with the chemo, he can continue getting the same dose, and we can keep kicking the S out of this cancer. Yay!

His next treatment will be September 30th.

(He snuggles with me in the car too! ♥)

Sep 15, 2010

Time for some therapy

Days 14 and 17, mostly - Sept 6th, 9th and beyond

Staple remover, stat.
Okay, not stat, per se, but it definitely was time to take the staples out on Monday, day 14 post-op. I have a staple remover (another artifact of my tech days) and did it myself. I planned to do it Saturday or Sunday, but I was a bit worried about the top where there was some irritation and it didn't look completely closed. The bottom was beautifully sealed and clean. Typically, they are taken out 10-14 days after surgery.

After noticing a little pink and bumpy irritation, I decided they may be doing more harm than good. (He's got a couple more layers of internal sutures anyway.) The staples definitely had irritated his skin in certain places, especially one area, near the middle, where I had been noticing a bit of yellow puss. It wasn't seeping from the suture so much as hanging around a bulbous skin protrusion just external to the suture. I had been warm compressing it for a couple of days, two or three times daily. It was getting better - shrinking - but still wasn't gone.

Over the next couple of days it kept healing. All of the other areas healed up nicely. On Wednesday, Sept 8th, there was still slight discharge around the middle part. The vet could look at it the next day though.

It's chemo time!
They say to start chemotherapy between weeks two and three post-amputation. I decided to set up an appointment with an oncologist at the UC Davis Small Animal Hospital, based on glowing recommendations from many vets and dog owners. Not only is the hospital state of the art, it also offers cheaper prices, a lot of personal attention, and opportunities to participate in clinical trials. At about 75 miles from home, the distance isn't so bad either.

Robyn (aka, Dabs) drove Cas, Rob, and I in her car, so once again, I got to ride in the back with Cas. We left at 9am and returned at 7pm. Long day. Also, a successful day, so no complaints here.

Let the shaking recommence
Although Castor was not pleased to be in another hospital, he seemed less terrified this time. It was probably a combination of lots of moral support and the size of the hospital diluting some of the scary smells. Less likely, he's getting more used to our visits. Regardless, I enjoyed his lack of teeth-chattering fear. (Shaking is sad but understandable. When the teeth get involved, it's heart wrenching.)

The exam and consult was long. Long but pleasantly thorough. A senior vet student took us back to an exam room and started by getting a rather comprehensive case history on Castor, not just on his osteosarcoma but everything from puppyhood on. She was friendly, accessible, focused, and clear. After she took his vitals (e.g., weight, temp, listened to heart and chest), the oncologist, Dr. O'Brien, came in to finish the exam and discuss his treatment plan. (Exercise: If Castor weighed 136 pounds pre-amp and 130 today, how much did his left leg weigh?)

On examining Cas, O'Brien said the, "he's in great shape," that I am, fortunately, so accustomed to hearing. His suture site looked mostly great too, aside from that bit of puss that wouldn't leave. He'll be enjoying a 10-day course of Clavamox now. (Weee...more antibiotics! [that's sarcasm tinged with gratitude.])

Our drug of choice
On to the chemo options. Basically, I could do none, do Carboplatin once every three weeks for six treatments, or participate in a clinical trial. The trial was monitoring dogs receiving either six doses of Carboplatin (as in my second option) or alternating doses of Carboplatin and Doxorubicin (Doxo) for a total of six treatments. Were Cas to participate, one of the two tracks would be randomly assigned to him. Unfortunately, there was no discount involved, and unfortunately the second, Doxo can have, usually after 6 doses, negative side-effects on the heart. Since Great Danes are already prone to having heart problems, he would have to have an ultra sound on his heart pre-treatment.

All in all, I left the conversation with nothing in the pros column for Doxo. In answer to my questioning, O'Brien said that there was no difference in survival rates between the two drugs noted in the current literature. Plus, Doxo is a bit trickier to administer. It requires an IV drip and can be very bad if it doesn't go directly into the vein. Worst case could lead to amputation. Of course, this has never happened there and is probably very rare. Still, another con for Doxorubicin.

Beyond that study, Jen had heard about a current clinical trial at Davis involving inhalant chemotherapy administered to post-amp osteosarcoma dogs. I asked O'Brien about it, but there were drawbacks to this study as well. On the good side, most of the treatment would be free. It is a purely experimental study using chemo administered as an inhalant, because osteosarcoma generally presents secondarily in the lungs. There were no previous data to look at though. Also, the doctor running the study is out of town until October. We all thought it best not to delay Castor's chemo.

So, I decided between the Carboplatin and the Carb/Doxo clinical trial. It seemed the only benefit to the trial was to be of service to the veterinary community. I definitely considered that when making my decision; however, given the heart concern and the potential added expense of the ultra sound, I opted to go with my original plan.

Honestly, by the time I went to the first oncologist, Dr. Cadille, I was pretty informed and tentatively set on a path for treatment - amputation and chemotherapy. I spent the week after Castor's (pretty sure) diagnosis reading a lot about osteosarcoma and speaking with Jen about surgical options. (Not to mention all the research that Dabs did, as well.) Still, I imagine that without that research, I would have felt sufficiently informed at the end of this Davis consult to make a confident decision on how to proceed.

Carboplatin, it is. So, now what?
After deciding on Carboplatin, we went into the side-effects. O'Brien reiterated the positive news that 85% of dogs experience no visible side-effects. The other 15% experience some nausea, vomiting, and/or diarrhea. Maybe 1% end up in the hospital. (For those of you who like anecdotal evidence, she'd only seen that at Davis twice, and they treat a lot of dogs.)

What's the difference? Why don't they lose all their hair and end up sick-as-hell, in bed until it's over? Well, she said, we treat dogs' cancer differently than humans. We worry more about quality of life, not wanting to sacrifice happy time for more time alive but feeling miserably. It makes sense, given the significantly smaller life spans of dogs than humans. The trade-off, I suppose, is that in humans we strive to eradicate the cancer. In dogs, perhaps, we just look to slow it down. Still, I think there is room for us, as humans, to give a little more weight to the quality of life issue when treating cancer in other humans. (There was an excellent New Yorker article, Letting Go, about this a few months ago.)

As for the potential, mostly gastrointestinal side-effects, they gave me Metronidazole (aka, flagyl) and Metoclopramide (aka, reglan) in case of diarrhea and vomiting, respectively. If he is to suffer these problems, it should happen around day three. If not, yay!

So, I am to monitor his mood, bowels, and desire to eat and let them know, at our next visit, if anything was out of the ordinary.

My dog is not average
That brings me to a topic I've already touched on, namely, median survival rates. Vets love to talk to me about this, it seems. (And it's not because they know I'm a mathematician. Rob inquired about the distribution of the data after O'Brien said, "median," and she backed away from the Land of Math very cautiously, perhaps so as not to arouse its predatory instincts by turning and running.) For completeness's sake, I'll say that O'Brien observed the survival rates of dogs with osteosarcoma after diagnosis as being:
  • 0-3 months without treatment; dog dies from pain, usually after breaking their bone
  • 3-6 months with amputation and no chemo; dog usually dies from lung cancer
  • 12 months with amputation and chemo
How do I interpret these numbers? Well, I assume my boy will have total remission. Period. If you want another anecdote, one that I find particularly useful, check out Nova the Great Dane. Her 19-month ampuversary was in June, and her lungs are still clear. You see, a median is just a certain type of average. A median survival rate of 12 months means that half of the dogs lived less than a year and half of them lived longer. It's that simple. There is no reason to assume Cas will fall on either side of that line, so I believe he'll follow after Nova. (Planting seeds of joy, remember?)

For instance, at the time of writing up one study of 35 dogs with osteosarcoma who were treated with Carboplatin and Doxo, 7 dogs were still free of lesions and 24 died from metastases. The median survival time of this study was 320 days. The longest surviving dog at that time, then still metastasis-free, was at 974 days post-amputation.

A median is a prophecy, not a prescription.

Will this tea and essence of flower cure my dog's cancer?
I only jest. Really, I had plenty of things to talk about besides the chemo drugs. I want to make sure I do everything possible to help my dog's battle be won. Of course, a teaching veterinarian at UC Davis will have different views than, say, the Great Dane Lady, but the more opinions, especially differing ones, the better, right?

I'll be honest; I am a skeptic. That's who I am, and I love that about myself. I want to believe that people have cured cancer with many things, even an alkaline diet, but (in the case of alkaline diet, anyway) I tend to believe it was something else entirely. I have not been presented with evidence that a person's (or dog's) alkalinity can be altered enough to affect cancer cells, nor that feeding them no carbohydrates will starve their cancer cells but keep the others healthy. I will try herbal, holistic, or alternative (take your pick) treatments, but I do expect some evidence, some data, some something to show it's viable. Something, in fact, more than testimonials on the internet. (Sorry, but I know the difference between science and anecdotes. Both great for different things.)

Over the past few weeks, I have read or been told about many different cancer-defeating weapons and some supplements and treatments that just support bone and overall health. For instance, among other things, people have recommended I try:
  • high-fat, high-protein, low-carb diet
  • alkaline diet
  • Essiac tea
  • Milk Thistle Dandelion (non-alcohol formula only for pets)
  • Yucca
  • Vitamin D
  • probiotics
  • accupuncture
  • physical therapy
So, I asked Dr. O'Brien, as well as others, their take on some of them. Her responses, to quickly paraphrase, were the diets are crap. Physical therapy is a great idea. Accupuncture may help with his pain, but everyone thought he wasn't actually in pain anymore. "His pain is gone now," the senior student said. (She was very sweet and helpful.) I stopped his Tramadol (pain med given post-surgery) a day prior, and I am stopping his Metacam (an NSAID) for the time being. I'll just be using it as needed, if I see limping, etc., which I don't anticipate.

Milk Thistle Dandelion (MTD)
is actually used by them sometimes (in a drug mixture) for liver support; however, Carboplatin isn't filtered through the liver (like Doxo) but through the kidneys (or "the kids," as I affectionately refer to them). So, while it wouldn't hurt and in some cases does help, his liver is functioning great and none of his drugs are liver-taxing. Thus, no MTD for Castor yet. Probiotics are fine too, unless he's having bad diarrhea, in which case some docs opt to not risk the "good gut bacteria" getting outside of their domain via the blood system. No one really knows if they're good elsewhere in the body.

For diet, most commonly you will see "high-fat, high-protein." The idea is that carbs feed cancer cells, so you want to try to starve them a bit. The problem? All cells feed on carbs. So, per Cadille and O'Brien, theoretically it makes sense, but practically, there's no data to support it helping in a fight against cancer. At all. However, independent of this topic, I had decided to switch Castor from Innova to Canine Caviar after finding out that Proctor & Gamble bought Innova. (P&G have been longtime animal experimenters, which I do not support.) Canine Caviar (CC) seems to be a great, whole food-type, "holistic" and independently run brand. There are other great brands for sure, but I chose this one.

I started Castor's transition to CC right after finding out about his tumor, and before knowing the facts, so I chose the high-fat, high-protein Venison and Split Pea formula, which really lives up to its name (caviar prices!). No vet I've asked has heard of Canine Caviar, but I was told the ingredients sound great. ("Really high fat and protein though.") O'Brien and others have said Innova is a great food too. After Castor's slight post-op picky-ness, I decided to continue feeding him half-Innova, half-CC for the time being. I may switch to something altogether different in the near future. Not sure yet, though. For now, they're both great foods, and he is tolerating the high-fat and protein in the CC.

Assuming he's getting a complete diet, which he is, Vitamin D is not necessary. In fact, I was told that it can cause problems if he gets too much. No Vitamin D - check.

As for Essiac Tea and Yucca, these are two of the go-to alternative medicine (or whatever you want to call it) cancer remedies. My mom tends to lead me down this path and she has had success using such options on many of her animals for many years, including her dog who died of osteosarcoma. (Yes, this is an anecdote, plus it's from my mom. How biased can I get, huh?) So far, I haven't been told negative things about either. I intend to investigate, at least yucca, further soon. I'm most likely try these two alternative options on Castor thus far. I picked up some Essiac but haven't used it yet. As for yucca, the Canine Caviar I'm feeding happens to contain it already.

Finally, as I hinted to earlier, the alkaline diet seems, from my reading and conversations with vets, to be bogus. The body regulates it alkalinity to be within certain bounds. That can't be overridden, nor would we be necessarily dandy-er if it could be. No evidence to support and lots of evidence to the contrary equals me think hogwash.

The take-home message for supplements and food was feed a complete diet, don't let him gain weight (cause he's perfect now), and be careful with antioxidant-type supplements. The thing is that they help prevent cellular breakdown, but that's exactly what we're going for now. We want to breakdown the cancer cells. So, lay off the antioxidants for a while!

I did set up an appointment with a physical therapist. The vet and student raved about her! It is great to at least consult with a pt for your pet's new tripawd life. There are lots of home stretching and strength training that can greatly benefit them. I plan to start Castor's therapy and work-out regime right after our consult. More on that later

Blood, x-rays, and drugs
We left Castor with them for the treatment. It would take a couple of hours. They have to take chest rads (x-rays) to get a baseline for future sets. He will have two more sets taken during his six treatments. This set came out as clear as the last, i.e., very. (YAYAYAYA!!!!)

He also had a blood panel done. His blood looks great. Better than most, she says. =) He will have to have a CBC (complete blood count) done 10-14 days after this treatment. It's done to monitor his white blood cells, making sure they don't drop too low (i.e., neutropenia).

The Carbolplatin was then administered into his vein (no need for an IV drip with this one, remember).

We picked him up about 4pm. He came running out, tail a-wag! He adjusted so quickly to life on three. Everyone was impressed by his resiliency.

They said he was a fantastic patient! (I am not surprised.) We picked up his scripts, paid the bill (ouch, but not super ouch), and set up another appointment for the 30th.

On the way out, we spoke with the physical therapist briefly. She said it sounded like we were doing well, except for one thing. Oh, the horror on her face when we mentioned the 12 stairs at home. "I would move," she said. Simple, direct. Okay, I guess we'll look into it. For now, with his Ruff Wear harness (How cute is he in it?!) and the Walkabout harness for his rear that we just ordered (by her recommendation), Rob and I pretty much carry him up and down. He floats along the steps carrying between 0 and 15% of his weight. Good enough for now. (My boy hops and flies!!)

Always Questioning
One more thing. (I promise.) As a former vet tech, I appreciate being able to have meaningful, informative discourse with vet professionals about my boy. I got that from my first trip to Davis, as well as my discussions with Dr. Cadille and Dr. Wright. (Thank you all!) I can't say enough about making sure, if you ever go through something as involved and important as this, that you understand what your doctors are telling you. They are there for you; in fact, you're paying them for that support. So, don't ever feel bad about asking more questions, even the same ones again!

There was once, that I can remember now, that I felt my question was not answered at all by O'Brien; it was a little far afield though, so I let it go. (I was curious as to the different mechanisms of the two drugs of choice for osteosarcoma. So, alas, I am still curious, but those answers can wait.) Other than that, I feel very informed and supported. I have had all of my (many many) questions answered. I even email O'Brien and Cadille to ask more questions as they arise. They always get back to me quickly.

I never agreed that, "there are no stupid questions." Sometimes questions do seem stupid to those you're asking. So what? Sometimes people get sick of answering your questions. True story. And? That's fine. What's most stupid is making decisions based on information you still have questions about. If your doctor doesn't answer you or gives you reasons to feel uncomfortable asking, find a better doctor. So, speak up. Ask your questions.

Any questions?


p.s. - Here is the report I mentioned above, if you're interested: Kent, M. S., Strom, A., London, C. A. and Seguin, B. (2004), Alternating Carboplatin and Doxorubicin as Adjunctive Chemotherapy to Amputation or Limb-Sparing Surgery in the Treatment of Appendicular Osteosarcoma in Dogs. Journal of Veterinary Internal Medicine, 18: 540–544. doi: 10.1111/j.1939-1676.2004.tb02582.x (Enjoy!)

Sep 10, 2010

Everything's coming up roses...period.

I guess it's time to create another bead; Castor had his first chemo treatment Thursday.

Oh, yeah, the bead talk probably needs some explaining. Please forgive me a seeming digression from the Land of Castor.

As I've mentioned, I themed my last yoga class around life as constant change and brought our focus to the transitions. Many describe Patanjali's Yoga Sutras, near 200 sweet aphorisms which, taken together, systematize Raja Yoga, as the threads of a mala. Sutra translates as thread. I find this metaphor animates a beautiful approach to a spiritual practice.

The sutras are so bare - many of them not complete sentences - so as to be elegantly universal. The practitioner gets to imbue the teachings with specifics, with texture, with herself. One gets to put their beads onto this thread, creating a unique path. ("Truth is one. Paths are many.")

In this time of change and even chaos in my life, I see the mala in a slightly different way. Each of our lives are continuous, unique entities floating around in this ecstatic universe. They each fumble around, soaring and falling into and around each other. Sometimes we come together, often we never meet. The Yoga Sutras, or any other spiritual teaching one follows, provide us a path, some guidance on our ups and downs and back and forthing. As are our lives, the threads of Yoga are traveled continuously.

As humans, however, we love to interpret time discretely. We have "the big moments," those moments we label as important, as devastating, as life-altering. These are like the beads on our mala. They are the revealing moments with which we decorate our lives. In the past, many of mine were colored in tones of regret and shades of anger.

I will never forget the time my mom picked me up from high school. A non-exceptional Wednesday. I got quickly into her car, a half-blue, half-primer gray Camero with T-tops and the word "Fluffy" painted in primer gray on the rear left side. (Thank you, mom's boyfriend.)

Immediately, I knew something was wrong. It was probably what my mom didn't say to greet me. Then I noticed her red eyes. She'd been crying. A lot.

I was not surprised by her words, which seems odd to me now. Perhaps I just don't remember my surprise. "It's your dad." That's all I needed to hear. He was gone. I was in shock - no tears, few words, even fewer breaths. He was gone. It was really happening this time.

What does this mean? What do I say now? What should I do?

"Surreal" comes to mind, now that I know that word. Back then, at 17 and still living in Englewood, CO, I just fumbled with my, "what happened?," and other such nonsense. He fell down, hit his head on the coffee table, and bled to death. I know it sounds rough, but unfortunately, there's no way to make a death like that sound peaceful and clean. He had been drinking. More precisely, he was drunk.

The most unfortunate part? He died alone, and I wish more than anything I could have been there to comfort him. He was living by himself, about four hours from my house. A life-altering moment.

On August 13th, a seemingly normal Friday afternoon, I put the most recent bead onto my thread. More upsetting words. "It looks like cancer." Followed by more shock and more questions.

What now? What do I do for him? ... You get the idea.

This time was different though. He's not gone. Though I spent the first day and night grieving, I have spent all of my time since then spending time with him. He's not gone. Grieving him has no place here now.

What I have learned from that 15-year old bead to this one is, well, a lot. Specifically, I've learned that, "The big moments are gonna come. You can't help that. It's what you do afterwards that counts. That's when you find out who you are." (Joss Whedon via Whistler in BtVS)

So, yes, we like to decorate our malas with beads. Sometimes pretty and, in my past, all too often melancholy. We get to choose them though. Now, I try to cultivate a strong, serene thread with tiny, beautiful beads, accenting but not weighing down my loyal thread.

Thich Nhat Hanh, a Buddhist teacher, encourages us to ask, "what's not wrong?," as we pass through our uncertain days, planting seeds of joy not pain. Though I created a new bead for Castor and the Big C, it is not an ugly moment I remember with anger or regret. I remember a gift. I was presented with the opportunity to do for Castor what I could not do for my dad. I will hold him through this transition. I will, with immense gratitude, comfort him through all of his remaining stages of life. And, by goddess, I will plant seeds of healing and optimism.

As we begin the next phase of his treatment, chemotherapy, I remind myself that real living is continuous, is breathing, is moving from one place to the next. First we walk, then we hop. Nothing wrong with that. As long as I am supporting Castor, as long as that is what I do next, I will enjoy finding out who I am.

Everything's coming up roses. That's all there is to it.

Sep 6, 2010

Home is where three paws meet cement

Day 10 - September 2nd

It's also where the ♥ is, of course. And the Castor...

After a short night's sleep, we awoke ready to tackle the day.

Ok, so that's me talking with my thinking-positive hat on. I was tired. And Castor, well, he was enjoying most of the bed. I slept better than you would think after seeing the room Cas left for me. (Yep, this is exactly how we slept. I had that space to the left of his bum. He's so generous, huh?)

I'm so happy to have this little bed hog still by my side, though.

Before adventures with Cas, it was time for me to teach yoga at Laughing Lotus. It was very healing to create a class designed around the theme of living in transitions. It was also healthy to focus on non-Castor beings for a couple of hours. Plus, I had everyone do a bunch of 3-legged dogs, in honor of my boy. Cute.

Afterward, I headed home. Time for stairs, cement, and hills. Bring it.

god me he's trained
There are commands Castor learned that I knew were important. "Sit," "stay," and "slow down" come to mind. Now, some are essential. Think: "go potty," "step," and "up." Perhaps the latter two need some explaining.

This January, after a trip to Santa Barbara during which Cas seemed trepidatious and rather clumsy, we went to see an eye doctor. He was diagnosed with progressive retinal atrophy (PRA). The vet estimated he had about 10% vision left. It's gotten worse since, though his growly cuteness the other day (see last blog entry) proved to me he still sees something. Not much though.

You will notice that Castor's eyes are glowing bright green in his bath time picture. Rather than absorbing light, his retina reflect light. This had been going on for quite a while before I noticed him having trouble seeing. During a sunny day out, for him it's dark as night.

On the way home from the ophthalmologist, to help him see better in the house, we purchased several new lamps.

The next month, our electricity bill doubled.

And so, I officially became Castor's seeing eye human seven months ago. I had to train myself to be his guide. I still let him be off leash most of the time. He listens when I tell him slow down, wait, and over here. And he would never step into the street without me. How he knows he's reached the corner, I still don't know. I learned to pay close attention to him and his surroundings.

The important additions to our language became words for stepping up and down. I chose "up," for obvious reasons, and "step," because "down" was already taken. (I didn't want him to lay down at the end of a sidewalk, after all.) A few weeks later and with the addition of gentle tugs on his collar, it was impossible for most to notice he was nearly blind.

Except, of course, for those unfortunate few who he runs straight into at the dog run. They know. Zero serious injuries, so far. =)

With his new challenges, I am grateful that we've overcome the lack-of-sight obstacle. The biggest difficulty his vision presents now is that it's not easy for him to adjust to new environments. So, the idea of moving to a new place without stairs, for instance, is not without it's drawbacks. Also, the new ramp for my car is a very mixed bag for him (see: below).

All in all, I have never been so proud of myself for his training. It's one thing to show off a dog that won't beg at Holiday gatherings. It's another to support a highly adaptable, confident tripawd. Soon, we'll review and relearn "down dog," but for now, I'm letting him get used to hopping around. He's already got being adorable down.

(Note: Jen was invaluable during the first year of training. Without her mentorship, the inevitable and tiresome, "who's walking who?," questions would be justifiable.)

Down we go. On three...
Our Castro apartment comes complete with fantastic bay windows and is filled with beautiful things and thriving plants. Unfortunately, one must climb twelve marble stairs to enjoy it. This morning Castor had to find his way back down on three.

Thankfully, there were four sets of hands to help. If just for reassurance, Castor, and perhaps I, needed them. It went ok. We got him down safely, averting his first plan to jump down about six stairs in one giant leap.

Thank you hands! Along with hands, however, there were also four human mouths creating a bit too much audible chaos for the boy (and you, the viewer?). Hence my newly adopted only-meL-talks-to-Castor rule. This has been a successful dictatorial decision so far, if I do say so myself.

All teasing myself aside, it was just too much having everyone try to give Castor commands. He was frozen with confusion. He listens best to me and loves to please, so we all agreed it was the way to go. The stairs are getting easier and easier as we learn how best to help him.

Going down is easier on his rear legs and tougher on his fear of falling. When he climbs up, I try to take weight out of his rear leg. Hear wears a ruff ready harness now, so that we can lift some of his weight off of his joints. There's a delicate balance to find where we help but don't freak him out. He still has to feel grounded on his own three paws.

Gawd, a ramp too?!
We decided a ramp was the way to go for getting Cas into my car. The one we found, however, is only 17 inches wide. Not wide enough. He kept stepping off the side and usually ended up clawing his way to the top. You can check out the drama for yourself. This first time was actually not one of the worst attempts.

Still, I decided pretty quickly to ditch the ramp. I just park perpendicular to the street now, rear tires to the curb, and help lift his rear into the car. It's quicker, more familiar, and my beetle isn't too far up from the ground. The way out is even easier. I support his chest with my arms, and let him down easy. It's like giving him a big, arduous hug. No more ramp.

I will look for a wider ramp for times when we need something, but for everyday trips (i.e., the everyday trips to the park we'll be having now), it'll be a quick hop in and out.

The grass is always greener at the park
At least all of this effort was getting us somewhere fun. We ended up at Dolores Park. He was happy to be in grass again. We found a nice shady area to sit in. There was a sweet couple sitting nearby inquiring about Castor's situation and recovery (you can see them in the background of the picture to the right). Almost immediately, he demonstrated his ability to poop on three legs.

Yep. Rob even caught it on video by accident. Again, I'll spare you the images. They understood, of course, and we were all happy he went.

We spent some loving time in the ridiculously warm (for San Francisco) weather. Mom, Matt, Rob, Cas, and I breathing, laughing, and appreciating each other. Well, Castor didn't laugh so much as grunt. But I know that's his way of saying he's pleased.

After a couple of hours, we headed back. The adjusting is so much more pleasant surrounded by family.

At home, I gave Cas a long massage, and put an ice pack on his left hip. The swelling is gone. The bruising is gone. He is down to 50-100mg of tramadol once to twice daily, and almost over his 14 day Cephalexin course (antibiotics). I will take his staples out on Monday.

Time to start setting up the first chemo appointment. I still have to decide between VSA in San Mateo (pricey but sweet Dr.), UC Davis (cheaper and maybe some clinical trials), and a practice in Los Angeles (very far => more car rides => ugh).

I'm leaning towards UC Davis at this point. We're supposed to start 2-3 weeks post-op. Stay tuned.

Sep 3, 2010

On the road again, again

Days 8 & 9 - August 31st and September 1st

The blogging has been a bit stopped, because readjusting to SF and having multiple visitors have taken my full attention. I'm back now. Let's catch up! (Note: I have uploaded, possibly too many, videos to my youtube channel, bespeakmel. Some are embedded in my posts, but there are more, if you just can't get enough. ha!)

Castor's recovery is going fantastically still. His bruising is almost gone. He's hopping happily around the yard and house. He's demanding attention. In a cute way, of course. I've started giving him only 2 tramadols twice daily (down from 2.5 pills three times daily, right after surgery).

Me? Well, I'm hanging in there. I think the constantly being on guard and at Jen's finally started to get to me on Tuesday. And then there was the imminent departure thing.

Let the, transitioning begin
Ugh. That about sums it up.

Castor and I have become really comfortable here in Santa Ynez. The grass, the friends, the animals, the pleasing dry air (the last one is to be read sarcastically). And now, it's time to go back to our little home in the hilly city. (duh duh duhhh...)

Yesterday, I started feeling pretty irritable and more than a bit nervous. I have done a hell of a job at staying grounded and cheerful through the transition from quadru to tri. This new transition, from grassy space to marble stairs, is really testing my inner peace though. Also, I'm reaching exhaustion at this point.

As Castor soaked up the last day with his Auntie Jen, I worried about him adjusting to life in the city. We sat on the grass for several hours yesterday. Our only concern was the sodding flies, a small price to pay for the beautiful breeze and gentle sun also keeping us company. The simple sounds of horses nickering and leaves shuffling soothed me. And Castor's silly growl gave me the giggles.

I love those sweet moments when I am grateful for the oft-unnoticed pulses of life. (Thank you, life!)

Ready or not
Matt came back to pick us up on Wednesday morning. Cas greeted him with wags and kisses. I did a good job greeting him with smiles, despite my rising stress level. It's good to have such understanding, loving help. I can support Castor, but without my friends, I might not be holding myself up too well at this point.

So, we loaded up the Bug. Just like our first big move together to Madison, sans the kitties. I made a pillowed palace for him in the back, and we put all of our stuff on the luggage racks. Off we go!

Are we there yet?
I kept thinking, after about 45 minutes in the car. Thankfully, the last 3 hours went pretty quickly. Castor decided to be adorable, which distracted me for a while. While Matt and I argued about the dangers of texting, I breathed deeply.

"Gawd, I need some alone time," I thought.

In the same breath, I felt gratitude for all of Matt's help, especially letting Cas lick all over his face. (You say bad, bad breath, I say awww.) So, I tried to let the texting go, and Matt tried to let me do some of his texting for him. We compromised. How cute. (I still maintain that texting, eyes on the road or not, makes driving too dangerous to be acceptable. Plus, it seems that most states have already made it illegal. So, =P, Matt. )

We got to SF at about 8pm. It does feel good to be home. Plus, finally some summer weather here. It was 85 degrees when we arrived. Great weather, bad timing. Cas was panting like crazy. A fan and some ice cubes later, we settled down for the evening.

I don't remember how getting up the stairs happened, but it did. Tomorrow will be filled with stairs. Up and down. For tonight, we rest. I think his favorite part was being reunited with my (excuse me, our) queen bed.

My mom also flew in tonight for a visit. I'm so glad she's here, and I know she understands that the excitement in this trip will revolve around Castor's trials. The two most important creatures in my life are here, and I am filled with love. Not to mention the several others here with us that are high on that list.

Did I mention love?

Alone time can wait a little longer.