Nov 1, 2010

A little massage with his chemo

I know, I know. It's been a while since my last post. I know life just isn't the same without my (potentially lengthy) stories about Castor, but it's been one of those 3 weeks that is busy busy. I try to keep the actual dates posted before the stories though. (You're welcome. =P )

**OH, and I'll add pics and video to this later today.

Thursday, October 7th

And then, we were off to Davis again...weee!

To be honest, I don't mind our excursions. It's a whole day to be with the boy, to work casually from a cafe I don't spend enough time in to be sick of, and I get to take naps on the way home with Cas in Dabs's backseat.

Too bad Robyn has school this week. No napping for me, but Castor's getting what he needs. Plus, there's garlic fries waiting for me!

20 questions for the PT

We went first to Oncology to have a CBC done. This time, as expected, his levels were back to normal. After the blood test, we waited for our physical therapy appointment. He would have chemo administered afterward.

Jackie Woelz, the physical therapist, is very warm and very accessible. Every person I mentioned his physical therapy appointment to at Davis immediately replied, "Oh. Jackie's so great, isn't she?!" Indeed, she is.

We talked about his situation and our typical routines - diet, exercise, home set-up - for a long time before she assessed Castor. She let us stay in the courtyard just outside of her building the entire time. Castor loved that. He soaked up the sun while we chatted.

She started with one simple question. "What do you want to get from this visit or from physical therapy?"

I want to do whatever I can to help Castor stay as healthy as possible in his 3-legged body. For this visit, that means I want to figure out any exercises and stretching I can do to keep him flexible, strong, and sans pain. I mentioned that I wanted to be shown stretches to do for him each day to keep the range of motion in his joints ranging on.

I had a lot of questions for her. Like:
  • What stretches should I do?
  • Are the stairs okay to do as we have been?
  • Should he have acupuncture?
  • What about chiropractic adjustments?
  • How long should I take him out to play and exercise?
  • Isn't he cute in his, i mean, is this a good harness for lifting and assisting him?
  • How do I know if he's too tired?
  • How much should I limit his activity, if at all?
  • Anything else I should know? (This is a good question in general. After all, they're the experts.)
I have the, perhaps annoying, tendency to cut vet professionals off a bit. It's just a consequence of my preparedness and research combined with my itty bitty amount of patience. They seem forgiving.

So, after minimal prompting I explained that yes, I had covered all of our slippery surfaces in the house. Yes, I raised his food and water. Yes, I had cut back and altered our pre-amp play time and walks.

Namely, no more urban hikes up and down the hills of our concrete neighborhood. We also don't typically hang out at the dog park for an hour. Most days, we go out to a grassy park in the morning for 30 minutes and in the afternoon/early evening for another 20-30 minutes. She was very pleased. Grassy ground? Check. More frequent, shorter trips out? Check.

It's not good for Cas now, as it wasn't as a giant breed puppy, to go out for "warrior weekends." He needs regular, moderate activity. And that's what he gets.

There is one sign to show me when his body's tired. She said to pay attention to the turnout in his rear leg. When his quad muscle is feeling fatigue, he may turn his paw out for support. That action locks his knee, which prevents his leg from buckling. However, it's dangerous for his knee. When that starts happening, it's time to go!

And getting out of the house? Fortunately, I had video on my phone to show her our trip down the stairs at home. I explained that though it sucked to have stairs at all, we were trying to minimize the impact on his joints and avoid and falling accidents by using both his Ruff Wear and Walk About harnesses.

She thought his trip down the stairs was great. (YAY!) She said it was really good that he dropped his head down so low, which would help keep him balanced and take weight out of his rear leg. It's really a result of his extremely poor vision. (Does he see at all now? I do not know. Not much, if any.)

She was familiar with and said the Ruff Wear harness was great, with one caveat. She didn't like the under part. Especially with a dog Castor's size, the slender straps that for the underside of the harness are not very supportive. I have worried that they dig into his (massive) chest. He sometimes makes an airy, grunty sound when we catch him as he hops out of the car, like the wind's being knocked out of him.

The other Ruff Wear model, the double back, has a full size underside, in the shape of the top. She recommended that, if possible, noticing however, that it is a bit heavier. She showed us one, and it's much heavier duty. I may invest in one, or she suggested I try altering his harness by attaching some heavy fabric to the bottom straps. A good excuse to practice sewing? Perhaps.

Walk, Stay, Sit, Lie
After all of the talking, Castor was ready for a rubdown. But first... We had him stand and walk to show Jackie how he do. She said he looked great!

He has great extension in his rear leg as he walk/hops. She examined his spine and said it was minimally curving with his new structure. It barely curves at the end to accommodate his new tripod posture. Upon running her thumbs down along his spine, she also didn't think he was in any notable pain.

She seemed very impressed with and happy about his physique and movement.

I explained that I was re-teaching him to do down dog (adho mukha svanasana). Thankfully, I taught him that last summer. I thought it'd be great for his shoulder movement. She agreed, though only because I explained that Rob supported his rear with the WalkAbout harness during his attempts. Cas is getting it; he can do almost anything for a carrot!

I also mentioned squats. Should I be having him sit and stand and sit and stand and... to build up his rear leg muscles. She was not keen on this idea. It's hard on his knee and his joints. She gave me a modified exercise though. Positioned behind Castor, she bent her knee on the ground under him. She had him sit on her thigh, which is halfway to the ground. Then stand. It's like people sitting down into a chair during physical therapy. Much better.

Massage me already!
Finally, (says Cas) we got him on his side. (Another command my smart boy knows ;-) ) I explained the stretching book I'd read along with some of the exercises. She was not familiar with it, but did recommend the book "Four Paws, Five Directions," for a guide on acupressure points. (HaHa! My mom's been suggesting that for more than a year now.)

To make a long story less long, she is more a fan of massaging than stretching dogs (and one would assume, cats, ferrets, and horses too). When she tried to, for instance, extend Castor's front leg (shoulder extension), he resisted her, big time. And my boy's strong!

Basically, if your animal patient resists, you can really hurt them. If I work on Cas for a while, just rubbing his muscles deeply, he relaxes a lot. Then I can usually stretch him for a while. She said the massaging part was plenty to keep his muscles supple and long.

So, I will not be stretching him, unless he asks for it. Instead, I'll be requesting a few down dogs after we get back in the house and his muscles are warm. Then at least once daily, I'll give him a good rubdown.

The most important muscles to keep supple are his triceps, trapeziuses, and his rear leg muscles. She also said I could gently to moderately draw my fingers or thumbs down along either side of his spine. NEVER on his spine.

And What Else?

She wholeheartedly recommended acupuncture. She has many clients who receive acupuncture and have had tremendous success with keeping up their energy, for example. She says she can guess by seeing them if they've just had a treatment or are in need of another.

She gave me the names of two people her clients have used for acupuncture, one in SF and one in Berkeley. There is someone who does home visits near Davis too, but that's not so pertinent to us. I will make an appointment with the SF doctor next week.

As above, she suggesting hitting acupressure points too. I was referred to the book mentioned above for that.

Castor and I get A+'s
Other than that, keep it up! That was her recommendation. He looks GREAT! I'm doing great! Everything is great! We will see her if and when he needs more help.

She said, "you both get A plusses." It was partly for assessment, and partly encouragement. Sweetness. I haven't had one of those since I started grad school.

FANTASTIC. We couldn't be more pleased. And grateful.

And just when he thought it was over...
And as if to reinforce Castor's love of Jackie, we took him to see the poking, prodding docs in the other building again. =\ We dropped him off for his chemo treatment.

We left for lunch. Fries! Yum.

We came back about an hour later. Thankfully, they were quick and on top of things.

He was given 90% of his initial dose. Hopefully, his WBC count would stay above 1,000 this time. I would have another CBC done in 3 weeks this time around. And they would see us next time.

Everyone says he looks great. Well, yeah he does. My little 3-legged rock star!

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