Sunday, May 27, 2018

The Agony Of Being A Patient. How the Vet Mom Faces The Reality of Being The Vet Client.

I can hear crying in the back room. I. however, do not recognize it as my own. It is an ominous cry-bark of desperation and pleading.

The tech had to tell me it was my beagle. I have never heard him bark, or sound even remotely, like that. It breaks me. Some deep maternal need to make it ok for him in this foreign place.

He, is my Jekyll, my beloved beagle. He is waking up from his second round of radiation and he is scared. (I think that is the sound in his voice?). He knew something was awry the minute we hit the car this morning without his companion and sidekick Charleston. I never split them up. When I have to they are both cautiously afraid.

After radiation treatment number 5. May 20, 2018
 I carried Jek home from his first radiation treatment last week wobbly, disconnected from his inherent alertness and the ability to walk upright. He didn't know where he was but he did know he had to leave.. quick step.

We drove back home the two (plus) hours home sleeping next to me on the passenger seat. For a few moments he woke up and was thirsty. We took Starbucks drive thru to get coffee and water. I let him drink a little too much too fast. I regretted it as soon as he vomited it all back up seconds later onto the drivers console. (I knew better). Seems the fear was only second to the post op anesthesia and nausea.

The drive home from radiation treatment number 4. May 15, 2018
The visit last week was harrowing. For me, anything new, looming, and foreboding, is often met with self-protective apprehensive fear.  For Jekyll fear is learned. He loves anything new as an open invitation to excitement filled opportunity awaiting. Last week he walked in the radiation oncology door inquisitive and engaging. He boldly introduced himself to every new staff member as the most adorable boy they would be lucky enough to cuddle. This week I had to carry him in the door. He wasn't going to volunteer to be a patient again.

Patience and blind acceptance are not virtues I possess, nor foster a desire to acquire. I am loathe to be waiting and fierce to avoid being blind-sided. Jekyll's disease and this foreign place where I am now called "client" meant I have to try to address both gracefully.

Leaving the oncology office... he's smiling and happy. We both are.
Being a patient, the person on the seat at the end of the leash fated to another practitioners skills and expertise, is a tough spot to be in. I am far more content at the conn, fingers gripped on the ships wheel, clenched hands determined to plot the course through the storms fury. This place, in command, is where I want to meet my maker should the fate not bend to my will. I am terribly inept at the passenger side of life. I am an unskilled, unconditioned veterinary client. but, this day, with Jek I have to be.

Maybe it centers around blame? Where will I place it after the shit has passed the fan, and the death has won his match? Maybe I need that part to be mine, fully, as I deal with my grief process.



Maybe it is the deep centered knowledge that Jek isn't just a patient? The gravity of his stature and place in my life? Maybe only I know this and therefore decisions for options hold a more perilous cost than the distance of medicines calculated indifference can measure.

Maybe it is finding a way to buy time to help me swallow the terribleness of this disease?

Maybe it is a little bit of me feeling like I would be a total hypocrite if I recommend to others what I am not prepared to do myself? How many other vets, clients, loving pet parents, would accept this as a death sentence and let death come at its own pace? There is a side of me that feels compelled to be more pragmatic and erudite. Accept life ends in death. Enjoy said life for as long as you can and move on. Graciously... I am not this person. (Maybe I will grow into her? But, secretly I hope not).

It is humbling and subjugating. For Jekyll it is torture meets deference. His beagle bashfullness overtakes his charm and he cowers knowing he is powerless to protest. I hate this for both of us.

The client and the patient wait for the vet.

The words I hear countless times each day echo in my thoughts, "I don't want to put him through that,, or, anything invasive,, or exhaustive." I never know if this excuse is for financial reasons, emotional submission, or lack of vision in what lies ahead when you willingly surrender?

I am not one of these parents. Turns out I am those parents who relegates her pets to 'kids". The castigation of my non-veterinary unlike minded friends often leaves me seething venomous words as weapons to their cold-matter-of-fact animal perception of what exactly a "pets place" is, or should be. I have spent two decades weeding out those who don't see the magnitude of the importance of my pets as "my family." You can judge me many ways but criticize my dedication to my kids and the ties are severed indefinitely. No apologies. Unconditional love wins every time, never mind my personal obligation to protect and serve my family as the concept I choose to define it.

And still,, I sit as patiently as my psyche will permit me,, and I wait,, for the cry-baying to cease. My inclination is pulling me, hard. I want to run to him. Pull rank. Use my professional status to intervene and comfort him. My pup crying behind a wall audible and unrecognizable. Wondering,,,, Did I make the right decision? Is this all for nothing except expense to allow me to not feel like I gave up on him? Will his last days be filled with stressful fear of pokes and prods and nausea induced anesthesia?

Medicine is always a pendulum living on a scale. Risk vs. Reward. Advantages vs. Disadvantages. Cost vs. Consequence. And guesses. We veterinarians, the supposed "experts" in this field, we, well, we guess a lot. Our emotional and experiential tally serve us to help guide others in similar situations. I have so few case examples to guide me on this path with Jekyll. Cases of young pups with metastatic prostate cancer who have been down this path before us. BUT, I knew he would die the beautifully young vibrant boy he is months ago IF I didn't intervene hard and fast. I had to be the client with the dying patient and forge my own path, after all, the reward, disadvantage and cost of not doing everything to save him, but him time, was more than I could take last Christmas. I just wasn't prepared to say goodbye, yet.

And, so, here we are, me and Jek. The client and the patient. Scared and confused. Strapped in, climbing the track clickety-clack track up the roller coaster, in the little car alone, about to face the crest, about to be pounded by the ocean of forceful intentions to remind us who we chose to be in life. There is no other way to describe this journey right here, right now. We bought the ticket. We chose to ride. We had no other options IF we wanted to try. Free fall or Divine Intervention awaits us...

The victim who gives up, for all the reasons we think are compassionate, kind, and unavoidable anyway.
OR,
The fighting, hoping, determined to give it everything modern medicine can offer kidnapped-captive who refuses to go willingly into the night.

It is agony whichever you chose. I have lived this life long enough to know that I don't give up. I don't get to take the money with me, and I know where my responsibilities lie. I chose to be this. I hope it is what is best? What I won't regret fitfully later?


Jekyll is here. Still here. Happy, slowing down ever so slightly, and alive thanks to me overcoming the voices, the fear and the excusable excuses to hide away and wait.

No matter, I will always struggle with the vulnerability and fear of being the client with the patient in the waiting room,, even though I am grateful for the options and resources this life has afforded us.


Post Script; Jekyll has metastatic carcinoma of the prostate. It is one of the worst diseases and prognoses one can get. It is always terminal. Always is a tough statistic to beat. He has been given a reprieve from this because of the amazing care of his oncology crew. Nine rounds of chemotherapy. One a week. Then weekly doses of radiation. Five in total. It is not the course of care the majority of my clients elect. It has placed me on the receiving end. The client end. I am grateful to have the experts surrounding me that I do. Honest, dogged, and optimistic. Jekyll is here because they are on his side. He is also happy. Functional and happy. So for all of you who think that chemo and radiation takes away, I will remind you that he is not a human. We aren't pushing him to the edge of death to win back his life. He isn't bald, he isn't depressed, he isn't hospitalized. He is home, on his bed alive.


My advice to all of you dealing with terminal illness, impending loss of life defining functional needs is to try not to let the fear guide you. Utilize the tools that are available, and give yourself and your pet the benefit of medicine and its magical powers. Oh, and say thanks to everyone who offers support and guidance along the way. Here is how Jekyll and I face our fears. FOOD! We bring snacks, lunch, donuts, something at every visit. It helps break barriers and it is a welcomed gift to give as much as it is to be received. EXCURSIONS! We get outside and we breathe, sniff, and investigate the life around us. EXERCISE! Move. Keeping the athletic body of the beagle alive keeps him more comfortable and keeps his precious gi and urinary tract healthy. Prostate strangles the body like a Boa constrictor on the colon and bladder. Jek will die because he can no longer urinate or defecate.


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Friday, May 18, 2018

the Little Things

There are too many "little things" that Jekyll does that have me reeling. How can I go on without them? Never seeing them again? I cannot imagine not having them in my life every single day. He is going to not be here one day, soon, and with each passing day I wonder, "Is this the last time he....?" 


The "little things," his little personal idiosyncrasies, those special things he does, only he does, are the spirit of his independent originality. They are what makes him who he is,, so irreplaceable and magical. They are the pieces of his life that made me stop and take pause and leave me now feeling as if there will never be another perfect moment captured just like this. These are the things that largely no one else knows. They are what make us.


His life is the series of "little things" I don't want to imagine living without and never seeing again. 


Here's to you my Jekyll-pup.. all your guts, glamour, and gluttony. I'm grateful for every second we had, until the very last of each of them.

Here's to all of your "little things" ....


The cowardly curiosity of the walnut in the pond. This boy loves the abundant life of the farm. He loves the pond and stream obsessively. There is so much hidden moving living mystery that lurks beneath. But the uncovering of those mysteries is often too intimidating for his cowardly curiosity. For instance, he will focus on a bobbing being for an hour. Too perplexed to look away, and too frozen in fear to challenge it. Almost always it turns out to be a walnut, a leaf, some odd shaped stick. He will jump backward 10 feet if it haphazardly approaches him too close. Until eventually, inevitably it is revealed as it is, dead, lifeless, and harmless.  To which he will paw at it, remind it he is master of this (and every other domain) and move on to thwart the next wayward detritus.


At the base of the heart of every beagle resides two things; firm, steadfast, and consistent through the ages; love for all, and dedication to food.


The explosion of joy that was running for breakfast to be made. The running full tilt to the kitchen for breakfast. Getting up in the morning is the most wonderful moment of the day because FOOOOD!! comes after.  The running of the bulls has nothing on the bellowing, bucking, bouncing race of the beagle to the kitchen.


The way he will greet anyone and everyone with the same gentle charming curiosity..


The howling for attention when Charlie was stealing the show. For the small number of times that Charleston (his older, quieter, less assuming pitbull mixed brother) had one second of attention Jekyll would howl to remind you that he was still here."



The digging for grubs. This pup of mine was gifted with a nose more acutely intelligent than any morsel of carbon (past-present-or-future), kernel, or remnant could elude. I tell people that "in the event of a Zombie apocalypse you need only grab Jek. He can find food in the desert." (Although convincing him to share it is another thing). He used to wait at my feet for the morning kibble to clink to home to his bowl. If I dropped a kibble he was on it faster than you could bend or grab. He has stopped doing this.. I miss his obsessive food frenzy. (I now beg and bargain to get food in his gullet).


The afternoons with the sunshine on his face the the nose on full alert. He was a proud unsurpassed valiant sentinel. He loved everyone  he ever met, but you better have been invited to his house first.


The way he never misses a nap with his brother... Who always loved him more than he probably deserved. (Jek usually got his big brother into terrible situations and then abandoned him to catch the blame solo).





The racing through the fields, nose locked on the whisps of a scent left behind by a fellow fawn colored furry fieldfellow. He can track a molecule of aura like a gifted psychic. He is called. He cannot be dissuaded. And you cannot escape the millennia of hound genetics that built him.

The way he always understood, and hated, being the prodigy of a veterinarian. No other pup ever had to endure more intensive veterinary training, practicing, and care. The plight of a beagle is their compliance and docile demeanor. It is why beagles are the chosen breed for all of the testing and teaching done on dogs. I'm sorry Jek... I'll call it devoted care, you can call it biased training.


The fact that he will ALWAYS sneak on the couch when you are not looking.


The glass was always half full. We should all be so lucky to see the world through Beagle glasses. The world is his oyster, his grub-hub, his cornucopia of delectable delights.





The way you can take him anywhere,,,  and he makes himself at home.


Independent Brewery loves dogs! We love them too!

The way he worships and eeks affection from everyone. (That face is irresistible!)


The way I worship him.. (even though he probably doesn't love me as much as I love him too).





The wiggle dances on the bed. Nothing signifies true raw joy to be alive than his wiggle dance. Belly up, snorting face sniffs of exuberant glee, and an itch he cannot reach but doesn't give up on.










The utter deference to the cat who claimed him. He cannot walk. He cannot be. He is Jitterbugs bequeathed. I don't know why he never challenged that cat? But he never did. He never has. And there are days that I know he feels bad...really sick and painful bad... and still Jitterbug reminds him he has a cat to coddle.


The boy and the cat who claimed him.


All of those crazy ways he chooses to get himself comfortable.  He is usually side split sway footed. He is a goof and it is endearing.


The front seat of the pick up truck. He has this crazy way of sitting  half on your shoulder (if you are driving) and half on the seat. That way he can maintain balance and keep an eye on the road. He feels like a parrot on your shoulder and he is incorrigible.


The joy in how much he loves going for rides..


The shot gun of the Gator. It took a while to get him to ride in the Gator with us. Once he realized that the "Land of Abundant Opportunity" That Gator was his ride to the ends of the earth, the walls of his domain and the ticket to ride without having to over exert yourself. (He is a smart cunning cookie).


The perching the one leg and half butt cheek on your shoulder for stability and viewpoint, and how incredibly difficult it is to drive with a beagle perched on your shoulder and leaning on your head...


The low wag throwing himself at anyone else.


He has this way of greeting  his old friends. He lowers his ears, he drops his back and bends at the knee. It is a curtsy as much as it is an invitation to be reminded how wonderful he thinks you are. That face. This one act of true loving affection is the one single thing that reminds me how precious he is. How lucky we all are to know him. He is love and gratitude and he dishes it out to those he truly loves.

When he loves you he tells you...
The elephant memory of a snack he scored from years past.



The pawing for attention if he could get himself into the passenger seat. If he ever has to share a car seat he will remind you to use your time and proximity wisely. He will paw at your arm until you surrender the affection and land himself a belly rub, ear tickle, or soft pat of reassurance that he is still the center of the universe.



The snorting happiness,,, his way of expressing his own joy to no one but himself.
the sharp bark of alarm. He stands watch in repose. But, he is always on the job,,, even if it only looks like he is sleeping on his front porch couch.

We call it "the perch."
It is where he does his best work and works through all of the problems of the world.


The magnitude of his presence... maybe I am the only one who can feel it?.. but I know where he is even if I cannot see him or touch him.. I know if he is near, and I know if he isn't feeling well,,, lately, it feels as if it has been too much of the later.






The fishing anticipation. To everyone else who tried to go fishing at our pond I know he drove them nuts. The anticipation of a wiggly-jiggly-floppy fishy pops from the waters and slithers its way onto the bank. It is like Christmas! How else do you get delivery in the boonies?


All of these "little things" remind me how long our journey has been, how much we shared, how hard living with an obsessively independent, adventure driven boy intent on keeping the woods free of bunnies, deer and any other self indulgent bold soul is, and has been, and how much it will all be missed.


He is a companion to cuddle with as much as he is a force of nature to reckon with. He is, like all dogs we share our most quiet times, or most painful moments, and the tiny insignificant life defining moments that shape our concept of what our life means.

Walking out  of his fourth radiation treatment, smiling..

Every life is a collage of pieces and moments to remind us how lucky we all are to have our pets to share it with. Jekyll has been one of those lives I am beyond grateful to have known and loved. I will miss him when he isn't with us any longer to share his little things with. But, as with every part of this life I will get another beagle, invest my whole heart and soul into them, build a new set of memories and I'm sure see little pieces and flashbacks to this boy, his immense presence, and his utterly undeniable magic.

Until then, my friend, I am here for you until the end,,grubs, rubs, and all our "little things",,


More  on Jekyll here;

Jekyll Arrives

Jekyll Loses His Tail Mo-Jo. Tail Droop.

The Things Only A Mom Knows. Planning for our pets lives beyond our own.

A Tribute To A Beagle, Jekyll.

Slowing Down Without Giving Up.


Threats to Impending Death, and a Vet Moms Promise

To all of you who have a pet that you adore, or have lost a pet and left you feeling lonely, I empathize. It is impossible to say goodbye. Know that the day is coming when they won't be here. I want to say it's ok to grieve. To mourn, to not know where to go, or what to do. I feel it too.

Be who you are. The most precious and beautiful parts of everything are fleeting. Savor and celebrate them even if they hurt later. The hurt will fade and the joyful memories live forever. Protect your compassion with everything that you are for it is your most valuable asset. And, lastly, go love again. There is another soul out there who will love you back and help you go on...

If you have a pet story that you would like to share, or an experience with this condition please add it to our Storyline page at  Pawbly.com.

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