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.
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.

For more on us, our journey, and this life we lead please follow us here;
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1 comment:

  1. Than you, as always for sharing your journey! So sorry for the challenges you and your beloved Jekyl are facing. So glad you are paving the path right for you, your kids, your practice! Your knowledge and advocacy for all of us "families of 4 legged kids," is appreciated, and needs to be said more. Positive thoughts for more time for Jek and you! Thank you for all you do!