Dips, Chips, Chains, Whips

Mina seems to be feeling pretty good right now. She’s eating well, and has decided she prefers her chicken baked rather than boiled. We’ll see how long this lasts … The sarcoptic mange is in retreat and I’m going to dip her again tomorrow evening in the lime-sulfur stinky stuff. We may dip her one more time, though, to make sure it’s really cleared up.

Her hair is growing out, although in a different color! She used to be blonde, like a regular Wheatie, with a black spot on her back, like a regular Airedale. Her new hair is growing in red, however, like a regular Airedale! Her paws that used to be pinkish-brown from all the licking she did since she was a puppy, are now white. She doesn’t lick them anymore and both Dr. Cliver and I find that very odd. I have so many photos of Mina with those iron-colored paws and now they’re just white like when she was a wee pup.

So … on Tuesday I had a half-hour phone consultation with Dr. Charles Loops, DVM, a holistic vet recommended to me by Dr. Kocen’s staff. It was a pretty thorough conversation about Mina’s cancer treatment, her personality, her habits, her likes and dislikes. At the end of the consultation I paid my money and his staff sent out the homeopathic protocol via FedEx. I just got it today.

The instructions for homeopathic cancer treatment are really complex! I’ll have to consult this document every day and make sure my iCal is updated with the day’s treatment protocol. The remedies Mina will take, starting tomorrow morning, are Sulphur LM/3, Cadmium metallicum LM/1, Cell Salts, and Carcinosin plus 200C.

I’ve used homeopathic remedies for myself for years. In fact, my medicine cabinet is stocked with specific remedies for pollen allergies, but I rarely remember to take them. When I do take them, they really help. I’ve kept Rescue Remedy on hand for a long time, especially for during Mina’s chemotherapy protocol, and used it on both of us. Whenever we take a really long trip in my car, I give Mina a shot of Rescue Remedy before we get started. She’s great in the car, but it can’t hurt to help her out a bit.

We also saw Dr. Cliver today, the third visit in as many weeks. I needed another bottle of the lime-sulfur dip and I wanted her to check Mina’s right mandibular and right prescapular lymph nodes. They’re about 5 percent larger than last week, according to Dr. Cliver’s educated guess. We all believe it’s the cancer, even Dr. Loops was pretty sure of that. Dr. Cliver doesn’t believe that re-aspirating those nodes will give us any better information, either. She told me about a poor dog who’s been declining for more than a year now, whose seen a half dozen vets (including Dr. C. and B. at VIMP), none of the aspirates all these vets have done are conclusive. (Dr. C. at VIMP is certain it’s cancer as is Dr. Cliver.) So, it may be that we’ll never get a definitive diagnosis of the return of the cancer from a needle aspirate. We’ll have to watch Mina’s behaviors and habits for clues to how she’s feeling.

I will take her back in a couple of weeks though to have the lymph nodes examined. Dr. Cliver wants to give the homeopathy some time to work and see what results we get. It’s some strong stuff so I’m hoping it pushes the cancer back a bit and gives Mina some more quality time on this earth.

For my part, I have accepted that Mina is going to die from cancer. No point in fighting an immutable truth, is there? This acceptance has made it easier for me to enjoy our time together and relax a little, and that helps Mina a lot.

In the meantime, my beloved has a birthday coming up on Saturday – she’ll be 13 years old. That’s about a year longer than the average lifespan for a Wheaten Terrier. We’ll be visiting a favorite local winery and we’ll have cake and snacks and Mina will be her usual, sweet, very social self. If you’re local to my area and you didn’t get an invitation, my apologies, please send me an e-mail message to nothoney at gmail dot com, and I’ll tell you where and what time.

Now, I have to do lots of iCal entries for this new protocol!

s.

 

If the Cancer Don’t Kill Ya, the Chemo Will

Mina’s cancer seems to be in a retreat, but physically she’s not doing well. Down to 47.7 pounds as of Tuesday and she hasn’t eaten since then, either. Nothing seems to tempt her but bison bites and she can’t live on those. I’ve been heating her Chow Now in the microwave because she seemed to prefer it warm, but that’s not even working since Tuesday evening.

Then there was the debacle over the e-mail I sent demanding better estimates for Mina’s chemo expenses. I apologized, ’nuff said, moving on now.

We’re also having problems with pilling Mina. Last night I gave her some peanut butter with her pills and one of the smaller tablets got stuck on the roof of her mouth. I was able to remove it, but now she looks at the spoon very suspiciously. This morning it appears one of the capsules, either milkthistle or Keflex, melted in her mouth or throat and that was a couple of minutes watching her make faces and rub her tongue around and smack her lips. I gave her some more peanut butter and that seemed to help get the bitter taste out of her mouth. She’s on to every trick now and really doesn’t like being pilled manually. Yesterday, she bit down on my thumb with her back molars and that really hurt.

Mina is taking too many drugs and not eating enough. Period. I have to give her the medicine but it makes her nauseated so she doesn’t eat and that makes her feel worse. So today I’m calling VIMP, at Dr. Smith’s suggestion, so they can prescribe a stronger anti-nausea drug. The Metoclopramide just isn’t cutting it for Mina.

It’s been a hard couple of weeks, lemme tell ya. Still no word from the bank on my loan application.

s.

 

It’s Doxorubicin Day

**UPDATE** Mina will stay at VIMP until 3 p.m. Dr. Smith explained that Dr. Birnbaum is in a procedure and hasn’t been able to write Mina’s discharge orders and give her a final once-over. I called back to find out how much my bill will be and it’s not completed but it’s already more than I expected. More than I have in my checking account and I can’t make a transfer until July 1. I’ve used up all my transfers this month. So, I applied online for another loan to help cover the rest of Mina’s chemotherapy. I just hope it’s enough and that I can afford the payments. To say I’m despairing today is true.

Mina is at VIMP where she’ll be until around 11:30 a.m. Right about now, the LVTs are taking her blood and urine to make sure she’s fit for today’s 90-minute infusion of chemotherapy’s nastiest, and most effective, drug.

She didn’t want to stay and even burped up some puke while we waited for her paperwork. The tech came out with some Litmus paper to test the puke and then cleaned it up for us. Mina was shaking when the tech took her to the lab. I feel bad for her because she’s nervous but I know they take very good care of her.

They’ll do a CBC and if her numbers are good they’ll give her the infusion. If not, they’ll call me to come and get her and reschedule it. I put her on the scale in the waiting room and she’s lost nearly another pound this week. I simply can’t get her to eat much of anything, despite the mirtazipine. I told them this in the form I fill out every week to let them know how she managed the last chemo.

If she does get the doxo today, it’s going to be a rough week for her. That shit make her feel nauseated all the time, and she eats even less. But next Tuesday starts her rest week so I’m hoping to shovel as much food down her as possible before we start the third quarter.

As for me, I’m running out of money and it’s causing me enormous anxiety. I talked to Dr. Cliver last night, one of Mina’s regular vets, and I told her that if we both survive the chemo it’ll be a miracle. I honestly had no idea – NONE – how difficult this was going to be for Mina and myself. Mina’s a champ, she’s doing the very best she can, but I’m the worst cancer caregiver on the planet. I don’t sleep much, I’m cranky, and I can’t concentrate for very long. Last week was supposed to be a vacation, but I swear that Mina was depressed when I didn’t go to work yesterday. I think she needs a break from the constant insanity of my anxiety.

More later when they call me.

s.

 

A New Drug and PANIC

Mina will likely be glad to not have me around this evening. I’m a mess. I had a panic attack on the phone with her cancer vet, Dr. Birnbaum.

See, Mina’s anemia is much improved and her white cell count is normal. But, Her popliteal and prescapular lymph nodes were palpable, meaning, Dr. B. could feel them. That’s not good.

Then, I set out to get her prescription for chlorambucil filled. She has to take 15 tablets of 2 mg. each ALL AT ONCE.

Can’t find any place that has it, not Rite Aid or Target or CVS. They don’t carry it in any of their pharmacies. I put in three calls to VIMP and Dr. B. answered the phone the third time and was so nice. I’m sure she thinks I need meds, but she calmed me down and said the lymph nodes aren’t worrying her because Mina’s spleen is normal. She also told me the only pharmacy that carries the chlorambucil is in Lake Ridge and I can’t get there in the next hour.

The VIMP budgies talked a lot today!

So, I’ll go tomorrow and get her meds and give them to her immediately. Dr. B. said if her anemia and white cell counts are good next Tuesday, we’ll go ahead with the next Vincristine IV, possibly at a higher dose than last week, despite being a day behind.

Mina lost 0.6 pounds this week despite a healthy appetite. I am not happy about that but I appear to be the only one worried that she’s a sack of skin and bones these days.

See how skinny?

I hope Mina has a good evening while I’m out and that she enjoys being with people who aren’t afflicted with anxiety disorder. I’ll get some batteries this week and start the tapes again because – clearly – I need a refresher.

s.

 

Vomitus Maximus

We’re having a rough time here in the Cancer Ward.

Last night, as I was getting ready for bed, I found two puke deposits in a corner of my bedroom behind a dining table chair. Two piles of rice and Sunshine Burgers, no liquid, no brown stuff, no “coffee grounds,” just Mina’s dinner. It cleaned up easily, at least.

This morning I couldn’t sleep past 3 a.m. so I took Mina out in the pouring rain for a quick pee, gave her the famotidine, then tried to go back to bed. No luck. We went outside around 4:45 a.m. and about halfway through our walk Mina vomited again. This time it was the usual yellow, foamy stuff that she’s been puking up her entire life, and two partially-digested Dasuquin MSM tablets. That makes three episodes of vomiting and one diarrhea for this chemo week.

I need some good information on what to feed Mina. I’m getting advice from good people but none of it’s working for her. I can’t keep feeding her whatever I think she’ll eat. She needs solid nutrition and something that will stay down and I need to know WHY she’s not eating. Is it the chemo or the cancer? Is it Mina herself? WHAT? She’s lost at least two pounds this week from the looks of her and the feel of her bones. This cannot go on for 19 fucking weeks – she won’t survive the damn chemo if she’s a skeleton.

CLEARLY I’M SOMEWHAT ANXIOUS LATELY. That’s not helping either of us. Maybe Dr. Lundquist, the holistic vet we’re seeing on Friday, will have some answers. I dunno what to do. I just don’t know what to do. Neither of us is eating right, we’re both massively stressed and anxious, I’ve been home for FIVE DAYS just cleaning up pee and worrying about what to feed Mina and I believe I’ve reached the end of the rope.

help

 

Waiting

Dr. Smith met us this morning at VIMP and the place was already hopping at 8 a.m. I dropped off the coffee cakes and was told by the receptionist (whose names I should know by now but I’m careless about names of humans) that there are vegans and vegetarians on the staff who’ll be very happy to have tasty vegan treats.

The VIMP budgies were puffed up and singing to each other this morning.

Mina’s white cell count dropped from 29.5 to around 10.somethingorother, so well within normal limits. She’s still mildly anemic but that’s the cancer. It’s a go for the doxorubicin infusion.

She gained almost two pounds! She might lose those pounds this week but that’s the chemo roller coaster.

I asked Dr. Smith about the rapidly spreading spots of staph infections on her belly and around her vulva. He said not to worry too much, her immune system is suppressed so that’s why I’m seeing more of these things, but she’s on a strong antibiotic so it’s unlikely to get really bad. Then he gave me some antibacterial wet wipes and dry wipes to clean her with ’cause I don’t think mild soapy water is cutting it.

Now I wait for them to call me …

 

Good News Today; Chemo Is a Roller Coaster

Dr. Smith, the PWEVC doc whom Mina sees, told me that chemotherapy is a roller coaster. He wasn’t just whistlin’ “Dixie.”

Today’s trip to VIMP was a surprise all around. We were met by Dr. Smith, and I immediately felt better. He’s grown on me. He’s positive, he’s straightforward without being cold, and he clearly likes Mina. He took her away and came back about 20 minutes later and told me he examined her, took blood for a CBC and DPP (which he explained as breaking down a part of her blood even further), an ultrasound level 4, and CBC Differential Antech T330 – I have no idea. I’m sure Dr. Smith told me but I got lost on this news …

Pred head at VIMP waiting to see Dr. Smith

Her spleen has shrunken “dramatically.” His word. Her original ultrasound on April 21 revealed a spleen of 6.9 cm, and today it’s 2.07 cm! It’s still huge and full of nodes but it’s smaller. THE CHEMO IS WORKING.

I know, right?

Now, there are some potential problems. Mina’s mild anemia is up slightly from last week, as is her white cell count. There are some other blood values that they’ve sent to an outside lab for further testing. I’ve got a call in to Dr. Cliver, Mina’s regular vet, to clarify what those values mean.

The VIMP budgies were squabbling again today

Another potential problem is her kidneys. Her urinalysis showed no “overt evidence of infection,” but there was something about the specific gravity of the specimen that was off. It could be the dilute nature of her urine (’cause she’s drinking like she’s been in the desert), or it could mean her kidneys are starting to show a problem. So, we’ll do a urinalysis every week.

Mina’s Prednisone dose was reduced to just 10 mg. once per day. She also takes Metoclopramide for nausea 5 mg. three times daily, Famotidine 10 mg. twice daily, Tramadol 50 mg. twice daily, Remeron three-quarters of a 15 mg. tablet once daily, and her Dasuquin MSM – two tablets daily.

I don’t wonder that she lost another pound this week, putting her weight at 49 pounds. It’s the loss of muscle mass that really bothers me, but Dr. Smith reminded me of our talk about how cancer works and also told me that some dogs lose a lot more per week than Mina’s losing. He’s not that worried about her weight right now. I remain freaked out.

Also, she has little staph infections on her belly from her urinary incontinence. I’ve been washing her belly daily and putting Neosporin on the owies but FAIL. I didn’t realize she was so immuno-deficient that any little irritation can become a big problem. Later on, after she’s rested from her VIMP visit, I’m going to trim away the hairs in that area and do a much better job of keeping her clean and medicated.

So. We started the Cytoxan today. She got two 50 mg. tablets after her vet visit. She’ll get one 50 mg. tablet tomorrow and that’s it. This is serious shit. Here’s some of the information that came from the pharmacy:

Cyclophosphamide (sold as Cytoxan) is used to treat various types of cancer. It is a chemotherapy drug that works by slowing or stopping cell growth. Cytoxan also works by decreasing your immune system’s response to various diseases. Side effects: Nausea, vomiting, loss of appetite, stomach ache, diarrhea, or darkening of the skin/nails may occur. … Temporary hair loss may occur. … Tell your doctor immediately if any of these unlikely but serious side effects occur: pink/bloody urine, unusual decrease in the amount of urine, mouth sores, unusual tiredness or weakness, joint pain, easy bruising/bleeding, etc. …”

VIMP is mostly worried about “Cytoxan cystitis.” I think Mina’s dose is small enough that some of the side effects listed on the pharmacy literature are not common in canines. She has to drink A LOT. She has to pee A LOT. Trust me, we’ve already got both. I just steam-cleaned the carpet again with a strong vinegar and water solution. I’m going to work from home again tomorrow to make sure she’s drinking and peeing a lot.

Overall, I feel a lot better today and my nausea has disappeared. Mina is resting now, but we need to go outside soon for a walk. She’s eating boiled chicken and rice and later on sweet potatoes every couple of hours. She’s acting really hungry and I think that’s the Remeron that Dr. Smith prescribed. I hope he’s her LVT from now on, but he may have just been filling in today.

Oh, and we saw Carole from Chow Now and her husband at VIMP. I’m ashamed to say I don’t remember his name, but I’m like that with human animals. I do remember that their dog, Polly, was at VIMP for a bowel resection and I hope she’s doing well. Lovely people, really.

s.

 

All Your Freezer Are Belong to Mina

That is the whole of my freezer. The frozen organic peas, frozen loaf of multi-grain organic bread, Earth Balance margarine, tempeh tucked behind it, and leftover WFM pizza in foil are mine. The rest is Mina’s stock of chicken Chow Now Petfood.

I have to cook more of it tonight so I’m saving my last beer until then. Sam Adams Light and wine donations gratefully accepted.

She LOVES the sweet potatoes I made for her today. Oh! and she’s scent-marking again which I think means she’s gaining muscle control back. It could be something else but I’m going with the positive aspect – for once.

s.

 

Apologies to the Planet for the Water I’m Using

I’ve decided I can balance the amount of water I’m using everyday to wash out all the carpet coverings by not showering.

We got up after four hours of sleep to go outside and then start the laundry. An hour later the “famotidine alarm” went off and we went outside again after I gave her the pill. At 5 a.m. the “prednisone/Tramadol/Dasuquin” alarm went off and I meant to wake up, but somehow didn’t. Mina came to get me around 6:20 a.m. Outside for a potty break, back in for some pills and a hearty breakfast of Chow Now, boiled chicken, and mashed potatoes.

The laundry’s done for the morning and Mina has eaten twice. I’ve cooked more Chow Now and some boneless, skinless carcass and all is sanitized and clean again.

I feel like I’m living in an alternate universe. I see people, I hear from friends every day, but this is such an isolating experience. I lied about not dwelling on the news that the lymphoma may be in her bone marrow.

s.

 

Vincristine Today

From Buddha, via Colleen:

“Those who unhesitatingly embrace and tenderly serve
All suffering creatures during this degenerate age,
Just as a loving mother painstakingly cares
For even the most wayward of her children
They alone are the teachers of the holy life.”

Mina had her IV treatment with Vincristine today. This drug is commonly used in non-Hodgkins and canine lymphoma and is administered intravenously. Here’s how it works, according to Wikipedia: “Tubulin is a structural protein which polymerises to form microtubules. The cell cytoskeleton and mitotic spindle, amongst other things, are made of microtubules. Vincristine binds to tubulin dimers, inhibiting assembly of microtubule structures. Disruption of the microtubules arrests mitosis in metaphase. The vinca alkaloids therefore affect all rapidly dividing cell types including cancer cells, but also intestinal epithelium and bone marrow.”

If Mina is going to experience side effects, they’ll probably occur in the third or fourth days after treatment. That’s when the drug reaches its peak.

Overall, her cancer docs are pleased with how she’s doing. They measured her peripheral lymph nodes and found they had shrunk a little. They’re nowhere near normal, but they’re smaller. They palpated her spleen and it didn’t seem smaller, but they didn’t perform an ultrasound to check.

She stays on the prednisone at the same dose she’s been on the past week. It’s possible they’ll reduce the dose after this week, though, but she’ll have to be weaned off it slowly.

She lost a pound. That was depressing news. I asked why, when I’m feeding her several times a day, is she losing weight? The vet tech said it could be that she’s shedding her cancer. She has lost a lot of muscle mass.

But the news got even more depressing … Mina’s CBC results indicated anemia of 32.5 percent along with an elevated white cell count of 17,000. This could mean that the lymphoma is in her bone marrow. If that proves true, then the chemo won’t extend her life. We won’t know until next week when they take blood again for another CBC. I’m not dwelling on this now because I just want to enjoy being with her and not be all depressed and sad.

The VIMP budgies were puffed up and snuggling today.

I took Mina home and gave her the prednisone in a beef-flavored Pill Pocket, and left to visit Dr. Cliver and run some food errands.

At Dr. Cliver’s I got a prescription of Metoclopramide, in case she does have nausea and vomiting – I’ll need to pick up some Imodium in case she has diarrhea.

I mentioned the anemia and white cell counts to Dr. Cliver and she asked what I’m feeding Mina. Right now she’s still eating boiled chicken and cooked Chow Now along with a few treats. Dr. Cliver had read the label on the Chow Now and said “There are no carbohydrates in Mina’s diet!” She thinks it’s possible the lack of carbs in her diet could account for the anemia and recommended … potatoes. Apparently, dogs love potatoes. I hope she’s right because I don’t want this to be the way Mina’s life ends. Not without a few months of feeling good and doing all the things she loves, y’know?

So, off to Marshall to Bloom for their brand of chicken that’s most like the stuff at Whole Foods and a five-pound sack of Yukon gold potatoes, then to the Marshall IGA for a few more cartons of Chow Now, then home to the Mina Bean. She ate more chicken and chicken Chow Now, and is resting in front of the open window.

Next week, we have to take a urine sample for analysis because cyto-toxic drugs can cause cystitis. They’ll recheck her CBC, as well. At a later date, they plan to do another ultrasound of her adbomen and chest for evaluation of her internal organs/structures to judge further response to chemotherapy treatment.

And if one more person asks me how old Mina is and says, “Well, she’s lived a good, long life” I swear I will cut off their head.

s.