Wednesday, July 30, 2014

Day 1688

Janet took Dash to dog training class tonight, while I stayed home with Dot. Our instructor initially thought Dot had made an amazing recovery as he watched Dash sail over some high hurdles. "That's pretty good for an old, sick dog," he told Janet. Hey, it's an honest mistake. They both have spots. Maybe he got the dogs mixed up because Dash behaves better with Janet. She told me that he made it through the entire class without any of his typical annoying barking.

For her part, Dot had a very good day as well. We made it through the night without any accidents. She didn't even leak on the waterproof baby crib liners strewn around the house for her to sleep on during the day. We're all learning our new routines. I take her out every three hours to pee, and once again during the middle of the night. Dot is off pain medication now and her vet says that we can begin transitioning her back to her regular diet. You can tell that Dot is happy to slowly be returning to normal. She is holding her head up high for the first time in weeks, and her tail is starting to wag again. Dot doesn't understand the concept of baby steps. My big concern now is to keep her from overdoing things while her body continues to heal.

As Dot gets off the critical list and continues her recovery, my own life is returning to normal as well. I spent a busy day revising and adding pictures to one website while finalizing the design of another. I still can't leave the house, but that really isn't a serious problem, since I seldom leave the house anyway. It is usually boredom, not necessity that causes me to get in the car and go somewhere. I certainly haven't been bored this year, but I think I would prefer boredom to dealing with a constant barrage of major medical emergencies. This has been a rough year. It would be nice if life would stay in balance, but it seldom does. I'm still hoping for healthy dogs and a little variety in my workload.

Can you believe that tomorrow is the last day of July? This year has literally flown by. I'm grateful that so far this has been one of the coolest Summers on record. To be approaching August with only one or two days of triple digit temperatures is almost unheard of in Texas. There have been quite a few mornings where the temperature was in the low 70's while I walked Dash around sunrise. Most of the wildflowers are gone by now, but I did happen to see a few Lanceleaf Coreopsis flowers still blooming this morning. It will be nice when I can walk both dogs again. This is usually my most relaxing time of the day.

We'll waterproof the bed again tonight, but hopefully Dot's incontinence is nearing an end as well. She certainly had a good day today. Tomorrow, I'll continue taking things one day at a time. It's been working so far.

Penny is today's Dalmatian of the Day
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Tuesday, July 29, 2014

Day 1687

We got Dot's pathology report today. The growth that was removed one week ago today was a Low Grade Soft Tissue Sarcoma. Yes, this is cancer, but it's not quite as bad as it sounds. Most soft tissue sarcomas have a relatively low chance of spreading to other parts of the body. Since Dot's tumor was located in her intestines, it was not attached to surrounding tissue and it was possible to remove it completely with clean margins. This means that a healthy segment of the intestine was also removed on either side of the tumor to ensure that no cancer cells were left behind. The oncologist told me today that since Dot's tumor had clean margins, there will be no need for chemo or radiation treatments. With any luck, the surgery will be all that is needed.

I also found out that Dot's incontinence probably has nothing to do with the surgery itself. Her internal medicine specialist told me that incontinence is very common when a dog has been receiving IV fluids for an extended period of time. These fluids help prevent dehydration and are used to flush toxins out of the body, but they can also interrupt normal kidney function. "Sometimes it takes four to six weeks before the incontinence goes away," the doctor told me. At least we've got a plan now. Whenever she wakes up and starts looking around, we assume that she has to pee. I took her outside around 2:30 AM this morning, and she made it through the rest of the night without incident. I try to take her outside every three hours and that seems to do the trick. There were no major accidents today. I only had to wash two small baby crib liners, instead of all the bedding we own.

I'm starting to get cabin fever from watching Dot 24/7. Her condition continues to improve, but she's still not stable enough to leave on her own. She still has a bit of trouble getting up and down and needs to be kept off the bed and furniture. Usually, she follows me around anyway, so keeping her nearby is not a problem. Dot has clearly regained her appetite. I decided to fix myself a nice breakfast this morning, instead of just eating my regular oatmeal and both Dot and Dash wanted the sausages I fixed. Instead of a relaxing meal while watching old Dr. Who episodes, I had two dogs barking at me. It's good to see Dot active and engaged though. Slowly but surely, she's getting back to her old self.

Last night we made elaborate preparations to ensure that Dot wouldn't wet the bed.  In addition to the layer of waterproof baby crib liners, we placed a thin sheet of vinyl between the comforter and Dot's blankets. This might have been a mistake. The bedding didn't breathe anymore and I woke up about 3 AM in a pool of sweat. At first I thought that Dot had managed to get under the covers with me, but then I realized the problem was me. It was Niacin flushing. Live and learn. I guess taking a big dose of Niacin at night for cholesterol while laying under a sheet of vinyl isn't a good idea.

I hope Janet and I stay healthy. Having two dogs with cancer at the same time is just about all I can handle. We're doing pretty well though. Against some pretty long odds, Dash is making a spectacular recovery and Dot is doing her best to follow in his footsteps. For my part, I'm trying to take things one day at a time even though this doesn't come naturally to me. One way or another, we'll pull through this.

Tink is today's Dalmatian of the Day
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Monday, July 28, 2014

Day 1686

We hit a little snag today. Incontinence. Dot began having urinary incontinence when she was hooked up to IV tubes in the ICU. Now that she's recovering from surgery and beginning to eat normally again, we expected the incontinence to stop. She doesn't wake up in a puddle of pee every night, but last night she did. What a mess. Despite the fact that Dot was sleeping on top of three waterproof baby crib liners, all our bed linen got soaked. I'm glad I had the forethought to get a waterproof mattress pad years ago when we bought the bed, or the mattress would have been ruined as well.

Until we can resolve this issue, we need to be a lot more diligent about getting Dot outside in the middle of the night to pee. Three hours seems to be the maximum amount of time she can hold it. Needless to say, we didn't get up last night and I spent most of the day doing laundry. If I didn't need to keep a constant eye on Dot, I would have gone to a commercial laundry. The bulky comforter and mattress pad took forever to dry in our dryer. Everything is fine now, but I must have done ten loads of laundry today. If you think the solution is just to have Dot sleep in a crate or on the kitchen floor until her condition improves, you haven't owned a Dalmatian. They all insist on sleeping in the bed with you. Heaven help you if you try to get them to sleep somewhere else. Dalmatians are very stubborn and tenacious dogs.

When I was throwing away junk mail and trash today, I came across some financial papers I should have signed and returned three weeks ago. That's the trouble with the mail these days. So little of any importance finds it's way to our mailbox anymore that I tend to ignore all the mail. Checking the mail had become just like checking the spam folder on my computer. Mostly it's all junk, but you still have to check, because every now and then something important winds up there by mistake.

I got a call from my hepatologist this morning telling me that the lab results from last week's tests had come back and I was still virus free. This is probably as close as I'm going to get to being declared officially cured of Hepatitis-C. Since I was one of the first to receive the new Sovaldi treatment, I'll probably continue to get tested periodically indefinitely. That's OK by me. With all the advanced testing the dogs and I have been subjected to recently, I've become somewhat addicted to test results.

Sometimes technology is just too complicated. There is no sound on the TV in the bedroom. The sound works fine on the TV in the kitchen though. My deductive mind tells me that either something is wrong with the TV, or something is wrong with U-Verse. Hmm. The TV in the kitchen is receiving the U-Verse channels, so U-Verse is apparently working. The TV in the bedroom gets sound from the Hulu channels, so there's nothing wrong with the TV itself. Why am I getting cable on only one of the two TV's when they are getting the same signal from the router? It's a mystery. I guess I'll just go to bed and hope I remember to get Dot up at 2 AM to pee.

Queenie is today's Dalmatian of the Day
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Sunday, July 27, 2014

Day 1685

Dot has turned the corner. We discontinued her Tramadol last night, because it made her so loopy, we couldn't tell if she was getting better or worse. She slept well without the powerful drug, and when she woke up this morning, she was almost back to her old self. Hoping for the best, we fed the dogs their breakfast and took them down the hill to the park for a short walk. All systems were go this time. After eleven long days, Dot finally pooped. I don't think I've been so happy to see a dog poop in a long time.

We've still got a long way to go, but the surgery now appears to be a success. Every day, Dot gets a little stronger. We're starting to mix some dry kibble in with her critical care diet and she's eating it. Today, she walked about 200 yards, instead of yesterday's 50 feet. She doesn't need my assistance when getting up from her dog bed anymore. She's rather do it herself. These are baby steps, but they are important ones.

It's still not wise to leave Dot alone, but Janet and I were able to take turns running errands and got a lot done anyway. We were each even able to go to the gym. I haven't been to the gym for several weeks during this extended dog crisis and my body let me know I was getting rusty. I'll be sore tomorrow, but still not as sore as Dot. She's still got to be uncomfortable from the surgery, but from all appearances, she seems to actually feel better now than the days just before her hospitalization. This tumor must have been bothering her for a long time.

I'm still worried about the pathology report on the tumor that was removed last Tuesday. There's nothing I can do about the results. We'll just learn what Dot's body already knew some time ago. Whatever happens, we'll deal with it. We haven't come this far to give up. As Dot's life slowly returns to normal, I need to make an effort to get my own life back to normal as well. I'm behind on several projects, but I'll get caught up. I'm glad my priorities put the dogs first, but you can only ignore work for so long. There are always bills to pay.

I stocked up on food at Central Market this afternoon, so I won't have to leave the house while Janet is away at work. I can still walk Dash very early in the morning while she's getting dressed. Dash seems to prefer these early walks anyway. Long quiet days with a convalescing dog are actually pretty conducive to website work. Hopefully Dot will continue to improve day-by-day as I sit nearby, writing the code that will eventually pay her vet bills.

Deuce is today's Dalmatian of the Day
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Saturday, July 26, 2014

Day 1684

Dot passed another milestone today. We took her back to the cancer center this morning, where they removed her surgical bandages and examined her incision to make sure it was healing properly. There was no leakage or infection at the incision site and the doctors were pleased with her progress. Now all we've got to do is get her to poop. We've already passed the initial deadline when her gut was supposed to start working again, but the doctors still tell us not to worry. They say that some dogs take five or six days after surgery before the intestines start working normally again. Hmm. Unless I'm doing the math wrong, it's already been five days. Dot did lose a lot of weight during her week on IV fluids. Probably a lot of the special low fiber food she's eating now is just being absorbed to help rebuild her body.

Dot's appetite is pretty good now, but we don't want to feed her too much until she starts eliminating what she's eating. After all we've been through so far, we definitely don't need a blockage. A week without eating can change a lot of things. Dot's rear legs have been weak for quite a while. That's why she's been using the underwater treadmill for physical therapy. Since she lost five pounds during hospitalization, her muscle tone isn't as good as it should be, and her legs are shaky again. She definitely can't take the long walks in the park that usually inspire her to poop. I know she'd like to eat more now, but until food starts passing through her system, it could be dangerous.

To complicate things further, the Tramadol she has to take for pain often causes constipation. We've got a dog that isn't pooping, but pees when she sleeps, since some of the many drugs she's taking impair bladder control. I'm convinced that all this is temporary and am still hopeful. Dot appears to be a little stronger with each passing day. We did go out and buy some waterproof crib pads at a baby store for her to sleep on though. She still likes to sleep on the bed and I'd hate to ruin the mattress. Needless to say, we're doing a lot of laundry.

Our cooler than normal Summer appears to be over. It got up to 103 today. The brutal heat is hard on Dot. She likes spending time outdoors, but not in this kind of weather. None of us like this kind of weather. When it got a bit cooler after dinner, we tried taking Dot and Dash on a very short walk in the park, thinking the familiar smells might put Dot in the mood. It didn't work. Dot was too tired and we returned home after a walk of only 50 feet.

Despite my disdain for Walmart, I got a prescription filled there today. My doctor told me that the drug, which is not typically covered by insurance, would be cheaper at Walmart. I didn't expect that it would be twice as cheap. It really makes you wonder what is going on in the world of medicine when the cost of a drug can vary by 100%, just depending on where you buy it.

Against my better judgement, I made a short social media comment supporting a good friend's position on Israel. Almost immediately, I was chastised by another friend all the way over in Norway for not supporting the Palestinians. I usually don't talk about politics on social media and this is why. The world has become so polarized that it is almost impossible to talk about anything without starting a flame war. I still prefer to talk about dogs. Everybody loves dogs.

Smokey is today's Dalmatian of the Day
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Friday, July 25, 2014

Day 1683

I was Dot's nurse today. I really appreciate what the nursing staff did for Dot in the ICU last week. It is not easy keeping a sick and very tired dog on the path to recovery. I'm a worrier too, so anything abnormal about Dot's behavior freaks me out. Dot has a laundry list of meds that she needs at various times during the day. The doctors want to get her up and walking about every two or three hours. She doesn't need much activity, but staying in one place all day isn't going to help her recovery. It's dificult to get Dot up again once she's lying down on her blanket, but once she's up she seems to move about fine. There's a fine line between keeping her mobile and pushing her too hard and sometimes it's difficult to know exactly where the line is.

I walked Dash so early this morning that there was still dew on the leaves, even though it was a hot July day. When we returned, Janet left for work and I took over nursing duties for the rest of the day. I thought Dot seemed hot, but when I took her temperature, everything was completely normal. I though her heart was racing after a very short walk down the back alley, but when I compared her heart rate to Dash's, who had been sleeping, they were both exactly the same. I worry that Dot hasn't pooped yet. Up to a point, this is completely normal for a dog recovering from abdominal surgery. After that point, it can be serious though. The trouble is that I have no idea where that point is. Every dog is different.

I'm glad the weekend is here. I could really use a good night's sleep. My primary care doctor wants me back on statins again, now that my Hepatitis-C treatment is finished. I started taking Simvastatin and timed release Niacin last night and the combo seemed to have the same irritating sides effects as it did before. Niacin flushing is common and it makes me feel like I'm burning up. When I woke up to check on Dot last night, my skin felt like it was on fire. The flushing only lasts a few hours, but when I'm awake, this is two hours too many. My liver specialist wants to re-test me in 12 weeks to make sure the Simvastatin and Niacin combo aren't screwing up their good work. Both drugs can have an adverse effect on the liver. Once again I am caught between dueling doctors. Is it my heart or my liver that is going to win? I haven't got a clue. I'd much rather be having a cheeseburger and a beer.

We go up to the cancer center tomorrow morning to get Dot's surgical bandage removed. The stitches will stay in, but the doctors want to remove the big bandage covering her belly as soon as possible to help the wound heal. It is easier to check if the incision site is leaking of becoming infected if you can actually see it. I have a long list of questions for the nurses, because I hate surprises. Doctors and nurses probably hate me because I'm always asking questions and slowing them down. I know the nurses are busy, but I'm a person who needs to know. I'll be polite, but I'll still ask all my questions. I'm curious about these things. Maybe I should have gone to med school.

Puppies are today's Dalmatians of the Day

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Thursday, July 24, 2014

Day 1682

Dot is finally home again. After spending an entire week in intensive care being poked with needles, hooked up to IV tubes, and being cut open by a surgeon, I think she is very glad to be back on familiar turf. The cancer center officially released Dot late this afternoon, sending her home with a big sack of meds, and special instructions on how to care for her for the next few days. She still isn't eating well, but her doctors thought that being back in familiar surroundings would encourage her to resume eating normally. So far, the plan seems to be working. Within two hours after returning home Dot ate a small can of Hills A/D Critical Care. I'm glad she seems to tolerate this special prescription diet, because as much as dogs would prefer cheeseburgers, bacon and fried chicken to help them get well, people food just isn't a good long term solution.

Dot has been through a lot this week and is very tired. After eating her small special dinner and surveying the house and yard to make sure everything was still there, she settled in on top of a soft pile of her favorite blankets in the living room and went to sleep. We'll go back to the cancer center on Saturday to get her surgical bandages removed and then two weeks later to get her stitches out. I'm hoping that is all we'll need to go back for. Assuming that everything goes well with her convalescence, the next major milestone will be getting the pathology report on the tumor that was removed. If the growth is not malignant, all Dot needs to do is continue her recovery and get healthy again. If the growth turns out to be cancerous, we'll have to come up with a plan of action. That can be dealt with later. Right now, the important thing is recovering from some very major surgery. We'll take things one day at a time.

While Dot was being evaluated by her doctors this afternoon, I paid a visit to my own doctors. They wanted to do another series of tests to determine if my Hepatitis C treatment was still working as expected. I keep waiting for a final thumbs up from these guys, but it appears I may never get one. When I asked whether the disease ever returns after this type of treatment, my doctor essentially said that nobody knows yet. I was among the first large scale group of people in the world to receive the new Sovaldi drug and there are no historical records to compare. I am one of the test cases that will ultimately determine whether Sovaldi works as well long-term as it does during the initial treatment phase. So far, the drug appears to be a home run. "You were real lucky to be included in this first batch of patients," my doctor told me. "Insurance companies are starting to deny coverage already because of the high price, and there is talk of reserving the drug for the most serious cases." Rationing a drug that actually works exactly as promised seems like a stupid idea to me, but I wouldn't be surprised if this is what the government decides to do. Why would you want to ration a pill that costs a small fraction of the price of a liver transplant and has none of the rejection issues or transplant side effects? At any rate, I'm glad I got approved for treatment before Sovaldi got on the evening news as the world's most expensive pill. Insurance companies hate it now.

I won't be going out to my breakfast restaurant tomorrow. We have a new schedule now. I'll walk Dash very early in the morning, while Janet is still home and getting ready for work. We want to make sure that one of us is there to watch over her at all times. We'll see how tomorrow goes. So far, Dot seems to be improving a little bit every day. Today was a very good day.

Molly is today's Dalmatian of the Day
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Wednesday, July 23, 2014

Day 1681

Dot started eating solid food again today. She ate a small jar of baby food yesterday, but this was the first time she has been able to hold down solid food since last Thursday. Janet and I fed her some canned chicken when we went to visit this evening and she enthusiastically devoured the entire can. If she doesn't vomit tonight and is able to pass the chicken she ate through her system, we'll finally be able to take the catheter out of her leg and unhook her from all the IV tubes.

Considering that she'd had major surgery less than 24-hours ago, Dot looked great today. Her medical team is very pleased with her progress. We continue to take things one day at a time, but if she continues to improve at this rate, there's a chance she'll be able to come home with us tomorrow evening.

Fifteen years ago, our first Dalmatian had to go through a very similar type of abdominal surgery. Spot survived, but he didn't have the advantage of the advanced medical care Dot is receiving now. I continue to be amazed at the resources veterinarians have at their disposal these days. Getting a CAT scan for Spot in 1999 wasn't even an option. The surgeon just opened him up and started looking around. Surgical techniques and medications are much better now. Actually dogs have more advanced care options than you or I do, since progress isn't hindered as much by government and FDA restrictions. Laser surgery, genetic testing, stem cell transplants, MRI imaging and much more are all commonplace in today's veterinary world.

It is terrible that Dot has to deal with the complications of major surgery and possibly cancer. She is lucky to live here in Dallas though. We have some of the best specialty care facilities in the country right here. I like to think that Dot is in the Mayo Clinic for dogs right now. Her doctors are taking very good care of her.

I'll have to admit that I'm getting some very good care myself. Tomorrow I go for my last regular  visit to the liver clinic. I will repeat all the tests I had at the beginning of my treatment, and if all looks good, I am officially cured of Hepatitis-C. Technically, I've been virus free for several months now, but these doctors are very cautious about over promising things.

We took Dash to dog training class by himself tonight. Janet thought it would be good for him to be around other dogs again. Dash seemed to enjoy himself until a cold front blew through and he sensed a change in the weather. Rain was on the way. I don't think Dot can hear the rain inside the hospital. I hope she can't anyway. She needs to get a good night's rest.

Jewel is today's Dalmatian of the Day
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