Day 101: A last taste of the Atlantic Ocean

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The swelling in Roo’s arm continued to worsen and her oncologist added prednisone to the rescue protocol she’s on. Prednisone is hard on Roo and I hated giving it to her. I was torn. Is the cure worse than the disease? Especially as it’s not a cure at all? And, in the same way this nightmare began with the Memorial Day weekend bookending the start of summer — the most damnable time possible for Roo to get sick, the hardest time for her to recover — when there was no immediate medical care available for Roo and we drove to Maine — the Labor Day weekend also delayed the delivery of the other chemo drug in her treatment.

The swelling of the lymph glands is horrible. They are hard and getting bigger. The oncologist said that the goal of this round of chemo was palliative. The drugs are well tolerated and shouldn’t make Roo ill. The hope is that they bring the glands down, but it seems too late for that. The more realistic hope is that they might buy Roo a little more time before she suffers too much to go on.

On Tuesday, though, while still waiting for the goddamned delivery from the supplier, I began to accept that Roo would not get better. I have seen this before. Orville died from this, and I have still not been able ever to discuss with anyone what happened then and won’t now. But I have seen this before. I won’t let what happened to Orville happen to Roo.

Roo is so tough that it’s hard to tell if she’s in pain. Maybe the pain is low grade and she just doesn’t show it. But while she still breathes, she still needs to take care of basic functions. 

She was willing to come outside but she wasn’t interested in walking. She moved towards the car, probably just wanting to lie down in there, but when I loaded her in I drove her – driving so slowly and gingerly that in anyplace less polite than this the cars passing us on the country roads would all have been honking – to several of the places she liked to take walks. We went to the town. She wouldn’t get out. We went to one park and then another. She wouldn’t get out. Finally we drove south to a point at the end of a spit of land jutting into the Atlantic Ocean. My intention was just to find somewhere to park and let Roo take in the view and breath in the air.

When we got there, Roo perked up. She wasn’t sure about getting out of the car and I took a picture of us. I tried to smile in the picture. I was surprised to see how grim I look in it. IT’s a reminder of how I’m failing Roo at every turn now.

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“What do you think, Chig?” I asked her. “Do you want to go swimming?” 

She decided that she did. It’s too high a jump for Roo to get out of the car on her own now. I’ve devised a way to lift her out that I don’t think presses on the lumps in her chest and arm and neck. Still, she grunted a little.

I hated putting her on a leash, because now more than ever I want her to feel the last of her freedom, but also because I left her harness in the first hospital when we arrived in Maine and the collar can’t be comfortable with swollen lymph glands in her throat. I’ve made the collar way too big for her, and I’m sure never to pull the leash, so it’s all right. Even as loose as it is, the collar looks lost in the folds of fur on her swollen throat.

There was a boat ramp and Roo went in the water. The salt water was clear and cool and Roo was so happy to get in. Her back legs tremble a little now and most of the hair on her tail is missing from the recurrence of dermatitis brought on by the cessation of her allergy meds necessitated by chemo and her belly, shaved three months ago for ultrasound is only fuzzy. I still see my puppy, but in truth the hard time she has been through shows. As she dunked herself I thought that this could be the last swim in her life. It seemed fitting that it would be in the Atlantic after swimming her way from the Pacific, where she was born, in the diametric opposite corner of the country, to the Sea of Cortez, two or three of the Great Lakes, the Mississippi, the Missouri, the Arkansas, the Ohio, the Red, the Salmon, the Columbia, the San Pedro, in countless Bear Creeks and Deer Creeks and Devil’s Creeks and in more and always more of the great rivers and bodies of water of this country and streams and ponds and brooks and puddles and ditches in every one of the Lower Forty-Eight than any other dog who has ever lived, or so I like to tell her because I would like to believe in that accomplishment of hers and I do. Watching her little dip in the ocean pretty much broke me down and I turned away so she wouldn’t see and I don’t think she did though that may just be the kind of lie we tell ourselves when we need to.

After her swim, she wanted to walk around a little, but after we walked on a gangplank to a lobster dock, from which Roo enjoyed looking at the water for a while, and a few more feet on the road, I said, “Maybe we shouldn’t go too far, Chig. Don’t you think it might be better to go back to the car?” 

She thought about it for a second but knew it was better. But first she flung onto the grass in front of someone’s house and rolled over on her back and gave herself a good wiggle while I patted her belly and called her by some of the names I have for her and told her how I felt about her.

Since then, things have gotten rough, but that’s all I can put down today. I have to get back to Rooki. And I don’t want to write about the way this coming weekend, when again it is impossible to get the kind of veterinary care we may need that has me worried tonight.

Day 96: Good mood. Bad arm.

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The wound on Roo’s right arm from the very first chemo treatment she had three months ago is once again so close to healing that it seems (though it has seemed many times before) like if she can be made to leave it alone for only a few more days it might finally stop troubling her. Nothing but an e-collar has kept her off the wound. In her sleep, she works her tongue so far down any bandage as to damage the wound. Even the e-collar she’s managed to get off. The inside of the camper is so tiny that it’s asking a lot, especially of a sick dog with bigger problems to worry about, to wear it.

But wear it she has been. It’s miserable for her because she can’t get into the corner she wants to be in, beside the bed. There’s a bigger corner, specially built for her on the other side, but she doesn’t like that one any more. Another mystery.

Early this morning she was bumping around trying to get comfortable. I took the e-collar off and pulled a sock over the scab. That’s workable when I can keep an eye on her, and so I did for the next hours.

She lay in one spot from seven in the morning until five in the afternoon. She didn’t move at all. That made it 34 hours since the last time she pooped, and that one, the day after the chemo, wasn’t good, so I worried all day about getting her out. But she wouldn’t go. I hated to leave her alone, but she needed some meds from the pharmacy and I had to get there before they closed. I dashed over there and to the pet store for soft treats, since she is refusing anything hard, even jerky, which I suspect could be from enlarged lymph nodes in her throat. 

The worst thing about nursing a dog with a complicated illness is that they can’t tell you what’s going on, what they’re feeling, what hurts or is making them sick. When I got back, she still hadn’t moved a muscle. She was going to have to go outside sooner or later, but I didn’t know if I should let her stay asleep or try to get her moving. Ultimately I convinced myself that she as exhausted from the bad night’s sleep in the e-collar as she was from the chemo and I decided to try to lure her outside with her beloved squirrel TV. 

“Chig,” I asked her, “do you want me to show you the squirrel?”

Squirrels on an iPad are evidently more interesting these days than squirrels outside, because she jumped up and came outside before I even turned the squirrel on, nosing at the tablet and bumping up and down as we made our way to the lawn. There. she had no interest in emptying anything. She just wanted to lie down and watch the squirrel.

I couldn’t believe the good mood Roo was in. Virginia and Jim came over to say hello, and though Roo didn’t get up, she was all wags and smiles while Virginia scratched her.

My mood had been in the gutter all day. I didn’t know if Roo was just sick (just?) from the chemo or if the cancer itself was doing it. But just seeing her smile and wag like that and show so much interest in watching the squirrel fight the snake boomeranged my mood. I shouldn’t use the rollercoaster cliché, because I’ve never felt a thing other than complete boredom and surprise that anyone would find them frightening on any rollercoaster, but this is a rollercoaster. A general sense of terrible foreboding with abrupt moments of relief and joy.

She wouldn’t walk, though. She was too tired – until I took the iPad and started walking with it. Roo had no interest in going into the woods behind the lawn. She’s too fastidious and doesn’t like to pollute her immediate environment. Roo wanted to head to the street. Roo was walking perfectly. She was interested and walking quickly. There were a couple of dogs out there and Roo stood tall and with tail held high and allowed them to greet her. She seemed to feel fine. It’s about 850 feet to the trail entrance, and she was walking with determination in that direction. I worried that any distance at all would be too much, but I gave in, if that’s what it was going to take to get her to disburden herself.

As soon as we got there, Roo started to feel some pain in her arm. She sat down and held the arm up in the air. It was trembling. It shot an arrow through me. I assumed it was the enormously swollen lymph glands she has there but I checked her paw for good measure. 

Gently I rubbed the fur on her arm in the swollen area and said, “I know, Little Bear. I know the arm hurts. We’ll just sit here,” and I waited with her until she got up on her own. It hurt too much for her to make it more than 20 or 30 feet at a time before she had to sit down again and hold the arm up. The trembling was awful. Luckily, we were just feet from the road. We made it there and Roo lay down in the middle of it. I called Jim and asked him to pick us up. I only had to wave a couple of cars around us, neither of whom asked whether anything was wrong that a dog had to lie down in the middle of the road, surprising in this neighborhood, before Jim arrived.

As soon as he got there, Roo got up and hopped right in the car. She made it look like her arm wasn’t even hurting. In the car, though, she was trembling a little in the back legs. Again the damnable question – is this a chemo thing or a lymphoma thing?

In the photo accompanying this post, you can see how huge Roo’s left shoulder area is. It is terribly swollen, hard on front and as soft as a water balloon at the elbow. And, because she can’t take Apoquel while she’s on chemo, her dermatitis is back with a rage, and where the puffy skin is rubbing in the soft skin of her armpit, she has a sore that itches her.

Roo wanted nothing but to watch squirrel TV in the driveway when we got back. She’s not in distress. She didn’t display any other signs of pain. But she also wouldn’t eat the ground turkey and rice I cooked her.

That’s how we end August. Not knowing whether these symptoms will persist, get better, or worsen. Not knowing whether the rescue chemo protocol will buy her some more good time. Not knowing whether the chemo will be making her feel bad in the coming days and whether it’ll be hard to tell if it’s the treatment or the disease bothering her.

Day 95: Rescue protocol

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When Roo and I went to the vet on Tuesday, we took the trailer because the tanks had to be emptied. Roo’s not in the mood to do much driving, so I’ve been going to the dump on her vet days so she doesn’t have to be loaded in the car more than necessary. When came out of the appointment with the confirmation (as though I needed any; it was obvious) that Roo had fallen out of remission, I saw that one of the trailer tires had lost air. I’d been expecting it to. The tires were worn out, the steel braid showing through the bald spots. 

We had to stop at a tire place and get them replaced. It would be a fast operation. The wheels are easy to get to and all I had to do was pull the trailer up to the garage bay. I hated to do it to Roo, because it was getting warm, but it would have been worse to blow the tire out.

While the guy was bolting the wheel on he asked me if I’d done a lot of traveling in the camper and I told him that yes, indeed, all throughout the Lower 48.

“I hope you had a dog or something with you,” he said.

“Oh, yes,” I said. She’s right there in the back seat.

“Yeah. You couldn’t do that without a dog,” he said.

I turned away from him and moved the few feet towards Roo, but had to turn away from her, too. For a minute, anyway. It was another of the hundred moments every day when I have to struggle to try not to let her see what I’m feeling. I’m trying to keep a front up. I don’t know what else to do. 

On Thursday we went to see the other oncologist. It wasn’t a hopeful visit. Roo’s cancer is not just back, it is attacking her aggressively. Her lymph nodes are swelling at a terrible pace. The bump in her arm – which they previously thought was another form of cancer – was this time confirmed to be from the lymphoma. Her forearm is swollen. It’s not hurting her. Or, at least, it’s not making her favor it or pay attention to it. And I don’t know if it’s part of the reason she’s not moving much or if that’s mostly from being rundown and ill from the lymphoma itself or the new rescue chemo protocol she began. It has to be all of them, I suppose.

On the way back from that clinic, I must have been distracted because I missed a turn which meant that we had to go about 20 miles and half an hour out of our way on a country road. I passed a sign for a public pond out there in the Maine countryside and thought about the hundreds of times Roo and I passed a sign like that I took the turn so Roo would have a good place to walk and swim and hunt. It’s how she saw the country and the reason she has swum and hunted in more places than most.

“Rooki, do you want to go to the park?” I asked her. She showed some interest and I turned the car around.

I lifted her out of the car. She welcomes the help nowadays, even though she lands with a little bit of a grunt because I’m not able to be too graceful about it.

It was warm, and though there was the pond, Roo didn’t want to go in. After we walked for about three minutes I asked her if she wanted to go back to the car and she looked relieved. I made a face-saving excuse about her old daddy being too hot and tired to keep going. I think she came along in the first place so as not to disappoint me.

Back in the car, the road became curvy, and though I drove the way I would have with a flat tire, it made her uncomfortable. It was the first time I saw that. It didn’t look like she was sick. It looked like she couldn’t find a comfortable way to lie down. She wanted to go in the back seat to try there, but she was unsteady. I pulled over so she could go back there more easily and she lay down.

By the time we got back to the Jim and Virginia’s house, Roo didn’t want to get out of the car. I tried to talk her out but she didn’t want to move, even though she was in an uncomfortable position in which she couldn’t rest her head. After five or ten minutes I offered to help her, but she gave me a short growl to let me know that she did not want to move. She has only growled at me three times. Once when she was a puppy digging a mouse hole in Arizona and I laughed at her for it and another time when it turned out she had a sore leg. And there have been times over the years, before she was sick, when she’s had to get out for one reason or another when she and I’ve had to pull her out. She never liked it, but she never growled. So this time, she meant it. She wasn’t threatening me. It was nothing like that. She was just letting me know that she had to stay right where she was for now. She immediately gave me a deeply apologetic look. She was worried about the impropriety of a growl.

I held her and said, “It’s okay, Little Bear. Don’t worry. I know you don’t feel good. I’m not going to pull you. You can stay there as long as you like.”

I closed the door and backed the car down the driveway into the shade and brought a folding camp chair over and sat beside her. She stayed there for about two hours, not wanting to move even though she couldn’t put her head down.

In the evening, Roo was highly alert. She didn’t want to go out, but she insisted on watching her squirrel movies over and over again. She had a good appetite. Other than not wanting to move, she was in a good mood.

This morning, she let me know with a gentle emergency bark at the unheard-of hour of seven that she wanted to go out. Yet, when we got out, she was in no rush to do anything. 

She was in a terrific mood. Bright-eyed and moving easily. She just wanted to lie down in the driveway. I figured she needed to let go of something, though, so after a few minutes I encouraged her to get up and she did.

She wanted to head down the road so I put her collar on and we went. It might have been the earliest we’ve ever gone out. I’m no early bird but Roo is far worse, a champion late sleeper.

We walked toward the trail, even if I had no intention of getting on it and risking Roo overdoing it. She did have to go. The chemo had upset her stomach. 

On the way back to the camper we ran into Virginia, who was walking to work at a nearby hospital. Roo loves Virginia and was happy to see her. Her mood was high.

Back at the camper, Roo, who must have been relieved, went back to sleep for several hours. 

She didn’t want to go out again for the rest of the day. All she wanted to do was sleep, and then, like a hospital patient newly addicted by imposed bed rest to her soaps, watch her squirrel videos.

I don’t know how long one might expect to see any benefit of the new, rescue chemo protocol she’s on, but I hope the answer isn’t right away, because today Roo’s lymph nodes are all the more swollen. She’s not in any distress. She’s eating and drinking without having to take the appetite stimulant. But those swelling glands are a building storm and they fill me with dread. Roo and I have spent these years together outrunning all sorts of storms. Hers and mine. This one is gaining on us.

Day 93: How to help a rundown dog get up and at 'em

Roo started feeling bad on Tuesday afternoon. Her lymph nodes are swelling. She’s out of remission and what happens next is unknown. At Dr. Mason’s suggestion, we go to see another oncologist, a colleague of hers, tomorrow.

Last night Roo started refusing any kind of hard food. She would only eat things like turkey and Dogswell Soft Strips. She didn’t want jerky, even broken up into little pieces. Today Roo felt so rundown and tired that she wouldn’t eat or drink anything at all or go outside. It had been 30 hours since the last time. Sorry, it’s not much of a video, but it gives you the idea of how we finally made a go of it. And tonight Roo feels pretty good. Waggy, even.

So, let’s end today on a high note. Tomorrow is another day.

Day 90: Ominous signs but feeling good

The pathology report for the mass in Roo’s arm came back – and told us nothing. It’s highly technical, but, according to Dr. Raker, it seems to say they have no idea what the growth is. The slides weren’t tested for lymphoma, though, so, even though the growth isn’t in a spot where lymph nodes usually are, that remains an open question. 

Roo is feeling pretty good. Her arm, which seems to be thickening, doesn’t hurt her. She was out of sorts from Thursday afternoon through Friday, but on Saturday and today she wanted to go for long walks and swims. She doesn’t favor the arm or limp.

So that’s good. The bad news is that another mass seems to be forming in her chest.

She sees the vet on Tuesday. The questions remain unresolved. It’s murder, my friends.

Day 87: In which Dr. Raker sums up Roo's new medical issue in one question

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My lifelong friend, Dr. Raker, summed up what happened today to Roo by saying, “Who gets two cancers?”

Jim’s and Virginia’s son Henry later answered the question: ” Roo.”

Because it appears that Roo might have a second, and completely unrelated cancer. The lump I found in her arm and which I thought might be a symptom of her lymphoma, was examined today by Dr. Mason. After aspirating the lump by placing a needle into it and drawing a tiny bit out, she went off to put it under the microscope while Roo and I waited in the examining room.

When Dr. Mason came back she had an assortment of treats for Roo and buttered her up for a minute until I said, “Doc, you’re killing me here.”

“Well, I’ve got to talk to her first, don’t I?” she said, and she was right. But the tension was in fact killing me and as much of a novelty a human death in a veterinary hospital might be, it would have been the last thing Roo needed.

I appreciate the way Dr. Mason played the tentative diagnosis down. She said that pending confirmation from the pathology lab, she was pretty sure this was a nerve shield tumor. She placed the accent on the upside of this type of tumor. On the low likelihood of their metastasizing and the way they tend to appear singly. It was kind of her. It protected Roo from my getting upset, which I work hard – and don’t kid yourself, it’s hard as hell – not to do.

Back at the camper I began the inevitable online research. What I learned was that a nerve shield tumor comes in two basic varieties, a cancerous form that is malignant and a non-cancerous one.

I’m too tired and wound up to write more now about the way this alters the decision tree as it branches out from this moment, but I will. For now I’m going to hang out with the Kahoo, who made it out for a slow walk that she enjoyed – I took that selfie when she lay down to rest on the grass for a few minutes – but is now not feeling too well.

Day 86: A fresh round of terror

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A torrential rain has been falling for hours, accompanied by occasional light thunder, which has been enough, of course, to terrify Roo. Like every time there has been thunder, I am glued to a weather radar app to try to spot a break when Roo might go outside. Finally a brief break appeared, but Roo was too frightened to make a go of it. She needed to poop, but every time she started to, she suspected thunder, or possibly heard some too far away for me to hear it, and bottled up. We got soaked and the mosquitoes, evidently outraged by having to fly between the raindrops, were vicious. Roo was too upset to keep trying. If she hadn’t been leashed she would have run into the woods and dug a hole. She kept suggesting it and arguing with me to let her.

When we got back to the camper Roo tried to run off and hide in the bushes. I hated to have to muscle her back – she’s no more in the mood for that than I am – but I couldn’t let her do that, if for no other reason that once out of eyeshot she would definitely lick the delicate scab on her arm open again.

But that’s not the source of the fresh terror. A new hard lump on Roo’s left foreleg is. I sent the picture you see here to the vet. My index finger is positioned on the lump. I first noticed it last night. It seems to have become harder overnight. Dr. Mason said that there’s no way to tell if it’s a swollen lymph node based on my description or the position of the lump. So, tomorrow Roo has to return to the hospital for a fine needle aspiration of the lump. She has also developed a bad rash on her belly, but that seems to respond a little to Gentacalm spray. And her fur is falling out in clumps. For all of that, she’s not feeling bad. Just scared. So scared.

Maybe it’s nothing, just a lipoma. But it could be the sign that Roo’s remission isn’t holding. Or something else entirely. So we’ll be waiting, in the racket of rain.