Staring down the inevitable?

For the past week my beloved dog, Hannah, has been very ill. The onset was sudden. Last Monday she had her acupuncture treatment and all seemed well. Very early Tuesday morning, I was awakened by the sound of her vomiting in the corner of the bedroom. From there, we have had trips to veterinarians nearly every day.

Her usual vet didn’t seem too concerned when I brought Hannah in on Tuesday afternoon. Hannah had been refusing food all day, yet took the small treat the vet gave her. “Let’s wait and see how she is tomorrow,” the vet suggested. That night, when Hannah started shivering, I couldn’t rest easy. I knew there was something going on with her, so I bundled her up and took her to the emergency clinic.

At the animal ER, her exam was unremarkable, but they did offer to take blood and run some tests, and I agreed. The results showed all her liver health values were much too high. Her ALT level, which we’ve been monitoring for about two years now, was over 4,000. (A normal level is under 100, and at her last check the previous week the value was 280). The ER vet told me that Hannah needed an ultrasound, and that I should check in with the regular vet the next day.

As soon as the clinic opened on Wednesday, I called and was connected with the vet right away. She told me that they did not have the correct personnel to do the ultrasound that day, and that it sounded like Hannah needed hospitalization with round the clock observation. I had two options to consider: taking her to UC Davis, or taking her to a pet emergency and acute care center in the opposite direction. The vet recommended the Pet Emergency & Specialty Center of Marin in San Rafael, so that’s where we went.

Traffic was light, so it only took 40 minutes to get to San Rafael from Napa. When we arrived they were ready for us, as my vet had phoned ahead and provided all the necessary information. I had to leave Hannah there so they could run new blood work, do the ultrasound, and give her IV fluids and antibiotics. The vet thought it safest to assume Hannah had an infection, and the hope was that she could be released the next day, on Thanksgiving.

I should have been working that Wednesday and preparing dessert for the Thanksgiving feast I was invited to the next day. But I couldn’t do either of those things. I stopped to talk and cry with a friend on my way back from San Rafael, I texted others, and I asked friends on social media for their good wishes.

Thanksgiving morning I got a call from PESCM that she was doing well. She had eaten some food, and they were going to try giving her antibiotics orally. They thought she could go home later that morning. It seemed fitting that on Thanksgiving — a day set aside for celebrating our blessings and bounty — I got to pick up my precious dog, my boon companion. Hannah was eager to be out of that place, too!

We had a pleasant ride home, and after we got inside the house she headed straight for her water bowl and drank quite a bit of it. I headed for the bathroom, and when I came out I saw that she had not held down much of the water she drank. I called PESCM back to report the problem, and the vet said that her nausea meds had probably worn off. She said that if I brought Hannah back she could get an injection of the nausea med, and they would give me some tablets to give her at home. I decided to wait a few more hours to see if the problem passed, and prepared to go to the Thanksgiving dinner with friends.

In the late afternoon, when Hannah was still refusing to eat or drink anything, I put her back in the car and made the round trip to San Rafael and back. She was given her nausea med via injection, and I also got the tablets to take home and give her orally.

We managed to get through Friday without a trip to the vet, even though it was clear that the nausea med wasn’t helping as long as it was supposed to. The med is supposed to work for 24 hours, but she was showing signs that all was not well after only 14 hours. I needed to give her antibiotics with food, so this was a problem. I gave her the nausea med early a few times so I could get her to keep some fluids and food in her system and give her the antibiotics. Then, first thing Saturday morning when her regular vet was open I called for a same day appointment.

Yesterday the vet we saw (not her regular one) prescribed yet another nausea med for her to take in addition to the other one. She loaded Hannah up with fluids, and told me to bring her back this morning (Sunday) for more fluids and an injection of nausea meds.

Today I’m cautiously optimistic that Hannah is on the mend. She managed to keep water and some food down over night and again this morning. She acted more normally last night by spending the night in her own bed instead of velcroing herself to me all night. (Not that I mind her being close to me; it’s just not her normal routine.) And while she has still been sleeping a lot and generally low energy, she doesn’t seem quite as lethargic as she was.

Throughout this entire experience, I’ve been worried that this is it: the end of our time together. She is nearly 15, which is more than 80 years old in human years. When I start thinking/saying, “I’m not ready to let her go,” I quickly correct myself because this decision shouldn’t be about *my* needs, but instead her comfort and quality of life.

I’m not sure if she will fully recover from this or not. For now, she seems comfortable enough and ready to keep chugging along. So despite how horribly expensive this has been (we’re roughly up to $2,300 in vet bills from the past week alone), I’m not going to give up yet. But I have to get myself comfortable with the fact that she is likely nearing the end of her time.

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My toddler brain

I’ve started to think of that part of my mind that stubbornly wants to make life according to my plans and desires as my “toddler brain.” Time and time again I’ve had to push past the “toddler brain” stage, to accept my life as it is and learn to deal with it from a place of reality.

When I went back for another glaucoma surgery in late September I had planned for my recovery stage to progress like the it did for the July procedure. That was not to be. The day after surgery when my bandage was removed I was horrified and shocked to see myself in the mirror. I looked like I had been beaten up. There was a lot of bruising, and my right eye was basically useless. There was only light and blurriness visible from it.

The pressure was non-existent, and that was a problem. There was a leak, which didn’t help the situation, either. The doctor prescribed eye drops that dilated the pupil in an attempt to force the pressure up and told me to return the next day. And the following business day, as well, because the situation required close monitoring.

The doctor also told me that I should plan to be out of work for a month. It’s a testament to my employer that there were no issues starting me on an unplanned medical leave of absence.

For the next few weeks I got very good at managing the public transit schedules between my home in Napa and the doctor’s office in San Francisco. Except for my unplanned drive into San Francisco to escape the wildfires in the area, I minimized my driving as much as possible because my vision was so poor.

It took about two weeks for the leak to heal and the pressure in my eye to elevate enough that the doctor told me I could stop the drops to dilate my pupil. He said it should take two more weeks for the affect to wear off and for my pupil to react normally. After three weeks, we gave up waiting.

So, here I am again at a point where I need to decide if I should have yet another procedure to try to fix my pupil. I’m now using drops to contract the pupil. That makes the vision better, but it’s still not that great.

I have a bunch of questions for the doctor, but I just couldn’t ask them during that visit. I was upset and crying. I told the doctor how I frustrated I was, though. That I had agreed to the surgeries to preserve my vision, but that it seemed worse now than before the surgery. He pointed out that my eye pressure was stabilized within the normal range without the help of any eye drops. I guess that’s supposed to be the mark of success.

The doctor told me that it should be OK for me to get new corrective lenses, so I made an appointment at the optometrist and started that process. The optometrist tried to find something that would work for my right eye, but he noted that with my pupil being distorted from the surgery, it was very challenging to correct. At least I’ll be getting a correction for my left lens, which will help me with my driving.

I started back to work last week. My anxiety meds are helping me deal with this potent combination of anger, grief, disappointment, and frustration, but it’s still been a challenge. That toddler brain starts kicking and screaming, insisting that this isn’t fair, and that somehow it should be made better. I wonder when it will stop.