Saturday, July 03, 2010

One Man's Normal

If I actually manage to start and finish one post in a single day, then tomorrow, July 4, 2010 will be the day that I take my 56th and final dose of Interferon.  A year and a month in my life.  It both seems like it's been going on for years, and also like it was days ago since I did the first injection.  It doesn't seem like time has flown by because nothing happened this last year, quite the opposite.  I think that because so much was going on over the course of those 13 months, time really did fly by.  Had it been mundane, boring and uneventful, time would surely have dragged on.

Let's take a quick journey through this time first:  On June 14, 2009 at around 9:00 pm I injected my first dose of Interferon.  About a month prior to this, I started really getting some serious food religion.  I expected that it was very likely that the Interferon was going to really take a whack at my appetite, and I wanted to make sure that if I wasn't going to able to eat enough food, that at least what I ate would be the most nutritious, healthy and fresh food, and that I would also be eating a balanced diet.  So starting in early May, I started going to the Pleasant Hill farmer's market, which is only about 3 miles from my house, if even that far.  I canned, froze and pickled myself into oblivion.  I put up enough food, including almost 100 fully prepared and then frozen meals; enough to make a Mormon wife proud.  I seriously cut down on my intake of highly-processed, junk and fast food.  I read In Defense of Food, and took it on as a religion.  I continue to see the rewards of that decision:  Do I feel healthy and strong and vibrant?  No.  But do I think this last year could have easily been a lot worse if my nutritional needs had not been met so well.  Absolutely yes.

I lost my 16 year old Basenji, Kaelii, when she fell into the koi pond on a warm summer afternoon and drowned.  I finished up the dealing with the will contest brought by Ken's family and saw it through to resolution.   I started to take my writing seriously and see if it could be turned into my craft; the jury is still out on that one.  I cut off my hair, that over the prior 3 years had grown to a length that had it about 1/3 of the way down my back.  I ended an almost 3 year relationship with Brian.  Though it was the right thing to do, it still didn't make the process any easier.  Ending a relationship is never easy, and it's not just the cost that it exacts upon you, there is another person involved, and their feelings need to be given as much weight as yours.  I spent the month and a half prior to Christmas baking, cooking and canning my way into oblivion, because I decided that the few Christmas presents that I did give were going to be gift baskets of homemade food.  I said the few presents because as much as I love Christmas, which I do, the present giving and receiving part is really not that meaningful to me.  If you're ever going to give me a present and you want it to be meaningful to me, don't give it to necessarily mark an occasion or a holiday, do it because you want to give me something.  That tends to be how I gift most of the time.

Early this spring, I started taking my first few tentative steps into the dating world - we can tackle that subject another time.   As part of my new food religion I decided that I was going to do a vegetable garden, so I've spent the last 4 months basically redoing my gardens; everything from changing out a lot of was was previously planted, putting in a bunch of fruit trees, redoing the irrigation to make it more efficient and less water-consumptive (and screwing up the job a few times in the process, but I tend to learn best from my failures).  Right now I'm just starting to eat the first fruits of my labors.  I've also learned a number of lessons in the gardening school of hard knocks.  I've figured out what grows well in my area and what doesn't.  I've learned that when you over-water your garden; you tend to make a lot of your plants susceptible to disease, most specifically fungal diseases, which then makes the plants more susceptible to pest damage.  I learned that squirrels really like tulip bulbs.  It's the squirrel version of potato chips, and if one wants to grow them in squirrel country, one must be very clever and put in a lot of extra work to make the bulbs inaccessible to the squirrels.

Then, 2 months ago, the one dog of mine that has become my most beloved dog in all the years that I've lived with them nearly died because of my negligence.  He has recovered, I've mostly figured out a way to stop beating myself up about it, and well, that brings us up to now.  This was a quick review, and I'm relying on a frequently faulty memory, but that is the stuff that sticks out in my memory.  There is one more fairly big thing that happened this last year, but it wasn't one specific thing that happened at one specific point in time; this is really more of a process.  This process deserves a name, I think, so I'm going to call it:


Things a Year on Interferon Taught Me

  1. I don't scare easily.  You can tell me that I have yet another horrible disease, that the only treatment is a year long, that the drugs are very toxic and will wreak havoc on my body, and still, that at the end of the day, I've statistically got at best a 30% chance that it will work.  Not only can I digest all of that, but I will still say "OK, let's do this thing."
  2. You can throw 10 or 15 things at me all at the same time; not fun things either, and somehow I will manage to find a way to handle it all and still maintain at least a modicum of my sanity.  Now granted, dealing with all of it might mean that I put off half of it, but I still know it's there and I just tell myself that I'll get to it eventually.  Now that eventually might be a while; I've still not hung the vast majority of my artwork, finished painting a bathroom, all the trim in the house, and finishing up the touch-up painting everywhere else in the house, and I've been in the house for 2 1/2 years now, but I know that it's still there waiting for me (the work, that is).  I also know what my limitations are, having lived with chronic disease for more than half of my life, so I know that all in all, the stuff that I don't get done really doesn't matter in the long run, so I can fret and worry, or I can triage my list, and get the work done in the order of importance, and just let go of what I can't do.
  3. I've always thought that I'm way too scatter-brained.  After this last year, with having my brains pharmaceutically scrambled, and as a result having to slow things down enough to process all of the information coming at me, I've realized this:  Maybe I'm not that scatter-brained, maybe I just have an inordinate amount of information coming at me constantly, and that even in the best of circumstances it's more than I can handle.  Maybe the problem isn't so much that I'm absent-minded as it is that I don't know my limits and continue to try to manage more than I really can or should handle.  Or maybe not.
  4. Don't ever let yourself feel any false sense of security.  Just when you think you have a problem licked, when you might just get a very rude awakening.  When you think you finally have the tiger caged, you might look a little more closely and see that you really have the tiger by the tail.  A couple of months ago, my barrage of adverse reactions to the Interferon didn't go away, but they did seem to be getting less severe, and nothing new and weird seemed to be happening.  As such, I started to think "hmm, maybe the worst is over."  The second that I had that thought I should have slapped myself.  About that time, the mouth sores, which had been at bay for months, came back with a vengeance.  3-4 days after every injection, I would have a day where from the moment I woke up, I felt like I had the worst flu ever.  This week it happened on Thursday.  I could barely get myself out of bed, take care of the dogs and the cat, try unsuccessfully to eat something and then to fall onto the sofa, from which I could barely get up for the rest of the day.  I had chills and a fever of between 101.5 and 102, severe muscle aches, lethargy, and just a general malaise.  The next morning, it was gone, and other than feeling a little residual fatigue, it was as if nothing ever happened.  A fever from Interferon is common, but usually happens early on in the therapy, becoming less severe as one gets further into the treatment cycle.  It almost always occurs within 10 hours of injection.  But I am me, and my body never seems to do anything the way that it is supposed to, so I ought not be surprised.  These are just examples of what has been happening lately, but there were many others.  I just don't need or want to go through an entire laundry list to make a point.  
  5. This is kind of an offshoot of number 2, but I still think it bears discussion as something discrete:  I have found out that I can watch a lot of shit hit the fan all around me, and keep my composure, even if the fan never gets turned off.  I've developed an ability to be able to just say "oh well" when what is happening around me is out of my control, rather than trying fix things that I can't fix, and even more, to be able to do this without getting an ulcer.  Loved ones die, pets die, people get sick, sometimes with more than one thing at at time and relationships fail.  Those are just the facts of life.  Accept that or go crazy trying to avoid the inevitable
  6. My idea of normal is a bit skewed.  When I say that I'm feeling good, what is good for me is very likely pretty crappy for most people.  That is what living with a chronic disease does to you - you adjust your sense of what is normal to the circumstances that you have.  So when I think that things are going great, if you looked at the situation, you might think I was either crazy or in denial.  But I know what my limitations are and I don't have unrealistic expectations, so for me, when I think things are going well, for me, relatively, they are.
I've really not wanted to put a lot of fanfare into tomorrow, I really have wanted to try to if not ignore it, at least not make a big deal out of it.  It's not like really something that I think bears a celebration.  The end of a crappy experience isn't something I want to celebrate, it's something that I want to lay to rest.  People don't celebrate anniversaries of divorces, funerals or personal tragedies, I really don't want to celebrate mine.  I just want this last 13 months to have meaning and to then just go away.  The most obvious way that this will be a meaningful experience will be if it works, and at this point, all indications are good.  A less obvious way might be that even if it doesn't work that I learn something significant from the experience, and again, I think I've succeeded.  I've not just learned something about myself from this, I've learned a whole bunch of somethings.

Then there is one last thing that I've asked myself:  If I had known from the outset how really crappy this entire experience would have been, would I still have done it, even factoring in knowing how statistically unlikely having a good therapeutic response was going to be?  Yes, absolutely.  It was worth the risk, and in my opinion, I really had nothing to lose.  I wasn't going to get better by doing nothing, so what were my options?

So here we are, 13 months later, and after a little trip down memory lane, I have to say, it's been an interesting time.  But I can pretty much say that about all my life, especially my life since February, 1983, when on my first visit to San Francisco I made a very poor judgment call.  I'm just lucky that I've survived the consequences of that decision, and rather than blaming the rest of my life on it, I used it to grow.  Allegedly.



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Doggydad's Life Now: The Viral Monologues by Parry Tallmadge is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
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Thursday, July 01, 2010

Lucky Me, Part 2

 I walked into the hospital that sunny afternoon feeling a very mixed up mess of emotions: gratitude, relief, anxiety, anticipation, even some optimism, fear, sadness and most of all, guilt. At that point I still couldn't let go of blaming myself, feeling that the guilt was some kind of worthy punishment for my unforgivable negligence in following my own protocol.

I check in with the receptionist, and tell her I'm here to pick up Danny. "Oh, well have a seat, it's going to take awhile, there is a lot to put together: paperwork, medications, instructions. That will probably take 45 minutes or so". Ugh; I thought that was why Rick told me to come a couple of hours after he talked to me, so they could get it all together. I'm ready to bitch about it, then I just lump it back down my throat. I remember how signals get crossed in hospitals all the time. And in the grand scheme of things, I'm tickled pink that Danny is still alive. Sidebar: If you, like me, are a word/language geek, and wonder where some of these idioms (like tickled pink) derived from, Google it; it's fascinating. Here is the story on tickled pink: http://www.phrases.org.uk/meanings/tickled-pink.html.

So I sit. Luckily, I brought a book to read so I nosed my head down into Huck Finn and waited. Have you ever noticed that the more you try to look busy to avoid conversation with a stranger or someone you know, but that you don't particularly want to talk with, the more they are likely to try? Of course it happened. But it was a sweet lady in her 60's. Somehow I let it slip about what happened to Danny, and after that, it knew I couldn't extract myself until she was good and ready to stop asking questions. Damn.

At the precise moment that my patience was just on the verge of starting to wear thin (but I'm putting up a good front), they came and got me and shuffled me into an exam room. Huzzah, free at last. Rick came in without Danny at first and proceeded to tell me that although he was continuing to improve, he was still very listless. He was, however, eating a little if they spoonfed him baby food and drinking water. He could walk, but with the combination of the narcotics for the pain and the extent of his injuries, he was very unstable on his feet. I'm getting a little antsy as I hear more negative news, but then he stops and says he is going to go get Danny. He comes back, Danny walking next to him, slowly and wobbly, but walking. The last time I saw him he was so shocky that he didn't even recognize me or respond to me. I take a deep breath and then look at him and say "Well hello, little Doodle Doo" (a nickname, don't ask where it came from), he looks at me, looking a little drugged out, but comes over and wags his tail, a couple of side to side wags. That alone almost made me cry, but I just knelt down and kept sweet-talking him, my eyes fully welled up and the waterworks ready to open up.

I need to stop here and tell you that ever since Ken died I cry, a lot; sometimes more over things that make me happy, and most of the time over things that make me melancholy. At first I found it annoying and embarrassing in public, but then I let go of my self-consciousness and let 'er rip. What this made me realize is that before Ken died, it took a lot to make me cry. Even as a child, I rarely cried when injured or sad. My mother says that as a baby I didn't even cry much. I was very active and interested in my surroundings, but I rarely cried, unless it was something serious. I don't know if it's my Montana upbringing and being a part of the "boys don't cry" generation, or if I was just a bit dead inside, but since then, it doesn't take much. Those 2 days after the wreck, I cried at everything. I made a delicious breakfast, and cried about it. Something went wrong with the drip irrigation system I put in and I cried about it. A hokey commercial came on, I cried about it. The Giants won a game or a player I like made a really spectacular play, and again, I cried. If anything in my daily life had the smallest of bumps in the road, the waterworks would open up. It was, acutally, downright comical when I think about now, with some distance. As I am writing this text, now 5 weeks and 2 days post-accident, I'm still pretty hair-trigger for crying, but whatever the stimulus is now, it's at least a slightly more appropriate response to the triggering event. Sometime in the prior week I watched an encore broadcast of Oakland A's pitcher Dallas Braden pitching a perfect game: for you non baseball geeks, a perfect game is recorded to the pitcher, not the rest of his team, though they are integral to him getting one. A perfect game is no runs, no hits, no errors, and no walks issued. 27 batters up, 27 batters down, none of them reach base, and the pitcher's team commits no defensive errors behind him. What even made this perfect game even more spectacular was that it was done against the team that at the time (and still now actually) had the best record in the major leagues: The Tampa Bay Devil Rays. To make it even more incredible, the A's are in the American League. In the American League, the pitcher doesn't have to hit; that place in the batting order goes to the designated hitter, or as us National Leaguers like to call the position, The Designated Sissy. The DH is generally someone off the bench, maybe not the best defensive player, usually older, but they can still crush the ball out of the yard. They are there purely to produce runs, preferably home runs. Pitchers, at least historically, are notoriously horrid pitchers. My Giants are lucky to have 2, maybe 3 starting pitches that are certifiably legit hitters, and the other 2 are at least good bunters. Pitching is a full-time occupation as one develops and maintains their craft, so in the process, they have to let something slide, and the most innocuous thing to let go is one's batting practice and coaching sessions with the batting coach. The best hitting batters are usually ones drafted out of college, in my observation. In college, everyone has to hit, and they are expected to be productive. Kids that are drafted into the farm system straight of high school, not so much. The pros get them and get straight to the task of turning them into great pictures, while not necessarily trying to make them good all-around productive players. I'm not sure that is so much of a good thing, but it is what it is.

Now even if you're almost completely disinterested in the game and I've nearly put you to sleep at this point, I really doubt that you could have watched the 9th inning of that game and not gotten a little choked up. Me? By the time they got to the 9th inning, my face was drenched. The last play, a ground ball hit to the shortstop, relayed to the first baseman, and the runner thrown out at first, a play known as a 6-3, got turned, and I got going even more prolifically. Mind you, this was not an easy 6-3. There are a number of things that can make the play more difficult: the shortstop might catch it on a funky hop, they need to reset their body to throw, their throw to 1st base might be offline, or a combination of factors could be involved, but despite it being very much not a routine 6-3, they turned the play. Dallas went jumping off the mound like a 5 year old, and when his catcher got to him and went to give him a hug, Dallas jumped up in his arms and wrapped his legs around the catcher. Then he looks up into the stands. His grandmother, who raised him, happened to have come to the game that day; they live out in Stockton, about 1 1/2 hours away, and at the start of the 9th they brought her down to just above the dugout. Dallas saw her, started to sob even harder as she ran over to him, grabbed him, and hugged him as tightly as she could, all the while sobbing into his uni. There were cameras and microphones right there, inches away of course, and you could hear him and her sobbing in each other's arms. I haven't got you yet? Well here is my trump card: The game happened on Mother's Day. As I write this now, tears are running down my cheeks and my eyes are fully welled up. As for me, at that moment, I was crying, actually sobbing out loud, alone thankfully except for the non-judgmental dogs, with tears almost shooting out of my eyes. Seriously, I was so over the top I couldn't see where the top was anymore. This is what happens when I watch something like this a full four weeks after the best dog I've ever had nearly gets killed. And this is the second time that I had watched it, to make it even more ridiculous. That darned dog of mine owns my heart, and it took a lesser love of mine, baseball, to bring it home even more clearly.

I managed to hold it together, choke back the tears, and just stayed down on the floor, stroking Danny and talking to him quietly. It was so amazing to see this dog that I had scooped off the pavement 72 hours earlier, nearly dead, to be walking and wagging his tail when he saw me. Rick continued talking, telling me that they had kept him on the IV's until the last possible minute in order to make sure that he was well-hydrated and also so that they could continue to give him the Fentanyl (IV narcotic) as long as possible. He told me that they had removed his urinary catheter, and there had been no incontinence, so it appeared that we had dodged the bullet on the possible spinal cord injury. He had not pooped yet, but he had only started eating that morning, so he was almost 72 hours without food in the meantime. I was told to try to small but frequent feedings, and as a last resort, baby food meat is usually the last thing a dog will eat, which makes sense, since to me it smells about halfway between dog and human food, it's seasoned with salt (dog food isn't), and it's rich. Stinky and rich food, doggy heaven.

I put a lead on Danny, grabbed all of his hospital records, paid the bill, took copies of all his X-rays, got the medications and headed out. As soon as we got out the door, Danny stopped, he had to pee. And pee he did, a veritable river of it. Since his urethra had been irritated from the catheter, I could see a little blood in the urine, which I knew was normal from working in hospitals. The irritation also had cut his urine stream down to a trickle; a very slow trickle, so this pee session went on for proabably about 3 minutes. I put him in the car and we drove home. Well, not directly home. I have to admit with some embarrassment that I've not fully lost my taste for fast food, in spite of the amount of pontification I've spewed as of late, giving inventory of the many evils it wreaks upon the human race and the planet; nutritionally, ethically, ecologically, etc.. My fast food guilty pleasure is Taco Bell, and I knew that there was one about another quarter mile down Monument Blvd. (the street the hospital is on), so I ran for the border. My tastes are simple when it comes to Chez Bell, and that meant a couple of crispy tacos, a bean burrito (which also kind of smells like wet dog food, oddly enough) and a Coke. And then I head home.

We get home. I have all the other dogs in the dog room already, so I bring him in to the house, take him outside in case he needs to relieve himself again, and we have another marathon pee session. I then take him in, put him in his pen, and he immediately lies down and falls to sleep. He is really very listless. He is obviously Danny, but so not the real Danny, that anyone who had ever met him would have figured it out in a minute, if it took even that long. He had already wasted most of his muscle mass, especially notable in his rear legs. Before the accident, Danny was the most muscular dog I've ever owned, and all of my dogs have always been pretty lean, mean and cut. Danny was particularly so; his legs looked like Lance Armstrong's, and if you ever tried to get him to do anything that he didn't want to do, you quickly found out how much strength a 24 lb. dog could have. Plus, his athleticism and endurance were unblievable: I have a 7 foot long sofa in the family room. All the dogs can jump up onto it over the arms, about 36 inches. Mini Me can jump onto it over the backside, at least 4 feet. When I bring the dogs into the house, they would almost always enter through the sliding door from the back yard into the family room or my bedroom. In the family room, one end of the sofa is about 4-5 feet from the door. Danny wouldn't jump onto the sofa, he would hurdle it, from end to end and never touch a toe to it. That is 36 inches vertically and 84 inches horizontally. The way I'm feeling now from the drugs, I think it's doubtful that I could long jump 7 feet. When I was a kid, yeah, but not now, and even as a kid, I was 70 inches tall (still am). Danny is 17 inches tall. Even if I stood him straight up on his hind legs, I'm pretty sure that he's well shy of 48 inches in height. That dog was an amazing athlete, and on top of his speed and strength, he had incredible stamina and unbelievable speed and reflexes.

The dog that I brought home that day reminded me of a very elderly Basenji. Plus, he was in terrible pain from both the abdominal surgery and the hip and sacral fractures. He could get up and move around slowly, but every time that he got up, and this went on for a couple of weeks, he would scream in pain and he walked very tentatively. Because of the location of the sacral fracture, for the first 2 weeks he would almost never bear any weight on the left leg. That was pretty weird, even the vet thought so, because the car hit him on his right side, and there were 2 hip fractures on that side. Just goes to show - the size of and the amount of normal stress a specific bone takes does not correlate to the amount of pain it will induce when fractured. I've broken toes twice, that is my extent of bone fractures in my lifetime. It was always a little toe, and at the time the fracture occurred (stubbing my toe in a dark bedroom both times), the pain was so excruciating I thought I was going to pass out, and I am no sissy about pain. I can take a lot before it breaks me.

But back to Danny, because this story is about him; it's not always all about me: I got him settled into his little hospital pen in front of the sofa and went and got some canned dog food (100% chicken meat) to see if he would eat it. Nope. So then I went and got one of the jars of baby food that I had bought at the store right before I went to get him. I got meat only: Chicken, turkey, beef and ham. I got a jar of beef, opened it and stuck in under his nose. He ate it right away. Maybe only 3 or 4 good licks, about 2 ounces at most, but he did eat. I figured that he was just home, no need to go and push him right from the get-go, so I left it at that. I then brought a small bowl of water over and stuck it under his nose. He drank maybe 3 or 4 ounces, and that was it. He then turned away and limped slowly into the kennel at the far end of the pen, lay down and shut his eyes. I figured that was pretty clear body language, so I let him be for a few hours.

A few hours later I tried the same thing with the food: no interest. I had brought a spoon with me, so I tried to spoon feed him and it worked. He managed to finish the remaining half of the jar of beef. I gave him the water, he drank, and again, went back to his kennel and went back to sleep. Those first few days, I doubt that more then 30 minutes elapsed between the times that I would check on him. I was not used to having him so quiet and it freaked me out. Invariably, as long as he was breathing, if he was sleeping I left him alone. During the first 4 weeks, I barely left the family room. I slept on the sofa, and if I left the house, it was never for more than an hour, and usually it was just to get some groceries.

The next time he woke up he came over to the edge of the pen closest to me (I was on the couch) and just stared at me intently. I realized that he hadn't gone to the bathroom in a good 6 hours or so; the last time I took him out was when we first got home. I reached over and went to lift him over the pen, and got the most bone-chilling, heart-wrenching scream with his head a few inches away from the ear. Not only did it make me cry to know he was in that much pain, it also made that ear ring for a good 30 minutes. After that I remembered to keep my ear away from his head whenever I was picking him up. We went out to the yard, and I set him down in the grass, front legs first. Barely a whimper. This was the way I continued let him out of my arms for a long time. I even sometimes still do it to this day (June 25, by the way), more out of habit, but it can't hurt and might help minimize the stress on his rear. He walked a few steps and started peeing...and peeing...and peeing. It was like when I first pottied him in front of the hospital on our way home. It went on for a good minute or more. I knew he had a lot of fluid in him; mostly because he looked thick, almost fat, and I knew that after 3+ days of not eating that it was not that he was chunky, he was just tanked up; so much so that between that and the trauma from the accident, water was going where it wasn't supposed to be due to leaky capillaries (known as third-spacing in medical vernacular). Those smallest of blood vessels were damaged and letting water leak out of the blood and into the surrounding tissue. I picked him up, but super gingerly this time, and he let out a little yelp, but it was much better than a few minutes ago. I actually noticed that for the first 3 weeks or so, he would always have a lot more pain when trying to stand or when being picked up after a period of rest than he was after moving around for a bit, which made perfect sense, when I've got an injury getting up to move is almost always when the pain is worst. I got him back inside, set him slowly down into the pen and went and got a can of the chicken baby food. I took it over to him and he turned his nose up. I got a spoon and tried to get him to lick the food off of the spoon, but he wasn't having it. So I went over, got another jar of the beef and took it over. As soon as I put hit under his nose, he took some licks, and ate about half of the jar. I tried to spoon-feed the rest of the jar to him but he wasn't having it. He then took about a 4 ounce drink of water and laid down again. It was getting late, it had to be about 11 pm by now, so I left him alone for the night. I set my phone to alarm every hour to wake me up to check on him, only to find that unnecessary, since I uncannily seemed to wake up a few minutes before it alarmed every time. He slept through the night, and looked about as comfortable as I expected he could be, but that was ok. My boy was home now, and I just felt in my heart that things were going to be fine.

On Saturday morning at around 6:00am, I decided to get up, so I folded the comforter and sheet I was using on the sofa, put them away, and then took care of the dogs. That first night, I had left all the Silkys to sleep in the dog room, loose. It's something that I've had to do on a rare occasion and they do fine with it. They were excited to see me, since they were used to sleeping in their kennels next to my bed and having me within eye and earshot all night. I fed them, cleaned up the room, cleaned out the dog run and then went in to take care of Danny, who was still sleeping until I went over and called his name. He awakened, slowly got up, with a lot of effort and a couple of really shrill screams from pain. By the way, I need to back up here, lest you think I was making him tough it out through the pain: I was giving Danny the maximum dose of a strong veterinary narcotic every 6 hours on the nose, the most frequently that was safe. So the pain that I was seeing was under a heavy cloud of sedation.

I got him up, took him out to the lawn to go to the bathroom, and he urinated and was ready to go back in. I tried to feed him, and he wasn't interested, turning his nose at whatever I offered him. He did drink and actually drank a pretty good amount. I noticed that he was looking much more bloated than the night before, but I tried to convince myself that this was expected with his injuries and not worrisome. If you stood over the top of him and looked down, it was kind of like looking at a snake that had just eaten a rat, with a pronounced bulging out in the center of his body. Throughout the rest of the day I tried to get him to eat, to no avail. I called the hospital and asked to speak to the vet on-call, who happened to be Matt, and I told him what was going on. By this time, he was getting very urpy, belching almost constantly, and a few times he vomited up the water that was in his stomach. Matt said that despite how tanked he looked, he may still be dehyrated, and instructed me to give Danny 200cc of IV fluid subcutaneously (under the skin, not in a blood vein). He said if I had any concern whatsoever to call him. He told me that he was on until 8pm and that Ben would be taking over for the night when he left. It was then about 3 pm. For the next few hours things stayed the same. I called Matt, and told him everything, injecting that if he was manageable at home that I would rather deal with it here. That is probably the stupidest thing I had said in longer than I could remember. Matt said I could give him another 100cc of fluid, and that if he wasn't doing any better I should probably bring him back in, at least for them to give him an exam. Despite a nagging feeling that my decision might not be the wisest one I ever made, I continued to try to manage him myself. About 7 pm, after he once again vomited up water that he had just drunk, he looked restless, so I took him out to go to the bathroom. I looked down at his urine stream and it was bright fluorescent yellow: RED ALERT. I looked in his eyes, and the whites weren't; they were the same bright yellow. That was it, the last straw: I decided that we were going back to the hospital immediately. I called Matt first to let him know that we were coming in, packed Danny up and headed out the door.

I arrived at the hospital in about 10 minutes, went to the receptionist window, and she sent us directly into an exam room. In no more than a couple of Minutes, Matt came into the room. He looked at him, shook his head in the way that you don't like to see a doctor shake their head and said only "Oh, Danny." I then told him what had transpired since I took him home the afternoon before. I was getting ready to tell him about the jaundice when he said something about it first. I also told him about the belching and vomiting, and that he hadn't eaten. I told him how dehydrated he seemed to be in spite of sub-Q fluids: his skin turgor (elasticity) was terrible and his mucous membranes in his mouth were bone dry. I told him that I was thinking that he was third-spacing the fluids and he agreed. We went over the list of prombles that he thought were most worrisome: his listlessness, jaundice, vomiting and gas, and dehydration. They needed to get him rehydrated with IV fluids, check his bloodwork, probably do an abdominal ultrasound to hopefully see what was going on with his liver and his digestive system. It was pretty obivous that he needed to say, so I didn't even ask. He told me that he would be going off shift in about an hour, but that Ben was going to be in overnight, and I would probably hear from him sometime between 9 and 10 pm. I left, depressed and disheartened. On the drive home the waterworks started, and I figured, screw the other people around, I'm just going to cry right now until I'm done. That ended up being the rest of the drive home. I got in the house, fed the dogs, sat on the couch and just looked at the 4 walls. I'm not sure how long this went on, I really lost track of time. At some point the phone rang, and as I suspected it was the hospital. Ben was on the other end of the line. He told me that they had him back on IV's and his heart rate had come down, so his hydration was probably improving. They did a chest X-ray and it showed that he had some fluid in his right lung. They had run blood work, and things weren't too bad, other than his bilirubin, which was 24. A normal bilirubin level is 0.2 - 1.5. When I had Hepatitis A a couple of years ago, mine peaked at 8 and I looked like a pumpkin. They had done an abdominal ultrasound, and nothing was really standing out. They were fairly certain that he had a bile duct obstruction; that was the only logical explanation for such a rapid spike, but on ultrasound everything looked absolutely normal. Nothing else they saw in his GI tract was explaining it, or giving any explanation for his stomach shutting down. He then told me that they were going to continue hydrating him and monitoring him closely, plus they were going to start him on a couple of gastric motility drugs to see if they could get his gut going. If nothing changed he told me to not expect to hear from him until the next morning.

The next morning the phone rang, and it was Ben. He told me that there weren't really any notable changes overnight. They were continuing to try to get him to eat and drink, and he would drink, but then later on would vomit all the water back up. He told me that he maybe looked slightly better, but if so, it wasn't by much. This is how things went on for pretty much the next 4 days. At one time, he would look better. 6 hours later he would look worse. At one point they gave him another blood transfusion. His red cell count was borderline as to whether or not he needed it, but he still had half a unit from the transfusion a week ago.

Thursday pretty much sucked. I got a call in the morning, and it was Rick. He told me that they had been completely stymied by his bilirubin, which that morning actually hit its peak level of 27, He had spoken to the GI specialist at the specialty clinic next door, and she had looked at everything, and was still convinced that he had a bile duct obstruction. He also had called UC Davis (the vet school) and spoken to a couple of specialists there, and they said the same thing; that this was reading like a bile duct obstruction, in spite of what diagnostic tests (ultrasound and X-rays) were showing. The intensivist at UC recommended that if they couldn't figure out what was going on, that they should consider doing an exploratory surgery. That was really the only way to see for sure what was going on inside. Rick told me that he was first going to have a board-certified radiologist come in and do another ultrasound, which they ended up doing at some time in the early afternoon. At about 5 pm I got a call from Rick: He told me that they did do the ultrasound and nothing new was showing up. He then told me that they had done a repeat chest X-ray a few minutes ago, and they now had an answer: On film they were now seeing a hernia of his diaphragm on the right side, and that his stomach, duodenum and biliary duct (which dumps the bile into the duodenum when things are working right) had all slipped through the hole and were up in his lung cavity; it appeared that the bile duct was kinked up at the duodenal junction, and the stomach was kinked off at that spot as well . He said that this would explain both his inability to empty his stomach, and the reason for his astronomical bilirubin values. He explained that from the film, it looked like the very lateral edge of his diaphragm had sustained some very severe damage at the time of the accident, but it took a week for the muscle tissue to become necrotic (die), which then allowed for an opening between the lung cavity and the abdominal cavity. He said because it appeared to be so far off to the lateral edge of the diaphragm, it hadn't impaired his breathing. He then told me that Danny needed surgery, and he wanted to do it as soon as possible, but he needed my consent. He also told me that although he does a lot of surgery and had been a vet for 30 years, he still wanted to have a board-certified surgeon come in and do the surgery; Danny just had too much going on, and with all his complicated issues he just felt the specialist was the way to go. He was going to call him in as soon as he had my ok. I of course gave it, and hung up the phone; it was around 5pm.

About 10pm I got a phone call, of course it was from the hospital. It was Rick, and his voice sounded far more upbeat than I had ever heard it. He told me that they got in, and things at the site of the hernia looked pretty much as they expected it to, so they moved the stomach and small intestine back down into the abdominal cavity. They then looked thoroughly around in his abdomen to see if there was any other trauma that they had missed. He said that the rest of his gut looked remarkably healthy, and he was very optimistic that he would recover quickly now that things were back where they bolonged. He told me to go to bed, and he would call me in the morning with an update.

At about 8am on Friday Rick called to tell me that Danny was recovering from surgery and doing remarkably well. Overnight his bilirubin had dropped from 25 to 4, and he was starting to eat and drink, and no belching or vomiting so far. He then told me that they wanted to watch him for at least another full day, but if things continued to improve as they had overnight, that he might possibly come home on Saturday. I got an update later that evening, around 10, and they told me that he had been doing well; he was getting up and walking around slowly, he was eating a little bit and drinking and still keeping it down. His bilirubin was now down to 2, and h seemed to be in a fair amount of pain, so they were keeping him pretty well narcotized. Rick told me that he actually felt that he was ready to come home today, and I could come and get him anytime. I told him I would be there in an hour. So once again I made sure that his hospital suite in the family room was all set up, I fed the other dogs and the cat and got everybody settled in and headed off to bring Danny home.

When they brought Danny to me in the exam room, his tail started to wag immediately. He still looked pretty sad, more like a 10 year old Basenji than like a 2 year old, but he looked 10 times better than he had 8 days ago when I brought him home the first time. I gathered up Danny, his meds, his paperwork and headed out. He actually walked at a pretty brisk clip as we were leaving and I can't say that I blame him. Had it been me I would have wanted to get out of there and go home myself. He got outside, took a pee, and I picked him up gingerly and put him in the car. He let out a little yelp, but nothing that made me too jumpy.

After what turned out to be his final return home, recovery was slow and steady, but he never took a backwards step. The first week the biggest problems were pain management and nutrition. For the pain he continued to take the Tramadol 4 times a day for about the first 5-7 days. Every time that he stood up from lying down, he would yelp. If I would pick him up to lift him out of the pen, he would yelp, and it was a very shrill yelp, so it certainly got my attention. He started eating the day he got home, and never refused to eat again. He would not eat a lot at the beginning, and for the first 5 days or so, he would only eat baby food, off of a spoon. A couple of times I would put a bowl of kibble in, and the first time he actually ate it, the second time, not. After about another 5 days, I was able to transition him over from baby food to wet dog food, and it seemed that the stinkier it was the better. After another 4=5 days, I was able to transition him back onto his kibble, and though it took him another week or so to snarf it down like he used to do, he would eventually eat a full portion over a couple of hours. Note: When you have a multi-dog household, you can't just leave dog food lying around and let them graze at their leisure. That is, unless you like breaking up fights. My dogs are fed twice a day, in their kennels. The rule is, ignore your food for 5 minutes and I take it away. Thus, all my dogs eat quickly. I also can tell faster if one is sick, because if they snub the food at a feeding, usually something is wrong, so that is a a good diagnostic tool. Within less than another week, he was eating at a normal pace again.

The incision healed quickly and 8 days after surgery, I removed the staples, cleaned up the incision, and everything looked great. He was still moving slowly, but at least a little better each day. By this time, the most notable thing that would tell you that he was not normal yet was his muscle tone. His rear leg muscles were completely atrophied and his gait was still pretty unsteady. By about 3 weeks after coming home, I was finally starting to see a little improvement in his muscle tone. What was really the most positive and obvious change, however, was in his personality. Every day, his tail would wag a little more exuberantly every time I talked to him. He was now actually wanting to come out of the kennel and walk around just about the time that his period of cage confinement was up; between 6 and 7 weeks post-injury. Sometime around week 5-6, he started to yodel (the joyful= melodic howl that some Basenjis make when they're happy. Danny was a big-time yodeler before the accident, definitely the most prolific one I ever owned, and I was continually praying that his happy go lucky temperament and his yodel would come back. I knew that if he was yodeling, that meant that to him, life was good.

By week 7 I started to let him hang out with the pack for more extended periods of time; up to a couple of hours. So here we are now, at, 8 weeks and 2 days after the accident. Other than a still rather undermuscled rear, you would have absolutely no idea what this wonderful dog went through. Last night he was having a big time wrestling match with Mini Me, my youngest Silky and his BFF. He got so wound up that he tried to launch himself over my body and flew off the couch, and in the process nearly made me lose my dinner from digging his feet into my abdomen as he jumped. He is full-time back with the pack, and very happily so. He is yoldeling at least as much, if not more than before the accident. His tail never stops wagging and once again, Danny wakes up every morning like today is going to be the best day he ever had. This last Sunday, my friend Patti came by with her 5 month old Basenji puppies, 2 girls, and had a play date with Danny. He was wonderful, other than trying to hump the little girl Frani every few minutes, but he played with them, and it was obvious that he loved having some of his own kind around. After they left, he was pooped and took a nap, but once he woke up, it was like old Danny was back. He has quit listening to me, ignores all commands and does pretty much exactly what he isn't supposed to - like most Basenjis, and I couldn't be happier.

I really dodged a bullet on this one. The Silkys were unscathed when they got out. Danny got hit, hard enough that it made his survival a surprise, and yet, I have him back. My wallet is about $17,000.00 leaner, but no money was ever better spent. He got incredible care. He was in the hospital for a total of 11 days between the 2 admissions. He had major abdominal surgery, multiple ultrasounds and X-rays and at least daily bloodwork, most days more than once. He had ICU-level care, and the progress notes in my copy of the medical records showed that it was indeed very intensive nursing care. They never gave up on Danny, and fought to the end to figure out what was wrong. They gave me back my dog and made it possible for me to forgive myself and to smile again.  Not so lucky Danny. Lucky lucky me.



(Danny, 4 weeks after the accident)



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Doggydad's Life Now: The Viral Monologues by Parry Tallmadge is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
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