Wednesday, December 30, 2009
A snow storm on Monday night left us with chain controls and dense/freezing fog advisories in the Sierra Tuesday morning. Rather than risk life and dog, we rescheduled our appointment with Dr. Beebe in Sacramento to next week, since a trip to Sacramento means travel over the mountains from here. Meanwhile, acupuncture on Monday went well… and chemo today (Treatment #9) proceeded without a hitch. Jack’s had a pretty good week and looks amazing for an older guy with two terminal illnesses (we can’t forget about his heart disease in addition to everything else).
We look back on the last 11+ weeks since his lymphoma diagnosis and are amazed at how well everything has gone. Linda came across the original paperwork from Dr. Rebhun when we first met him at UC Davis back in October, where he summarized our treatment options and prognoses for each one. Mostly, he cautioned us about the impact chemo could have on Jack’s heart. We know he was worried about that because no one could predict how the heart would react to chemo. We remember what a tough decision it was… and we remember many sleepless nights worrying whether we made the right decision. There are so many variables to consider, with Jack’s well-being and happiness the most important.
Thankfully… and happily… everything has turned out as well as can be expected. Notwithstanding a few “bumps in the road,” Jack has not experienced the nausea and resulting dehydration we were warned about (dehydration from nausea would be tough on his heart). He has never missed a meal and eats with great enthusiasm. We have never had to postpone or cancel a chemo treatment due to a bad blood test – all chemo treatments have been right on schedule. He manages to recover from each treatment with only a few days of fatigue and a lot of sleep depending on the drug given. And most importantly, his eyes are bright, his weight is constant, his coat looks great, he’s still in remission, and he seems happy. It just doesn’t get any better than that.
We expect to spend most of this weekend at home, since the drug he got tonight is the one that seems to make him the most tired by about day 3 (Saturday). Next week he has acupuncture on Monday and will see Dr. Beebe in Sacramento on Thursday. No chemo next week.
Sunday, December 27, 2009
11 weeks and counting since diagnosis and Jack is going strong…this afternoon he was rolling around on the living room floor kicking his feet in the air like a goofy dog – always a good sign. This week will be a busy one for Jack – acupuncture with Dr. Rinehimer Monday morning, a checkup with Dr. Beebe in Sacramento on Tuesday (http://integrativeveterinarycenter.com) and Treatment #9 on Wednesday with Dr. Schneider. We’re pretty sure Jack is liking the extra week of rest between treatments, and so is our checkbook.
Saturday, December 26, 2009
We hope you had as much fun for Christmas as we did. On Christmas Eve day, Linda had to work so Jack, Jenny and John piled into the car and took Linda out for lunch – a nice sandwich at the Sonic Drive-in. Jack loves that place - there’s so much activity between the car-hops, the drive-thru, and the UPS trucks zipping around it's sensory overload if you’re a dog. Granted, the food isn’t exactly gourmet, but it’s edible and provides an opportunity for us all to spend some quality time together in a rather small space… It should also be noted that Jack rolled belly-up on his futon while napping on Thursday. This is a HUGE deal – one of the key signs that he’s feeling good is sleeping on his back and he hasn’t done so for several weeks.
On Christmas Day Jack was not to be denied – he was taking Linda for a walk and that was all there was to it. So off they went heading for the mailboxes. When they reached the mailboxes, Jack turned and headed out into the park. At this point Linda decided to let Jack lead just to see where he would go. He proceeded to march out into the park, and then around the loop trail through the sagebrush. When he was younger he used to spend a lot of time out there, running with his doggie friends and chasing bunnies, but he hadn’t shown any interest in walking out there for several months so this was quite a surprise.
So how far did he go? Those readers who are familiar with our park will know the trail out to the ‘dirt pile’ down which he trotted like he owned the place. Once they reached the dirt pile, he was heading out into the sagebrush when Linda decided to turn him back. A huge walk for Jack and as Linda said the best Christmas present she could have received.
Not to be outdone, Jack was ready for more this morning so we loaded up and headed to Reno to do some shopping. Jack’s favorite trails are in south Reno and he was eager to walk again today, and again we had to turn him around when it was time to head back to the car. It’s very nice to see Jack engaged and interested in walks again. He seems to have a bit more stamina lately, and he doesn’t drag his toes or stumble when he gets tired like he used to – how much of this is attributable to the acupuncture we have no way of knowing but we believe it is helping him in a meaningful way. His next acupuncture appointment is on Monday, and chemo Treatment #9 is next week Wednesday – four days from now so we’ll see if we notice any differences with bi-monthly treatments.
Wednesday, December 23, 2009
Nothing says “Christmas” like dog boogies…yes, unfortunately Jack’s sinus infection has returned with a vengeance. (Sorry, no photos of that one…) So, while we are all enjoying a week off from chemotherapy treatments Jack is taking another round of antibiotics. Dr. Schneider Schweet-heart’s (Jack’s words…) only comment was that it can be tough getting those out of the sinuses. There’s never a dull moment at our house.
Meanwhile, like everyone else we’re looking forward to the Christmas Holiday and all of the family, friends, good food and good cheer that goes with it. But mostly we’re looking forward to spending the long weekend with Jack. 'Thank you' to everybody who reads the blog and sends emails of encouragement and support to Jack. It really means a lot to us. Over the next four days we’ll post as time permits, but for tonight we want to wish everyone a very Merry Christmas.
Monday, December 21, 2009
This afternoon Jack had acupuncture and this evening he gave a very spirited attempt to play with Jenny (who was more interested in her toy than in Jack). She was laying in the living room, squeaking on her toy with Jack in the dining room, barking at her… and everyone’s tail was wagging.
Jack looks good this evening and right now is on his futon, next to the computer, keeping me company as I type. Moments ago he was in the bathroom as I took a hot bath, keeping me company while I soaked. He’s never far from Mom.
Sunday, December 20, 2009
Today was Jack’s ‘sleep day’ – four days after Treatment #8. He slept all night, slept all morning, and slept most of the afternoon…until 3:00 when he decided that he’d slept enough. So Linda loaded him into the car and took him with her to run some errands. He stood the entire time – either helping Linda drive, or with his head out the window. He also barked up two motorcycles, and since they’ve been home, he’s been his usual self.
We’re anxious to see how he does now that his treatments going forward will be every other week, rather than every week. Hopefully that will translate into a little more endurance and he can start to get back some of the muscle tone that has been lost over the last two months. His regular weekly acupuncture appointment with the vivacious and effervescent (Jack’s words…) Dr. Rinehimer is tomorrow afternoon, and he has a follow-up appointment with Dr. Beebe (our Integrative Veterinarian in Sacramento) on December 29th. And of course, Treatment #9 is scheduled for December 30.
It’s been 10 weeks since diagnosis and we have to say, at this point, we have no regrets. Dr. Rebhun’s protocol has proven to be exactly right for Jack, he has experienced none of the nasty side-effects we were warned about (gushing blood out of his nose notwithstanding) and other than obvious signs of fatigue, he has remained ‘interested and engaged’ throughout.
This week marks the half-way point in Jack’s treatment protocol, and while there are no guarantees the second eight treatments will go as smoothly as the first eight, we remain cautiously optimistic. What we do know is that Jack is here for Christmas, and we are enjoying every day that we are blessed with him.
A few years ago we saw one of those little one-liners and it has always stuck with us: The value of life lies not in the length of days, but in the use we make of them. From that has grown our household mantra – ‘No wasted days.’ That has never been truer than it is now – with Jack, every day is a bonus.
Saturday, December 19, 2009
Following this week’s Treatment #8 at UC Davis, we expected Jack to be wiped-out this weekend. He slept a lot yesterday and slept well last night, but this morning he was bright-eyed with a good appetite for his breakfast. We decided to take advantage and go for a drive to Lake Tahoe for lunch at Kings Beach.
When we arrived, we got the dogs out of the car to stomp around in the snow for a few minutes before we headed in for lunch, and Jack marched us all the way down the beach to the lake’s edge. The beach had about 8 inches of snow on it and the beach was wider than usual because the water level was low. The walk down to the lake was several hundred yards, and Jack had no problem at all walking in the snow. He clearly enjoyed himself and wasn’t all that happy when Linda decided it was time to head back to the car (why am I always the “bad guy?”).
This afternoon he napped in the laundry room while helping with the ironing. Jack follows us (mostly Linda) everywhere, from room to room, and is often under foot. He’s always been like this and we take it as a very good sign that this behavior hasn’t changed. Jack remains interested in what we’re doing and wants to be with us.
We’ll see what tomorrow brings, and whether the after-effects of this week’s chemo treatment kick-in, but so far he’s handling this dose better than the last time (knock on wood… no bloody nose!). This week he gets a break from treatment – he doesn’t even have to go for a blood test if he’s feeling well! The only thing on his schedule this week is acupuncture Monday afternoon with Dr. Rinehimer.
Thursday, December 17, 2009
Jack submitted to his weekly blood test yesterday morning, and returned home to await the results. Dr. Schneider called in the afternoon to report that everything looked ‘good’ and we were off for UC Davis. Jack has always lived his life by fairly basic principals – when he’s hungry he eats, when it’s dark outside he sleeps, and when it’s light outside he’s pretty much ready to give anything a try. This makes traveling with Jack in the evenings drama-free; the sun goes down and he goes to sleep. End of story. The drive over the mountain was uneventful, and when we arrived in Davis there was just enough time to run over to Pluto’s for an order of roast turkey.
Everyone slept well, and this morning we walked over to campus to stretch legs, empty bladders, and tree a couple of squirrels before heading to the clinic for Treatment #8. We met briefly with Dr. Rebhun to discuss Jack’s blood counts and low-level anemia and were happy to learn that his anemia may not get any worse – this is typically the point in the treatments where the blood counts are the lowest. In fact, there’s a chance we may see improvement now that the next eight treatments will be every two weeks rather than weekly.
The UC Davis small animal clinic is a pretty busy place – on any given day you never know what you will see. The biggest dog we’ve seen was an Irish Wolf Hound (all 200 lbs of him), lots of Labs and Cockers, and of course cats of all makes and models. But not all patients are dogs and cats…on one visit we saw a chinchilla, another time we saw a goose in a dog crate (strange noises coming out of that box for sure), and today it was a beautiful green parrot named Lola in a cat carrier. No matter what the species, no matter what the ailment, the staff handles every one with incredible care and compassion.
Because Jack had his blood test and we drove over the mountain the day before our appointment, we arrived at the clinic early in the morning, and Jack moved to the front of the line. That also meant that his treatment was done before lunch and we were able to finish the drive home over the mountain in the daylight. Today’s results after Treatment #8: Jack looks great and feels good, he’s ‘interested and engaged,’ and his lymphoma is still in remission.
And on the way home, when not helping John drive or barking at UPS trucks, he enjoyed a nice nap on his pillow.
Monday, December 14, 2009
With all the snow everywhere (which now has an especially thick crust and is virtually impossible to walk on), the dogs haven’t ventured far on foot. Linda decided to take Jenny with her to the mailbox (about two blocks away), so at least she could get out and get some exercise. The thick, icy snow chunks from the snow plow are piled up in the gutters and sidewalks, making the street the only place to walk.
Complicating matters is that they chip-sealed our street about 6 weeks ago, so the street itself is more gravel than pavement and Jack’s not fond of walking on gravel. For all of these reasons, it was best for Jack to stay home and rest.
Yeah, right. For anyone who has wondered whether Jack is “interested and engaged,” here’s proof. Linda quietly reached for Jenny’s collar and leash, and as soon as Jack saw it, he jumped up and came over with a wagging tail… waiting to be leashed-up. So the plan then became to walk as far as John shoveled our sidewalk (we live on a corner), and bring Jack home before heading back out with Jenny.
It’s important to note that our mailboxes are at the common-area park, where trails lead past a grassy lawn and out into the sagebrush. This is where Jack has gone for walks for the last 9 years although we haven’t ventured out there in several months.
By the time we got to the corner in front of the house – the pre-determined point to turn back – Jack decided he was going to the park and off we went. He didn’t walk fast and he had a hard time with the ruts of snow, ice water puddles, and loose gravel on the street, but he was not to be deterred. As soon as we reached the mailboxes, Jack headed out into the park. There was a nicely packed path in the snow that made walking much easier, and he marched out several hundred yards before Linda decided it was time to turn back.
That’s about the farthest Jack has walked in at least a couple of weeks, and John thinks this shows the value of acupuncture. So kudos to Dr. Rinehimer and her magic needles.
Meanwhile, e-mail consultation with Dr. Rebhun at UC Davis determined that it would be best to postpone this week’s chemo treatment (Treatment #8) to Thursday, making it a full 7 days from his last treatment. That’s fine with us, since the weather on Thursday will be much better than Wednesday. We’re really not in the mood to head over the Sierra in a snow storm.
Sunday, December 13, 2009
Nine weeks and counting since diagnosis…you can say that we’ve settled into somewhat of a ‘routine’ – as much as one can when working through a chemotherapy protocol. The nose-bleed issue has thankfully not repeated itself and we have added high blood pressure to our list of things to watch, and with it has come a new medication. With so many variables in the mix, it’s hard to say what causes any one ‘trouble’ but last night Jack had an upset tummy. He seemed fine during the day yesterday, and seemed fine today, but last night was a little rough for him. His appetite remains strong, and he continues to be ‘interested and engaged’ in everything around him.
This week is the last of the weekly treatments and that’s a good thing – Jack is really worn out. We are cautiously optimistic that he will continue to tolerate the treatments as well as he has, and with treatments every other week he will have a chance to overcome the fatigue factor. Tomorrow he sees Dr. Rinehimer for acupuncture, Tuesday morning is his weekly blood test, and if all is well, Wednesday morning he will see Dr. Rebhun for Treatment #8 (mitoxantrone) at UC Davis.
Saturday, December 12, 2009
Today is the day after Vincristine when Jack is the most tired. We’ve noticed it with his earlier treatments, and this one was no different. It’s really challenging to write something interesting or funny about sleeping all day, with the occasional rally around mealtime. Something Dr. Schneider asked us last week has really resonated – is Jack ‘interested and engaged?’ The answer is a confident ‘yes.’ He keeps a close watch on where we are and what we’re doing, and will relocate his napping spot to make sure he’s with us at all times. As for meals, he doesn’t let us forget what time it is, and continues to be fully engaged when it comes to food preparation. From these simple yet important behaviors we believe that fatigue is still the only serious side effect of his chemo treatments.
We would be remiss if we failed to mention that Jack was rescued from certain death in the desert and came to live with us nine years ago yesterday. What a wonderful journey it has been for all of us. Thank you Aunt Marla!
Thursday, December 10, 2009
Jack was back at the vet this morning for Treatment #7 – Vincristine. As Dr. Schneider put it – Jack’s getting tired of Vincristine…and Vincristine makes Jack very tired. Seems like an ironic sort of relationship, but one we’ll live with to keep Jack living with us.
His blood pressure was high again this morning, so Dr. Schneider is calling Dr. Hosking (cardiologist) for a consult. There should be a medication available to us that will target his blood pressure while not upsetting the delicate balance of chemo and heart meds. If it sounds complicated, that’s because it is…good thing Jack has such a great team of vets who care about him as much as we do.
The other thing we noticed lately is that the skin on his front legs where he has been shaved for the IV catheter has changed color over the last few weeks – it’s now much darker. We spoke to Dr. Schneider about this and she wants us to keep a close watch. It will be one of the things on the list for his thorough exam next Tuesday prior to our trip back to UC Davis for Treatment #8 on Wednesday. It seems like every week we learn something new…
Wednesday, December 9, 2009
Treatment #7 has been delayed until tomorrow morning. After braving the ice, snow, and single-digit temperatures on our trek to the vet we learned that their blood machine was on the fritz, so the sample had to be sent out and results are due back tomorrow. However, it was not a wasted visit. After giving Jack a thorough once-over Dr. Schneider pronounced that Jack’s heart sounded good, his pulse was strong, his gums looked good, and his lymph nodes felt normal. While his blood pressure was high, she was not too worried and will re-check in the morning. Overall, she stated that Jack is doing well for a dog at this stage of chemotherapy.
Tuesday, December 8, 2009
When we left for work this morning at 6:30, the thermometer in the car gave us shocking news. It was -10 degrees (yes, that’s MINUS 10 degrees F). When Linda drove home for lunch, it had warmed to a balmy and semi-tropical 11 degrees – break out the swimsuits. As of this writing at 6:45pm, it’s 2 degrees.
Needless to say, with these temps, the foot of snow in the yard has a thick frozen crust and it’s hard to walk in – especially when you have cancer and feel week in the knees already. But Jack’s a trooper and he marches out there to do his business! (Sorry, no photographs of that for the blog…)
At some point this afternoon, he decided it was time to nest on Mom and Dad’s bed… this time on Mom’s side. No doubt it was a warm and comfy place to spend the afternoon!
Anticipating Treatment #7 tomorrow at 4pm, pending the results of the blood test.
Monday, December 7, 2009
A couple of things to celebrate. First, it’s been eight weeks since diagnosis, and Jack is still with us; and second, last night was the first big snowstorm of the season. Jack has always been a “snow” dog, and even though his energy level is down from the chemo treatments, he still got out there and made “first tracks.”
Wednesday is Treatment #7 (Vincristine) if his blood count is good, and next week we’re back to UC Davis for Treatment #8. This is significant because after #8 the treatments back off to every-other week which should give his body a better chance to recover. With chemo every week he just reaches the nadir from one drug when it’s time for the next.
So far, so good – still no severe reactions or side effects, just very, very tired.
Saturday, December 5, 2009
Jack was feeling a bit feisty this morning… and the weather was nice… so we decided to take a day‑trip to Davis and a walk around the UC Davis campus. There are always a lot of squirrels to chase on campus, and the Pluto’s restaurant downtown has awesome roast turkey. Mom and Dad have been known to get an order of turkey (or two) just for Jack and Jenny.
So there we are, walking around the Quad on campus, and there was Santa playing with a dog by some big pine trees. As we got closer, a nice young lady asked if we were there to have our photo taken with Santa… it’s a fund-raiser for the UCD Vet Aide Club (pre-vet students). How could we say no?
Jack and Jenny posed nicely with Santa for some great photos, and then we headed over to the picnic tables to see the photos on a laptop with a group of club members. Of course, they had to see the website and hear Jack’s story. The rest is history.
Jack has always been (according to John) a “Babe Magnet” and he hasn’t lost his touch. In no time a crowd of lovely young ladies started taking pictures of Jack, petting Jack, giving Jack treats, hugging Jack… Jack was in his element. He was a bit tired at this point (it had already been a big walk) so he sat there and soaked up all of the attention.
When we finally left, Jack had several new girlfriends and a CD full of great photos.
In case any of the students check the blog… Jack wants to send a giant SHOUT OUT to his new friends in the Aggie Vet Aide Club at UCD! Aggie Pride! Thanks for making our day so special.
Brett Fite Photograph, UC Davis Vet Aide Club 2009
Friday, December 4, 2009
Treatment #6 ended tonight with the third dose of cyclophosphamide pills following supper. So far, Jack’s reaction has been pretty much the same as the first round although he seems a bit more fatigued. In fact, if we had to pick one word to describe Jack’s overall reaction to chemotherapy it would be fatigued. He has shown no signs of nausea, the input/output systems are working with very little upset, he remains interested in being in the middle of all household activities, and certainly loves his rides in the car. He even initiates play with Jenny from time to time – he just doesn’t have the stamina that he used to have. We’re grateful for every day we have together, and if we can still do many of the same things we’ve always done – just for shorter periods of time – we’re ok with that.
And now a few words about Diet. We are completely sold on the dehydrated diet from Honest Kitchen, which comes in several varieties (no-grain, low carbs, gluten-free, complete meals, or a base mix to which you add your own protein). (www.thehonestkitchen.com) We didn’t know before Jack’s diagnosis that low-carb meals are recommended for cancer dogs, because cancer apparently feeds on carbohydrates. Dr. Beebe suggested we try a dehydrated food to reduce carbs and balance protein with increased greens and other healthy, unprocessed ingredients.
We are currently trying two varieties of Honest Kitchen dehydrated food – Embark (a complete meal… just add water) and Preference (the base mix to which we add water and a protein of our choice). The food is incredibly easy to prepare – it hydrates in about 5 minutes - and the dogs LOVE it! Even Jenny, who is a bit of a picky eater, licks her bowl clean and then checks Jack’s bowl to see if he missed anything (he never does…). For protein, Evangers (www.evangersdogfood.com) offers several flavors including 100% chicken, turkey, rabbit, venison, duck, and others. A few small bites mixed with the dehydrated food, and the dogs are in heaven! The nice thing about adding Evangers is the variety it offers, including protein sources we otherwise wouldn’t be cooking at home.
After two weeks, we see a real difference from this new diet. Eyes are bright, coats are luxurious, and stools are consistently good. What more could we want?
Wednesday, December 2, 2009
Good news! Jack’s blood pressure this morning was pretty much normal, and his blood test came back with solid numbers. His anemia continues to be a mild concern, but everything else was okay.
This week’s treatment (Treatment #6) is on-track, and he’ll have his first cyclophosphamide pills tonight at home, followed by a second dose tomorrow evening and the third dose Friday. We’re cautiously optimistic that he tolerates this drug as well as he did the first time. Cyclophosphamide needs to be accompanied with strong water intake, so we may end up ‘going out’ once or twice a night, but with dog doors to the backyard Jack can let himself out whenever he wants.
Tuesday, December 1, 2009
Jack had a good day today! He spent most of the day in his chair (formerly Linda’s chair by the front window-Jack commandeered it years ago) but he also climbed up on our bed to nest at least once (we can tell from the covers he moves around to get comfortable). The fact that he can curl-up in the chair like he used to is a good sign. For a while there, he was so stiff he could only lay spread-out on the floor.
Each time Linda came home (lunch and after work), he would glance over from his chair, looking very content and regal as if to say “Oh, there you are. Time to eat?”
Tomorrow morning we see Dr. Schneider for Jack’s weekly blood test and blood pressure check. If everything looks good, this week’s Treatment #6 involves pills he gets at home over the course of three days. He’s only had this drug once before and he handled it very well, so we’re keeping our fingers crossed for similar results this week.
In the next few days we’ll “archive” our November blogs, so if you want to read further back, please go to the link on the left.