Wednesday, March 31, 2010
Jack is almost over the effects of the Vincristine treatment last week. His energy level is back to where it was before treatment, and the bloody nose is almost history.
We've always assumed that the blood is coming from his sinuses, since he has a history of chronic sinus issues. The interesting twist to the story, however, is that we gave him his favorite toy on Sunday... affectionately known to us as the "Flip It" (apparently the real name is the Twist-n-Treat). It's a 
disc-shaped toy that's hollow on the inside to hold kibble. They push it around with their noses or flip it over with their paws to get the kibble out. It's a great toy for Jack since he's so food motivated. But when we gave it to him last weekend and he barely nudged it with the tip of his nose, it started bleeding again. That makes us think the bleeding isn't just up in his sinuses, but the blood vessels in his "sniffer" are affected as well.
We did an Internet search for bloody noses from chemo and found a couple of human cancer patient comment boards where people talk about the bloody nose or mouth sores they get from chemo. Knowing that, it makes us also wonder if part of the problem when he gets Vincristine is not just nausea, but that his mouth might be tender and that's why he eats a lot slower following that treatment.
So much to Jack's dismay, he's not getting his Flip It toy this week... and he's not getting his Kong. We want those tender nasal cells to heal. Try explaining that to a dog!
Monday, March 29, 2010
As you might have guessed, Jack has a number of friends who have followed along as he has travelled on this great journey. Two of his best friends are Tuggs and Smoke, who live in Wyoming. Tonight they insisted that Jack write his own blog…since Jack can’t type (that whole ‘no thumbs’ thing...) they offered to translate to their mom, who typed it all up. What a nice surprise!
“Someone asked me, (Jack) to make sure a tribute to my mom and dad was included in my next blog entry. You see, my mom and dad are very special humans - they love me with all their hearts. No matter how difficult or bleak the journey back to good health might have seemed, my mom and dad have been right there with me, every step of the way, making sure I have the very best medical care and medicines. They have given me the gift of an extended life, and I think they deserve lots of furry hugs and sloppy doggie kisses for that. Even though there have been some rather rough bumps in the road, we have had some very special and wonderful times since I was diagnosed with lymphoma. I definitely could not have done this without my mom and dad, and I love them very much. Love, Jack”
Thanks to Cathy, Tuggs and Smoke for such a kind and thoughtful message. Yes, we do love our little buddy Jack very, very much. (Yes, Jenny, we love you too!)
Sunday, March 28, 2010
We spoke too soon! When we wrote our last post, Jack seemed to be taking this treatment much better than the previous times – but that changed a bit at 12:15 AM Friday. (Why do these things always happen in the middle of the night…?). Jack woke us up with another bloody nose. His previous and only bloody nose followed a treatment back in November. Fortunately it was nowhere near the volume that we saw in November, and we swung into action. We placed towels on his bed, and on the floor in all the places where he likes to sleep. We were able to keep things pretty well mopped up, and as the Vincristine is working out of his system the bleeding is subsiding.
He is otherwise happy and engaged, great appetite, and was so full of energy today that we took a ride up to Reno for a nice walk on his favorite trails. He had a great time, met some new best friends, and surprised us with how far he wanted to walk.
Today marks 24 weeks since diagnosis – when we were told that he had 4 – 6 weeks to live if we did nothing to treat his lymphoma. The fact that he’s still with us, and he’s happy, interested and engaged is a tribute to the quality of medical care that’s available to our best little buddies, and to the talent of our ‘Dream Team’ of veterinarians.
Thursday, March 25, 2010
So far, Jack's handling this week's Vincristine treatment much better than the last two times. He's had a good appetite all day and although he looks tired, his eyes are bright and he's following us around the house, hoping against all hope that he'll get another biscuit.
Of course, he’s trying to tell us that he’s doing so much better this time because of the nice ocean air in Monterey last week. Therefore, he argues, we need to go back soon… and often…
Wednesday, March 24, 2010
Jack had his final Vincristine chemo treatment today. That’s a huge relief for all of us, including Dr. Schneider! He’s a very good boy for the treatment, but we all know that this drug has the biggest negative impact on him. We anticipate he’ll be feeling yucky (nauseous) starting tomorrow and until about Sunday morning. But, we’re ready for it and know what to expect (boiled chicken and broth are standing by in the fridge). With this treatment behind us, we have only one more at UC Davis in two weeks. At that point, he will finish the chemotherapy protocol developed by his oncologist, Dr. Rebhun, and we keep our fingers crossed that he remains in remission for a long while.
His blood test today gave good results. The hematocrit number was 37 – up from the last two weeks. That’s good news. His platelet and white blood count were both within the normal range. He’s still slightly low (but only slightly) on his red blood cell and hemoglobin numbers, but that’s to be expected for a guy on chemotherapy. All in all, we continue to be pleased that he’s handled chemo so well!
In two weeks, right before his final chemo treatment, Dr. Schneider wants to do a full blood panel to check organ functions – she said that’s typical when a patient nears the end of chemo, to make sure everything is working as designed.
You have no idea how happy we are that he’s had his final Vincristine treatment and chemo will be over in two weeks! We have certainly come a long way since his diagnosis last October. What a ride it has been! Our prayers now are that he stays in remission and feels good for as long as possible.
Monday, March 22, 2010
What a fun little vacation with Jack! We visited Dr. Beebe on Thursday afternoon and she was very pleased with Jack – in fact she commented that in all the time she’s been treating him, this is the best he’s ever looked. We’ll take it!
We motored over to Davis for the night, and had a spirited walk on campus in the morning before heading for Monterey. The weather was perfect and Jack was very interested in the drive down, especially since we took a route that was new to all of us. Once in Monterey, Jack clearly remembered where all the best walking places are and he was quite excited.
He is very familiar with the Carmel Valley Lodge, having stayed there numerous times. In fact when we unload the car he leads us to our cabin. (http://www.valleylodge.com) We noticed on this trip that while extremely interested and engaged, Jack has very low stamina. He clearly loved being there, taking short walks and making new friends – he really looked happy. We just had to make sure that we had plenty of time for him to rest.
To help Jack get in and out of the car a few months ago, we purchased a set of collapsible steps from Petloader.com. Carmel is a super-dog friendly place, and we were surprised by the number of people who came over and asked us about the steps. It seems that there are a lot of senior dogs out there whose owners are looking for ways to help their buddies go for rides. We readily gave out the information and heartily endorse this amazing product. (http://www.petloader.com/)
To cap off our awesome vacation, Jack wanted to do something really special. Turns out, he has never been to San Francisco and he convinced us that he’s always wanted to ride across the Golden Gate Bridge. Sure, it’s a little bit out of the way, but we didn’t have anyplace else we needed to be so off we went. After some careful navigation by Linda that included a lunch stop at the Stanford Mall (go figure…) those huge orange towers shrouded in fog, loomed into sight.
Overall, a really fitting way to spend a Sunday – 23 weeks after diagnosis – with Jack. Be sure to view the new photo essay of Jack’s Spring Vacation 2010!
Wednesday, March 17, 2010
Jack deserves a vacation, and so we're taking one! In the 9 years he has lived with us, we've made regular trips with him (and now Jenny) to Monterey, California. Typically we aim to go about 4 times per year. It's fun traveling with the dogs - they are good travelers and enjoy the trip, especially to a place as beautiful and dog-friendly as Monterey Bay. We stay up at the Carmel Valley Lodge, which is very dog friendly. It's about a 6-hour drive from here, but well worth the effort! If you've checked our photo album on this site, you'll notice that most of the photos are from Monterey.
The last trip we made was back in June before the heart disease got worse and long before he was diagnosed with lymphoma. We hoped to make it back before the holidays, but his weekly chemo treatments made it impossible. However, now that chemo is down to every-other week, we timed this trip to come a full week after his Cyclophosphamide treatment when he should be feeling about as well as he can. We've been holding our collective breaths, hoping we can make this trip. So far, so good!
Tomorrow afternoon we will drive to Sacramento for a check-up with Dr. Beebe, then spend the night at our favorite hotel in Davis (with a stop at Pluto’s restaurant for a nice side of turkey for our best buddy). Friday morning we'll drive to Monterey (about 3 hours from Davis) for the weekend, before returning home on Sunday.
We are very excited about this trip! And we are amazed that 5 months after diagnosis, we can still do it. No doubt, the sea air, sandy beaches, and new dog friends will be good for Jack. He really loves Monterey.
For the next 4 days we won't worry about lymphoma... chemo... or heart disease. It will just be a family vacation like old times, and we'll savor every minute of it.
Pictures next week...
Monday, March 15, 2010
If you live with a dog long enough, and you pay enough attention, you start to notice little ‘things’ about their personalities. You start to wonder if they had a voice, what kinds of things would they say. We’re pretty sure if Jack could talk, he’d have plenty to say about a lot of things, and some, if not most of it
would actually be interesting. Nevertheless, this photo from Jack's walk today just begs for a caption from Jack himself – with a little assist from us. You see, Jack can’t type – no thumbs. Actually, that’s pretty much his excuse for anything and everything he doesn’t want to do – “sorry, no can do – no thumbs.”
Jack meets Mr. Ed – “Seriously, you look a LOT smaller on TV!”
Eat every biscuit like you stole it, roll in the grass like nobody’s watching, and live every day like there’s no tomorrow.
Sunday, March 14, 2010
Today we finally got a break from the weather – it was clear and sunny, and most importantly calm. We decided to take advantage with a little ride to Truckee for lunch. Jack seems over the ‘chemo funk’ and he thoroughly enjoyed his ride. When we got home, Jack’s Subaru got a much-needed bath and the Thule box was brought down from its long-time resting place, washed, and mounted on the roof rack. Could it be that a little vacation for Jack is approaching…?
We thought it might be fun to look up things associated with the number 22 – famous athletes, racing cars, numerological meaning, etc. But the only thing important to us about the number 22 is that’s how many weeks it’s been since Jack’s diagnosis – he’s still with us, he’s interested and engaged, and overall he’s doing remarkably well. Only two chemo treatments left until he completes his protocol.
Friday, March 12, 2010
So far, so good on this week's chemo treatment. Jack had the final Cyclophosphamide pills this morning at home - he gets 3 pills each day (all at once) for 3 days. Dr. Schneider wants him to drink quite a bit of water when he takes the pills, to make sure they dissolve and flush-through properly. Jack will drink as much water as we give him as long as we put some chicken broth in it for flavor. Each time we have this treatment, we boil a chicken for homemade broth. YUMMY! The chicken is boiled in filtered water and we add nothing... no salt, seasoning, vegetables, or anything else. And of course, we love the chicken itself (which is organic and free range... go figure).
With all that drinking, we have learned to do this in the morning. He gets the pills 1 hour after he eats breakfast, so the pills go down and the water/broth is poured just as we walk out the door to go to work. Back in November we tried doing it after dinner, and we were up all night (try drinking several cups of water at bedtime and see what happens!). Duh. Lesson learned.
So far, he's taking this treatment well. No significant signs of fatigue or lethargy. His appetite remains very good and his eyes are bright. For the last two nights, he played with Jenny before bedtime. He might be tired this weekend as the drug's full effects hit him, but this treatment is SO much easier than Vincristine. Thankfully, we only have one more Vincristine treatment left... in two weeks.
Wednesday, March 10, 2010
The results of yesterday's blood test were mixed. All numbers were okay except his hematocrit number is down to 31, which means Jack is anemic again. Not sure why this happened. We had made huge progress is getting that number up to 39, only to lose all the progress we made in the span of only 2 weeks. The only thing we can think of is that the Vincristine treatment coupled with the antiobiotics a couple of weeks ago took a bigger toll than we thought. After all, he looked droopy after that and his eyes were not as bright. He's feeling pretty good right now and is very bright and alert, so maybe the number will come back up again? We sure hope so, because if it's not a result of the drugs, it might mean another problem somewhere. We're at our constituional limit for "problems."
Although we're not scheduled for another blood test for two weeks, we plan to take him in next week for a quick "hematocrit check-up" before going back to see Dr. Beebe.
Please think good thoughts for our best buddy.
Tuesday, March 9, 2010
Yesterday Jack had an acupuncture treatment with Dr. Hope Rinehimer, our local veterinarian who does acupuncture. She is at Sierra Veterinary Hospital, the same clinic as Dr. Schneider. Dr. Hope hadn't seen Jack for a couple of months (she was doing acupuncture on him last fall when we noticed he didn't feel well and she now has the dubious distinction of being the one who diagnosed his lymphoma), but it worked out this week to get a local treatment before this week's chemo starts tomorrow. It's a little tricky to get acupuncture the right number of days between chemo, and this week it was Dr. Hope's turn.
I'm pleased to report that not only was Jack very good for his treatment (as always), but yesterday afternoon was the first time in at least a couple of months that I saw him roll around on his back! Ahhh... that must have really felt good.
I learned from Dr. Beebe that acupuncture is most effective if the patient stays still and doesn't pace or move around. So we took one of Jack's favorite travel blankets and I made him lay down on it once the needles were in. Of course, the bag full of chicken jerky treats in my pocket helped, but regardless of the tactic, Jack was a really good boy.
This morning he donated blood for his pre-chemo blood test and had a "once-over" by Dr. Schneider. She still believes his nodes are normal, although she detected a short pause in his heartbeat that she hasn't heard in a while. Otherwise, he looked good and she seemed pleased with his condition. We'll get the results this afternoon and if all of the numbers are right, he will get his Cyclophosphamide pills at home over the next three days. He's done well with this drug in the past, so we hope he will again.
Sunday, March 7, 2010
21 weeks since Jack’s diagnosis - a truly remarkable experience for all of us. Jack continues to show us how much better he feels now that the chemo treatments are every other week and the treatments from Dr. Beebe are getting a chance to sink in. He was firing on all cylinders today; initiating play with Jenny this morning, loving his ride in the car this afternoon, and taking John for a spirited walk this evening.
Only three treatments left – this week is the final dose of cyclophosphamide. It will be interesting to see the results of this week’s blood panel, and if his hematocrit number has continued to climb. Jack remains interested and engaged, full of life and very, very interested in freshly cooked chicken currently residing in the refrigerator. You can’t ask for anything more from your best little buddy.
Thursday, March 4, 2010
Jack had a terrific day today! Linda had to go to Reno, so the doggies went along for the ride. He was bright, happy, and interested in everything, all day. He acted just like the “old Jack” we know and love, with no sign of “chemo Jack” anywhere in sight. Tonight after dinner he was very animated so John took him for what was suppose to be a short walk (in the dark). Jack started out slow as they rounded the corner we live on, but the further they walked, the more he seemed to loosen-up. They ended up walking around the entire block and Jack trotted for last half of it.
It would appear the supplement to improve his energy is working…
Wednesday, March 3, 2010
Jack had a great check-up with Dr. Beebe in Sacramento yesterday. Yes, it snowed. For days the forecast was for nice weather. At the last minute, they predicted rain later in the day. But at 9am as we headed over the Sierra, it was dumping snow. Of course it was! You can set your calendar for snow storms to hit on the days we drive to Sacramento. Our next snow storm will be March 18. Bet on it.
Dr. Beebe thinks Jack's low energy in the last few days is from the antibiotics, which coincided with last week's chemo treatment. She gave him a supplement to help him recover from the drugs and hopefully boost his energy. Otherwise, she believes he is pretty much stable - more so than other lymphoma patients she has seen. He had his usual acupuncture treatment with her and was alert and happy most of the way home. Right until he zonked-out in the car for a good nap.
While there, we also asked her to evaluate Jenny. Long story short... Jenny had an infiltrative lipoma (a rare and nasty kind of growth very similar to a cancerous tumor) that was removed once and came back with a vengeance, so it was removed a second time in 2008. She went through 3 weeks of radiation treatment at UC Davis (did I mention that UCD is our home away from home?). The growth was in a tricky location - her right armpit - which complicated matters. There was no way the surgeon could remove it all withough removing the arm. The radiation was in a delicate area and ended up over-radiating her lung. After she finished treatment, she was on 6 months of Prednisone due to the lung inflammation. Although Jenny's fine now, we're quite certain that 3 weeks of radiation (including daily anesthesia) followed by 6 months of steroids probably messed her up in some lasting way. (PS - While on steriods, she figured out how to open the refrigerator and empty the contents, but that's a story for another day. Let's just say that a Border collie on steroids is an interesting experience.)
Ironically, Jenny's last follow-up visit to UCD for a lung x-ray was on September 24 last year. On that day, one year and one day since she started radiation, they gave her the "all clear" and sent us on our way. Little did they know that 3 weeks later they would see us again with Jack's lymphoma diagnosis!
Dr. Beebe believes Jenny would definitely benefit from a 90-day herbal treatment to support her spleen and immune system, both of which are intended to get her system "back on track." Otherwise, Jen appeared to be in pretty good shape. She continues to be the "Babe-a-licous Babe of All Babes."
And yes, now that you know about Jenny's ordeal followed by Jack's heart disease and lymphoma, you can see that we've lived our lives at the vet for the last two years.