Tuesday, September 29, 2009

25 years

Yesterday was my "Americaversary," a term my parents came up with as a day to celebrate my adoption. I won't go into details of all that. I wrote most of that last year in this post reflecting on adoption.

In the past, it's always been a special day. My parents would send me a gift or flowers. This year, it kind of snuck up on them, though they both did call. I really didn't expect anything anyway since I've had a lot of major expenses recently. And I'm grateful they have helped me out. Otherwise, I usually went to a restaurant of my choice and enjoyed a nice, Asian meal with a friend or my family if they were in town which has been rare the last eight or so years (we all live in different states).

Somehow, I think 25 years in a milestone, and I really should celebrate it. Yesterday was a busy day, and by the end of the night, I was super upset with a friend who double booked in dog sitting right at the same time she is supposed to take care of my dogs when I'm gone for a week in October (and she's known about this for months, and I just spoke to her last weekend about it), my boss for a number of reasons, finances, etc. Everyone is busy, so they don't have time to go out or whatever anyway.

But despite this and feeling kind of overall crappy and like I'm going to cry, I'm going to try to do something for myself today even if it as simple as buying some flowers, taking a long walk (haven't exercised in months), or enjoying a great cup of coffee somewhere. I just need a moment to let go and RELAX. There is a lot in store for me in the next few weeks, and I need to be able to get through it.

Note--*I know I keep saying it, but this is the last blog post to be public for a month or so. Please let me know if you want to be added and at which e-mail address since many of you have multiple ones. If you've already e-mailed me, then I will be sure to include you.

Added 9/30 photos

Saturday, September 26, 2009

A humbling experience

When I walked into U. of Tennessee's vet clinic this week, I really had no idea what to expect. My mother traveled with me for the first appointment on Monday. Immediately, when we got there, we saw a couple crying. My mom's words were, "this isn't a good sign." I took note, hoping I would not be one of those people.

We both took a seat in the "so-called" waiting room which really reminded me of one of my old college classroom buildings where there were many chairs and seats on one side of the hall and lecture rooms on the opposite side. Only this time, it was exam rooms which were teeny tiny. Obviously, I knew where their funding went (a good sign really), and it was not towards an elaborate waiting room!

After Baxter was taken back to run labs and other tests, I took a seat in the waiting room. Much like other medical waiting rooms, since it is an open area, it is easy to hear conversations going on unless people are virtually whispering. It was interesting, because on one hand, the atmosphere was lively with people chatting about why their beloved pets were there, but on the other hand, the ambiance reminded me of a human
NICU unit, a pediatrics ward, or a surgical ICU. Everyone there is literally waiting for answers, holding their breath for good news, wishing their pets did not have to be there.

In the two days while I was there, I overheard many stories. There was a man who said his
german shepherd had a gum disease and had to have all his teeth pulled. It was either that or to be euthanized, and he could not do that. There was another woman whose 4 year old Cavalier was battling lymphoma. He was going through his second or third round of chemotherapy. She was determined not to give up on him. Another couple had a great pyrenees mix with a tumor on her leg. One woman had a cute pomeranian puppy who looked like a stuffed teddy bear. I think he was there for a digestion disorder. It was a good thing he was cute, because, he was "litttle cujo" in wanting to snap at people.

The rest of the cases I heard ranged from seizures to melanoma to other forms of cancer, and even "fat" cat weight loss studies. I also saw a
cockatiel brought in as well. This isn't real abnormal for major veterinary teaching hospitals. There is always a wide array of species and illnesses, and people sometimes come as their last hope or to receive treatment they cannot get elsewhere. There are always pros and cons to teaching hospitals, and I had to remember that it was okay to see a 4th year vet student on initial history intake (though being her first day, I was slightly concerned). I admit I tend to get a little biased in wanting to see a "real" doctor, but at the same time, I also had to remember to give that person a chance as everyone has to start somewhere and learn. Later, I saw the vet intern who consulted with the neurology specialist whom I found to be quite knowledgeable.

I remember thinking when I was there, waiting for Baxter's test
results, that I was not going to cry if it was bad news. And really for 3/4 of the trip, I did not. I took in all the comments said, spoke matter-of-factly about what I wanted or didn't want, and the vet obliged my requests. It wasn't until after I saw the MRI scan and was back in the waiting room, thinking and researching gliomas on my blackberry that I began to think too much. The running thoughts in my head were 1) I was not ready to let him go and 2) I could not imagine my life without him. And from that point, there were tears in my eyes. I'd wipe them away, only to have more forming. I never sobbed uncontrollably, but I had way more tears than I expected.

When the vet came out to talk with me about medication alternatives to phenobarbital, I had to make a decision on the fly, and I hated that. I had limited information on the medications in general, so I didn't have time to pick apart the minute details of them. I decided to go with
zonisamide, though more expensive, had virtually no side effects. We spoke more about the biopsy and if it was a glioma. I remember telling Dr. R., "if it is a glioma, I would really like to see about enrolling him in the UMN study. Other than this and the mast cell tumor, he has been very healthy. I think this is worth trying, because (gulp) I'd really like to see him stick around for a few more years." I said all this holding back tears in my eyes, though I know they were certainly evident.

It took me quite a long time to regain composure. It really wasn't until halfway through my car ride home that I seemed to be okay. For whatever reason, I tend to cry in the car the most. I guess it feels like a somewhat private place.

The thing I take back most from this entire trip was what a humbling experience it was. Everyone was there for different reasons, but the same cause--to get their companion(s) better. It reminded me a lot of how much people love their pets and how these pets were lucky to have this opportunity, as not everyone can. Even my regular vet said that he does not refer out often, but that he knew how much I loved Baxter.

I don't know what future trips will hold whether it is to UT again or
UMN or another place. My feeling is that although it will never be any easier, I still hold out hope for the best, whether this might be in continuing treatment, discontinuing treatment, or in the ultimate decision of letting go.

Note--*This is my 500th post!

Thursday, September 24, 2009

Sometimes wanting validation is too much

First off, I'm sorry for the delay in posting Baxter's results for those of you who have been following me via twitter. My satellite was not connecting, thus, I could not get online. It was probably the best case scenario anyway and allowed me to catch up on some much much needed rest.

It's been a pretty rough week, and it's only Thursday! I took Baxter to U. Tennessee Vet Animal Clinic on Monday morning. There, the vet did a full work-up, including a neurological exam,
bloodwork, a chest x-ray, and an EKG. All of these were WNL (within normal limits) except for one abnormality in his EKG which was inconclusive without a 24 hour Holter monitor. We both agreed that his seizures were probably not related to anything cardiological.

The vet wanted to run an MRI of his brain which unfortunately could not be done that day. I was going to leave Baxter there overnight and drive back, but he got super stressed and began having difficult breathing. He does this at vets' offices, but last time and this time appeared to be worse. The vets at the clinic were really concerned and stuck him in ICU with oxygen and eventually gave a sedative. Poor guy! We both agreed it was best to take Baxter home and drive up the next morning. I had already been there almost 6 hours, then had a 3+ hour drive back, so I was super exhausted already.

The next day, I had to leave at a crack of dawn 5:45 AM to make it there by 9 AM. The vet decided to do an upper respiratory exam first due to his breathing issues. There, they
discovered he had an elongated soft palate, typical of any brachycephalic dog, his was just 2 mm longer. I agreed to add a scan of his airway with the MRI of his brain. That scan showed no mass in his trachea (worried there might have been since they had a difficult time with the Endotracheal tube), just inflammation and edema surrounding his trachea.

The MRI of his brain, however, was a different story. It showed there was indeed a mass there in the left cerebral hemisphere. There are two options of what it is. It is either a
glioma, a brain tumor arising from the brain cells themselves, or it could be edema post seizure. The scan was not definitive of which one, but it points more towards a glioma. There was no change when they added contrast and the mass is unilateral which is uncommon for just edema. The only way to know for sure is to do a brain biopsy. He is scheduled for this next Tuesday.

In the meantime, he has been placed on a short course of
prednisone to reduce swelling and an anti-convulsant, zonisamide. We're only trying the zonisamide for a week. It is rather expensive, so I may have to switch to something else.

So things are still a bit up in the air without the biopsy. I know many people do not go to this length as
MRIs on dogs (same price as humans) are expensive, but for me, I have always been the type to "need to know." Plus, I want to know what I'm dealing with as well as placing the best possible treatment for my dog. I'm sincerely thankful to my parents for helping me out financially, as I would not be able to otherwise.

Since Tuesday, there has been many tears shed, simply because if it is a
glioma, his days will be numbered. Gliomas vary in range from low grade, slow growing to high grade, poorly differentiated malignant tumors. The factors of life span vary greatly from the type of tumor to the location to the treatment used. For some dogs, it's literally days after diagnosis, for others it can be 12 to 20 months. It's very hard to say.

I have decided if it is a
glioma, I'm going to try to enroll him in a new experimental treatment out of U. of Minnesota. It is using surgery, gene therapy, and vaccine therapy. Basically, surgery would remove as much tumor as possible, gene therapy would attract immune cells to destroy tumor cells at the surgical site, and an anti-cancer vaccine from the dog's own cancer cells would be given. So far, this is really promising with 9 or so dogs all having reduced or disappearance of the brain tumors. If he is eligible, then almost all costs would be paid. Not only is this study looking at dogs, but points towards implications for humans with brain cancer as well.

In the end, I know whatever treatment option I choose, is essentially prolonging life, as this can be treated but not cured. If Baxter was in poor health, I doubt I would go to this much length. Other than this, his
mast cell tumor, and an indolent ulcer in his eye seveal years ago, he has been very healthy. Now, I could be completely wrong in that it is a glioma, which in that case points towards "idiopathic seizures." But in any case, I still feel like I should prepare for the worst and do as much information digging as possible.

As for how I am holding up, it is so-so. I'm stressed, upset, and have a lot of stuff on my plate in general. This all just comes at the worst possible time. I know it is important to keep myself healthy, but it is truly very hard. The pattern as of late seems to consist of major slippage for several days, then getting sort of back on track, though not completely, then slipping again. I wish I had better things to say, it's just a difficult time.

Anyhow, I want to write another post on the vet hospital experience as I found it to be difficult, fascinating, and touching all at the same time.

Saturday, September 19, 2009

The question of validation

After my last post and crying for four days straight, I finally picked myself up and got back on track both emotionally and nutritionally. There wasn't a real clarity, but at least my thinking capacity was slightly better.

As you know from my last post, I have been pretty worried about Baxter, my oldest dog. It was heart-wrenching to watch him suffer 3 grand
mal seizures within a period of 28 hours. By Monday, he had a few petit mal seizures, tremors, and many falling down episodes. On Tuesday, I took him to the vet to get labs drawn. The labs were within normal limits with only a slight elevation of lipase which wasn't significant. While we were there, Baxter who was already stressed, had a number of tremors and episodes of falling down. Since I had a keen eye for what was happening, I tried to catch Baxter's every fall. I pointed out to the vet that this was what was happening. Since he was not sure the reasons for the seizures and these episodes, he referred Baxter to a canine neurologist in TN.

The earliest appointment I could get was Monday, so that is where I will be all day. Since Tuesday, Baxter's tremors and episodes have decreased in frequency and duration. Today was the first day in almost a week where he did not fall uncontrollably or have tremors. This is of course good news, and I almost thought about cancelling the appointment. I already contacted the vet via e-mail, so he is expecting me.

The feeling I can't shake about all this is the whole validation aspect. Though I hated to see poor Baxter have tremors and fall down at the vet, I was kind of glad too. This way the vet saw exactly what I was talking about. He knew I wasn't somehow making it up or that he was really okay, etc. So now, I worry that this neurologist will think there isn't a problem since he doesn't appear to be having seizures or tremors at the moment (This is obviously not my intelligent side of my brain talking here)

This thinking correlates with my eating disorder validation analysis of myself too. I've never truly fit the criteria nor physically looked the part of an eating disorder person (yes, I'm well aware you can have an eating disorder at any weight), but at the same time, the majority of professionals who've treated me have never doubted me either. Therefore, it doesn't make sense to me where I even get this thinking from. At this point, I know it doesn't matter, it's just that this aspect of validation keeps reappearing in my life in a variety of ways that are not conducive to my health. And I tend to have such a hard time letting it go or accepting it.

I guess the question boils down to why do I need such validation? What do I hope to gain from it? I don't know the answers to either honestly, but
for whatever reason this question keeps me up at night.

Question: do you have validation issues? Do you have questions/thoughts that keep you up at night?

Note--*I'm still placing my blog on private for a short time, but it will be next week sometime. If you want to be added, just send me an e-mail through my profile page.

Monday, September 14, 2009

FYI

The last several weeks have been very stressful here. This past weekend has been a big emotional roller coaster ride. First, Baxter had three seizures within a span of 28 hours. So far, he has not had any for 18 hours, so I'm hopeful that they have lessened. If you have never witnessed seizures in either people or animals, it really is frightening. I've had my own experience with seizures in the past, so this was only a reminder how helpless people felt at that time. I'm feeling a bit of guilt too since I'm almost positive the seizures were environmental and my fault.

Then, a good friend's mother passed away and she needed to board her four dogs. This same person's father also just got admitted to the hospital with pneumonia, so she is a mess all around.

Lastly, just everything else that is going on in my life.

For this reason, I'm giving a head up that I will be putting my blog on private some time mid-late next week. It is NOT permanent, but just because I'd like another outlet for myself and to hear other opinions as well. If you are interested in reading, please let me know. I'll put my e-mail in my profile, so you may contact me that way.

Sunday, September 13, 2009

A dieting example

Most of us know the mentality of dieting either through personal experience or observation of others. Many people turn into black and white thinkers if they aren't ones already. Foods become "good" and "bad." It becomes about deprivation of not only the food but also the soul. Of course, this does not happen with everyone, but the majority do fall into this category which is why dieting has such a huge fallout rate.

This was one reason I was pleasantly surprised at hearing my physical therapy assistant say that although she was trying to lose weight, she is not depriving herself. She said she is beginning to ask herself whether she is truly hungry and if she really wanted that piece of cake. If she does, she would take a small slice. I don't think she knows it, but she is beginning some intuitive eating.

The other thing that she said which is not something you'd hear from most people is "I'm going slow, I'm not in any real hurry." Though I am never into using the word "dieting," I do think she is taking an even keel approach at this, and I commend her for her work.

Something else she said stuck out to me. She said that when she got divorced and was raising her two daughters, she could not afford the healthy food most experts say we should all be eating.. She said "unfortunately, my kids paid the price." Many studies have shown that there is a link between socioeconomic status and quality of food. Even back in 2004, researchers were saying there was a relationship between obesity, "cheap" food, and socioeconomic level. (
here)

Though this news is not new to me, the fact that someone said it so blatantly was really surprising to me. I guess the saying "when you know better, you do better" applies here. Or rather, when you make more money, you have the ability to eat better.

Anyway, overall, this brief ten or so minutes of my physical therapy assistant recounting her dieting habits was a bit refreshing to hear. Here was someone who truly was losing weight for health in a healthy, moderate, slow way. This may not seem like much, but I think she is a rarity in these times. Kudos to her! Even though I am against "dieting," I do think changing a lifestyle in a positive, healthy way like this person is doing can be beneficial .I just wish more people did dieting this way.

Tuesday, September 8, 2009

The case of Emily Errico

Several weeks ago, there was a report of a young, anorexic girl named Emily Errico, aged 25, whose mother was indicted of neglect. For whatever reason, I found this case horribly tragic with a variety of thoughts brought up. If you are not familiar with the case, police found Emily in full rigor mortis, in a "completely weakened state" after a 911 call was made by her mother in 2007. The police said it was difficult to navigate the area, because there were trash bags everywhere, including on windows and on Emily. She was found with a fabricated halter top out of a trash bag, sweatpants, and at a very low weight for her height.

Police said her parents were very controlling and fed her a diet of only granola bars and seltzer, allowing her to waste away. Despite the fact that Emily did see a nutritionist back in 2004 and a diagnosis of malnutrition was determined, not much follow up was made, especially since her father canceled her appointments.

Though Emily did complete a college degree and was "exceptionally bright" according to the prosecutor on her case, her parents continued to control her food intake by bringing meals to her. After graduating, she moved back home where they had complete control over her. This control was evident from her birth where she was kept in a crib as a toddler and not permitted to socially interact with peers. Neighbors even say they never saw her leave the house. Most did not even know she was living there at all.

I bring up this, not to point fingers at parents, though I do think her parents are certainly negligible for her death in this case. I know most parents are not like this, and this case is on the rare side. However, I do wonder about the nutritionist who didn't follow up. Did she not follow up, because eating disorder patients are notorious for canceling appointments? Was this just another young, underweight girl in the crowd? To me, (and of course I am only speculating) if these parents were as controlling as they seemed and maybe a bit odd too, weren't any red flags raised? It's really hard to say, and again, I'm not pointing fingers, just asking questions.

This reminds me of the time I was 16 and
od'd. I actually called my therapist to cancel my appointment, telling her I was ill. Whatever intuition she may have sensed, she came to my house to check up on me, and of course, after finding me, called my mother, went to the ER, etc. My parents were forever thankful, but I know now that is like a one in a thousand occurrences since there are so many privacy laws nowadays.

I also wonder about the neighbors. These days, we are so afraid of being considered "too nosy," but what happens when a human or animal life is at stake? Where is the line drawn between what is too "private" and out of concern? It's similar to the cases which many of us have witnessed in stores of hearing stupid/hurtful/out of line comments said to young children/teens/adults about their body, their looks, their clothing, etc. We always wonder whether to speak up or stay silent. It really does become difficult to decide what to do. The line has to be
treaded so carefully it seems.

Certainly, I don't have the answers to any of these questions, and I doubt professionals do either. I know I have struggled with the issue of what to say or do, whether to intervene or not. Ironically, as this article came out, the story of
Jaycee Dugard hit the headlines. Though they are different, there are similar aspects to both cases. There are also many whys as well which may never be answered.

So what are your thoughts? Where do you tread the line?

Side note--father pled guilty of third degree neglect this year and faces three years probation and a psychological evaluation.

Note:--*Other related articles: Mom charged with neglect in adult daughter's death
Ermina Errico of Garwood indicted for neglect in conncetion with the death of her daughter
Invisible life: Learning from Emily Errico's anorexia death in Garwood
Following a hunch, solving a crime (how a mother's intuition helped free Jaycee)

Saturday, September 5, 2009

Photos of the week

Here are some photos I've taken recently.

This is a cool dragonfly that happened to fly in and stay overnight one day.




A view from when it was flying.

My almost perfect picture of my dogs. Ahh, how cool, gray skies does wonders for these types of photos. I should also add that I had absolutely no rewards with me for this photo shoot. It still took several to capture this one, but not bad. They are learning how much Momma loves to shoot all of them together.

This is Tovah and Luna, a recent boarder. Luna, a "snorkie," belongs to my former professor. She is very small, probably like 6-8 pounds if that. These two are buddies, and Luna puts up with Tovah's barking and play gestures! I have really cute video footage on my blackberry of them playing. I just really liked this photos for the expression.

My latest crave. I'm now over the plum thing and have moved onto grapes. A week or so ago, I bought a package of green, red, and black, as well as some cute champagne grapes which turned out a lot harder to eat than expected. The mix below is grapes, bananas, blueberries, honey almonds, and french vanilla yogurt. YUM!

Some of you may remember that pretty cracked bowl way back in March. Well, I finally replaced it with this beautiful handmade, turquoise bowl my mom found at the Tamarack, a cool store/restaurant in West Virginia.

A recent disaster which I came home to. Well, not really, but stuffing everywhere. And nope, it was not the littlest one, Tovah, but rather Hank, my Aussie X, the second in command. For whatever reason, he decided he needed t destuff his dog pillow. I guess no more sweet dreams for him. :grin:


This is a wasp nest. It's pretty and all, but it's definitely not something I like seeing under the ledge of the roof!

Observation: scales in non-traditional locations

Lately, it seems I have been seeing scales in many non-traditional places. Last week, it was in a corporate office restroom. Several weeks before that, it was in another office restroom. I even saw one in a gas station! It wasn't exactly a real scale, but one of those ones where you put a quarter in, and it gives you your weight.

Every time I see one, I am somehow shocked. I really shouldn't be since we live in such a thin-obsessed society. I have to admit it seems terribly odd to me to have these metal devices in public restrooms. I mean, isn't a scale an intimate object (too intimate for many of us)? I know even if I was on some Biggest Loser, Jenny Craig, or Weight Watchers diet, I can never imagine weighing myself on a scale in full view. Granted of course, if there is only one stall, then there would hopefully be no occurrence of this but you never know really.

My fear is that scales will begin to pop up everywhere--schools, restaurants, oh who knows, the laundromat or some other bizarre location. This is especially evident as many people are participating in workplace weight loss challenges. I think it is a horrible sign overall, and I really wish these scales would all disappear.

Have any of you observed scales in non-traditional places lately?

Wednesday, September 2, 2009

Quick update on family member

First off, thanks to the comments I received in my last post about a family member's lap band surgery. The surgery was complicated-free. M. called me yesterday in the afternoon and said he was okay. One thing he had to do was a lot of walking right afterwards due to the excessive amount of air they pumped into him.

He went home this afternoon and apparently had a tough day. The next few weeks are going to be difficult, so I hope the best for him. One good piece of information I learned was that his treatment team expected him to be able to walk two miles in two months time. I was glad they were not neglecting this aspect of after-care.

Now, only time will tell.

Again, thanks for the feedback everyone.