Zoomis Sumis Loomis Lonkin Climber Peer Dead Grass Eater crossed the rainbow bridge this morning under our kumquat tree and the morning sunshine. She asked this morning that we let her go, in a quiet voice framed by her dainty canine teeth. And so we quietly obliged. She departed to Karla Bonoff's "Goodbye My Friend," a song she wrote for her cat. Before she left I looked into the shimmering green of her eyes and told her that I would love her forever and miss her every second of every day. She went so quietly and so quickly. Once she was gone, I placed her in her favorite square basket and propped her just as she has propped herself so many times. She looked so peaceful, just like she was sleeping away a lazy morning.
The last couple of days have been so very difficult. She lost strength and life with each minute and we all kept hoping that the sliver of a miracle that lay before us might actually come true. So, I sat with her and recounted our favorite memories. I held her and sang to her. The sound of my voice, its familiar vibration, would ease her into relaxation. Last night she curled on my chest and we slept soundly together, her last night among the living. This morning, we woke peacefully and that is when she told me.
I am awash in grief. I don't even know where to be in this house. Sumis has been with me the entire time I have lived in this house - every corner of its structure holds a memory. I want to sit with her, quiet now in her basket, but I also need to let go. And the memories, while I am so blessed to have so many wonderful memories, they are so cutting to my raw heart. Still, I know I will sit in the next day or so and write for her, remember her, grace her with the last gift I can give her. I will post my list of memories as the final bookend of this blog.
To all of you who have followed the blog and who have supported me through this process, thank you. Please send your thoughts of Sumis high into the sky where she can catch them as she becomes acquainted with the mugs and mits already romping among the stars.
Saturday, January 30, 2010
Thursday, January 28, 2010
Fighting the Fight
Yesterday, Sumis took a dramatic turn for the worse. After eating her lunch, I put her on the floor to prowl around for a bit, and she was unable to stand without falling or to walk any distance at all. While she has been a little ataxic since her seizures, this was significantly worse. At that point, I fell apart, knowing it was time. I wrapped her up in her Paws for Peace blanket and sat with her out in the sun, whispering to her that I would keep my promise. We called the specialty center and decided to take Sumis in to see the oncologist. At that point our intention was to run our decision by an objective third party and get a IV catheter placed so we could do an at home euthanasia. The oncologist assured us that it was okay to say goodbye now, that we had given Sumis every opportunity to rally and she had just not been able to get out in front of it. She also told us that because the GI lymphoma seemed to be responding to the chemo we could try a round of radiation therapy to try to lick what we think is lymphoma in her central nervous system (brain and spinal cord). She said that because lymphocytes are so responsive to radiation we would use a very low dose and the side effects would essentially non-existent. She also said we would know quickly, within 48 hours, if Sumis was going to respond. If she didn't respond dramatically that either meant that her neurologic symptoms were a result of a thromboembolic event (throwing clots) or a result of irreparable damage caused by the lymphoma. Regardless of which of these was the cause, if we don't see a dramatic change by the weekend, we have decided to say goodbye to Sumis and let her drift to the peace of the Rainbow Bridge. Even as I type these words, I feel like I am being gutted. But, I have a promise to keep and as to that I am unwavering.
So, Sumis received her first radiation treatment this morning. We were concerned about putting her under anesthesia because she is so sick, but we had decided that if she didn't make it through the procedure, it was her way of saying enough. And it would have been an equally peaceful way to go on her part. The oncology service was very gentle with us this morning. And Sumis did just fine under anesthesia. In fact, her blood pressure remained in the high normal range for the entire procedure. Sumis was treated with a cobalt machine and received radiation on both sides of her brain for about 3 minutes per side. She woke up from the procedure quickly and peacefully. As I write this entry, she is asleep on her bed, waking only here and there to glare at the barking dogs who are on high alert as a result of the cable repairman's vist this afternoon.
So, for now, we wait to see how she responds. In the meantime, she is comfortable, although tired. And very hungry. She even showed an interest in my lunch this afternoon. I must say that the waiting involved in these treatment protocols has been the hardest part - with seconds stretching to eons. And here we are again with 48 hours of anticipation, worry, and trepidation spanning before us. But as anyone who has loved an animal knows, this difficult ending process is made worth the pain by all the years of undying and unconditional love.
So, Sumis received her first radiation treatment this morning. We were concerned about putting her under anesthesia because she is so sick, but we had decided that if she didn't make it through the procedure, it was her way of saying enough. And it would have been an equally peaceful way to go on her part. The oncology service was very gentle with us this morning. And Sumis did just fine under anesthesia. In fact, her blood pressure remained in the high normal range for the entire procedure. Sumis was treated with a cobalt machine and received radiation on both sides of her brain for about 3 minutes per side. She woke up from the procedure quickly and peacefully. As I write this entry, she is asleep on her bed, waking only here and there to glare at the barking dogs who are on high alert as a result of the cable repairman's vist this afternoon.
So, for now, we wait to see how she responds. In the meantime, she is comfortable, although tired. And very hungry. She even showed an interest in my lunch this afternoon. I must say that the waiting involved in these treatment protocols has been the hardest part - with seconds stretching to eons. And here we are again with 48 hours of anticipation, worry, and trepidation spanning before us. But as anyone who has loved an animal knows, this difficult ending process is made worth the pain by all the years of undying and unconditional love.
Tuesday, January 26, 2010
Her Eyes
Looking into the eyes of an old friend who has re-emerged from the fog of disease makes your heart skip a beat with joy. While Sumis still has a fight ahead of her, I can see her when I look into her eyes. She has picked some old habits up again - head butting, getting rubs and of course, swatting Fanny. She has retained some new habits - her insistent snuggling with the dogs, particularly Frisco and Fanny. But, for the first time in weeks I see hope, true and reasonable hope, before us and it feels good.
Poor Sumis has had several medications added to her growing regiment. She has to take lactulose to help combat her constipation, and while the smell just about bowled me over, she doesn't seem to mind taking it at all. Figures. She is taking her loose herbs in her food pretty willingly. She is at about half her dose and tolerating them well. I also started her on a blood tonic herb from Dr. P this weekend when I noticed that her gum and tongue color were very pale. This too seems to have given her a boost of strength. Overall, though, Sumis is a very compliant patient. She seems to understand the whole regiment and doesn't fight me. Thanks goodness - because I already feel guilty having to cram so much down her.
Tonight we see Dr. P for another qi gong treatment.
Poor Sumis has had several medications added to her growing regiment. She has to take lactulose to help combat her constipation, and while the smell just about bowled me over, she doesn't seem to mind taking it at all. Figures. She is taking her loose herbs in her food pretty willingly. She is at about half her dose and tolerating them well. I also started her on a blood tonic herb from Dr. P this weekend when I noticed that her gum and tongue color were very pale. This too seems to have given her a boost of strength. Overall, though, Sumis is a very compliant patient. She seems to understand the whole regiment and doesn't fight me. Thanks goodness - because I already feel guilty having to cram so much down her.
Tonight we see Dr. P for another qi gong treatment.
Monday, January 25, 2010
Emerging
We have had a very difficult week and even more difficult weekend. Sumis has had a hard time adjusting to the phenobarb. It has erased an already fragile mental connection she had to reality. On Thursday when I took Sumis to her chemo appointment, she was too weak to even sit up on her own. I knew objectively that this was a normal side effect of the phenobarb but it knocked the wind out of me to watch. I asked the oncologist if she thought we should continue. She told me that we should continue, that we would really know where things stand soon. She also said that despite the spinal tap results she suspected that the lymphoma had invaded Sumis' central nervous system. If it had been just a stroke we should be seeing some recovery and the fact that we hadn't made her fairly sure of this diagnosis. So, we altered Sumis' chemo protocol to include a drug that will cross the blood brain barrier. Lucky for Sumis this drug is oral, so no needles this week beyond her blood draw. The oncologist also said that lymphoma in the cns is "exquisitely" responsive to radiation treatment. She said that it often only takes a couple of treatments to completely "dry the cancer out." Before we give up, she told me, we will try some radiation. We had a little scare while waiting to check out. Sumis began to posture the way animals do when they are about to go into cardiac arrest. I panicked and nearly the entire oncology department came to the rescue. It turned out she was straining to poop! Needless to say, I felt pretty silly.
Friday Sumis was still very lethargic. Saturday, Sumis spent the entire, and by entire I do NOT exaggerate, day pacing. She had not pooped since Thursday and I could feel a pearl-like necklace of poop backed up in her abdomen (sorry for the details). By Saturday afternoon, I realized that Sumis was uncomfortable and constipated. So, we gave her some subcutaneous fluids and laxatone to try to help things along. Finally, Sumis collapsed in my arms late Saturday night. She slept a few hours before returning to her pacing. Sunday morning I awoke to Sumis vomiting. When I went to investigate, she was straining so hard to poop that she was making herself sick. At that point, my significant other administered an enema and had to manually remove some feces. Sumis felt so much better after this. She was finally able to rest comfortably. Throughout the rest of the day, Sumis was able to poop on her own.
Since emerging from the phenobarb fog, the constipation and the latest round of chemo, Sumis actually seems much better. She asked for chin rubs and head butts this morning and when she got them started purring. She is still not out of the woods yet, but I am farther away from the decision I thought was imminent yesterday.
Friday Sumis was still very lethargic. Saturday, Sumis spent the entire, and by entire I do NOT exaggerate, day pacing. She had not pooped since Thursday and I could feel a pearl-like necklace of poop backed up in her abdomen (sorry for the details). By Saturday afternoon, I realized that Sumis was uncomfortable and constipated. So, we gave her some subcutaneous fluids and laxatone to try to help things along. Finally, Sumis collapsed in my arms late Saturday night. She slept a few hours before returning to her pacing. Sunday morning I awoke to Sumis vomiting. When I went to investigate, she was straining so hard to poop that she was making herself sick. At that point, my significant other administered an enema and had to manually remove some feces. Sumis felt so much better after this. She was finally able to rest comfortably. Throughout the rest of the day, Sumis was able to poop on her own.
Since emerging from the phenobarb fog, the constipation and the latest round of chemo, Sumis actually seems much better. She asked for chin rubs and head butts this morning and when she got them started purring. She is still not out of the woods yet, but I am farther away from the decision I thought was imminent yesterday.
Wednesday, January 20, 2010
Qi Gong
Sumis received her first qi gong treatment last night. Dr. P gently assessed Sumis and the energetic patterns associated with her disease. Sumis was again at ease with Dr. P, resting her head comfortably on my arm during most of the treatment. The experience was very powerful. Sumis would periodically sit up and stare at Dr. P. When Dr. P would ask Sumis a question, Sumis would meow back. They conversed in the language shared by humans and animals - that of energetic patterns. Sumis was very receptive to the treatment and let Dr. P work deeply on her imbalances. Dr. P found that both Sumis' lung and kidney are tied to her disease. She also worked to clear Sumis' yellow room. In qi gong, the heart, the golden emperor, puts all the emotions that a given being is not yet ready to deal with in the yellow room.
The treatment lasted about 2 hours - time tends to slip away. When the treatment was finished, Dr. P and I discussed our treatment plan. We decided that Sumis would receive qi gong once a week and that we would start her on herbs. Initially, we are treating her liver wind and her cancer. If she tolerates these herbs, we will add an herb to support her liver and an herb to support her bone marrow. I have started her on a low dose of the herbs and so far she handles the herbs better than her kepra. I mix the herbs with tuna juice and she drinks them right down.
Unfortunately, on the way home, Sumis had another seizure. So, we had to start her on an additional anti-convulsant. This drug has made her very groggy. In some ways, I think this is good because it has decreased her pacing and is giving her body a chance to rest. But, it is also hard to see her so sedated. Since adding this additional drug, she has not had any additional seizures, although she has had some periodic twitching. The odd thing about her seizures is that she has her greatest moments of lucidity following the seizures. After this particular seizure, she started grooming herself, an act she gave up when she initially became sick.
Even on both of her anti-convulsants, Sumis is still displaying neurologic behavior. She does still pace and still hovers over the dogs. She is trying to reconnect with the boys, but they hiss and run away when she gets near them. She also still has trouble with walking off the edge of things, so her counter time has to be closely supervised.
We are on our way to the oncologist this morning to get her next chemo. Luckily she has had this drug before and tolerated it well last time.
The treatment lasted about 2 hours - time tends to slip away. When the treatment was finished, Dr. P and I discussed our treatment plan. We decided that Sumis would receive qi gong once a week and that we would start her on herbs. Initially, we are treating her liver wind and her cancer. If she tolerates these herbs, we will add an herb to support her liver and an herb to support her bone marrow. I have started her on a low dose of the herbs and so far she handles the herbs better than her kepra. I mix the herbs with tuna juice and she drinks them right down.
Unfortunately, on the way home, Sumis had another seizure. So, we had to start her on an additional anti-convulsant. This drug has made her very groggy. In some ways, I think this is good because it has decreased her pacing and is giving her body a chance to rest. But, it is also hard to see her so sedated. Since adding this additional drug, she has not had any additional seizures, although she has had some periodic twitching. The odd thing about her seizures is that she has her greatest moments of lucidity following the seizures. After this particular seizure, she started grooming herself, an act she gave up when she initially became sick.
Even on both of her anti-convulsants, Sumis is still displaying neurologic behavior. She does still pace and still hovers over the dogs. She is trying to reconnect with the boys, but they hiss and run away when she gets near them. She also still has trouble with walking off the edge of things, so her counter time has to be closely supervised.
We are on our way to the oncologist this morning to get her next chemo. Luckily she has had this drug before and tolerated it well last time.
Tuesday, January 19, 2010
Stroke, etc.
Because Sumis' MRI and spinal tap did not yield the expected results, the neurologists sent the MRI to a radiologist who specializes in reading MRIs. After analyzing Sumis' MRI, she found an area indicating an infarction, most likely a stroke. This diagnosis did not surprise me as it explained some of her more bizarre behavioral changes. What it means is uncertain - like it is with humans. Stroke recovery is a very individual process. So, this diagnosis just adds a secondary waiting game.
Following her appointment with the neurologists, Sumis started taking Kepra, an anti-convulsant, flavored for her with grilled tuna. Despite this attempt at palatability, Sumis finds the concoction repulsive. To add insult to injury, this drug must be administered three times a day. Initially, it seemed to decrease her twitching and she went several days without a seizure. However, last night, she had another seizure that lasted even longer than the previous three. So, at this point, she will likely switch to Phenobarb for her seizures.
Perhaps the most difficult side effect of either the seizures, the stroke or both has been Sumis' absence of cognition. Her eyes are vacant. Every once in a while when she is sleeping on my lap she will look up at me and I will see a glimmer of my girl. When not on my lap, Sumis paces the house compulsively. While this behavior has decreased slowly but surely day by day, Sumis still has a difficult time sitting still unless curled up in my lap. The neurologist said that if the pacing was related to the seizures it would likely clear up in a few days and if it was related to the stroke it may take a couple of weeks. Let me just say that when you are taking things hour by hour, a couple of weeks seems like an eternity!
Sumis remains weak and lethargic. I know that some of this is likely related to the chemo and some of it to the fact that her body is fighting on many fronts these days. At the same time, when I look at her life these days, which at this point consists of sleeping, pacing, mindlessly eating and being pilled, I don't see a great deal of quality. If happiness is just around the bend, I am willing to keep up the fight. But I do find myself wondering when the end (her potential recovery, in what a couple months?) no longer justifies the means (feeling sick, losing all sense of joy and love). But isn't this the age old question. How do you know when? You want to fight as hard as you can for your companion but you don't want to take it too far or cause them to suffer. So, at this point, I am left answerless.
Following her appointment with the neurologists, Sumis started taking Kepra, an anti-convulsant, flavored for her with grilled tuna. Despite this attempt at palatability, Sumis finds the concoction repulsive. To add insult to injury, this drug must be administered three times a day. Initially, it seemed to decrease her twitching and she went several days without a seizure. However, last night, she had another seizure that lasted even longer than the previous three. So, at this point, she will likely switch to Phenobarb for her seizures.
Perhaps the most difficult side effect of either the seizures, the stroke or both has been Sumis' absence of cognition. Her eyes are vacant. Every once in a while when she is sleeping on my lap she will look up at me and I will see a glimmer of my girl. When not on my lap, Sumis paces the house compulsively. While this behavior has decreased slowly but surely day by day, Sumis still has a difficult time sitting still unless curled up in my lap. The neurologist said that if the pacing was related to the seizures it would likely clear up in a few days and if it was related to the stroke it may take a couple of weeks. Let me just say that when you are taking things hour by hour, a couple of weeks seems like an eternity!
Sumis remains weak and lethargic. I know that some of this is likely related to the chemo and some of it to the fact that her body is fighting on many fronts these days. At the same time, when I look at her life these days, which at this point consists of sleeping, pacing, mindlessly eating and being pilled, I don't see a great deal of quality. If happiness is just around the bend, I am willing to keep up the fight. But I do find myself wondering when the end (her potential recovery, in what a couple months?) no longer justifies the means (feeling sick, losing all sense of joy and love). But isn't this the age old question. How do you know when? You want to fight as hard as you can for your companion but you don't want to take it too far or cause them to suffer. So, at this point, I am left answerless.
Thursday, January 14, 2010
Good News
Well, finally some good news. Sumis had an MRI and a spinal tap, neither of which showed signs of cancer. The neurologist said that sometimes with systemic disease the brain "gets mad." Or it could be a metabolic disturbance. Or, as Dr. P suggested, liver wind. At any rate, we will start anti-convulsant medication and continue chemo as planned. Unfortunately, because contrast was used during her MRI, Sumis could not receive her Qi Gong treatment last night. We are still hoping to start that in the next couple of days. Sumis was a little groggy last night from the anesthesia and is swollen and bruised on her neck from her spinal tap. But she seems happy to be home in a cozy lap or in front of a mound of food.
In the meantime, Sumis, queen bee, has re-emerged. She patrols the house like usual, and this morning even tried to horn in on the dogs' breakfast. She does seem a bit restless and still cannot jump up on things. But, I am happy just to see her sassy and hungry for now. She does need to gain some serious weight, so there are several daily feasts to be had. She has picked up a new behavior that is comical. Now, she will follow a particular dog to their bed, climb right up on the bed with them, and curl up staring at them. Bose, in particular, had no idea what to make of it. At first, he thought she wanted to play, so he charged her with a wagging stump. But that wasn't it. So, then he eyed her sideways with suspicion, trying to discern her intent. When that didn't work, he finally gave up and went to sleep with Sumis on guard.
Our visit to the oncologist this morning went well. The doctor is cautiously optimistic, saying that Sumis' bowel loops subjectively feel a little better. So, she received her next dose of chemo. Happily, this drug was given orally, so no more pokes for a few days! This particular drug has the greatest chance of all the chemo drugs for causing nausea, so we will have to watch Sumis closely to make sure she feels good. More chemo next week, but hopefully no more man-handling for the next few days.
In the meantime, Sumis, queen bee, has re-emerged. She patrols the house like usual, and this morning even tried to horn in on the dogs' breakfast. She does seem a bit restless and still cannot jump up on things. But, I am happy just to see her sassy and hungry for now. She does need to gain some serious weight, so there are several daily feasts to be had. She has picked up a new behavior that is comical. Now, she will follow a particular dog to their bed, climb right up on the bed with them, and curl up staring at them. Bose, in particular, had no idea what to make of it. At first, he thought she wanted to play, so he charged her with a wagging stump. But that wasn't it. So, then he eyed her sideways with suspicion, trying to discern her intent. When that didn't work, he finally gave up and went to sleep with Sumis on guard.
Our visit to the oncologist this morning went well. The doctor is cautiously optimistic, saying that Sumis' bowel loops subjectively feel a little better. So, she received her next dose of chemo. Happily, this drug was given orally, so no more pokes for a few days! This particular drug has the greatest chance of all the chemo drugs for causing nausea, so we will have to watch Sumis closely to make sure she feels good. More chemo next week, but hopefully no more man-handling for the next few days.
Wednesday, January 13, 2010
Neurologist
The past few days have been really good for the most part, that is until Sumis started having seizure activity yesterday. Her spirits have been high; she has been inhaling food (though without much weight gain). She has even been hunting Fanny again. But yesterday, she started frothing at the mouth, twitching, and staring at me like I was a giant purple monster. She has had two of these events so far. We talked to the oncologist who thinks that Sumis most likely has lymphoma in her brain now as well. To be sure, however, we are on our way to the neurologist today for an MRI. Because animals won't just sit still for imaging, MRIs require general anesthesia. I am hoping this anesthesia goes better than the endoscopy. I think it will as the actual procedure is less invasive. While we could treat without knowing for sure that it was lymphoma, if it is something else that is really bad, we will have to reconsider our treatment plan. If it is lymphoma, our oncologist will design a chemo protocol comprised of drugs that will cross the blood-brain barrier. Later tonight, Sumis will see Dr. P for a Qi Gong treatment to help calm the liver wind that in TCM is the cause of the seizure activity.
Saturday, January 9, 2010
Hard Morning
Sumis is having a hard morning today. We decreased her prednisone and I have to wonder if the lower dosage is not too low. Her energy and appetite have plummeted, as has her spunk. As usual, this lull occurs on a weekend when the oncologist is unavailable. I am trying not to panic, reminding myself that especially the first three weeks will not be without their bumps. But, I also remember that this is the time in which we evaluate her responsiveness to the chemo. Thank goodness we have an appointment with Dr. P tomorrow for Qi Gong. I am hoping that an afternoon in the sunshine and some junk cat food will perk her up. Until then, I remain by her side, keeping her warm and comfortable.
Friday, January 8, 2010
Visit to the Oncologist
On Wednesday, we took Sumis to see an oncologist. We love our internal medicine specialist, but we wanted to be sure Sumis received the latest and greatest treatment. So, we went not just to an oncologist, but to a doctor whose passion and grace is helping animals and their owners through cancer and who has seen it time and time again. Much of what we heard we already knew, but this oncologist knows how many little questions dog the owners of newly diagnosed cancer patients and was willing to sit and patiently answer every last one. Half a day of punkiness is okay, more than twenty-four hours is not. The only way to gauge remission without an invasive procedure is to watch Sumis' appetite and weight. We should see some serious results after 2 or 3 chemo treatments. The fact that she was feeling better already, after only 1 chemo treatment, was encouraging. And she had gained back 3.3 ounces. Cats very rarely have any side effects. The one side effect that is common is fatigue, so I shouldn't worry if Sumis seems tired but is still eating and otherwise happy. Yes, the median survival is around 11 months, but this oncologist has patients who have large cell and are four years out and still thriving. If the first protocol fails, there are still other options, but the whole treatment plan is up to Sumis. She will tell us how certain drugs affect her, how she is feeling. The whole point of chemo is to get your old cat back, with no medications outside the chemo protocol. Yes, we should try her off all her supportive meds and see how she does. The oncologist spent some time “cat-bonding” as she called it – getting to know Sumis. Doing a full body exam without Sumis realizing it – tricky doctor! So, we made the decision to have the oncologist treat Sumis. Her next chemo treatment is Thursday, Thursday being my class-free day.
Sumis is steadily better every day. She is eating almost normally now, both dry and wet. She is active and engaged with the family. She is hunting Fanny again. Yesterday while Sumis and I were on the hammock, Fanny came around wanting pets, which she got through the holes in the hammock. Apparently, Sumis was still perturbed about this half an hour later when we got up because the minute her feet hit the ground, she was on the hunt. And Fanny knew it, quickly seeking refuge behind my legs. In the end, I negotiated a settlement that spared Fanny a boxed nose – oh, the power of chin rubs. She has also been sassy with the other dogs. She got Robi on the ear and last night when Bose shifted positions in the bed gave him a swat across the face. At least she spares them her claws.
While her energy and spirit are soaring, Sumis is still a little weak. She can't quite jump on the bed or the counter. So, I now leave dry food down on the floor in the guest bedroom, gated off from prying canine noses who would be happy to help, but easy to reach for Sumis. This means that my cats are going back on a free-feed diet. Jaxon, only recently slim, will probably gorge his way back to a basketball belly before I know it. I am going to slowly try switching all three cats to Taste of the Wild dry food. While I am wary of messing with their food routine, it is important that Sumis be on a grain free diet. So, we will give it a try. All three of my cats have notoriously sensitive stomachs, and I eventually had to make a choice between having vomiting cats or having fat cats. Easy. So, we will try a gradual change and see if it works. If not, Sumis and I will have to engineer a clever way to feed her a different dry food than the other two, who already are convinced they are getting slighted when Sumis gets her canned food and they don't.
Today, it looks like another day in the sunshine with the mugs and mits.
Sumis is steadily better every day. She is eating almost normally now, both dry and wet. She is active and engaged with the family. She is hunting Fanny again. Yesterday while Sumis and I were on the hammock, Fanny came around wanting pets, which she got through the holes in the hammock. Apparently, Sumis was still perturbed about this half an hour later when we got up because the minute her feet hit the ground, she was on the hunt. And Fanny knew it, quickly seeking refuge behind my legs. In the end, I negotiated a settlement that spared Fanny a boxed nose – oh, the power of chin rubs. She has also been sassy with the other dogs. She got Robi on the ear and last night when Bose shifted positions in the bed gave him a swat across the face. At least she spares them her claws.
While her energy and spirit are soaring, Sumis is still a little weak. She can't quite jump on the bed or the counter. So, I now leave dry food down on the floor in the guest bedroom, gated off from prying canine noses who would be happy to help, but easy to reach for Sumis. This means that my cats are going back on a free-feed diet. Jaxon, only recently slim, will probably gorge his way back to a basketball belly before I know it. I am going to slowly try switching all three cats to Taste of the Wild dry food. While I am wary of messing with their food routine, it is important that Sumis be on a grain free diet. So, we will give it a try. All three of my cats have notoriously sensitive stomachs, and I eventually had to make a choice between having vomiting cats or having fat cats. Easy. So, we will try a gradual change and see if it works. If not, Sumis and I will have to engineer a clever way to feed her a different dry food than the other two, who already are convinced they are getting slighted when Sumis gets her canned food and they don't.
Today, it looks like another day in the sunshine with the mugs and mits.
Tuesday, January 5, 2010
It's What We Do
My winter break has not gone as planned to put it mildly. I wish I could turn back the clock and undo Sumis' sickness, but I can't, of course. Rather than writing creatively at Lake Patagonia, I have been writing a blog and fielding phone calls from Sumis' concerned fans. I have in the nearest sense been house-bound, unwilling to leave Sumis for any real length of time. But this week has, as so many instances this last year have, reminded me that things unplanned are often the most deeply fated you will ever experience.
The last week has brought spectacular weather to the old pueblo, and I have enjoyed almost every minute of it outside with the mugs and mits (my term for dogs and cats). The sun is the warm yellow of mid-spring, the time of year when it is just warm enough to comfortably sit outside without a jacket and the color of the light is cheerful and promising. Yes, it is still January, but you wouldn't know it sitting outside. Our yard is full of birds and their chatter. Sumis has insisted on spending most of her time in my lap, sometimes positioned to permit easy reading, sometimes not. Today, in fact, Bose, the little yorkie, insisted he be held at the same time as Sumis. Between the two of them they occupied both legs, both arms and one hand. This left one hand, with the full range of wrist motions, available to me. I did manage to teeter a book in one hand for a few minutes before just relaxing into the afternoon. This is how the past week and a half has gone for me. The daylight hours have been spent outside in the sunshine, sporadically reading, catching up on letters and well, ... watching, thinking, enjoying four-legger company, and maybe just being. For the first time in years, I have slowed down. I have been on fast-forward for the last several years, stopping only long enough to get the minimum hours of sleep. I have packed my days with school, work, and extracurricular activities and my breaks with more of the same. Now I am reaping some of the benefits of this pace, but I know that I missed many of the delicious details along the way. Today, I am quiet enough to notice the moments slipping by and enjoy each as it passes. I don't waste my day running superfluous errands, or locked on the internet. Sitting outside this afternoon, I pondered this, my book and tea out of reach on the ground, Sumis fast asleep in my lap. This is what I needed more than anything. I needed to stop. Certainly, I would have preferred it happen under different circumstances, but it hit me how good it felt to be in the sun, watching the birds and the shadows on the mountains with a kitty asleep on my lap and dogs napping at my feet. This week, I realized, is one that will remain firm in my memory not just because of Sumis' treatments but also because of its perfection. Still moments sealed with sunshine, love and perfection. Moments that any coming turmoil cannot disturb. They remain still and solid, Sumis' seeds planted. When I recounted this thread of thought to my significant other later in the evening, the response I got was “but of course. This is what Sumis does. She takes care of you, and this is what you needed.” I looked at Sumis and said, “Missy, I thought we had a talk about this, about me taking care of myself.” Then, I realized that no matter what the future holds for Sumis and me, we will always take care of each other. We can't help ourselves. This is what you naturally do for those you love.
The last week has brought spectacular weather to the old pueblo, and I have enjoyed almost every minute of it outside with the mugs and mits (my term for dogs and cats). The sun is the warm yellow of mid-spring, the time of year when it is just warm enough to comfortably sit outside without a jacket and the color of the light is cheerful and promising. Yes, it is still January, but you wouldn't know it sitting outside. Our yard is full of birds and their chatter. Sumis has insisted on spending most of her time in my lap, sometimes positioned to permit easy reading, sometimes not. Today, in fact, Bose, the little yorkie, insisted he be held at the same time as Sumis. Between the two of them they occupied both legs, both arms and one hand. This left one hand, with the full range of wrist motions, available to me. I did manage to teeter a book in one hand for a few minutes before just relaxing into the afternoon. This is how the past week and a half has gone for me. The daylight hours have been spent outside in the sunshine, sporadically reading, catching up on letters and well, ... watching, thinking, enjoying four-legger company, and maybe just being. For the first time in years, I have slowed down. I have been on fast-forward for the last several years, stopping only long enough to get the minimum hours of sleep. I have packed my days with school, work, and extracurricular activities and my breaks with more of the same. Now I am reaping some of the benefits of this pace, but I know that I missed many of the delicious details along the way. Today, I am quiet enough to notice the moments slipping by and enjoy each as it passes. I don't waste my day running superfluous errands, or locked on the internet. Sitting outside this afternoon, I pondered this, my book and tea out of reach on the ground, Sumis fast asleep in my lap. This is what I needed more than anything. I needed to stop. Certainly, I would have preferred it happen under different circumstances, but it hit me how good it felt to be in the sun, watching the birds and the shadows on the mountains with a kitty asleep on my lap and dogs napping at my feet. This week, I realized, is one that will remain firm in my memory not just because of Sumis' treatments but also because of its perfection. Still moments sealed with sunshine, love and perfection. Moments that any coming turmoil cannot disturb. They remain still and solid, Sumis' seeds planted. When I recounted this thread of thought to my significant other later in the evening, the response I got was “but of course. This is what Sumis does. She takes care of you, and this is what you needed.” I looked at Sumis and said, “Missy, I thought we had a talk about this, about me taking care of myself.” Then, I realized that no matter what the future holds for Sumis and me, we will always take care of each other. We can't help ourselves. This is what you naturally do for those you love.
First Treatments
Chemotherapy
Yesterday was Sumis' first chemotherapy session. When we arrived at the specialty center, she knew right where we were and clearly remembered her last visit, especially the aftermath. When I reached my hand into her carrier to reassure and soothe her, she was trembling. At this my heart cracked, but I knew we had no choice. I spoke with the technician, who was very gentle, and she told me the treatment would take about an hour. First, they would administer benedryl so that Sumis would be less likely to react to the chemotherapy. Then, they would administer her first two drugs: vincristine and L-asparaginase. I watched as the technician carried her to the back before departing. I headed down to the university to return library books so that I would not be twiddling my thumbs waiting for Sumis. It was a brisk morning, and I enjoyed the walk across campus. After returning my books, I still had 20 minutes or so before Sumis would be ready, so I dropped by a new coffee shop near campus for a cup of tea. Finally, the time had come and I headed back to pick Sumis up, not sure what shape she would be in. The technician who returned her to me told me that she had done just fine, had been a good, compliant patient. I took a peek in Sumis' carrier and she gazed back at me, not angry but ready to go. So far, no side effects. She did fine for the rest of the morning. Her energy levels held, as did her appetite.
Traditional Chinese Medicine (uyyyyyyyhhu – says Sumis)
Later that same day, Sumis and I headed to see Dr. P, our alternative medicine veterinarian, for an initial consultation. We wanted to make sure to address her disease at every level, from every angle. Dr. P has worked with several of my other pets to miraculous ends. If ever there was a master of eastern medicine, it is Dr. P. Just walking into a room with her will quiet both animal and human spirits. She is focused and deep in her treatments, monitoring even the slightest changes in an animal's energy as she performs her treatment. When I got into the exam room with Dr. P, we went over the western diagnosis and lab results in depth. We then moved onto Sumis' symptoms, behaviors and energy level. We discussed diet – with Dr. P suggesting a diet of wet, protein rich cat food as well as a liquid medical food used by humans with IBD. Oddly, Sumis had chosen a brand Dr. P recommended from among my various attempts to tempt her to eat. We would begin ozone enemas shortly and would tailor an herbal regiment to treat her disease based upon her final chemotherapy plan. Additionally, we would hit the disease hard with intense medical Qi Gong over the weekend. Medical Qi Gong is a modality used in Traditional Chinese Medicine (TCM). This modality is the most alternative by American standards but also can be the most powerful and most successful. Dr. P once described it to me as a modality that inserts energetic needles into the entire meridian, as opposed to the one point tapped with an acupuncture needle. To the naked eye, it looks something like reiki.
Sumis was at ease in the exam room, as I expected she would be. At one point, she wandered over to Dr. P and curled up in her arms, hiding her head in the nook of Dr. P's elbow. “She is a special girl,” I said. “You two are very close?” Dr. P asked. I nodded. “So, she is you.” Dr. P said. I nodded again.
Dr. P looked at me intently, saying, “Okay, I am going to get a little personal here. How is your GI tract?” At first, I almost responded “Fine, just fine,” and then I thought to myself, “Are you crazy?! Your stomach is where you hold all of your stress and you suffer crippling stomach aches as soon as the stress lets up.” I answered, “actually, my GI tract is a mess.” Dr. P nodded. “Often animals who are so closely linked with their owners internalize the pathologies of their owners. It is nothing to feel guilty about, but it just means I will have to treat the both of you.” So Sumis and I will be heading in together this weekend to receive medical Qi Gong. I am also supposed to let Sumis know that she is no longer responsible for taking care of me – certainly her lifelong project. Who knows if she will listen ... she is a cat with a mind of her own.
After evaluating her condition, Dr. P diagnosed Sumis with spleen deficiency and a slight liver wind. She reminded me, when I voiced an awareness of the severity of Sumis' prognosis, that in TCM, there is no such thing as cancer, just energy stagnations. “We will work through this,” she assured me. “I don't want to give you false hope but I also don't want you giving up hope,” she told me. And it is true. Animals, my own in particular, have had impossibly good responses to treatment from Dr. P. Things traditional medicine told us would not/could not happen have. And so once again, I put my trust in Dr. P. I left feeling light and positive, and I think Sumis felt the same.
Yesterday was Sumis' first chemotherapy session. When we arrived at the specialty center, she knew right where we were and clearly remembered her last visit, especially the aftermath. When I reached my hand into her carrier to reassure and soothe her, she was trembling. At this my heart cracked, but I knew we had no choice. I spoke with the technician, who was very gentle, and she told me the treatment would take about an hour. First, they would administer benedryl so that Sumis would be less likely to react to the chemotherapy. Then, they would administer her first two drugs: vincristine and L-asparaginase. I watched as the technician carried her to the back before departing. I headed down to the university to return library books so that I would not be twiddling my thumbs waiting for Sumis. It was a brisk morning, and I enjoyed the walk across campus. After returning my books, I still had 20 minutes or so before Sumis would be ready, so I dropped by a new coffee shop near campus for a cup of tea. Finally, the time had come and I headed back to pick Sumis up, not sure what shape she would be in. The technician who returned her to me told me that she had done just fine, had been a good, compliant patient. I took a peek in Sumis' carrier and she gazed back at me, not angry but ready to go. So far, no side effects. She did fine for the rest of the morning. Her energy levels held, as did her appetite.
Traditional Chinese Medicine (uyyyyyyyhhu – says Sumis)
Later that same day, Sumis and I headed to see Dr. P, our alternative medicine veterinarian, for an initial consultation. We wanted to make sure to address her disease at every level, from every angle. Dr. P has worked with several of my other pets to miraculous ends. If ever there was a master of eastern medicine, it is Dr. P. Just walking into a room with her will quiet both animal and human spirits. She is focused and deep in her treatments, monitoring even the slightest changes in an animal's energy as she performs her treatment. When I got into the exam room with Dr. P, we went over the western diagnosis and lab results in depth. We then moved onto Sumis' symptoms, behaviors and energy level. We discussed diet – with Dr. P suggesting a diet of wet, protein rich cat food as well as a liquid medical food used by humans with IBD. Oddly, Sumis had chosen a brand Dr. P recommended from among my various attempts to tempt her to eat. We would begin ozone enemas shortly and would tailor an herbal regiment to treat her disease based upon her final chemotherapy plan. Additionally, we would hit the disease hard with intense medical Qi Gong over the weekend. Medical Qi Gong is a modality used in Traditional Chinese Medicine (TCM). This modality is the most alternative by American standards but also can be the most powerful and most successful. Dr. P once described it to me as a modality that inserts energetic needles into the entire meridian, as opposed to the one point tapped with an acupuncture needle. To the naked eye, it looks something like reiki.
Sumis was at ease in the exam room, as I expected she would be. At one point, she wandered over to Dr. P and curled up in her arms, hiding her head in the nook of Dr. P's elbow. “She is a special girl,” I said. “You two are very close?” Dr. P asked. I nodded. “So, she is you.” Dr. P said. I nodded again.
Dr. P looked at me intently, saying, “Okay, I am going to get a little personal here. How is your GI tract?” At first, I almost responded “Fine, just fine,” and then I thought to myself, “Are you crazy?! Your stomach is where you hold all of your stress and you suffer crippling stomach aches as soon as the stress lets up.” I answered, “actually, my GI tract is a mess.” Dr. P nodded. “Often animals who are so closely linked with their owners internalize the pathologies of their owners. It is nothing to feel guilty about, but it just means I will have to treat the both of you.” So Sumis and I will be heading in together this weekend to receive medical Qi Gong. I am also supposed to let Sumis know that she is no longer responsible for taking care of me – certainly her lifelong project. Who knows if she will listen ... she is a cat with a mind of her own.
After evaluating her condition, Dr. P diagnosed Sumis with spleen deficiency and a slight liver wind. She reminded me, when I voiced an awareness of the severity of Sumis' prognosis, that in TCM, there is no such thing as cancer, just energy stagnations. “We will work through this,” she assured me. “I don't want to give you false hope but I also don't want you giving up hope,” she told me. And it is true. Animals, my own in particular, have had impossibly good responses to treatment from Dr. P. Things traditional medicine told us would not/could not happen have. And so once again, I put my trust in Dr. P. I left feeling light and positive, and I think Sumis felt the same.
Sunday, January 3, 2010
Diagnosis
The preliminary pathology report indicates that Sumis has large cell GI lymphoma, a high grade form of cancer. Small cell is more common in cats and has a better prognosis. But, neither Sumis nor I will let the severity of the disease dampen our spirits. She will start aggressive chemotherapy on Monday along with Chinese herbs, acupuncture, Medical Qi Gong and ozone enemas. Cats apparently handle chemotherapy much better than humans, with only 5% showing even mild symptoms. So, I am hoping that her body handles the drugs without too many side effects. She won't lose her hair, although, she may lose her whiskers.
This weekend we have been managing her symptoms, tweeking her drug regiment until she is alert, happy, and pain and nausea free. She is finally eating again, though not much. She has rejected all but the junk food, but at this point, she calls the shots. So, she gets whatever she wants. As she has begun to eat more, her energy has also increased. She has been waking me up about 4 to demand pets and head butts. She purrs a lot these days, particularly when snuggled up on my lap. Watching life creep back into her body over these past few days has given me hope, which while guarded, still blooms full deep in my heart.
We have had warm afternoons here in Tucson for the past week, so all the animals and I have been spending hours outside soaking in the sun. Sitting in the quiet afternoon, listening to the sounds of a neighborhood on vacation, watching Sumis move into the sun, then back out, I can almost pretend that everything is normal - that my room is not full of needles, pills, fluids and pooch pads. And so I let myself give in to the delusion just for a bit. I watch her and see her as she has always been. I let go of the worry and heart-sickness and just enjoy the afternoon with the mugs and the mits.
This weekend we have been managing her symptoms, tweeking her drug regiment until she is alert, happy, and pain and nausea free. She is finally eating again, though not much. She has rejected all but the junk food, but at this point, she calls the shots. So, she gets whatever she wants. As she has begun to eat more, her energy has also increased. She has been waking me up about 4 to demand pets and head butts. She purrs a lot these days, particularly when snuggled up on my lap. Watching life creep back into her body over these past few days has given me hope, which while guarded, still blooms full deep in my heart.
We have had warm afternoons here in Tucson for the past week, so all the animals and I have been spending hours outside soaking in the sun. Sitting in the quiet afternoon, listening to the sounds of a neighborhood on vacation, watching Sumis move into the sun, then back out, I can almost pretend that everything is normal - that my room is not full of needles, pills, fluids and pooch pads. And so I let myself give in to the delusion just for a bit. I watch her and see her as she has always been. I let go of the worry and heart-sickness and just enjoy the afternoon with the mugs and the mits.
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