Saturday, November 18, 2006

Time to nuke the dog

i started writing this post while watching the dog eat his breakfast while he's lying down. the past couple mornings he seems to be in a lot of pain, and eating kibble standing up is harder on the tile than on the carpet. it also seems harder to for him to reach down to the floor. but even when he is eating his food off a raised platform on the carpet, he's uncomfortable enough that he doesn't eat the whole bowl. after he lies down, i put it next to him and he'll almost finish it. he usually gets hungry later in the day, but i have to make him eat in the morning so he has some food before he takes his pills (which probably make him feel good enough to want to eat, frustratingly enough). a few hours after getting up, he seems a lot better though.

in general, he's in good spirits, racing around the house when i come home, happy to meet new people, always thinking about how he might cadge some food or chase a cat or squirrel. i have decided on radiation over amputation. one of reasons is this: according to statistics, he may only live another couple months (if the radiation and chemo are started early enough and work, it should be more). if he died in a couple of months and had spent two weeks of that time recovering from an amputation, i would regret the amputation. the side effects of the radiation aren't much, maybe a little sun-burn like irritation on the site. his quality of life is pretty good right now, it seems a shame to waste it.

i'm also planning on following the radiation with chemo. the doc said only 20% of dogs have any chem side effects at all and 5% have significant side effects like vomiting or diarrhea. mac is an old hand at digestive indiscretion and subsequent gastrointestinal upset, so the package of odds and symptoms don't seem too bad.

monday is our next appointment with the oncologists. hopefully mac can start radiation next week. apparently he needs some chemosensitization first and administration of a supplementary bone-promoting drug, pamidronate.

i have found the way the oncology practice is administered to be very frustrating. they are bad at returning calls, bad at gathering records, bad at hand-offs between doctors (i should add that once i have an individual's attention, i am completely willing to believe they are at the top of their field). due to this and recent events with my own medical care, i will be treating this as if i were mac's primary doctor, wanting everything that will happen to him at each visit explained to me before it happens, making sure i understand it completely first. i don't trust their disorder. at this point i believe that i can compensate for their deficits in organization and communication with my own organization and focus and will. if i stop believing that, i'll have to find another oncology practice.

in an effort to be informed about our options, i have been doing a lot of reading. scientific and medical research articles are written in code - i'm glad that i've spent the last half decade learning to read at least the scientific side of the code. there are journal articles on immediately relevant topics. if want to buy access to them through the publisher, the articles cost $30. happily i can request copies from my university library for about $6. knowledge is power, but power is power too: if i'm associated with a powerful institution, i can access the knowledge.

and attention is a kind of power. i'm not the best at steady focus, organization and preparation. i think i'll need that for this process. motivation helps.

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