The Oncologist Visit

Monday, Feb 21, 2011  9:30am
I cleared my schedule knowing I was a "work-in" appointment.  Dave and I brought Riley's bed to ensure she would have something familiar and comfortable during this long wait.  Dr. Brown had me in the exam room by 10am. 

She went over our options.  1) Do nothing; Riley might last another two weeks.  2) Treat with prednisone; This would keep her fairly comfortable, and give her maybe 30-60 days.  3) Chemo; this would set the cancer in remission and on average, this option gives dogs 12 months. 

As the doctor left the room, my horrible internal war of ethics began.  What is right?  I listened to her labored breathing.  She has a couple of swollen lymph nodes sitting right on her trachea which make it hard for her to breathe.  I've always been a bit of a naturalist when it comes to dogs.  I like training without any leash or even a collar for that matter.  I like to use their natural motivations to capture desired behaviors.  I don't like force.  I like hands-free training.  I don't like making something happen.  I like to simply work with the animal before me, and see what happens.  The thought of chemo made me sick.  It isn't natural... This isn't what Riley would want... Is it?  Is life over-rated?  Is cheating death just a human quest?  Who are we to fight the inevitable?  Maybe dogs willingly, peacefully accept death.  I'm sure of it.  Of course they do.  It is as natural as birth, just part of the cycle.  Dogs are far more accepting than humans.  I am going to let her go.  I am going to treat with prednisone, until she lets me know it is time.  I sobbed and wondered if this is what she would want.  It seems more natural, Riley.  I can do this.  I can let you go.  You have given me so much... I can give you this.  I told Dave that I can do this.  I can let her go.

The doctor's main concern was that the cancerous tumors might have invaded the intestinal lining.  Chemo would kill those cancerous growths and leave gaping holes in her intestines causing her severe discomfort and pain as blood and bile leak into her body. 

I needed time.  I can't believe how fast this all happened.  She went from perfect to damaged in such a short time. 

The doctor recommended an ultrasound on her abdomen... just to see.  Dave and I agreed.  We had to know how invasive this was.  The results came back in Riley's favor:  no holes or tumors in her intestinal wall.  She is a good candidate for chemo.

Dr. Brown was so patient with me through this struggle.  I cried and didn't know how to move forward with a decision.  I told her that I just want her to feel better.  She assured me that with her first chemo treatment, she would feel great tomorrow.  Really?  I doubted it.  My oldest sister, Michelle, suffered from breast cancer and I remember her pain...her body aches. 

"So, she will get a shot and feel better?" I questioned.  "But, it is horrible for people... the vomiting, the diarrhea...the body aches!"

She assured me that this was not the case with dogs.  "You see," she said, "with humans, we give a powerful dose.  We almost kill the person to stop the cancer.  We do whatever we can that we think the human can take.  With dogs, we just do the minimum to stop the cancer.  To send it into remission.  You shouldn't see vomiting or diarrhea, even.  In fact, most patients feel fantastic the next day."

"Fantastic?"

"Yes, fantastic.  Most owners will call us that night and say that the lymph nodes have already noticeably decreased in size."

"So, she will feel better tomorrow?" 

And as the vet nodded, I agreed to the chemo.  I feel weird about it.  I don't know if this is right.  But, we are doing it.  And we are taking it one treatment at a time.  As soon as she has more bad days than good... we are out.  And I talked to Riley about it and we are okay with this for now.


Tuesday, Feb. 22, 2011  8am
Riley waits for me at the food bowl.  Wolfs down her food.  She feels good.  She looks good.  Her appetite is back, her stool is solid.  Our little victory party involved her and I laying on the couch watching Vegas and Wigglestink romp, play bow and chase each other in the living room.  It felt like last week again... before this blew up in our face.  Riley and I watching the pups play.  And every once and a while, we give each other the knowing look... "Oh, those silly dogs," we say, "so glad we are so refined."  And we smile.