Where Do We Go From Here???
Some folks’ lives roll easy as a breeze
Drifting through a summer night
Heading for a sunny day
But most folks’ lives, oh they stumble
Lord they fall
Through no fault of their own
Most folks never catch their stars
And here I am, Lord
I’m knocking at your place of business
I know I ain’t got no business here
But you said if I ever got so low
I was busted,
You could be trusted
Some folks’ lives roll easy
Some folks’ lives
never roll at all
Oh, they just fall
They just fall
I am writing this with a mixture of sadness and despair, rage and contempt, denial and indignation. It seems so simple to me – goodness should be rewarded and badness should be punished. Unfortunately, that’s not how life works….not even close. No, shitty people continue to do shitty things, bringing misery at will, yet seemingly unscathed by the pain that the rest of us feel. Perhaps evil has a special resiliency, but I think not. I think that life is just not fair.
Our emergency visit to the vet today, during a snowstorm, has hammered home the realization that no matter how good of a girl you are, the randomness of the universe can, and will, bite you in the ass. Attacks by an unknown, unseen enemy named Cancer have brought us to our knees and we are unsure of whether to fight, or make ourselves comfortable while awaiting the inevitable. The middle, uncertain ground is never a place where I enjoy finding myself.
Just what IS a grade 3 mast cell tumor? Often called ‘the great imitator’, mast cell tumors can only be diagnosed by removal and biopsy by a pathologist. Mast cell tumors are also known as histiocytic mastocytoma, mast cell sarcoma, and, in Lilly’s case, mastocystosis. They can appear as warts, lumps, or opened sores. The recurrence of tumors, their location on the body and definition of the cell walls are all criteria for ‘grading’ (examining the cells to predict the prognosis of the disease and develop treatment strategies). Tumors on the mouth, paw, lymph nodes or any particularly venous area of the body are particularly worrisome. Lilly’s tumors were over her throat, in her armpit and on her leg. Mast cell tumors are often mistaken for lipomas (fatty tumors), as Lilly’s were, and ignored, particularly when the dog is ‘older’. It wasn’t until we began going to another veterinary practice, for reasons not related to Lilly at all, did the veterinarian aspirate the tumor on her neck, returning with the diagnosis of probable mast cell tumors.
So, the question remains, “Where do we go from here?”
There seems to be something, deep inside my soul, that doesn’t allow me to give up, or give in….particularly when ANY hope has been extended (even if that extension is only within MY mind)!! However, we have been through chemotherapy with a senior pit, named Otter, in the past. He was 10+ at the time of diagnosis. While admittedly significantly older than my Lilly, I fear that my refusal to defer to death may have caused him considerable suffering, most probably with no significant increase in his lifespan. Our miserable, two and a half hour-long trips back and forth from UPenn became the most dreaded trek of my life. He underwent two separate surgeries in an effort to be cancer-free. After his first round of chemo, I decided enough was enough. He was so very sick from it. His eyes pleaded with me to help him, but I couldn’t undo the medication or grant him relief. Finally, I put him on a mixture of herbs meant to inhibit the growth of tumors and enjoyed our time together. Although he far exceeded the most liberal estimates on longevity, he passed, after 23 months, of kidney failure. He lapsed into a coma one morning, awaking long enough to ask to walk out onto the porch to enjoy a stunning March afternoon for a few moments. He was helped across the bridge that evening by our compassionate vet.
Financially, the decision to go to extreme lengths to have Lilly, perhaps, beat the odds, is not a sound one. As a single mom, with a full-time job, bills, other dogs that need care, teenagers (who need everything), and volunteer work, it simply isn’t really logical to be spending half of my income, monthly, treating a dog with late-stage cancer. I don’t know of anyone in my extended family who would support that decision. I may know of two or three people, in my close circle of friends, who would support such a decision – mainly those who have met Lilly and experienced her energy and countenance and our love for her and her’s for us. However, putting ourselves in financial peril, especially given the current economic trends, in an effort to ‘hope against hope’, is simply not the judgement call of a rational person.
Practically, what are her odds? What if money were no object? Admittedly not known for my pragmatism, I am able to break some issues down into smaller parts and examine them objectively. A major problem is, the odds in this case are contingent on so many other factors that I am unable to verify. For instance, one factor that would impact a decision on whether to pursue life-saving treatment is Lilly’s age. If she were six, that would increase the odds that her body may to be able to tolerate more aggressive therapy, than if she were eight. The fact is…we really don’t know! Another issue is how the tumors were ‘graded’. While her AgNOR did indicate a likelihood of malignancy and recurrence….what if each recurrence were caught in time and removed? What if a different pathologist would have ‘graded’ her as a two? Of course, now I am rationalizing…but my point is that there is simply so much that we just don’t KNOW!!! Lilly’s Facebook page is replete with comments from owners whose dogs have survived, beyond reasonable expectations, with diagnoses thought to be much more deadly than Lilly’s! Perhaps the fact that medicine is simply so subjective causes my pragmatism to falter….
Emotionally, what toll will a full-tilt, ‘throw-down’ against canine cancer take, both on me and on my kids? What lesson(s) will I be teaching my children? As a family who has already suffered devastating loss, am I sending the message that life should be pursued at all costs? If I do that, am I promoting, or negating, the beliefs that I have already taught them about death? Whenever one family member is ill, but moreover terminally ill, all dynamics tend to shift in support of the one with the illness. I believe that is a natural occurrence in any tightly bonded family, albeit one that has a definite impact on the other members as well. Lilly has both good days and bad. I often find myself consciously fighting the disappointment, anger, helplessness and uncertainty that I feel, especially on the bad days, to prevent it from spilling over into the aura of everyone else. As her illness progresses, our lives will, no doubt, be increasingly centered on her. I am left to wonder what effect that will have on the various aspects of our lives. I am already hoarding vacation days. I find myself calling to check on her during the day, and becoming impatient when the person on the other end shares something, other than her status, at the beginning of the conversation. When Gabe comes home, rather than proceeding to pick up the phone or bike or remote or skateboard, as most teens do, he goes directly to Lilly. He has begun to insist on accompanying us on trips to the vet’s office. Our lives are gravitating, already, around sweet Lilly. But I can’t imagine it any other way, but is that the best course for everyone?
Finally, the last, but most important consideration, is Lilly’s quality of life. That is certainly the most difficult aspect to write about, but crucial for decision-making. For those of you who have never met Lilly, she exudes approbation. She doesn’t know a stranger- loving and accepting everyone on equal terms. As I have written about before, she is also remarkably intuitive, not only picking up on the energies in her environment, but acting on them as well. On a recent trip to the veterinarian’s office, there was an elderly man in the waiting room who was obviously upset. His wife would pop out from time to time, whispering updates on their dog’s condition. Lilly honed in on him immediately and made several attempts to ‘enter his space’ by physically placing herself increasingly closer to him. Although I made it clear to her that I wanted her to remain within ‘our space’, she persisted, which was very uncharacteristic of her. After Lilly saw the doctor, we, again, were in the waiting area. The elderly gentleman was still there, head bowed. He appeared to be glancing at her out of the corner of his eye, but did not respond to her, now blatant, attempts to engage him by doing the infamous “Lilly Grunt and Wigglebutt Dance”. The receptionist whispered that he may be afraid of pit bulls (perhaps something he had shared with her while we were in with the doctor). As we checked out, I hooked the handle of her lead on the hook designed for that purpose, to enable me to write a check. The vet tech was explaining the new medications, when suddenly, she stopped – mid-sentence – with her eyebrows raised and her mouth opened. At the same time, I looked down and was mortified to realize that I hadn’t hooked the lead on the hook correctly, allowing Lilly the freedom to finally stroll across the waiting room to make physical contact with the object of her affection. I turned to find her standing with her back to me, facing him. The entire top of her head bowed and placed against his calf, as tightly as could be. She stood with her body perfectly still, as if she were trying to transfer some sort of calming energy directly into him. She didn’t even wag her tail… The man, head bowed and face expressionless, had the hand closest to Lilly out, fingers pointed toward the ceiling, like he either wanted to touch her, but couldn’t bring himself to do it, or was planning on warding off any attack she may spontaneously decide to launch. And there they were…frozen in time….for what seemed like forever. My first instinct was to scoop up the lead and snatch her away from him….but I didn’t. Something told me to stand down and let Lilly deal with it…she’ll know best. Slowly, she lifted her head, eventually meeting his eyes with hers. No longer a grunting wigglebutt, she was the epitome of calm, but focused, energy. As she lightly rested her chin on his knee, her eyes dropped and looked away, enabling him to summon the courage to lightly touch the top of her head, which caused her tail to slowly wag. That lone touch caused a visible release in him. He began stroking her head with both hands. She remained still as could be! Then he said, in a half-whisper, half-sob, “I know it’s going to be alright, Lilly.” I was shocked that he knew her name, even more surprised that she evoked that response. As I held her lead, and shifted my feet to align myself with her, so she knew that we were leaving, I felt like an intruder. I gently touched his shoulder, without saying anything, There was no need to speak…Lilly had said it all with her calming energy and her gentle strength. I often hear of people saying that this dog, or that dog, is an excellent ‘Ambassador of the Breed”. I have heard that said of Lilly, too. But I disagree. Lilly, if deemed the ‘Ambassador’ of anything, would be the paladin of hope, of strength, of kindness, of compassion….who just so happens to be in a pit bull body! A true “good girl”. I would never do anything to jeopardize such an extraordinary energy, for fear of tempting fate by forcing the unnatural extension of such a phenomenal rare gift. While I don’t want to waste the awesome vitality that has been entrusted to me, by not taking every advantage to preserve it, neither do I have a desire to force it to burn beyond its time, for fear its brightness would diminish and spoil.
After completely analyzing the multiple aspects of my Lilly’s illness…I am still left with the question, “Where do we go from here?“