April 30, 2012

Time to visit the vampire.  Arri, Teva and Oregon are headed to the vet.  Oregon for his 3^rd set of puppy shots, Teva to get weighed in one last time before leaving for college and Arri to get bit by the vampire.  He needs to get a chem panel and CBC test to see how his blood is before his chemo appointment tomorrow.

After our local vet visit, I got a call from the oncologist office confirming Arri’s appointment for tomorrow.  I let her know they should be getting a fax with the blood test results.  She said they already received them but she did not think they had been reviewed yet.  I asked that they review them and call me yet today with the results, explaining that in the morning will be too late based on what time I need to leave to arrive at our appointment.

I didn’t think they were going to call but at 5:30, the phone rang.  The tech said one of Arri’s numbers was low and she did not think the Dr would want to do chemo tomorrow.  The Dr was gone for the day so I could ask no questions. Or I should say, I wasn’t going to get many answers.   I told the tech the tumors are growing and I felt a lump higher up on the leg.  Do I keep the appointment or reschedule?    This brought up an interesting schedule issue.  The tech wasn’t sure what was going to happen but she would talk to the Dr in the morning.  I pointed out that if they wanted Arri to come in, I had to know by 9:30 in order to make our 12:00 appointment.  I can only say my blood pressure went up in frustration when she said the oncologist won’t be in until 10:00.  She did make a note to talk to the surgeon right away in the morning and call me before 9:30.

April 26, 2012

I found a lump higher up on Arri’s thigh.  It might be a lymph node swelling from the chemo or it might be a lump.  Arri’s next appointment is on Tuesday.  He is in high spirits.  Playful and energetic.

April 18, 2012

I have noticed that the hair on Arri’s leg is growing back.  Yeah!  Although if I had my choice, I would rather the leg be permanently bald and the cancer gone.  I know chemo doesn’t work instantly but I was kind of hoping to notice a change.  The waiting is really annoying.  Arri has not shown any side effects.  I guess his blood work came back fine.  I called the oncologist to see if he needed a refill on the Amoxacillian.  I was told to finish giving him what he had and he should not need any more unless he starts to appear ill.  At that point, he will need a blood test first but then he may need more.

At the first meeting with the oncologist, I was told that the more treatment you do on the cancer, the greater change you have of the cancer changing.  It may spread more or become more aggressive.  I have noticed that the current cancer is growing differently.  Before, it was firm but stayed fairly round.  The current growths start round but now seem to be growing like a cookie in the oven – spreading out more horizontal than vertical.  The area of growth is roughly 2.25 inches by 1.25 inches.  There are many ‘pebbles’ that have merged together.  I was not thrilled after the last surgery – that the doctor did not remove the additional 3 growths I had found.  Now I know it does not matter.  Within a week of removing the cast, I had found two more growths.  Even if he had removed all that I had found, the cancer would have been showing it’s ugly face in a matter of days.

April 14, 2012

The tumors are growing.  I can see them clearly now.  Maybe others wouldn’t notice but I do.  Arri went in for his blood test yesterday.  Tim took him in.  Dr Mike agreed they are bigger than the last time he checked.  I don’t know the results of the blood test.  Not sure if anyone will call to let me know or not.

Personality wise, Arri is still a dork. He is playful and goofy as always. He is shedding like a fool right now.  Just the weather I think.

April 10, 2012 so far, so good.

From all the information I have been given,  side effects from chemo show between days 2 and 5 following treatment.  So far, Arri is doing great.  He is playful, eating well and most importantly, his rear end is funtioning just fine.  I have to remind myself not to check his leg every day.  His current growths won't show well in a photo so I keep touching them to see if there are more or if they are growing.  Tomorrow Arri starts on antibiotics.  His white cell count trends low normally so the antibiotics are a precaution if the chemo drops the white cell count futher.  Blood tests on Friday will tell us if there have been any changes.

April 6, 2012 Chemo begins

I got as many cakes done as I could before leaving for our appointment.  Once we are out the door, the rest of the day is shot. 

And so the journey continues.  Nice day for a drive with the exception of a lot of traffic.  Many people heading somewhere for the Easter weekend.  I was once again reminded of how God watches over my travels as I see traffic in the other direction at a complete stop due to an accident.  Fast forward to the trip home; same exact thing.

When we check in, they announce over the intercom that Arri has checked in.  All of Arri’s friends come out to see him.  Kathy, from radiology, brings him a HUGE handful of treats.  I warn her of the dangers and she holds out an open palm of 6 or 7 good size nuggets.  Arri swallows them in one bite – whole.  He has no manners around other people.  I take one treat and instruct Arri to prove to everyone in the room that he can take a treat nicely.  That boy KNOWS not to snatch it out of my hand.  Why we have never been able to transfer that behavior to others, I don’t know.   While we are waiting for the doctor, more people stop in the exam room to say hi to Arri. 

When Dr. Obradovich does make it into the room, she is talking very fast and in circles.  I was having a very hard time following her point.  It felt like she was continuing a conversation she thinks we had, that we never had.  She certainly does not want to give the feeling that there is not hope but really, that is the point.  From this moment forward, it is about disease control and quality of life.  Radiation has a 90% success rate.  Radiation did not work.  So we discuss the options.

For the first time, amputation comes up at as a serious option.  She does not believe the loss of the leg would be too much for Arri to deal with.  His weight is good and his hips are good.  Recovery would be 2 – 3 weeks.  The thing about amputation is it is still not a guarantee.  And once the leg is gone, it can’t be put back.  If the cancer were to move elsewhere, then he still has cancer and now he is missing a leg.  Ok, so that is still a last, last resort and I am not sure I will ever go there.  If Arri were younger, yes, I would try it but why do I need to put him through that.

Option 2: Melanomic chemotherapy.  This is a low dose chemo that is generally given daily in a pill form.  We discussed this back in January.  It is a fairly new treatment.  It had all sorts of handling and storage requirements.  Regular blood tests are necessary and it has a 40% chance of slowing down the cancer.

Option 3:  Chemotherapy.  This is high dose chemo.  It requires in office IV treatment.  We do 5 treatments 3 weeks apart.  Regular blood tests are still needed but I can have them done locally and the data faxed to the oncologist.  There are many drug options so if one does not seem to be working, we can try another.  My biggest concern with chemo is the side effects.  Nausea, vomiting, diarrhea and loss of appetite are possible but common.  They can occur 2 – 5 days after treatment.  It sounds like dogs tolerate chemo better than people do.  Or maybe they just hide it better.

Option 4:  do nothing further.   It is estimated that in 4 – 6 months, the cancer will have grown to the point of inhibiting use of the leg and quite probably become painful.  It also has a higher risk of spreading to the lymph system.  At that point we would be dealing with pain management and waiting for the right time.   The Dr. checked the nodes in his upper thigh and was pleased to note that they are not enlarged at all, something that is common post radiation.

I should say Tim was not with on this visit.  We did talk about what we could, not knowing much going into this appointment.  If you have been following Arri’s journey, you may know what I chose to do.   Say it together:   Dee chose option……3 - chemotherapy.   He will be starting out on the drug Carboplatin. I am hoping that Arri has few to no side effects.  I really don’t want to make him sick in order to make him better.  If he does respond poorly, then we stop treatment.

From this point I have two choices.  They can draw blood and do a chest x-ray now, to verify he is healthy to proceed with treatment.  Then schedule treatment for next week sometime.  Or they can draw blood, do a chest x-ray, verify he is healthy to proceed with treatment and start the treatment immediately. Treatment will take an hour. Decisions, decisions.  It’s 3:00.  I want to get home for the Good Friday service. But I do not want to make an extra 5 hour round trip.  Being late for church wins out over a tank of gas and another day of work lost.  They take Arri into the back and get started.   I go out to the car to make some phone calls.  Gotta call my mom and let her know I will be late for church.

An hour later, Arri comes bounding out off the treatment area.  It might have been nice if his genetic code contained a little less ‘happy ‘ gene and little more ‘cancer fighting’ gene.

The drive home involved a lot of speeding, some dirty looks and a thanks to God that the accident was on the other side of the road.  I dumped Arri off at home, changed clothes and made it to church 5 minutes late.  Just in time to join the choir for the first number.

April 3, 2012

Thank you for all your thoughts and prayers.  It is a comfort to know you are out there.  While no one actually said it, I need to stop thinking so much.  Trust my gut and don’t live in a ‘what if’ world.  It’s funny, because I do not play the ‘what if’ game in any other part of my life.  So the ‘what ifs’ are now out of my system.  Arri is not in any imminent, life threatening condition. At least, we don’t believe he is.   If we stopped all treatment, he would still have months – paws crossed - years left in him.  Stopping the treatment would mean a slow disabling of his leg, maybe not so slow.  The cancer is growing very fast, extremely fast actually, but is localized in the leg.  It is not known to spread to organs or lymph system.   However, if left untreated, the tumor would grow excessively large and could break up over time and spread.   

Of course, surgery generally slows growth for a year or more and when combined with radiation, it should be in complete remission.  Since none of that has been effective, I guess I should not put much hope in the statistics.  He is not in pain and he has no issues with walking, running or jumping.  He eats just fine, with the exception of an addiction to cheese.  Thus the dilemma: to treat or not to treat.  If he acted like an old dog, I would give him a break and enjoy the time.  But he thinks he is only 5 so, I have to fight for this old dog that is so young at heart.  On Friday we will talk to the Doctor.  I may change my mind once we talk but for now, we fight.  And if it does more harm than good, I will work less and we spend some time at the beach this summer.  Maybe we should do that anyway.  I know you love the water sweet boy.

I hope nobody minds if I double the price of my cakes to pay for all of this.  Just kidding…kind of…..