Saturday, August 20, 2011

Things Are Never So Bad That They Can’t Get Worse: Part V

I picked up the call that would changed everything.

Hello, this is Hope at Cornell Veterinary Hospital, she said, just like every other call.

Hey, so, I’m figuring she survived the night, how is she doing?

She’s actually doing a lot better!

What? My brain was scrambling. Better?

Really? I asked, in complete denial.

Yeah, so she’s more alert and aware.

She went on to describe how her breathing was far better than it had been, not the wheezing of before, and how they had inserted the central line so she wasn’t being poked every hour and the feeding tube so her body was starting to get some nourishment. They were unable to insert the catheter however, since she is just too damn tiny. So instead to carefully monitor her urine output they have been weighing puppy pads pre and post peeing. They also managed to collect a urine sample (A feat I actually congratulated them for, given that my dog is only 2 inches from the ground when not squatting - catching a urine sample in a dachshund requires the agility, speed, and timing of an Olympic sport) so we could check for kidney cell death.

When I took her out this morning, she even walked back up the little ramp back inside - she has never done that before while she’s been here, Hope said, the excitement evident in her voice.

This...wasn’t the call I was expecting, I said.

I sat in disbelief. I was in shock and almost denial...because I WASN’T grieving.

So, her breathing is better?

Yeah, a lot better.

So, you don’t thinks shes in immediate threat of respiratory distress?

I mean, theres no way I can say, we can’t be sure of anything or garauntee anything...

Yes yes I get all that. But let’s just say I didn’t sleep last night and right now you’d guess she’d survive the next 3 hours for me to go sleep while her blood work is tested?

I mean, theres no way to be sure but she’s looking a lot better. You sho

uld probably go home and get some rest.

Yes, I probably should. Thank you so much for the wonderful update.

I sat in the truck staring at the vet hospital across the street.

Thing was, hearing how she was higher energy, still peeing and therefore her kidneys were still working, and had managed to reabsorb the liquid that was killing her. After that call...I just dared to have something I had long given up on...hope. I dared to hope I may bring my baby puppy home alive.

She might just live. The fact she survived the night showed she beat the odds. But the fact she might live....I was hopeful, but not cautiously so. The plasma could be artificially sustaining her while her own kidneys and livers continued to fail, soon to be nonfunctioning without the external supplement. Her bloodwork could come back and I’d be facing goodbye all over again.At least she wouldn’t be drowning by breathing through her own lungs I thought. That was an indescribable relief.

I dared to call my mom with the news- she literally cried from her happiness. I didn’t tell anyone else, even the closest of friends who texted me through those terrible 14 hours. I compared it to being less than 3 months pregnant - you have joyous news you want to share with the world but its all so tentative, so unsure you don’t dare because then everyone would have to share your grief too. I’d always have gained the solace and joy that I did the right thing by treating her with plasma even if I did lose her, but everyone else would have just ridden the rollercoaster of emotion for me with no reward.

So, knowing that my baby wasn’t likely to die in the next few hours at least, I texted friends “she survived the night, waiting on bloodtests.” I drove home and hopped into bed I didn’t sleep well, but probably the best I had since she was admitted to Colonial a lifetime ago on Friday.

I woke up and just stared at the ceiling until I got the bloodwork call, around noon, from Dr. Got-it-Right. Her liver and kidney values were stlll dangerously high...but had improved over night. Her pancreas was now showing signs of being angry about the whole situation too. The urine sample had none shown any signs of kidney cell death though, so even her kidneys had held on. Dr. Got-it-Right said, “I can’t believe it.”

I couldn’t believe it. She was by no means out of the woods yet with such alarming values of her kidneys, liver, and now her pancreas- but hope crept into my daily thoughts, plans for getting the house ready for when she came back...

I started making calls. But not to tell my friends to expect me in 14 hours, but instead to tell them baby puppy made it. The joy I heard in their voices makes me smile even now. And I have never had a facebook status with more comments or likes before. Everyone was celebrating for Espresso.

I went to visit Espresso that afternoon. Even though she now had a feeding tube (secured with a single stitch in her nose and a STAPLE on her forehead...not the easiest thing for Momma to see even if Espresso barely noticed) and a central line in her neck (so it was completely bandaged with 3 IV inputs coming out, she was very high energy compared to the day of the almost death. Someone had drawn hearts on the bandages covering her central line.

She also very adorably would try to stealthily rub the feeding tube running through her nose - I’d scold her and she’d stop mid-rub and look up at me like “whaaaaaat. I totally was just putting my head here at this incredibly awkward angle...I was sooooo not trying to rub my feeding tube.” Hope shared with me that apparently she would bury under the blankets so the vet techs couldn’t see her rub the tube. I will say, Espresso is damn smart when it comes to figuring out how to get what she wants.

Even though my dog was still yellow, still in kidney and liver failure, but she was Espresso again. She even was able to lick my face a little as I bent over her on the table, holding my little fighter.

We discussed the treatment and plan and tentative hope but still fear for the future, before Dr. Got-it-Right suggested we try to see if I could get her to eat at all. Hope brought in a sample platter of recovering doggie foods to see if we could get her to try anything. It was a long shot but we could at least assess how nauseous the liver failure was making.

I have never cried of joy before. I honestly rarely cry and even more rarely let anyone see me cry. I never understood why people cried at weddings to be honest - that happy feeling that may tempt a tear to leak out was always easily controlled for me. When Espresso lapped up the chicken baby food off of my finger and then even from the dish itself tears streamed down my cheeks. I probably cried more from happiness and joy as I watched Espresso nibble on the wet food after she had demolished the baby food more than I will ever cry on my own wedding day.

We were all astonished that she even had interest at food this early - she was DYING less than 12 hours ago. I left the hospital feeling positively elated.

I also let Espresso contribute to the amazing research facility that saved her life. Apparently a researcher had been hunting Dr. Got-it-Right down because he needed patients who were getting blood drawn and here was a dachshund getting blood drawn twice a day. Dr. Got-it-Right never brought it up before this moment because

we all had greater concerns. However, with the hope sprung from today, she told him she’d bring it up with me since she knew I was a student.

Given the fact Cornell saved my puppy, that their research has let them reach a point where they could save Espresso’s life, and that this school will be inadvertently paying their own vet bill via my very generous living stipend I myself am getting because

I will be doing research, of course I wanted to let Espresso and myself give back to the institution that saved her life. And all it involved on her part was blood that was already being drawn and allowing them to shave a few patches of hair. Dr. Got-it-Right made sure that this would all be done under the condition of lots and lots of cuddles.

In the days to come, no one could believe the speed of Espresso’s recovery, let alone the fact she was recovering at all. While her kidneys were still not 100%, she had to remained hospitalized and on IV fluids, but I got to visit her every day and see her improvement.

Each day she was stronger - by Thursday she leaped up on her hind legs and licked my face half to death. The yellow gently faded away and my puppy’s pink ears and bright white of her eyes returned. Each day, her liver and kidney enzyme levels slowly decreased. She was fully off of pain medication, anti-vomiting meds, and merely on fluids and treatments. The feeding tube was removed by Wednesday.

It was the highlight of my day, everyday, to walk into the vet hospital and know I’d see my baby IMPROVING. Everyday Hope would come out into the waiting room and say “Lindsay?” and look around. Whenever we made eye contact, we both smiled. She would humor me and my obsessive need to know everything about Espresso’s day and regail me with stories about her. Apparently she was very loved by the techs and got many compliments on her cuteness. She held out on eating the kidney food in hopes of more chicken baby food. And - what she would become famous for in the ICU - she would try to bury the rest of her uneaten kibble and wet food in her blankets.

On Thursday she was downgraded from the ICU to the less intense but still highly supervised overnight care unit. Apparently a tech working the night shift in this unit thought Espresso needed a squeaky toy - Hope even brought it in for our next visit. Espresso was very very happy to have a squeaker and loved showing it off to anyone that passed by apparently. She showed Momma how well she could squeak the toy for a good portion of my visit that day.

Hope still called religiously every morning and evening - always indulging me with more Espresso stories.

It was Friday that I got to have a nice long visit. Her kidney values had returned to normal so they were slowly weaning her off the IV fluids - I would take her home the next day. We ate a little, played a little. While Hope was giving me and her time together, I actually saw Dr. Reason - the ER doctor from what felt like a lifetime ago that originally admitted Espresso, called in the ultrasound team - through the door window. We made brief eye contact and I smiled - she quietly knocked and I waived her in.

We both said hello, and I caught her up to speed on Espresso - how she had deteriorated even since she last saw her, but the plasma transfusion and great care by Dr. Got-it-Right and Hope saved her. Dr. Reason was all smiles and gently petted Espresso who was loving the attention. She looked so happy and relieved to see that she had made it. I can only imagine that as an ER doctor she probably doesn’t have many happy endings. I was glad to she got to see Espresso doing so well, see my happy ending. As she was leaving, I thanked her for her prompt care and insight that day I brought Espresso in - I thanked her for

helping to save my dog’s life.

Eventually Hope and Dr. Got-it-Right came in to discuss the plans for bringing her home, her improving state, etc. In the end we just stood and talked about t

he miracle puppy that was currently sleeping in my lap. We all kinda just acknowledged the awe and shock we all felt that she had survived and was starting to thrive. It was very nice to take this quiet time to just be with the people who had shared my worst nightmare and celebrate our victory.

So what was it that almost killed my dog? That Tuesda

y that she made her great recovery was also the day her Leptospirosis titer test came back...negative. Especially since her red and white blood cell counts had stayed completely stable throughout her entire episode, Dr. Got-it-Right surmised it was likely toxin ingestion.

What the hell was the toxin? I have no idea. You can be sure I’ve wracked my brain 1000s of times, replayed every part of the week leading up to the point she got sick. I wish I could say I took her to a park where I saw her eat a mystery something, or that she had gotten into the trash and eaten something, or even that the previous tenant of my apartment hadn’t been a dog owner and therefore may have left a toxic pest bait or something out. But instead, all we had done all week was hang out in the backyard, take walks around the neighborhood and hang out in our new apartment. Just like we had for the one week before since we had been in Ithaca.

It likely means that what almost killed my dog - what made us both suffer insurmountable amounts of pain - was likely in my own backyard. I have scrubbed every inch of my apartment and short of the mild mold and mildew that lives in dark corners Espresso never explored and spiders that seem to come back a day after I vacuumed, there was nothing. The best guess we all could come up with is that it was something in the backyard. Maybe runoff a pesticide from four houses up due to the rain that she somehow licked. Maybe fungal spores growing on a pear she snacked on. Maybe a mold in the bushes I didn’t notice her inhale. God only knows. The fact it makes me scared of my own shadow, want to watch her every second of every day, and begin a long term overhaul of my backyard is an entry of its own.

Take home message? I don’t know what almost killed my dog, and that hurts so much. But she survived, and that’s what mattered.

I got to bring my baby home on Saturday evening. Her kidney stats had returned to normal on Friday, but 24 hours of observation and time to wean her off the IV was needed. It was after general hours, so I had to buzz myself in, just like when I admitted her. However this time I got to say into the speaker “Hi, this is Lindsay, here to pickup Espres

so, Dr. Got-it-Right is expecting me.”

Hope came to pick me up from the waiting room for the last time. She’d be on a new rotation next week, so this really was

goodbye to Espresso for her even though I’d have a follow up visit. I was just so thankful that she was able to stay on my case for the whole time - knowing the voice that gave me the news of my dog and knowing Espresso got to see the same familiar and caring person every day comforted me beyond anything. Besides, only Hope who had seen Espresso from the day she was admitted would understand the triumph of her survival. Hope led me to a room and explained the medications Espresso would need and gave me cans of the kidney food.

Dr. Got-it-Right came in for one last check in with me. She couldn’t stay long, she had other critical cases. As I had said in weeks earlier when she got back to me late or came in a few minutes after expected, I didn’t care at all. I loved being the non-critical case.

I’d see Dr. Got-it-Right next week for a follow up appointment, but Hope had to say goodbye to the little “princess” as she called her. I will always be so thankful for that 3rd year vet student. I told her such and that she’d make a kick ass vet one day. I thanked Dr. Got-it-Right, and pulled out Espresso’s harness and leash from my purse - it had been in there ever since I had first taken it off her all those days ago, I never had the heart to take it out in case I needed it for her. We walked out the room, down the hall, and outside of the vet hospital. We both sprinted out onto the lawn for a bit of a romp in the sunshine before loading back up into my truck.

Everything was back to how it should be. Just like everything was the same. Just like nothing had happened. Me, my dog, in the truck, headed home.

With Espresso, knowing that she pulled through, I am ready to make New York my home. I have struggled - am still struggling - with everything that happened, with the same fears that plagued my before - a fear of being lonely, a lingering heartache, and a twang of homesickness. But now, everything that was so consuming, is just not as important to me now. I have Espresso. A part of me believes she fought so hard for me because she knew how much I needed her.

With Espresso, I am prepared for whatever comes at me. Yes, things are never so bad that they can’t get worse. But together, Espresso and I can take it all on. And blog about it.

Bring it New York.

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