Cali Update

6:00 PM

I just left Cali at the vet school hospital, undergoing emergency surgery.  We will know in two hours if she made it or not.  Without, she would have lived only four more days unless the gallbladder ruptured.  In that case, she would have lived eighteen to twenty-four hours.  

If the surgery is straight forward and she only required a  stent placed at the common bile duct to allow bile to drain from the biliary tree and the gallbladder into the duodenum, she has agreater than 85% chance of survival.  If it is complicated, and the gallbladder has to come out, she has no more than an 85% chance of survival, still good odds.  But if her surrounding structures are so compromised by inflammation and her drain system has to be reconstructed, she has about a 15% chance of surviving to lead a compromised, weak little shortened life.  It is the latter condition under which I gave permission to let her go, that is, to euthanize her.  

I have cried all the way home, consumed with self doubt and selfishness, wanting to call the surgeon and say "Save her no matter what!"  But, I can't do that to her.  It would be for me, not for her.

I did ask the surgeon to make sure my doggie was held while she died, if she cannot be saved.  She assured me she would take off mask and gloves and personally hold, kiss and talk to her.  She says she does that for all the animals that she must allow to pass on.  We discovered that we both believe that there are all types of medicine; touch, talk, music, stillness, prayer.  I think she will be a fine stand-in for one of us if Cali has to leave.  But I hope and pray that she will come home with me tomorrow or the next day.

The bill will be from $2500 to $5000, in addition to the $1300 already spent on diagnostics and medicine.  How do you put a value on love?  I don't know the answer to that.  I am just following my heart and what I believe is fair for Cali.

I will know in a couple hours.  I'll post again then.

Cali update

Our little girl had a rough weekend; nausea, vomiting, zero appetite, sad eyes and lethargy.  She could not even keep water down.  I gave her little bits of water by syringe in the mouth, which she hated.  Her antiemetics (stop puking medication) had to be dissolved in water and given forcefully.  I called the vet at 0800 and she had her blood drawn by 1000.

Bilirubin had gone up from 0.8 to 9 (critical level).  The doc thinks her liver is fine, but that her bile ducts are block, from sludge or stones.  So, to, she goes back up to the OSU veterinary teaching hospital for more treatment, probably a cholecystectomy, or gallbladder removal.

This on the same day that I have a steroid injection on my right hip.  After the injection (notable for the needle being imbedded into the bone, then withdrawn slightly), instead of going home to rest, I will be driving 45 minutes north with my girl.  It's what ya do when someone needs you.  Code of the West, baby.

More later, wish us well (please?)...

Check this out, empty nesters!

There is a site dedicated to supporting those of us who are going through the empty nest years.  It offers fun, practical, compassionate, and 'been there' advice, suggestions, and a shoulder/ear for transitional times like these.  Check it out:  

http://www.emptynestsupport.com

Let me know what you think.  It seems to be a good balance between 'Snap out of it; women have been doing this for generations', ''Oh, you poor thing', and 'Wow, now it's time for ME ME ME!'.  All of which I go through like an iPod on dance shuffle!

Cali Update

Well, Cali seems so much better.  Of course, what is happening inside her body as this week wore on is a mystery to be revealed on Tuesday after another round of blood tests.  She rests a lot, but that is her job description.  'Rest, relax, eat, repeat.'

She still does not seem to enjoy her food.  I used to give it to her with a little water in it, warmed up a bit.  She would wolf it down, I mean to the point that I was considering getting those eater marbles to put in her bowl to slow her down.  Now, she picks slowly, gathers a kibble or two, then takes it to the carpet to sit down and crunch it.  She walks away after there is a big area of crunched kibbles with a Chihuahua ass shadow in it, without having eaten much at all.

So, today, I cooked some natural turkey breast, simmered it with fresh baby carrots, veined fresh celery, rice and broth, then blended it.  I gave her a tablespoon full.  Oh, my gosh, ecstasy was etched on her little furry face!  she kept it down, so I gave her some more two hours later.  Again, the enthusiasm.  So, I will continue on this route for a while to see if I can put back on a little of her lost weight.

Meanwhile, your thoughts, prayers, and inquiries about her health is appreciated.  I'll keep you posted.

What retirement means to me

I am an empty nester, as I have mentioned before.  Such a cute little name for such a sad thing. But what does that really mean, on a day to day basis?  For me, it means:

• I have been forcibly retired from the best job I have ever had, the one I longed to have for years, but held out for until my nest was secure and stable with the right mate.  I was CEO of the best company in the world, center of growth and excitement, a devoted and tireless work-a-holic.  Suddenly, I was phased out, without the retirement party, the golden parachute, or the gold watch.
  
• We have sold the big beautiful house custom built for my kids and our lifestyle.  I live in a place that has never echoed with the giggles or running steps or childhood arguments of my kids.  Or the excitement of Christmas morning.  I listen, but, nothing.  I no longer even have access to the closets and beds that still smell like my babies.  If I did, I would lay down and sleep, sometimes.
• I miss the growth charts on the wall that recorded heights every four or six months.  I taped a piece of acrylic film over the chart and copied it before the wall was painted when we sold the house.  It stays rolled up in a closet.
• I miss being touched.  My kids and I are very touching people.  When each was born, I couldn't get enough of them.  After more than two decades of hugging, cuddling, nursing, rocking, soothing, and closeness, I went cold turkey to touch.  And it leaves an aching void.  My husband is not overly demonstrative, and therefore no substitute.
• The house is so quiet.  No slamming doors, no loud music, no stream of young people in and out and in.  I have deliberately made our home welcoming to all friends of my kids, and enjoyed the company of many over the years. They would walk in, say 'hi', and hit the pantry for snacks before heading upstairs to see whomever.  They borrowed money, spent the night, did their laundry, went on trips with us, or just dropped by to hang out.  No one does that anymore.
• I laugh less.
• I holler less, whether in summoning, cheering, or stopping a disagreement.
• When I am home alone, I often go the entire day without speaking.
• I worry more about what my kids think of me, whether they will someday not want to call or come home.  I don't have anything specific to offer anymore, our relationship will from hereon rely on friendship, regard, and love.  I hope that there will be enough of those.
• I drive a big vehicle that carries only me now.

If that sounds a little desperate, so be it.  I am in transition, in a type of mourning, for the family I once had.  Of course I still have it, in a different form, but right now I hurt.  I am a strong, independent and intelligent woman, capable of anything I put my mind to.  But, I am an empty nester, and believe me, this ain't for wimps.

Cali Update

This little doggie is one tough cookie.  She is stoically taking her meds, with pathetic eye contact, and doing everything I ask of her.  Of course, the capsules are mixed with vanilla yogurt (her favorite), the larger pills are surrounded with cheese, and the half capsules are given in peanut butter.  Good stuff for bribery!

She has the cutest little shaved belly; complete with hematoma at the biopsy site.  

You would never know she is ill; she greets me when I come home from work, and, tonite, came upstairs to whine/bark/howl to notify me of George's arrival.  She seems clingy, as if she knows her health depends on me.  It is strange to know that she is so ill, so close to terminal, as she bounces around and acts goofy and playful.  She demands her treats, as if it is a normal evening, despite barely touching her real food.  It makes me sad.

Today, at work, I had some tough patients.  One, a little, tiny, 95 pound, frail elderly woman who had fallen last Sunday.  Blackened her eye, broke her hip.  After the repair, she didn't come out of sedation as hoped.  She arrived on a ventilator, fighting for her life.  It was heartening to watch the team struggle to save her, to analyze blood gases, to arrange for donated blood to strengthen her, to give medication to first increase, then decrease, her blood pressure.  To give her that one more chance that her family was praying for.

In PACU, there are no Code Blues.  We deal with the crashing patient ourselves.  No announcement goes over the loudspeaker stating, "Code Blue, PACU".  We deal with it internally.  We resusitate, no matter what.  And, it is rare for a patient to die while in our care.  

We take pride in our ability to keep them from that precipitous edge.  And, if they plunge over the edge, we bust our balls to bring them back.  We are the last frontier for the post-op patient. Everyone is precious, everyone gets the Full Meal Deal.

I sensed that same attitude in the veterinarian student and resident that cared for Cali yesterday; her recovery was a point of pride for them.  She arrived at the hospital in my husband's arms, with her favorite blanket and stuffed toys, Lalligator and Possum.  She was sleek and clean from a recent bath and conditioning, and she was well behaved and curious.  The team gave her their best, knowing that they were dealing with a loved little dog.  They held our hearts in their hands.

It was instructional, as a nurse, to experience what is probably only a fraction of the stress and concern that my patients' families go through at my hospital.  It makes me want to be a better nurse as I experience what life doles out to me.  I never want to forget what I felt like as my good friend died tragically when we were eighteen, as my father died at fifty-eight when I was twenty, as my mother died from medical negligence when I was twenty-nine, as my father-in-law died twelve years later after a long diminishing illness, and as numerous beloved pets have succumbed to old age or accident.  I never want to be insensitive to that pain.  

It is a gift to find care givers, for humans or for animals, who connect with the emotional element of illness as it impacts the family of patients.  I appreciate the professional and kind vets and students of the Oregon State University Teaching Hospital for their handling of the case of Caliente, our sweet little Chihuahua.

Day Off

I am going to take today off.  My sweet little Caliente, Cali for short, is very ill.  She is in extreme liver failure.  Yesterday, George made a flying trip forty miles north to the veterinary teaching hospital for diagnoses, a move suggested and arranged by our vet.

Her liver enzymes are twenty times what they should be.  She is nauseated, not even keeping fluids down, eating not at all.

I will update you all as our family moves through this tough time.  I will be giving her five different medications twice a day.  I'm a nurse, and giving meds is what I do, but my patients rarely clamp their jaws shut, poke away with their foot long tongues, and chew on my fingers as I ram the pills down the throat.  Nor can they spit out a pill that I have deposited to the distal end of the esophagus, just at the entry to the stomach, causing chew mark up to my elbows.  Well, Cali does.  

The docs say there is cause for hope, and we are hoping. And praying.  And bargaining.

More later...