Tuesday, July 13, 2010

A bitter pill

I had a follow-up appointment with my oncologist a few days before we left on our Myrtle Beach vacation in June. She gave me a prescription and also a two-week supply of the estrogen-blocking hormone pill (Arimidex) that I'm to take for the next five years. She agreed that I could wait to start taking it until after I returned from vacation.

So, I waited. And then, when we returned on June 26, I waited some more. And then another week went by and I was still waiting. It's odd, because with the chemo, I was kind of anxious to get started. My mantra became, "The sooner we start, the sooner it's over." The 7 weeks of radiation? "The sooner we start, the sooner it's over."

Well, you could make the same case for the hormone therapy. The "sooner, sooner" theory. But it's hard to tag five years with the word "sooner". We're talking long-haul here. And while chemo and radiation both had their possible side effects, they were temporary. But with these little white pills come all sorts of possible undesirable companions: insomnia; joint disorder; hot flashes. It gets worse. Check out the laundry list of possible adverse reactions:
1. Asthenia (no clue what that is, but pretty sure I don't want it)
2. Reduced bone density (osteoporosis)
3. Fractures (see #2)
4. Joint pain (for my cortisone-injected knees?)
5. Abdominal pain
6. Chest pain
7. Hypertension
8. Nausea
9. Dyspepsia (irritability?)
10. Arthralgia (again: huh? and no thanks)
11. Myalgia (don't they hawk something on TV for that?)
12. Arthrosis (????)
13. Depression
14. Bone pain
15. Hypercholesterolemia (translation: elevated cholesterol)
16. Cyst
17. Anxiety

Well, who wouldn't be depressed and anxious after looking at that list -- and it's only partial. There are about 66 possible adverse reactions listed, and that's before I decided not to turn the page for more. Among them -- are you ready? -- breast pain and endometrial cancer. And I've saved the most unacceptable for last: weight gain! C'mon! That's just cruel.

How can one little pill pack so much potential evil doing?

So, I waited some more. And finally, I took the first pill Sunday night. Tonight will be my third pill. Who knows what's brewing inside this old carcass, but, so far, to my knowledge, no asthenia, arthralgia or arthrosis -- whatever they might be. No neoplasm either, that I'm aware of. But if I see one crawl by, I'll be on it with a flyswatter.

With a little luck, in five years this little poison pill and I will have warded off a recurrence of breast cancer, but potentially every other body part will have collapsed into a powder and I'll have a skin rash to boot.

Saturday, July 3, 2010

God bless Riley. Our sweet, sweet boy.

The tears just won't stop. And I suspect the thought of him will make my eyes well up for a long, long time. Riley was 12 years old. We had hoped he'd live to be at least 20. Twelve years ago, on the 4th of July weekend, we rescued that little six-week old orange tabby. Today, July 3rd, we reluctantly had to have him put to sleep.

We got him out of grief after losing a 20-year-old cat preceding the 4th of July in 1998. We looked at a rescued litter and I had my eye on a gray, black and white tabby who seemed very shy, but Jeff asked to see the long-legged orange tabby. He handed him to me and the little guy climbed up and played with my necklace and nuzzled against my chin. Jeff said, "That's the one."

He had comically big ears but there was also an elegance about him. He looked like a lion cub. In addition to his long legs, he had the lengthiest tail I'd ever seen on a cat -- at least 18 inches long, maybe longer. His striped legs looked like they'd been drizzled with butterscotch. His intelligent green eyes were huge and they held your gaze. He also had a wired personality; he had so much energy, he'd bounce off the walls and many times we had to put him in a closed-door bedroom for some quiet time. I'd open the door and peek in and he'd be staring right back at me. Feeling sorry for the little guy, I'd go in and lie on the floor and just watch him. He'd rock back and forth while eating from the food dish; couldn't even sit still to grab some dinner. Then he'd run over to where I was lying on the floor and he'd rub his nose against my face and neck, then go back to rocking around the food dish. It was instant love on my part. I'd never seen such a personality in a cat.

I can't imagine coming through the door and him not being there to greet us. Or going to sleep without him jumping up on the bed and curling up next to me. Or opening a bottle of Gatorade and not having him run in, waiting for me to toss the ring for him to catch. Or watching him swagger down the hallway, and calling his name and seeing him stop and turn and look at me. Or curled up in Jeff's arms while they watched TV together. Or seeing him sit on the floor and stare up at us, patiently waiting for permission to jump up on the sofa or chair and join us.

He really was extraordinarily long legged. So much so, that he could stand up on his back legs and try, with his front paws, to grab a sandwich I was making on the kitchen counter. He would follow us everywhere and if we stopped suddenly and turned around, he'd leap up, do a 180 in mid-air and take off in the opposite direction. He would also leap high and bat a tossed ball or Gatorade ring like he was playing volleyball. A super athlete.

He was smart too. He'd have been a good engineer. He could find solutions to problems. If his younger brother Dusty (sibling cat) lost a toy under the bifold door of the linen closet, Riley would hook his paw under the right side of the door, get the door to unfold a bit, then poke his head into the slight opening and shove the door all the way open. With a "there you go, kid" look, he'd leave the bathroom and let Dusty grab the toy.

He was stubborn and determined and incorrigible. But you couldn't stay mad at him, because he was the cutest guy ever in a fur suit.

He'd been losing weight since late last year. Once weighing in at 15 pounds, and still looking lean, he'd dropped down to 9 pounds. For months, we'd been regular visitors at the Vet's office. Riley had two different antibiotics, but he was still ailing. All his blood work looked good. His heart was strong. It was a mystery. Then he was diagnosed with pancreatitis and we were given an enzyme powder to sprinkle on his food. With the powder on it, he wouldn't touch it. We boarded him with the Vet when we went away a few weekends ago to attend a wedding in St. Louis and they said he was then down to 7 pounds. We were leaving again the following weekend for an 8-day vacation and we boarded him then too so he would be given special care, medicine and plenty of nourishment. He gained a half pound, but the doctor had felt a mass. It could be cancer. Or it could be an impacted colon. We were to keep an eye on him. As long as his appetite was good and he was getting around and not in pain...

Then yesterday he started having trouble getting up the stairs. Whereas he used to always race to beat me to the top, now he took them one by one and stopped to rest twice. But he ate. He was hungry. We could tell his back legs were weak, but once he gained more weight, we thought he'd get his strength back.

Then this afternoon, he wobbled and collapsed. I picked him up and laid with him on the sofa. He looked up at me as I petted him, then craned his neck to look over at Jeff. It was like he was saying goodbye. Shortly after that, his eyes weren't focusing on anything. And then he began having seizures where he'd flail his front legs and howl; afterwards, he seemed totally unresponsive.

We took him to an emergency pet hospital and they determined his blood sugar had plummeted, causing the seizures. His heart rate was low, his coloring was pale (meaning he was probably anemic) and his temperature had dropped. He was shutting down. The Vet felt a mass in his abdomen and thought it was likely the culprit for the low blood sugar levels. They could try to get the blood sugar to rise, but with everything else failing, it was likely to be a temporary solution. And in his weakened condition, any one of the things they would try to do for him might actually kill him. Plain and simple, he was dying. He didn't seem to be in pain while they handled him. The howling was part of the seizure reaction, related to the low blood sugar, and not a pain response.

Jeff wanted to at least give it a chance by trying to raise the blood sugar and see if he improved. Part of me wanted to as well, but I knew in my heart it was futile and that he would never have quality of life again. They hooked him up and started a glucose treatment. The "coordinator" then came in and showed us an estimate of what the costs would be for 36 hours of treatment and monitoring. $3600.

Wow. We really loved that little guy. We asked to go in and see him. He was under a blanket, with his little face in a cone. His eyes were open, but he was not reactive. The Vet told us they'd tried two times to get his blood sugar elevated, but it had stayed the same as when we brought in Riley. I looked at her and she shook her head.

They gave us a room with a sofa and we held and petted Riley for quite awhile. His eyes were more alert and we wondered if perhaps we should just take him home. We set him on the sofa, but he couldn't stand. He couldn't move at all. So we did what we thought was the most humane thing for our little buddy and I blubbered like a baby.

I held him all the way home and it looked like he was sleeping. His big ears still stood up. His eyes remained open. I curled him up on his blanket on the sofa and sat next to him and petted him.

I'm struck by the coincidence of his entering and leaving our lives on the same holiday weekend.

Tomorrow we'll bury him with a short eulogy of what a special boy he was. And there will forever be a void left by this funny little guy who brought such joy and affection into our lives.