Sunday, October 31, 2010
For many years -- although it seems to have gone by the board lately -- Gary and I had a tradition, on Halloween, of listening to Fairport Convention's classic version of Tam Lin, from their beloved album Liege & Leaf. On our first date, we discovered that we both adored the song Crazy Man Michael from that album. I'd been introduced to the album by Ellen Kushner, who gave me my first place to live in New York City when she rented me the maid's quarters in her gigantic prewar apartment -- in the famous gargoyle building on 110th Street -- for $200 a month in 1987. After Ellen moved to Boston to take her radio job with WGBH, she sent me a cassette tape of Liege & Lief, which I listened to nonstop for months. That album's the soundtrack for part of my life.
At the party where Gary and I met in 1989, we were chatting about NYC architectural details; he'd taken a photography course which involved going around snapping shots of neat buildings. "Y'know that building on 110th Street with the gargoyles?" I said.
"Sure. I have a picture of that building."
"I used to live in that building."
A week or so after the first date, it turned out that the picture he'd taken was one of the writing gargoyle. He'd taken it in 1987, when I was living (and writing) in the building, but when we didn't know each other yet. The photograph hangs in my study now; it's our talisman, kind of.
Now you know our cute-meet story. So, anyway, it turns out that there's a fiddle tune called Tam Lin, and tonight I started trying to learn it from the YouTube video, in honor of Halloween. I'm having great fun butchering the first few measures. I have a new C-string which still sounds like a cross between a foghorn and a moose, and that's not helping much, although I can easily transpose the tune up to the G string. I hope to have both the C-string and the tune in slightly better shape the next time I see Charlene, so she can correct everything I'm doing wrong.
In honor of Halloween, his Royal Highness finally allowed me to get a halfway decent close-up of him, although since his ears are missing in this shot, he looks uncannily like an owl.
Balthazar, Master of Disguise!
I hope everyone's having a happy Halloween, Samhain, All Saints, or whatever you celebrate. At church this morning, the clergy read a long list of the names of dead loved ones. The list included both of my parents, Gary's dad, my cousin Ken -- and Harley. I'd asked beforehand if it was okay to include pets, and after hesitating a minute, the priest said, "Sure, if you give the pet a first and last name." So Harley was Harlequin Palwick Meyer, although I believe that got shortened to Harlequin Meyer during the reading.
To the best of my knowledge, no one laughed at me about it. At the peace, a friend came up to me and said, "May the peace of the Lord be with you, Susan, and with your little cat." So kind!
In our annual evade-the-trick-or-treaters maneuver, Gary and I are going to a movie and then to dinner. When we get back, I'll tackle the remaining Mound o' Grading, which is smaller than it was.
Saturday, October 30, 2010
Loyal reader mbj asked quite some time ago for a close-up of Bali. This evening I took a short break from Mounds o' Grading (TM) to try to get a decent one.
It isn't easy. He moves a lot, either away from the camera or -- as in this case -- towards it.
I think the nose here makes him look a bit like a pig, but maybe that's just me. But after looking at this picture, I was tempted to rename him Wilbur.
Even when he's staying relatively still, he blurs, as in this shot, which at least allows you to admire his glossy fur and his fanciful cold-weather ruff.
His ruff is one of his glories, as are the tufts between his toes. Both achieve their pinnacle in March or April, before he starts shedding Pounds O' Fluff (TM) to get ready for summer.
Here's another version with more visible eyes and a slightly better view of the ruff. In this one he looks like an owl, not a pig. Such a versatile beast!
So there you have it. I tried, mbj, really I did. He just isn't a cooperative subject!
He wishes to inform his viewing public, however, that he will pose for food, especially his beloved cashew nuts or frozen peas. But only if you also ask very, very nicely.
I think the last Bodily Blessings column I linked to here was April's. In the meantime, Hope and Healing has changed its name to Church Health Reader and has posted four more of my columns.
Here's the August one, which is one of my favorites. You can use the sidebar to reach the ones for May, June, and July, should you so choose.
Thanks for reading!
I just got back from a mini-shift at the hospital (two hours instead of four). As I suspected, it was just what I needed: the work grounds me, makes me feel connected to the divine and to other people, and, generally, reminds me what's important.
Several of you implored me to stay home this weekend because I wasn't feeling well. First of all, the back's improving, and the PT guy didn't put me on any restrictions. But secondly, and more important: at least for me, volunteering isn't a distraction from self-care, but a form of self-care. I don't volunteer because I'm a nice person. Sometimes I'm nice and sometimes I'm not -- people who deal with my daily in the flesh might say I'm more often not, especially when my back hurts! -- but that's not the point. I volunteer for entirely selfish reasons, because the work's good for me. The fact that it's at least sometimes good for other people too is a lovely bonus.
See Frederick Buechner: "The place God calls you to is the place where your deep gladness and the world's deep hunger meet." See also research on service as treatment for depression.
I worked two hours instead of four today because I still have eleven hours of grading to do this weekend (this is after six hours yesterday), but I've vowed to myself that if I'm away from the hospital entirely, it will be because I'm ill or out of town, not because I have mounds of papers to grade.
Not surprisingly, though, two-hour shifts are less tiring than four-hour ones. If I get my sabbatical next year (crossing all toes and fingers here, which makes typing quite the challenge), I may very well break up my four hours per week -- which is what the hospital asks of volunteers, although they're very flexible about it -- into two two-hour shifts. That will also allow me to see more patients, since the ED population often doesn't change that much in four hours. During the academic year, though, I'm pretty much stuck with a four-hour shift on Saturdays: other days are too problematic because of teaching, committee meetings, prep, church, and fiddle lessons.
Speaking of which, yesterday I had my first fiddle lesson in two weeks. Because of the back crud, I'd only been able to practice three days since my last lesson, but Charlene was very kind about my progress (or lack thereof).
Right. On to the mounds of grading.
Thursday, October 28, 2010
The MRI was essentially normal: some degenerative disc stuff, but nothing unusual for my age and nothing that would account for the severity of this latest episode. My physical-therapy guy informed me briskly that my problem was a flattened lumbar curve, aggravated by tight hamstrings, and gave me a bunch of exercises to do, along with stern instructions that I am never to sit back in a comfortable chair again, but must always perch on the edge and maintain the proper curve of my spine. He thinks he'll only need to see me for two weeks.
Okay, so this is all good news, although the exercises have made me so sore that I just had to take a pain pill for the first time in three days. Why, then, am I not happy? Well, I still hurt, for one thing. Also, I like comfy chairs, and the idea of giving them up for life doesn't sit well, as it were. And the PT guy's efficiency made me feel like a pot being stirred on a stove: he had five of us in there at once and, with the help of an assistant, went from one station to the next, poking and prodding and flexing and instructing. This doesn't matter if his exercises work, of course -- and the cost per visit is a mere $20, a real blessing after the almost-$700 MRI -- but . . . well, I guess I was craving comfort, and that wasn't it. I was looking in the wrong place, of course, and that's my problem, not his.
A lot of this is the blasted grief issues, which probably have a whole lot to do with the severity of the current episode. At the MRI place, I had a long conversation with the receptionist, whose husband died suddenly nineteen years ago and who said she can still remember every detail of that day. She was very sympathetic to my recent losses. So was the lady who cut my hair today, who's a cat person and showed me pictures of her cats after I told her about Harley. So was my eye doctor, who was extra sympathetic because our vision coverage is decreasing drastically in July. I'm getting new glasses. I hope they last a while, since this is the last time my insurance will help pay for them! (And they were almost $500 even after insurance.)
Okay, I'm whining. (Gee, y'think?) Obviously I'm a prime candidate for that grief retreat a week from Saturday! But I'm also seriously considering looking into some non-Western treatments. A few years ago I talked to a friend who's a family physician about "alternative medicine;" she declared all of it bunk, but did admit, somewhat grudgingly, that any benefits patients receive from these treatments result largely from the fact that the practioners actually listen.
A few years ago I had some acupuncture treatments. They helped my sinuses a lot; I stopped going because I intensely disliked the practitioner (I found his politics appalling and his personality arrogant), and also because he insisted on my taking Chinese herbs that did nothing for me. But I was standing on line at the grocery store today, thinking idly about maybe trying to find another acupuncture person, when I spotted -- in the rack with People and the Weekly World News -- the Mayo Clinic's Guide to Alternative Medicine 2011.
Acupuncture's number one on their "top ten" list (they offer acupuncture at the Mayo Clinic itself), and they say it can help with lower back pain. They also recommended guided imagery, hypnosis, massage, meditation, music therapy, spinal manipulation, spirituality, tai chi, and yoga -- in that order -- for various ailments.
So I'm not going to stop my PT exercises, but I may very well look into acupuncture in addition, especially since my allergies are still in overdrive and the sinuses could use some help. In the meantime, I haven't yet used my sister's birthday gift of a ninety-minute massage at my health club, so I'll try to do that in the next few weeks, too.
Does practicing the viola count as music therapy, even when you haven't been able to pick up the instrument for weeks because of back pain, so that when you do pick it up again, it sounds like a deranged animal being dipped into molten lead?
I hope to get back to the hospital on Saturday. That should help, too; volunteer shifts are an excellent way of regaining perspective.
Monday, October 25, 2010
This morning I woke up figuring I'd be more or less back to more or less normal, because meds plus several days of bed rest has always put me right before. But it quickly became apparent that a) the back wasn't back to anything like normal and b) I was going to have to take meds to get through the workday.
I took the meds and got through the workday, more or less, although in one class where I normally sit a lot I had to keep standing up because sitting was too uncomfortable. Sigh.
My MRI's scheduled for one tomorrow afternoon. The imaging place called the house to say that it was scheduled for this afternoon, during one of my classes -- nice of them to check with the patients on these things! -- but Gary called me at work to alert me, and I called the imaging place and got the time switched. I'd have canceled my class if they hadn't been able to get me in tomorrow, but I'm glad it didn't come to that.
Since I haven't met this year's deductible yet, the MRI will cost $630. Ouch. But hey, that's what emergency medical funds are for. At least we have it. (The very nice scheduling lady told me they have a twenty-four-month interest-free payment plan for people who need to do it that way.) My rheumatologist, who referred me for the scan, should have the results tomorrow, so I'll call late afternoon and see if they know anything, and in the meantime I'll call the PT place and try to get an appointment for Thursday.
I went with this PT place after several friends raved about it, but another friend today told me that this guy made her worse, and gave me the number of her chiropractor instead. However, I haven't had great experiences with chiropractors, so I'll start with PT and see what happens. I just hope that somebody can get me back to feeling normalish sometime soon, because this is getting extremely tiresome. Y'know how about halfway through a cold or the flu, you can't remember what it feels like to be healthy? That's how I'm starting to feel after three weeks of crankyback.
Saturday, October 23, 2010
The new muscle relaxant, Metaxalone -- say that ten times fast -- is working very nicely indeed. It keeps pain to a dull roar and isn't very sedating at all; I was comfortable driving Gary downtown to see an opera simulcast this morning. And it's allowed me to be quite productive. Yesterday, I graded eight essays in my rocking chair (this may not sound like a lot, but since I type a full page of comments on each paper, it's significant).
The problem with meds for back pain, though, is that if they work, the patient can be tempted to overdo it. Hence I discovered that after my happy grading run yesterday, the rocking chair was no longer comfortable. I worked in bed most of today, moved to an upstairs rocking chair when lying in bed became painful, and am now back in bed after the second rocking chair went ouchy on me.
Today I've graded ten more papers. I think my comments are even coherent, although my students will have to be the final judges there. I have about ten more to do tomorrow, plus a set of exercises and prep for Monday. Most of these papers are for a Wednesday workshop in my freshman comp class. I'd ordinarily save some of them for Tuesday, but I'm trying to clear as much time as possible for the MRI and physical therapy, both of which I fervently hope will happen sooner rather than later.
I miss the other things I'd hoped to do this weekend, my hospital shift and dinner with friends. I'm hoping to swim and get to church tomorrow -- today's technically my second and last day of resting at home -- but we'll see how I'm feeling then, since I maybe haven't been resting enough. I'm pleased with what I've gotten done, under the circumstances, but I hope I haven't inadvertently caused more damage.
It probably goes without saying that I haven't written and haven't even attempted to practice the viola! I've knit a little bit, and my Kindle's been a very nice companion. So have the cats, both of whom love having a warm human, lying among blankets and pillows, to use as a radiator.
Normally I tend to focus on what I haven't gotten done, even though I'm well; now I'm focusing on what I have gotten done, even though I'm sick. So it's a definite glass-half-full kind of thing, and I know I need to work on maintaining that attitude when I'm feeling better.
I do hope, though, that you're all having more fun this weekend than I am!
We're expecting storms this weekend, so it may get wetter yet!
Friday, October 22, 2010
I'm afraid we won't be giving him tuna, however. The ash content in fish is bad for cats and especially bad for male cats, and can cause kidney issues.
He loves cashew nuts and frozen peas, though, so we'll give him a treat in your honor!
Rather predictably, I got no work done yesterday. This morning I woke up feeling worse rather than better and limped in to see my primary-care doc -- getting out of the car was a very interesting exercise! -- who seconded the MRI recommendation but also said that he'd always recommend physical therapy over surgery, whatever the diagnosis. Yesterday's doc had said that depending on what the MRI showed, surgery might be the best option, but I'll do almost anything to avoid it. I'm told there are people who've had good outcomes from back surgery, but I've never met any.
So, anyway, I was glad that my primary agreed with trying therapy first. He wants me to start with it right away; some friends have gone to someone they greatly prefer to the outfit normally used by our insurance, and although this therapist technically isn't covered by our insurance, he charges the $20 copay and whatever insurance gives him. So I've given that info to my doctor so he can provide a referral.
He also put me on a different muscle relaxant; they're all pretty much the same, he said, but some people have different reactions to different drugs. My pharmacist said that this one, after the first few doses, is less sedating than the one I had been on, and that people even go to work on it. This is very good news.
After the new drug and a nap, I'm feeling more comfortable than I have in two or three days. Thanks be to God! The back's not normal, but it no longer feels like it's constantly on the verge of spasm. Now I have to figure out how to get work done. I'm currently in our family room, in a rocking chair that tilts way back, with my feet up on the coffee table and my back and head supported and cushioned by lots of pillows. I seem to be able to type comfortably this way; we'll see how it works for grading papers. I have my dad's old lap desk, which should help.
When I was picking up the new meds, I also bought a new thermometer, since our old ones have broken or gone missing. All I saw were digital; the pharmacist told me that the old standby, the little glass tube with mercury in it, is now illegal for medical use, although one can still get them in hardware and hobby stores. I was annoyed -- I've never liked the digital ones as well -- but progress marches on.
Figgy was a real lap cat today. After I ate my lunch (also in the rocking chair) he got on my lap for a snuggle. He got down when Bali showed up, since Bali's the alpha around here, but he came back later. First he lay across my lap. Then he lay across my chest, right under my chin. (I wound up with fur all over my face, natch. Cats are so generous that way.) Then he moved back to my lap, with his head snuggled in my armpit. I think he's trying to make me feel better. I just hope he isn't trying to tell me he's sick, which is what that armpit move sometimes means. Figgy and Bali, please stay healthy for a long time!
Thursday, October 21, 2010
So my back's been acting up since the day after Harley died. It hasn't gone into full-fledged spasm, but it hasn't been right, either, and my usual remedies -- like swimming -- haven't helped as much as they usually do.
For the past two days, the pain's been worse (although still not quite as crippling as in the most acute phase of a spasm). I've only been comfortable when lying down; sitting and walking have been increasingly unpleasant.
The day after Harley died, I had my primary-care doc call in a script for muscle relaxants, which I've used sparingly, mostly at night, ever since. But I've never gone this long without the back getting better, so I called today and got an appointment to see him tomorrow morning. In the meantime, though, I had an appointment with my rheumatologist today, so I told him what was going on.
He did an examination, discovered that I can't extend my left leg without sharp pain in the lower back, and frowned. "That's not good."
"That's sciatica, right? Which can be a symptom of a slipped disk?"
I was correct on both counts. He's sending me for an MRI, although we probably won't be able to schedule it until Monday, since we need to clear it with my insurance company first. In the meantinme, he's put me on bedrest for the next two days; I can go see my PCP tomorrow, can use the bathroom and get up to eat, but that's about it. (And I'll probably have meals in bed too, since sitting up is so uncomfortable.) I asked if I should take muscle relaxants, and he said they don't actually do anything directly for the muscles: they work on the brain and make people sleep a lot, which helps the muscles heal and also helps the time pass so you aren't bored in bed. So he said I could take them if I wanted to, and that I should use a heating pad (not ice, which I had been doing).
So here I am in bed with my laptop, phone, Kindle, knitting, and mountains of grading. We'll see how much I get done. I canceled my fiddle lesson tomorrow, my hospital shift on Saturday, and dinner with friends on Saturday night. Gary's being a dear about fetching and carrying, and when I'm lying down (even if I'm propped on lots of pillows) I don't hurt much, so things could definitely be worse.
One of my best friends from college has had a slipped disk for years now, and she's done great without surgery or anything: her main medicine is lots of swimming, which the doctor recommended too. (I swam today and it definitely helped, although I'm still worse than I usually am after swimming.) So if I do have a slipped disk, I also have a role model of someone who's stayed active and healthy.
Elsewhere in the realm of fun, the car woudln't start yesterday. The "check engine" light had been on since about two hours after my last oil change, but when I called my garage, they said the light probably had something to do with emissions and not to worry about it until the car needed servicing for something else. The AAA guy who came yesterday jumped the car and told me I needed a new battery, but when I dropped the car off at the garage, I told them to do the engine check too.
Turned out some nitrogen sensor was out, or somesuch. That plus the new battery ran me $662. Ouch! But yesterday we also got some of the money from Mom's estate, so again, things could have been worse.
As I drove home from the doctor's office today, the "check engine" light came on again. Criminy! I called the garage and my mechanic said I should bring it back next week, when I'm feeling better (he gave me a ride to campus yesterday, and was worried about how cautiously I moved getting into and out of his truck). He said there will be no charge for the follow-up visit.
So yeah, things could surely be worse, but I wish things would stop breaking!
Monday, October 18, 2010
Here's the traditional career path for an academic: You're hired as an Assistant Professor. After six years, you endure the nail-biting anxiety of going up for tenure, a process normally linked with a promotion to Associate Professor. Once you have tenure, you theoretically have job security -- at least, most of us breathe a bit more easily at that point -- and can look forward, in the fullness of time, to another and final promotion, this time to full Professor. At UNR, each promotion comes with a ten percent raise.
To be promoted, you need to be vetted and approved by your department, by your college's promotion and tenure committee, by a university committee, and on up the food chain until you get to the Regents.
I was tenured in 2003. Like most people who've gone through the process, I have my horror stories, but everything turned out fine. Since then, though, the promotion process has become increasingly difficult. An extremely accomplished and distinguished friend of mine (in another department) is going up for full professor even as we speak, and is being raked over the institutional coals in ways that wouldn't, I think, have happened before the current budget disaster. Yes, more and more documentation has been required since my promotion to Associate: multiple binders of paperwork, five letters of support from people at other universities (rather than the three I needed), ever more careful scrutiny by the various committees. But watching my friend's ordeal has made me question some of my assumptions: a) that the departmental vote is the most important, a decision almost always supported by the ascending levels (after all, one's immediate colleagues are best at understanding one's work), and b) that promotion to full is a matter of continuing to do what you were tenured for doing, although perhaps at a higher level.
Keep in mind that I firmly believe my friend will indeed get this promotion. But watching that ordeal has made me dread the promotion process for myself even more than I already did. Every year, my chair sends an e-mail to anybody who's been at Associate for four years or longer, inviting us to e-mail him our CVs so the full professors in the department can offer advice about preparing for promotion. I've been getting those e-mails for several years and ignoring them: I find CVs about as pleasant to prepare as tax forms, and I was in no rush to start collecting all the material for those binders, either. But I had to update my CV for my sabbatical application anyway, so I thought, what the hey, and e-mailed it to my chair, who then shared it with the other full professors.
Last Thursday I met with him to discuss their recommendations. These are offered, mind you, in the spirit of wanting colleagues to succeed; they're very much constructive criticism. My chair identified two problems with my case:
1. Lack of national service. It's evidently no longer enough to do a lot of very nice local service. The university insists that full professors have a national profile. This is relatively new, and it surprised my chair when he started shepherding people through the process. In my case, such national service would need to take the form of, for instance, being elected to an office in an august professional organization like the Modern Language Association, being asked to judge a lot of writing contests or to review a lot of manuscripts, or publishing lots of reviews of other people's work ("dozens," my chair said, to clarify this).
I don't do this stuff. I never have. It doesn't interest me. If it interested me, I'd already be doing it.
2. Although my colleagues like how much I publish -- and tenured me for writing SF/F, for which I'm eternally grateful -- my publishing record needs to be more accessible to people who don't know anything about science fiction. So my chair, who was doing everything humanly possible to be helpful, said, "The problem is that people outside science fiction don't know about Tor. But Tor's a subsidiary of Macmillan! Everyone's heard of Macmillan! So what you need to do on your CV is say that you're published by Tor-Macmillan! That would be completely justified! And then they'll get it!"
This is ludicrous. Nobody in SF says they're published by Tor-Macmillan.
My chair ended the conversation by saying that the Upper Echelons would want outside letters that said, for instance, "I've known her work for years and think she's wonderful," rather than, "I've never heard of her, but I really like her work."
I went home feeling rather like a squashed cockroach. I'd expected to be told that I had several years of work to do to get ready for promotion -- another novel, say -- but I hadn't expected the prospects to look so bleak. I said mournfully to Gary, "I'm not famous enough to be promoted."
"Then don't go up," he said promptly. I have tenure; people retire at Associate Professor rank all the time, and there's no shame in it. The big drawback is not getting that ten percent raise (the only chance for any kind of raise, in this economy), but as Gary points out, I could go through the agony of the promotion process and not get it anyway, because each tier is now under increasing pressure to shoot people down. My safest shot at extra income, not to mention additional fame, is to publish more. Running for Grand Poobah of national professional organizations would definitely interfere with that, as would writing dozens of book reviews.
On Friday morning I saw my therapist, who emphatically agreed with Gary and thinks that doing the work I'd need to do for promotion would be actively bad for me. My friend Sharon, who probably knows me better than anyone in town except Gary, was even blunter: "It would kill you." And when I talked to my chair again and said that I was seriously considering just staying where I am, he gave what sounded like a sigh of relief and said, "Yes, I think that's right." Then he told me about two people in the department who've been Associate "since before we were born," because they wanted to focus on their families and on other matters closer to home.
It's a mark of how little any of this matters -- or of how little attention I pay to it, anyway -- that I didn't even know those colleagues' ranks; I'd assumed both of them were full, and were startled that they weren't. I'm really glad my chair told me that, though, because it made me feel better.
In all kinds of ways, I think this decision makes a lot of sense, and I can always change my mind down the line if I achieve unexpected stardom. In many ways, it's like my decision to walk away from ordination to the diaconate (and it's easier than that was). But because I've been an academic overachiever most of my life -- although you wouldn't know it from my non-national profile -- I've had to give myself a stern talking to about how this is a free choice, not a mark of shame or failure.
The irony, of course, is that much of my lack of fame in the academic context arises from my working in popular fiction, in a genre accessible to more people than your average issue of PMLA. Twice in the past year, I've had casual conversations with people who wanted to write SF but didn't know I was a writer; when I said I'm published, they asked me coolly who my publisher was, and when I said Tor, both of them went wide-eyed and babbling. "You're published by Tor? I'd give my [fill in the body part of your choice] to be published by Tor!"
Meanwhile, at my fiddle lesson on Friday, I told Charlene that I wasn't famous enough to be promoted. Her eyes bugged out. She gestured at the bookshelf across the room -- her husband reads SF, and it was stuffed with Tor paperbacks -- and said, "You're published by Tor! Whaddya mean, you aren't famous enough?"
Yup. Of course, I'm not a famous Tor author, which is probably the larger issue -- my readership is exceedingly discerning, but very small -- but in many circles, Tor's more recognizable than Macmillan.
I really do think remaining at Associate is a healthy decision for me, and who knows? Maybe the economy will improve; maybe someday we'll get merit or cost-of-living raises again. In the meantime, I won't be slaving over binders. But the choice also represents the loss of a professional goal, however dimly held. It shifts my internal landscape, already eroded by too much loss over the last two years. And it puts more pressure on my writing, a process that often shuts down at the first hint of pressure.
Yet another reason why the Auburn workshop is perfectly timed!
Yesterday our local paper ran a story about our parish closing. Hard to believe we only have five weeks to go.
I went to the service yesterday, for the first time in several weeks, to hear a friend preach there for the last time. I managed not to cry -- for a change! -- but I didn't linger too long afterwards. I'll only be attending two more services -- the last two -- at St. Stephen's, on November 14 and 21. Otherwise, I'll be going to my new church, to the quiet little 5 PM service that leaves me feeling peaceful and refreshed.
My hospital shift on Saturday was quiet and peaceful too, relatively speaking (certainly more so than last week's, anyway!). In the volunteer chaplain's office, I saw a flier for a retreat center in Auburn, CA, a gorgeous ninety-minute drive from here. When I got home I checked out their website and found a very appropriate -- and inexpensive! -- one-day retreat on healing from grief and loss, so I've signed up for it. If I like the place, it will be an excellent alternative to Berkeley for spiritual getaways; it's closer and the classes are less expensive (and some include food and lodging, I think). Unfortunately, Auburn has wonderful shopping, just like Berkeley does, but there's a little less of it than in Berkeley, so maybe I won't be quite as tempted as I always am there.
The timing of this retreat is perfect. Today's the two-year anniversary of my father's arrival in Reno. Yesterday was the two-year anniversary of his last night in Philadelphia, when he collapsed at my sister's house and had to be hospitalized (true to form, he left against doctor's orders the next morning to get on the plane to come out here). When I was talking to my sister this weekend, she said that when he collapsed, she really thought he'd just died. It was unbelievably traumatic for her. I'd never known that. All I remembered was her sobbing phone call about how he'd just been loaded into the ambulance, a call she now doesn't remember making.
So, yeah, I'm definitely having some anniversary reactions in through here, and the day in Auburn should be a lovely bit of self-care.
Monday, October 11, 2010
I'm having an absolutely miserable time with allergies, despite taking multiple OTC medications. I'm wondering if I should give in and go to see an allergist, although they've never been terribly helpful to me before. Aaaargh! The weather's changing, so I hope that will help. This not-being-able-to-breathe thing is really annoying.
This weekend's hospital shift was unusually stressful, with two especially poignant psych cases. One was very grateful for my company; the other warmed up after initial hostility, but everything I tried to do to help only made the patient feel worse, which landed us back in hostility again. I'm well aware that this was a function of the patient's illness, not my efforts, but it's heartbreaking to see someone whose misery and terror are so well defended and deeply entrenched that any attempt to alleviate them just intensifies them instead. Most painful of all, the patient was in the ER for non-psych issues, and was being released; we had no way to address or treat the psych symptoms, although everyone but the patient was aware of them.
Awful. The situation was as literal a depiction of hell as I've ever seen, a darkness no light could penetrate, because all our puny flashlight beams were deflected by neurochemical forcefields. I'm not sure even God could get through that barrier, although I'll keep praying for a miracle.
All I managed to do, after much effort, was to give the patient a soda. "I can only drink X or Y," the patient told me fretfully, and neither X nor Y were available in our small fridge with its tiny cans of soda-for-patients. So I grabbed a few bucks from my purse and bought a bottle of the Right Soda from the cafeteria. I've never done that before, and of course the patient expressed no gratitude -- I didn't expect any -- but the gesture left me feeling a tiny bit less shredded. Maybe I was being manipulated (although the patient didn't know about my $1.35 expenditure), but so what? If the only thing you can do is give someone a soda, that's what you do, and hope that it produces even a molecule of pleasure in the moment.
In other cheery news, today's the six-month anniversary of my mother's death.
On the bright side, we went to a lovely dinner party this weekend.
Okay, gotta blow my nose again and get some more grading done. Happy Monday, everyone.
Thursday, October 07, 2010
My back's quite a bit better. I swam today, which definitely helped. I wouldn't say it's back to normal yet, but it's at 85-90 percent.
Since today wasn't a teaching day, I took it as a mental-health day and worked on knitting projects (and on swimming). I also bought some new jeans, and stopped by PetSmart to see if a lovely orange kitten Gary and I had both admired was still there. The kitten is still there, but he's a male, and we really want a female as our next cat.
Yeah, it's too soon. I know. Just a few days ago, I said to Gary, "Since I've applied for a leave next year and will be on reduced pay if I get it, we shouldn't get another cat until afterwards" (or until we find out that I haven't gotten the leave). Gary agreed. This is the sane, adult approach to the issue.
But today at the gym I kept thinking about the lovely orange kitten, and managed to convince myself that it's our sacred duty as cat lovers to have the maximum number of housecats allowed by Reno law: three. (I know many people have more, and I don't know if the law's enforced very stringently, but obeying this particular law is a convenient way for us to limit the number of cats in the house.) My sister laughed pretty hard when I explained the reasoning behind my about-face. I've now done another about-face and am back to sane, adult reasoning, which will last until the next time I'm within a mile of PetSmart, which won't take very long because it's only 1.4 miles away.
Must not get new kitten yet. Too expensive going into possible leave year. Unfair to other cats, still rattled by Harley's departure. Unfair to humans rattled by Harley's departure.
If a female Maine Coon lookalike shows up, we're goners.
As mental-health days go, it was a bit wacky, as you can see. It got wackier an hour ago when I sat down to sort through the piles of grading I have to do. Oh, yes, and committee work, and recommendation letters, and my own writing. I wound up panicking about the fact that I'd taken a day off.
It will all get done -- it always does -- and I'll even enjoy the piles of grading when I get down to them. (And I'll be more efficient for having taken a rest day, right?) But I keep thinking about a letter I saw in the paper last week, from somebody arguing that the higher education budget should be slashed even further because whenever he goes to the university on a Friday afternoon, most of the classrooms are empty, and therefore the professors aren't working a forty-hour week.
Who are these people who think we're only working when we're in the classroom? Have they heard of prep, grading, research, writing, committee work, course design, and supervision of graduate students? (I'm sure I'm leaving something out.) This is like saying that lawyers aren't working unless they're in court, because all the time they spend taking depositions and writing briefs doesn't count, or that athletes aren't working unless they're on the field competing, because practice and training don't count. Most of my work takes place outside the classroom, just as most of my students' does.
It scares me how many people don't understand this.
A kitten would understand.
Must not get new kitten yet.
Tuesday, October 05, 2010
Between not getting to the gym for the last four days, lugging Harley's carrying case around, sitting on uncomfortable seats in the AEC waiting room, and the stress of losing the cat, I'm now -- not surprisingly -- semi-crippled by lower back pain. The back muscles haven't gone into full spasm, but they're threatening to do so any second.
The funny thing here, if you have a particularly dark sense of humor (and who doesn't?) is that I'm walking with a severe limp, not that different from the cat's gait after his surgery. At least I'm sure mine's not caused by a blood clot!
Earlier this afternoon, I managed to lower myself onto the floor so I could try to do some stretching exercises. That didn't work very well, so I tried to get up again, which worked even less well. I had to call Gary for help; between the two of us, we finally managed to get me into a position from which I could get back to my feet.
"Oh, good," Gary said as I stood up. "We won't have to take you to Animal Emergency."
Yeah, no kidding!
I called my doctor, who phoned in a prescription for muscle relaxants. Gary walked down to the store to get them, since I don't think driving would be a great idea. (I know swimming would help my back, and the doctor said he'd recommend it, but, well, I don't think driving would be a good idea, especially now that I've taken the muscle relaxant.)
I'm hoping that since I've addressed the back pain before it went into full spasm, I'll be feeling well enough to teach tomorrow.
Monday, October 04, 2010
Many thanks to everyone who's e-mailed or commented with messages of sympathy. Gary and I really appreciate them.
Our doorbell just rang (very unusual if we aren't expecting anyone) and Gary opened it to find Dr. Wilson, Harley's non-emergency vet. She'd stopped by the house to give us flowers and a beautiful sympathy card. So thoughtful!
That was definitely the nicest possible ending to a surreal day. Yesterday, I slept most of the day. I got up before dinner thinking I'd work until one or two in the morning, since I had heaps of grading to do for today's classes. But I conked out again around ten. My stomach hurt, and my back hurt, and I couldn't keep my eyes open, even though I'd napped all afternoon, and I figured that if there were any time when it was okay for me to give myself a break, this was it. I wasn't getting much work done, anyway.
So I went back to bed and slept through the night. I woke up at 6:00 -- on my own, without an alarm -- showered and had breakfast, and started working through the piles of papers. I was frequently interrupted by Bali, begging for attention and affection: both he and Figaro have been much needier than usual today, and have clearly been searching for Harley.
At 9:00 a.m., the phone rang. I thought, I bet that's Dr. Wilson. I bet she got the faxed report from AEC and she's calling to give us her condolences.
It was indeed Dr. Wilson. "Isn't this just a kick in the teeth?" I said.
"Yeah, I know. So how's he doing?"
I blinked. What? "He's dead! Didn't they tell you?"
"What? Oh, Susan, I'm so sorry!"
It turned out she'd gotten the first report from AEC -- the one about Friday night's visit -- but not the one from the second (and final) visit. She was clearly shocked. "He did so well with us! We were so careful!" But when I described the symptoms, she agreed with Dr. Pratt that it absolutely sounded like a blood clot.
The weird thing is that she says he was walking fine after the surgery -- "I wouldn't have sent him home with you otherwise!" -- but the minute he got out of the carrying case at home, that back end was down. Gary says that when we picked Harley up after the surgery, as he was carrying the case out to the car, he felt a thump, as if Harley had fallen down inside. At the time he just thought Harley was woozy from the surgery. Now we're all thinking that that's when the blood clot hit him. When he got out of the case at home, I assumed he'd been walking that way at the vet's office, too. Now I wish I'd taken him back right away, although Dr. Wilson said we would have wound up at AEC anyway.
It probably wouldn't have changed anything. I have to believe that.
So, anyway, she stayed on the phone with me for fifteen minutes, saying all the right things, and then I got off and got back to my grading and went to work.
Work was surreal. A colleague across the hall told me that his two cats were in and out of emergency care all weekend too, and that one might die. Another colleague said she'd just finished writing a condolence note to a friend whose dog died last week. One of our priests at church sent me his homily from yesterday, about his dog who died last week. And Dr. Wilson says they've been doing more euthanasias than usual. Is there something in the water? Is it the change of seasons?
Classes went fine, I think; I got all the grading done, anyway. I had to cancel my office hours to make that happen, but that's okay. Students can e-mail if they really need me, and again, if there's any time I cut myself a break, it should be now. It's strange, though, because I was very conscious of the whole disenfranchised-grief thing that happens with pets. I told a number of people what had happened, but most of them (not all) had very casual reactions -- "Oh, that's too bad," as if I'd broken a favorite vase -- even if they have pets themselves.
Okay, so we all know that cats and dogs don't live as long as we do. But most of us expect to live longer than our parents, too, and no one treats that loss as a minor one. Because pets are so dependent on us, they're woven into our lives more closely than anyone except infants, or loved ones of any age who've become disabled by age or illness. Even if they're small, furry, short-lived, and don't have opposable thumbs, their deaths leave huge holes in our lives.
But my friends with pets certainly know that, so their reactions were probably just part of the general cultural cluelessness about dealing with death. For all that cluelessness, we have a slightly better sense of what to say when a person dies.
When Dr. Wilson dropped by with the flowers tonight, we talked about all this a little. I asked if vet students get any special training in dealing with grief. She said they don't. There's no mechanism for veterinary folks to process their feelings about having to euthanize animals, which has to be the toughest part of the job. Gary told her, "You need a chaplain." (And he's an atheist!)
She'd read Harley's obit and said, "Yeah, I noticed a pet chaplain on your blogroll!" I said I could never do that kind of work; it would upset me too much. Having now gone through hospice, albeit briefly, with both of my parents, I think I could do human hospice work, and would in fact find it very fulfilling, but most dying humans can, at some point, talk about what they think is happening to them. They can make sense of their experience. Animals can't do that in any way that's accessible to us. Their people can, but it's still a lopsided process. (Although I believe there are now veterinarians who specialize in hospice/palliative care/end of life issues.)
Since there are such vets, shouldn't there be more training for vets in regular practice? I need to do more research on this. In the meantime, if anyone's aware of any grief-related resources for veterinarians -- other than vet-school grief hotlines like the one at Davis, which Dr. Wilson knew about and which are really more for owners, anyway -- please fill me in!
There was just a huge crash as Bali knocked over Dr. Wilson's flowers, shattering the vase (not a favorite) and showering the floor with glass and water. We've gotten that cleaned up. Now Bali's stretched out on my desk, looking for things to chew.
Must go play with the kitty.
Sunday, October 03, 2010
May 2, 1999 - October 3, 2010
Harley, aged eleven, died at 6:50 a.m. on Sunday, October 3, 2010, the day when many Episcopal and Catholic churches observe the Feast of Saint Francis and hold special services to bless animals. Euthanized after complications from routine dental surgery, he is survived by grieving owners Susan Palwick and Gary Meyer, and by fellow felines Figaro and Balthazar.
Harley, shown in this photo with Figaro, entered Susan and Gary's lives on July 2, 1999. Susan had gone to the animal shelter to look for a lost cat (we never found Grendel, who probably fell prey to coyotes), and discovered a pile of black and white fluffballs covering the bottom of a huge cage. Someone's cat had had kittens at home. The day the kittens were eight weeks old, the owner brought all of them to the shelter. One of the black-and-white fluffballs had climbed the side of the cage and was hanging there by its toes, mewling furiously with flattened ears. Susan interpreted this protest as, "Take me home," and decided to do just that. Because the tiny black and white kitten looked he was wearing a mask, Susan named him Harlequin before even leaving the building.
Susan's mother Helen, who predeceased Harley by not quite six months (April 11, 2010), was visiting when Susan adopted Harley, and was in fact waiting out in the car. Helen had refused to go into the building because she loved animals, and shelters upset her too much. She fell in love with Harley instantly and held him on her lap on the ride home. In later years, she often commented that Harley -- who loved to roll on his back, as in this photo -- looked "like his stuffing is coming out."
Susan treasures the "Harley Mama" mug Helen gave her one Christmas. Other people think the mug has something to do with motorcycles, but of course they're wrong.
As a kitten, Harley delighted in using the rungs of a livingroom rocking chair as parallel bars, spinning around them in cat gymnastics. He was also an energetic devotee of the laser pointer, which he enjoyed even more than toy mice. As an adult, he was especially fond of cavorting in packing peanuts.
Like almost all cats, Harley loved boxes and the challenge of wedging himself into small spaces. His personal twist on this habit was a game Susan called "Everything Here is a Cave," which involved entering small spaces head-first, leaving his furry rump hanging out. This was an especially amusing exercise when performed in trashbaskets, in which Harley sometimes then rolled across the floor. Unfortunately, no photographic record of this hobby exists.
One of his most endearing traits earned him the moniker "Rescue Kitty." If one of the other cats was trapped in a closet or in the garage, Harley would find Susan or Gary and meow while pawing at their legs, prompting the human response, "What's wrong, Lassie? Is Timmy trapped under the tractor again?" He would then lead Susan or Gary to the appropriate door and paw at it until they opened it to free the other cat. In a hilarious version of this exercise, Harley frequently tried to rescue Susan from the shower, which he considered a diabolical death trap. Racing in circles around the bathroom, he'd yowl until Susan emerged, when he'd rub himself frantically against her legs to express thanksgiving for her deliverance.
When Susan and Gary's cat Belphoebe had to be euthanized several years ago, Harley's role as "Rescue Kitty" became especially poignant. He traveled in circles around the house, examining each door he found, as if hoping that Phoebe would be behind it. Susan finally told him, "Harley, she's behind a door we can't open.'
As devoted as he was to his humans and the other cats he lived with, Harley was good at striking haughty poses. He was particularly adept at a disapproving stance Susan dubbed his "owl look," in which his ears flattened back and his eyes narrowed. (This was much the same expression he'd worn at eight weeks old, hanging by his toes from the animal shelter cage.) He often danced away from visitors who wanted to pat him, although he was very gracious to overnight guests and to our friends' Rob and Shelby's son Erek, who delighted in patting Harley "because it feels like patting a pillow." Veterinary staff often commented on what a sweet and cooperative cat he was, a trait they especially appreciated because Susan and Gary have had other cats (the late Pyewacket, and the current Bali) who go ballistic the minute they see a carrying case.
Harley was a beautiful animal, a study in contrasts, with the softest and silkiest coat of any cat Susan or Gary have ever had. For most of his life, he did such an excellent job of grooming himself that Susan and Gary didn't have to brush him. In the last few years, however, he occasionally had to go to the vet to have a huge mat cut out of his fur. He bore these annoyances with characteristic dignity and grace, and he had so much fur that his losses were rarely obvious.
Although Susan and Gary did everything possible to give Harley the best life they could (spoiling him rotten, in other words), he didn't get to go outside as much as he would have liked. When he was still young, we let him explore the deck once in a while, but after Grendel disappeared, we started keeping all the cats inside. Harley loved to look out windows, especially during snowfalls, and especially at the quail who provide Kitty TV in our yard. When he could, he'd dart out the front door and roll ecstatically on the front walk before Susan or Gary recaptured him and brought him inside again.
As Harley grew older, he began to develop kidney disease, a common problem in cats. His veterinarian, Dr. Sarah Wilson of Kings Row Pet Hospital, kept a close watch on his health with regular bloodwork. Last summer, she recommended that he have dental work this fall, since dental problems in cats can contribute to, or cause, other health issues.
Susan scheduled the surgery for Friday, October 1. Because cats have to be under general anesthesia to have their teeth cleaned, Dr. Wilson did extensive lab work on Harley several days before this to make sure he'd be able to withstand the anesthesia. His bloodwork showed that his kidneys were about where they had been, so we went ahead with the surgery.
On Friday, Harley had five teeth extracted. Dr. Wilson kept him in the hospital longer than usual, giving him extra fluids to help his compromised kidneys flush the anesthesia out of his system. When he came home on Friday evening, though, he could barely move his back legs.
Because it was now after hours (Susan has learned never to schedule veterinary surgery on a Friday!), Dr. Wilson wasn't available. Susan called the Animal Emergency Center in Reno and was instructed to bring Harley in to rule out a blood clot. The veterinarian on duty, Dr. Chap Pratt, initially did rule out a clot, because Harley's femoral pulses were strong. He gave Harley more fluids and sent him home, with instructions for Susan to call if Harley's condition didn't improve.
On Saturday, Harley was still very unhappy. His gait had gotten a little better, so Susan and Gary hoped he was on the mend. But he didn't eat all day, and in the early evening, he began howling in pain. Susan brought him back to AEC, where Dr. Pratt told her that Harley's symptoms were classic for small blood clots that would not completely block the arteries -- and thus not interfere with pulses -- but that still caused great pain, and could also travel without warning to the heart or lungs, causing sudden death. Unfortunately, this is not a very treatable condition. Dr. Pratt took x-rays and performed other tests to rule out conditions with better prognoses, but found no evidence to contradict his initial diagnosis.
Harley was hospitalized at 11 p.m. on Saturday so he could be given more effective pain medication than Susan could give him at home. Dr. Pratt said that he would monitor Harley through the night; if he was better or the same this morning, we would have begun more extensive diagnostic testing.
But at 5:30 on Sunday morning, Susan and Gary were awakened by a phone call from Dr. Pratt, telling them that Harley's pain had gotten worse, despite the best efforts of the hospital staff to alleviate it, and recommending euthanasia. Harley's increasing pain was classic for a pattern of progressive blood clots, possibly secondary to an underlying but invisible heart condition, that would almost certainly kill him quickly.
After showers and a quick breakfast, Susan and Gary arrived at AEC at 6:40 on Sunday morning. A tech carried Harley, wrapped in a soft blanket, into an exam room so they could say goodbye, but Harley was howling and clearly miserable. This was so hard to watch that Susan and Gary immediately summoned Dr. Pratt to end Harley's pain. After the first shot of sedative, Harley stopped howling; after the second shot, his heart stopped very quickly. His end was peaceful.
Susan and Gary stayed in the room for several minutes, hugging Harley and each other. Susan blessed Harley and said a prayer over him, and (with her ever-present knitting scissors) took a memorial lock of his fur.
We wish to thank the many friends who have loved Harley throughout his short life. We especially thank Dr. Wilson, Dr. Pratt, and the technicians at Kings Row Pet Hospital and the Animal Emergency Center.
Rest in peace, Harley. You're behind a door we can't open, but you're finally Outside, where you always wanted to go. We hope you're having splendid adventures.
Saturday, October 02, 2010
Even though I'm generally good with medical stuff, my head was swimming at AEC, so I asked the doctor if there was any way I could get a written report. He e-mailed me the following (after apologizing for his grammar, since I'm an English professor . . . I wish people wouldn't do that!):
Harley's delayed recovery from anesthesia, progressive weakness in the back legs and progression to severe pain is very concerning. Harley's history, physical exam findings and diagnostics lead to a diagnosis of a blood clot though we unfortunately cannot confirm this problem at this time. With aortic thromboembolism/blood clot formation we see that patients have a very guarded-poor prognosis and have a high risk of development of further blood clots in the future. In combination with the chronic blood in the urine, continued weight loss, chronic kidney failure and kidney stones we see an additional risk of terminal problems but with efforts, can be managed.I've never gotten such a long, thorough e-mail from a medical professional. (His e-mail included the same links I've used above.) Whatever the outcome, I'm very impressed with the care this doctor has given Harley, and me.
At this point we have elected to give Harley overnight on IV fluids, pain medications, antibiotics and low dose aspirin to see if we have a clinical improvement. Our hope is that with time Harley will have less pain, become more alert and improve with time and supportive care as we would expect with a non-progressive blood clot. If we have any worsening of clinical signs or Harley remains painful in the morning it is my professional opinion that Harley has a poor prognosis and euthanasia should be considered.
If we see a positive response to treatment we may elect to proceed with the abdominal ultrasound in the morning to further define the prognosis and continued care of Harley.
1. Aortic Thromboembolism – This is often times seen as a sequel of Hypertrophic Cardiomyopathy (HCM) which can often times be missed on physical exam and radiographs due to the nature of the disease. Blood clots can also form due to bacterial in the blood stream (increased risk with dental disease, possible kidney infection, etc.). Blood clots can lodge anywhere in the body though including the spine, back legs, kidneys, etc.
2. Hydronephrosis – Harley's kidney function is less than 75% of normal, resulting in elevation of the kidney values (currently BUN 41, Creat 1.9). Decreased kidney function can result in a number of complications including kidney stones of which Harley has and decreased breakdown of anesthetics/medications. Often times those urinary stones do not become problematic though they can harbor infection and become displaced. Displaced kidney stones can cause and obstruction leading to further injury to the kidney and severe pain. Considering the likely stable kidney values and lack of focal pain during kidney palpation this process is less likely for Harley's problems.
3. Pancreatitis – The pancreas produces digestive juices that are placed in the GI tract helping to break down the foods that we eat. When the pancreas becomes inflamed it can cause severe pain and result in increased risk of blood clots or other problems within the body. Pancreatitis can be seen as a complication from anesthesia and in combination with the radiographic changes it remains a differential, though again based on physical exam it is felt less likely.
I just got back from three and a half hours at the Animal Emergency Center, where Harley will remain overnight. The short version: we're not sure what's going on, but whatever it is, it's definitely not normal recovery from anesthesia.
He didn't eat all day. I gave him his scheduled pain meds, but around six -- after my speaking gig, which went fine -- I started to worry about his once-a-day antibiotic dose, which I wasn't supposed to give him unless he'd eaten. Also, his hindquarters still weren't working right, and he'd started a terrible yowling, the same noise I've had other cats make when they're dying, although I wasn't that worried because it's also the noise Harley makes when he's trying to hawk up a hairball. I wasn't worried about the hindquarters because of what my sister told me about her cat's nerve damage from an injection.
So I called AEC, figuring they'd tell me to bring him in for more fluids and maybe some force-feeding so he could take his antibiotics. They indeed told me to bring him in, but when I got there, the doctor -- the same one we saw last night, a very nice and supersmart guy who looks like he's in third grade -- said that the howling plus the dragging back end was a classic symptom of blood clots. Even though Harley had good pulses last night, he could be throwing small clots, possibly secondary to heart disease, which could cause pain without completely blocking circulation. I asked about the injection theory, and the doctor said that the kinds of shots Harley got for his dental work (I brought his records with me yesterday) wouldn't cause that kind of nerve damage.
I gave him permission to take an x-ray and give poor howling Harley stronger pain meds. While all that was happening, I went across the street to Whole Foods for a quick dinner, and then came back and listened to other people's tales of woe. A couple of dogs got to go home after mishaps like choking on a piece of steak, but a pet ferret had to be euthanized.
Periodically, techs came out to update me. Harley had been given superstrong pain meds, kitty morphine, and was much more comfortable now; Harley's x-ray was finished and they were waiting for the radiologist to read it; the radiologist's report wasn't back yet. (The radiologist was looking at digital images in, I kid you not, New Zealand, and may have been interrupted by other emergencies.) Finally the nice young vet called me into an exam room and showed me the x-ray; he still didn't have the radiologist's report, but he could tell me some of what we were dealing with.
First of all, Harley has kidney stones. Even I could see them. In fact, I pointed to them before the vet even said anything and said, "What are those?" These might account for the blood in his urine, but the doctor can tell from physical exam that they aren't the cause of Harley's current pain. Furthermore, they're too large to pass.
The current pain is most consistent with blood clots, and the escalation of the pain over several days is consistent with a series of blood clots. Cats can be given low-dose aspirin, but there's really no treatment for clots, no kitty coumadin, and cats with this condition don't have a good prognosis. They usually six to eight months, with sudden death always possible if a clot travels to the heart or lungs.
The vet told me that clotting problems can actually be caused by dental issues, which makes me wonder if Harley should have had the surgery sooner . . . but the last time we saw our vet, she said he should have it done in the fall, which started, like, last week.
He emphasized that Harley was indeed much happier on kitty morphine. I got to visit him in his large, clean, comfy cage, which would have made me feel better if the other large, clean, comfy cages in the room hadn't been filled with moaning animals. I patted him until I started crying -- which took about thirty seconds -- and then went back to the waiting room, since I didn't want to upset him more by being upset.
The NZ guy weighed in: kidney stones, yes, but no obvious heart problems (which doesn't mean there aren't any) and no spinal abnormalities to account for the dragging rump. There was some suggestion of pancreatitis, though, which could cause some of these symptoms, although blood clots are still more likely. It's also possible that the kidney stones are causing a blockage.
So, the nice young doctor said, he wanted to keep Harley overnight and do some bloodwork and an ultrasound to look for things he could treat. He didn't think he'd find anything, since blood clots are still the most likely suspect, but it would be good news if he did.
He showed me the estimate for one night of hospitalization plus the tests: minimum of $950, and probably more like $1,100. I told him I had to call my husband. He said, "Of course."
Gary wanted to know if we could hold off on some of the tests or do them at our regular vet office, where they might be less expensive. The ultrasound's the biggie, though, and although our vet does do that, I suspect these guys are more skilled, and if the cat's already miserable in the hospital, I want to get everything done at once.
So this is the game plan. If Harley's the same or better tomorrow morning, the doctor will go ahead and do the ultrasound. If he's worse tomorrow morning, the doctor will call us to recommend euthanasia.
Harley was in such bad shape last night that I did wind up driving him down to Animal Emergency, where they ruled out a blood clot and sent him home with subQ fluids and instructions for me to bring him back if he wasn't eating, drinking, and walking much better this morning.
I slept until ten -- obviously, I'm not at the hospital today! -- and couldn't get him to eat or drink anything when I woke up. I'm not supposed to give him his antibiotics until he's eaten. His gait's a tiny bit better, but not much. I called our vet only to learn that they aren't open today: they're open every other Saturday, and I guess this isn't it. I called Animal ER. The doc we'd seen last night had gone off duty, but another doc told me to give Harley pain meds and take a watch-and-wait attitude: if he wasn't better in a few hours, I should bring him back in.
In the meantime, I talked to my sister, who told me that one of their cats couldn't walk right for two weeks after an injection hit a nerve. My sister's vet said this isn't unusual.
So I gave him the pain meds. He's asleep right now, wedged between the toilet and the sink in our upstairs bathroom. He's been seeking out cool, smooth places during this ordeal, but cramming himself into tiny nooks that don't seem at all comfortable to me. My instinct is that sleep's the best thing for him, and to let him alone, even though he still, as far as I know, hasn't had anything to eat or drink. (I've offered him wet food, water, and a "broth" of water and dry food -- as per the helpful comment on my last post -- but he has no interest in any of it. I may try to tempt him with some tuna juice later.)
I know cats go downhill really quickly when they're dehydrated, especially with underlying kidney issues. I know his kidneys could be deteriorating as we speak. I also know that going back to the hospital would be inexpressibly traumatic for him, and that can't help his kidneys or anything else, can it?
When Gary and I moved to NV from NJ, we had our three cats shipped by air. The youngest was so freaked out by the journey that he climbed on top of the kitchen cabinets and lay there panting, refusing food and liquid, for days. He was fine afterwards, but he was a much younger cat without underlying organ issues.
On top of everything else, I have a non-negotiable speaking engagement in a few hours. I was supposed to attend a banquet afterwards, but I think I'm going to skip the banquet and instead come home to see how Harley's doing. If there's been no improvement by tonight, I don't know what I'll do. I'll be as torn about it then as I am now. The Animal ER people will want me to take him back down there. I don't want to have to do that. Please pray for him to be better.
Gary's furious at our vet for not foreseeing any of this, although I know enough about post-surgical complications to suspect that there's no way she could have. I'm furious at myself. Why in the name of all that's holy did I schedule surgery on an elderly, ailing animal on a Friday, right before a weekend crammed with non-negotiable engagements?
Aaaargh. Guilt guilt guilt.
Friday, October 01, 2010
Because his kidneys haven't gotten worse, fuzzy beast had to have dental work today. They wound up extracting five teeth, and sent him home with pain meds and antibiotics.
When we got home, he staggered out of his carrying case and started dragging himself, rump bumping the ground, in circles around the house while he howled. He kept blundering into extension cords and getting himself tangled up in them. Because we had to go out tonight -- I shouldn't have scheduled his surgery on a day we had an inflexible social commitment, but I've never had a cat do this badly after dental work before! -- we put him in the downstairs bathroom with food, water, and a litter pan, as per the vet's instructions. When we got back, he was crouched panting in a corner, his nose to the wall, having urinated all over the bathroom because he couldn't climb into the litter box.
I feel awful, although certainly not as awful as the cat does.
Gary cleaned up the bathroom while I followed Harley around as he staggered in circles around the family room, resting for a while with his nose against the patio door while I patted him. We've now given him more pain meds (he starts the antibiotics tomorrow), but he's still staggering in circles and he still can't move his back legs properly.
I like and trust our vet, who was very careful with him today and gave him extra fluids because of the kidney issues. This lameness worries me, though. If he's not better tomorrow morning, I'll take him back in: they're open on Saturday, thank goodness! There's no way I'm subjecting him to Animal Emergency right now, especially if this is just normal -- if miserable -- recovery from anesthesia.
We don't think he's eaten anything; we can't tell about water. At one point he looked like he was trying, unsuccessfully, to throw up, so I suspect he's nauseous (as the vet said he might be).
She said the teeth they extracted were probably hurting him. I just pray that whatever freedom of pain this procedure buys him is worth the horror in the meantime.
I suspect I won't be going to the hospital tomorrow. I'm still hammered with allergies, and I'm giving a talk to a local convention tomorrow afternoon, and I'm behind on grading; and on top of all that, I now want to stay home with Harley, if only to apologize to him for my absence tonight.
Maybe he'll be all better tomorrow morning. I sure hope so!