Chemo, A Part of Life



Part 3

I was committed to sharing our experiences day to day with JJ’s cancer and treatment. I knew very well that the chemotherapy’s purpose was to alleviate the symptoms stemming from her very high calcium level. Hopefully, it would slow down the progression of the disease. While many people would prefer to handle something like this privately, I was committed to being open about what we were going through. It would have been disingenuous of me to not to find a way to share these details. Dealing with a life limiting illness is not that different between people and our pets. Talking about the concepts of palliative care applied to both, and it has always been my goal to continue these difficult conversations, even when it was so close to home. I also knew from the very beginning that I would need to guide so many people through JJ’s disease progression and dying process when that time came.

I learned quickly after JJ’s video went viral that anything I put on her social media drew all sorts of opinions, usually posted through comments, but often through private messages as well. I have had family members of patients tell me how opinionated people could be through a keyboard, especially when it came to decisions around treatments. For the most part, people were supportive of how we chose to treat JJ, although of course, there were people who thought we were cruel to “subject” her to it. My husband and I had both been told how well dogs tolerated chemotherapy but had no experience. Our oncology team was very open to giving information and letting us choose the course of treatment with no pressure either way. My goal in being transparent with what we pursued was to share information and our experiences for anyone who chose this option.

Along the way, I got many, many comments and messages on what to do. “Tumeric.” “Ketogenic diet, otherwise you must be fine with killing her.” “CBD for pain.” “CBD to cure.” On, and on it went. I get that it was coming from a place of good intention with people trying to offer ideas and support, but it often didn’t feel this way as the recipient. It was a good lesson for me to remember to offer any information if asked, not when unsolicited. These days, I think it is safe to say that most people and pet owners have resorted to an internet search or two when faced with any challenging diagnosis. As a nurse, I also am fully aware that no one person or animal responds to treatment in the same way, so a blanket statement of “xyz” curing cancer is silly and not helpful. We felt very confident of our plan after coordinating care between conventional and holistic veterinarians. The critical thinking nurse in me also had done some research but chose not to pursue options that only had anecdotal evidence behind it. JJ was started immediately on a raw cancer diet and was on an assortment of supplements chosen to support her immune system and organs from the effects of the specific chemotherapy she would be getting.

Knowing the prognosis for T-cell lymphoma, even with treatment, was typically no more than six months, I took a page from JJ’s playbook and decided we would make sure to enjoy each day. Dogs are brilliant at living in the moment, and as a longtime hospice nurse, I see every day that we have no guarantees.

Except for needing to delay a few weeks of chemo due to low blood counts, the first six and a half months were uneventful. JJ continued to play and work as she usually did, even on work days. In July, however, we all noticed she was starting to have some changes with her breathing pattern. In hospice, we are all highly attuned to the changes in breathing. Our assessments tend to pick up subtle changes, and my co-workers and I had been watching her for a couple of days. On our regular follow up visit to OSU, I mentioned my concerns to the student, but I clearly was not insistent enough when I said I wanted a chest x-ray. I left JJ for her bloodwork and checkup. Because her physical exam showed nothing out of the ordinary, they chose not to x-ray. By the next day at work, even our clerical people were noticing a change. The next day was a Friday, the research day at OSU, so I took JJ in to our general veterinary clinic to have an x-ray done. I wasn’t sure what it would show but knew something was changing. She had developed bilateral pleural effusions, meaning she had fluid in the lining surrounding each lung. This also happens in people and is often related to a cancer. It makes it more difficult to get breath. I immediately called OSU and JJ’s oncology resident called back, wanting us to get to them as soon as possible. On ultrasound, they did find fluid and were able to remove 800 milliliters, which is quite a lot for a fifty-pound dog. True to her nature, JJ stood quietly while the fluid was removed with a needle. The pleural effusions were caused by the tumor in her chest, which had been present from her initial diagnosis and was not something that could be removed surgically. It was clear that the current chemo protocol no longer was working, so we immediately changed to a rescue protocol. Most of the time you get about half the remission time received from the first chemo protocol, but we were just hoping to slow her lymphoma down again, so she didn’t have a recurrence of her pleural effusions.

As I continued to share what JJ was going through, I learned that people had a very low tolerance for any perceived suffering she might be experiencing. When I would share stories from work, many would insist JJ needed rest, although she was the queen of sleeping half of the day away long before ever having cancer. Despite what I shared, I believe people equated her chemotherapy to the horrible side effects well known in people. During the time when she developed the pleural effusions, I started receiving many comments and messages along the lines of “How long are you going to make your dog live like this?” These were typically from people who didn’t know our story. It was upsetting at the time, but interesting to think back on. Over the time span of an entire year, JJ had about twelve "bad" days total. Having people tell me “you need to put that dog down” during one of these bad days made me wonder if they would choose euthanasia simply because they couldn’t stand thinking an animal had short term symptoms from a fixable problem. I was reminded of when JJ's sire Dash was hit by a car and fractured his femur. It took surgery and time to repair, but we had years together after his surgical repair. My viewpoint may differ because I am a hospice nurse and specialize in managing symptoms, while being present with the person experiencing those symptoms. Had we not fixed her simple medical complications at this time, we would have all missed out on several more months of enjoying her antics while she lived life. I have no doubt we made the right decisions for JJ. 

Comments

  1. I remember that journey with JJ well. During that time my lab was diagnosed with cancer of the adrenal glands. I remember you said thank you for all of the comments, but we have a plan for now or something to that effect. I did not think anything of it until my dog was diagnosed and the flood of well meaning suggestions came in. That is really what it felt like a flood, drowning me in good intentions. Thank you for sharing your time with JJ. Often in reading your posts I felt like you were one of the few who understood what my family was going through. Much love and peace.

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    1. A flood of good intentions is a good description. I do see it even more when a pet is involved, but also know it happens often for people as well. I get people want to be helpful, but man, it wasn't.

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  2. Enjoying the blog. You are an excellent storyteller!!!
    Thanks for sharing

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    1. Really enjoy the blog, you’re very good with words and your explanations flow so nicely. I’m glad you are able to reflect back and put your feelings into the never ending JJ’s journey šŸ’•. And also, sorry for all the “well-intending” folks that caused you to dial back your difficult FB postings...

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    2. Thank you. I didn't dial back much, but as we went along some are very memorable, similar to the time I had two people messaging and commenting I should die because I bred dogs. It is a part of the territory of being public. It was a challenge to deal with the "flood of good intentions" as Mary commented on.

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  3. We've had the same experience with our dog, Honey, and her malignant anal gland tumor; we chose not to go the chemotherapy route as through my research and speaking extensively with her oncologist and our regular vet we realized that it wouldn't make much of a difference for her. It was the hardest decision we've had to make, and I really didn't broadcast it as I just didn't want the Google Veterinarians coming out in force. I have one friend who constantly questions me and our decisions, but I know it's coming from a good place (and it's only one friend, that I can handle; several more and I would lose my proverbial crap) so I just move on if I cannot answer her. Others have commented about our plans (I've already ordered Honey's urn, as I just wanted to and our daughter helped pick it out; it has helped us) and I've been able to reply better than I would have previously - more of a practical response rather than a scorched-earth response, hee. Although I will admit to having the scorched-earth response in my head, but I sat on my hands until the urge passed. ;)

    Your telling of JJ's story, through the book and Facebook pages, has helped me and my family tremendously as we go through our journey with Honey. I can't tell you how much I have appreciated your pragmatic voice and advice when I've had to have hard conversations with our daughter, who is Honey's "puppy" and best friend. Thank you so much.

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    1. My policy of keeping to the mission of being respectful prevented me from going off publicly. Some, I just blocked.

      I am glad to be of help and feel for you all regarding Honey.

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  4. Tracy, you are able to give "words" to the heart. And I hope you realize that, by sharing the feelings of your heart...the true and raw feelings...you have allowed others to be open with their feelings about losses and their loves. JJ is still making such a difference in our lives in so many ways. <3

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  5. I'm so sorry you had to deal with all of those comments on top of everything related to JJ's illness. You are a one strong lady and I am so grateful to you for all you have taught and shared with us. JJ was a special dog and she was lucky to have you and Wiggle Man as her people. I don't think I have ever loved a dog I've never met as much as I loved JJ. I'm enjoying reading your posts. <3

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  6. Thank you, Tracy, for this blog about JJ and your decision(s) concerning her care. She was certainly loved by many, those that knew and met her AND those that never met her. I am one of the latter. I'm in the same boat as Coleen as to having loved JJ as much as one can love a dog that they never met. I had to let one of my fur babies go to the rainbow bridge in August of last year. You and JJ helped me with that and the adjustment to my life afterward. Again, thank you.

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    1. Thank you. That is one of the goals. šŸ’–

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  7. Your blog post is spot on in so many ways that resonate with me. Lady died on New Years Day 2018. I heard thru a family member that another family member questioned my decision on Lay's quality of life, and that I was taking pleasure in "killing" my dog. I kept Lady's decline private, as I didn't want the barrage of well meaning comments that would only serve to upset me coming my way. I called my good friend, Ed, and asked him to be with me when Lady died. He knew her, he saw her on a daily basis...so his presence helped both of us. I have learned a lot from your blog, and from the Facebook pages you write. I continue to live my life in the spirit of Barke Diem...I will continue to do what my mind and my heart tells me is right.

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    1. Oh man, unfortunately your experience happens a lot, which is why I like to talk about it. I have had the same responses over the past year "good intentions; trying to be helpful; we all see it differently" any time I would say something. Luckily, on the really ridiculous stuff, people would step in right away and take care of it. I am of the mindset that unless asked, either a benign "thinking of you" or nothing was best.

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    2. Tracy, I'm enjoying your blogs so much!! BTW, I am getting emails when the blogs are posted. Death, be it human or pet, is just plain hard. Like you always say, no one gets “out of it.” As a whole, our society & our education system, really do not prepare us for our death or the death of a loved one. I do believe it's getting better, although it is slow. Thank you for all the posts on death & dying. What brought me to JJ's page was “the video.” When JJ got sick, it was tough, for sure. However, I along with many others, are so glad you shared JJ's Entire Journey with us!! Thank you for what you do, each & everyday!!

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  8. Amen, I found it so interesting that I could love a dog and her family all the way across the United States as much as I loved JJ and hers. Now, I love them all, the whole bunch, knowing we many lose Mama G but we as a community will move forward, because JJ taught us to love not lament. To grab the goodness from every single day and shouldn’t we always have been doing that. I’m sure glad she reminded this 62 year old that very important lesson.

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  9. Just testing to see if I can leave a comment now...or if it will disappear. I had originally posted from my desktop but now I'm on my phone. Fingers crossed!

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    1. Hey I'm somebody! At least I have a name now- no picture but a name will be sufficient for now!

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  10. I wrote a comment yesterday because we walked a very similar journey as you did with JJ with our golden retriever Bo. Bo was 4 years old and we did everything you did for JJ as far as treatment. We were lucky Bo's treatments could be done at our local vet office north of Spokane,WA with a protocol that was advised by our vet with assistance from Washington State University. Bo did great and his time with us was extended 10 more months. We had reservations treating Bo at first but our vet was more than supportive and she understood that if we wanted to stop treatment at any point in time or if Bo struggled at all with treatment we would stop immediately and let Bo be the beautiful golden boy we added to our family and let his time on earth play out. Bo handled treatment like a champ. We knew his time on earth would more than likely be shorter than we wanted but those 10 months that were added to his life were like winning the lottery! He felt good, he looked good and he had very few side effects. I totally understand what you did for JJ and why you did it. The day did come for us to say goodbye to Bo but I wouldn't change one thing that we did. We also heard people say not so nice comments about us but we also knew that some people reacted from not knowing specifics about the situation. Most people react in the way they are familiar with in regards to chemotherapy treatments for people. I must admit we had reservations prior to treating Bo but with some research and confidence of our vet we wanted to proceed. It's not an easy decision but if you feel informed and guided by your vet and team it helps alot. We also lost another 4 year old golden to stage 3 mast cell tumor and we only proceeded with surgical excision at WSU. Unfortunately Tigger left us also but he handled it like a champ and recovered quickly from the surgery. I'm on golden retriever #7 and as we all know not all goldens leave us at such young ages- look at Mama G and I had a rescue golden live to 14. I've also seen my mom journey through lung cancer. She left this world too soon also but I know she has all my dogs with her up above and I'll see her and all my dogs again. I guess what I'm trying to say through all of what I just wrote is I understand totally the choices you made for JJ and I THANK YOU for your education and information you share with all of us. The knowledge and experience you have with both human and animal is something very special Tracy. It's apparent you care deeply for many and your passion is definitely to be admired. It's heavy at times I'm sure- especially someone as close to your heart as JJ. Thank you for sharing all of your information and educating all of us in the grieving process for both human and animal. To this day I grieve all of my losses. I always will, but I'm learning to embrace the losses and learn from them. It isn't easy but necessary. I also must admit it's necessary to have a good cry now and then also. Thank you Tracy- I look forward to more from you. I look forward to learning more of the Art of Bark Diem!

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