December 11, 2013: Discovery Day

I didn't realize how hard it would be to look back on that day in December when we discovered her tumor and write about it.  Stella has now shallowly outlived all initial prognoses and as days turn to weeks turn to months, I have reached a tentative detente with her cancer (though I still give it the side eye and refuse to lay down arms).  When I look at my sweet girl today, I can see her as the big personality she is rather than frantically searching for signs of something amiss or only seeing her as  a collection of difficult health crises rising up to swallow her whole.  A few quiet weeks with no imminently mortal dangers have permitted this brief period where I can look at the experience and write about it without grief overwhelming and obliterating everything I do.  Who knows when that will change?  For now, as I type this, Stella rests her head on my leg and whines for another walk, another meal, any kind of attention that involves a ball or perhaps stalking squirrels ("But don't pet me, for god's sake!  Ugh!"). The fact that she's up and about making her little noises and insistent demands sets the clocks and proves that, this day at least, all is well in our little neck of the woods.

Leprachaun Movers, a group of really big Irish ex- rugby players, showed up on December 10th to move us the 1 mile from our old house to the new house.  Stella loved them immediately, each stopped to pet her and even throw the ball a few times (nothing pleases me more than a big dude who makes coo-ing noises to my girl).  She did really well that day, even though it could have been confusing for her.  We had been coming over to the new house for a couple of weeks by then, feeding her dinner where she would be eating from the move on, and all her beds were in place so she always had a good comfy spot to safely sit out of the chaos.

It took about ten hours, but by the end of the day, all the boxes were in the right rooms, all the furniture was in place, and we collapsed into bed in the guest room, which I had set up the day before so that we could be out of the wood floor fumes.

I don't remember much about the next day.  Jim went back to work and I am sure I walked Stella and then got to work on the boxes.  There was still a lot to do over at the old house and our dear friend Craig was over there helping us patch nail holes and repaint.  I do remember talking to my girlfriend Jenny on the phone about how happy I felt and what a relief it was to be beyond the blues that were brought on by the other house, that we could finally just land and be happy here. 

It was pretty late when we finally went to bed. I was already undressed and Jim was somewhere else when I realized Stella was really going at her neck.  I was sure either dust from the move or the fumes from the new hardwood floors were being a bother.  I got down on the floor with her and I could feel immediately that her neck was warm. What she was scratching was a hard swollen lump the size of a freaking orange on her neck, close to where it meets her chest.  Jesus Christ, what the hell was that?  The skin beneath her heathered yellow hair was a fierce, angry red and it was very hot to the touch.  I felt a catch in my heart come loose and I knew, I knew it was a tumor.  It was a big fucking angry tumor.  In a panic I called out to Jim and he came running from the bathroom, frightened by the tone of my voice.  "Stella has a lump," I cried, very close to hysteria, but doing my utmost to remain calm.  "There is a really big lump on Stella's neck."

"Let me feel it." Jim was not a stranger to my inclination towards hyperbole. "Jesus, that is big."

"We need to take her to the emergency vet right now, Jim.  Right now."

"She doesn't seem to be in distress.  She seems fine.  It might be a spider bite."

"It could be a spider bite or she could be having an allergic reaction to something.  But, I think it's a fucking tumor." In case you haven't caught on to the fact yet, I swear like a sailor.

When we took a step back form her, we could clearly see it protruding from her neck, pushing the hair around her normally pretty Elizabethan collar in a messy, awkward manner.  How had we not seen this before?  How had we not felt this before?  I ran my fingers along her old incision regularly and never felt anything, but it never dawned on me to palpate just up and over six or ten inches.  

I hit the internet like it would save my life, googling tumors, spider bites, allergic reactions, you name it.  There was no sleeping for me.  At about 4am, I came up onto the main floor, lay down on the couch in the darkness and surrounded by cardboard boxes, sobbed till I was wrung out, dehydrated and exhausted.  When 8am finally rolled around, bleary eyed and hoarse, I called the local vet and the receptionist said we wouldn't be able to be seen that day.  I protested in the most polite manner I could muster, sleep deprived and a little nutty with worry.  She said if I just came around 11 and was patient, she would see about fitting me in around other patients.  I thanked her, overwhelmed with relief, and then gave in a took an ativan.  

The local vet did finally see me that first day.  She said the same exact thing that Dr. Stacy did back in 2011, "I don't like the look of that."  When she tried to palpate beneath it, Stella squealed and I had to squelch a scream.  She decided to take a fine need aspirate biopsy of it, and after feeling as if she didn't get a good sample the first time, pricked her again.  She said the slide was too bloody for her to have a look at it, but that it's proximity to her pre-scapualar lymph node made her think it was lymphoma.  And with that, she sent us home. 

I walked out of the vet office feeling utterly lost and rudderless, not knowing what the hell I could do for our girl and feeling sure certainty that we were going to loose her.  I called my sister and wept.

20/20 Hindsight: All The Little Signs

Looking back over last Autumn, it's hard not to feel that we should have known something was amiss with Stella's health.  Hindsight lends itself to self flagellation and guilt, a lot of guilt, because there were a half dozen posts along the way, each shooting small sparks of information that, alone, didn't seem like much, but when collected, morphed into a well lighted map pointing to big trouble.

Since moving to California in the beginning to 2013, we had being living in a classic Berkeley Hills 1939 bungalow.  I use the term "classic" in the real estate sense.  We're talking moist, few updates, and stinky.  Really, really stinky.  By last fall,  I was obsessed with finding a new place for our family to live.  Stella and I still walked our miles in the morning and around the neighborhood in the evening, but practically every other waking moment was dedicated to scouring rental ads, writing introductory emails, fielding calls, meeting homeowners, and driving through neighborhoods.  If I had lifted my head, I would have noticed that Stella was sleeping a bit more.  When I did see her wonked out on our bed, I chocked it up to the heat or her now being eight and officially an "elder dog".

Then one morning, Stella balked at the start of our walk. She does grow bored when we take the same route repetitively, something she protests by walking very, very slowly (then when I drive her somewhere new, even the same day, she pulls my shoulder out).  I figured she was bored out of her skull by our morning walk up the hill, because she flat out refused to go forward.  We ambled home and she went back to napping.

Never bored with a stick!

I did notice that she was breathing a bit harder when we would walk uphill.  My brother called this exercise intolerance and he said to take her in to see her local vet.  The local vet who we had seen once before in the spring when we first arrived did some blood work, looked her over, and said she seemed fine, just an older dog starting to show signs of slowing down.  This was tossed out in between her narrative about her children, her dogs, her office remodel, her employees.  A little voice in the back of my head said, "Find a new vet."  I will never again ignore that voice.

In November, Jim and I took Stella to our favorite dog friendly resort on the rough Mendocino coast, situated on a wide estuary where the Big River meets the Pacific Ocean.  Stella started to cry with excitement the moment we turned off Highway 1 (honestly, we are just as excited as she is and spend the last fifteen miles of the drive ooh-ing and ahh-ing at every new view of the immense surf).  She loves riding in the Canine Cruiser, a large outrigger canoe with the perfect spot where she can lie down with her paws over the lip of the boat and watch harbor seals, river otter, and cormorants.  It was a beautiful weekend where we walked on the highlands above the water, hiked beside the river, read in bed, and just checked out from the world (no cell phones!  No internet!).

Stella in the Canine Cruiser

After returning home, I noticed Stella was pretty itchy.  I assumed she had picked up fleas at the inn, even on flea and tick preventative, but I never found any buggers.  Then I thought perhaps the sand or the river water may have bothered her skin.  Perhaps she ate something while we weren't looking (exacerbating her food allergies).  I bathed her carefully, but the itching continued intermittently.

Sometime around Thanksgiving, Stella started to scratch at her ears.  This has happened before when she gets a little yeast growth (that's a labrador for you).  But when I looked in her ears, they looked normal.  No brown goop, no red, tender skin.  They looked clean and healthy.  But still she bothered at them and was shaking her head more frequently.  I put her through a week long course of ear cleaning and steroid/antifungal ointment just to be sure.

One night, while Jim and Stella were playing around in the kitchen, she let out a sharp, painful yelp and backed away from Jim.  That sound always elicits a fiercely overprotective, overblown maternal response me.  Jim will tell you (as he has, unfortunately, most often been at the receiving end of my reactive fury), I turn into a demolish-the-neighborhood Godzilla type when Stella is injured in any way.  I shrieked, "What the fuck?"
"I have no idea."
"Did you pull on her ear?"
"I don't think so.  I was just grabbing at her neck."
"Well, don't do that!"
"Jesus, Beth, we were just playing."
"Sorry!  I'm sorry!  I just hate that something hurt her."

Yeah, I know.  I'm working on that.

In late October, I had found a new house for us to move into and I started packing like mad ahead of our early December move in date.  We would have the new house for two weeks before moving in so that I could clean, paint, and do the little tweaks that would make the rental our home.  That first week in December, new floors had recently been put in and they were off gassing like mad, but I opened all the windows and went to work with Stella by my side.  It was a very busy time.

When I think back now, I can not help but wonder had life been a little less hectic, would I have noticed all the little signs and seen the big picture?  Would I have recognized that when Jim was playing with her neck, he had actually pinched an incipient tumor? Would I have looked a little deeper as to why she was scratching that left side of her neck and chest, why her ears were bothering her?  For god's sake, why did I let my little girl lie in her bed on newly polyurethaned floors?!?

This sense of "jesus, we should have caught this sooner, we should have seen what was happening, we should have done something, anything, earlier" and "what did I do to cause this?!?" are apparently a common feelings among pet owners after a grim diagnosis. Many dog owners I've spoken with who are going through similar health struggles with their dogs were initially hit with an outsized sense of responsibility and guilt over their dog's illness.  When we, the people who given them their everything in life, miss some of their cues, of course we take it to heart as a failing on our parts.  In that first couple of weeks after The Discovery, I carried that lead weight in the center of my belly and it grew heavy tendrils through every moment of every day, rendering sleep difficult and eating next to impossible. The sense that I had let Stella down and would now loose her quickly colored every day like a tablespoon of ink or blood in a glass of pale milk.  I would wake up at 5am (inconceivable to those who know me), silently move to the living room (in this new, foreign house), lift the shades and watch San Francisco's night lights shimmer and wink, grief like an illness in full fever wracking my body.  I couldn't get comfortable and I couldn't find respite.

But, here's the thing.  Dogs, for the most part, carry their discomforts silently and stoically for a long time.  It's easy to see the picture on the jigsaw when all the pieces are perfectly placed, but it looks like a mess of visual noise when you first open the box.