On Weekend Mornings in the City

I love walking with Bailey early on a weekend morning before the city awakens from its nightly slumber. All is quiet and still, save an all but inaudible buzz emanating, I believe, from the hundreds of thousands of snores from the tens of thousands of apartment dwellers in the thousands of units in the hundreds of buildings that line the dozens of streets in my in-town neighborhood. It is peaceful and quiet and calm. I can close my eyes and imagine being in an open field, on the top of a mountain, or deep in the woods—it is that calm and that peaceful. But I keep my eyes open as the stillness is treasured even more here, standing in such sharp contrast to the cacophony of sounds, tensions and bustle that filled the city only a few hours before, and that will soon explode again. For a short time, it is just Bailey and I, and the occasional passersby, almost always accompanied by a dog at their side.

I love walking with Bailey early on a weekend morning when the street lights change for no apparent reason, with no one to stop for the red, no one to go on the green, and no one to ignore the yellow. A thirty-something man frantically trying to hail a cab to National has yet to dry from his shower. An early twenties girl, disheveled, hung over, and having to think far too much about remaining upright while walking, has yet to wipe the stupor from her eyes and fully remember whom it is lying beside her. They will appear soon, as will many others. Soon, a young couple will tie their laces and stretch their tired muscles in preparation for a morning jog. Soon, a middle-aged woman will speed by, marching primly and orderly to the market so as to get the absolute best pick of the absolute choicest vegetables proffered. Soon, from all the brunch places that line 17th, the chatter of overly enthusiastic, brightly attired young gay boys will combine with the clinking of Mimosa glasses and the clamor of flatware and plates. And soon a woman looking far older than her actual years will shuffle through the contents of her cart, carefully rearranging the remnants of her life, before slowly strolling the streets of the city for another day. But for now it is just Bailey and I, and the occasional passersby.

I love walking with Bailey early on a weekend morning, when all I hear is the clicking of canine toenails against the concrete sidewalk, and the ting of dog tags clapping against each other. The clicks are more rapid this weekend, far faster then in many weeks. And the claps come so quickly as to become hard to distinguish one from the next. I cannot explain this change, and don’t particularly care to give it much thought. For now I prefer just listening to the round of applause Bailey’s clicks and claps offer to this new day.    

I love walking with Bailey early on a weekend morning when the sun is gentle and the air is yet to be thick and wet. I love walking with Bailey early on a weekend morning when all is quiet and calm. I love walking with Bailey on a weekend morning when the city is just beginning to awaken and the air is effervescent with the hope of a new day.

Six Months

Six months and a day ago I called my sister to tell her the news that had, in an instant, transformed a day full of optimism into one of despair. I told her about Bailey’s unexpected diagnosis and the even worse prognosis. And, in an attempt to provide comfort, she reminded me that veterinary prognoses were nothing more then best guesses, and that Bailey could well make it longer. “After all,” she noted, “this is Bailey! She’ll live another 6 months.”

Six months and a day ago, and for several days following, others offered similar words of encouragement. “She is so energetic—she is bound to live longer.” “Everyone is dying, just at different speeds.” “She looks so healthy—she’ll beat this.” Her three different vets seemed certain in the their advice to plan for no more than 4-6 weeks and to hope for an outside chance of maybe 3 months. But everyone else seemed to think that Bailey would live much longer. Maybe they were just being kind and supportive. But they all generously offered such encouraging words—thoughts that I did appreciate even though I was not quite able to accept the words. But that is not really accurate.

Six months and a day ago I did not want to accept encouraging words. I know… that must sound harsh (I feel like an ass even writing this thought). But it is the truth. It is not that I did not appreciate the support offered--I really did and still do. And it is not that I was wallowing in my despair or getting into my grief. Just the opposite. Now knowing that in a very short time I would or even might lose my most faithful companion, I wanted to savor every minute. And seeing Bailey with a newfound energy following the introduction of a pain medicine, I wanted to take advantage of every opportunity for both of us to live fully and enjoy what would be or even might be our last days together.

Six months and a day ago I did not want to adopt any thoughts that risked leading me down a path of denial, or that I could (and likely would) use to minimize what I was feeling. I wanted to experience both the pain and the joy of the situation to the fullest. And I most adamantly resisted any thought that Bailey might live longer, lest I start putting things off with notions of “there will be time”.  Six months ago I wanted to live each day as if it could be Bailey’s last, and I wanted to make each “last day” the best it could be.

My last words to my mother were, “We’ll speak again tomorrow.” She had called at a time when I was busy with mundane things that I did not really care about. Even though I knew that she was dying, I put her off. I said, “We’ll speak again tomorrow” without a thought that there might not be a tomorrow. And there wasn’t.

Six months and a day ago I decided to live as if Bailey had no more than 4 weeks left to live. And I am very glad and very proud that we—Bailey and I—did just that. It was a remarkable four weeks. But, five months and a day ago I held on to hope that Bailey might be able to swim one more time in the Potomac River. And four months and a day ago she did just that. And nearly three months ago Bailey celebrated the birthday-that-was-never-supposed-to-be. And two months ago she greeted another season that I never dreamed she would see. And one month ago, with a newfound un-realism, I ordered a ridiculously large bag of dog food with the absurd hope that Bailey would live long enough to eat it all.

Six months and a day ago I greatly appreciated the support and comfort that you all gave so freely, but I did not accept any encouragement for a longer life than the vets so confidently predicted. But six months and a day have passed and Bailey is still very much alive, albeit six months older and somewhat weaker. Six months have passed and what had seemed like an absurdly large order of 900 poop bags now just seems like everyday over shopping. Six months have passed and that large bag of dog food is nearly gone. Six months have passed and I am now absurdly hopeful for another six months.

Six months and a day ago I needed to think only in terms of days and weeks. But six months have passed. Now I can truly thank you all for not only your words of support, but also your words of encouragement. I suspect that at the time you may not have fully believed them yourself, but I am very glad that your predictions were right.

Six months have passed, and Bailey has not. Well done, Bailey. Good girl, Bailey.

Fourth of July

On the morning of July 4, 2000, Bailey arose to her third day in her new home just across the river from the District of Columbia, barely a mile upstream from the Washington Monument, where they light one of the largest fireworks shows in the world. She was excited to see me, and even more so to romp after Fred, who dashed to safety after a warning spit and hiss failed to deter the unwanted addition to his home. She had no idea of the turmoil that would soon explode the night like nothing she had yet experienced in any of the 60 nights that had come before. But I did know what would come, and I was determined to turn it into a positive experience that would not cause her to shrink and shake every Fourth of July to follow. It was time to get something out of all that advanced psychology training!

During the day of the Fourth, I introduced Bailey to a new game—I would make a sudden, loud sound and she would get a treat. She caught on to getting the treat very quickly, as dogs do, so I soon began making the sounds louder and more startling. A couple of shakes and concerned looks, but these lasted no longer than the fraction of a second it took to get the treat to her mouth. After a few repetitions of the game throughout the day, she came running to me with excitement whenever she heard a loud noise. She was ready for the real test.

That night, I stayed home for the 4^th of July for the first time in many years. With Bailey asleep in my lap, I watched the concert on PBS, not for any real interest in the concert, but because I knew that when it reached the final song, the fireworks would start. I then muted the sound on the TV and listened carefully, giving Bailey a couple of freebie treats to get her primed and to capture her attention. The first firework came almost instantly followed by a treat, cheers and an excited look on Bailey’s face as she waited expectantly for another treat. Then the next blast, the next treat, the next cheer and the next yelp of excitement. And then another, and another and with increasing speed, another and another. And when the finale came and the blasts were too rapid to separate into distinct stimulus-response sequences, Bailey pranced with great excitement and glee as she knew the pace of treats would also increase—and they did. The fireworks ended not with a trembling pup frightened by the startling sounds in a still strange environment, but by a happy and excited Bailey who raced around the room and showered me with kisses between each lap (also by an unhappy Fred lying on top of the TV looking down with disgust and contempt at the overly enthusiastic intruder).

Along with numerous planned outings to loud events with lots of commotion, similar early games left Bailey nearly impervious to startling noises. She never feared fireworks or thunder or the demolition of a a large chunk of roof and an exterior wall (thankfully followed by the construction of an incredible new kitchen and deck). For years, Bailey either stayed home on Independence Day without incident, or came with me to get a closer view of the fireworks. And while she did develop a still not fully explained reaction to wind, Bailey never feared thunder and lightening. These were never problems… until she got old.

Last year, it was too hot to bring Bailey for the short walk up to Meridian Hill where I watched the fireworks with a friend. For the first time, Bailey must have become frightened by the noises. When we returned home, we found her trembling in the guest room in which she had somehow managed to become trapped. Since then, Bailey has also become less than fond of thunder. Perhaps it is because of a change in her hearing, or her reduced eyesight or just a slowing in processing and responding to stimuli. In any event, my dog who used to have almost no startle response, now becomes fearful very easily. And while she can barely hear me call her name, she does hear and reacts to loud, percussive sounds.

So tonight Bailey and I will spend what will almost surely be our last Fourth of July together, much like we did our first Fourth—at home with plenty of treats and even more love.

I hope you have a great Fourth with sky's filled with dazzling fireworks. Even more, I hope your Fourth is as special as I know mine will be.

A Bag of Food

I bought the large bag of dog food this time. I want to tell you this right off. I want you to know that I bought a bag of food that should last at least 6 weeks. I want you to know that I trust that Bailey will eat every kibble from this bag, and that I will have to buy yet another large bag after that.

Until now, and with full intention, I have avoided posting detailed updates about Bailey’s health status. But, as Bailey has continued to beat the medical odds for so long, several people have asked for more details about how she is really doing. And all of these requests undoubtedly have come from sincere concern for Bailey’s health, or true awe about her survival. Both are warranted: awe as Bailey continues to be very happy and appears so healthy long past all expectations, and concern as there are nevertheless signs of declining health resulting from both cancer and age. So, for the first time and for whoever is interested, I offer this report on these two realities of Bailey’s health.

Bailey (standing) with two 6-year-old Goldens

It is human nature to give ten times more weight to bad news than to good news. Knowing this, I want to emphasize how amazingly well Bailey is doing—and not just for a dog with a cancer that everyone expected would have killed her months ago, but for any 13-year-old Golden. Most Golden owners that see Bailey underestimate her age by several years. A few weeks ago I shared on Facebook and showed many others the following image of Bailey with two other Goldens. No one guessed that the other dogs are less than half Bailey’s age. But even more important than appearance, Bailey continues to be comfortable the vast majority of the time, she continues to be active even if less than she was a few months ago, and she continues to be interested in and excited by people, food and life in general. Most important, she continues to be very, very happy. Let me say that again and please remember this as you continue to read—Bailey continues to be alert, comfortable, and very happy. This is one of the two realities—the one that led me to buy that large bag of food.

Still, at 13, Bailey passed the median lifespan for Goldens’ nearly a year ago. Plainly put, she is an old girl and, as such, she suffers some of the same ailments as others her age. Her peripheral vision has been narrowing for a couple of years, and the clarity of her focus is now decreasing as her pupils become increasingly clouded. And then there’s the arthritis in her front elbows—the arthritis first noted in early adulthood but which posed no functional issues until it advanced significantly last year, leading to the start of a prescribed NSAID just before the cancer diagnosis. And this therapy was very successful, having produced the near miraculous relief that afforded us that incredible “last” month (Four Weeks), and four additional “last” months… so far!. But as time and age seems to always win out, Bailey’s arthritis has again advanced to the point that her front legs are stiff and unbending most of the time. Stairs have become both difficult and risky, and (whether for pride or comfort) Bailey rarely lets me carry her. After a couple of minor falls, however, she does now wait patiently for me to “spot” her going up and down stairs. And on a few occasions she has reluctantly looked to me to carry her—I still allow her to make this call only because the crestfallen look that always follows saddens me more than anything else we have yet encountered.

So Bailey is an old girl who struggles with some of the same issues that confront most old dogs and most old people. But, Bailey is an old dog with cancer and this makes things less clear. Is the current  symptom du jour just a condition of aging or a seasonal allergy or a routine upset stomach? Or is it the result of a new or expanding tumor? It is simply not so clear anymore.

Bailey’s cancer is spreading. I learned this fact shortly before her 13^th birthday when a chest X-ray revealed two clear nodules in her lungs and a less definitive shadow on her spleen—two organs frequently involved in the course of hermangiosacrcoma. And it would be typical for this type of cancer to have spread even further, but I cannot be sure having opted out of additional imaging since the results would alter neither treatment nor eventual outcome. So, while I have no way of knowing what other organ systems may be involved, the chest X-ray made clear that Bailey’s cancer is spreading. That is one of the few things that has been clear ever since.

Knowing that it is metastasizing, and knowing how aggressive and lethal hermangio’s are, everything out of the norm now has to be seen under the shadow cast by the reality of cancer. Bailey had a bout of repeated diarrhea with some blood in her stool… fear a colorectal tumor but treat as and hope for typical digestive tract upset (which it turned out to be). On occasion, Bailey stares into space and appears disoriented. Granted that she has always been my goofy dumb blond, but she had never previously just stared idly at nothing until jolted by some distraction (usually, the repeated sound of her name leaving my mouth with increasing volume). Hmm… run-of-the-mill disorientation that comes with age, or a brain tumor? And her hearing took a marked and troubling dive in just a few days.  Now, when standing out of her sight, Bailey no longer responds when I call her name or clap my hands unless done very loudly. If within eyesight, she reacts quickly at lower volumes and responds immediately to hand gestures. Yes, this type of hearing loss is common in older dogs, but given the very rapid rate of the decline, it well could be the result of metastasis to the brain—also typical of hermangio’s. Very little is certain anymore.

Indeed, the only symptom that is clearly a product of the cancer is the arrhythmia caused by the tumor on her heart, along with the labored breathing it produces. These were the symptoms that originally made me suspect that something was wrong back in December, and which appeared only occasionally at first.  In mid-March, however, Bailey had the first of two series of very bad days—days when her arrhythmia became quite pronounced and her breathing became labored for extended periods. For several days, she was not at all comfortable and not at all happy—leading to my first serious thoughts about euthanasia (Is it Time?). And while Bailey did recover from this episode, she did not regain her former level of functioning. A new normal had been established in which the irregularity of her heartbeat was itself now regular. Activity would now be limited to no more than a walk around the block, and that only on a very good day. 

June 25, 2013 - Bully stick joy

Within the limits of this new normal, however, Bailey continued to be happy, alert, interested and hungry. And she continued to insist on strolling the 1-1/2 blocks to the dog park nearly every day to interact with both canines and humans—though mostly humans.  Her activity and energy had both declined, but her happiness and interest in life had not.

Three weeks ago, Bailey suffered another series of very bad days. As before, her arrhythmia had become very pronounced and her breathing was very labored—this time, however, disrupting her sleep and sapping her of the breath and energy required to stand or walk more than a few steps. Although her appetite continued to be good and her output normal, she was clearly neither happy nor comfortable, and she was struggling.  By the forth day, I not only considered if it were time, but had decided that if there were no improvement by days end, I was going to bring her to her primary-care vet—not to the urgent care animal hospital for an attempt at treatment, but to the one vet who saw Bailey since near the start of her life, to see to the end of her life.

This time, Bailey must have gotten the memo. She started walking a little more, and her energy and activity continued to rise gradually through the afternoon, the evening, and for the next two days. Based on our prior experience, I was expecting that her recovery would be limited to a new new normal, but within three days, Bailey was back to where she was before. But only for a few days. Then came the periods of disorientation. Then came the rapid decline in hearing. And then came an ongoing if gradual increase in periods of labored breathing.

June 27, 2013 - A little wrestling

The reality is that whether from cancer or age, Bailey’s health is declining and at some point, whether from cancer or an age-related problem, she will die. But, that is just one of the realities. Bailey is truly amazing and she regularly proves that I underestimate just how amazing she is.  She continues to insist on going to the dog park, even if struggling for air and even when so stiff that walking is painful. On occasion, she has even surprised me with a spunky, if brief, wrestle with a puppy, as she did just yesterday. So, one reality is that her health is declining and she is approaching the end of her life. But the other reality is that she still wears a huge smile most of the time, she is still comfortable, she is still interested in life and, most important, she is still very, very happy. 

Oh, and she continues to eat away at that large bag of food.