endless tears

I still can’t believe that DD left us for good! I can’t stop thinking of him at home or at work. He seems to be everywhere. When I am driving, I remember the way he stood against the window, sticking his head outside to sniff the wind. That was long time ago, before his IVDD, or even before his sarcoma. The last time I remember him doing this was when in Lansing, on Collins road. It was rural road and had horse training and such in that area.

Since we buried DD, I have picked fresh flowers and put them on DD’s grave every morning. It makes me feel good and I hope it makes DD feel good as well. He hasn’t visited me in my dreams yet. Has he forgot me? Maybe he is now in a state or status where there’s no pain, no tears, no past and no present. An angelical status. After the ‘missing shoe’ dream at on Sunday night DD, I dreamed of 2 rabbits and my deceased Grandma on Monday night. Then I dreamed of a banquet in a local Buddist foundation on Tuesday night.

I hate to go to work now because I have to leave DD at home although I know he’s no longer around. I have to try very hard to hide my tears at work and to make a smile to my co-workers.

Labor day

It is the Labor Day today. The worst holiday for me. I am in terrible indescribable pain. My heart aches as if it was stabbed thousands of times. I can’t stop crying and blaming myself. If I had monitored his kidney health since 1 year ago, he wouldn’t have died because he was a fighter and I expected him to live up to 20 years old or even longer. He had survived tracheal collapse, sarcoma cancer, and IVDD. He could have survived this one if I had been more responsible. It’s going to be a long process mourning the loss of my best friend…

I was hoping DD would visit me in my dream last night after we buried him yesterday, but he didn’t. I did have a dream though. In my dream, I went to a shoe store to buy a pair of new shoes from a on-sale sections. In the next scene, I was riding a weird bicycle. The reason that it was weird was because the seat was only a few inches above the ground. Then I found I lost a shoe, a canvas shoe. I turned around and watched the shoe slipped under the bike. I then took out the new shoes I bought earlier only to find that they are not a pair, one shoe didn’t match the other in style or in color. So I went back to the shoe store but couldn’t find the on-sale section any more. How do I interpret the dream? Was the lost shoe symbolizes the loss of DD, my dearest?

Burying DD in my heart

We buried DD this afternoon. 5:30 p.m., Sunday, August 31, 2008.

It’s a tedious but rather smooth procedure. We planned to bury him on Saturday morning, but couldn’t let go of DD until we “had to”. The grave is in our backyard, almost 2 feet deep. We were supposed to dig it deeper, but the earth was too hard to dig through. DD was shrouded in 2 of DH’s T-shirts. We did so because we knew DD liked us a lot. I mean A LOT. He always liked to sleep on our clothes. Maybe he felt it was a secure place. Then we placed DD in a cardboard box lined with one of DH’s old blue jeans. On top of the jeans laid a towel which was a free gift from Science Diet. I put a lavender scented double-layered hand-quilted pillow case under DD’s head. On the pillow, next to his head, we put one strand of my hair and one strand of DH’s hair, bother tied up with red thread. I also gave him a hand made handkerchief that can be used to wipe out the fluid that may ooze out from his nose and mouth someday. A water cup that he used to drink water from. A renal supplement that I purchased last month to help improve his kidney health. Some cookies from the vet. 3 business cards: 1 of the vet’s so he can call upon the doctor for any more discomfort, 1 of DH’s with his phone number, email address, and current residential address and address in our home country.

An online poem said, “The best place to bury a dog is in the heart of his master.” DD, I buried you in my heart, but you are always alive in my heart.

Rememebering DD

DD passed away last night at the age of 16 and 5 months. Around 8:30 p.m., Friday, August 29, 2008.

DD had been suffering from kidney failure for more than 1 week since August 14 or so. We thought it was just digestion problem there didn’t rush him to the vet in a timely manner partially because of my in-laws’ visit. The delay became irrevocable mistake. When he was hospitalized in August 27, it was apparently too late. He accepted IV treatment to ease the pain and possible dehydration, but that can’t stop the vomiting and diarrhea. In the evening of August 27, he was shaking while receiving IV treatment. In the morning of August 28, he was given tranquilizer and was able to sleep. That evening, he seems to regain his strength and was able to kicks his legs. We were happy to see that. On Friday evening, hoping to see a big improvement, we were only devastated to find out that his BUN value only dropped from 339 to 237 and he was blood cell was not functioning. His vomited three times when we were there. The first time he vomited, his pale tongue stuck out flat. The vet said that meant “He doesn’t want to be around”. When prompted, he suggest blood transfusion. When my husband went out to pick up blood for 7 lb dog. DD’s heart beats weakened. The vet said it’s not good. Right after the transfusion, DD seemed to get a bit better, being able to open his eyes and his heart beats were a bit stronger. Then, while my husband was talking to the vet who was treating an ill cat, DD vomited again, and again. I put a tissue under his muzzle to pick up the vomit. Suddenly, I found DD stopped breathing! After a quick examine, the vet concluded that DD’s heart stopped. But my husband thought he’s still breathing faintly. The vet checked again. Meanwhile, with his eyes wide open, staring at me, DD left the world and us behind.

Happy Lunar New Year!

It’s the first day of Lunar New Year. Year of Pig, that is. We had steak at home for dinner, and that’s not common. I also made pork buns, and did some cleaning. But each day seems to be more precious, and it’s only because of dd. DH will fly to California on Tuesday to unite with his parents and brother’s family. So dd and I will be home alone for 10 days. Hurray! But I still have to work…

suture removal

Today, we took dd to our regular vet to have the suture removed. The stitches came off easily and the surgical wound seemed to heal pretty well. That’s a good thing. He thinks radiation is the best, but if we can not afford it, “there is alway an option.” He wants us to monitor dd closely, and if the tumor grows back, he can remove it. The doctor also said he can do teeth cleaning for dd after 6 months. They only charged 10 bucks. That is so nice.

It’s Lunar New Year’s Eve today, so I decided to prepare some nice food. We went to the Korean supermarket after vet visit, and picked some bulgogi beef, tofu and some other goodies. We had hot pot for dinner, I also made fragant sweet rice that Mom always prepares for us during Lunar New Year holidays. DD also ate some bulgogi beef. What a nice day today!

Immunohistochemical report.

The hospital called DH to pick up the report and pay off the bill. I hope this is our last bill with this animal hospital! Their price is sky-high! Anyway, the report said that that tumor is “peripheral nerve sheath tumors”. The doctor still recommends radiation. If we decide not to do radiation, we need to monitor him closely, and as soon as the tumor grows back, a second surgical removal is required.

I google a bit about peripheral nerve sheath tumors and find that in this site, it says that,

“The pathology report says that this tumor is a schwannoma. These are also sometimes referred to as peripheral nerve sheath tumors, if you wish to search for information using that name, too. These tumors can be malignant (have the potential to spread to other areas locally or in other areas of the body). In this case, the pathologist thought that the tumor was malignant and that the malignant characteristics were strong.

The best hope for controlling the spread of these tumors when they are malignant is surgery done using strict adherence to oncological (cancer) surgical procedures. This means that a wide margin must be removed in every direction around the tumor. It sounds like your vet made an effort to do this but may not have been totally successful because there were tumor cells in the margins of the tissue submitted to the pathologist. Another possible explanation for that situation is submission of an incomplete sample. This happens when the tumor is cut into after it has been removed and made into smaller pieces so that formalin can preserve the whole thickness of the tissue submitted. Sometimes, this makes it very hard to identify the surgical margin. I think that you have to accept that the mor likely explanation is that the margin of tissue removed at the time of surgery was not enough to get all of the tumor cells.

Schwannomas do not respond well to chemotherapy, unless something very new is being used that I have not heard of, yet. The oncologist would be aware of the most research on this option. Some vets feel that these tumors respond to radiation therapy but more vets feel that they do not. I was not able to find objective information on radiation therapy, so I think that these opinions are based on a few cases and information from human research on similar tumors.

The initial surgery is usually the best chance for getting all of the tumor. However, if this tumor returns at approximately the same site, a second surgery may be beneficial. If that becomes necessary, it would be best to have a board certified surgeon or oncology surgical specialist do the second surgery, if that is possible. It takes a great deal of discipline, and faith in the technique, to remove
enough tissue around a tumor, if underlying bone or an eye have to be removed to get wide enough margins. Oncological surgeons are used to making these choices and have more experience dealing with the complications of this sort of aggressive surgical procedure.

If the oncology specialist in your area feels that radiation therapy would be helpful, it seems reasonable to me to give it a try, since other options are not available. However you do need to remember that the general feeling among oncologists appears to be that the benefits of radiation therapy are questionable for schwannomas.

Hopefully, the recover from surgery has progressed smoothly after the initial complications and there will be a long interval between this surgery and the reappearance of this tumor.

Mike Richards, DVM
12/24/2000″

What scares me is that the article says, “the general feeling among oncologists appears to be that the benefits of radiation therapy are questionable for schwannomas.” I am not sure if this statement is correct and if the technology has advanced since the post of the page. The cost is so high that I really don’t want to waste a lot of money for a questionable therapy.

Waiting for pathology report.

While dd is recovering from the surgery removal of the tumor, I am also waiting for the pathology report which will determine whether chemotherapy is also required, besides the already recommended radiation therapy. The hospital will calll me when the report is availabe, probably at the end of the week or next week. I also need to take dd to our regular vet to remove the suture at the end of the week or next week.

Update: the doctor called my this morning and told me the pathology report came back, but also suggested that they need to run an addition immunohistochecmical test that will determine what type of radiation is required. I picked the report after work and left the doctor a note telling her to proceed the test.

3rd day after surgery.

It’s Sunday, a beautiful and blessed day, having dd back to home, back to us, again! I feel much better after the long depress and stress since dd’s illness. I decide to finish up a blouse project I started 2 weeks ago and after several hours’ ripping and tweaking, I have my blouse almost ready in the afteroon, except the sleeves that sppear to be way too long for me. I am thinking of cutting off the sleeves 2-3 inches or simply apply elastic instead of cuffs but I haven’t decided yet.

DD is doing well today. He almost gets back to his normal self now, and that makes me feel very very happy. I didn’t give him pain killer this morning since he’s not showing any pain or discomfort at all. But DH gave him pain killer at dinner. I want to make him another jacket to protect his chest from getting wet or soiled. Maybe tomorrow. I’m tired today after the sewing, cooking, and laundry.

1st weekend after surgery.

It’s Saturday today, and I am glad that dd seems doing fine after the surgery. I think it’s time for me to get back to my everydayness, so decided to go to the fabric store to buy some new Vogue patterns and to use my 50% coupon. I end up buying 5 patterns, and a peachy eyelet. Not that I need any more fabric, but this eyelet is a rare find that I just can’t pass it. Then I go to the farmer’s market and buy a lot of fruit, veggie, an Armish chicken and some ground pork. Such a deal at this store.

We have pork chops, brown rice, red pepper, and zucchini for dinne. I gave DD Punina with a bit of chicken as well. This is the third day I gave him pain killer as prescribed.