Regression and a Big Decision Today

Despite having a really good Sunday evening, Monday, and Tuesday morning, when I got home from work yesterday evening, Lexie had regressed.  She didn't want to eat anything, not even hot dogs, and she was very weak.  A little later in the evening, she finally went into the kitchen to drink some water.  She drank a TON of water, actually, but then she staggered into the living room and threw up all the water she had just drank.  Justin tried to tell me that she probably threw it up simply because she drank so much so quickly, but there was no consoling me.  I knew that none of this was good.

We decided to sleep in the living room with Lexie last night because she had started moaning and groaning a bit.  Mind you, Dobermans are known to be big whiney babies, especially when they're wanting some attention, and this is definitely true with Lexie.  However, Justin and I didn't sleep all night because we each took turns laying in the floor, spooning Lou and trying to comfort her.  No matter how much we cuddled her, though, she continued to moan and groan all night long. 

Finally, around 5:00 a.m., I tried to give her two Tramadol pills for pain.  She wouldn't open her mouth for me, but I managed to pry her jaws open just enough to slip the tablets into her mouth.  A few minutes later, she spit them out.  We did this a couple more times before she finally swallowed them.  I thought that the pain medication would at least knock Lexie out so that maybe Justin and I could sleep for a half-hour before we had to get up for work, but she still continued to moan and groan.

At that point, I felt that it was probably time to end Lexie's suffering.  It just so happens that she already had an appointment with Dr. Ellis this morning because she's supposed to have her stitches removed today (such cruel irony).  So, I texted Zach, Kristy, and my mother to give them all the heads up that Lexie may not be coming home from the vet today.  Zach and Kristy both came over to say their potential good-byes.  I asked Justin if he would be willing to help me take Lexie to the vet because I wasn't even sure at that point if she was able to walk.  She had barely moved a muscle all night long.  However, when I asked Lexie if she had to go pee, she actually sat up.  She even managed to stand up, although she was very unsteady, probably due to a combination of the pain medication making her loopy and half of her body being asleep from not moving all night.  Regardless, she managed to find her way onto the porch, then down the front steps and into the yard to pee.  She even got into the car all by herself.

Normally, I'd be very happy about those things, especially with Lexie getting into the car independently, but all it did was make me even more confused about what I should do.  On one hand, I know I'm going to have to euthanize her eventually, no matter what, and I certainly don't want her to suffer if she's in pain.  On the other hand (and I realize I'm probably just trying to convince myself of this), I keep wondering if her backslide yesterday evening and all the moaning last night were reactions to stopping her pain medication cold turkey.  (We stopped giving her the Tramadol after her Monday morning dose.) 

The reason I'm having such a hard time just "letting go" right now is because I want SO BADLY to be able to give her at least a few happy days after being fully recovered from her surgeries before it's time to finally say good-bye.  When I told this to Kristy this morning, she said, "But you have given her a LOT of good days.  She's lived a very happy life."  I know this is true, and Kristy makes a good point, but I just hate with all my heart the thought of Lexie going through all this pain and misery, all those trips to Ohio, those long, overnight stays at MedVet, and THREE surgeries, only to finally come home and be euthanized before her stitches are even removed.  I mean, what was the point of any of this?!?

People also keep telling me not to beat myself up and that I made the best decisions with the information that I was given at the time.  I know this is also true; however, that doesn't make any of this easier for me to accept.  It doesn't stop me from being SO ANGRY over the fact that I was told Lexie's abdominal ultrasound showed no signs of cancer, which was the reason why I decided to let her have the enucleation surgery in the first place.

Speaking of that, I sent Dr. Kennedy an email full of questions yesterday, to which he replied yesterday evening....from his iPhone.  I am now going to copy and paste the questions I emailed to him and his answers for you to read (I have not altered this text in any way, other than highlighting his responses):

1. Could you please tell me again exactly what Lexie’s cancer diagnosis is?  I tried to take notes while we were on the phone, but all I wrote down was “vascular and lymphatics,” “inflammatory mammary carcinoma, “Stage III,” and “50/50 it will return in 12-15 months.”  Obviously, I should have taken better notes, but I was in a combined state of shock and devastation at the time.

Mammary carcinoma

2. You mentioned on the phone that the size of the two mammary tumors removed during Lexie’s surgery were quite large, and you said this was “concerning.”  I actually have a few questions regarding this:
   1. How big were the tumors? Over five cm
   2. Why is the size of the tumors still concerning if they were removed? Because we could not take the amount of normal tissue desired to be sure all cancer was removed
   3. When you first mentioned the possibility of removing Lexie’s swollen mammary glands on July 7, 2012, because you said the tumors could be cancerous, I informed you that Lexie had just recently had an abdominal ultrasound, which I was told showed no cancerous tumors.  At that time, you explained that it takes billions of cells to form even a small tumor that is visible enough to be seen on an ultrasound.  If that is the case, and the two tumors removed during Lexie’s surgery were so large that you find them to be concerning, why weren’t they visible on her abdominal ultrasound performed June 20, 2012? The statement about the cells refers to x-rays. I do not know what to say about the presence of the masses at the time of the ultrasound. There is always some mixed inflammation. In these rumors and that might be why they were so obvious to me.

3. When you said that there is a 50% chance that another tumor will appear within 12-15 months, does that mean that the two tumors that were removed during Lexie’s mastectomy were the only cancerous tumors she had?

The only ones we could detect. It is likely that more will form in others glands or within our surgery site

4. You mentioned something about further tests being done on the tumors to see if any lymph nodes were also removed during surgery.  Could you please re-explain the reason for this?  Also, when do you expect to have the results of these additional tests? We submitted a mass of tissue. The lymph node should be in that mind of tissue. If the pathologist finds it he can assess any sites for metastasis (spread) as this will worsen her prognosis if found.

I do not know when to expect it back but hopefully by the end of this week

5. Does Lexie have a life expectancy given her recent diagnosis?

 Potentially as little as 5-7 months

6. Do you know of any current clinical trials for canine cancer treatments for which Lexie might be eligible?

 not that I'm aware of

I'm a little infuriated by his response to question #2c.  Why would he have answered my question about Lexie's abdominal ultrasound with information that pertained to X-rays?  I am 100% certain that I did not ask him about Lexie's X-rays because 1) her X-rays were not performed at MedVet; they were done at Animal Care Clinic in Huntington, and 2) When Dr. Kennedy called on July 7 to discuss Lexie's swollen mammary glands, I mentioned her abdominal ultrasound to him because it had just been performed at MedVet two weeks prior, and I was told that the ultrasound did not show any cancer.  I didn't mention Lexie's X-rays to him because they were X-rays of her chest, not her abdomen.

Anyway, I know that what's done is done and that going over all the shoulda, woulda, coulda's isn't going to change anything, but I just feel so...wronged.  While I can accept that Lexie has cancer and will eventually need to be euthanized, possibly even today, I simply cannot accept the fact that the veterinarians at MedVet missed two Stage III mammary carcinoma tumors that were both over 5 cm in size, nor do I find Dr. Kennedy's reply of "I do not know what to say about the presence of the masses at the time of the ultrasound..." to be acceptable in the least.  I plan to call MedVet today to request a copy of Lexie's medical records, including her ultrasound images.  If another veterinarian looks at Lou's ultrasound and tells me that they do not see cancer, then maybe I will stop feeling so angry. 

In the meantime, Lexie is currently at Animal Care Clinic, and I am waiting for a phone call from Dr. Ellis so we can discuss Lexie's current condition and whether or not she should be euthanized today.  If Dr. Ellis tells me that Lexie's behavior yesterday evening and last night were a result of the sudden medication withdrawal or possibly some other explanation, and if she thinks that Lexie's still got a few good, pain-free months left in her, I will probably choose to bring her home.  If Dr. Ellis tells me that Lexie is in pain due to the cancer, I will not make my Lou suffer any longer.

So, What Now?

Just to recap, the following is a fictitional representation of the actual conversations I've had with veterinarians regarding Lexie since the beginning of June, 2012:

June 5, 2012 - Dr. Corbett:  "Lexie has an eye condition called anterior uveitis, but the good news is that she's not going blind!  Just give her these medications and follow-up in a couple of weeks.  That'll be $300."

June 18, 2012 [Lexie's eyes are worse] - Dr. Lilly:  "Lexie has glaucoma and she could go blind any minute!  Quick, you must rush her to MedVet!  Oh....wait....nevermind.  Dr. Corbett said to just give her these $100 eye drops, and then take her back to MedVet in two days."

June 20, 2012 - Dr. Corbett:  "Remember when I said that Lexie wasn't going blind?  Well, I forgot to mention that she could develop secondary glaucoma and potentially go blind within hours, which is what has happened.  So, we need to figure out what's causing her anterior uveitis because then we can possibly get rid of the glaucoma, too.  Cancer is one of the things that causes anterior uveitis, so let's rule that out.  That'll be another $700 for a chest X-ray, abdominal ultrasound, and blood work, please."  [An hour later.]  "Good news!  Lexie doesn't have cancer!  Therefore, this must be an autoimmune condition.  Give her these new meds and I'll see her again in two weeks."

June 21, 2012 - Lexie officially loses her sight. 

June 25, 2012 - Dr. Ellis:  "I've consulted with Dr. Corbett, and becuase Lexie's eyes haven't reponded to treatment and just keep getting worse, we both recommend enucleation."

June 29, 2012 - Dr. Ellis:  "There has been a surgical complication.  Lexie's blood won't clot.  She must have developed Von Willebrand's disease.  We're going to do a transfusion, but she's in critical condition."  [Two hours later.]  "The only way we could get the bleeding to stop was to pack Lexie's wounds with gauze, but she's now bleeding through those.  Therefore, you need to rush her back to MedVet tonight and pray she doesn't die on the way there.  You'll also need to pay a $1250 deposit when you get there."

July 2, 2012 - Dr. Corbett:  "Good news!  Lexie's surgery to remove the gauze was a success!  We're not really sure if she has Von Willebrand's disease, though, and we noticed an infection has started in her wounds, but we cultured the infection so we'll know exactly what kind of antibiotic to give her when she goes home."

July 3, 2012 - Dr. Corbett:  "Good news!  Lexie is stable and is cleared to go home!  That'll be $2300."

July 4, 2012 (14 hours later) - Lexie's stitches burst in her right eye, and she has to be rushed to the local Animal ER for an overnight stay.

July 5, 2012 - Dr. Lilly:  "Sorry I waited until fifteen minutes before we close to tell you this, but I don't want to stitch Lexie back up, so you're going to have to take her back to MedVet."

July 6, 2012 - Dr. Webb:  "We just got Lexie's cultures back and it turns out that she has TWO different bacterial infections, which are pretty extensive.  No wonder her incision pulled open!   I guess she wasn't "stable" when we sent her home the day after surgery, after all.  Anyway, we're going to need to keep her for another few days and then perform another surgery, but don't worry, we're going to do everything we can to keep the costs as low as possible for you."

July 7, 2012 - Dr. Kennedy:  "How long has Lexie had these swollen mammary glands?  There's a 50/50 chance that those are canerous.  Those are going to need to come off, too.  I don't have a cost estimate for you yet, but don't worry!  We're going to do everything we can to keep the costs as low as possible for you."  (I mentioned that Lexie JUST had an abdominal ultrasound and I was told that they did not show any cancer.)  "Well, it takes billions of cells for even the smallest tumor to show up on imaging, so even though it's GOOD that her ultrasound didn't show any tumors, that doesn't necessarily mean she's cancer-free."

July 8, 2012 - Dr. Sawyer:  "Lexie is responding really well to her new antibiotics, so we're going to push the surgery back until Wednesday.  I don't have a cost estimate for you yet, and I know we just tacked on another three-night stay to your bill, but don't worry!  We're going to do everything we can to keep the costs as low as possible for you."

July 10, 2012 (the day before surgery) - Dr. Sawyer:  "Dr. Kennedy told me to tell you that he was given permission to discount your services, and the cost of Lexie's surgery is going to be ONLY $1800!  That doesn't include the cost of her seven-night stay, though, which will be an additional $1400.  Don't worry, though!  We may still be able to get you more discounts!"

July 11, 2012 - Some random surgical tech:  "Ms. Bell, I'm just calling to let you know that we're getting ready to perform Lexie's incision repair and mastectomies now."  (I hadn't approved the mastectomies yet because I was told "there may be more discounts," which would be the deciding factor as to whether or not I could afford the mastectomies.  I raised a fuss, and they finally agreed to charge me "only" $1800 for all of Lexie's services over the last seven days, including the mastectomies.)

July 13, 2012 - Lexie comes home.

July 23, 2012 - Dr. Kennedy:  "I just got Lexie's biopsy results.  She has Stage III mammary cancer.  The size of the tumors worries me, though, because they were both pretty large.  There is a 50/50 chance that in 12-15 months another tumor will appear.  You can speak to Oncology about chemo options if you'd like, but they will charge you for the consultation."


In summary, I guess that cancer was the cause of Lexie's anterior uveitis after all, but here's my main question:  If Lexie's TWO mammary tumors were "so large" that Dr. Kennedy is concerned about metastases, then why didn't those two large tumors show up on her abominal ultrasound?  If I had been told on June 20 that her ultrasound revealed Stage III mammary carcinoma and that there was a 50/50 chance that I would have to euthanize her in 12-15 months, I'm not so sure that I would have chosen to have her eyes surgically removed, which would have saved her from having to go through THREE different surgeries and a very difficult recovery (not to mention the thousands of dollars for which I am now in debt).  It also would have saved her the stress and depression that has resulted from her sudden blindness. 

However, I also cannot say for certain that I would have chosen to put Lexie down instead of going through with the enucleation if I had known she had cancer.  It definitely would have been a very difficult decision, but you also have to keep in mind that, at that point, I wouldn't have known that so many other complications were going to result from the initial enucleation surgery (blood clotting issues, infections, two more surgeries, etc.). 

With all of that said, I strongly doubt that I would have chosen to spend so much money just so Lexie could spend her final days adjusting to sudden blindness.  If I had chosen to euthanize her a month ago, I would have at least been at peace knowing that Lexie lived a very full, VERY happy life up until that point.  As it stands right now, I simply don't know how well Lexie is going to adjust to being blind, or how much time she has left.  So far, she's had a difficult time with both recovery and adjusting to blindness.  Her appetite is poor, she's weak, she rarely looks happy, and she has no energy.  If these things don't improve before the time comes when I have to make the decision to put her down (whenever that may be), I will always regret with all my heart that Lexie spent her final days being scared, sad, depressed, weak, in pain, and blind. 

So, what do I do?  I have had several people ask how much her chemotherapy treatments would cost and suggest that I try to do another fundraiser to pay for it, but my heart and my gut are both telling me not to do that.  For one, it took everything I had in me to swallow my pride and ask for donations the last time, and now I just feel horrible that so many people gave so generously to help save Lexie's life, only to find out later that she has cancer.  Besides, Lexie has already been through SO much, and I'm not sure how much fight she's got left in her to go through chemotherapy treatments.  For that reason, I feel like I'd rather just try to make her as happy as possible for as long as I possibly can, rather than keep driving her six hours back and forth to MedVet for however often she needs chemo treatments.

The travel that would be involved is actually another reason why I don't feel like chemotherapy is the best option.  I have already put a TON of miles on my little Prius, and I even had to buy new front tires before our last trip to Ohio because the ones I had been driving on were so bald.  Not only that, but traveling that far that often is just grueling for both us and Lou. I'm not saying that it wouldn't be worth it if it meant saving Lexie's life, but the fact of the matter is that there is no guarantee that her treatments would be a success.  I'm also not even sure that Lexie would be able to receive her treatments on the weekends, as most of the specialists at MedVet only work Monday through Friday.  If that's the case, I definitely couldn't take off work that often. 

Pretty much the only way I would be able to even consider putting Lexie through chemotherapy would be if I won the lottery, or if some other lottery winner came to our rescue, because it would require Justin and I quitting our jobs so that we could move closer to MedVet, finding a place to live that would allow us to have three big dogs, and also being able to afford Lexie's cancer treatments, which I'm sure are very expensive.  Unfortunately, I don't foresee any of that happening, so I feel like the best option is to try to make Lexie as comfortable and happy as possible for the rest of her days here with us. 

So, on that note, I do have some good news in regard to Lexie's recovery.  Since she enjoyed her solo adventure to Justin's parents' house and the car ride home so much on Sunday, we decided to take her on another little adventure yesterday evening.  She got in the car all by herself, which made me happy, although she wasn't as interested in looking out the window this time.  She just laid in the back seat as Justin drove us down to Camden Park, which is on the other side of town, so that I could scout shooting locations for a photo session I've got coming up.  Then, we drove to Kroger's so that Justin could buy Lexie some hot dogs and baby carrots (she gobbled up a hot dog that morning, and baby carrots have always been one of her favorite treats).  While Justin was in the store, Lexie and I took a walk along the grassy edge of the parking lot.  It was a hot evening and she was panting, but I really felt like Lexie was enjoying her "adventure walk."  When we returned home, Lexie ate not one, but TWO hot dogs!  Justin had bought some vitamins for senior dogs while he was at the store, and he managed to get her to eat a couple of those,  and since we were on a roll, I decided to also give Lexie her "hippy medicine," AgariGold and mangosteen juice, which Dr. Wagner from the Integrative Medicine department at MedVet had given Lexie to help boost her immune system and energy levels.  (I'm going to seriously start looking into holistic cancer treatments for dogs, by the way.)

By the end of the day, Lexie was pretty tired, but she had a full belly and seemed happy, which is all I can ask for.  This morning, I was also very pleased because she seemed a little bit stronger than she had the day before.  She was more steady on her feet, seemed more alert, and even had a decent poop!  (It's hilarious how excited we get over Lexie's bowel movements these days.)  We've decided to try weening her off her pain medication again, too.  She didn't have any last night and seems okay so far, so I didn't give her any this morning, either.  Justin will check on her during his lunch break today, and if he thinks she could use some pain medication he's going to give her one pill instead of two.

So, basically, I'm going to try to stay focused on the positive things that happen day-to-day, rather than stay focussed on the fact that, oh my God, Lexie has cancer!  I'm still angry and heartbroken about it, and I probably always will be, but wallowing in sorrow isn't going to help either of us.  So, for Lou's sake, and for the sake of all the kind people who have been so supportive and encouraging, Justin and I are now going to do everything we possibly can to help Lexie fully recover from her surgeries so that she can continue to live the happiest life possible from here on out, even if it means feeding her hot dogs for every meal and driving her around the neighborhood for a couple of hours every evening.  :)

Horrible News

I just got a call from Dr. Kennedy at MedVet.  Lexie's biopsies came back from her double-mastectomy.  She has Stage III mammary carcinoma.  All of the details are a blur to me right now, but Dr. Kennedy said something about her type of cancer affecting the vascular and lymphatic systems.  He also said there is a 50/50 chance that another tumor will either come back in her mammary glands or appear elsewhere within 12-15 months. 

He said that I could speak to someone in their Oncology department about possibly starting chemotherapy, but I know there is no possible way I could afford to give her chemotherapy treatments after already spending thousands of dollars on her eye treatments and surgeries.  Not only that, but there is a consultation charge just to speak with Oncology about chemo options for Lou. 

I'm too shaken up to really talk any more about this.  All I can tell you is that right now I'm heartbroken and angry.  I'm angry that they weren't able to see a Stage III carcinoma on her X-rays, abdominal ultrasound, or any blood work.  If they had, I probably wouldn't have put her through all of these surgeries and racked up another $2000 in debt on my brother's Care Credit account.  I don't mean that to sound cold or sound like all I'm thinking about is money, because it absolutely isn't.  It's just one of the things I'm so angry about right now.  Mainly, I'm feeling horrible for putting Lexie through all of this.  Recovery has not been easy on her, or any of us, and now it doesn't even feel like "recovery."  It feels more like I'm putting us all through torture.  I thought that this tough recovery period would be 100% worth it once she was all better and was able to adjust to her new life as a blind Dobe, but now....

I'm So Exhausted

Last night, Justin and I agreed that the swelling over Lexie’s right eye may have worsened a bit (I photographed her from the left side so you could see how far her right eye incision is bulging out).  Neither of us was very concerned, as we thought she possibly just bonked her head while we were at work, but we thought it might be a good idea to call MedVet anyway.  After all, last Saturday, when a woman from MedVet called to check on Lexie, I mentioned to her that I noticed a tinge of blood in Lexie’s stool that day, and she told me to discontinue Lexie’s anti-inflammatory medication, as that can sometimes cause bowel irritation.  So, Lexie hasn’t been taking her anti-inflammatory medication since last Saturday, and I thought that maybe they would just prescribe her a different kind of anti-inflammatory once I told them that the swelling in her eye had gotten a little worse.

The woman I spoke to last night, Julie, asked me all sorts of questions:  How has Lexie’s appetite been?  Is she drinking water?  Is she going to the bathroom regularly?  How is her mood?  I was able to answer all of these questions with either “good” or “yes.”  Then, Julie asked if the swollen skin around Lexie’s right eye was warm or tender to the touch.  I put her on hold as I felt Lexie’s eye, but I couldn’t really feel a difference in temperature between her right and left eye, and she didn’t act like it bothered her when I touched it.  Then, Julie asked me to take a couple of pictures of Lexie’s eye, email the photos to Dr. Kennedy, Lexie’s soft tissue surgeon, take Lexie’s temperature (note to self: NEVER use the digital Walgreens thermometer EVER again!), and then call her back.

After following Julie’s instructions (Lexie’s temperature was 101.2, which is in the normal range for a dog), she contacted Dr. Kennedy, who reviewed the photos I sent him.  He said it looks like it could just be a seroma, which is normal.  However, if the swollen area becomes tender, if we notice a discharge that looks more like frank blood and not bloody fluid, if there is an odor, or if the discharge looks like pus then we are to bring Lexie back to MedVet because it could be an abscess.

Greeeeeaaaaat. 

 All I could do for the rest of the night was stare at Lexie’s swollen eye.  I went to bed in tears over the possibility of having to take her back to MedVet. 

This morning, the swelling didn’t look any better.  Then, after Lexie bumped her face on the steps while coming back inside after going outside to pee, I noticed a little bit of blood (not bloody fluid) coming from the swollen part of her eye.  I've also noticed that Lou's appetite seems to be diminishing, although Justin thinks she’s just becoming picky because we made the mistake of feeding her a lot of table food when she first came home.  At first, she would eat both table food and dog food, then she stopped eating her dog food, and now she’s even becoming a little picky about table food.  I used to put her medication inside little balls of bread, which she loved, but now she turns her nose every time I offer her the same bread.  Then, I started putting her medication inside these organic peanut butter treats our friends, Zoltan and Sarah, made for her, which Lexie also loved at first, but now she no longer seems interested in them.  This morning, the only way I could get her to take her medication was to put the pills inside rolled up slices of cheese, and even then I felt like I was making her eat them.  Not only that, but she looked kind of shaky and unsteady on her feet while she was walking around this morning (all the more reason for me to worry about her while I’m at work today).

I honestly don’t know how much more of this I can take.  My life has basically been CONSUMED with worrying and taking care of Lexie ever since she first became sick at the beginning of June.  In fact, I feel like I no longer have a life of my own. 

I have a large, close group of friends, whom I love.  We would all hang out at least a couple times a week and on the weekends, and when we weren’t hanging out, we would all keep in touch daily via social networking and text messaging.  However, I can’t tell you the last time I sent someone a text or posted anything on Facebook or Twitter that wasn’t Lexie-related.  For that reason, I haven’t really texted anyone or tweeted in a long time because I feel like I’m just wearing everyone out with Lexie stuff at this point, and yet there’s honestly nothing more important to me right now, which is why I can’t even think of anything else to talk about.  I have also turned down several invites to various cook-outs and other random opportunities to hang out because I needed to stay home and take care of Lexie.  I have made time to hang out with my friends on a few occasions over the last couple of weeks, but whenever I do, I feel like I literally have to bite my tongue to keep myself from talking about Lou all night, and I just worry about her the whole time anyway. 

I’ve also fallen behind with my photo editing (I’m a photographer on the side) because of all my trips to Ohio and now having to watch Lexie like a hawk, and my house is a complete wreck for the same reasons.  Justin and I haven’t done anything fun or spent any quality time together since June, either.  Our lives and conversations revolve solely around Lexie.  We’ve got a big beach trip with our friends coming up at the end of August, which normally I’d be super excited about, but this year I’m almost dreading it because I know I’ll just be worrying about Lexie the whole time (she’s going to be staying with Justin’s parents, and she’s not very familiar with them or their house).  Not to mention the fact that I’m the type of person who eats her feelings, so let’s just say that I’m not exactly feeling “bikini-ready” at the moment (all of my work pants are fitting kind of snug lately, which makes me feel awesome.)  In general, I really miss what my life was like before June, 2012. 

With that said, please do not take this little rant to mean that I regret even one single minute of the time I’ve spent taking care of my Lou, because I don’t…at all!  I’m just venting, basically, because I do miss my friends, I do miss having fun, I do miss doing “couple things” with Justin, I do miss not worrying about Lexie 24/7, I do miss feeling comfortable in my clothes, I do miss having at least a little bit of spending money, and I do miss feeling like I’m more on top of things like housework, editing, bills, etc.    

I just want things to feel normal again, but now that I’m sitting here wondering if I’ll be taking Lexie BACK to MedVet soon, it just makes me feel like this TRULY is never going to end. 

Surgery #3 Was a Success, But....

The last time I received a "but" after one of Lexie's surgeries, it was, "Lexie's surgery went really well, but we did notice she has developed an infection...."  That infection, of course, turned out to be extensive and actually two different types of bacteria (staph and serratia), which caused Lexie's incision to pull open just approximately 14 hours after she was discharged from MetVet.

Dr. Kennedy called me last night around 9:30 p.m. to tell me that Lexie's surgery to repair the incision and also remove two mammary growths (not just one, as it turned out) went well, "but the anesthesiologist did make a note of some twitching that occurred during anesthesia."  I asked Dr. Kennedy if this is a reason for concern, but he didn't seem too worried about it.  He said he just wanted to mention it simply because the anesthesiologist noted it on Lexie's report, but he didn't think there was any reason to be concerned.  After all Lexie has been through, though, I wouldn't be surprised if she had a grand mal seizure a few hours after I get her home.  (Oh God, I didn't mean that!  *knock on wood!  knock on wood!*)

Anyway, Dr. Kennedy just called me again this morning to give me another update, and apparently Lexie did really well overnight.  He said that there was some swelling, but nothing like she had before.  He also said there was a little oozing from the incisions this morning, but that is to be expected.  I asked him if her eyes were going to ooze bloody fluid non-stop like they did the last time I brought her home, and he said he didn't think it would be as bad this time. 

On a side note, I asked Dr. Kennedy if they had ever received the results of Lexie's Von Willebrand's test (I noticed on her bill from her last surgery that I was charged for that test).  He said he wasn't sure if they had received the results back yet, but that he'd check.  I know that it takes a while for that test to come back, so I'm not going to be upset if they don't have the results yet.  Besides, at this point I'm kind of convinced she doesn't have Von Willebrand's because bleeding wasn't an issue in either of her last two surgeries.  I'm starting to think that Dr. Corbett's theory for why Lexie almost bled to death during her initial enucleation surgery is probably true:  She said that it's possible that all of Lexie's bleeding simply resulted from the fact that the eyes are very vascular organs with lots of veins and blood vessels that have to be surgically cut during an enucleation. 

So, technically, Lexie is allowed to come home tonight, but I told Dr. Kennedy that I would prefer to wait until Saturday to pick her up.  I reminded him that the last time I brought her home the day after her surgery, her stitches burst 11 hours later.  He said he completely understood and thought I was making a wise decision.  I know that leaving her two more nights for observation is definitely a better decision than picking her up this evening, but it's also killing me to know that she could come home tonight.  I want my Lou home with me so badly!!!!  I'm going to be strong, though, and hold off until Saturday morning to go get her, because I know it's for the best.  Well.....maybe tomorrow night.....

A Deal Is Made...Minutes Before Surgery

I finally got a phone call from MedVet a little after 6:30 p.m.; however, it wasn't Dr. Kennedy calling to discuss the cost or hear my decision about Lexie's mastectomy.  It was just some girl calling to say, "Ms. Bell, we're just calling to let you know that Lexie is going into surgery now."

I asked, "Well, what exactly is she about to have done?" to which she replied, "Ummm....I don't know.  They just told me to call you.  Let me get someone else."

The next girl who came on the line told me that Dr. Kennedy was unavailable to speak because he was in surgery, but asked if she could help me.  Oooooohhhhh.....that poor girl.  I basically WENT OFF.  I will spare you all the minute details of my psychotic rant, but here is a run-down of some of my major speaking points:

• The doctors knew that Lexie's wounds were infected the day they performed her surgery.
• The doctors know that an infection can sometimes cause an incision to pull open.
• The doctors had not yet received the results of Lexie's bacterial cultures the day after her surgery, so they were not aware at that point that she actually had both staph and serratia infections, which were quite extensive, and yet the doctors told me that Lexie was "stable" and ready to go home when she clearly was not. 
• The doctors sent us home with Cephalexin, an antibiotic to which staph and serratia infections are resistant.
• Lexie's stitches pulled open just approximately 14 hours after she was discharged from MedVet, and now she has had to stay there for another seven nights and have another surgery as a result.

I told that girl that I did nothing wrong.  I simply came and picked Lexie up when the doctors told me she was stable and cleared to go home, which was obviously too soon.  I felt like I was having to pay for THEIR mistake.  I also launched into a big rant about how I've been told by five different doctors all week long not to worry about the cost of this visit because they were "doing all they could to keep the costs minimal," so I honestly wasn't expecting to pay more than $1500 TOTAL.  I told her I was perfectly fine with the fact that I would have to pay full price for Lexie's mastectomy IF I was actually being cut a break on everything else.  I even went so far as to say, "I'm even willing to pay the $1800 that I was quoted for this surgery if that's ALL I have to pay."


She put me on hold for about 20 minutes while she spoke with Dr. So-and-So, who apparently has the ability to approve or deny discounts.  Finally, she came back on the line and told me that my total bill for Lexie's stay and surgery, including the mastectomy, would be $1800.  I said, "That's all I wanted.  Thank you."  


Lexie is in surgery as we speak.
'

Not a Word

Dr. Sawyer told me last night that Dr. Kennedy would call me before Lexie's surgery today to discuss the cost of the surgery, which may or may not include a mastectomy, as I still haven't decided whether or not I can afford it.  I have waited ALL day today, yet I have not received a single phone call from anyone at MedVet.

I finally decided to call them just before 2:00 p.m. I was transferred to a surgical tech, who told me that Lexie had not yet undergone surgery due to the fact that they had a couple of emergency surgeries this morning.  That is completely understandable, and I was not upset at all by the fact that she hadn't had her surgery yet.  I explained to the woman on the phone that Dr. Kennedy was supposed to call me before Lou's surgery, so I was just calling to find out what was going on since I hadn't heard from him yet.  She told me that Lexie would probably have her surgery in about an hour, and she said someone would call me beforehand.

That was two and a half hours ago.  I'm about to start taking bets on whether or not Lexie actually has surgery today... 

THIS Is My Discount?!?

I have made it very clear to the doctors at MedVet that money is a HUGE issue for me at this point.  They have all seemed very understanding and sympathetic and have been telling me since I brought Lexie back last Thursday that they were going to do everything they can to make the charges "as minimal as possible" for me.  I wasn't required to leave a deposit this time, either, so I trusted that the doctors at MedVet really were going to cut me a break.  After all, they had sent Lexie home before knowing she had TWO different bacterial infections (staph and serratia), which they later told me were the reason why Lexie's stitches burst.  Furthermore, not only was Lou sent home with the wrong antibiotics for her type of bacterial infections, but she was also sent home without an E-collar to protect her stitches, even after I specifically requested one!  (The vet tech, Amanda, told me that they "generally don't think an E-collar is necessary" and added that "it may get in Lexie's way as she tries to find her way around the house.")

So, I really wasn't THAT worried about cost at first, but every time I asked a doctor for an estimate over the phone, I was told that they "didn't have one yet."  I started to get a little concerned when I learned that Lexie's surgery was being pushed back another few days AND Dr. Kennedy was recommending she have a mastectomy.  I specifically told Dr. Kennedy that I wanted an estimate so I could decide whether or not I could afford to have the mastectomy performed at this time.  Dr. Sawyer told me yesterday that Dr. Kennedy had spoken to Administration, and they had given him the go-ahead to discount Lexie's services.  She said that he was going to "crunch the numbers" that night, then call me with a cost estimate for everything today.  She also said, "Believe me, we're doing everything we can to help you out, so you don't have to worry...."  I truly believed at that point that I would end up owing maybe $1000-1500 when it was all said and done, which is still a lot, but I was trying to stay realistic.

Well, I waited all day today, but never got a call from anyone at MedVet.  So, I called a little before 6:00 p.m. to find out what was going on.  After all, Lexie's surgery is scheduled for tomorrow, and I didn't want them to perform the mastectomy if I can't afford it.  Mind you, I have NO money left.  The only way I'm able to "pay" for this next surgery is because my brother, Zach, was kind enough to open a Care Credit account for me to use (I was turned down for one).  His credit limit is $3000, but, like I said, I was pretty confident that I'd only need about half of that.

Well, I was wrong.  First of all, Dr. Sawyer said that Dr. Kennedy had a family emergency today, which is why he didn't call me.  He told her to tell me, though, that the estimate for Lexie's surgery, AFTER the discount, is going to be around $1800!!!!  That includes the mastectomy, but does NOT include the charges that have accrued from Lexie having to stay there for so many nights.  Dr. Sawyer said the balance for Lexie's care and overnight stays so far was at around $1400, but she also said that a discount has not been applied to that amount yet.  Even so, Lexie still has to be there for two more nights!

I told Dr. Sawyer that I was expecting to not have to pay more than about $1500 TOTAL because everyone has been telling me this whole time not to worry about the cost and assuring me that Administration was going to "help me out."  I also explained to her that I HAVE to stay under Zach's $3000 Care Credit limit, to which she replied by assuring me that they'd do all they can to keep my total under $3000.

REALLY?!?!?!?  Gee, THANKS!!!!!!  I know that $3000 must not seem like a lot of money to these doctors or the big wigs in Administration, but that's almost two whole months' salary for me!  How can they not take into greater consideration the fact that I just paid MedVet $3500 (thanks solely to the generous donations of others) last Tuesday, plus a $1250 deposit a couple nights before that, AND I paid them around $1000 during two separate visits prior to Lexie's enucleation surgery?!?!

Seriously, I cannot freaking believe they are acting like they're doing me a favor by ONLY charging me another $3000 to repair her incisions, which never should have opened in the first place!!!!!!  WHY did they send her home one day after her surgery before they even knew the type and extent of her infection, especially knowing that infection sometimes causes incisions to pull open?

Ladies and gentlemen, I am not happy.  I'm in shock.  This can't be right, can it?!?!  I keep thinking that this additional 7-night stay and need to perform an additional eye surgery could have all been avoided if the vets had simply kept Lexie there for a couple of days while awaiting the results of her bacterial cultures.  I am SO disappointed right now because I truly do believe that MedVet provides excellent medical care.  Therefore, it's such a shame that my opinion of them may now be tainted due to their inability to accept more responsibility for all of this.

Still on Schedule...Still No Estimate

I just got a call from Dr. Sawyer, the doctor who's name I couldn't remember from my previous post, but there's nothing really new for me to report.  Lexie was really good when they changed her bandages yesterday, and the wound still looks good.  So, as of now, her surgery is still scheduled for Wednesday.

Dr. Sawyer then told me that Dr. Kennedy has spoken with Administration about my bill, including the cost of performing Lexie's mastectomy while she is under anesthesia on Wednesday.  She said that Dr. Kennedy is going to "crunch some numbers" tonight, and then call me with an estimate in the morning. 

In the meantime, I don't think Wednesday has ever felt so far away...

Surgery Pushed Back to Wednesday

After crying off an on all day yesterday about the fact that I'll have to wait until probably Tuesday to pick up Lexie (I miss her so much it hurts), I found out today that I probably won't be able to pick her up until at least Thursday.

The reason I've been so upset about not having Lexie home with me, despite knowing she's receiving excellent medical care right now, is because I feel like these first couple of weeks after having her eyes surgically removed is a very important time for me to BE THERE for her, and I'm not.  She awoke from her surgery to a pitch black new world, and instead of learning how to re-adjust to her daily routine with mine and Justin's help and love,  she has spent these last couple of weeks either in a car being rushed to the vet or locked up in a kennel for observation.  Besides the 11 hours she was actually home, her only interactions have been with unfamiliar doctors and vet techs.  It breaks my heart to think about how confused and alone she must be feeling right now.  She's probably wondering why she hasn't heard mine or Justin's voices in so long and wondering where her sisters are.  

However, I'm trying not to dwell on such thoughts too much because I do realize it's actually a very good thing that they've pushed back Lexie's surgery.  The doctor I spoke to this morning (I forgot her name) said that Lexie's infection has cleared up a lot since we first brought her back in last Thursday night.  Apparently, her staph and serratia infections were much more extensive than I had realized, but the doctor said that the wound looks much better today.  She said she even took a picture of Lexie's wound and sent it to Dr. Kennedy, who agreed that the antibiotics appear to be working nicely.  Therefore, they've decided the best plan of action is to wait another couple of days to continue to allow the antibiotics to do their thing and clear up the infection as much as possible before repairing her incision, which will probably be on Wednesday.  (Remember, these infections were the reason why Lexie's sutures pulled out, so the less infection present in the wound when they sew her back up, the more likely the wound will stay closed this time.)  Therefore, even though I'm bummed that I have to wait even longer to pick up my Lou, it's nice to know that the vets are being extra cautious this time to ensure that no further complications will occur once I finally get her home.  In fact, I'm trying not to even get my hopes up about bringing her home the day after her surgery because it's quite possible they may keep her an extra day or so, just to be safe.  I probably won't know that until after her surgery, though.  

I also don't know yet whether or not Lexie is going to have her swollen mammary gland removed during the same surgery.  I reminded the doctor I spoke with today about this, and she said she'd mention it to Dr. Kennedy and see if they can get a cost estimate for me.  I hope I can swing it, because now I feel like I just want to have it done so as not to have to put Lou through any more surgeries.  *fingers crossed*

Then, They Brought Up the "C" Word

Dr. Kennedy just called to give me an update about Lexie.  She's doing well.  They cleaned her right eye really well yesterday and bandaged it, but they aren't going to change the bandage again until tomorrow.  If it looks like it NEEDS to be closed tomorrow, they will, but Dr. Kennedy would like to perform the surgery on Monday, if possible.  

Then, he asked me about Lexie's swollen mammary gland and how long it has been producing a discharge.  Excuse me?????  I had noticed her swollen mammary gland for the last couple of years, but I had never noticed a discharge.  I certainly would have taken her to the vet if I had.  My dog, Sam, had growths happening all over her body for a few years, but the vet assured me they were just benign fatty deposits.  Still, I decided to have five of Sam's growths removed  last year (shortly before Lexie had to have emergency surgery for pyometra) just because I didn't want them to get any larger.  I had planned to do the same for Lexie this year, but then all of this happened.  

Anyway, I was not aware that a growth in a dog's mammary gland is a bigger deal than a growth anywhere else on the body, until Dr. Kennedy just told me that.  He said that anytime there is a growth in a dog's mammary gland, there is a 50/50 chance that it will be cancer.  Not only that, but if they were to aspirate her growth right now and the cells tested positive for cancer, then it's cancer; however, if the cells tested negative for cancer, there's still a 50/50 chance that it's cancer.  I asked how much an aspiration would cost, but Dr. Kennedy said that he hated to perform one because, if it tests negative, it's just a waste of money.  

I asked Dr. Kennedy if cancer would have shown up in Lexie's X-ray and/or ultrasound that she just had done recently.  He said that it takes billions of cells for an X-ray to show a 1 cm growth.  So, while it's GOOD that Lexie's X-ray and ultrasound did not show any signs of cancer, it still does not mean that there is no cancer present.  

AWESOME!!!!!!

Basically, Dr. Kennedy just wanted me to be aware of the fact that a mammary growth is not something that should be let go for very long and suggested I have it removed sooner than later, because even if it's not cancer it still needs to be removed.  I told Dr. Kennedy that, after all Lexie has been through lately, I would love to be able to wait until her eyes are completely healed before putting her through another surgery.  On the other hand, now I'm super worried to wait any longer to have her mammary growth removed.  Dr. Kennedy said that he still didn't know what Lexie's current stay and upcoming eye surgery was going to cost because Administration has just told the vets to do what Lexie needs to have done, then they'd discuss my bill.  However, Dr. Kennedy said he was going to go ahead and ask for an estimate of how much it would cost to also remove Lou's mammary growth during her surgery on Monday.  He made it clear that Administration is only going to try to cut me a break on Lexie's eye surgery, so if I decide to have her mammary growth removed I will be charged their regular fee for that procedure.  

So, yeah.  Now there's also the question of cancer to worry about.  It's probably going to depend on how kind Administration is to me in regard to the cost of Lexie's eye surgery whether or not I will have Lou's mammary growth removed on Monday.  Believe me, if I can figure out a way to afford it, I'm going to have it done.  If I can't afford it right now, I'm going to save all my pennies so that I can have it removed as soon as possible.

Will This Ever End?

I swear, if you look in the back seat of my car right now, it looks like I have murdered an animal.  My car is covered in fur and spots of blood, which you can see in this photo.  Bless her heart, Lexie licked that seat almost the entire way to Ohio last night.  Anytime she leaves a spot of blood on the carpet, a pillow, the car seat, or even my leg, she immediately tries to clean it up for me. 

Anyway, I just got a call from Dr. Webb at MedVet (Dr. Corbett is in Cincinnati this week, but Dr. Webb works with her).  Lexie's incision sites did not bleed much through the night, which is good becuase it's a sign she does not have Von Willebrand's disease, but they don't know for sure if she has it yet because her test results still aren't back from New York.  Anyway, Lexie's bacterial culture did come back showing that she's got two different kinds of bacterial infections right now:  staph and serratia, which are resistant to the antibiotics she is currently taking.  I should also add that Dr. Webb believes that these infections may be the reason why Lexie's incisions are pulling.  So, they've changed Lexie to a more heavy-duty antibiotic. 

Meanwhile, Dr. Webb has consulted with their soft tissue surgeon, Dr. Kennedy, who will be repairing Lexie's incision.  Luckily, Dr. Kennedy feels Lou still has enough surrounding soft tissue to make it possible to re-close the wounds without having to perform a skin flap surgery, which is kind of an extensive (and I'm presuming expensive) last resort procedure.

I did ask Dr. Webb about Lexie's immune system because I know it has been weakened by the Prednisone (steroid) she was taking in the 1-1/2 weeks leading up to her bilateral enucleation surgery.  She had been prescribed Prednisone because it was believed that her original disorder, anterior uveitis, was an autoimmune disorder, and Prednisone's function is to weaken her immune system in order to get it to stop attacking her own body.  However, the ER vet on duty last night, Dr. Foust, explained that Lexie's weakened immune system could be a reason why she's having these post-surgical complications and not healing as quickly as we would like.  Therefore, I asked Dr. Webb if there was anything they could give Lexie that would help build her immune system back up.  Dr. Webb said I posed an excellent question, and she would speak to their Integrative Medicine department, which specializes in alternative therapies to compliment conventional treatments and veterinary medicine.  She said they may have some suggestions for improving Lexie's immune system.

On an up note, when I asked Dr. Webb about a cost estimate, she said that she didn't have one yet, but added, "I promise, we are going to do all we can to keep the cost as minimal as possible for you."  She said that I would probably still end up with a balance, but she said she was going to talk to Dr. Corbett and even Dr. Ellis to see what they could work out.  (I forgot to mention that when I dropped Lou off last night, Dr. Foust told me they weren't going to require a deposit this time, which was such a relief.) 

As I was writing this, Dr. Kennedy called.  He said that the fact that Lexie has a staph infection, which is quite extensive, in addition to the serratia infection, is a little concerning.  He said it would be prudent for them to treat this as an open wound for a couple of days in order to allow her new antibiotics to start fighting the infections while they also treat and clean the soft tissues of her wound.  That way they'll be as healthy as possible when she goes into surgery on Monday, or possibly Sunday.  He sounded confident, though, that Lexie is going to be okay when this is all said and done (if it ever ends!!!!).  I asked Dr. Kennedy if HE had a cost estimate, because Dr. Webb had predicted that Lexie would come home tomorrow, but now it looks like Lexie may not come home until next Monday or Tuesday.  Dr. Kennedy said he did not know yet what this will cost, but he said that they are still "working on it," and he'll call me later with an estimate.

Please continue to keep Lexie in your thoughts in prayers, especially for her immune system to regain strength in order to fight the bacterial infections, along with her new antibiotics.  As much as I love the doctors at MedVet, I'm hoping never to see them again after this next surgery.  *knock on wood*