Prologue to The Last Time

I started a post titled The Last Time in the spring of 2016. I wasn't happy with the ending. It was too glib, but I didn't know where to go with it, so I pressed pause on publishing it. Now almost two years of loss later, I'm ready to write the ending. But first, a glimpse into my life since that spring, and some insight into why I've reached a place where the ending will probably write itself.

In late March of that year, my older sister was diagnosed with pancreatic cancer, and my life fell apart. I sobbed and sobbed wondering how I could possibly live through saying goodbye to my first friend in life -- and turn into the oldest sibling -- within two to six months. The irony of having just written a post about the "last time" wasn't lost on me. I couldn't stand to even think about it.   

We received semi-good news though -- her tumor is a neuroendocrine pancreatic tumor, which, at the time, meant a prognosis of three to ten years, based on therapies that were three years old, and new cancer therapies are introduced rapidly now, even though pancreatic cancer research remains severely underfunded. 

Then my husband's sister was diagnosed with bulbar ALS, a strain that begins in the brain and works its terribleness quickly so that within a month of diagnosis, she had to be moved to a nursing home. My mother caught a cold that we all came down with over Easter, except with her lungs comprised by COPD and pulmonary fibrosis, she didn't recover and we found out it had turned into pneumonia when one of her lungs collapsed. She never fully recovered and was gone within three months.

Meanwhile my handsome and loving mama's boy kitty, Ranger Boy, was bravely living with three different diseases of older cats -- one where treatment for one exacerbated the effects of another. After two years, his exhausted heart just couldn't keep up anymore, and we gave him the gift of peace -- eight weeks and six days after my mother passed. Yes, when you lose your mother, you count in days and weeks for a long time.  

And while my mother was sick, I became convinced it was turning into a contest between my husband's mother and Mom as to who was going to leave us first. My mother-in-law was not well, living with several diseases of the elderly humans. Besides diabetes and a heart condition, she had cirrhosis of the liver -- although she had nothing more than a glass of wine on a rare occasion, and COPD -- even thought she never smoked. She wryly quipped that if she'd known she'd come down with those conditions, she would have lived it up a lot more. Nine weeks to the minute after Mom passed over to the other side, my Other Mom joined her there. 

I had taken in my mother's cat, Kitty Elizabeth, several years before when my mother couldn't care for her anymore. Struggling through my grief of losing Mom, Ranger, and my mother-in-law, while trying desperately to concentrate to work in my home office, I would pet Kitty -- who spent the day in her bed on my desk -- and say, "At least I still have you." Until one day I didn't. The tumor that had likely grown from thyroid tissue but was so close to her heart that we couldn't do anything about it grew large enough to start impeding her breathing. Breathing, breathing, breathing, all this death from the inability to draw in enough air to continue living. 

A week later, it was my husband's sister's time. How were we still standing?

But life had more to throw at us. The sweetest cat ever, Kia Pet, was tentatively diagnosed with a nasopharyngeal tumor. She too was struggling to breathe. The surgeon at the veterinary internal medicine clinic was optimistic though that it was a lymphoma and could be treated with an easily tolerated chemotherapy regimen. He needed to get a sample of it though, to confirm. I didn't want to put her through uncomfortable procedures for my sake, but he talked me into the surgery, saying it would be minimally invasive and he would absolutely do it for his own 15-year-old cat. When he called after the biopsy, he had incredible news. When he tugged with tiny tweezers to pull out a piece of the tumor, the entire mass came out through the small hole he'd created in the soft palate to reach it. Except for the stalk it was attached to, it was gone. Any chemo would be to prevent it from coming back, not trying to shrink it.

Less than two weeks later he called with even more incredible news. The tumor was benign. Kia had a new lease on life. My joy was indescribable. I called her my miracle kitty. Other than the discomfort she'd been experiencing from the tumor, she was healthy for her age, and we could expect her to live at least a couple more years. Until we couldn't.

I had taken the opportunity of not having to do any caregiving for anyone to go on vacation. When I got back home, I noticed blood in clump of cat urine in the litter box. I mentioned this to Hubs, and he said that he had noticed that Kia had had some bloody urine while I was gone. So on a Sunday afternoon, we were off to the emergency vet, thinking we were going to be treating a UTI. Except that we weren't. The emergency clinic had a handheld ultrasound wand and they thought they were seeing something, but couldn't get a clear enough image. When I got Kia in for full abdominal ultrasound with a radiologist later that week, it showed two masses in her bladder and several spots that indicated more masses were beginning to develop. Metastatic bladder cancer. Less than a month after receiving the news that her nasopharyngeal mass was benign. From the highest of highs to the lowest of lows. It still hadn't been a year since my mother had passed. 

In between the discovery of the bloody urine and the official cancer diagnosis, Evilbaud laid me off. I couldn't thank them enough. I had the gift of time -- finally. It was still a blow though, and a huge financial worry with a sick cat whose meds were running about $100 a week. 

But Kia and I hung out on the couch together and I looked for jobs in between our naps. I threw myself into being her caregiver, managing her pain and encouraging her to eat, and peripherally noticed that Oliver Jackson, who had a permanent cold from the cat herpes virus, was sneezing more and more and getting worse. The Convenia shots that had always worked in the past didn't take it down. I got some antibiotic eye drops so the antibiotic fluid would also go into his nasal passage, something that had worked for my sister's cat. That didn't help either. 

I had an annual appointment scheduled for Molly Badger, but Oliver had become so lethargic that I brought him in instead. The news was dire. He was actively dying. As it turned out, he had end-stage kidney disease. This seemed impossible. I'd brought him in for his annual senior check-up sometime in June, squeezing him in around Kia's multiple appointments.Then I remembered walking out thinking that was the fastest physical I'd ever been through with a cat and wondering why it had gone so quickly. I had to take an appointment that worked around work because of all the time I was missing and had missed and didn't get either one of our two usual vets. This one never asked if I wanted to do a blood workup.  

I would absolutely have done a blood workup on him. I was expecting to. I had reached caregiver overload and needed the expert to remember to do her job completely, not rely on me to remind her. The vet tech could see in the chart that neither box was checked for the blood work. In particular, "refused" was not checked, which meant I was correct that I had never been asked.

They gave Oliver fluids and sent him home with us to see if he'd turn around -- more likely to give us the night to say goodbye. I slept all night curled around him. He perked up but by morning was fading again. The only medical option was to put him in to the critical care unit at the internal medicine facility and start pumping fluids to flush his system in a effort that would take several days and had a low chance of success. His kidney levels were literally off the charts high. We opted to let him go, peacefully in our arms. I'll never get over feeling like I failed him. Losing him before Kia, after her diagnosis, was just wrong. 

And then of course, the day came when we came to that most difficult of decisions for Kia. She lived about 10 weeks from the day of her diagnosis, which was longer than the initial prognosis. The oncologist had told me that when she got very uncomfortable urinating to let him know and he could prescribe an anti-spasmodic that would probably give her a couple more months, since her main tumor wasn't in a location where it would interfere with urination until it got very large. To me, it was just postponing the inevitable while putting her through the stress of yet another medication. I'm sure I only got the pain and anti-inflammatory medications into her because she wasn't feeling well. She was truly the sweetest cat ever, but try to medicate her orally and scenes from The Exorcist came to mind. The glasses I wore while medicating her still sit on the secretary where I kept her meds, spattered from the times she managed to spit back at me what I was trying to carefully insert into her cheek pouch. I can't clean them. I just can't. It would feel like wiping her from my life. Just like the nose prints from Kitty on my office window. Someone else can wash that window, but I cannot. 

...to be continued    

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