Monday, August 16, 2010

The Dog Days of Summer

It’s been a long difficult summer at our house and not just because the heat and humidity have been so bad, each time I walk out the door the phrase “Is it soup yet?” comes immediately to mind.

Our first summer challenge was the absurdly long, painful recovery from the spine surgery I had at the end of April. To be honest, the recovery was as much from the injury I sustained a week after the surgery as it was from the surgery itself. Much to my dismay, I still have a long road ahead but I am indeed moving in the right direction.

But, more painful for me than any injury or illness from which I’ve had to recover, has been the last month during which my service dog Stone has been critically ill. It began in July with a severe GI problem that was eventually diagnosed as something called HGE. Each vet we’ve seen along the way has felt it necessary to tell me how often dogs die from this because they don’t get to the vet right away. Call me overprotective or hypochondriacal-by-proxy, but, we have a general rule at our house - whenever we see blood literally pouring out of our dog’s hind quarters, we rush him to the vet. Crazy us, I know.

The first two days he was at his regular vets with me laying on the floor next to him for much of the time. In the evening of day two, he was transferred to an acute care doggy hospital. While there, he was diagnosed with a heart problem they hoped was just a transient consequence of the physical stress of being so ill. It seemed the most plausible explanation to the abnormal EKG and ECHO cardiogram because at the end of his very thorough vet exam in late April, his vet said Stone was so healthy he was 2 – 3 years younger than his chronological age.

My Mom’s intuition had actually picked up the heart problem on Thursday morning before the vets even did, but they thought his pulse was fast just because he was in pain. Unfortunately, it was a lot more complicated than that. As it turns out, sometime’s Moms do know best. (Editorial note: if anyone tells my Mother I wrote that, be assured, I will deny it.)

His GI problem has since cleared up but sadly, his heart problem remains. After two trips to a doggy cardiologist at Ohio State University’s Vet Clinic, Stone’s been diagnosed with something called Dilated Cardiomyopathy. Apparently, it’s genetic but it doesn’t express itself until adulthood. The GI illness was the catalyst that kicked it off.

It will lead to Congestive Heart Failure. How quickly that will happen is unclear. The OSU vet’s best I’ve been doing this for a long time guess is that it won’t be for 6 months. It could be longer or shorter; I vote longer.

This week the vet started him on meds that have been shown to be cardioprotective and, as per the vet’s recommendation, we’re switching him to a special food made for dogs with specific heart problems. The food contains all the natural supplements I’ve been reading about on wholesitic vet websites, much to Stone’s relief, as he wasn’t looking forward to Mom force feeding him all kinds of weirdo-hippy-supplements that undoubtedly come in horse pill size capsules. The hope is that the meds, natural supplements and special food will slow down the progression. Sometimes they do and sometimes they don’t. The vet can’t really predict life expectancy until we see if Stone responds well to them.

Happily, we have a lot of things working in our favor. The OSU vet is apparently one of the leading doggy cardiologists in the country. He has the wisdom and intuition that come from years of experience and because he’s a professor as well as practicing vet, he’s up on all the latest research findings. In addition, we caught it at the very earliest stage which increases the likelihood the medication will be helpful. Plus, the bond Stone and I share is so strong I will hopefully notice the onset of new symptoms, warning signs or medication side effects when they occur. The vet said Stone will need frequent vet appts and regular EKG and ECHO cardiograms to monitor progress so he can make appropriate medication adjustments. Clearly, I’ll make sure he gets all of those. In the vernacular of health care professionals, we will be VERY compliant patients.

On top of all of that, Stone has a very special factor working in his favor. As soon as we get the results of his Holtor Monitor (24 hour EKG) and they decide if he needs medication for an irregular heartbeat, he’ll be cleared to resume his out and about with Mom ‘cause she needs my help life. Even now, I keep “accidently” dropping things on the floor and need him to pick them up for me. Certainly having purposeful activity has been shown to extend healthy years in humans, so perhaps it’s the same for dogs. I’m hoping it is.

He does have some activity restrictions and because he’s my service dog in addition to being a cherished member of the family, that means I have some activity restrictions. Sadly, his restrictions include no more running, which is breaking my heart because watching him run, whether its chasing a ball or running round and round in those wide circles he seems to love, is one of the greatest pleasures in my life - pure unadulterated joy. But, we will find new ways to play ball to be sure, as it’s been his obsession from an early age. Also, he can no longer power walk or go hiking in the mountains, which means I can no longer do those things or if I chose to do them, I run a greater risk of getting hurt without my brilliant service dog there to keep me from losing my balance and falling or misjudging distance and walking into or tripping over things.

Anyone who’s ever loved an animal has some sense of how I feel as I deal with the reality of Stone’s failing heart. Anyone who’s ever met Stone knows how special he is and anyone who’s ever seen me with him or heard me talk about him, knows how much he means to me. Anyone who has a service dog or who spends a lot of time around service dog “teams” or who has heard or read our story has a clearer understanding of the impact this is having on my emotions and my life. And, most of all, the people who have seen the before and after, who remember how impaired I was before Stone spurred on my post brain injury rehabilitation and who are able to contrast it to the life I am living now, well it’s those people who, most of all, truly understand why Stone’s failing heart is breaking mine.

I was partnered with Stone 5 + years after an auto accident left me with a brain injury. In the years that followed my accident, as is too often the case, I sustained additional, less severe brain injuries, and countless bumps, bruises and sprains, because of my impaired balance and depth perception. When I moved to Cincinnati to be closer to family I had to give up my beloved dog Puff, the third Weimaraner I’d had since I was 5 years old.

It was my friend Heidi who first suggested I apply for a service dog. Although I didn’t tell her at the time, frankly I thought she was whacky. (Those of you who know Heidi, know she is in fact whacky, in all the good ways, but in this particular situation, she was actually not being whacky at all.)

At that point in my recovery, I had enough insight to understand that I did in fact have a disability but, service dogs, I reasoned, were for people who have capital D Disabilities and I was quite certain I had a little d disability. I shared Heidi’s idea with my Rehabilitation Psychologist, expecting, (hoping actually), she too would scoff at the idea. She didn’t. Instead, she did that annoying psychologist thing and asked me how I felt about that idea. (Don’t ya just hate when people make you think for yourself.) I told her my theory about little d disability and capital D Disability.

Again, she prompted me to think for myself (annoying!) reflecting back to me the reality of my life as it was then. She said something to the effect of, “Okay, let me see if I understand. When you leave your home you are mostly in a wheelchair. You can walk about as far as the end of the block, not around the block mind you, just to the end of the block. But even that isn’t safe for you to do alone as you too often fall or trip. You haven’t been anywhere outside of your home by yourself since your injury, because it’s not safe for you to go places alone and you have a live in care giver because your balance and depth perception problems leave you at great risk for falling and, when your brain is cognitively fatigued, your judgment is so impaired you sometimes make risky choices so it’s not particularly safe for you to be alone even in your own home. If that doesn’t fit your definition of a capital D disability, I’m wondering what would.”

Point taken.

Flash forward to today. I can not only walk to the end of the block, (when I’m not recovering from spinal surgery that is), Stone and I walk several miles nearly every day. We even go hiking in the mountains on trails marked “difficult terrain”. After years of never going anywhere by myself EVER, Stone and I take the bus, we go to stores and the library and the post office and the park and restaurants and the movies… I never knew how exciting these ordinary, mundane, daily tasks could be.

Not long ago, while waiting at the bus stop with Stone, an old friend drove by and waved. The next time I saw her, she said she wished she had been going in the same direction as we were, so she could have saved me from having to take the bus. While I appreciated her kind intentions, in my head I was saying, “Saved me from HAVING to take the bus??? Try - I’m doing the dance of joy because I’m ABLE to take the bus.”

Because of Stone, not only have I built up the capacity to walk and hike and lift weights and take the bus and, thanks to his help, actually remember to take my medication on time, I’ve also been able to return to doing volunteer work, using not only the skills and experiences my social work background provides, but also utilizing the lessons I’ve learned the hard way from being the client instead of the social worker during these last 15 post brain injury years. When I’m facilitating a support group for brain injury survivors, or speaking at a brain injury conference or providing on-line, in person or on the phone support for a person with a brain injury or someone who loves a person with a brain injury, my own brain injury is actually an asset, because I understand in a much clearer way now. It’s the one area of my life in which my brain injury is value added.

I, as well as anyone I’ve helped along the way, have Stone to thank. It’s because of him that my recovery has been so remarkable I am now able to give back in those ways.

Stone hasn’t just improved my life, Stone has given me a life.

I’m feeling quite nostalgic these days about all the ways Stone has been of service. In the weeks and months to come, I have no doubt that I’ll be blogging more about Stone and our journey together.

I feel so privileged to have this truly extraordinary dog in my life and I’m incredibly grateful that we will have more time together during which I will soak up and relish every ounce of love he has to give. As time goes by, I will become more and more his service human and believe me, I am more than happy to return the favor.