Friday, July 25, 2014

Asha fights for her life

It is 12am on Thursday and I am laying on the floor in the ICU of our local 24 hour emergency veterinary hospital. I am face to face with our dog Asha, who is also lying on the floor, watching her breathe. I'm not sure if this is the end for her or if it will be just another bump in the road. I have spent the last 48 hours pondering that question and trying to come to terms with whatever way things may go.

12 hours earlier, Dr Megan, came and sat with me and Asha on this same floor and told me that we were at a crossroads. Asha was seriously ill and she was not getting better. Despite a very aggressive protocol to treat what presented as pneumonia, Asha was showing no improvement. It was time to make some decisions. We talked for about an hour. Up until that point, I was hoping that Asha would get better, that she would respond to the endless barrage of antibiotics, pain killers, airway dilators, IV fluids and oxygen. This was the moment when I couldn't hope anymore. Reality hit me in the face.

Asha's chest xrays looked like a tree in a snowstorm. Her lungs were full of white, there were nodules of white. All of this is abnormal. A chest xray should look like a tree in the dark night. All that white was mucus, inflammation and/or infection. All of that white was suffocating our girl, taking away her breath. She has been struggling to breathe since Sunday night. We visited her regular vet on Monday and when he saw those xrays he said "we are transferring you to the 24 hour emergency vet, there is no time to wait". We had been there a week earlier when Asha has started with a dry hacking cough. It was so minor that she didn't even do it during the visit. He listened to her lungs and they sounded fine. The diagnoses was kennel cough and we were going to keep an eye on it. A week later Asha started to struggle to get comfortable at night and the next night her breathing started to sound crackling and bubbly. Her cough was no longer hacking and dry, but shallow and wet. Within 24 hours she was struggling to breath. The vet seemed as surprised by it as I did. The urgency and seriousness in his voice concerned me. I drove as fast as I could (in rush hour traffic) to get to the ER.

Now, here we were 48 hours later, trying to decide how to save our girl. There were really two options. The first was to perform a bronchoscopy and CT scan. They would put Asha under anesthesia and scope her lungs. They would take samples of anything that looked unusual and send it to the lab. Then, a CT scan would be taken for a more complete view. This would give us all the diagnostic information possible to see if Asha's lung issues were being caused by either bacterial pneumonia that was just not responding to the broad antibiotics, cancer, an autoimmune inflammatory disease or something else. It would allow us information on how to treat her situation. The other option was to let her go. She wasn't getting better and couldn't breathe on her own.

Dr Megan looked me in the eye and told me that we had to make a choice. She said that we also needed to know that the procedure has risk because Asha would go under anesthesia and with her strained breathing, that was risky. Dr Megan said "there is a very real possibility that she will not survive the anesthesia and you need to prepare for that". She also told me that we needed to go into that choice with no regrets, knowing that we had to make a decision because she wasn't getting better on her own.

I knew what our answer would be, but I had to call and check with Trevor. Dr Megan left to go put together an estimate. My quiet tears turned into loud sobs as I digested the information I was just given. I was laying on a pile of blankets in the ICU room. Asha was laying in my lap. There was one other dog in the ICU. His name was Hunter. He had been there since Sunday and just doing so well. His mom was there visiting him. She was so happy about how well Hunter was doing and she got to sit there and listen to me get this most awful news. She then got to listen to me cry. The ER vet is a tough place to be.

I called Trevor, told him what we had discussed and we agreed we really only had one decision and that was to do the procedure. He was going to leave work and head straight to the hospital, He hoped to arrive before they took Asha to the procedure, but said not to wait. I told Dr Megan we were set to proceed. She told me that she was 100% in and she wanted us to be 100% in too.

During our earlier conversation, I attempted to convey our relationship with Asha and her place in our family. I explained all we had been through with Asha and all that she meant to us. Dr Megan said she had spoken with Dr Pachel, Asha's Behavioral Vet, earlier in the day and he was explaining to her the bond between Asha and us. I finally said to Dr Megan "Asha has to live". She assured me that she would do everything she possibly could to make that happen.

The procedure was scheduled for 3, Trevor arrived shortly before that. It actually began at 4. During the time between when I spoke with Dr Megan about our options and when they took her back for the procedure, I sat in the room and tried to understand what this all meant. I wondered, if this was all we got with Asha, just these three short years, would it have been enough? Did we do all we could, did she experience all the things she wanted, all the things we wanted? What would it mean for us to go on without her. I am Asha's mom, Trevor is Asha's dad. I can't imagine a life without her. For those few hours, I tried to imagine it and it was more than I could handle.

Earlier that day, when we started to realize that this wasn't just a  little thing, we started contacting those closest to us and those most involved in Asha's life, to let them know what was happening. We are always very active on social media and so many people follow Asha's life through that. I didn't want Asha to die and have to share the unexpected shock of that. I also wanted every God that was believed in to be prayed to, I wanted every positive thought, energy work or mediation to be given towards Asha's healing. I wanted the Universe to be alive with love for her. I wanted her to be lifted up and surrounded by everything good, kind and right with the world. That meant that I need to let everyone know.

When they took Asha back for her procedure, Trevor and I went into the comfort room and I wrote a post detailing what was happening. Our phones and computers lit up with all the things I had hoped.

Asha came out of the procedure fine. They felt they could rule out cancer and were more likely to lean towards other causes, but we would know nothing for at least a day maybe more. Asha's Chinese medicine vet, Dr Hope Valentine, came up to provide some acupuncture therapy. They added some additional antibiotics, I stayed with her for the night and Trevor headed home.

Asha was laying next to me, resting calmly. Then, she sat up, rolled around for a couple seconds and I realized she was having a seizure. I called for help, the nurses and doctors came. They worked on her, the doctor telling me this wasn't a set back, a seizure after that procedure with her history was not unexpected. I texted Trevor and he headed back to the hospital.

Asha came out of the seizure and her breathing was erratic. It would not calm down, she could not get it under control. Either it was left over from the seizure or she had breathed in some vomit or fluid and made her pneumonia worse. If it was just the seizure, a sedative was going to slow her breathing, if she had breathed in something and her condition was worse, the sedative wouldn't work and we would probably lose her.

They gave her the sedative and said it should work within 5-10 minutes. I put my hands on her body and said the Lord's Prayer to myself. Over and over. We all sat there watching to see how she would respond. Within about 3 minutes, her breathing slowed. We turned up her oxygen and settled back in for a long night.

Trevor needed to go home, he had work the next day. Before he left, we sat with the doctor and discussed all the possible scenarios and what our decisions would be in those cases. That way I could make the decision without having to check with Trevor, giving Asha the best chance to survive.

Trevor left and we both knew that Asha was in big trouble. She couldn't seem to catch a break and we both felt we were exhausting her options. We were heartsick. I could see it in his eyes and that is why I love him so very much.

The staff at Columbia River Veterinary Specialist have been amazing. They have been so supportive and complete with Asha's care. They have been honest and open about our options and the consequences.  The first night we arrived, Asha was belligerent and wouldn't allow them to put her on oxygen or put in an IV. I remember thinking that she was going to die because she wouldn't let them help her. When they realized she wouldn't go into a kennel without going nuts, they made a bed for her in the middle of the floor. When I decided after the first night that I didn't want to leave Asha's side, they made me a bed right next to here's. Every night, they walked around me while I tried to sleep next to Asha. They would turn out the lights in the ICU when they could and turned on soft music to keep the other noises out. If I wasn't there, Asha would get up and be restless, so it was better for them, me and her recovery for me to stay close. One nurse brought me lunch, another gave me some of her food. They have told us over and over how welcome we are to be here and how happy they are that we can be here. I appreciate that I don't feel like I am a bother or like I am in the way. They have welcomed input from the rest of Asha's team, all her doctors. I know we are in the right place and that everyone is working towards the same goal....a healthy Asha.

We had two of Asha's favorite people come to visit on Thursday morning. At that point we weren't sure Asha was going to make it through the day. Tamara, Asha's friend and pet sitter came first, Asha was thrilled to have some awesome belly rubs.  A little later, our friend G came. Asha is in love with him and couldn't get close enough. There were many tears during these visits. These were very special moments when I had the chance to see what effect our girl has had on others. It was incredibly moving and I will carry this in my heart always.

It is now Friday. We have been here since Monday. Asha is doing better, She is breathing on her own, eating on her own, drinking on her own. We have some initial results back and think we know what is causing her illness. The doctors all suspect it is eosinophilia. Basically her body is attacking her lungs. We don't know why, but we are starting to treat it. I have lots of questions for the future, those answers will come. We have to get her self sufficient enough to leave the hospital. That will probably happen tomorrow. We will have a plan and go forward. I feel good about the fact that we have hope again. There was quite some time here when I thought I would leave this place without my girl. I don't think that will be the case. I look forward to leashing her up and marching her out the doors we came into 5 days ago. I love this girl and have never taken our days for granted. But now we really won't waste time. She's never touched the ocean. That's first on her list, so we'll make that happen.

We've seen a lot in this place during the last 5 days. While we have been dealing with our crisis, we have seen others dealing with theirs. We've seen some animals come and go home, we've seen others who didn't make it. I have seen these doctors and nurses care for their patients with an amazing amount of love. They talk to the animals the same way their owners do, in soft, funny, baby voices. They are kind, even when presented with belligerent difficult animals. They answer endless questions. They come in on their days off and check on their patients. I don't know how they do it. There is a lot of sad stuff going on here. I have also seen their joy when a dog who they didn't think would walk again starts to walk. I see their joy when Asha starts to eat on her own. They are rooting for every one of these creatures and they balance that with the ability to know when enough is enough. That is perhaps the greatest measure of compassion. They have cried with us and cheered with us, laughed with us and been concerned with us. Asha's team has just expanded exponentially and we are incredibly blessed.

The story doesn't end here. There will certainly be more to come. Stay tuned and thanks for loving our family.

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