Friday, August 15, 2014

The Gift

The last four weeks have been a blur.  Back in July, our dog Asha had started showing symptoms of kennel cough. We had taken her to a self serve pet wash and a pet store, three days later she started coughing. We assumed she picked up a virus. She coughed for a couple days and we took her to see our vet. While in his office, Asha didn’t cough a single time. The vet listened to her lungs and believed she had a mild kennel cough that should resolve on its own. A week later, Asha was still coughing and it was getting worse. I called the vet and he prescribed an antibiotic and cough suppressant. She took those for one day and got significantly worse. Her breathing went from a dry, hacking, deep cough to a wet, raspy, shallow cough. Within a day she was laboring to breath. I still don’t really understand how we got from there to here. I finally had the chance to reflect on those first days and all that has happened. I see how Asha continues to teach me things about hope and life and love.

I remember thinking that we would go back to the vet, Asha probably had pneumonia, they would take  some xrays, prescribe a different medication and that would be it. When the vet came into the room to review her chest xrays, he looked at Asha with worry. I was surprised when he told me to get to the 24 hour emergency veterinarian, because Asha needed to be hospitalized. There are several of these types of facilities in the Portland Metro area and he wanted to know where we would go so he could call and prepare them. I chose Columbia River Veterinary Specialists because they were 10 minutes from our house (I believe that decision saved Asha's life,I don't think we would have gotten the same care anywhere else). Our vet didn’t typically refer patients there because it was further away from his office but said he would call them. I told him that we would go wherever he felt Asha would get the best care and if after talking to CRVS he didn’t feel like that was it, he needed to tell me.

The vet came back and told me they were expecting us at CRVS and suggested I be sure to keep the air conditioning on during my drive (in order to keep Asha as comfortable as possible). It was rush hour and the drive took forever. I know the gravity of the situation had not sunk in. I remember thinking about the words the vet used – severe bacterial pneumonia, suspicious nodules….these sounded serious. But how could that be? Just a couple of days ago, she was relatively fine.
We arrived at CRVS and they had Asha on oxygen almost immediately. They started IV fluids and medications. Trevor and I left her there for the night – we figured it would be easier for the staff to give Asha the best care without us there. She had been in the ER overnight as a puppy, when she had her first seizure. After she recovered that night, she barked until we picked her up in the morning. I honestly expected it to be the same way this time. I called and checked on her before we went to sleep and then again during the night. I thought I would call in the morning and they’d say she was better and come get her because she won’t shut up! That didn’t happen.

When I called in the morning, the doctor said Asha wouldn’t eat and asked if I could come over and help them. Again, I still expected I would get there, feed her, and we would come home later in the day. When I arrived, I was shocked. Asha looked sick. For the first time, she really really looked sick.
Asha was born deaf and blind, she has epilepsy and anxiety. She navigates the world well and it has taken us her entire life to get to a good place with her. But she still decides what she will and won’t do. Being in a strange place, with strange people, is not okay with her. She would not go into a kennel and she wouldn’t settle down when left alone. The staff at CRVS had taken the door off a kennel and made a big bed for Asha on the floor of the Intensive Care Unit. Then, someone sat with her almost all night. I was happy to take over that duty. When Asha was younger, I slept on the bathroom floor with her…for months. So this was familiar to both of us. Asha leaned in to me for comfort, just as she has since the first day I met her.

Asha wouldn’t eat. This was a problem because she couldn’t take her medication, so they started giving them to her by IV. The goal was to get her breathing under contol. I decided I would stay with Asha all day. I was able to do my work from there and it made us all feel better. The staff welcomed this.

As the day went on, Asha’s conditioned worsened. Then things got even more serious. I met with the doctor late in the day and she told me that Asha’s digestive system had shut down. Her stomach was not emptying and was filling with fluid. This was a problem because she could burp up that fluid and aspirate or breathe it in. That would make her pneumonia and breathing worse. If her stomach didn’t start to empty they would have to put a tube down her throat to suction out the fluid. They had started her on medication to get her digestive system re-engaged. Hopefully there should be movement within 24 hours. 

I remember calling Trevor and telling him this in a matter of fact tone, but feeling complete and utter disbelief. What the hell was happening here? Asha had been in the ICU for 24 hours and there was no talk of going home. Her health was going in the wrong direction. How was that possible?
Trevor and I decided that I would stay the night with Asha. She wouldn’t do well on her own and we wouldn’t do well not being with her. I don't remember us even discussing it. We had come home for about an hour to take care of our other dogs and when we headed back to see Asha, I had my pillow with me. I laid awake all night on the floor of the ICU willing her to get better. The next morning, the vet felt like she would have digestive function by the end of the day – the medication seemed to be working.

As the day went on, there seemed to be no improvement in her breathing. I was so focused on the moment that I wasn’t really thinking about the fact that she had been there for almost 48 hours and there had been zero improvement in her condition. They had been pumping her full of oxygen and medications and she wasn’t getting better. Then Dr Seekins (I called her Dr Megan in prior posts – up to that point we had seen so many doctors and I didn’t know any of their names, instead we referred to them as “blonde doctor”, doctor with curly hair who checked us in” and “Dr Megan with the cool tattoo on her forearm”) came in to talk to me. It was during this conversation that I realized the graveness of our situation. I wrote about that in my previous post HERE.

Asha had the diagnostic procedures and we felt like we had some better answers. I was hopeful we could start to make progress. Then, she had her seizure. I look back now and know that I was fortunate to have been there when it happened. There were no staff in the room, they were tending to other patients. I realized Asha was having the seizure, I called out for help and within minutes the nurses and doctors were treating her. When the nurses came in, I got up and out of their way. I sat down in a chair in the corner. I didn’t freak out, I didn’t cry. I texted Trevor and then closed my eyes. I could hear them working on Asha and I summoned every ounce of positive energy from the Universe. I wanted to fill the room with hope and life force.  At the same time I wondered how much worse it could possibly get. When  was it going to start to get better? Was it going to get better?

After we got Asha’s breathing under control, we sat and talked with Dr Miller about our options and what things could go wrong during the night. We discussed that Asha’s breathing could again become unregulated and they may not be able to get it under control. In that case the options would be either they put her on a respirator or they let her go. Dr Miller said that Dr Seekins did not think putting her on the respirator would be the right thing to do. It didn’t hit me at the time, but I later realized what that meant. Dr Seekins must have believed there was a real possibility that Asha was going to get worse. Trevor and I decided that we wouldn’t do that if it came down to it and then we looked at each other with all the hope in the world that it wouldn’t come down to that.

I spent that night laying on the floor in front of Asha. I could see her face and could also watch her chest rise and fall. I literally lived breath to breath for the next 12 hours. I watched each inhale and exhale. There was no before and no after. There was only that breath. Once we made it through the night I started to live minute to minute, then hour to hour.

We finally started to see progress. We were 72 hours into our stay. Things had gotten worse and were now getting better. There was some talk of going home now, but it wouldn’t be for a couple more days and that seemed so far away. You would think the time would drag, but it went surprisingly fast. Every two hours Asha was getting medication, trying to be fed, being nebulized, going out to potty.

There were benchmarks. We had gotten through the eye of the storm and were now working the plan. We had reduced her oxygen and then stopped it all together. We started to move her medications from IV to oral. In order to go home, she needed to be able to take her medications…and there were a lot of them….by mouth. We worked on this for over 24 hours and finally had success.

I felt quite a bond to the staff, to the doctors and especially the nurses and techs who spent their time with us. They were seeing me at pretty much the worst moments of my life and I knew they were on my team. As Asha started to improve, her personality started to come out and I could see these people realize how special she is. I could see them start to understand what I had been trying to explain for 5 days….that this dog is my soul. My favorite thing is when others get a glimpse of how amazing she is. That started to happen. I could also feel their hope grow….their hope that she would actually go home. When I felt that, I started to have hope too.

At one point I asked the doctor to go over all the medications Asha was on and would have to take once we got home. She went over the list and I felt like I had been punched in the gut. I had been so focused on the moment to moment that I hadn’t thought about going home and what the next steps would be. It was overwhelming and intimidating. I began to see that getting out of the hospital was not the end…we still had an uphill climb and a long way to go. I tried to be grateful that we even had the chance to move on to this next phase. We would be leaving and Asha was coming with us…alive.
The last three weeks have been focused on making sure that Asha continues to improve. I watch her like a hawk, so concerned that she would go backwards. She has not, she has continued to improve. She's had two sets of xrays, both showing her lungs starting to clear. We are slowly reducing her medications. She has spent time with Dr Hope Valentine, her Chinese Medicine Veterinary. I have no doubt Asha is alive because she was able to be treated with both western and eastern medicine, in a very integrated approach. We are moving forward and that feels so very good.
Asha whole life with us has been impossible and yet there was always somewhere else to go, something else to try. We never felt like we were at the end with her, there always seemed to be another possibility, another hope. I think that is what saved us and what saved Asha. I refused to believe that this was it for her….that this was it for us.  Usually when one of our pets is dying I have a conversation with them about heaven. I never did that with Asha. At one point, I did tell her that if she needed to go, she could go…but I didn’t want her to. I look back and wonder why I wasn’t preparing her for death, because she was on the brink.

My life changed the day I met Asha. I have learned so many things about myself and the world because I have loved her. I feel so lucky that the Universe chose me to be Asha’s advocate in this life. Every time I think I’ve learned all there is, she brings me yet another lesson. Through this experience, I’ve found another part of myself that I didn’t know existed. I’ve seen a strength in myself and in Trevor that is beyond what I believed possible. My bond with my husband has grown deeper through this struggle. I have always known that he and I are a good team, but this really showed me that we can get through dark times as long as we lean on each other and stick together. He is my person and there is no other who could do that job the way he does.

Asha has taught me that when you think it is the end , there is always another beginning. The start of something new. We have started a new journey, along an untraveled road. We will meet the most amazing people and have the chance to expand Team Asha and let more love and light into our world. This is a tremendous blessing. Without Asha, without this chapter in her life, we would not have met Dr. Seekins and her team and what a shame that would have been.

Asha is also teaching me about letting go and giving up control. This is an ongoing lesson, the one that I believe she was sent into my life to teach. It is my nature to want to be in control, to plan, to have the next 4 steps figured out. I can’t do that right now and it is incredibly difficult for me to not know what comes next. We have done more than anyone could possibly do and I must come to peace with that. Asha’s life will continue to unfold the way it should and all I can do is continue to support that in every possible way. However it turns out, I can have no regrets, I can never wonder if we should have done anything differently. I can only have faith that anything is possible and that we have searched to the ends of the earth for her and for us.

I know without a doubt that my life, my world is better because of Asha. This sweet soul was entrusted to me and I to her and that is the most beautiful gift I have ever received.

And so our story continues....

1 comment:

Hyacinth said...

Oh my goodness, I read this post with my heart it possible to love a dog you've never met...and to worry about her so much? I'm so happy that she's on the road to recovery. Please give her some extra cuddles from me and tell her we're sending love and light from California!