Friday, March 6, 2009

Hope for the Future

Whew! I am SO glad to have this Doctor's visit over with. The bottom line is that Dr. Obradovich did another round of chest x-rays on my big goofy girl and they were pristine CLEAR. Yaaaaayyyyy!! Whooooo Hoooooo!! YeeeeeeeeHaw!! I was REALLY stressing going in there. I know that any of these visits can easily bring bad news of lung mets which means moving on to the next stage in the journey. But today was not that visit, thankfully, and I am breathing a big sigh of relief. Next week on the 11th Nova will celebrate her 4-month "ampuversary."

"I'm livin' in the moment and looking ahead to a healthy, hoppy Spring!"

Since we were not buried in snow today (like at pretty much every other visit) I was able to make it to the oncologist's office in under an hour. Nova always finds out some creative way to stretch out in my dork-mobile (minivan) and make me want to turn around and take her picture:

"Now Chrysler was REALLY thinkin' when they put these Great Dane chin rests here on these seats"

The tech came out and we examined Nova together to see if she had developed any more lumps or sebaceous cysts anywhere on her body. They are keeping a little map of her, identifying all her lumps and bumps. Nothing new, so that was one less thing to worry about. We took her back to get her on the scale and discoved she had GAINED another 3 lbs (up from 113 to 116). This was really cool, since Nova has always been so skinny, and was extra skeletal after the amputation. Now the trick is to keep her from gaining too much weight, since she has a lot to support on her tripod leg. She's been eating great, eats twice a day, grain-free Evo kibble for the most part. I have cut back on some of the Evo canned food, serving it only every day or two, just to save a few bucks.

The tech took Nova back for the x-rays and of course I sat there and prayed the whole time they were gone. I prayed for good news of course, but I also prayed for the strength to be able to handle bad news if that was what came of it. The tech came back out about 20 minutes later, with no expression on her face. All she said was, "I need to put you two into a room." Oh boy, hearing that made my heart sink, because getting put into a room usually means bad news there. She took us to a room, and I looked at her expectantly, and for some reason she didn't make eye contact with me (you can tell I really like to over-analyze situations), just said that Dr. Obradovich would be in shortly and left. Argh. Tears started to well up in my eyes, since this was the same tech that burst into the waiting room all bubbly and smiley with the good news the last time we had x-rays done.

"Am I okay, Mom? Whaddid the Doctor say?? Any bad stuff in those big pictures they took?"

I passed the time reading all the letters and pictures on a bulletin board in the room. The walls of Dr. Obradovich's treatment rooms are covered with framed pictures of patients, thank you letters from pawrents, and such. As I started reading them, I started getting even more emotional. Most of the letters were written after their pet's eventual passing, rather than during their treatment. But they said things like "Thanks for giving me more time to say goodbye" and "Thank you for giving Fifi another 6 years" and such. When you think about it, when people are going through something like this with a pet or family member, they don't always think to say thank you to all of the people who help them along the way during their battle, they tend to wait until the battle is over. It made me take note to remember to give thanks to people NOW, while we are still on this journey. I think that's especially true with Doctors, because in some way we want to wait and see if they can prove themselves, and work miracles first, and then we thank them later. And if their recommendations don't work, I think people tend to blame the Doctor. Anyway, as I read the stories I silently vowed to say thank you to the Doctor, the techs, and to some of the friends I've made on Tripawds who've helped me get through this with Nova.

Dr. O finally came in with a big smile on her face and said, "It's so wonderful that the chest is all clear, everything looks pristine." She assumed that the tech had already told me. Emotion flooded over me, I had just spent the last 15 minutes preparing myself for the worst, and now to hear that everything was still perfect, I STILL got all emotional. This journey is such a roller coaster! Dr. O was all geared up and ready to start talking about next steps. A few weeks ago I had sent her an email on a few treatments I had read about on, so she was ready to discuss. I had my big yellow legal pad and pen, ready to go.

She was gung-ho on metronomic chemotherapy, which is a pill (or in this case combination of two pills) which is a low-dose of chemo, given on a daily basis. Her recommendation was Cytoxan and Feldene (also called Piroxicam), which she said she preferred to the Metacam that I had read about on Tripawds. She said that it might be expensive to purchase the drugs within her office, but recommended I get the prescriptions filled at Costco. (On my way home I stopped at Costco to drop off the prescriptions and was thrilled to find out that the Cytoxan was only $28.31 per month (it was $93.75 at the vet's office). And the Feldene was only $5.59. What a relief!) I was thrilled to find out that oral chemo was so affordable. This was one situation where Nova's weight worked in her favor. Usually, things cost more for giant breed dogs because everything is based on size and weight (x-rays are a nightmare because they have to get several views to get her whole giant body covered). But because she weighs the same as a human, she was able to get human dosages, which are less expensive. Cool.

Dr. O did not strongly recommend Artemisinin, which is a chinese herb I had asked about. I had seen some information on Tripawds that showed that it might be effective, and she didn't argue with me on that, but just said that she had a lot of concerns about purity when it came to herbal treatments, especially coming from China, where there has been some bad press about ingredients in tainted dog food (I'm assuming she was talking about all the melamine stuff). She is not against alternative treatments, just doesn't recommend them unless she can trace the source of each ingredient, and feel comfortable that it is safe and pure. It was nice to hear her say that if I decided to try it anyway, she would not object, just that it wasn't something she would do if it were her own dog. Okay, I can respect that. I still don't know how I feel about some of the herbal treatments, personally I am quick to try different herbs for myself personally, without really researching the source of the herbs, purity issues, etc. Guess I never really thought much about it.
She did mention something about turmeric (the spice), had been proven somewhere to increase cancer cell death, and if she or her dog had cancer, she might be inclined to try it. I'll have to ask some of the people on Tripawds about that. She recommended I start Nova on Omega-3 Fish Oil capsules, which I got at Costco. And she also recommended something called CAS Option, which is some kind of multivitamin for cancer patients. I still have to look into an affordable source of that, obviously buying anything in her office was going to cost too much.
The oral chemo will require monthly CBCs at first, which I can have done much more affordably at my regular vet. Costco won't have the prescription ready til Monday, so I will have the bloodwork done on Monday, have them fax the results to Dr. O, and provided everything looks good, will start her on the medication.

I left the office feeling REALLY good, and very hopeful about Nova's future. I so much want her to live through another summer of summer runs and a fall cross-country season, where much of her social life is. Two years would be even better! Dr. O reminded me that the best results she had seen had come with amputation plus 4 doses of carboplatin, which averages 351 days survival time, but if the dog makes it a full year then they have an 85% chance of making it a second year. This is really good news considering we are talking about 1/4-1/3 of her entire life! Really exciting. Dr. O has seen complete cures about 20% of the time (rare with osteosarcoma) and in some cases where there wasn't a cure, dogs made it 2-3 years. Awesome! I hope to be keeping this blog for many months to come (maybe years!)

It was particularly wonderful to find a nice sunny sky when I left the office, and 63 degrees. Nova danced out to the car with her silly hop, and I felt like dancing right behind her. We got in the car and my satellite radio was blaring that song from “Rocky”. YEAH! It sounds corny, but it was inspiring. WE ARE KICKING CANCER'S @$$!!! I decided to break up the ride home and stop at Kensington Metropark to take Nova on a short walk to sniff the Spring air. We followed the "Handicapped" path, which is the quickest, flattest way to the lake from the parking lot. She ambled out onto one of the fishing docks to sniff around.

"Big fun! We get to go for a W-A-L-K at the park!"

The park was quiet and deserted, definitely a perfect setting to just enjoy the beautiful day with my big girl. We had a good time, this was the first time that we had gone outside and spent a lot of time together. Usually she's such a house cat, and with all the cold weather, she hasn't had much interest in staying out long. But today was different and it was great to get her out and about.

She did great on the paved path, but was a little nervous walking out onto the dock, I think it must feel a little unstable when you hop on it.

"Spring makes me feel very, very hoppy!"

"Sometimes it's nice to just stop and sniff the air and let the wind blow your ears back. Ahhhhhhh!"

"Mom and I have very high hopes for 2009 and will continue to kick cancer's @$$ together!"

Nova got creative with a variation of the chinrest pose on the ride home. I can't believe she is actually comfortable sitting like this! That's my goofy girl!


OKim1 said...

This is wonderful news for Nova! I am so happy that her x rays were clear. It is a sigh of relief and great to hear some good news for a fellow tripaw. A very Happy Spring to you! Your a lucky girl!
Kim & Buster xoxo

Jerry G Dawg said...

WOW! Awesome visit, fabulous news!!!!!!

Your oncologist sounds really wonderful, I would feel comfortable with everything she advised. I'm especially thrilled about the inexpensive meds at Costco, we had no idea. Thanks for letting us know. If at some point you remember, be sure to spread the word about it on Tripawds.

What a glorious day, both weather wise and news-wise. Life doesn't get better than that. Congrats!