The new chapter begins

Today was the first day in the new chapter of Blue, he had received all of his chemotherapy injections, and returned from a two week stay in the Highlands of Scotland, more on the holiday to follow.

After his final injection of chemotherapy, with agreement of his clinical team at Fitzpatrick referrals Oncology and Soft Tissue (FROST), this visit was the first in a new chapter.

Blue was only ever going to be permitted a number of Chemo injections, between 4-8, that number would be influenced by how he responded to the treatment, and how effective it was on the cancer.

To achieve this visit today is a milestone none of us could foresee back in November, where his life was being counted in terms of coming out of major surgery, to the next hour, the next day, the weekend, the next week, and to this day no further ahead, we choose to treat each and every day now as if it were his last.

We are now living with Blue, who lives with cancer, we have all learnt a lot about ourselves, but more importantly about Blue.

Blues new treatment is now to be in tablet form only, there are a variety of cocktails which will help him live with the cancer, how long for is still unknown, we would like that to be forever, but each day is welcomed and blessed on its arrival.

The medication Blue will be on will consist of 6 tablets a day, this in itself is a game of wits, one that can allow Blue to win the odd battle, but we need to ensure that the days he refuses his medication does not become a habit.

The tablets Blue has taken in the past, have been given in many forms, mixed in with fluids, solutions, foodstuffs and even via a syringe. While we were on holiday Blue had gone from somehow getting the tablet out of the food to under the plate, and when that didn't work, he began storing them in his jowls, as if he was some sort of hamster. Needless to say, a way of giving the tablets is ongoing work in progress, just like a game of chess.

Blue will have to be monitored for side effects, and return in two weeks time for a checkup.

Today was the consultation to discuss the next chapter with Senior Consultant Dr Kelvin Kow, who has been an absolute marvel with Blue, and with us also, we can not sing his praises enough, a credit to his profession.

Blue enjoys a short break, a quick wander out into the carpark

A visit to "FROST" is always an event, and today was no different, this is how it went:-

• Blue was lifted into the car at 9:45 feeling slightly lighter, but with no sedatives
• A journey of just under an hour see us arrive at "FROST" 
• Wearing  his Halti and a muzzle Blue Sue and me were welcomed at reception
• We were directed to the consultation room to await Dr Kelvin Kow
• A number of attempts to weigh Blue confirmed he was around 49 - 50 kg
• Minimal fuss as we discussed the options available for Blue
• Urine sample required for a baseline, this would be fun, out we ventured into the car park.
• Armed with a kidney shaped bowl we sought to gain a sample from Blue
• On command Blue obliged, and Dr Kelvin expertly collected the valuable sample
• We returned into reception, Dr Kelvin carrying said sample, took Blue from us.

At this point it was a terrific feat achieved by Dr Kelvin, walking along with said sample, and an un-sedated Blue, all was going well until Blue realised we were no longer with him. How the good Dr managed to hold Blue, who was making his best efforts to return to us, and not spill a drop amazed all onlookers, eventually he handed the sample to a nurse, and him and Blue disappeared through the doors to the treatment area. 

Sue and I waited for about 40 minutes, until we recognised those familiar sounds of paws on tiles, pulling a heavy load, sure enough, it was Blue coming back with Dr Kelvin, and his assistant.

The reports were good, he was no longer anaemic, and all other counts were where they needed to be.

Blue had become stressed, this was a concern of Dr Kelvin, and said that for Blues next visit, perhaps he should have sedatives, but only 5 not 10 as previous visits. Blue when anxious will not settle and his breathing is very rapid, while we waited for his meds to be prepared, I took Blue on a tour of the reception area, this helped calm him a little but not a lot.

Blue is a beautiful dog, and often receives admiring looks and comments, today was no different, but there were two special ones today.

Blue exchanges tweets with @PawsomeErik, who's Mum works as a Nurse at "FROST"  she popped out to say hi, passed comment that Blue was doing well, and gave Sue some gravy bones for Blue.

The other was from Laurent, the surgeon who removed the mass, which filled Blue's abdomen, Laurent commented on how well Blue was looking, we thanked him for the major part he played in helping Blue.

Dr Kelvin returned with Blue's meds, and was very complimentary, even though it sounds he may have pulled a muscle in his shoulder while holding Blue earlier. We all said that we could do with a rest this afternoon, wished each other well and said good bye until the next time.

Blue waited patiently at the reception desk while Sue paid for todays visit and set the appointment for a fortnights time.

Since we have been home Blue has enjoyed a play in the garden, a bit of rest and then a 30 minute walk.

At the start of this blog I mentioned we had gone to Scotland for a two week break, below are a few pictures of our holiday with Blue, I will follow this up soon with a blog dedicated solely to our holiday.

Blue says "Thank you for caring".

Chemo Session #5 & a CT Scan

Today Blue attended his Chemo session number five, how quick the time goes by. It hardly seemed three weeks that he had his last session.

We have slipped nicely into a routine, learning more each visit and continuing to monitor Blue while ensuring he gets as much opportunity to feel self-satisfied with his life.

This visit is different, Blue is to have a CT scan to see how the cancer is affecting him internally, and for that reason we are a little more apprehensive, but determined for Blue's sake not to show it.

To help approach today in a positive frame of mind we have done things a little different, the buster collar and muzzle were placed in the car last night, it did seem that Blue had began the last session a little apprehensive.

One other thing we did was to take Blue out for a longer drive in the car at the weekend, a visit to Cheddar, where he enjoyed a 50 minute walk around Black Rock Nature reserve. (*more on that later).

Back to today, the morning commenced without breakfast for Blue, only a solitary sardine to help the sedatives go down, still 10 required, after he had a short walk in the local park, to do his business.

We set out for Guildford at 8:15 to make our 9:30 appointment. Soon after our journey began the A329(M) was at a standstill, so we cut though Wokingham, to get to Bracknell. The journey then see the sat nav warn of stationary traffic along the A31 into Guildford, reset the sat nav to follow a diversion, but this was not needed in the end, our journey was completed just after 9:20am

Blue needed scooping out of the back of the car, and attempted to walk through closed glass doors, not waiting for the mechanism that slides them open to operate, safely through those two obstacles we were soon parked in the pod awaiting our call.

The Oncology and Soft Tissue unit of Fitzpatrick Referrals is now a far busier unit than when we first come here in November last year, Blue quickly settled, and only gave a hint of interest when Dr Kelvin and the Nurse came to collect him.

This didn't go exactly to plan, as a few steps away from us Blue turned 90 degrees and planted his bum firmly on the floor, looking straight back at Sue and me. It only took me to walk over to where Blue sat and urged him to walk, and he stood up and walked Dr Kelvin through the door to the business part of the unit, not even a backward glance to see if I was still with him.

Today was a big big day, the CT scan would present a true image of what was going on inside of Blue, we were all going into the unknown. We knew today was going to be a long day but emotionally, how do you prepare yourself?

We chose to stay and wait, not really in the right frame of mind to go into Guildford and look around or drive home to sit and wait, time to sit and wonder, and finish off my book, Cloud Atlas.

A couple of hours later, Dr Kelvin Kow came to share the news, the early signs were very encouraging, the mass that had filled Blue's abdomen was not clearly visible, not gone, but only further examination under the trained eye of a radiologist may pinpoint any current tumours.

This news was far better than anything we could of dreamt or prayed for, Blue was now being prepped for his chemo session #5

I found this news hard to take, saying very little due to the dry lump in the back of my throat, we all three looked at each other and had a small smile, and thanked heaven for this.

Our news could not be shared with Blue for a further 3 hours, in which time several nurses came out to say how good Blue was being and thought how great his news was.

Finally nearly five hours after watching Blue walk out the door, he came back to us pulling Dr Kelvin with him, and Nurse Jen following behind with his med's.

Our destination was to be a consultation room where we were told a bit more of Blue's condition.

The CT scan takes upward of 4,500 images which enable detailed examination in black, white and various greys in-between of Blue

Dr Kelvin was keen to show the images to demonstrate the change that was within Blue. He guided us through how he was now, showing his organs where they were and no signs of cancer affecting the lungs or kidneys etc. We then see the images of Blue pre-op, these were shocking, how large the mass in his abdomen was and how it was pressing on major organs such as displacing one of his kidneys, and placing pressure against the spine.

We were told that there will likely be cancer still within Blue, but for now the treatment was proving effective in subduing it's growth.

Blue has now reached a stage very few dogs achieve, it is unusual for them to get to 5 sessions of chemo, and the CT scans have given everyone a very pleasant surprise.

When we said about it would be nice to give Blue a holiday, but perhaps Scotland would be too far, Dr Kelvin said, why, he will be fine go and enjoy it.

Blue has really been a model patient, and has found a new bunch of friends, he will continue to live for today and enjoy the moments as they arrive.

We have often mentioned Dr Kelvin Kow, and he was kind enough to have his photo taken with Blue and us before carrying on with his busy schedule.

One other thank you is to all the staff both on reception and behind closed doors for the tremendous work they do, looking after the animals and people that come through the doors of Fitzpatrick Referrals.

* Remember a while ago I said we went to Cheddar at the weekend, it was wet, it was cold, it was muddy it was tiring, but it was well worth the trip.

While I have been writing this blog, Blue has had a good sleep in front of the fire and the only sign that is evident of his trip today is the shaving of his port above his hind leg....

Blue has grown a number of followers to his @BluetheGSD Twitter account. He has had toys, gifts, best wishes and prayers sent his way, neighbours ask after him, he is in the thoughts of work colleagues.

Blue is a special dog, we know because we live with him, and those that meet him he will have an impact on and share those same thoughts.

Blue takes what life throws at him and deals with it, truly inspirational.

Chemo Session #4 (and a new job)

Sedated but always aware.......

Today was Chemo Session #4 for Blue, which has become a routine that Blue finds quite relaxing, but that is on Blue's scale. Any other dog you may feel Blue is far from relaxed, but trust us when we say "he is relaxed".

Blue began the day the evening before, let me explain. Ahead of Chemo, Blue is required to take anti-sickness tablets, these were lovingly crushed in a pestle and mortar, sprinkled and mixed in with a tin of sardines. Once sniffed, for any nasties, Blue wolfs it down, and proceeds to clean the bowl of all evidence that it was ever used to dish up food.

So back to today, we all had a lie in, and Blue went and done his business in the park, before coming home and having a hearty breakfast, unaware of what lay ahead, until 10 minutes before we left, he spotted the muzzle on the stairs. But there was no fuss, that might be in part to the sedatives that he was given at 8:20 am
The previous session the sedatives did not seem to kick in within the prescribed 2 hours, so we gave him them a little earlier so they would be in his system and working before his 10:30 appointment.

We left home shortly after 9:00am needing to get fuel for the car and a minor diversion to Asda to exchange a DVD, a completely different story.

 Reading to Guilford is just over 30+ miles and at this time of the day, very little traffic was encountered meaning we were there at 10:20am As we opened the car door, Blue was not up and alert ready to go, so a bit of coaxing was required, but once his paws were on the pavement we were heading for the door, well Blue was heading for the door, we did well to keep up. The push button on the sliding doors activated before Blue could ram it with his snout, and the same with the inner door. We made our way to a waiting pod in reception, where Blue quickly settled, to await our turn.

Once in the pod with Sue and me, Blue quickly settles, and is very relaxed, although he has been here before many times, he accepts it as a safe place, that is a credit to the Staff, team and designers of this state of the art unit. 

Bliss was disturbed with the arrival of Dr Kelvin Kow, and his assistant Nurse Emma. Moments later Blue settled back down, giving us the chance to recall how Blue has been since his last visit.

We told how Blue had been improving to the point that he had gone for two swim sessions and an hour plus walk at Queen Elizabeth Country Park in Hampshire. Also he retained a healthy appetite and was on minimum pain relief.

There was some concerns about Blue that we had agreed to share, it would be in Blue's interest long term. That concern was since Blue had undergone the major surgery to remove the mass from his abdomen, to date we had seen improvement in various different ways. That changed on Sunday, Blue was being playful and boisterous, and rolled over on his back, and gave a yelp. We then noticed he was "hovering" his back leg. From there on in we have tailored back his walks and avoided getting him too excited.

Dr Kelvin suggested we did not jump to any conclusions, let's see how he is. With a bit less than usual handling Blue went with me and Dr Kelvin to the door through to the business part of the building, where Nurse Emma and Dr Kelvin took Blue for his session and checks.

Sue and me sat in our Pod, accepting the offer of coffee while we waited, the 30-45minutes.

Sue recognised Blue was approaching, before he had turned the corner and come into view, Blue was coming straight back to us, with Dr Kelvin on the other end of the lead, doing well to keep up.

Blue quickly settled down enabling us to be updated; Dr Kelvin Kow was pleased on a number of counts, blood tests were normal for Blue, based on previous tests. Although there would be concern for blood results returned in a healthy dog, these were causing no concern in Blue. His weight has gone up about 300grams. 

There was a twist though, not only was the Dr pleased with what he had seen, but was taken aback at how well Blue was walking, and his strength, we joked and said "Blue knows where Blue wants to go" and he said he started to protect me like I was one of the family, when a Nurse approached them.

Sue said, welcome to an exclusive club, fancy that Blue protecting the vet, which made us all smile.

In three weeks time Blue will return to the Oncology and Soft Tissue Centre of Fitzpatrick referrals where he will have a CT scan, this will determine the next stage.

Blue is not following a well defined path, his treatment is bespoke to him. The permutations are endless, even as we were consulting with the Doctor, you could see he was working out options that would best suit Blue and his condition. 

Blue has gained a new friend in this process, one he is keen to protect, and that is Blue's new job.

Blue was even presented with his own file box, to keep his paperwork up together..........

We arrived home safe and sound around about 12:30 and once again found it difficult to scoop Blue out of the car, I said to Sue, we could do with one of them tipper trucks.
Blues medicine for the next three weeks.......

 If you have found this blog interesting, enlightening especially the progress of Blue and his fight against cancer, you can learn more of what this practice does on 4th February 2016

World Cancer Day is the subject of a forum from 6-7pm

https://www.fitzpatrickreferrals.co.uk/services/oncology-and-soft-tissue/

Blue stayed awake for one more picture before getting his head down,the eyes say it all!!