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!!

Active Blue

No it's not a new after shave, but a collection / playlist of Blue having fun in many ways.

Decided to share this playlist after hearing how much a friend of Sue's had commented on watching and enjoying all 17 clips.

Today it was confirmed when Blue goes to his Chemo #4 session next week, he will not be having a CT scan, it will now likely be booked in for another day, 16th February 2016

Taking a trip out.

This week we broke our own golden rule, not to plan ahead. Well I say broke it, is not exactly true, let me explain.

At the beginning of the week I suggested to Sue, we took Blue out on Saturday morning for a walk somewhere a little more exciting for him. The place I had in mind was Queen Elizabeth Country Park set in Hampshire. A place we have visited in the past, and had many an enjoyable walk.

Before we share our walk, a little more on events this week;

Blue has now decided that pain relief tablets are no longer digestible, no matter how they are masked wrapped, disguised they are off the menu. Consulting with the Vet it has been agreed, Blue can go without them. We need to make sure he does not suffer pain, but Blue does not hide pain very well. To this end we feel we could tell if he was suffering in a detrimental way. The tablets he was taking remain in the cupboard, and we would find a way if needed to re-introduce them to him.

Blue remains active and walks have increased in length, but only marginally.  He rests well, and is now accustomed to coming into our bedroom and sleeping on his bed, most nights without a murmur, occasionally an excursion in the wee small hours, if you get my drift.

Wednesday was swim night. Two things were different, first and foremost for this occasion the camera was left at home. We already own a huge amount of pictures of Blue swimming, more would never be enough, but for all the right reasons, tonight was camera free.

The second and greatest challenge, Blue would go swimming without a buoyancy aid/jacket. We all agreed it was best that Blue wore a walking harness with a tethered line, which would not impede his swim, but would aid a rescue should one be required. I gallantly suggested "if he got in trouble Sue and Carol could rescue him first and I would help if they struggled", women first, as they say in the movies. I think they got the joke.

Blue did not need rescuing and was in and out of the pool chasing his trusty ball, having a shower and blow dry at the end. Cautiously he only had 12 minutes, but he was content.

Friday night came and we looked at the weather forecast, cold and dry, ideal walking conditions, tomorrow was on, we were going to go to the Park in Hampshire.


Queen Elizabeth Country Park

As you may of guessed already, from the picture at the top of this blog, we went to the park.

Located just over an hour from our home in Berkshire, it would be far enough to travel, but not much more than Blue has travelled recently, certainly less than our recent journey to Milford on Sea.

We set out at about 10:00am and entered the postcode, obtained from their website,  into the satnav.

11:15 we were parked up in the "Juniper" Car Park all day cost of £3 a bargain, as there is no other cost to go walking to your hearts content.

As always Blue had been impeccable on  the journey, not a murmur just popping up each time the indicator was activated, if the car remains in motion he settles back down, if it stops, he begins to get excited and looking at where we have arrived at.

We obtained a map from the gift shop, and decided our route. We agreed it would be a gentle walk of about an hour. In fact it lasted one hour and twelve minutes. Sue has always kept a log of the duration of Blue's walks since his spinal surgery when he was a pup.

As we began our walk we passed some children playing with their parents and were overheard saying "Wow, look a German Shepherd" said with excitement and glee, and followed it up with "He's huge"
This made both me and Sue smile, as we have heard many times throughout Blue's life.

Blue makes an impact wherever he goes, not always for the right reasons, today was no different. The previous comments were not said direct to us, but as one person said what a beautiful dog, Blue replied with his customary bark, defending us. Strange sometimes what goes through his mind.

The walk was great, and ended up with a picnic on a bench, alfresco, we had a great time, good fun, good exercise and our own great company.

Unlike the swimming we decided to capture the day on camera, and loaded up the footage on Youtube last night

and a few pictures taken of the picnic

That is all for now, only one thing left to say, when we went to bed last night, Blue slept on our bed.

We had spent the day together, and then the night together, we all slept content and soundly.

Thank you to all, for the tremendous support for Blue on this amazing journey.

Chemo Session #3

Some pictures we take, can mean so much, but for others to see, what you see, it is necessary to share the journey that led to that picture.

Blue has today been to Fitzpatrick Referrals for his 3rd session of Chemotherapy, although still drowsy from the sedatives, he is now at home with a bag of treats from the kind Nurse, who has a dog called Erik, that Blue shares tweets with, @PawsomeErik on twitter.

It has been a few weeks since news of Blue has been blogged, there is good reason, Christmas was one and the other, time was better spent enjoying his company.

Back to today, at 10.00am Blue was given his usual 10 tablets of Acepromazine (10mg) we were all ready to go for 10.30 for the trip to Guildford for a noon appointment.

As we walked out of the house the tablets were already having an effect, Blue leaning on anything that came close, walls, radiator, legs anything. We got him to the back of the car, and as we jointly lifted him up into the car, I commented that he has had some Christmas excess.

We arrived in good time, the journey just over an hour, meaning we were a bit early, but decided to take Blue in and await our appointment in one of the receptive pods, ingenious idea. Blue settled quickly, which was good. But as it came to his turn, the sedatives seemed not to be so effective as in the past, keeping the muzzle on was a good idea.

The next part is some on the hoof choreography, this was because Dr Kelvin Kow and PawsomeErik's mum approached and Blue was vocal and alert, suspicious at what was going on. The idea was that Blue would be taken to the treatment room for his Chemo session.

So leading off Sue supported Blue's wobbly back end with a sling, as I lead him out of the pod and in the direction of the door.

It was a cross between a dance and a relay race, seamlessly the Doctor and the Nurse took the reins in mid flow, and guided Blue to the transfer door, and gave little resistance as he walked off with his new dancing/relay race partners.

We waited back at the pod, for about half hour, until Blue returned, with the Nurse and his bag of treats. The Nurse had said that Blue had done well, and was nice and calm throughout his session, the Doctor was soon with us to explain the results.

His 3rd Chemo session was administered without any problems, his blood tests had shown a small improvement in the red blood cell count, lower than normal but better. Blue's weight had gone back up to 49kg.

Dr Kelvin spent a further 10 minutes talking through how Blue was getting on with the chemotherapy, gaining weight, and an appetite to interact and be more mobile were all positives. For Blue there can only be today, but we have to discuss what is on the horizon. Blue is booked in for session #4 in three weeks time.

Dependant on how Blue is, a week before that session, we have to call and advise the Doctor, he will then make a decision about whether Blue will need a CT scan at his next appointment. The scan will determine if there is a return of any masses or tumours, that will then be a crossroads to decide what the next stage is for Blue.

The treatment he is receiving is limited, to 4-6 sessions only, and they normally cease to be less effective beyond the 5th or 6th treatment. Continued usage risks damaging the heart irreversibly, but there is an antidote. There could be a change of treatments, to tablet medication, which attacks the cancer cells in a different way. But to make that decision the CT scan is required, we have said that we will follow the advice and be guided by their expertise judgement.

We shook hands, and it was time to transport the little fella back home. Traffic was light and the return journey was only an hour.

How do you lift a 49 kilo ball of fur out of a car, we tried several ways, each time his head was lolloping out the back of the car door further and further, we both got the giggles, but finally somehow using the sling and kinetics we got him out, good job we weren't being filmed, that would have been a sight.

Since our last blog, Blue has got to walk a little further each week, and last weekend he got to walk a whole circuit of the local park, so for a special treat for all of us we went to the seaside.

Words not needed, you can tell how much Blue enjoyed his trip to Milford on Sea.

 

Christmas was fun, especially the quality time we had together.

But the one thing that has always been special to Blue, was being able to go swimming.

Thank you for reading.

The time spent with Blue is worth more than money.

The lessons learnt with Blue are invaluable.

Special Thanks to all those who have supported the three of us:

Unsupported walks and night time games.

Blue has been doing well since our last blog, progress is small, but progress is progress.

There have been no ill-effects with the Chemotherapy, and the fur is growing back slowly, the spirit that Blue has shown confirms our decision to go through this route is most welcome from Blue.

Generally there has been a day on day improvement, so much so, that yesterday, Blue rested a little more than recent days, maybe he had over done it, maybe this would be the pattern of his activity levels, maybe there is something else going on inside of him.

We will continue to take one day at a time, not look towards the future, living for today.

Each morning as the curtains are drawn back we get the chance to wonder the dawn of a new day to share with Blue and realise how lucky we are to have each other.

The improvement has seen Blue not require the use of his support sling, for the last week, walk more comfortably to the park, and even have a short walk in the park, the equivalent of about half a mile in total. All at his pace and in the direction he chooses. We are very guarded about being in the park because of other dogs, most naturally give a wide berth to German Shepherds, but not all. Blue is very switched on in his mind and senses, once he is aware of another dog in the park, he will be fully focused, so we do have to also guard Blue against Blue.

He has also made the excursion to the local cemetery, a place he has walked daily in the past, but not since his treatment started.

His medication has now seen an end to the anti-biotic Therios, it has done a good job of helping fight off any infections

His daily dosage of medication is continuing with Tramadol, Gabapentin and Metacam along with the herbal Chinese product Yunnan Baiyao.

Blue is due his next Chemotherapy session on Tuesday, which will see him also take Cerenia in tablet form prior to and after the session. 

Blue will require 10 Acepromazine to partly sedate him ahead of his visit.

The many forms of tablet he is taking, go down with very little fuss, the only issue is if one splits and discharges the contents onto his food, then even the most appealing sausage has to be offered a few times before consumption.

Tuesday he will have a short stay for his treatment, where they will also undergo the removal of the stitches associated with his port placement. All being well this will enable Blue to return to his weekly Wednesday swim sessions at Aquadoggies, fingers crossed.

Sue continues to sleep downstairs in the week with Blue, where they both sleep through the night.

Friday and Saturday are my usual nights for taking a turn on the put me up.

Friday took us by surprise, I was busy cleaning my teeth, Sue was getting the duvet stuff ready, and who should appear upstairs, Blue, for the first time he had found the will and energy to climb the stairs, not only that, but after wandering around the upstairs rooms checking things out, he went into our bedroom and jumped straight on the bed,  circled a few times and landed with a contented grunt. Looks like we are all sharing the same bed for the night.

15 minutes into the night, Blue made it clear he wanted to go downstairs, so Fridays sleeping arrangements were to return to those that had gone before.

After we had settled for a short while Blue wanted to go out the back, to do his business, oh no to play football !! 

We played for a little bit, and I thought it would be a nice moment to capture, and went indoors and got the camera.

Eventually he had enough, and with the temptation of a food treat, we were back in doors to do what normal beings do at night, go to sleep.

Yesterday did see Blue be a bit more reluctant to raise from a slumber, but perhaps the clue was in the story above, lack of sleep in the night.

Those are the moments that will one day be cherished, it is still very heartwarming the support and understanding we get regarding Blue, neighbours stunned by our news always ask how he is, sometimes a knock on the door, presents us with a chance to update a concerned neighbour who had not seen him for a few days. Work colleagues keen to hear his progress, and how he is.

We are also pleased to have prompt settlements from the Pet Insurance, this enables us to continue supporting Blue, money is not everything, but it can open doors and provide opportunities. Some of the costs which must be paid for up front can quickly deplete resources. It does show the true value of Pet Insurance, and using a good reputable company, we chose ours wisely, do your homework and make your choice the right one

We have decided this year will be a Blue Christmas, Blue themed and focused on Blue. 

Yesterday we did the Christmas food shop, the main item was the turkey for Blue, if I am good perhaps Sue and Blue will let me have a slice for my Christmas lunch!!

Blue has some medical days out.

Wow where does the time go? In our case oh so quickly, and as we have become accustomed, a microscopic world with little focus away from Blue.

Blue underwent his Chemotherapy last week, had a port fitted, without an overnight stay, all of us very happy to not be parted for too long. Today Blue was back for his blood tests, and results were given before we left.

Blue has normal white blood cell levels, but red blood cells are well down, last week were 39.4% today only 27%


That was the summary, now for the detail;-
Last Tuesday Blue was booked in at Fitzpatrick Referrals to undergo a procedure, which would incorporate the placement of a port into his leg which would have a line directly into a vein. This would be how Chemotherapy would be administered and also to obtain blood samples as and when required.
Once again Blue resisted sedation, but was a bit weaker, and was soon leaving the consultation room with Laurent, Senior Surgeon of Oncology and Soft Tissue, as they walked across reception, Blue must have thought we were following, but we were heading in the opposite direction towards the reception desk to conclude the necessary paperwork.

As we glanced back, before they walked through the open door, Blue looked back directly at us, an expression that words could not describe, filled us with emotion that could only escape through the corner of the eyes, all the moisture left our throats, this is tough.

We returned home, and both went to work, tonight was going to feel empty at home.

Later in the afternoon, news came through, Blue had come through the procedure, and they would keep an eye on him to ensure there were no adverse reactions.

6:30 in the evening the call came though, Blue was up to being discharged if we would like to collect him, he would be ready for discharge at 8:15, we were there at 8:05

Blue was brought willingly through those same doors, that he had exited this morning, joyfully and as eager as a puppy as soon as he see us. We went with the Nurse into the consultancy room, where once again the line was removed, but with a bit more co-operation from Blue, and a lot less blood spillage.
The fur that had been growing back, had once again been removed, along with the stitches, and new ones to secure the opening around the port.

After a drive back home we entered our front door at 10:00pm a long eventful day for Blue was now behind him, once again a model dog and a model patient, back home for plenty of cuddles.

Blue no longer has bad days, he only has better days and good days.

The weekend has seen Blue vary with his appetite for exercise, but he has been taken to the park for a short walk. He has even had a couple of trips out to the grounds of the local University. Some parts unaided other times with his sling for support.

The Chemotherapy comes with some issues, one of which is that any wee or poo in the days soon after therapy should not be licked. So hygiene is important.

Whilst Blue has been more mobile, he has an issue when weeing, he stands with his right leg further back for balance, with his stitches the direction of his wee goes straight towards his front leg. We came up with a plan, a plastic storage box lid, acting as a splash shield. We must look a peculiar sight, but it does the job, and hurts no one.

Medication has been a challenge, at one point a tablet was crushed mixed with water and Sue literally wrestled with Blue in a headlock and squirted the contents of the syringe down the back of Blue's throat. This was not agreeable for any of us, the answer laid in a tin of sardines, we had found Blue's passionate food, too tasty to resist and too tasty to be spoilt by tablets, everyones a winner.

Todays visit;
Blue had an afternoon appointment to have a blood test carried out. This time he was given sedatives before hand, Sue had to give him 10 yes TEN tablets 2 hours before his consultation.

We arrived in good time, were shown directly into the consultation room, the tablets were having the desired effect, as the reception lady held the door open Blue had a cursory sniff, and no more, he was entering the "dozy zone" we were offered and accepted coffee, and took the opportunity to have a weight check, Blue tipped the electronic scales at 48.7 kg
By the time Laurent came in to commence, the old Blue was there but in a much more subdued manner, with a laid back high pitched attempt at a bark.
We held Blues head steady while the blood sample was removed via the port, Blue was co-operating as best he could.
Ten minutes passed and the results were back, a bit of a mixed bag really, some good, some could be better, Sue had a long list of questions, each one answered fully and comprehensively by Laurent.

Laurent said that someone else wanted to see Blue, Dr Kelvin Kow, Senior Consultant Medical Oncology, whom Sue had spoke on the phone with the other day. Between the both, they gave us everything we needed to understand how Blue is doing, and how things may get. Not all good but again some better.

The same surgeon that had carried out a life threatening procedure, answered all our queries in a clear and concise manner, shook hands with such warm friendship, took the coffee cup and saucer from my hand, and left the room, how humble a gesture I have not witnessed before.

Blue could not be in any better hands, talking of Blue, he was now deep in the zone, consultation over we had to get this little fella through the building, across the car park, and he was as drunk as a lord.

Below are a few pictures that sum up part of Blue's day

The Staff have been truly great and a credit to their profession, when asked if it can be a heartbreaking place to work, yes it can but, you must look at each one as a gift and enjoy them

Today as I was driving back, Blue came into the former bracket, but I would use the word "talent"

Talent is something that is learnt and earned. Blue is a special talent that has faced some tough challenges through a life that other dogs could only dream of, his paws have trod where mountaineers walk, where fishes swim in seas, brooks, burns, lakes and lochs, pools and puddles, where cows graze, where deer and sheep graze,  sand and pebbles have been no match for paws or peat bogs not too soft for the spread of his paws, he has the look of a friend and a gaze to melt the hardest of hearts.

Who knows what this talent will achieve next......................

Living for today; The only way;

Last Saturday we took Blue out for a trip in the car, to give him a different perspective, and to see the world around him.

Just after returning the phone rang, that phone call was one we were expecting, but not the news we wanted.

Blue's results were in regarding the mass removed from his abdomen, it is an aggressive cancer that is incurable, Blue was given 3-9 months to live.

Our world had just collapsed, Blue had sensed something had disturbed us, came over to where I sat on the floor laid down and rested his head in my lap, allowing us to comfort each other. How do you come to terms with a bombshell like that?

Blue will continue to receive our love and devotion until the time arrives for our goodbyes to be said, we are all fully committed, to do what is best for Blue.

Holidays to Scotland in May, have now been abandoned, we will more likely go to the New Forest in Hampshire instead, around about January, this will be as long as Blue is up to it.

Medical stuff
Blue has Hemangiosarcoma, which is a cancer that takes different forms in many breeds of dog, also cats. It is not rare especially in large breeds of deep chested dogs, normally found but not exclusively in dogs between 6 - 12 years old. Breeds affected more commonly are German Shepherds,Golden Retrievers, Labradors, and mainly in male dogs.

In Blue's case, his has got into the blood, leg muscle and part of his nervous system, removing the mass will play no better or worse effects in terms of longevity of life.

On Tuesday Blue must return to the Oncology and Soft Tissue hospital in Guildford, where they will be removing his stitches. We have elected for Blue to have Chemotherapy, which will also be administered on Tuesday. To aid further administration of the treatment Blue will have a port fitted just under the skin, which will deliver the medicine directly into a vein. Normally it is fitted up near the neckline, but in Blue's case his will be inserted in his hind leg. No medical reason for doing this, just simply Blue will resist co-operation and handling by strangers, so if you like, put it as far away from his teeth for the safety of others, that's our Blue.

He will be dropped off on Tuesday morning at 7:30 where he will be booked in for treatment, and overnight observation, we will collect him on Wednesday.

It has taken a week for this to truly sink in and come to terms with, Blue Sue and me are now mentally strong to take this path side by side until we reach the inevitable end.

When Blue gives us the signal, we will do the right thing for him, no matter how hard that decision will be, it is about all of us.

Medication

• Metacam - liquid on food
• Gabapentin - capsules
• Tramadol - capsules

Twitter and Google plus
We have finally shared this dilemma that faces Blue on Twitter and Goggle+ and the support has been so heart warming, Blue even received a box of gifts, one of which is a monkey that keeps him comforted in his crate "Monkey-Crate-Mate" seen here as a shoulder to lean on

A comforting comment was sent via a direct message to Sue. 

"Blue only lives for today, he has no plans for tomorrow"

We have drawn a lot of strength and perspective from that, and will continue to do so. We know there are divided opinions about Chemotherapy, while Blue shows an appetite for life, we will explore all avenues.

Blue now never sleeps alone downstairs, and it would be too difficult for him to safely negotiate the stairs, weeknights he has Sue for company, weekends it is my turn to sleep on the put-me-up, there is never normally more than four hours sleep, as soon as Blue stirs we have been taken him out to the garden for a wee, and he duly obliges, even though sometimes it is a splash and a dash.

Each day we have been taking Blue across the road to do his business on some openland, each day he longingly looks up the road towards the park.

This morning he got his wish, me holding his rope lead, Sue supporting his back legs with a sling, we went to the park, where unaided but still on a lead he got to sniff and stroll around the park for 5 or so minutes, his expression said it all. When he sat down to admire and survey his kingdom, we knew the time was right to to head back; We are now like the proverbial pantomime horse, we all three walk together attached and in unison.

Breakfast was eaten once again with no fuss, and tablets went down a treat, Blue is now resting in his crate, which he sees as his space, his comfort area.

We have not put our life on hold, and will not grieve until Blue has passed over the rainbow bridge, that day will be hard enough, but we will draw strength from those days past, and the new memories we continue to make.