Simone Update 9/13

After my hysterical crying and screaming rage around 1:45pm today, I thought it was ironic that the word of the day displaying on my Gmail was "plangent: beating with a loud or deep sound; also, expressing sadness."

We have been expressing a lot of sadness today. Sadness in realizing that our girl might not make it through this. Sadness in learning that she is ill beyond repair. Sadness in discovering there is nothing we can do about it, except to love her and make her as comfortable as possible.

I received a call from Amanda, the vet student we were working with yesterday, at 8:31am this morning. She said that during the night Simone's arterial packed cell volume (PCV) had dropped from 27 to 17. Not good. Any lower and they would have to give her a blood transfusion. She said it appeared that the internal bleeding had stopped, and they were gradually removing the pressure bandage around her abdomen (1 inch every 2 hours). She said they had checked her PCV again at 8am and it was the same. She said Simone wasn't interested in eating the dry or canned food they offered her and asked if I could bring by Simone's chicken and rice that I had been making her. I told her I'd be right there.

I arrived 10 minutes later and the student was paged. She quickly came up to the reception area to greet me, and then escorted me back to the ICU where Simone was staying. She was laying down in a bottom cage with her belly wrapped tightly with what looked like a giant ace bandage. She flopped her tail a little bit when she saw me and sat up a little when I kneeled down beside her. I talked softly to her and tried to feed her some of her chicken and rice, but she wouldn't take it. She wouldn't even take any of the cookie I offered her. She was panting hard and seemed uncomfortable. Amanda said they had given her some pain medication in case she was hurting. I asked if I could take her home today, but the student said they wanted to keep an eye on her and make sure her PCV didn't drop any more.

I got to spend about 10 minutes with her before I had to leave, and then told her I had to go. She perked back up and then started talking with her eyes. She looked at me, and then the student with a worried look, and then me and then the student. Yes, I told her, I'm leaving you with Amanda, but I'll be back soon. She looked at me, and then Amanda again, like, really, you're going to leave me here? It was hard telling her I had to go, but she was in good hands, and they would help to make her better. She then put her head down in the cage and looked sad. Say what you will, but my Simone has an amazing command of the English language. It was so hard to leave her.

I waited by the phone for the rest of the day. Every time it rang, I jumped. Amanda finally called around 1:30 pm. She said Simone's noontime PCV was holding at 17. No better, but no worse. She said they would recheck it at 4pm. I asked if I could come see her; she said she would have to find out when we could come in again and get back to us. I asked her about Simone's prognosis and likelihood that she could come home tonight; she said she couldn't comment on either, but Dr. Ruaux would talk with us later this afternoon.

So, back to waiting. And then a meltdown. And then that wild, jittery feeling like you have when you're hopped up on too much Halloween candy and are moments from seeing it come back up again. There was little peace this afternoon, and no work done. I couldn't tell you what I did exactly after that 1:30pm call, only that it took forever and I was able to fritter it away until Amanda called again at 4:00pm.

She said we could see Simone at 4:30pm, and also meet with Dr. Ruaux again then. She said the PCV was still holding at 17. She said the doctor was going over all of her test results and would be deciding if Simone would get to come home tonight or not. We gathered our things, and then headed out the door and over to the vet hospital.

The doctor met with us in an exam room at 4:45pm. He again did a fantastic job of explaining everything down to a cellular level and helped us to understand everything that they had done and what they knew about what's going on with Simone. He said they had taken a few more X-rays today to get a better look at her lungs, but didn't see anything. He said they had looked at a stool sample, but didn't see any blood or evidence of parasites. He said her abdomen wasn't as distended as it was last night, and some of the blood in her abdominal cavity had begun to be reabsorbed, but not all of it. He said he did not have a good answer for why her red blood cell count is so low. He said the only thing we haven't checked is her bone marrow, and there are basically two types of bone marrow cancers that might be causing her anemia. One is treated with prednosone (which she is currently on and her RBCs are not responding to), and the other is untreatable. Even if we were to decide to put her through the painful procedure, there wouldn't be much to be gained from it, except to know for sure if she had an untreatable bone marrow cancer. Or maybe it would show no abnormalities, and then we'd still be where we are, with no better understanding for why this is happening. Either way, we decided not to do a bone marrow biopsy, to keep her on the lower dose of prednosone, and hopefully get her home.

At this point, we don't know how much time we have left with our girl. It could be a few days or a few weeks. There's still that hope that maybe she'll snap out of it and respond to the lower dose of steroids, but without an adequate supply of red blood cells, she won't be getting enough oxygen. If she continues to have low/no appetite, then that will make things even more difficult and may accelerate her decline. We're not ready to make the decision about having to put her down; although the thought of finding her passed away at home is not an easy one either. We're hoping that we can make her comfortable, that we can let her know for a little longer how much she is loved, and then have her pass from this life without pain or misery in a familiar place with us at her side.

Realizing we have to begin letting go is one of the most difficult thing we have ever done. Simone was the child we chose to have, the child who chose us. Those of you who know her well know how much of a person she is. Her soul has touched ours in ways we never would have imagined. We're having a difficult time imagining life without her.

Please keep her in your hearts.

Love, Carley and Gary