Wednesday, July 6, 2011

Love and Lullabies: Farewell, Sweet Sophie

In this very special and attentive network of families of pets with cancer, word travels fast. Although it's taken me some time to post an update for our friends at RCF, many of you may have heard through other channels that my sweet Sophie passed away on June 17. What a tragic time for so many of our fellow pet parents - we had also lost Naleya, Potter, Roxy, and Celia the kitty (plus even a few others I've met throughout Sophie's fundraising campaign) within just a few weeks. Although I'd had nine months since her diagnosis to prepare emotionally and imagine every possible outcome, I was definitely taken by surprise.

When I posted our last update, "Time To Exhale," Sophie and I were settling in for some much-needed R&R - she after her second of two radiation treatments, and I after surgery to restore my hearing in my left ear. Knowing I would be required to abstain from physical activity for a couple of weeks and that Sophie would be resting up, I scheduled our procedures so that we could recover together. Sophie was undergoing a fairly uncommon treatment known as half-body radiation. It is a series of two radiation treaments, spaced two weeks apart with a strong dose of chemo in between. The desired outcome is extended remission from lymphoma. I was hoping for two more years.

Sophie's oncology team was thorough in explaining what to expect during her recovery: little to no side effects following first radiation, normal chemo effects in the interim week, and some tough times following second radiation (GI issues, inappetance, lethargy, diarhhea) followed by a return to healthy remission. Things played out as expected, and Sophie and I were a couple of lazy lumps around the house that week! We were able to manage a couple of short daily walks, and of course Sophie would muster all her energy to give our two roommates ("aunties" Hilary and Rae Ann) the usual waggly greetings as they came and went. She also enjoyed visits from the friends and neighbors who checked in on us that week, which was a real treat for both of us.

Unfortunately as I was regaining my bearings (and my hearing), Sophie seemed to be heading in a different direction. After a few days with very little food and extreme lethargy, I decided to take her the hospital for a checkup on Friday, June 17. I wasn't yet cleared to lift anything over five pounds, but Sophie wasn't up for the walk down to Broadway to catch a cab, so I hoisted her up onto my shoulder, like an infant (this always makes our roomies giggle). Hilary helped us downstairs and we were on our way. Of course Sophie did her usual show-off routine for the doctors, rendering useless my claims that she could barely walk on her own. After a thorough examination and sample collection, everyone felt that although she was struggling, her symptoms were within the normal range, given her recent radiation treatment. The doctor was comfortable sending us home with an appetite stimulant and anti-nausea meds, and told us they'd be in touch that afternoon with her test results.

I had just enough time to settle Sophie back into her comfiest spot, run down to my otolaryngologist at NYU Medical Center, and have the surgical packing removed from my ear. After wearing a hearing aid for over a year, I was elated to hear the sounds of the city in my left ear without it! I returned to Sophie's side and we enjoyed a long nap together while she sprawled on my chest. We were awakened at 6:00 pm by a call from the doctor who'd seen us earlier at NYC Veterniary Specialists. She had bad news, and everyone at the hospital was stunned. Sophie's blood calcium was sky-high, indicating that her cancer had returned with a vengeance. Her kidneys were in danger from the hypercalcemia and I had to bring her back in as soon as possible.

The next thirty minutes played out too dramatically, like some tragic, surreal film about inevitable heartbreak. The skies had just opened up in a passing yet brutal downpour, and hailing another taxi would prove nearly impossible. I placed a few frantic and tearful phone calls to friends with access to cars, to no avail. I stood in the lobby of our building holding Sophie, wrestling with whether I should wait out the storm or make a run for it. I did the latter, and by the time a taxi finally stopped, we were both soaked. On our way to the hospital, I had already decided that our fight had gone on long enough. The return of Sophie's cancer so soon after such a promising treatment was a sure sign that we had done everything we could. Most of the oncology team had left for the day, but many of the technicians saw Sophie on their way out, and stopped by for kisses and to say goodbye. My neighbor and dear friend Melanie, the same friend who happened to be with me the day I first brought Sophie to NYCVS, happened to be a few blocks away at the time. She rushed over and waited for me while I said my own goodbyes, and then saw me home.

That day began and ended on two entirely opposite ends of a spectrum of hopes and expectations. Still, I felt lucky that the decision came to me as definitively and peacefully as it did. And what better way for my girl to spend her final days than playing nurse to her mom, receiving so many loving visitors, and seen off by the caregivers who'd fought with her every step of the way. It was a week filled with snuggles, love and lullabies.

I'd like to emphasize that Sophie's passing is not attributed to her treatment plan; her cancer took full advantage of this vulnerable moment to return, and it simply wouldn't back down. Half-body radiation has favorable outcomes in dogs with lymphoma, which was carefully considered by the experts at RCF when they agreed to help us with the costs. I am not a medical expert by any means, but as a pet parent, I wholeheartedly advocate this treatment option and I don't regret our choosing it. In the spirit of openly sharing information on all available treatment options, here are the links to two studies on which the half-body radiation treatment is based:

"Sequential low-dose rate half-body irradiation and chemotherapy for the treatment of canine multicentric lymphoma."
Lurie DM, Gordon IK, Théon AP, Rodriguez CO, Suter SE, Kent MS.
J Vet Intern Med. 2009 Sep-Oct;23(5):1064-70. Epub 2009 Jul 14.

"A toxicity study of low-dose rate half-body irradiation and chemotherapy in dogs with lymphoma."
Lurie DM, Kent MS, Fry MM, Théon AP.
Vet Comp Oncol. 2008 Dec;6(4):257-67.

Although I'm still in the darker moments of my grief, I know there are many favorable outcomes to look forward to, thanks to the people and organizations I have come to know during Sophie's illness. After six years of life as a "single doggy mom in the city," scheduling my days around walks and meals, declining invitations in lieu of cuddling at home, and constantly worrying whether Sophie had all that she needed from me, I have more time and options available to me than I'd care to have. But when the dust has settled, I'll want to create new ways to channel Sophie's struggle into hope and funding for more families of pets with cancer. (I'm beginning to train for my first running of the NYC Marathon in November, a prolific fundraising opportunity if ever there was one!) My sadness will be overwhelmed and overturned by the treasure trove of memories of Sophie and the new friendships she brought into my life. My lullaby to Sophie the day she passed was "Lean On Me," and someday, I'll be there for YOU to lean on, too.

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