Tuesday, May 27, 2008

Trying to Find the Silver Lining

I'm slowly beginning to move on although there are still those moments when I feel that deep, deep sadness knowing Coltrane is gone forever.

Like last night when I sat on the couch watching TV and realized I was never going to see that big guy drag his bed from the bedroom into the family room and beg for his kong to be filled with a treat as a reward for his job well done. Or tonight when I dropped a piece of bread on the floor and had to pick it up instead of having him there at my feet picking up my scraps. It's a sorrow unlike anything I've ever known.

There's also the anger. It sounds illogical but the more we learn about how and why Coltrane died, the more angry and at peace we are with his passing.

We now know that Coltrane passed away from MRSA - that nasty antibiotic resistant 'superbug' staph infection. At one point during the past year of treatment, he tested positive for it and, while we thought we'd treated it, it was still in his system (we've since learned that MRSA never really goes away - it's always in your system). Once his immune system was suppressed by the prednisone, the MRSA flared up.

While we know that, medically, UGA did the best they could with the information they had, it's the things they didn't do that bother us. They didn't have us follow-up with our local vet regularly which, given the dose of prednisone he was on and Coltrane's history, would have been prudent. They knew we had a newborn at home (he was with us during those last visits) yet, it was only after my husband called to get the test results (note: they didn't call us - we had to call them) that we learned of MRSA. The vet then added that that it was probably a good idea if we get tested. (I wonder when they would have mentioned that if my husband hadn't called to get the test results.) This week we received an itemized bill in the mail with a credit card slip stapled to it; they simply charged the final bill to the credit card we used for the deposit - no call to tell us the final total or ask us how we wanted to pay. And, what bugs us the most is that the orthopedic doctor who was handling Coltrane's case - until that last visit when we realized the severity of the infection and it was turned over to the internal medicine vets - still hasn't called. A short, 'I'm sorry to hear about Coltrane' would have gone a long way toward making us feel better about the situation.

The odd thing about this is that we have a friend who, for the past year, has had MRSA issues mirroring Coltrane's. Even odder: Coltrane injured his knee at our friend's house during the same weekend when our friend's MRSA issues began.

On each visit to UGA we mentioned our concerns about the MRSA - about how strange it was that the cases followed a parallel path, that we were worried it was still in his system and that we had concerns about the prednisone. We wish the doctors had paid closer attention to our concerns about MRSA instead of looking at us like we had horns when we told them about the similarities between Coltrane's prognosis and our friend's condition.

But, ultimately, MRSA is such a new and nasty thing that doctors barely know what to do with it in humans. Our friend has been battling it for over a year and they still don't have a grasp on how to handle it. The test that allowed them to finally find the source of the issues in our friend (an infection in his bone) is rarely done in animals. The closest facility that has the capability is at the University of Tennessee and diagnosis alone would have cost approximately $10,000; who knows what treatment would have cost - assuming it was even available.

I hope that UGA uses this as a learning experience - that they learn how to treat cases like this, that they don't make these mistakes in the future, and that Coltrane's death will help some other animal who comes in with the same symptoms. It's the only bit of peace I can find in this situation.

Saturday, May 17, 2008

The End

Funny how life works sometimes. Just the other night I was looking through some posts I wrote about our dog Coltrane's knee surgery. At the time I read the posts, a little over a year had passed since the surgery and we were still dealing with the consequences - a leg that wouldn't heal, a litany of medicines, and a dog that, for the past few months, hadn't been himself.

Then the bottom fell out.

We noticed some changes in Coltrane about a week ago. Some we chalked up to the new baby in the house, others we thought were a result of the lingering surgery issues and a few we thought were caused by a recent change in his food. But we knew things weren't right a few days ago when he wouldn't eat. Then on Wednesday, when we went out for a walk, he collapsed - he did it again that night.

Yesterday we took him to the University of Georgia - where he'd been receiving treatment for the past few months. We met with the doctors in the morning and ran some errands while they ran tests - that afternoon, while in the Target parking lot, we got a call from the doctor. Coltrane had an infection - a serious infection.

When we got back to the hospital that afternoon, we met with the internal medicine doctors who kept stressing the severity of Coltrane's condition. Apparently this was more than just an infection. But, we left Coltrane in their hands, remained positive and headed back to Atlanta.

That evening we got a call from the doctors - the infection was so severe that it had caused inflammation throughout his body. While they thought they could get the infection under control, the other issues - mainly the condition of his heart - were grave. They felt we should come over the next morning to see him as he might not make it through the weekend.

A few minutes later we got a call telling us to come that night.

We drove back to the university that night and got there at 10:30 pm. The school was dark and, as they let us in, I felt as though I was someplace I shouldn't be; it was eerie and ominous. We went into one of the exam rooms and talked with the doctors who told us how Coltrane was fighting but that his prognosis was grim; after discussing options, we told them to do whatever they could to save him.

We went in to see our buddy, saying what we knew could very well be goodbye. He recognized us and I promised him Brewster's ice cream every week if he pulled through. We told him how he needed to fight for his new little brother Miles. We choked back tears as we petted him while he laid there in on the floor of the ICU with tubes attached to him everywhere.

We headed back to Atlanta in silence and hoped for the best but ultimately his little heart couldn't handle it. At 1 am, when the phone rang, we knew - we didn't need to hear the doctor say it, Coltrane had passed.

There are a million and one things I could say about how amazing Coltrane was - about how he was the kindest, gentlest dog in the world (even at 100 pounds, he'd play with the 5 pound bichon frise down the street without any of us ever worrying about him hurting her), how he was so happy (no matter how crappy my day, just hearing him run to the door to greet me would cheer me up the minute I stepped in the door), how he was loving (he never wanted to be without us and would follow us around the house - complete unconditional love)... Honestly I could go on for hours but it would never do service to what an amazing creature he was.

We loved that dog as if he were our first child and, while at the hospital after Miles' delivery, the only thing I could think about was getting home to see that furry little guy again and having him meet his new brother. I'm sad that Miles won't get to know and grow up knowing a family member who was a huge part of our life. And each time I think about never seeing that big bushy tail, that ear-to-ear grin or those cute white feet, I ache with a pain so bad that I wonder if it's capable of ever going away. Quite honestly I'm having difficulty putting it all into words - it's like being hit with continual tidal waves of grief, anger, and the type of sadness that literally makes you hurt inside.

I'm trying to focus on the good - the 6+ years of pure joy Coltrane brought into our lives and the many years of joy we have to look forward to with Miles - but it's a minute-by-minute struggle. I know that with time it will grow less painful and it may one day be something that doesn't cause me to shake and cry uncontrollably - it's just hard seeing that proverbial light at the end of the tunnel.

Rest in peace little buddy - you'll be missed.

Saturday, May 3, 2008

A Second Plea

Dearest Miles,

Thank you so much for listening to Mommy - she was thrilled when you decided to start events leading up to your appearance on 4/20 but waited until 4/21 to actually show up. And what an appearance it was - you're absolutely beautiful and we couldn't be happier to see that perfect cherub-like face.

But it's about the screaming - the daily (or, in most cases, nightly) eight to twelve hours of almost uninterrupted screaming. I realize that you may think the fact that you're so adorable makes up for the fact that you're a total pill but cute only goes so far. Dad said it best this morning: you're kicking our asses. We could deal with having to get up ever few hours for feedings - your big brother Coltrane got us used to that with his 5 times a night pee breaks - but the fact that you simply won't sleep must change soon.

The doctor says you have reflux and although it kills me to give medicine to my child whose life is still measured in days, we've been loading you up with Zantac twice a day in hopes that it will help. So far it doesn't seem to be doing anything other than pissing you off when we squirt foul-tasting liquid into your mouth but your doctor insists it will take up to a week so we're trying to be patient.

We have so much we want to do with and for you. Mommy would like to have 30 minutes a day to take a shower or a 15 minute recess from the screaming fest to give you a sponge bath so people don't look at her like some horrible neglectful woman when she takes you out in public with your face covered in vomit. And Daddy wants a few quiet moments to pay bills so that mean people don't come cut off our electricity and kick us out of our house. But, we can't do any of that with you insisting on partying like rock star at all hours of the morning.

I love you so much little bean. You really are perfect and we couldn't be happier to have you here - now be a good boy, listen to Mama and show us how well you can sleep in that cute little Star Wars crib of yours.

The 'Rents