On the mend

Look at this face! Look at it!

It's been two days since Max's craniotomy and he's definitely on the mend. Our little guy is such a trooper! It's incredible to us that he could undergo such major surgery and be doing as well as he is only two days later.

Max has much more control over his mobility than he did yesterday. He's pretty steady on his feet and has a better sense of judging spatially. He's still not allowed to have big means, so he's getting lots of small hand fulls of kibble throughout the day. He's big on the frequency of snacks but it's obvious he resents the paltry portions.

Last night was a little rough as Max was really whimpery in the night. He was up and panting a lot, which meant lots of trips outside. He also really wanted to scratch his stitches, which seems like a REALLY bad idea, so I spent a good deal of time trying to keep his behind under a blanket. He hadn't pooped since coming home from the hospital and had pungent gas. Poor guy. This morning he woke up and wanted off the bed NOW. Well, we can only move so fast, but I threw a hoodie on and scooped him up and put him on the floor where he immediately walked into the bathroom and took a massive dump on the floor. Way to go, Beag! I didn't even care about the floor - I was just happy he'd finally pooped cuz now we're cookin' with gas. Or dung. Either way, it's good.

Our kitchen calendar has notations for who gets what meds when so we can keep Max and his brother, Taz's, scheduled straight. Taz is our 17 year old cat undergoing a steroid load and taper right now, too. The boys' shelf in their kitchen cupboard looks like a mini pharmacy. Good times.

Yes, Taz is usually as crabby as he looks.
Brandon considers this his best quality.

Warren offers moral support by sacking out on the couch. 

After preparing and dispensing the four customized feeding and medication distribution as appropriate, we got Max ready for a morning walk with his dad. He's so cute in his coat - I wanted to snap a picture, but Brandon's not so indulgent in the mornings. You can take it up with him.

After picking up a bit in the house, I went to the front door to check on my guys. Brandon had max in the park across the street from our house and I could see him trotting along in the cold morning, looking for all the world like a normal dog. These are the quiet moments we're grateful for.

Max's head gets puffy from air that leaks into the space between his skin and his skull that was
destroyed by the saw blade because they had to go in through his sinuses to access his brain.
The amount of air varies depending on his breathing patterns. It's a bit creepy.

Back Home

On the journey home!

We picked Max up from the hospital this morning, which is both a huge relief and really daunting at the same time.

We were told he did wonderfully overnight. Eating, drinking, walking, peeing. All the things he's supposed to be doing. We were also told he'd been resting a lot, which is also good. We sat in a visiting room while Dr. Pluhar went over his discharge instructions with us. Max fell asleep on my lap during that brief meeting. 

He has a complicated regimen of medications that will be changing frequently over the next several days as we need to wean him off of his steroids and administer antibiotics for a while. He will be on Phenobarbital, his anti-seizure medication, for the rest of his life. He also got to come home with some Tramadol, and opiate-based pain medication. I'm a little jealous.

I'm trying not to let my worry run away with me, but Max is obviously not fully himself. I have never undergone surgery where I needed to be anesthetized, so I don't know what it feels like. And I don't know anyone that has undergone brain surgery. Max is a bit disoriented, unsteady on his feet, weavy when he walks, has difficulty judging spatial relations, and he also seems to fixate on odd objects. He stared intently at my water bottle for several seconds after it caught his eye. Same thing with the hanging fruit basket in the kitchen. Either this is a side-effect of the drugs he's on ("whoa, dude...") or something in his brain is severely damaged and he'll never be the same Max I loved again. Obviously, there is a likely explanation and an unlikely explanation here, but just because my worry isn't dragging me down the street doesn't mean it's not clinging to my ankles.

I won't be able to kiss his head or right between his eyes for a while.
He has some swelling. We're told an ice pack every few hours
will help. But, unfortunately, Max won't.

He's been whimpering a bit, too. Isn't it odd when a little tiny thing can cause such a huge concern?When Brandon attempted to put an ice pack on Max's head, he yelped and barked. A clear objection and request for him to back off. The whimpers, on the other hand, could be him expressing pain, discomfort, frustration, confusion, or even relief. I would much rather deal with a loud but clear message then a subtle and ambiguous one any day. From anyone.

My brave, amazing boy.

We're supposed to keep Max quiet and resting as much as possible. He cannot be left unattended unless he's in a crate, go up or down stairs, jump on or off furniture or into/out of cars. We need to monitor his stool for blood. We've been told not to worry if he bleeds from his nose, but do worry if the blood is pure and doesn't have snot mixed in. He's susceptible to pneumonia right now so we need to be careful about that and bring him to the vet at the first sign of difficulty breathing. Basically, I have a great excuse to be as neurotic as I want for the next couple of weeks.  Lucky Brandon.

We just have to see how everything unfolds. I'm guessing we'll know more in a few days about how ha's come out of surgery personality-wise. It's hard to imagine that part of his frontal lobe can be taken out and his personality won't change; though that's exactly what we've been told will (not) happen. I'll feel much better when I see for myself. I can't wait until he looks at me and I know without any doubt that he knows who I am and he's happy and excited and comforted to see me. I think that's all any parent really wants to see on their kid's face, right?  

Max's tumor is GONE!

Max's surgery was a success! His tumor is all gone!!

Dr. Pluhar called at about a quarter to eleven this morning to say that she'd finished with Max's surgery and he was being brought to have an MRI done before being woken up. Because he's an older dog, his surgery was a little easier than most because his brain had atrophied a bit over time. Because of the tumor and the edema surrounding it, the center line of his brain had shifted to the left (the tumor was on his right side), but after removing those as well as some tissue from his frontal lobe, his brain was centered once again.

Wait a minute! Did you say they removed  part of his brain??

Yeah, I know. It freaks me out a bit, too. But we have been assured that other dogs have had more of their brain removed and lived happy, long lives. 

I'll write more about my feelings on animal research later as I have been thinking a lot about it (more so than usual, which is frequent under normal circumstances) since we've started considering enrolling Max in this study. We're aware that Max could experience side effects that we won't be able to detect, since he can't give us a detailed account of how his body feels at any given time or with any specificity. I was especially concerned that the tumor or surgery could affect his sense of smell, since dogs experience the world through their noses like most of us experience the world through our eyes. 

We aimed to be there so max could see us as
 soon as possible after waking up from anesthesia. 

The best we can do for Max, and all animals, is to pay close attention to their own unique way of communicating and really try to understand what they may be saying or experiencing. It's a simple concept, and often it's easy to do. But when the stakes are high, it's easy to second guess. And when they're really high, the weight of the responsibility for making the decision to approve, pay for, and participate in a highly invasive, life-altering, painful procedure to be performed on someone else's body, without their consent, is difficult. Brandon and I drew on everything that we have learned about Max through living with him for the past eleven years and decided that this study was the best option for him and us. But just because we are confident in the choice we made doesn't change the fact that the options we had to pick from were pretty awful. 

We arrived at the hospital about an hour after I hung up with Dr. Pluhar and we were waiting in the hallway to see Max as he was being brought from the medical imaging area to the ICU. Max was wheeled over to us on a stainless steel cart that had been transformed into a temporary gurney. He had a heated blanket to lay on and soft fleece draped over him to keep him warm. And even though he had just been extubated minutes before, his head was up when they wheeled him around the corner.

I have to admit that seeing him with his shaved head, incision, and stitches was a bit of a shock. Though I had been told what to expect, it's one thing to imagine and another thing to experience. Max looked like any number of animals I have seen photos and video of who have been either documented in or liberated from research labs. I immediately thought of Britches, the infant monkey who'd been liberated from a horrendous lab wherein sadistic people at the University of California had taken him from his mother and sewn his eyes shut and put him in a sterile cage with nothing to cling to but a padded cylinder. Then I thought of the unimaginable numbers of beagles who are, right this moment, languishing alone and in pain in research labs after having their bodies cut into and sewn back together by people who don't care anything about them. 

Max is in our lives because of the incredible work that people have done to expose what is done to these helpless and vulnerable animals. We adopted Max way before the creation of The Beagle Freedom Project, a group working to get labs to release the dogs for home placement after they are no longer wanted for testing as an alternative to killing them. We adopted Max because Brandon was so touched by the plight of beagles in labs.

This may be part of why it was so important to me to be there for him as soon as possible after he woke up. Even if he was too out of it from the drugs to know I was there, I believe that somewhere inside he would know that he is dearly and fiercely loved. That he's not alone and not forgotten and never, ever, ever will be.

I can't say enough wonderful things about the team of clinicians at the U of M. They're ICU staff is incredible, and have always been tender and loving to Max. I know he'll be monitored closely, and any person who interacts with him will do so gently and with his comfort and health in mind. 

I'm so grateful for that, and at the same time my heart hurts with the knowledge that the only difference between Max and any of those other animals in labs waking up from surgery is that someone decided Max would go to live with a family instead of being sold to a research institution. The entire life experience of nearly all domesticated animals is determined by a human (or humans) and there's so very little that they can do about it. 

Maxwell a couple of summers ago, enjoying his yard.

I'd like to acknowledge anyone who has made a choice to listen to and honor someone from another species, and take responsibility for that power that we're born into by virtue of being human. And challenge you to do make a commitment to furthering those actions in whatever way makes sense for you. 

To Max.

Watching the Clock

I've been watching the clock for a couple of days, counting down to today. Counting down to when we can give Max his last bit of food before surgery, counting down the time we have with him before dropping him off at the U of M Small Animal Hospital, and now counting down the minutes until he's in surgery.

According to Dr. Pluhar, Max's surgery would be starting about now. Part of me feels a bit silly for being so fixated on something that I can't control or have any influence over. And another part of me knows that this is the only way I have right now to "be with him". I can be aware of what he is likely experiencing by watching the clock.

Denying any dog breakfast is hard, but with beagles (who live to eat) it's a downright struggle. Luckily, today, Max was distracted enough by the odd hour that his dad and I were up and getting ready for the day. I took him out to the car while Brandon gave Warren his morning meal and then we were off to Saint Paul.

Riding with him on my lap, I was trying hard to emanate calm for him. As with human children, dogs often pick up on what their caregivers are feeling and either mirror it or respond to it. We had a quiet ride and took our sweet time getting from the car to the front door of the clinic. Max is a typical scent hound in that if he's outside, his nose is to the ground and working like crazy. There were so many smells, too, with all the traffic the U of M Vet Clinic sees. I stood patiently waiting for Max to catch up on all the latest happenings along the walk way and when he was ready, we went inside.

While Brandon checked us in, Max got to sniffing the inside of the clinic. And within less than a minute, he was emptying his bowels in the lobby. Never mind that we just spent nearly ten minutes getting from the car to the front door. Maybe he was just helping them to adjust their expectations for him right away. "I gotta be me."

Dr. Pluhar came out and welcomed us right away and made a fuss over meeting Max. She expressed surprise that he's fourteen, as everyone does upon meeting him. Granted, we adopted Max as an adult and just go by the shelter's report that he was three years old when we brought him home. But knowing Max, I think it makes perfect sense that he would embody the "You're only as old as you feel" adage.

I have to give props to Dr. Pluhar that she acknowledged my sensitivity and anxiety about Max's surgery by asking me how I was doing. I told her I was okay, and immediately explained that I have been talking to Max about what he can expect today in an effort to alleviate any fear he may have about the next couple of days. She laughed, good-naturedly, but it was a reminder that the way Brandon and I and many of the people in our lives regard animals is quite different than the way most other people do. Even many of those who spend more time with them than most and who have dedicated a large portion of their lives to helping them.

Refusing to feel awkward about the possibility that I would come off as a kook to his surgeon, I crouched down and explained to Max one last time that this is the time when his dad and I were going to leave him here because they have the machines and the medicine to make him feel better. I reminded him that the people here are very kind and they know a lot about how to make dogs feel better when they're sick or hurting. I told him that he was going to go to sleep later and when he woke up, he will probably feel funny and maybe be sore, but that his dad and I will see him as soon as we can and we would be coming to pick him up and take him home tomorrow.  Dr. Pluhar indulged me in my choice of goodbye and reassured me one more time that he was going to be fine and she would call us later to let us know when he would be out of surgery.

Then she took Max's leash and tried to lead him away. He wasn't keen on going, so I spun him in the direction he needed to go and gave his tush a little nudge. He went along with her but tried to keep his eyes on us. I wasn't sure what to do - if it would be best for us to walk away and not be in his sight, or if we should stay where we were so he didn't interpret us turning our backs on him and leaving as abandonment. We ended up slowly shuffling away as Max was being reluctantly ushered in the other direction. When he was out of sight, the tears came.

I hadn't realized how much I had been stuffing down for his benefit. I wasn't having second thoughts, I was just finally able to cry without concern about how it would impact Max.

We took a few minutes and Brandon said the same things he's been saying to comfort me for a week. That this is the best place he could possibly be, that he should feel better when it's over, and that Max knows how much we love him. It helped, like it always does.

So now we wait for the call from Dr. Pluhar telling us we can come back to see him for a "drive by" visit as they transfer him from the surgical ward to the ICU. She's not authorizing visiting hours for Max tonight because he needs to stay quiet and resting, and if he sees us he will either get too excited or very distressed when we leave him again. So we're going to just see him when he's still coming out of anesthesia so we can see him and know he survived and he'll be okay.

Warren is going to be a little spoiled for the next day or so.

Max's Surgery Is Tomorrow

Tomorrow morning we bring Max to the University of Minnesota Veterinary School to have surgery to remove as much of his meningioma as possible and begin the process of his enrollment in Dr. Pluhar's Canine Brain Tumor Research Study. I'm nervous and scared but trying not to come undone because Max would worry. He doesn't know what's happening tomorrow, which is a blessing because he doesn't have to deal with anxiety or fear leading up to the procedure. I get to do that for the both of us.

Kisses before bedtime.

He's been up in the night wanting to go outside or get a drink of water, or a snack, or just roam around the house, as far as I can tell. And we take turns getting up with him. I've been having difficulty getting any good rest because of the serial trips out of bed every night as well as the relentless dreams full of upsets, discomfort, fears, and frustrations. Driving a car that has faulty brakes, finding a cat and kittens who need help and not knowing how to help them, being in prison and away from all of the people who love and support me... I wake up exhausted. But then I remember that I will miss getting up to let Max out in the yard at 4:30 a.m. when he's not here to wake me up anymore, and I try to make it the best trip to the back door and back that I possibly can. 

This is how I interpret the responsibilities and heart of being a parent. The getting up when you're bone tired because someone who you love needs you. The trying to shield your little one from anything that might make them feel insecure or concerned about things they can't change. Looking at them standing in the doorway watching you and trying to imprint that memory as fully as possible because it's ordinary and precious and we don't want those moments never caught on a camera to be lost when time inevitably changes everything.

All In

max·i·mum

ˈmaksəməm/

adjective

1. 1.

   as great, high, or intense as possible or permitted.

   "the vehicle's maximum speed"

   synonyms:

   greatest, highest, biggest, largest, top, topmost, most, utmost, maximal "the maximum amount"

2. 
   

We adopted Max when he was three years old, he's now fourteen. He was diagnosed with a meningeoma in December and is scheduled to undergo a craniotomy on Tuesday, January 27th.

Max isn't one for half measures. He's an all-or-nothing kind of guy, in stark contrast to his parents who are both cautious and conservative when it comes to risk-taking. We believe in insurance, emergency preparedness, and read reviews not only on large purchases but small ones before we purchase as well. Obviously, signing our beloved beagle up for brain surgery is unsettling for the likes of us.

This guy has been through some extreme and unusual episodes, and somehow he always ended up on his feet looking for his next snack. We know he can't do this forever, but we're sure that he's not done with life yet. And if brain surgery is what it takes for him to get to keep getting more snacks, we're confident he'd consider that a fair trade.