Friday, July 31, 2009
Improvement! Day 5
I emailed the clinical trial tech at MU for an update on Linus:
Dear MrsLacubrious,
I was just down in ICU looking at Linus, he seems to be doing much better today. His temp is down to 102.8, he is still ataxic, but not nearly as bad as yesterday. He pulled Lorie around this morning when she took him out for his walk. He did tolerate the rest of his plasma transfusion. I think that the worst is behind us. I will check with Dr. Selting when I see her this morning about repeating a CBC on him today to see if his platelets are rebounding yet.
He is sleeping like a baby now. I’m sure he’s exhausted he had a bad day yesterday.
I’ll keep you posted on how he’s doing.
DT
*******UPDATE FROM LORIE***********
Linus was alert and walking although still somewhat wobbly. He went outside and did his "thing". They gave him his medicine wrapped in some ham which he took but when they offered him dog food he turned away. So they fed him Vienna sausages! He ate those but later on vomited, probably due to the sausages! He's not used to that type of food! Anyhow, they're going to continue giving him fluids and monitor him overnight. The neurologist still see that he has some neurological deficits but he is brighter and more alert than yesterday so we're hopeful he'll continue to improve.
If they release him tomorrow we're considering just going up to Columbia and staying Saturday night and Sunday night so we can cut out some driving and be ready to take him back in on Monday for his clinical trial evaluation. It would be nice to bring him home though if even for a little while...
*******ANOTHER UPDATE FROM LORIE***********
So Linus just went outside again and seemed to enjoy the nice weather for awhile but eventually stopped walking and just stood in one place. They gave him something called Cerenia to help control the nausea. They plan on offering him food again at 5pm. Then they will monitor him this evening and run more blood tests in the morning. I emailed Debbie Tate, the clinical trial coordinator, to let her know that soft foods are what we had Linus on this last month. So now he probably prefers them. The ataxia is still present. Lorie said he walks like he's drunk which fits in nicely with our crowd (LOL). Seriously, we hope that the ataxia will wane as he gets better and is certainly something we can cope with.
Thursday, July 30, 2009
Update on Linus's return to ICU
MU called and Linus's fever is down to 104.1 but he had an allergic reaction to the plasma tranfusion. So it was stopped while they treated him with benadryl. He still has no appetite but they're hoping after the itching and facial swelling subside he will feel like eating.
In an earlier call we were told that he is anemic and low on protein. So tranfusions would be needed. A call to NIH was made and the study manager indicated that these low numbers did happen in other animals on the trial and that they had recovered.
The thing to watch for is something called capillary leak.They will recheck his bloodwork in the morning and once his temp has come down to normal they will reevaluate his neurologic response namely the weakness in his legs (ataxia). They plan to do a spinal tap to rule out some things.
Sent from my iPhone
Back at the University :( - Day 4
Linus had to be taken back to MU since the fluids were not helping the fever enough and he started showing signs of ataxia. First in rear limbs then in his front limbs. I had to lift him out of the car at MU but couldn't get him to walk so I carried him into the clinic.
Bad night...
She pushed the 1st 100 ml in within the hour then dialed it down for the rest of the night. Since we had no way to confine him we opted to leave him at the clinic for the night and check on him in the morning. Dr. Stuart was going to call MU first thing to give them the info on his status.
Sent from my iPhone
Wednesday, July 29, 2009
Linus is home! Day 3
This video shows where he had his neck shaved for the jugular cath and also where his front leg was shaved. I took him on a short walk down the block hoping he would perk up a bit and maybe eat some dinner. As you can see he's fairly alert.
Tuesday, July 28, 2009
Evening update #2
Morning Update - Day 2
Speaking of energy, here's a pic from the time that Linus destroyed "bobo", his stuffed dog toy!
Monday, July 27, 2009
Evening update...
Sent from my iPhone
Morning update...IL-12 Injection Day 1
dogs0056_NI
Originally uploaded by dehmystic
Jen Wolf called from MU Vet School to let us know that Linus had a good night and was alert and in good spirits this morning. He was walked and went potty normally.
The plan for the day was to sedate him for the jugular catheterization (ewww) and inject the clinical trial meds. She promised to call around 5pm to give us an update on his status. She also confirmed that he will be in ICU until we pick him up on Wednesday.
WE miss him!
Yesterday I took him for a walk with Baby so he would be calmer for the ride. We headed out around 3pm to take him to Columbia and we stopped to buy him a plain hamburger (minus bread), which he LOVED! He even licked the wrapper! Then he settled in for the ride. We got delayed by a motorcycle accident on Hwy 47 just past Marthasville but I made up the time on the Interstate. (I will not tell you how fast I drove!) We ended up 15 minutes late but it was fine. We signed the Hospitalization Agreement and resuscitation authorization. Then they took him away. DH and I got the heck outta there before we put too much thought (tears) into it, headed to Flat Branch for a couple of beers and a snack then out of town and back home to Baby.
dogs0034_NI
Originally uploaded by dehmystic
Saturday, July 25, 2009
Girls Night Out
A drink special by Grady, bartender #1.....the Grady-Licious
A drink special by bartender #2.....Brass Balls
Wednesday, July 22, 2009
Committment...
As I stated before, we decided to take Linus to the Missouri University Veterinary School in Columbia, Mo. Per their website, the visit was just what we expected. Jen Wolf, Senior Level Student came out to the waiting room to take a history on Linus. Then when they were ready we took Linus to an exam room and Jen checked him out from head to tail. After that, she went to get Dr. Alix Partnow and review the history with her. Dr. Partnow came in and she examined Linus herself, and went through all of our possible options, explaining things as she went and as we asked questions. What they needed to do before anything was to "stage" his tumor, meaning they needed to know if it had spread anywhere else or if he had any other type of masses or health issues. The meant we had to leave Linus there for a few hours while they ran blood tests, aspirated his lymph glands, xrayed and ultrasounded his body (they shaved his belly!) and performed a urinalysis.
We were told to return at 5:15pm to pick him up, however we got a call at 4pm telling us they were done and no other masses or issues had been found! Good news! So we headed back to the hospital to get him and figure out what to do.
Jen Wolf, Dr. Partnow and Dr. Sandra Axiak, the oncologist, all met us in the exam room to discuss the choices for dealing with the tumor. It was news to us that the bulge he still has on his gum line is a tumor. It grew back that fast and I do not think the Vet in Sullivan was aware of this. In fact, I'm sorry we put him through that first surgery because I do not think it did any good other than giving him a tiny bit of relief for only a week.
Basically, the choices now are:
--Do nothing and watch the mass on his gum continue to grow until it affects his eating, metastasizes, and impacts his life.
--Enter him in the Clinical Trial NHS-IL12-IL2 or NHS-IL12 Immunotherapy for canine melanoma.
--Treatment with the human DNA (tyrosine) based melanoma vaccine.
--Surgically remove the tumor and surrounding tissue and bone in hopes of getting all the tumor cells out. Radiate the area for 4 to 6 weeks.
--Debulk and laser the tumor and surrounding tissue and bone. Radiate the area for 4 to 6 weeks.
We decided to try the clinical trial for several reasons;
#1 It's least invasive, although not entirely pleasant for Linus.
#2 The entire cost of that treatment is covered by the study.
#3 We can turn to the other solutions if it doesn't work within 3 weeks.
#4 Linus has a chance to leave a legacy of contributing to science and a cure.
#5 Linus's tumor tissue sample will become part of a tissue bank regardless of success. Canine Comparative Oncology and Genomics Consortium (CCOGC)
#6 We just aren't ready to put him through surgery again so soon.
So here's what is in store for Linus (and us) over the next 5 weeks...
Week#1 - Drop Linus off at the hospital on Sunday, July 26th. On Monday they will shave his neck and insert a "port" for blood draws. He will then be given either NHS-IL12-IL2 or NHS-IL12 and then his temperature and blood will be monitored according to a schedule over the next 2 days while he is in doggy ICU. We will pick him up midday on Wednesday and we will need to take his temperature daily for five days and report it on a special form. We can expect him to be lethargic and not quite himself due to the immune system response.
Week#2 - The following Monday, Linus will need to be brought in for more bloodwork, fine needle aspiration of the lymph glands, and biopsy of the tumor. The tumor size will also be measured to see if there is any response to the immunotherapy.
Week#3 - Repeat of week#2. If there is response we continue. If not we stop the trial and discuss other options for treatment.
Week#4 - Repeat of week#3
Week#5 - Repeat of week#4 and evaluate 28 day regimen.
So, this is the plan for now. I know some people wonder if we are putting him through too much but honestly he still gets excited to get in the car even though his last 3 trips were to be poked and prodded. That tells me he has no lingering effects from his medical treatments.
Last night we came home to find our chain link fence completely installed! We put both dogs out there and even got Linus running around and chasing the tennis ball a little bit. So he's all about living in the moment and we're all about making sure he has as many moments as possible.
Tuesday, July 21, 2009
Linus in Columbia
*****UPDATE*****
Linus has been accepted to the clinical trial of IL12 or IL2! More info to follow.
Sunday, July 19, 2009
Holistic Options
options for treating his melanoma. She had two things to consider
neoplasene (bloodroot) and cats claw. BUT she recommended holding off
until after our consult at the University on Tuesday. She thought that
if Linus gets into the study then they would not want him on any other
treatments.
She did identify some pain in his hips and we got some muscloskeletal
complex and an herbal analgesic plus cod liver oil. So we will start
on those and see if that helps his allergenic paw licking and his hip
pain. He does pant a lot and that can be a sign of pain so I'm hoping
to see a reduction in that as well.
Saturday, July 18, 2009
Fixin the feedback
armed and ready with WD40. Why, you ask? Because every time we've been
at LaGra the kitchen door squeaks in tone that sounds like feedback!
Ugh so MrJonez brought the juice to fix the problem and ensure a
squeak free evening ..... Awesome!
Thursday, July 16, 2009
Mad as a ...
This was a nest of Bald Faced Hornets. Which, according to Wikipedia, is not a true hornet but more related to the wasp and yellowjacket family...whatever. We've watched them building the nest for a bit and I was planning to get them one night with chemical warfare while they were sleeping and we had a more time to hide from their wrath. Either way they're in insect heaven now.
This is pretty much what it looked like BEFORE...only on ours the entrance to the nest was at the bottom. Picture: Copyright 2005. Jason Edgecombe
Change of plans...
On the advice of our vet, I called/emailed the Veterinary School in Columbia, Mo. I thought that the least I could do was find out about the clinical trial and see whether it would be an option.
What I found out is if Linus doesn't have a tumor that they can monitor then he probably won't qualify. I did find out that we would have to pay for the initial workup ($300 - $400) but if the dog is accepted in the study then the associated costs are covered which would be wonderful.
We've decided to take Linus up there for a review of his situation and just see what they say. I cancelled our local oncologist appointment for Monday and instead I'll take Linus up to Columbia on Tuesday.
I did call the local oncologist office just to get an idea of the expense...The vaccination is $525 and there would be 4 of them, one every two weeks. This brings the cost to $2,100 not including any workup, xrays, etc....so that is something we will need to think about.
It might just be that we will have to wait for the melanoma to become visible as another tumor before the University will accept him. Though delaying treatment doesn't seem a wise choice either.
On another note I received the copy of Linus's lab work and pathology report. His bloodwork suggests that he may have an iron deficiency. NO ONE even mentioned this at the vets office so I'll bring it up at his holistic vet appointment on Saturday and see what we need to do there. I guess I need to feed him some raw meatballs or something!
Tuesday, July 14, 2009
Linus Update
infection and said the site is healing fine. They gave us clindamycin
to treat the invisible infection and hopefully improve Mr. Stinky's
breath! OMG the dog breath!
After staying at the vet all day and then getting meds and a two mile
walk ole Linus is beat!
Sent from my iPhone
AKC Gazette Article
Here's a link to a pdf article that appeared in AKC Gazette last year which explains the science behind the melanoma vaccine.
I printed a copy and took it to Dr. Franklin today when I dropped off Linus for his appointment. Since he did not mention the vaccine when he told me about Linus's melanoma, I thought he might be interested to know that it is available, although limited only to vet oncologists at this time.
Monday, July 13, 2009
Why I am getting an IPhone 3GS...
IPhone 3GS vs iPhone 3G Photo - Flower Macro
Originally uploaded by respres
#1 Can you see the difference in these photos?!? My blog posts will be much improved with a clear, crisp visual.
#2 SPEED, yes the 3Gs is reportedly 2x faster.
#3 VIDEO, VIDEO, VIDEO.
#4 So MacBoyKurtis will hate my face...lol!
Check out this link for more amazing photo comparisons between the 3G and 3Gs.
http://www.flickr.com/photos/respres/sets/72157619968064754/
Update...
Okay, so Dr. Bob Menardi emailed me with two vet oncologists in STL who administer the vaccine:
Midwest Veterinary Referral Center
Dr. Michael Buss
17709 Edison Ave, Ste A
Chesterfield
MO
63005
Phone: 636-536-4991
Veterinary Specialty Services
Dr. Joanne Graham
1021 Howard George Dr.
Manchester
MO
63021
Phone: 636-227-9400
I will be calling them to see who can see Linus the soonest.
Also, Linus's breath has turned really smelly over the weekend. (Ack! dog breath!) I think the surgical site is infected so he's going back to Dr. Franklin tomorrow for a quick looksee and probably antibiotics. The site is also swelling a bit although his eating and appetite are unaffected.
*******Addendum*******
Linus is seeing Dr. Franklin tomorrow, Dr. Frick on Saturday for his holistic consultation and Dr. Buss on Monday for his vaccine consultation...3 CAR RIDES!!! He'll be loving that!
Sunday, July 12, 2009
Linus Update...
Not that we can put a price on his worth, but it doesn't do him or us any good if we risk our financial well being. However, we would regret doing nothing for him. It is also important to us that he spend the remaining time he has in little or no discomfort.
So I've spent the week researching various solutions, contacting people with experience and knowledge about the disease, and evaluating it all as much as I can at this point.
Of course the first thing to do is Google as much as possible about canine malignant melanoma, learn about the disease, and find out all possible treatments. Melanoma can occur anywhere on the skin or orally. Typically, oral manifestations are likely to metastasize and are one of two common locations, the other being between the toes.
As I stated in a previous post, surgery and radiation have in the past been the primary treatments. I have learned that in 2007, Merial, an animal drug company released on limited USDA license a vaccine for canines with melanoma. This vaccine is only available to veterinary oncologists. It has a 40% success rate in reducing and even shrinking melanoma tumors. This vaccine was developed in conjunction with human studies at Sloan Kettering and is actually derived from human DNA. Similar vaccines are being used in radiation resistant melanoma in humans as well.
Since the vet that removed Linus's tumor did not even mention this vaccine, I'm assuming that he's not heard of it. I did some online searches for veterinary oncology and so far the closest place that I've found is the School of Veterinary Medicine in Columbia, Mo. So using the Internet I was able to find out that Tim Leard, director of biologics research and development at Merial will be presenting at a conference in July about the path to licensing the melanoma vaccine. From this I was able to track down an email address and took the chance to send him this email about Linus:
Hello Dr. Leard
Thank you for taking the time to read this letter.
Last week my 13 year old dog Linus had an oral tumor removed. The pathology came back as malignant melanoma. The vet I am seeing has only suggested that he could get radiation treatment at a Missouri Veterinary School which is 100 miles away. In my online research I have found that Merial has a vaccine available for this type of cancer…and that the vaccine may help prolong his life. He is a spunky pup even at 13 and goes on a 2 mile walk with me nearly every day and plays quite vigorously with his “sister” so it is difficult to accept that he is terminal.
I am looking for a veterinarian in the St. Louis, Missouri area that would be able to treat Linus with this vaccine. Do you have any information that would help me or is there a way for my local vet to order it and administer it?
Thanks so much for your time,
I was pleasantly surprised to get this response back by the end of the day:
Thank you for inquiring about our vaccine. We currently distribute the vaccine to veterinary oncologist for administration to dogs with melanoma. This insures proper workup, administration, and followup for each patient.
I am copying Dr Bob Menardi who is our product manager for the vaccine. He can provide you with contact info for oncologists near you.
Please keep us informed and best of luck with Linus.
Regards, Tim Leard
Blackberry Wireless
So hopefully, Dr. Menardi will send me info on a local vet oncologist to treat Linus. Additionally, I've contacted a local veterinarian, Dr. Ava Frick, who specializes in alternative and holistic treatments. She's suggested bloodroot plant. Neoplasese from Buck Mountain Botanicals. So I'm going to make an appointment for Linus to see about getting him started with that as well.
Friday, July 10, 2009
Thank goodness for the Port-O-Potty
After that I walked back home, hydrated, and leashed up the dogs for a walk which they enjoyed. We had to take a different route due to the Fair blocking off our usual streets.
Then DH and I got ready and headed out to grab a Jimmy John's, I love the veggie unwich! We picked up some coffee and soda and headed out, driving around a bit to see what's what in the 'hood. We ended up all over the back country and spotted some great views and neat farms, but that giant coffee had gotten to me! Soon we were looking for a wide spot in the road to pull over so I could get some "relief". Luckily, we spotted an old farm house that was being dismantled, presumably to reclaim the old wood so we turned in the driveway to get a better look and voila, my prayers were answered:
--not the actual potty--
Yes folks, out in the country we found a port-o-potty. I had DH keep lookout (there was no one around!) as I hopped out of the car and into the potty! Now we could keep on driving out in the boonies and I didn't have to risk a tick bite on the a$$! Serendipity!
Good, Bad, and Ugly...
dogs0056_NI
Originally uploaded by dehmystic
The good news is that Linus is back to his perky, playful self. Last night he wrestled with Baby, our other dog and was so cute rolling around on his back just like a puppy. DH and I commented on how much better he must be feeling. I took the dogs on a short walk after my Podrunner session so maybe that gave him the energy to play.
The bad news is that Dr. Franklin, our veterinarian called this morning.
The ugly news is that Linus has Malignant Melanoma. The Vet is sending me the pathology report. This is the worst type of cancer for Linus to have. It typically will metastisize to the lymph nodes and/or lungs. I'm not sure what we will do. This vet clinic doesn't have the staff or resources to deal with this. The vet said radiation is an option but that it would have to be at the University and Linus would need sedation every time and it would be many sessions.
I'm thinking about getting another opinion. I think we need to know if it has metastisized. So a chest xray would be in order. I think that would tell us at least how much time he has and what we can expect as far as symptoms and his level of comfort when the time comes.
He's just so lively right now that this is hard to process.
Thursday, July 09, 2009
How long will you be in debt?
Wednesday, July 08, 2009
Tuesday, July 07, 2009
Credit Card Delinquencies at Record High!!!
Since our brush with over-in-debtedness, we've made great strides to eliminate all credit card debt. I have to say that this current economy made me even more determined to get ahead in that area as well as our other debt. We no longer want to be burdened with debt. It just seems that it prevents us from making decisions or taking advantage of opportunities. That's not to say that once we're free of debt we're going to quit working and live a life of leisure, but the ability to be flexible is certainly enhanced by reducing debt and increasing savings.
So how did we do it? We chipped away at it painfully slowly. We closed our business and went back to working full time. We cut expenses. We packed our lunch more often. We ate out less. We bought cheaper and less food. We traveled less. We conserved gas. We paid for the necessities and put whatever was left on the most expensive debt. We checked our bank balance every day. We tracked our net worth. We tracked/graphed our debt. We regularly maintained our vehicles so they would last longer. We took advantage of balance transfer offers. We stopped focusing on "things".
Was it easy? NO WAY! Was it worth it? ABSOLUTELY!
As I've said before, Trent from The Simple Dollar has been through this, conquered it, and now makes a living giving advice about it. He has created 10 postings about his progression from indebtedness to solvency. All are worth a read but #9 The Road to Recovery is the one that I find most relevant.
What is really boils down to, it taking PERSONAL RESPONSIBILITY to change. Change what you're doing, talk to your family about your concerns so they can support you. Use the situation as a lesson for everyone. Dispose of the guilt about the situation (you can't change the past) and channel that into change. Brainstorm with your spouse about ways to make things better. MrLacubrious and I frequently discussed the state we were in. Blaming each other was not the answer. We decided on a plan and agreed that the goal was reasonable and made it happen. It was much easier being on the same page. Did we slip up from time to time? OF COURSE, but we didn't beat ourselves up, we just got right back on track.
The positive reinforcement from making progress on your debt is addicting. Post a chart on the fridge showing where you started and update it monthly for a visual reminder of the progress you've made. We kept our debt info in a spreadsheet that we could open up anytime we thought about the situation. #1 It would keep us from spending on "wants" and #2 It made us appreciate the progress we were making.
So, all you folks with credit card debt....What change will you make starting this week to put a few extra dollars toward that debt? It can be done!
Podrunner Week 1 - Run # 1
I hate that I can't make a permanent commitment to a regimen of exercise and eating right....but even semi permanent is better than nothing at all...right? Well, I say it is, so I'll embrace all my false starts, chalk it all up to learning what works for me and continue on my merry way!
So, my latest foray into fitness has been taking advantage of the warm weather and walking the dogs more regularly, but I'm kicking that up to actual jogging. I've tried it before and never could work past the pain and strain of running. This time, I'm determined to find a better, more gradual way. PODRUNNER INTERVALS!
So what is PODRUNNER INTERVALS?
Well, it is a music mix, with pre determined beat changes to correspond to increasing and decreasing activity levels. Basically, the interval I am using is called First Day to 5K otherwise known as Couch to 5K (ha ha). It gradually moves you from intervals of jogging and walking into a full 30 minute run (5k).
You use each week's mix 3 times that week, then move on. You can move on at your own pace, but ideally within 9 weeks you'll be ready for a 5k run.
I originally read about the Couch to 5K on Lifehacker. Then again I saw that Pasta Queen was using it to get back into her running routine...so I decided to give it a try.
I started with Week 1 on July 2nd...ugh I ended up missing the last running interval. I'm so WEAK! I think it is because I first walked the dogs two miles, then headed out on my interval....bad idea.
I ran Week 1 again on Sunday and made it all the way through! THEN walked the dogs!
I plan to run Week 1 again tonight, then walk the dogs again to cool down and stretch. This seemed to work in my shin splints favor last time...yeah! I hate shin splints...I stretch and ice and stretch and I still get them mostly in my left shin which is weird. I think I have one leg shorter than the other or something.
Anyhow, Podrunner Week 1 is this:
20 minutes from 128 to 142 BPM
BPM CHART:
5-minute warmup @ 128 BPM
60 seconds @ 142 BPM
90 seconds @ 128 BPM
60 seconds @ 142 BPM
90 seconds @ 128 BPM
60 seconds @ 142 BPM
95 seconds @ 128 BPM
65 seconds @ 142 BPM
95 seconds @ 128 BPM
65 seconds @ 142 BPM
90 seconds @ 128 BPM
65 seconds @ 142 BPM
90 seconds @ 128 BPM
60 seconds @ 142 BPM
95 seconds @ 128 BPM
65 seconds @ 142 BPM
3-minute cooldown @ 128 BPM
Off I go!
Friday, July 03, 2009
Beware the 5th bottle!
is awesome with mr$mrs Lacubrious Jonez and us plus Karen! Woooo!