Signs of Life

After last nights hours of wailing and screaming, we were actually pretty delighted that this morning Sophie was sleeping really hard. Her eyes were rolled up in her head, she was snoring and she seemed in a relatively comfortable position. We tiptoed around the house trying not to wake her for fear the wailing would start up again.

We checked on her periodically, but she was really zonked. We finally drew the line at 10 am. That was the time we would roust her, make her walk around give her more medicine, water, food, whatever we could get her to take. At 10 am she was still zonked. We looked at each other, worried, but thinking it's good that she is resting. And she is in her kennel so she is safe.

Another hour goes by, and another. Roy draws another line in the sand: 2pm. If she isn't starting to wake up by then, we are calling the vet. 2pm came and still no effort by Sophie to lift her head. By now Roy and I have worked ourselves into a pretty good panic. Is she in a coma? She hasn't had anything to eat or drink since she got home, is she dehydrated? To what degree is her AIHA involved? Her inner eyelid was up and covering her eyes, was she going blind? Does she have neurological damage?

We call and leave a message with the on call vet at VSA. Yesterday, our messages got us a call back within 15 to 20 minutes, but this afternoon it took a good hour. You know us, we put that hour to good use. We revved up our panic. We practiced lifting the kennel. We measured the kennel, measured the back of my car. Measured everything again. Called my dad - he came over (THANK YOU!!!). Packed up Sophie's meds in a bag. Packed a dinner for Joey. And otherwise prepared to take Sophie to the ER. My dad was great. He checked her out and explained what concerned him and what didn't. What pain medicines can do and how long they can stay in the system. He checked her eyes and thought they were reacting OK. He generally helped us gain some control of ourselves and the situation.

When the doctor called, he and Roy spoke for a while. He had Roy do a skin test to see if Sophie was dehydrated - she wasn't. If you know Roy you know that he asked lots of good questions and restated the answers to be sure he understood. We learned a lot (again - this vet is fabulous) and when we hung up we felt pretty certain that Sophie was either extremely exhausted, heavily medicated due to the patch on her ankle (oh yes, the patch, we forgot about that) or both. We were told to force her to get out of her kennel and walk even if only for a few steps.

That's what we did. We got her up and helped her hobble across the room to a throw we had waiting for her. She has been on that blanket for the past few hours. She has started to open her eyes a little be more. When they are open, she seems to follow our actions around the room. She has adjusted herself a few times and just a few minutes ago she stood up and headed for the back door - she wanted a bathroom break.

She is again resting on the blanket. She still has had nothing to eat or drink nor has she had any of her meds. We will reassess in the morning.

This is hard

I only do well with my own pain. When Roy had his kidney stones it was so hard to watch him experience those waves of pain. He at least could talk to me; tell me that a wave was coming, and leaving and when it was time to tackle a nurse for more morphine.

Sophie can't do that. She can't say "Hey, the pain meds seem to be wearing off, let's load up another one." All Sophie can do is scream when it hurts and I don't handle that well. She is panting and whining, wailing and screaming. Picture a polar bear calling her cubs that are a half mile away. That's wailing. And I'm not allowed to give her the pain medicine in any less than 8 hour intervals.

Last night was rough. Sophie wailed, and screamed until at least 11pm. We called the vet (again) to ask what we can do for her. He said definitely no more pain meds 'til morning and it was possible she was simply over medicated and that was causing the wailing. He said to put her in her kennel, cover the kennel with a blanket and ignore her. WAY easier said than done, but we did it. It took a few hours and a few visits from us to say "It's OK" but she finally was able to sleep.

Sophie is still sleeping this morning. I can't really give a report on how she is, since she hasn't done anything but rest. Rest is good.

Sophie is home

Sophie is home! We were able to pick her up Saturday morning first thing. The nurse carefully explained to us all that she had been through, what meds she is on will be on and when to stop what. I took lots of notes.

They seemed pleased with how she is recovering from the surgery. She clotted well on her own so she did not need a blood transfusion. She is still producing material that she is blowing out her nose. That will diminish as she heals, but I don't think it will ever completely go away.

You can click the picture above to see that her head is shaved from above her "eyebrows" down to her nose. She has a line of stitches that goes from between her eyes down her snout to her nose. She has two holes in her forehead. Those used to have the tubes that were used to administer the anti fungal medicine. She came home in an Elizabethan collar and a sling to assist her rear half with walking. We are supposed to keep her in a small room with walking only allowed for bathroom breaks for two weeks. Our vets have said several times in different ways that THEY MEAN IT. Sophie's got a reputation. So do we.

We got her home, let her walk in the yard for 5 minutes for some relief and then straight to bed. We have her in our rumpus room with the windows slid open so she can enjoy the breeze from outside. She has repositioned herself a few times, but is now resting and watching our every move. I am sitting on the floor next to her and will be for the next few days.

Joey was delighted to see Sophie. She wiggled and waggled around, but knew immediately that Sophie needed her space. She is very interested in what Sophie is up to, but she is also being respectful.

Sophie is "Hanging Out"

We got a call this morning from the vet's nurse updating us on Sophie. She did fine overnight and is still resting this morning. She is on lots of pain killers and is probably a bit loopy. She will be taken for a walk around noon and her anti fungal treatment is still planned for this afternoon. We will know later today if she is coming home or will spend another night.

But right now, she's just "hanging out" in her kennel (which is a good thing - better than panting or whining).

Props should also be given to the littlest labrador. Joey has stepped up her game in the past few days. She has decided Frisbee is pretty darn fun - so is chasing down the flat soccer ball. And she snuggles in extra tight when mom buries her head in the pillows.

Surgery is Done

We just heard from the veterinary surgeon and Sophie did well. They cleared both nasal passages of all the fungus (I'll spare you the details of THAT - ever see the movie "Face Off"?). Thankfully, the CT scan was accurate and the fungus had not reached the brain. The fungus is apparently a lot like bread mold, ew. She also put in the tubes that, tomorrow, will be used to fill the nasal passages with anti-fungal medicine.

She is in the process of waking up and getting her wits about her. She is not completely out of the woods yet, there is still a chance that she will need a blood transfusion and with her AIHA (anemia) this is extremely dangerous and potentially life threatening. Cross your fingers that this afternoon's lab tests show she doesn't need a transfusion.

If all goes well, we can bring her home as early as tomorrow. She will have a shaved face with stitches from between her eyes down to her nose and a BIG collar to prevent her from rubbing her face. She is looking at a two week recovery with the collar then we'll see what's next.

We had the surgeon assess the severe limp and take x-rays too. We don't know anything for absolute certain, but it appears to be "lower back pain" - who among us doesn't have that? We will try to treat that with anti inflammatory medicines while focusing on recovering from today's surgery. We might have to revisit that issue later.

So. In short, Sophie is not completely in the clear, but she is doing as well as can be expected right now.

Whew.

Surgery on Thursday

We spoke to Sophie's vet late this afternoon about her test results. She confirmed that Sophie's fungus is Sinonasal aspergillosis not disseminated aspergillosis. That's the first bit of good news as the disseminated aspergillosis is much farther reaching and has poor treatment outcomes.

As stated before she recommends surgery for Sophie's condition and I'm trying not to flip out over the fact that she "insisted" that we do it Thursday if we feel that is our best course of action. The implied urgency is what is upsetting to me. However it is understandable when the doctor explains that this fungus has already invaded Sophie's septum and it is important that it not be allowed to reach the brain. The CT scan did not indicate the brain had been invaded. That's the second piece of good news.

We have an appointment to meet with the surgeon Thursday morning and presumably we will leave Sophie for surgery and at least one overnight stay (if we don't leave Sophie it is because we decided not to go ahead with surgery). What we know right now is that they will saw open her skull to literally scoop out the fungus and apply medication. At that time they will also insert two tubes in her head that will be used to administer more medication. The surgery is delicate and intensive and will take several hours. Sophie will stay over at least one night, and perhaps a second one depending on her experience after the procedure.

One reason they will keep Sophie is that it is common for air to leak through the fracture in her skull which causes her head to fill with air - not dangerous, but upsetting to see. Once home we will have to watch her carefully for the first week for the possibility that another anti fungal treatment is needed. Fingers crossed, after two weeks will be back to the Sophie that existed before the fungal infestation. That sentence right there is the entire reason we will go through with this.

Although we are hopeful, optimistic and full of questions for the surgeon we are both very nervous. We had the same high hopes when we took Sammy in for her surgery years ago and that ended in great sorrow.

There's a Fungus Among Us

All things considered, Sophie is OK.

Sophie has been having a nasal discharge for a while. It was clear when it started (meaning likely an allergy), but recently it has become green, brown and red and smelly. Her breath as been really bad too. When we took her into see her specialist for her anemia we reported this (which we had before) and we all agreed it was time to put her under, do a CT (to check for tooth/root problems) and do a scope of her nasal passages too if the CT suggested it was a good idea.

So Sophie got scanned and scoped (and her teeth cleaned and toenails clipped). It appears she has a fungus growing in her nasal passages (aspergillosis) all the way up to her frontal lobe. Apparently we all encounter fungi in our environment everyday, but her compromised immune system (due to her AIHA) couldn't fight it off. She will likely need surgery next week to fully remove the fungus as it is too high up to be treated any other way. The surgery will mean opening up her skull to completely extract the fungus and medicating the area. I'm not liking the idea of that at all, but if we don't treat her, the fungus could eat her brain.

Right now she is groggy, and bleeding a little from her nasal biopsy. But her attitude is good, she is eating and she is drinking. So all things considered she is OK. The hardest part is her rear left leg got hurt somewhere in the process of the scans and scopes so she as been walking on only three legs. Her scans and samples have been sent out to be read and tested. We should know more Tuesday or Wednesday (holiday weekend).

I, on the other hand, am a mess. I think I will go completely grey this weekend.