TAKEWAYS POST SURGERY

What did I learn from this experience with Annie?

• If the consequences of the medical issue can be profound, always get a second opinion even if you agree with the diagnosis. We should have done this from the very first time the subject of the lump was discussed. An earlier surgery would have translated into less anxiety and worry for us, less of an ordeal for Annie and probably lower medical expenses.
• Don't lose sight of the bigger picture. I convinced myself everything would be OK, losing sight of the worst case scenario. I'm not advocating doom and gloom here, I'm just saying that hoping for the best but preparing for the worst might be the best course of action.
• Ask questions, ask questions, ask questions. And did I say ask questions? Ask 'em until you're blue in the face; ask 'em until you have satisfactory answers you can live with and enough information to make intelligent decisions.
• Stay calm and carry on. The British motto from the days of the blitz holds true when dealing with medical emergencies. The stress of a major medical crisis is the same as being under siege. If you don't stay calm you won't think clearly, act rationally or make solid decisions.
• If you're uncomfortable with any aspect of diagnosis, treatment, etc. talk it over and talk it out until you are comfortable.
• Above all, love your animal and try not to communicate your negative feelings. Our pets really do sense what we feel. You want to stay positive, calm and loving so your pet won't be stressed any more than necessary by their medical emergency.
• Finally, don't spend time beating yourself up. You are only human after all, there is only so much you can do and as long as you are doing the best you can be easy on yourself.

Annie's saga is by no means over. Our little family will  have to relive the possibility of another cancer diagnosis with every 3-month Oncologist visit. Another medical emergency came back in force and it will be the subject of the next post.

ANNIE'S CANCER SURGERY

Quite a while ago I promised to write about Annie's surgery once I could bring myself to do so. Now is the time.

As anyone following this blog will know, Annie had a lump at the bottom of her rib-cage for more than a year. Both myself and Artie as well as Annie's doctors were monitoring it. The lump felt like a fatty tumor. At the time of Buddy's death, Artie wanted to have it removed; I did not want to put her through surgery if it wasn't necessary because of her age as well as the dangers associated with surgery and anesthesia. We decided to continue to monitor the lump.

Around Thanksgiving we noticed the lump was bigger. Not by much but now we were concerned with 'quality-of-life' issues - would it be uncomfortable for her to lie on her side? If we didn't remove it now and it became bigger wouldn't surgery be riskier as she aged?

Annie went for an office visit December 13th. We discussed our concerns with the doctor and a sample was taken. When the cytology report came in December 15th, the findings were as follows:

"No significant inflammatory response was evident. The spindle cells displayed minimal atypia. Findings may reflect a benign fibrosing cystic structure, cystic spindle cell tumor (fibroma or low grade malignant potential sarcoma), or other underlying nonexfoliating fibrosing cystic structure."

At that point the both of us AND the doctor wanted it removed. Surgery was performed December 20th; Annie came home the same day. She was still somewhat under the effects of the anesthesia, on Rimadyl, not interested in food or water and did nothing but sleep. It took a few days for Annie to return to her usual self - a sure sign that my girl is older now.

Christmas was a somber affair as we worried about the biopsy results. The results of the biopsy came December 26th and the lump definitely was cancer. The report characterized it as a slow-moving soft tissue sarcoma. The surgery did not produce clear margins; Annie needed to have additional surgery. If the second surgery did not produce clean margins, she would need radiation therapy. We were referred to Dr. Cohen at VERG (Veterinary Emergency Referral Group) and an appointment was made for the next day.

Early the next day, Artie and I took Annie for her consult with the oncologist. Dr. Cohen was wonderful and Annie fell in love with her. After the exam, Annie was taken for a series of x-rays while we waited in the examining room.

Dr. Cohen returned with the x-rays and reviewed them with us. Annie had several points in her favor.

1. Her behavior was normal which Dr. Cohen assured us was a good sign.
2. There were no visible tumors on any of the x-rays - a good indicator that the tumor most likely wasn't metastatic.
3. Radiation would only be needed if the second surgery did not produce clean margins.
4. Annie had a good chance of a 100% recovery if the second surgery produced clean margins.

We discussed radiation therapy which would be done over a period of eighteen days if needed. My mind was reeling from the logistics.  There were 3 places Annie could go to, the Animal Medical Center in NYC, a facility upstate or a facility in New Jersey. She would go on an outpatient basis which meant going in and coming home daily or she could stay for 5 days coming home for the weekends. Dr. Cohen suggested not thinking about next steps until we had the post-surgery results. The follow-up surgery was scheduled for January 5th and we all went home to wonder what 2013 had in store for Annie health-wise.

I will pick up this narrative in a second post along with post-surgery photos.