Tuesday, February 9, 2016

How Do You Decide To Break Your Own Heart?

How do you go from trying to save the life of your partner to making the decision to let her go in a single hour? How can anyone make that decision? How can a person even entertain that idea? It seems unthinkable, impossible. Life without Prada? What a ridiculous notion – how could I have come to this? The world doesn’t make sense without Prada in it! How could I even think about life without my partner, my best friend, my beloved? How did it come to this?

If you hear desperation, consternation, and despair in my voice right now, it’s not your imagination. Every move I have made since that dreadful hour Thursday morning, every thought I have had, has come to a grinding halt as I realise that I have to move and think differently now because she’s not here. That’s not an exaggeration, believe me. My first thought when I wake up is “I have to take Prada out.” Then I remember she’s not here. Then I get dressed, and I immediately glance at her bowls to see what she needs, and I flinch, remembering that she doesn’t need food or water anymore. It was only yesterday I had the heart to empty her kibble back into the bin. Then I sidle past her food to get into the closet, because if she’s actually eating this morning I don’t want to disturb her. She has – had – as irregular an eating schedule as I do. Then I step outside of my room, and her harness is hanging on the door right there. I close the bedroom door behind me to make sure she doesn’t go back in to wake Derek up while I get ready to take her out – but she won’t ever poke him with an overly-enthusiastic wet nose too early for his liking ever again. I put my hand down to pat her head while I drag a brush through my hair and put my contacts in, but she’s not there. The day goes on like that. Until she was gone I had no idea how many unconscious habits I had developed around her, like checking behind my rolly chair in the office to make sure she wasn’t sleeping behind it, or putting my hand down to touch her head every time I stand up from any chair in any building. I have to edit her out of every thought and move, every habit and pattern in my life because she was in all of them.

But I knew I would outlive her, and many more dogs, when I applied to The Seeing Eye for the first time. I signed up for this grief, after all. I knew there would come a day when her pain would be so great, either thorugh old age and the depression that accompanies retirement or thorugh injury or illness, when I would have to make the decision to choose heartbreak over a few more days or weeks with her. I think committing to working with a service dog is one of the few relationships in life where you have fair warning that you will have to grieve over multiple loved ones. You know ahead of time that you will outlive your beloved. You know, and that makes the decision just the slightest bit easier. But not living in the aftermath of that decision. Nothing in the world could make that easier.

The average working life of a German shepherd who starts his career around 18 months old is seven to nine years, according to The Seeing Eye’s graduate statistics. Prada was 36 months old, and she worked with me for six years, seven months, and nine days. That puts her squarely in the average work expectancy, but she was in such good health that I thought she’d manage at least another two to three years. She hadn’t shown any signs of slowing down at all, and after all, average is just the average, an equation that balances both the shortest and longest time spans.

Six years, seven months, and nine days. Funny what dates and time spans you can remember throughout your life, isn’t it? I remember that I wore braces for three years, two months, and three days, and I remember that Prada worked with me for six years, seven months, and nine days. Those two have nothing to do with each other, and the discrepancies between their magnitudes of impact on my life are incomparable. But I know I will always remember those numbers.

I’ve not questioned my decision once since I made it. I’ve never doubted it was the right decision. In fact, it didn’t even take me an hour to make it. I made that choice as soon as I heard the word “cancer” come out of the vet’s mouth. It just took me that long to say goodbye.

So how did I go from posting on this blog that Prada was recovering from having a cyst lanced to posting an obituary just days later?

You probably guessed by now that pesky cyst wasn’t actually a cyst. It was a tumor from the cancer that had metastasized through her body. The tricky thing about most blood cancers, as I understand it from the vet, is that because they’re in the blood stream they metastasize rapidly because blood travels to every part of the body constantly and at a decent clip, too. Both the emergency vet who found the hemangiosarcoma and my regular vet assure me that once the cancer developed, it wouldn’t have mattered how quickly we caught it. It is always fatal, and always painful. I’m still waiting on the necropsy and post-mortem reports from my vet so I won’t go into the specific medical details of the condition, and this post is already pretty long so I won’t detail the brief history of her decline. Instead I’m going to focus on that last hour, the hour in which I made the decision to let her go.

When we arrived at the emergency vet clinic a technician took Prada right away to get an ultrasound. He brought her back out to us and the vet came out and asked us to join her in an exam room. She showed my husband the ultrasound image, because she knew I wouldn’t be able to see it, and described the tumor that had begun bleeding into her stomach. She also confirmed that the lump on her shoulder wasn’t a cyst at all, but a tumor, irrefutable proof that the cancer had metastasized throughout her whole body by then. She described our treatment options as follows:
1)                  Surgery to remove the tumors would give her four to six months, with a two-week recovery period, and it was unlikely she could keep working during that period.
2)                  Surgery with chemotherapy would give her a year at most, with the possibility that she could keep working during at least a few of those months. Dogs tend to react better to chemotherapy than humans do, but no guarantee that she could keep working. She would be at risk of retirement depression, which would probably kill her faster than the cancer. Service dogs don’t tend to live more than a few weeks after retirement (that’s from The Seeing Eye, not the vet).
3)                  I could let her go, right here, right now, and save her months of painful recovery and depression.

As I said above, the minute the vet said “cancer,” even before she discussed treatment options, I knew it was over. Based on her age, my very general layman’s knowledge of cancer treatment recovery options, and retirement factors in service dogs, the answer was very clear to me. She would be miserable no matter how she was treated, and she would never be my Prada again. Still, I felt distinctly underqualified to make that decision. What did I know about veterinary medicine, or service dog lifespans? After all, this was my first dog! So I listened to the treatment options, then asked the vet how long I had to make the decision. She assured me Prada would be dead by morning, bleeding out into her stomach, and that it would be very painful, so I had to make the decision as quickly as possible. I asked if I had time to call The Seeing Eye for advice, and she said I did, and left the room so I could make the call. My husband stepped out into the empty waiting room to update our families and call a friend to come sit with us during this period; we would need support no matter what decision we made. I called The Seeing Eye, hoping and praying that they had staff available 24/7 because it was about 2am on the East Coast where the school is. Turns out they do, and I’m sure I knew that but as you can imagine I wasn’t exactly thinking clearly at the time. The on-call representative directed me to the night-shift trainer, who listened very patiently as I gasped out her diagnosis and prognosis with all her treatment options, then told him what I thought the decision ought to be. He let me take my time, and confirm that that was indeed the right decision, reiterating a lot of the thoughts that I had cobbled together about depression and retirement in service dogs, and assured me that I was making the right decision for my partner.

I sat with Prada alone in the exam room for several minutes after getting off the phone with the trainer. She was so calm and lethargic that I knew she felt awful. She hadn’t gotten up and paced the exam room, hadn’t poked at the door handles or nosed the cracks under the doors, hadn’t gotten up once from where she lay next to my chair. She wasn’t quivering or crying, just sitting patiently and quietly next to me. As I noted these details about her behaviour and compared them to normal visits to vet offices, I became more and more resolved; I had to let her go. She was in pain, and depressed already. It was the hardest and easiest decision I’ve ever made.

I don’t have the heart to finish my description of how Prada died right now. I will share it with you sometime in the coming weeks, but right now all I can do is show you how I made the decision to let her go, which I’ve now done. Future posts will include discussions on grief, more medical details of her condition, what the reapplication for a new dog is like, what it’s like going back to being primarily a cane user, even temporarily, and filling in the gaps of Prada’s life on this blog. Although they may take time to answer, I will answer questions about my personal grieving process, and other sensitive topics related to her passing. I encourage you to ask anything that crosses your mind, no matter how difficult for you or for me. I cope with stress by telling stories, true and fictional. Writing and sharing my experiences, educating and advocating is vaguely comforting to me, and I strongly believe that the more we share of ourselves the more we will empathise with strangers and those different from us. As John Churton Collins wrote, “if we knew each other’s secrets, what comfort we should find.”

Also, I am collecting pictures and videos of Prada. It amazes me how many people have pictures and videos of her that I don’t have, how many people captured memories of her in unexpected places. If you have any that you’d like to share with me, please contact me on this blog and I will make arrangements with you to receive them. I don’t put my email address on this blog for a variety of reasons, not the least of which is spam, but we’ll make arrangements if necessary. Thank you to each and every one of you who has read and shared this blog, and who grieves with me over Prada and cherishes memories of her as a happy, healthy, loving friend.

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