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The Parabola

I am the .1 percent that makes the parabola possible. I am that weirdo.

My doctor saw my blood pressure rising precipitously over a couple of months this fall and decided to put me on a blood pressure medication. I was too tired to argue. I’d hoped to avoid new medication trials, and new doctors, until the end of graduate school, but clearly the emergency lights were flashing, so I took the medication and a referral to a cardiologist.

At first I just felt dizzy and even more tired than usual and kind of nauseous, but my blood pressure was going down (I had to check it at home twice a day). I went to the cardiologist for a work up anyway, like the good obedient girl I am, and suffered through lots of tests, and history taking, and quizzical looks about my long term lack of a diagnosis for such a crazy list of odd and debilitating symptoms. Each test and appointment was physically exhausting, and then the cardiologist decided that I would need to see another pulmonologist, and another rheumatologist, and consider changing this or that medication that could be the culprit for my rising blood pressure (high dose NSAIDs in particular can raise blood pressure and I’ve been on one for years now).

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“I’m exhausted just thinking about it.”

I wish I could act like Cricket does at her doctor visits, and bite and scratch and hide under tables, but it doesn’t go over as well with the doctors for humans. So I accepted the needles and the stickers and the probes and the treadmills, with all of the inherent humiliation of being treated like a science experiment, and I smiled and kept my mouth shut so I could get out as quickly as possible, limping down the hallway after one more person told me I seemed fine.

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“No one can make me go to the doctor!”

And then, one morning, my lips were swollen to three times their normal size. They were itching and hurting and I thought there must be a secret hive of bees under my pillow, but no, it was an allergic reaction to the blood pressure medication. It’s a well-known reaction, though not well known to me, because doctors think that if they warn me about possible side effects I will decide to have all of them. The doctor took me off the medication and said we’d wait for the reaction to wear off before trying something else, with no advice on how to make the swelling go down, or a time frame for how long this would be going on. I sat in front of the TV with ice on my lips for hours so that I could be moderately presentable for a few hours at my internship, and then I came home and watched my lips blow up again. I took Benadryl at night, and daytime allergy meds during the day, but the swelling kept rising and falling unpredictably.

A week after the original allergic reaction, my lips blew up even bigger than before. We called the pharmacy and they said to go to an urgent care center and get an epi pen, to which I said Nooooooooooo, mostly because I didn’t want to have to get dressed and deal with people. We called the doctor, and he said to take Benadryl four times a day, which meant that I would be mostly unconscious until the allergic reaction wore out. So I did that. It took another week for my lips to resemble their previous selves, though they are still not quite back to normal. For quite a while there, I’m pretty sure people assumed I was getting collagen shots.

No one believes me when I tell them that I tend to have all of the side effects and few of the positive effects of medication, and have a habit of getting paradoxical responses to medication (biological medication meant to resolve psoriasis led to the skin flaying off of my fingers, seriously). No one believes me when I tell them that I am the patient that makes the bell curve possible. But I am that person.

Cricket paid no attention to any of it. She is immune to changes in how I look. She only notices when I change my clothes, because that’s what’s important to her. Pajamas are good, work clothes are evil, sneakers and jeans could be either/or.

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“Mommy can’t go anywhere without this.”

I have doctors’ appointments scheduled for the foreseeable future, and most likely more medication trials, and more exhaustion, and more people who think I’m being melodramatic until they realize that I’m just bizarre. None of this is normal. I’m not supposed to be exhausted and in pain all the time. I’m not supposed to have all kinds of weird auto immune reactions and connective tissue disorders. I’m not supposed to need so much pain medication that it leads to even more health problems that bring on even more medications. People my age are supposed to work full-time, raise children, and have social lives, not work their asses off just to make it through part time hours, with no energy left to do the food shopping.

Cricket thinks the problem is that I don’t spend enough time scratching her, and walking her, and if I devoted myself solely to those activities at least one of us would be happy.

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“When I’m happy, everyone is happy.”

I feel like I’m holding the parabola in place single handed lately, and there’s no Olympic medal for that. For every one who is safely in the middle of the parabola, with normal reactions to medications, and diseases that can be accurately diagnosed, you’re welcome.

The Clumsy Bird

 

A few years ago, I started working on a children’s story about a clumsy bird, but I couldn’t figure out how to finish it. I knew who the main character was: if there was a tree or a power line or a roof in her way, Lola would smack into it. Her mom took her to every doctor she could find and the bird doctors did every possible test on Lola. They diagnosed her with bad eyesight, then partial deafness, attention deficit disorder, maybe a neurological movement disorder of unspecified origin, or bird seed intolerance, but nothing seemed to stick.

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This is what I think Lola looks like

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This is what Lola thinks she looks like

The last doctor Lola went to was a specialist in flying disorders. He squeezed Lola’s feet, and rotated her wings and had her fly to and from his medical nest twenty times. And then he stared into her eyes, with his wormy breath going up her nose, and said, “You’re fine, go away.”

The flight back home was long and Lola’s Mom had to tie a rope between them to avoid an accident along the way.

Of course Lola had an older brother, who was embarrassed to be seen with her. And mean girls in her flying class (aka gym), who made fun of her for her awkward flying technique and tendency to fall out of the sky.

There was a boy bird in Lola’s class who was taunted for being “as blind as a human,” because he couldn’t see where he was going as well as everyone else could. Lola was nice to him, thinking they were in the same situation and could offer each other support, but he resented her sympathy. He called her clumsy, and taunted her along with the rest of the class, just to feel like at least he wasn’t as low down on the social ladder as she was.

I kept looking for ways for Lola to save herself. She was an inventor, by necessity, and created parachutes and nets and trampolines out of whatever she could find in the garbage. She spent months in physical therapy with the seagull at the beach, who was a little too hard core. He made her stand on pebbles to stretch the webbing in her feet, and wrap her wings around the trunk of a tree, and then he’d drop her into freezing cold water to shock her brain, but nothing changed. And then she was sent to the wise goose, who worked at the median of the main road. He spoke in riddles, while walking in constantly changing patterns to help retrain her brain. It didn’t work, but at least with the goose Lola felt less self-conscious, if only because he wasn’t like anyone in her own community, and he didn’t laugh at her for being different.

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This bird is one hard core trainer

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“Are you saying I’m fat?”

But what I really wanted was for there to be something in the bird world that would work better than in the human world. I wanted the elders of her community to come up with a non-stigmatizing way to help the disabled birds who lived amongst them. I imagined bird community conferences, with the elders sitting in the sacred tree, and the younger birds left to line up on the telephone wires, but I couldn’t figure out how to make the birds creative and compassionate enough to make the clumsy bird feel welcome.

I have this block against writing better endings for my characters than I have experienced for myself. It feels like lying in a way that fiction doesn’t usually feel like lying, to me. But I want better for Lola than to have to be in it alone, hitting up against walls that shouldn’t be there. I just don’t know how to get that for her.

 

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“You can do it, Mommy. I believe in you.”

 

 

 

A Study of Sleep

 

 

I had to do a sleep study for the new Pulmonologist. He did breathing tests, and x-rays, and walking-while-breathing tests, and inhaling-vile-stuff-while-breathing tests, and then he wanted a sleep study to see if sleep apnea was causing my exhaustion and shortness of breath. Each new doctor has his own set of tests you have to take, it’s their thing, and if you want them to take anything you say seriously, you have to jump through all of their hoops. I’d done a sleep study years ago that came out normal, but he wanted to check again.

I was really anxious that this new sleep study, which would be done at home, would be like the ambulatory EEG, which involved having a video camera pointed at me at all times, and wires glued to my head. But there was no video camera or glue this time, thank God. I had to wear monitors, but they were small and wrapped around my chest and abdomen with elastic, and a nasal cannula was stuffed into my nostrils, and there was a monitor on my wrist and middle finger to keep track of the oxygenation of my blood. It wasn’t especially humiliating, though neither of the dogs chose to sleep near me that night. I’m sure that was just a coincidence.

The results of the sleep study were, as I’d expected, normal. I do not have sleep apnea. The thing I don’t understand is, if you are going to study sleep to try to discover more about my overall health, why would you only focus on a limited area like sleep apnea? Isn’t there anything else about sleep that is worthy of attention?

I have always had trouble with sleep. Even as a kid, I would wander around, go to my Mom, visit the bathroom a few times, and then stare at the ceiling and count the circles in the asbestos tiles for hours. Every creak of the house made me worry about monsters under the bed. But even now, even when I get to sleep on time and wake up on time, I still don’t feel rested.

The dogs are champion sleepers. Cricket can pull a blanket off the couch and smush it into cozy nest for herself on the floor and take a short daytime nap any time she pleases. Butterfly will find one of the stuffed toys, anywhere Cricket has left it on the floor, and stretch out for nap right next to it. Cricket can stretch into all manner of unimagined yoga poses to vary her sleep style and keep it interesting.

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“Platypus needs this blanket more than you do, Mommy. “

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Two toys are better than one.

In fact, the dogs change sleep positions very frequently. I think I do this too, except that I don’t have as much room for variation as they do. I’ll turn over, or kick my blankets away, or curl up, or stretch out, but they actually move from place to place and alter the whole landscape of sleep. I only sleep on my bed, but they can sleep on my bed, on the hard floor, on their pet beds, on carpets, on couches, under couches, chin on a shelf, or chin on my leg. But no matter how they sleep, or when or where they sleep, the dogs wake up raring to go, and ready to go outside and pee, and then ready to eat, and then ready to get back to sleep. They can wake up and fall asleep so quickly!

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Platypus is a very accommodating sleep partner.

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But so are my shoes.

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Cricket can’t decide which bed to sleep on.

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Or maybe she should sleep on the floor.

It seems like the sleep study should have looked at some of the practical issues of sleep. Maybe along with the heart rate monitors and oxygen concentrations monitors and such, they could have asked me questions, like, was I too hot or too cold? Did I wake up during the night? Did I have bad dreams, or nightmares? Did I feel rested in the morning? But they don’t want to know if I kick or turn a lot when I sleep, or if I’m in pain when I wake up. They don’t want to know about problems they don’t know how to solve. All they want to know is if my breathing is interrupted when I sleep, because they have a machine for that.

Maybe if each doctor took a more detailed interest, in each area of testing, they could have figured out something by now. But instead they choose the easiest thing, for them, and the hardest thing for me, and come up with nothing. I bet if Cricket could read medical journals, she’d have me fully diagnosed by now. She could use Butterfly to monitor my skin temperature, and flavor, overnight, and she herself could test my reflexes with her patented Jump-On-Mommy-While-She’s-Still-Sleeping test. Both dogs watch me very carefully, and I’m sure if they could write they’d fill many notebooks with all of their trenchant observations. And yet none of my doctors have asked for their input in making a diagnosis.

Phooey.

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Diagnostic exam in process.

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Cricket consults with Butterfly before delivering her diagnosis.

 

Thin Skin

 

Butterfly has bumps all over her body. She’s an eleven and a half year old Lhasa Apso, and the doctor says these bumps are normal for her age and breed. One of the bumps is like a tiny pink mushroom growing from her neck. Some of the bumps are small and rounded, above her tail, under her ear, at her hip. But one of the bumps looks like a cauliflower, and it bleeds every once in a while. It may simply be that her taller bumps get nicked when she goes to the groomer, or she scratches them, or bangs them into things accidentally, but from the very beginning, I worried about it. Butterfly’s skin is a light pink, with brown age spots hidden under her white hair, which, along with her bumps, is only really visible when she has a bath and her hair becomes translucent for a moment. I used to count her bumps obsessively before each vet visit, to report on any changes, and find out if this or that one was suddenly going to kill her.

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Butterfly’s big bump.

The fact is, though, despite her bumps and heart problems and diabetes, Butterfly is pretty hardy. She doesn’t sprain her ankles or tweak her back or whine when she gets her twice daily blood tests and insulin shots, and her feelings don’t get hurt easily. She doesn’t like having her hair messed with though; that’s something she learned from Cricket. She learns a lot from Cricket.

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“Are we going for walkies yet?”

Cricket is more sensitive. She thinks having the goop removed from under her eye is torture beyond canine endurance. She hears and reacts to every noise in the world. If she eats a little too much, or the wrong thing, it shows up in her digestion and her mood.

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“Are you talking about me again?”

I have Psoriasis and I am hypothyroid (both since I was a teenager), so my skin has always been sensitive and easily scarred. I have a scratch on my wrist from October that never healed, and just starts to itch out of the blue every once in a while. I’ve read too much of the bible in my lifetime, so I end up feeling like my skin, and my health overall, makes me a leper. But I also, still, have figuratively thin skin to go with the literal kind. If someone tells me that I’m lazy or untalented, I take it to heart. I can build myself back up again, but it takes days or weeks, instead of minutes or seconds, the way it should.

At my last doctor’s appointment, my GP decided to test me for Lyme disease again. I’ve been tested for everything over the years, multiple times. This time around, the preliminary test for Lyme came out negative, but my doctor decided to go on and do the confirmatory test anyway, and that showed that I was positive for Lyme disease in the past, even though I’ve never had a positive Lyme test before, in almost ten years of testing. The doctor wasn’t sure what to make of these results and told me to go to an infectious disease specialist to check it out. I may have dragged my feet and whined a bit, but I went.

In the meantime, my mom went to Google and found that there are mixed opinions about Lyme disease and Chronic Lyme, and the validity of these blood tests, or lack thereof. There’s also, her googling suggested, the possibility that a positive blood test for Lyme, like mine, could be an indicator for some other virus or disease process, as a signal for further testing.

I went to the new doctor, he looked at my blood tests and crossed his eyes and said that he would never have sent my blood out for the confirmatory test, after negatives on the preliminary tests, because of the risk of false positives. He said it five times, in answer to five different questions from me, as if he couldn’t hear me, or had no other answers to give. He said that there was no point in re-doing the test because it would either be negative, or another false positive, because I had no risk factors for Lyme. He had no interest in my medical history, and no curiosity about other possible diagnoses to explain my symptoms.

The fact is, I thought this was a long shot, and didn’t have much hope that a strange doctor would take any of it seriously, but I’m annoyed that I had to go through the motions, just to prove that I’m doing everything possible and not being passive. I am not comfortable with theories that come with no proof at all and seem to be, at best, placebo level positive results (30%), but I’m also not comfortable with the rigidity of western medicine, which prefers to blame the patient when problems can’t be solved, instead of taking on the problem and studying it further.

It’s a relief, instead, to take care of the dogs. When they have symptoms, their doctors believe them, and believe me, and treatments are offered, when possible, and pain and comfort are considered. Maybe, when dogs start suffering from whatever it is I have, the veterinarians will figure out the cause, and treatment, and the doctors for humans will finally take me seriously. But probably not.

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Harrumph.

 

 

 

The Three Echos

 

Three of the four of us had to have echocardiograms recently. Butterfly had hers first. She’s an old hand at doctor visits at the clinic, and always tries to bolt when we get near the front door, but her doctors are friendly, and the women at the front desk think she’s adorable, even though she’s too anxious to take the treats they offer her. Butterfly has to have an echo every six months, to keep an eye on her prolapsed valve and enlarged heart, and she does not enjoy the experience.

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“Are we leaving yet?”

As soon as we checked in and sat down in the waiting room, my mostly non-shedding dog released hair all over my jacket and drooled on my shoulder and tried not to pee on the floor. She was curious about the other dogs sitting in various states of terror around her: the three month old Labrador who couldn’t contain her enthusiasm; an eighty-pound brindle Pit Bull who was hyperventilating under his owner’s legs; a cat hiding in her carrier. But the Chihuahuas seemed reasonable to her, and the floor itself was a potpourri of odoriferousness. She went adventuring for a few minutes at a time, and then asked to be picked back up for emotional refueling before making her next attempt to survey the territory.

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Butterfly believes that all floors must produce kibble, like the floor at home does.

She went in for her echo in the arms of a vet tech, trusting and blank. She trained herself to accommodate humans many years ago, living in the puppy mill, and still uses her old coping skills, pretending-she-is-not-where-she-is, as they slather cold goop on her chest and probe for pictures of her heart.

It is not surprising that her heart has been damaged, or that her heart is bigger than it is supposed to be. I could have told you that without all of the fancy equipment. After the test, her cardiologist came out to tell me that she was the same as she’d been six months before – with a leaky valve and an enlarged heart and no need, yet, for medication.

He couldn’t see on her pictures that she has learned how to chase squirrels and run like the wind and jump for chicken treats. He couldn’t know that she has developed a full range of expressions, and only once in a while falls back into her blank stare of old. But he believed me when I said so, and he was happy for her, and for me.

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“I’m dancing!”

My echo was a different kind of experience. I’ve had a few in the past, and hated them all. One in particular, was both humiliating (changing into and out of the flimsy robe with the door half open and strangers walking by) and painful (half an hour of rib bruising pressure). This new doctor was specially recommended, and requested, by the new pulmonologist who is trying to figure out the possible causes for my shortness of breath.

The paper “gown” I had to wear was not much of anything, and the tech this time was male. In my three previous echo’s I’d only had female techs and assumed that was the norm. Stickers were placed above each breast and on my abdomen, and then wires attached. I was told to roll to my left, away from the tech, which was a relief.

I could hear the whoosh whoosh whoomp sounds of my heart coming from the computer behind me, but it was hard to concentrate because the probe was pressing hard against my breast bone. I could feel a black and blue mark forming and could only grit my teeth and tell myself it would be over soon. Whoosh whoosh whoomp, whoosh whoosh whoomp.

Because of the position I had been placed in for the test, on my left side with the probe at my chest and the tech leaning over my body, it almost felt like I was being hugged. It wasn’t sexual or disturbing. I did not expect this feeling at all. His hip and waist were pressed against my back, so that he could comfortably reach over and take the sound pictures of my heart. And despite the pain of the probe on my chest, the pressure of his arm over my side was a relief. I felt safe. I sensed no danger, no inappropriate or confusing energy from his body, just presence.

The doctor came in to look at the pictures, then, and he said that my leaky valve was, pfft, not much, and if you use an expensive machine like this you’re bound to see “something” but that doesn’t mean that “something” really means anything. He was annoyed that anyone would come for an echocardiogram and have a boringly normal heart to show him. Pffft. You’re fine, go home.

And normally, that dismissal is what would stay with me, but instead, this time, it’s the hug; the closeness and security of a stranger next to me. I don’t know what to make of it except to file it in the back of my mind, under surprising, and good.

Mom’s echo was the third in the series. She gets them regularly, though not as often as Butterfly, ever since her “minor” heart attack more than fifteen years ago now. It did not seem minor to me, or to her, at the time. The only explanations given were a leaky mitral valve and “stress”, which my doctor-brother pooh-poohed. The result, though, was that she started to take much better care of her health, and found a less stressful job, closer to home. The regular echos, and stress tests, and blood tests, are another thing she has accepted and rarely complains about, at least to me. I asked if it hurt. No. Or if it was humiliating. No. Or if the wait was long. No. She and Butterfly share this capacity, for going somewhere else in their minds when they need to not be with their bodies. It’s a skill I do not have.

Cricket has no such skill either. If she needed an echo they’d probably have to knock her out, like they do for an x-ray. Thank God, her heart is fine. Normal whoosh, normal whoomp. I know, because she likes to suffocate me in the morning, with her chest close enough for me to hear the sound pictures without any fancy equipment at all.

Pffft.

We’re all fine.

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Grandma and Cricket, whoosh whoosh whoomp.

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Whoosh whoosh whoomp.

The Glucose Curve

In January of 2014, Butterfly, my ten year old Lhasa Apso, was diagnosed with diabetes. We went for monthly visits to a doctor she loved, and did twice daily blood tests and insulin shots, and we seemed to be making progress. But, over the summer, her doctor left the clinic and Butterfly’s sugar started to go up and down like a roller coaster. By the fall, nice doctor or not, we had to go back to the clinic for advice.

Butterfly was not feeling well.

Butterfly was not feeling well.

The doctor who saw Butterfly in October was a per diem, filling in for the day, and he was concerned about her sugar. He made me very nervous, despite his choir boy face and laughing Scottish accent and frequent stops to tickle Butterfly behind her ears, because he said there might be another underlying health problem. He wanted me to do a glucose curve at home: starting first thing in the morning, I would test her blood sugar every hour or two, until I couldn’t stay up any longer, then I should send the results to one of the regular vets, to see if they could recognize a pattern.

But she always loves those ear tickles.

But she always loves her scratchies.

The glucose curve day was, possibly, the best day of Butterfly’s life. Every time I went to take her blood, she made me chase her around the apartment first, and after each test she got another chicken treat. I had to break the chicken treats into tiny pieces to avoid an exploding Butterfly halfway through the day. And, of course, Cricket matched her treat for treat, and attempted to climb the bookshelf to reach the bag of treats when the pieces were too small for her liking.

Butterfly's tail is ready.

Butterfly’s tail is ready.

Cricket's tail is running away.

Cricket’s tail is running away.

Cricket and Butterfly, ready for their treats.

Cricket and Butterfly, ready for their treats.

By the last blood test, at two o’clock in the morning, Butterfly was wiped out and ready for bed, but still willing to grab a last chicken treat on her way down the hall.

We made an excel sheet out of her test results, with comments about her moods, and meals, and exercise, and pooping. The vet we sent it to was duly impressed, but she said she was worried about Butterfly’s very low sugar numbers midday. She wanted us to lower the insulin dose and redo the curve in two weeks.

I liked the compliments – I really love compliments, and I especially like when my organizational skills are noticed and appreciated – but I was hoping for a different response. Anything but “do it again.” The second glucose curve, two weeks later, was closer to normal, and the vet told us to keep everything the same, and redo the test in a few months.

By December, Butterfly’s twice daily blood sugar readings were getting wild again, so I ordered extra test strips and lancets and chicken treats and woke up at 5:45 AM on December 30th and started testing her blood every hour or two, administering an enormous amount of chicken treats to get her, and Cricket, through the ordeal. We stayed up until 2 AM, or I stayed up, Butterfly took a few naps.

Nap time.

Nap time.

When we finally met Butterfly’s new vet in person, she had a theory she wanted to test: that Butterfly’s blood sugar was bouncing up so high as an over-correction to too much insulin, and if we lowered the insulin dose again, maybe things would even out. Two weeks on this dose, and then another glucose curve. This was becoming normal for us.

Cricket sniffed Butterfly all over when we got home, to make sure no extra treats had been consumed, but also to make sure Butterfly was still Butterfly. We’d tried taking Cricket with us to the clinic, once, and she spent the whole time hiding behind my legs and barking at everyone and everything. But still, staying home alone made her disgruntled and suspicious.

Cricket's suspicious face.

Cricket’s suspicious face.

Unfortunately, the low insulin dose skyrocketed Butterfly’s blood sugar levels into the too-high-for-the-meter-to-count range. She was drinking and peeing constantly, in the house and out, so even without a glucose curve, we raised the insulin back up. And, of course, waited two weeks and went through the whole day of testing again, to Butterfly’s delight. And the numbers were still not right.

I was afraid that the doctor would give up on getting Butterfly’s sugar normalized and tell me to accept that she’s just going to die sooner rather than later, and it’s not worth stressing about. But she’s my baby! And I am stressed about it! I was angry that being a conscientious dog mommy hadn’t added up to better health and better luck for Butterfly, and for my carpeting.

“What’s wrong with peeing on the carpet?”

And then Mom came up with a plan (okayed by the vet) to give Butterfly an extra unit of insulin when her blood sugar levels are high, and the regular dose otherwise. I have no idea if this will work long term, or why the doctors haven’t wanted us to try it before now, but so far it seems to be helping.

I just want Butterfly to feel better, and not need to pee every five minutes, and live forever. Is that so wrong?

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Puppy On Call


 

            Cricket needs a job. She has a lot of excess energy, and uses it for barking and biting, and I’d like to find more constructive ways for her to keep busy. Some ideas that have come up in the past are:

·        Fitness trainer. She could help anyone build upper body strength and cardio, by pulling like an ox on her leash for three or four miles at a time. She might have a lot of one time customers, though, after an hour with her, I’m not sure we’d get follow up visits.

"Streeeeeeettttch!"

“Streeeeeeettttch!”

·        Assistant dishwasher at a restaurant, pre-cleaning the dishes. Except that any dangerous foods would have to be picked out before she got there, like onions and raisins and chocolate…

Cricket is an expert dishwasher. At least, Butterfly thinks so.

Cricket is an expert dishwasher. At least, Butterfly thinks so.

·        Ball puppy at a tennis court. Though I wonder if anyone would really want the ball back after she’d been carrying it in her mouth.

·        Carnival barker? I don’t think they really mean her sort of barking.

Nothing seemed quite right, and then I started thinking about my brother, the doctor. What if Cricket could do something in his field? I don’t actually believe she could go to medical school (anti-puppy prejudice!), but a hospital would be a fascinating place to work.

Doctor Dog (found online)!

Doctor Dog (found online)!

            Children in the hospital can get very lonely, especially at night, when their visitors go home and the noise quiets down and they are supposed to be asleep. I know dogs have been invited in during the day, but I think they could be even more helpful at night. I can picture the puppies wearing blue scrubs, and beepers at her necks. Puppies could be called by the nurses when a child had a nightmare and couldn’t get back to sleep, or when parents had to leave at bedtime and knew that the child would be lonely.

The human handlers could bring the dogs in and leave a jar of treats by the child’s bedside table, with a bowl of water the dog could reach.

            The job of the human handler would be to be as unobtrusive as possible, but also to know when a child and puppy combination would not be a good match. If the child was angry, at being in the hospital and poked and prodded, and lashed out at the dog, the human handler could remove the dog from harm and prevent the dog from needing to fight back.

            The puppy-on-call room would have to have treadmills, and fake grass to pee on, and a water fountain to drink from, one for the big dogs and one for the little dogs. There could be a play circle filled with tennis balls and chew toys, and mats and beds to sleep on between jobs.

The dogs could do rounds earlier in the day, to meet the children currently in the hospital, and help the doctors with sniffing diagnostics, and then the dogs would be on call at night.

            But now that I think of it, I’m not sure this would be a great job for Cricket. She’s a bit more of a me-me-me dog, rather than an aching-to-be-of-service-to-others dog. Now Butterfly, she’s a whole other story. But her scrubs would have to be a light pink.

Butterfly is very patient.

Butterfly is very patient.

And very Zen.

And very Zen.

            Maybe Cricket could work for the police? Drug sniffing? Recapturing escaped prisoners? She’d be great at catching anyone resembling a leaf or a stick.

"Gotcha!"

Cricket always gets her leaf!