A week after seeing the substitute vet, and being told not to spend more money on tests, we were able to get an appointment with Ellie’s regular vet and he recommended an ultrasound, to see if her distended belly was filled with fluid or with something else; and he confirmed that it was all fluid. He recommended against trying to poke around with needles to empty the fluid, because it could stress her literally to death, and because the fluid would come back in a few days anyway. Instead, he raised her diuretic dose a little bit and sent us home, saying that, like with Cricket, if Ellie doesn’t eat for three or four days, she’s suffering.
It certainly wasn’t the news we wanted to hear, but it is what we expected, and it was a relief to know for sure what we were dealing with.
The raised dose of the diuretic helped a little bit, at least enough to allow Ellie to feel hungrier and to enjoy her food again. She especially liked the Chinese food we got for my birthday dinner. Her belly is still full of fluid, and she spends most of her time resting on her side, but her joy in eating is wonderful to see.
“Where are you hiding the Chinese food?”
When we were looking through her papers recently (which makes it sound like she has her own filing cabinet and a small business to run, but we were just looking for her exact birthday so we could celebrate it with her), we realized that she is turning ten this year, not nine like I thought. There’s a little bit of relief in knowing she’s made it all the way to ten, just like there was relief in seeing Cricket pass the sixteen year mark, but it’s still not enough.
We didn’t plan anything special for her birthday, because every day she’s still with us feels special and important, and really an act of will on her part. Just seeing her eat, and take all of her medication, and enjoy getting her back scratched, feels like a celebration to me. I’m so grateful that she wants to stay with us for as long as she can, and I’m especially grateful that we’ve been able to have this time with her, after Cricket’s death, to shower her with as much love and attention as she can absorb, so that she knows what it’s like to be the center of everything, at least for a little while. Even Cricket would have wanted that for Ellie, though not as much as she wanted it all for herself.
Now we’re just going day by day, trying to accept that we won’t have that much more time with her. Her sweet spirit still shines through, even when she’s tired, or worried, or struggling to catch her breath, and we know how lucky we’ve been to have her this long.
Happy birthday dear sweet Miss Ellie, my beautiful girl!
“I need more chicken, Mommy.”
If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
I spent more than two years working on Intuitive Eating being superconscious of hunger and fullness levels and fighting with myself to stick to smaller portions, but after three months of gradually raising the dose of Ozempic, I realized that, beyond weight loss, Ozempic has made Intuitive Eating much easier. Now I can eat half of my breakfast and put the rest aside for later, without thinking about it or arguing with myself. Is this what normal people feel like around food? Because I still enjoy eating, and I still have cravings for this or that, but it’s just not overwhelming anymore.
“Chicken!”
So, of course, as soon as I was fully on board with Ozempic, and ready to go up to the optimal dose of 2 mg a week, I found out that I wasn’t immune to the Ozempic shortage.
The pharmacy had had no trouble getting the lower doses, so as I got used to a faint sense of nausea and more sensitivity to acidic foods, there was no stress around getting the weekly .25 mg, .5mg, and 1 mg doses. But it turned out that I should have become aware of the shortage when my doctor moved me up to 1 mg a week, because my pharmacy didn’t fill that prescription. Except I didn’t notice, because I still had three boxes of the lower dose pens, so I just took two .5 mg shots to make up the 1 mg dose, assuming that’s what I was supposed to do. So when the doctor raised my dose to the full 2 mg, and told me that there might be difficulty getting it, I was surprised to hear it. She told me that if the pharmacy couldn’t get the higher dose I should just stay at 1 mg. I didn’t hear anything from my pharmacy after the 2 mg dose had been called in, so when I went in to pick up a few other refills I asked for the 2 mg prescription of Ozempic and the kid at the counter sent me over to the pharmacist for the bad news. Not only couldn’t they get the 2 mg dose, they couldn’t get the 1 mg dose, and couldn’t give me the available smaller doses to make up the higher dose (I guess it’s an insurance thing). He said they would let me know if a supply of either the 1 mg or 2 mg dose came in, but he had no idea when, or if, it would.
I called the doctor’s office to let her know about the problem and to ask if there was another medication she could switch me to, and the secretary, who’d heard it all before, said no, just call around to different pharmacies until you find one with a supply of Ozempic, and then call us back and we’ll send a new prescription.
I still had 1.5 mg left at home, so I made plans to make it last two weeks, taking .75 mg each week, and crossing my fingers that the pharmacy would come through by then; because I didn’t want to have to call a million pharmacies, and then call the doctor’s office each time someone said they might have an extra dose for me; but also because I couldn’t quite believe that it was an emergency. I couldn’t believe that my doctor would have started me on Ozempic if there was a real, even reliable, chance that I wouldn’t be able to keep taking it after the first few months. That just seemed crazy.
When I told my nutritionist, and my therapist, and Mom, that my plan was just to wait, they said absolutely not. You must be more proactive! You must keep calling and running around to get this medication that is actually helping you! But I couldn’t do it. I felt like a black hole was opening up under my feet at even the thought of chasing down Ozempic doses across Long Island. I couldn’t even put into words why it felt so awful, but I’m pretty sure I made sad puppy dog eyes, just like Ellie, because Mom volunteered to call around for me. She found a big pharmacy a few towns away that was expecting to get a shipment after the weekend. All I had to do, they said, was call my doctor for the prescription on Monday morning and it would all be fine.
So on Monday morning I called my doctor’s office and the secretary said that the doctor would call in the prescription. I called the pharmacy every few hours to see if they had filled the prescription, but each time the automated operator said they didn’t have my name and number in their system yet and I should call back later. After eight PM, when I’d given up, Mom called one more time and got the notification that my prescription had been filled and a four week supply of the 2 mg dose of Ozempic would be waiting for me in the morning. I was so relieved, and so exhausted just thinking about having to go through this again in a month.
I was still up at one thirty in the morning, anxious and preoccupied about Ellie’s health and the war in Israel and Gaza, and trying to read a mystery to distract myself. I’d finished yet another chapter and decided to check my email for a break, and that’s when I found the notification from the new pharmacy saying they had run out of Ozempic and couldn’t predict when they would get the next shipment in.
“Oy.”
I don’t know exactly what happened. Maybe there was enough Ozempic at eight o’clock, when they put it into the computer, but by the time the pharmacy had closed an hour later it was all gone. Or maybe someone stole a box of Ozempic out of the back door after midnight. But it was starting to seem like Ozempic was being doled out on a first-come-first-serve basis, or some sort of Hunger-Games-style competition with no rules at all.
I’m not good at fighting for what I need, or racing to get places faster than someone else. Even the thought of competing for scarce resources exhausts me down to the bones. I’ve spent so many years trying to manage my weight, and spending enormous amounts of money and time on diets and nutritionists and programs and apps and on and on. And I’ve spent so many years being criticized by doctors for not being at the right weight, and for not trying hard enough, and finally there’s a medication that actually seems to be helping me, but I struggle with the idea that I should get something when someone else needs or wants it too. I don’t believe that I should be the first on anyone’s list to get Ozempic when people with type two diabetes, the original patients the drug was made for, are struggling to get their medication. I can’t make an argument for why I should get what I want in a way that convinces me, let alone anyone else.
For days, this huge, raw, unhealed wound full of self-loathing and hopelessness opened up and practically swallowed me whole, and I just wanted to cover it with duct tape and wait for the Ozempic shortage to end on its own. But, gradually, the weight of it started to recede, just enough for me to be able to hear Mom say that someone at our regular pharmacy had suggested calling independent pharmacies in the area, instead of the big name ones.
I dragged myself over to the computer and googled independent pharmacies near me. I made a list of about ten places, including the one down the block that had been closed for a long time but was supposed to reopen under new management any day. But making the list was the most I could manage at that point, especially at ten o’clock at night, and I planned to start calling another day, when I’d built up another dose of hope.
The next day we had to take Ellie for another echocardiogram to see how she was doing on her meds. They raised the dose of one of her medications and said to bring her back in four months, which felt more hopeful than at our last vet visit; and then I had to go teach, and as I was leaving Mom said, do you want me to make those calls for you?
Of course I do, Mommy!!!!!
By the time I got home from teaching, all I needed to do was send a picture of my insurance card to the just-re-opened pharmacy down the block and they said they would have a four week supply of the 1 mg dose of Ozempic ready for me the next day. I wasn’t sure I believed it, though. I had to wait until the phone call came the next morning and we drove over and became the first customers to pick up a prescription from the newly opened family run pharmacy (all three staff members standing behind the desk smiling at me).
I have no idea what will happen in four weeks when I need a refill, and I have no idea if I will ever be able to go up to the 2 mg dose, and I don’t know what lesson to learn from this. Have faith in humanity? Support local small businesses? Trust that even deeply felt, unbearable hopelessness will eventually pass? Let Mommy handle everything?
I don’t really understand why a small pharmacy was able to get the 1 mg dose of Ozempic when my big chain store couldn’t get it; and I don’t understand why the second big chain store was able to get the un-gettable 2 mg dose, or where it went between the time they told me they’d filled my prescription and the time they told me they couldn’t.
But I do understand why Ozempic is so popular with so many people, in a world where even an extra five pounds is counted against a person’s character, and doctors believe that extra weight is the cause of all disease, even when it’s not.
I wish I didn’t need to take this medication. I wish my body could self-regulate to the perfect weight without any intervention. I wish I didn’t need any medication at all: for pain, for depression, for a faulty thyroid, for high blood pressure, or for my weight. But I do. And I’m afraid this whole thing is going to happen again, and again, and I don’t know that I will be any more prepared to manage the waves of emotion next time. But for now, I have my medication, and Ellie has her medication, and we both have my Mom nearby for support when we get overwhelmed.
As for anything else, we’ll just have to take it day by day, because thinking ahead is too freakin’ hard right now.
“It’s nap time, Mommy.”
If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
In the midst of Cricket’s terminal illness, we were also dealing with very bad news about Ellie’s heart: it was two times the size it should have been, and surrounded by fluid that shouldn’t be there. She would need to take four new medications, twice a day, and we’d need to find a diet for her that was both low in sodium and tasty enough to get her to take all of her meds. But it just didn’t seem possible to me that Ellie could be so sick, not while Cricket was busy dying.
Sisters forever
A week before Cricket’s death, we took Ellie back to the vet, because she had been coughing more than usual and we wanted to make sure we were doing everything possible to keep her with us. A new x-ray showed that her heart was still twice the normal size, and that there was still some fluid around it, so the vet raised the dose of her diuretic and told us to come back in two weeks for a blood test. The coughing stopped for a few days, but after Cricket’s death Ellie had more of the fainting attacks that had sent us to the vet in the first place, months earlier, losing control over her legs and flopping down on her chest.
In the car on the way to the vet for the follow up blood test, Ellie was even more nervous and agitated than usual, and we wondered if she was thinking of Cricket, and how Cricket hadn’t come home from her last trip to the vet. Standing in the same examination room where Cricket had taken her last breath, the vet took Ellie’s blood and suggested another echo sometime soon, to see if issues had progressed into her lungs. I had a whole list, at home, of questions I’d planned to ask and medication refill requests, but I couldn’t remember any of it. Eventually, because she was giving me her sad puppy eyes, I remembered to tell the vet that Ellie had become a very picky eater recently, wanting only the special foods (chicken treats, greenies, chicken liver, fresh cooked chicken) instead of the well-rounded, low-sodium diet we were trying to give her. And the vet turned back from the computer screen, where he’d been updating her chart, and said “treat her like a make-a-wish kid, and give her anything she wants.”
“Anything?”
I didn’t curse at him, out loud. I just stood there, forgetting to ask for the refills or anything else. He recommended a brand of healthy treats from the pet supply store next door that might help Ellie eat her good-for-her food, and then we paid our latest bill and went next door for the treats and then went home, to Ellie’s great relief.
The new treats went over well enough, though Ellie now believes she should be hand fed each meal. And then, within a few days of her vet visit we noticed blood spots on her wee wee pad and I freaked out. We had to follow her around with a ladle to get a pee sample, but in a few days we found out that she had a urinary tract infection, which was much better than the ten other imaginary diagnoses that were spinning around in my head. The vet put her on anti-biotics, which made her even more exhausted at first, but eventually started to make her feel better.
In the middle of worrying about Ellie, and grieving over Cricket, we had a moment of joy. Out of nowhere one night, despite still refusing to eat her regular food, Ellie begged for some of Mom’s dinner, a piece of red pepper, a few pieces of broccoli, and then pumpkin bread, all foods that Ellie generally ignored, but Cricket had always loved. Maybe she was just craving something different because of her illness, but it seemed to us like she was channeling her sister and bringing her back to us for a moment.
Ellie still looks for her sister around every corner, almost as if she expects Cricket to pull a “Gotcha” on her at any moment, and I look for Cricket too, imagining that she’s just sleeping and that’s why the apartment is so quiet. I’m still in the numb phase of grief, unable to take it in for more than a few minutes at a time. And, in the midst of that grief, I just can’t think of Ellie as having only another six months to a year, which is what the vet predicted when he first told us about her heart, months ago now. I like to tell myself that the vet never expected Cricket to live as long, or as well, as she did, so what does he know? Except, Ellie isn’t Cricket. Ellie had to use up a lot of her spirit surviving her first four and a half years as a breeding mama, and I can’t expect her to fight for more time the way Cricket did. Instead, I want God, or the universe, or veterinary medicine to intervene and give her the extra years she deserves; and I’m pissed off, beyond words, that that probably won’t happen.
But for now, we still have Ellie with us, and she’s recovering from her UTI and getting some bounce back in her step, and asking for cuddles and treats and looking askance at our continued attempts to feed her the “healthy” food.
“Pot roast? Chicken?”
It’s cruel that my sweet, loving, almost nine-year-old Ellie is going to die too soon, from an oversized heart, of all things. Butterfly, Cricket’s first rescue sister, had the same heart issues (along with a few others, caused mainly by her eight years as a breeding dog at a puppy mill), and the same sweetness as Ellie, and she lived to almost thirteen years of age despite all of it. But the vet says Ellie’s heart disease is more serious and more advanced and there’s nothing we can do, other than what we are already doing. I know he means well and wants us to be prepared, but right now the thing I want most in the world is for the doctor to be wrong.
“Doctors are always wrong. It’s a rule.”
If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
If I had the energy, I would go back to Ikea for more bookcases, to line the walls of my room, and the living room, and maybe the hallway and the dining room too, and then I’d fill them all with books.
If I had the energy, I would go back to school to become a rabbi, or a cantor, or at least a Jewish studies professor.
If I had the energy I would go for long walks in different places every day, sniffing the smells and breathing the air and listening to all of the sounds, like Cricket and Ellie like to do.
“Walkies?!”
If I had the energy I would finish writing the novels I’ve started, no matter how many revisions it takes or how much time I’d have to spend fighting my internal demons, and I would keep reminding myself that writing the book is the important thing, even if no one ever reads it.
If I had the energy I would live on a farm, with horses and sheep and alpacas and one of every kind of dog in the world!
“Other dogs?!”
If I had the energy, I would go back to ice skating and tennis and learn how to just love what I can do and not always compare my abilities to the people who do these things at the highest levels.
If I had the energy I would make dinner every night, learning new and complicated recipes for meals that I would love to eat.
If I had the energy I would travel across Israel, and then across the United States, and then across Europe and then Asia, learning new things and eating new foods and meeting new people.
If I had the energy, I would go back to school for a PsyD, and train with people I admire, and become a child psychologist so I could help the kids I don’t know how to help now.
If I had the energy I would write memoirs and mysteries and musicals; I would write down everything I know and every question I have, and then I would read and study and ask and interview until all of my questions were answered, and then I’d start all over again with new questions.
If I had the energy I would practice guitar and piano every day, and then learn how to play the violin, and the drums.
“That would be loud.”
If I had the energy I would do the gardening and the landscaping at the co-op so that no one would ever cut one more branch off of one more pawpaw tree.
But to be fair, if I had all of that energy, I would be overwhelmed, with too much to do and no idea how to decide which of my priorities should go first, and not enough time or money to do it all anyway. Because there are so many versions of me in my imagination, and they all keep competing for what little time and energy and focus I actually have. And even now, when the amount of energy I have in any given day has dwindled down to something incredibly small, I still can’t focus enough to fill that time well and accomplish the things that should be possible, because I spend so much time arguing with myself, unable to stick to one version of me, even for a day, even for an hour.
So maybe it’s okay that I don’t have the energy to do everything my imagination can come up with, because that would be too much to fit into any one life. And most likely, if I had more energy, I would have an even longer, more unreasonable list of things to do, and the same feeling of failure to live with.
Maybe the goal is to accept the amount of energy I have today, and hope for more for tomorrow, and be kinder to myself about the limits, to my energy and my focus and my decision making skills,…but I should definitely get over to Ikea to get those bookcases one of these days.
“Bookcases are where you store chicken treats, right?”
If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
After months of worrying symptoms and doctor visits and medication, Ellie’s heart failure has stabilized enough so that we finally felt safe taking her to the groomer to deal with her very overgrown mop of hair. It was also Ellie’s first visit to the groomer alone since she’s been with us (four years!), because Cricket doesn’t need much grooming and I didn’t think she would be up to the stress of it anyway.
“I’m perfect just as I am.”
As we were leaving the apartment, I made sure to give Cricket a Greenie (a green dog treat, shaped like a toothbrush, with questionable teeth cleaning capabilities) to keep her occupied while Ellie had her leash put on, and immediately, Ellie snapped her teeth on the Greenie, already in Cricket’s mouth! They stood there fighting silently over that Greenie with all of their might, and somehow Cricket managed to hold on to it until I could convince Ellie to let go and follow me to the front door.
And I was sort of in shock.
Ellie, my calm, loving, usually submissive sweetie pie, had actually tried to steal food from her grumpy, stubborn, aged sister’s mouth?!
“Who, me?”
I was laughing out loud as I led Ellie outside, thrilled both that Ellie’s appetite was back in full force, and that Cricket still had the strength to fight for what was hers.
Once outside, Ellie ran gleefully to the car, seemingly forgetting that she’d missed out on a treat, possibly because she’d finally remembered that she’d had a full breakfast just moments earlier.
On the drive to the groomer, Mom sat in the backseat with Ellie to keep her company and defuse her car anxiety and the weirdness of not having Cricket there with her. When we dropped Ellie off at the groomer, I started to feel more anxious about leaving her there, out of my sight, for hours. She still coughs every once in a while, even though her medications seem to be managing most of her heart failure symptoms. But I tried to be positive and focused on driving Mom to her Neurologist’s office, where she would hopefully find some relief for the pain in her legs and feet, if not a cure for the numbness that has prevented her from driving lately. And then, while sitting in the waiting room at the doctor’s office, I was preoccupied with worrying about Mom, and worrying about leaving Cricket alone at home for so long, and then worrying about fifteen or twenty other things swirling in my mind, and there wasn’t much room to worry about Ellie, who, at the very least, was not alone.
After the doctor’s appointment we had to stop off at CVS to pick up prescriptions, and to drop off one for Ellie (because one of her medications is only available at the human pharmacy), and then we went to the market that always has chicken livers, unlike our regular supermarket, because when Cricket is refusing to eat anything else she will still eat chicken livers. She’s often not hungry in the morning, but that’s when we need to give her the doggy Xanax to help her calm down enough to receive her subcutaneous fluids to manage her kidney disease. Chicken livers, and cinnamon buns, oddly, seem to be our most reliable treats when the wet dog food isn’t tempting enough.
And then we were back at the groomer to pick up Ellie, who was now less than half the dog she’d been a few hours earlier, and thrilled to be going home.
Cricket was standing at the door waiting for us when we returned home, and she thoroughly examined her shorn sister, to see what fresh hell she’d been through, but more importantly, to find out if she’d had any secret treats (she had, her groomer loves to give her treats!).
And then the dogs banded together to beg Grandma for even more treats, eventually running out of steam and deciding to start their favorite afternoon activity, sleep tourism, wherein they proceed to take naps in as many different places throughout the apartment as possible. And then I was able to relax too, knowing we’d all made it through another challenging day. Together.
If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
A couple of weeks ago, when Cricket lost the ability to hold off peeing until she could reach the wee wee pad by the front door, we created a yellow brick road of wee wee pads, from Grandma’s bed to the front door, to help her out. And, either as a result of the Gabapentin and ACE she takes every day (in order to tolerate the subcutaneous fluids for kidney disease), or because of incipient dementia, Cricket has started to pace around the apartment at all hours, peeing along her wee wee pad path, especially in the middle of the night.
After she’s jumped off Grandma’s bed, to get a drink of water and to pee, Cricket will come to my room, sometime around four o’clock in the morning, and bark at me for the mommy-elevator up onto my bed, where she wanders around and around in search of the perfect sleeping spot, which is often elusive. For some reason, Ellie has decided that instead of staying in my room at night, the way she used to, she prefers the wee wee pads – at least the as yet unused ones – as her favorite place to sleep.
“Are you telling my secrets, Mommy?”
When I accept the inevitable and finally get up, around 7 AM, Cricket and Ellie are ready to go outside, walking down the stairs together if Cricket is up to it. Neither one of them can run and play the way they used to, but Ellie gets a lot of enjoyment just by standing still and listening to the sounds of the neighborhood, while her sister wanders around the yard sniffing all the smells.
When we get back inside it’s time for Ellie’s medication, carefully stuffed into small pieces of chicken or chicken liver, with a few pieces going to Cricket as well. And, if she’s willing, Cricket gets her ACE and Gabapentin in her food too, so we can get her fluids done early and give her time to pee it all out during the day, instead of needing to walk her path so much overnight.
“Give me more fluids and I’ll be swimming down the hallway!”
We’re still in the trial and error phase with all of this, constantly adapting their diets and schedules and adapting our expectations of what they can and can’t do, based on how things are going each day. Ellie is mostly consistent, though she needs new high value treats every few days to help her tolerate all of her pills. Cricket is the wild card. Some days she seems like she could go at any moment, and other days she seems so normal that we almost get complacent. Almost.
We’ve started to get rid of rugs that have been peed on too often, by both of them, and we’re doing a lot of extra laundry, but we love them, so we walk the wee wee pad path, replacing one pad here and there as we go along, trying to keep them happy and comfortable. I wouldn’t have chosen this, but I wouldn’t want to miss a day of having them in my life either, so this is what love looks like right now.
If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
A few weeks ago, maybe after the apocalyptic day in New York, when the skies turned orange and everything smelled of smoke because of the Canadian wildfires, Ellie started to cough.
“Are you talking about me?”
It’s not that she’d never coughed before. In fact, she has a full menu of interesting coughs and sneezes to her name: including the how-dare-you-pull-on-my-leash cough, which sounds like a frog is jumping out of her throat; and the excuse-me-where’s-my-dinner cough, which is more like a whisper, with her head turned away for deniability. But this cough was something new. It sounded like she was choking on something, or suffocating, and then she’d sort of cough up whatever it was and collapse as if she’d run a marathon.
The first time I witnessed this, I was afraid she was going to die right in front of me. I may have taken it more seriously as a result of the debarking surgery that was done when she was still a breeding dog, because the scar tissue from that surgery has made her throat more constricted than it should be.
It was a few days before I witnessed another coughing attack, and I was shocked by it again, especially by the way she seemed almost paralyzed for a couple of minutes afterward, but then she was fine, and I was relieved. She started to cough more frequently after that, but with less seriousness, and I wondered if maybe it was just an allergy, exacerbated by the air quality, and, really, I was distracted. Cricket had been diagnosed with kidney disease and needed fluids every day, and we’d had a car accident and had to buy a new car, and I’d had to go to five or ten doctors’ appointments, and prep for my second oral surgery (the follow-up to last year’s surgery), and that’s only the top line of the chaos that was going on around here, and there was no way to keep up with all of it, so each time Ellie stopped coughing and seemed to be breathing and walking and eating okay, I just breathed a sigh of relief and let it go.
But last week, when Cricket had to go back to the vet for a follow up blood test, and I was between medical appointments, it seemed like a good opportunity to bring Ellie in to be seen as well.
Of course, as soon as we made the appointment for both of them, Cricket, who had been doing surprisingly well, had a downturn. She couldn’t eat and she was woozy, even without the calming meds, to the point where she allowed me to insert the needle for the fluids without a fight. We all went to bed that night thinking this was the end, and we’d have to leave Ellie home the next day, and bring Cricket in to the vet for the last time.
But in the morning, my little phoenix rose from the ashes again, climbed up and down the stairs herself, ate her breakfast and demanded more.
“I’m hungry!!!!!”
So we went, all together, to the vet, me as the chauffeur in the front seat, Mom sitting in the back with both dogs, so that Ellie wouldn’t have to sit alone back there (Cricket has never tolerated sitting in the backseat. When we would put her in a harness early on in her life, she’d escape within thirty seconds and make her way up to the driver’s seat). With Cricket and Grandma sitting next to her, Ellie got through the ride without crying once, though she was still breathing heavily.
I carried Cricket into the vet’s waiting room, not wanting to have her walk on the hot ground (Ellie refused to be carried), and the vet took Cricket out first, to take the blood, and then focused on Ellie and her cough. I tried to reenact the cough for him, so he’d know what he was dealing with, and he gave me a look and said, “Can you do that again?” It took me a second to realize he was joking. If he has a sense of humor it is very, very dry. He checked Ellie’s heart and looked in her mouth and took her temperature (which she found horrifying), and he gave her an anti-inflammatory shot and sent us home with antibiotics and a cough suppressant for her to take twice a day, and he said to call him in a few days and let him know if she was coughing any less (because if not, he’d want to follow up with an x-ray).
And we were free. This visit, which, for a few hours there had seemed like it would be the last time I ever saw my Cricket, turned out to be routine and quick. When we got home we were all ready for an afternoon nap, maybe me more than everyone else, to be honest.
“Oy.”
Both dogs were thrilled with their treats (with their separate meds hidden inside) once the naps were over: Cricket discovered a great love for sardine juice, and Ellie discovered that she had no such great love and stuck with pieces of chicken.
Ellie coughed less for a few days, though she became more and more picky every day about the treats within which we could hide her pills, but then the coughing came back, and Ellie was barely eating anything at all. We called the vet and he said to stop the antibiotics, because they might be causing her lack of appetite, but keep up the cough suppressants for a few more days and then call back.
Pretty quickly, though, it was clear that Ellie was getting worse. She was breathing heavily, leaving treats uneaten (where Cricket could easily steal them), and refusing to walk more than a few feet at a time. So we called the vet for an emergency appointment this morning and brought her in, and as soon as he saw her he said she didn’t look good at all. He took an x-ray and said her heart was huge and misshapen, and there was fluid collecting around her heart. He gave her a shot of a diuretic and told us he would send the x-rays on to a specialist and then let us know what medication she could take going forward. But, he said, she could collapse at any time. He couldn’t explain how she’d gone from having a little bit of a cough to being in heart failure within a week, but most likely the cough had been caused by the enlarged heart in the first place, pressing on her trachea.
Ellie’s home now, still breathing heavily, but peeing rivers, which will hopefully relieve some of the pressure on her heart. But my heart is overwhelmed. Cricket is oblivious: sleeping on Grandma’s lap, eating well, and barking her frustration at all of the attention her sister has been getting. And now we wait, to see what comes next.
If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
A few weeks ago I was afraid Cricket was on the edge of life, diagnosed with kidney disease, struggling to walk, knocking into things. We started giving her subcutaneous fluids on the off chance that it would help extend her life, and it’s actually working. Though in order to give her the fluids we have to medicate her with a combination of gabapentin and ACE, which makes her woozy for hours. At times, she seems like a wraith, her feet slipping out from under her, not even protesting when the needle slips under her skin.
Ideally, she would have gotten used to the whole procedure by now, and she wouldn’t try to pull off the muzzle, or lift up her head to get away from the needle. Ideally, I’d never have to give her any calming meds at all and she would just accept the fluids as a necessary evil and get it over with and get back to living her life. But then she wouldn’t be Cricket, and all of this effort is to make sure she gets to be Cricket for as long as possible.
“Oh, I can be even more Cricket-y. Just wait.”
Every day, at the beginning of all of this, I was afraid she was going to die overnight, and when she actually woke up in the morning, and ate her breakfast, I was surprised, and afraid to be hopeful. But with each day she seems to improve a little bit. The meds make her into a rag doll, yes, but then the next morning, after she’s slept it off, it’s like she’s been brought back to life, refilled with her fluids and her spirit, and ready to sniff the whole world again.
It’s still nerve-wracking to watch her skin fill up with the fluids. I even worry sometimes that her neck is going to explode (I’ve seen too many movies), and I worry that I’m going to put the needle in the wrong place and puncture something vital. I was worried for a while that I was inserting the needle the wrong way and causing scar tissue to form because I could feel these quarter-sized bumps under her skin and I was afraid I would run out of loose skin and not be able to give her the fluids anymore, but then the bumps started to dissolve, and that worry, at least, went away. So much of this is trial and error and the circumstances seem to change every day. It feels like a magic trick each time she wakes up in the morning and walks and barks and eats and acts like herself, but a magic trick that is unreliable and hard won.
I’ve been thinking about my friend Teddy, the miniature poodle, who died from kidney disease a few years ago. His death came as a surprise, at least to me. He hadn’t been diagnosed with the disease ahead of time, and by the time they caught it he was too far gone to be helped by fluids or anything else. When Cricket was diagnosed I was afraid it would be the same thing, and every day, even though I knew her case was different, I expected the same results.
Some days are better than others. Every once in while she has a bad night, her breathing is shallow, she pees on the floor because she can’t get to the wee wee pad in time, or she’s not up to climbing the stairs, but other days she seems to be getting better, growing stronger, and enjoying her life.
I was telling myself that I just needed Cricket to reach her sixteenth birthday, but now that she’s accomplished that goal, I need more. I need to feel like I did everything I could possibly do for her. I need to not have any regrets, and not feel like if only I had been stronger or smarter or kinder or more loving, she would have lived longer.
I’m also doing my best to make sure Ellie doesn’t feel left out, and gets extra hugs and scratchies and treats to make up for all of the attention her sister is getting. But when Cricket feels better she goes back to taunting Ellie, so then I feel guilty for taking such good care of Cricket and, at the same time, I feel guilty for not taking good enough care of her.
“If I keep my eyes closed she won’t bother me. Right?”
The thing is, Cricket isn’t giving up. She doesn’t think sixteen years is enough, even if each day is a little harder than it used to be. And if she’s going to be this stubborn, then I guess I’m going to have to be stubborn too.
If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
Cricket has kidney disease. She had a really bad day recently: she fell down the stairs when she was coming in from a walk, and had to be carried up and down the rest of the day. By the next morning, she was back to herself, climbing the stairs and eating her breakfast and barking at the UPS guy, but we took her to the vet anyway and he checked her out and took blood and the next morning he called to say it was her kidneys, but he’d need a pee sample to know if she also had an infection. I had to follow her around all day with a ladle, collecting a teaspoon of pee at a time and storing it in the fridge until we had enough to bring to the vet. Thank god, Mom didn’t take the picture she threatened to take of this particular activity. The results: no infection, but very watery pee, confirming kidney disease, so we’d have to go back to the vet and learn how to give her sub-cutaneous fluids once a day. With a very big needle.
“I hate needles!”
Cricket only weighs 9.5 pounds now, down from her original 14 pounds, and she looks like a naked chicken from the neck down, but she still has her rebellious spirit. So as soon as I knew I would have to put a needle under her skin every day, I started searching everywhere for her muzzle. We’d never actually used it before, but we had it somewhere, just in case, because she is a biter. I finally found the muzzle hidden behind her old harnesses and winter sweaters in the hall closet, and she let me put it on her, for a moment, before she started trying to pull it off.
At our next appointment, the vet demonstrated how to hang the fluid bag on the door, and hold Cricket still, and pull up the extra neck skin like a tent and insert the needle, and Cricket calmly let him do all of this. We watched her neck swell up like a balloon, which he said was totally normal, and then he removed the needle and pinched the skin so that the fluid wouldn’t spritz out. Then he showed me how to change out the old needle for a new one, easy peasy. By the time we got home, Cricket was feeling so good that she skipped down the lawn on her way to the front door.
My first attempt at giving her the fluids myself, the next morning, went almost as easily as when the vet did it, even with the big needle and the bite-prone Cricket, but on the second day, she rebelled. She bared her teeth at me, and pulled away from the needle, and then she bit me, three times. I tried again later in the day and managed to get the needle under her skin and a small ball of fluid in her neck, before she bit me again.
“You bit me first!”
On the morning of day three, we tried giving her food during the procedure, to keep her distracted, but she turned the bowl over and spread the food all over the floor and hopped over it to get away from the needle. So, in desperation, we gave her a quarter of a doggy valium, and waited. An hour later I was able to put the muzzle on her, and insert the needle under her skin, and give her the rest of the fluids she should have had the day before. The only problem was that we had no more doggy valium. So off to the vet we went to get more medication, and incidentally, to make sure it was okay for her to take it every day. It was, but even that small amount of ACE (the doggy Valium) made her stumble around and wiped her out for the rest of the day.
“It helps to have somewhere to put my head.”
A week after starting the fluids, we took her to the vet for another round of blood tests, to see if the fluids were helping, but when the doctor called the next morning, it turned out that her kidney numbers were worse. He told us to keep doing the fluids, with some added B vitamins, and he gave us Gabapentin to try instead of the ACE, to see if the combination would give her more good days. He had no prediction for how much time she has left. He just told us to keep an eye on her eating habits, and if she doesn’t eat for three days in a row then that would mean she’s suffering and it will be time to let her go.
We tried the gabapentin to no effect, so we went back to the ACE, but decided to give it, and then the fluids, at night, so that she could sleep it off and wake up feeling better, and that seems to be working better for her.
I don’t have high expectations, but I’d like for her to enjoy the end of her life as much as possible, and I’d really like to have a little more time.
“Where’s the rest of the chicken?”
If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
We were in a car accident a few weeks ago. I didn’t write about it at the time because Mom was shaken up and didn’t want her aunt to worry.
Mom has been losing feeling in her feet for a few years now, and going to all of the doctor visits to try to figure out why and how to stop it, but nothing has worked. It has mostly impacted her balance, because she can’t feel the ground as well through her shoes, so more often than not, when she takes the dogs out for a walk, she goes out in her socks or bare feet.
“We go outside barefoot all the time. What’s weird about that?”
For some reason, that evening, on our way to synagogue, she wore a pair of shoes she hadn’t worn in a while, and very early in the drive she realized her mistake, because she was having trouble feeling the brake pedal, but when I suggested that she pull over and let me drive, she said no, she was fine.
But she wasn’t fine, and at a crucial moment, when she thought she was stepping on the brake, it turned out that she wasn’t.
She could have had another career as a race car driver, so even without brakes Mom was able to maneuver through traffic to get to safety, with only minor damage to another car, but our little red Honda was basically totaled, not so much because the accident was terrible, but because the car had so many miles on it that the insurance company thought it wasn’t worth doing all the necessary repairs.
Mom was in a daze after the accident, overwhelmed that she’d been the cause of it and frightened that the numbness in her feet might take away her independence. But as the days passed she decided that it really was that one pair of shoes, and with thinner soles she could still feel the brake pedal and drive as well as before. At least for now.
We were both fine, physically, and to my surprise I really didn’t have much of a post-traumatic stress response like Mom did, so I did most of the driving, and emptied all of the gardening tools and grocery bags and random detritus out of the old car before the garage took it away. Thank God, Mom was up to making all of the phone calls with the garage and the insurance company and the rental car company.
“I hate phone calls.”
As soon as we found out that the insurance company didn’t want to repair the Honda, we started to look for a replacement, and since Mom has been wanting a car that’s easier to get in and out of for a while now, she had a good idea of what she wanted. We went to the nearby Subaru dealer and found a lightly used charcoal grey Subaru Crosstrek, which also has some safety features we didn’t have in the Honda. It’s a good car, and comfortable, and has lots of trunk space, and the driver’s seat can be maneuvered every which way, to give Mom the best possible control over the pedals and view of the road, but it’s not red.
And there’s this deep sense of loss. The little red Honda Civic has been part of our family for a long time, and I’m used to her. Switching to the rental car, a white KIA, with a push button start and rearview camera and lots of bells and whistles, took some adjustment, and the car didn’t smell like dogs and wet dirt from Mom’s gardening adventures, so it really was a stranger.
I’m pretty sure the trunk of the new car will be filled with gardening equipment within the first few days, and there will be dog treats stuck into the cushions, and it will start to smell right. And it will be a relief to know that Mom can keep her independence and feel, and be, safer. And the car only has 25,000 miles on it, so we’ll probably be able to keep it for a long time, until it too becomes like family. But the loss is real. Things are changing.
“We don’t like change, Mommy.”
If you haven’t had a chance yet, please check out my Young Adult novel, Yeshiva Girl, on Amazon. And if you feel called to write a review of the book, on Amazon, or anywhere else, I’d be honored.
Yeshiva Girl is about a Jewish teenager on Long Island, named Isabel, though her father calls her Jezebel. Her father has been accused of inappropriate sexual behavior with one of his students, which he denies, but Izzy implicitly believes it’s true. As a result of his problems, her father sends her to a co-ed Orthodox yeshiva for tenth grade, out of the blue, and Izzy and her mother can’t figure out how to prevent it. At Yeshiva, though, Izzy finds that religious people are much more complicated than she had expected. Some, like her father, may use religion as a place to hide, but others search for and find comfort, and community, and even enlightenment. The question is, what will Izzy find?
rachelmankowitz 