Carmella's Medical Miracle-Part Two Completed!

Carmella has now had the NDV injected into the Foramen Magnum (the area at the back of the neck just below the skull). Everything went according to plan and she has not had any adverse reactions.

This morning Dr. Muller came into the room after we had spoken with the nurse assigned to her about the medical miracle, and you could tell that he was excited about the prospect of doing something that few vets have tried in the course of their entire career.

Often veterinary medicine in private practice can become rather mundane and routine. There are only so may rabies shots, spayings and neuterings, routine check-ups and common injuries you can take care of before it all just runs together, and so this day was filled with wonder and possibility.

Dr. Muller was beaming from ear to ear as if he'd known us for a long time, greeted me, and shook my hand. Carmella went right up to him and jumped up with her front paws on his white coat, sensing that he was one of those few who really "got" her and the value of her life. The nervousness she'd shown in the taxi on the way over seemed to melt away and was replaced by the current state of hope and anticipation that filled the air. At first he seemed a little unnerved by her exuberant and unabashed entrance into his personal space but soon he forgot all that and reached over and petted her. Carmella has a way of doing that without even trying. Her spirit shines through with the intensity of a thousand suns to transcend the confines of species.

"So she is having myoclonic jerking in the right front leg?"

"Yes, and some now in the left back leg too" I replied.

The vet opened the box containing the NDV and looked over its contents. I told him that the bottle contained B1 rather than LaSota strain and relayed what Dr. Sears had said last night indicating that the different strain should pose no problem and it should work just fine.

"Hmm. Dr. Norwood told me verbally that the company sent him LaSota strain."

"Yes, I thought it was until I looked at the print magnified. It really had me worried there for awhile, but I'm glad it's not going to mess things up."

"True; it shouldn't be a problem. I read your blog and you've done quite a good job of documenting all this and put alot of time and research into it. I think all these doctors are just afraid of trying something so new and there is a risk of death anytime you go into the spinal area, but I believe in this instance the benefit is worth the risk because these dogs invariably will progress to disability and die if it's not done. Then there is the issue of all the supportive care and the cost of that, and the special needs for the rest of the dog's life."

"Exactly."

"And the point is well-taken that there's alot more Distemper out there that's not being addressed simply by prevention." Dr. Muller held up the bottle of dillutant and commented on the intense blue color. "This looks pretty nasty. I wonder what's in here? Probably food dye, but I just wonder if that could cause a reaction?"

"Yes, I wondered that myself and was a little shocked when I saw it too."

"I hate to put this into the CNS." He paused holding it up to the light and pondering. "I bet I could just use saline solution instead and that would be kinder."

"That makes sense to me."

"Yes, that seems like it would work well instead of this blue stuff." His ability to think outside the box and trouble-shoot was something that had been missing in the other vets I'd spoken with over the past nonth or so. Where others backed away he was instead thinking of ways to solve those particular weaknesses in the equation. This was just the kind of ingenuity needed.

He asked whether there were any instructions included as to how to mix the two and I said that it didn't appear so. He noted that some of the print on the bottle seemed to be in French. Then he went about calculating out loud the proprtions of saline that would be needed and how best to mix it with the NDV, returning the scary-looking blue stuff to the box. Then he looked over the instructions he got from Dr. Sears and I handed him my copy that I'd printed out. There appeared to be a few discrepancies; possibly one was written later than the other or there were two variations which could be followed interchangeably.

"If there's anything you aren't sure about be sure to call Dr. Sears before you get started just to make sure. He's very nice and says he's willing to give as much back-up as you need. He's retired so he's most likely home most of the time."

"OK."

"He did tell you that you shouldn't expect results immediately..."

"Yes."

"Really we're looking at 4-6 months before we're going to see restoration of the myelin."

"Yes, we talked about that last night."

"I think it will go well. We have ultrasound here so I can see where the needle is and make extra sure it's in the right place."

"Oh, good. That makes me feel alot better. As long as you're skilled enough not to hit the spinal cord then I think it will be smooth sailing."

"The needle just needs to go in about this far" he showed with his fingers "and as long as you don't go in at an angle then you're alright." He seemed to be replaying it in his mind as a trial run, something which many athletes, musicians, and other talented people do to prepare for major challenges ahead, and a very useful brainstorming technique.

Then he and the nurse took Carmella to another room and he told me that he'd come out to the waitingroom to let me know how it went.

I must have read just about every magazine in there. I think it was around 10:00 or 10:30 when I saw him open the door leading to the back part of the clinic.

"Mom?" he said. He was smiling, so I knew the news was good. I jumped up as he motioned me in. "She did really well. No problems, no shock." I followed him down a hallway to the left and into a little room where the same nurse was who had spoken to me earlier. They were just getting Carmella up off the table and she seemed to scramble up with a start, somewhat disoriented. They put her down on a blanket on the floor and her IV came out in her struggling to right herself. The nurse asked if she should put another one in and he told her that it probably wasn't necessary and if she needed more fluids they could always do it again later.

Dr. Muller showed me the vial of cerebrospinal fluid he had withdrawn for the antibody and strain tests. It was milky and somewhat thick, about the consistancy of shampoo. He remarked that he had no trouble getting it and I asked about Carmella's shaved neck where there was a small dot on the left side at the top. That was where he had stuck the needle and he explained that they figure a triangle in order to mark the area to go into. Her bare neck made her look much like a Hare Krishna.

I sat down with her on the floor and she started to crawl into my lap and whine. He'd given her some morphine and it was beginning to wear off. He did not want to give her any anti-inflammatories because the process by which the Newcastle Disease virus vaccine works requires an immune response so that the cytokines in Carmella's brain and spinal area can locate and then kill the Distemper virus. The immune system is thereby put on high alert, turning up a few notches in order to create the power necessary to eradicate it completely.

The NDV in effect acts as an irritant to the dog's immune system in much the same way that sand acts in an oyster except that rather than encasing the virus the way an oyster forms a pearl around a grain of sand it just bombards it. This immune storm takes place within a 24-48 hour period after the injection is given into the spinal canal.

Certain events during that period such as seizures can happen until things calm down again and the virus is gone, so they are keeping her overnight for observation. They have an ICU much like hospitals have for humans. The nurse assigned to Carmella showed me where they would keep her. There were about two rows of cages one on top of the other, and Carmella was placed in one on the upper deck. Across from there was an area with desks and there must have been 15 staff in that room all looking at charts, documenting, monitoring, and taking care of the dogs. I was glad to know that there were people there in that room 24 hours a day in case of any unforseen emergencies.

At the end Dr. Muller told me that he'd leave instructions for the vet on-call for tomorrow and that he or I could call him at home if we needed to. The nurse wrote her name and the other vet's name on our paperwork and explained that if I didn't hear from them by 10:00 tomorrow morning to call and have one of them paged so I could find out how she did overnight. Since the cost of the cab over there was huge I asked if it would be alright if I picked Carmella up later in the afternoon if I could get somebody I knew to bring me after she got off work, and she said that would be no problem.

I looked in on Carmella one more time before heading home and reached in between the bars and petted her muzzle with my finger right near her whiskers and she gave me a wide-eyed look as if to say, "You're going to leave me here?" I told her I was coming back to get her tomorrow. I instantly was tempted to change my mind and take her home then, but figured I better not in case she had an emergency in the middle of the night and I had no way to get her to an emergency vet fast enough. I walked out hoping that maybe she would get some sleep and that it would soon be tomorrow and she'd be over the worst of it.

Her hospitalization required that I pay half the bill in advance which was about $200. I put that on my CareCredit.

The house feels empty without Carmella here and I hoped that people were not bored logging on to watch the Carmella-cam without Carmella. The kitchen seemed overly still and vacant with dog toys and cushions strewn around on the floor.

I was beginning to get very drowsy and develop a headache from lack of sleep and the rest of my body had begun to ache also. If I didn't have an autoimmune disease myself I would have thought it was sympathetic pain to what Carmella was feeling. I at a late lunch, put an ice pack on my head, and went to lie down. Finally the pain subsided and I did get some sleep.

I called Dr. Norwood's office to give them the good news, and sent an e-mail to Dr. Sears. I also asked where he got the Distemper strain tests done, as Dr. Muller had said that Antech labs only does the antibody test. He'd mentioned to me in the office that we might have to send it off to a University vet school and I told him that was alright with me. If Carmella's information could help other dogs then it was worth it.

Before Dr. Muller said goodbye he asked if he could keep the remaining part of the bottle of NDV because he has another dog he'd also like to treat with it that is just beginning to develop neuro symptoms.

I really hope he and Dr. Norwood do collaborate on a paper about Carmella's recovery. Somebody has to be the first to get this cure into the medical journals, no matter how small a story. It will be nice if this happens in Dr. Sears' lifetime. He deserves to see this put on the map while he can enjoy the accomplishment, and if no more dogs and their owners are left out of luck because there is something written up, then all this work will have been worth it. Carmella is a testament to its effectiveness, and that is a beautiful thing.

http://Giftbearer.etsy.com/

Reaching Out-When One Door Closes Another Opens

It's times like these when you really find out who your friends are. There are those who are with you every step of the way and those whose real agenda becomes clear in time, and the latter fall away like soggy leaves of lettuce rotting in the late day sun. Perhaps it is nature's way of doing some Spring Cleaning (only in this case it's Fall Cleaning). It is not fun to find out people you thought supported you really didn't, but I guess maybe that makes room in your life for great people to come in.

My best friend, bless her heart, is still sticking by me, and it was good to hear from her today. That support came when I needed it most.

Yesterday there were two bead shows in town and I didn't even want to go. It takes alot for me to pass up one of those. Hopefully I will feel better next weekend. I believe there's another one coming then. I need to get some things to create some exciting new pieces and would much rather pick the supplies out in-persin than have to shop online.

Earlier somebody I've known for years said some not very nice things to me today because of her own issues and I went from feeling pretty precarious to devastation again. It took me most of the day to shake it, but coming home to Carmella's smiling, enthusiastic face seemed to soften the blow. She jumped up with her front paws and with tail wagging licked me and wedged her head under my arm, then did her Mickey Mouse pose, puffing out her chest and leaning her head back with a broad grin. I brought her a big giant ham bone that had been baked in Barbecue/Terriaki sauce and she dug into it appreciatively!

Then I threw a stick for her outside for awhile as she ran and retrieved it. Afterwards I worked on training her to lie down and to stay. She caught on quickly, but still wanted to chew my hands in the process especially when I had dog buscuits for her.

Tonight I got a few local news media contacts and sent an e-mail off to the first one this evening , a woman from WSB-TV Channel 2 News. I will be thrilled if she or one of the other reporters does an interview.

I probably won't know until Monday whether Dr. Norwood has flown the coop or not, but I know that Carmella will need a vet who is determined not to give up on her and is capable of taking care of business for the duration. In time it will all become clear who that's going to be.

Carmella is a gift to the world and her kind of inner beauty does not come along every day. Sure, she is beautiful on the outside, but what captivates people with her most is that there is something pure and shining underneath that emenates from her; an essence of dignity and grace and of wisdom.

http://Giftbearer.etsy.com

Some Good News and Some Bad News

Just when I though things couldn't get any worse...they did. Things were looking up and I was finally able to turn off my hypervigilance long enough to make a new pair of hoop earrings.

Then I called Dr. Norwood's office to see whether he'd put in the referral to UGA and the other receptionist, Jocelyn got him to the phone. Dr. Norwood seemed unsure of himself when it came to talking to UGA about the need for Carmella to have this treatment and he wasn't sure whether they would be interested in a cure for Distemper, and maybe even less in trying it on one dog, even if it was going to save her life. The line between who does research and who does treatment in veterinary medicine is very fuzzy and nobody seems to be sure who is responsible for what. On one hand UGA might not do the treatment unless it already fell under a study they had planned, on the other, private practice vets won't do this because they consider it research. So where does that leave Carmella?

Dr. Norwood expressed frustration at "irresponsible owners" out there who don't spay and neuter their dogs and don't have them vaccinated, and when I said to him that even if most people did that then what are those who are currently infected supposed to do. They and the owners who are good owners should not be penalyzed for the actions of others, and the focus of vaccines and prevention left dogs like Carmella absolutely out in the cold. Also, I'm not so sure that the systemic/societal problem can be explained so simply as being due to "irresponsible dog owners", especially in this bad economy in which many are falling on hard times through no fault of their own. I wouldn't be surprised whether some dogs are not being vaccinated because their owners are in foreclosure or were laid off and they have to choose whether to pay vet bills or pay to move so they themselves don't become homeless and hungry. Whether the people who are not doing those things are irresponsible or not, the dogs did nothing to deserve being left up a creek without a paddle, and they deserve to be cured if they get sick.

As for Carmella, she could not be more loved or taken care of, and as much as I think it was wrong for the shelter I got her from to conceal that she was sick, the course of events did result in getting her a good owner and me, a great dog! I don't know if there are very many people who would go through this with her and had she ended up with someone else she may have been killed the first week as soon as they realized there was something more serious than kennel cough wrong with her. I have always believed that my finding her was divinely guided and that things happened to bring us together at just the right time.

Dr. Norwood related that it was a tough week and that three people had dropped dogs off on his office doorstep which he took home with him for lack of any other place to put them. He was going to try to find homes for them through the office first, and he'd found a home for one little poodle already, but the other two were going to be less desireable and a harder sell. He said that on occasion he had to take dogs to "animal control", that many times the no-kill shelters were full and would not take even one more.

While we were talking about the under-reporting/diagnosing of Distemper he made the statement that "animal control has its place". I disagree with that and I think it is a barbaric way for humans to deal with animals they don't know what to do with, and the killing of such animals for our convenience as a species is the ultimate in irresponsibility. Furthermore, I don't like when shelters refer to that as euthanasia because in reality it's not, and it implies that we humans are doing it to "put them out of their misery", when often the real misery is in the reality that nobody wants them and they are disposed of like heaps of garbage, nobody caring that they have feelings, that they breathe, eat, and drink, and they can love. Many dogs are put to death that are salvageable, either with nothing wrong with them or something that can be fixed. Imagine if every time we got a cold or the flu, or cancer (God forbid) the determination was made to kill us because it was costing too much in resources or nobody wanted to give us medical care. If that were legislated into law for humans you can imagine the public outrage that would ensue, the letter-writing, the demonstrations, even riots!

Carmella is stuck in a no-man's land and I told Dr. Norwood that waiting for each vet to make up his mind while she has to have "supportive care" in the meantime to maintain her "living with" the disease is more costly than if they'd have just treated her when I first asked them to. He said that most private practice vets were "bleeding hearts" and could not live with their conscience if something went wrong. He thought that was even more of a factor than their fear of liability. That just doesn't hold water because if most vets in private practice were that paralyzed from taking any action that could result in a dog's accidental death or injury then why don't they take the same position each time they are asked to do surgery? Every time an animal is put under general anesthesia he/she could die, and he/she could die from the procedure itself, or suffer complications, say for instance open heart surgery, traumatic injuries to internal organs that must be repaired, and a number of other medical procedures.

To me the risk/benefit analysis in this instant is a no-brainer: If they treat her Central Nervous System there is some risk involved, but if they don't they can almost guarantee with 100% accuracy that she will get worse, and eventually die of it. If something happened (and I sure hope it won't), but if it did, then at least they would not have sat around waiting for her to die because they didn't even try to save her. Doing nothing to save her is definitely worse. How could Doctor do-nothing vets like the ones who are able to do this procedure but merely chose/choose not to (and they know who they are) have a clear conscience just because they can say they did nothing to "actively" cause her death or possible harm. That is a rationalization if I ever saw one! Just a trick of the mind, a re-write of morality of sorts. It is no better than to wittness a car accident and to stand there not calling 911 while a man or woman bleeds to death, or even more to the point, if the wittness was a doctor and failed to do CPR or provide help that he had the knowledge and skill to provide in an emergency.

It is the same type of mind-set that allows women to be beaten by their abusive and violent husbands, children to be molested and raped, and allows corrupt judges and government officials to just keep on breaking the law with no consequences ever applied to them. Once we become a society built on excuses and expending more energy on new and creative ways to avoid doing, rather than on ways to do the most we can do to make the world a better place, we lose our humane-ness and our humanity completely.

Carmella's neurological disease-progression is like an evil weed that won't stay hidden from view and it dawned on Dr. Norwood as we were on the phone that this "every vet for himself", passing the buck stuff could not continue or it would be Carmella (and me) who would pay the price. As much as he blanched at the thought of approaching UGA or having to take a strong stand in the face of an industry that just didn't want to hear it, buck up he must. There is an emergency brewing and this could be put off no longer. Gone were the days that he could console himself with the thought that "maybe" she wouldn't get worse. He asked whether Dr. Sears could talk to UGA because he himself didn't know anybody there and he theorized that they wouldn't listen to his opinion because he was not as familiar with the biochemistry as Dr. Sears is, and is certainly no expert. He seemed to worry that he wouldn't come across as if he knew his stuff when faced with these board certified neuro vets from a school like UGA.

Then he said that maybe he could think of somebody at Tuskegee, his Alma Mator, then once she was treated and showing signs of recovery her case could be presented as the impetus for some of these vet schools to do clinical trials on this cure.

I came away from the conversation with renewed hope that maybe finally something would work out in the end.

Then soon after, I found out that I don't have a way to get there. I thought how ironic it would be if the one person who would and could do this injection turned out to be a vet at Tuskegee and then of all F'ing things I had no way to get there. Bear in mind that because of a disability I can no longer drive. I had to stop years ago because I was having accidents, each more serious than the one before. Greyhound does not allow dogs, and from what I've been able to deduce the closest airport is 42.3 miles away (Montgomery Dannelly Fld Airport) and it's a small one, not even on most of the airfare sites, so even so, it looks as if one would have to access at least 42.3 miles by car any way you slice it. I was able to find the nearest hotel (only a little more than a mile from the University), and by today's standards it's not bad, but it's still not cheap! So if that is where Carmella's answer lies it's going to take alot more money, and then someone who could pick me and possibly a friend up at the airport. I was shocked to find that the lowers faires were over $500 for what amounts to about an hour-long airplane ride. It's not like we'd be traceling to California! That is almost a month's income for me when I'm not making any sales.

I went online to see if there were any organizations that might be able to help and did find a few that say they help with vet expenses but I don't know if that applies also to getting there for specific treatment or just covers the treatment itself. That is what I'll be working on tomorrow. Then Carmella goes to see Dr. Norwood at 4:30 so that he can document her worsened condition. Hopefully by then we will find out if he's had any luck with any of the vets at Tuskegee. If that's a no-go, then we can go back to persuing UGA although he wasn't sure if they'd be interested since he has never gotten a call for research subjects on anything to do with Distemper. He just may need to talk to Dr. Sears again and take notes that he can use when he talks to the referral coordinator. This is one of those "feel the fear and do it anyway" situations. I've been doing that all along. Now it's some other people's turns.

If you would like to do something to help Carmella please take a look at my Etsy store, make a purchase and help save a dog.

http://Giftbearer.etsy.com/

It's a Rainy Day In Georgia...Feels Like it's Raining All Over The World

The constant ooze from the sky seems to match what's been going on for the past couple of days. A heaviness has settled upon this house, and as Carmella and I hunker down inside, little drafts come in all the cracks, the linolium floor barren and tracked with flecks of mud, and pieces of saturated leaves scattered about from our recent walk. Neither of us wanted to go far, making a hasty retreat from the grey light which permeated our very beings. She was glad to be finished with her bathroom activities and return to the kitchen. It almost feels like the beginning of winter.

Carmella's restlessness of the previous few days gave way to a silent gnawing tension, much as a man on death row might feel awaiting the electric chair. She did not make a move to chew on her rawhide stick, but lay down in her bed which she'd turned upside down, sprawled out and looking up at me like, "Now what?" Her right leg and shoulder jerked perceptibly as if programmed by some external remote control. She seemed almost used to it by now, nevertheless understanding the gravity of the course which lay ahead. On some level she knew that she had crossed some line in the sand and there was no turning back now for either of us.

Setting my sights on UGA I placed another call to try to verify whether I'd sent the e-mail yesterday to Dr. Schatzberg's correct e-mail address, and still the front desk staff was not sure. I was transferred to the Small Animal Clinic and spoke with a woman there about Carmella's situation and the treatment she needs, and asked whether Dr. Schatzberg was on vacation. She said he was there but just wasn't on clinic duty this week and that the three neuro vets employed there take turns rotating one week each at a time. She said that if the e-mail did not come back then he probably got it but if he didn't answer then it was probably because he got so many he couldn't get to all of them. She recommended I have my vet contact the referral coordinator and said that we could most likely find out whether they could do it before we drove all the way out there when Dr. Norwood spoke with them by phone.

I then called Dr. Norwood, and Felicia, one of the receptionists, answered the phone. I explained that Carmella's jerking was getting worse and that she needed to get the referral to UGA as soon as possible. She told me Dr. Norwood was in with a patient and did not seem to want to take down the phone and fax for the referral coordinator, but I insisted, figuring that his getting it from me later would just take extra time. I told her that they close for the day in one hour, and she said that she didn't know whether he could call them by then. I asked her to have him call me before he left.

In all, I called 4 times today, and 3 out of those 4 he was in with a patient, and the 4th time they'd put the answering machine on indicating that they had closed. My heart sank.

I wrote Dr. Sears to update him on the events of the past few days and to let him know we were going to try UGA, and asked if he could possibly put together a list of references; vets who had used this treatment either for the body or in the CNS, so that we have something organized to show them with which to make our case (if we need it). I take nothing for granted after seeing how many vets have turned us down so far.

A sudden sleepiness came over me while I paradoxically thought about the fact that I really need to make some more jewelry. Although I'd like to, I'm not sure I can stay awake much longer.

I'm still going through alot of existing inventory and listing/renewing jewelry, so if you see anything you like for yourself or for someone on your gift list, please make a purchase and help a puppy.

With love and action, all things are possible.

http://Giftbearer.etsy.com