Tag Archives: chemotherapy

Health

Canine chemo treatment number four…

Yesterday started out sunny and pleasant, but later became overcast and a little depressing. I took the dogs for a walk, noticing that some kind of event was going on at the local church. A lot of people were dressed in black. I wondered if maybe there was a funeral going on, even though our town has a cemetery with a chapel.

It was Thursday, which meant that Arran had a chemo appointment in the afternoon. It was his fourth. Arran has been doing surprisingly well with the lymphoma treatments. He willingly scarfs down his medications, mainly because he’s always hungry due to the steroids, and because I wrap the pills in yummy things like chicken, peanut butter, or beef.

Arran and I got the vet’s office early and met a couple of local ladies who thought he was adorable. They asked me many questions, and we were hampered by our masks and our mutually terrible German/English skills. That is, they spoke perfect German and limited English, and I speak perfect English, and very limited German. But I did manage to tell them a little about Arran, and one of the ladies told me about her dog, who is 12 years old and was evidently at home.

My dog was totally eating up the attention, trembling a little either due to nerves, or the slightly chilly weather… or maybe both. He willingly went to the ladies, and enjoyed being the center of attention as they called him “Schatzi” and petted him. He’s still such a gorgeous dog, with a beautiful, lush, thick, glossy coat. But he’s also clearly an elderly gent.

For a moment, I wondered if I should tell them why we were there, but then realized that people can be judgmental about dogs getting cancer treatments, especially when they’re as old as Arran obviously is.

I will admit that Arran did look a little sad and scared at the vet’s office, and maybe some folks might think it’s wrong for him to be subjected to cancer treatments. What other people don’t see, though, is the way Arran is the rest of the time, when he’s not at the vet’s office. They wouldn’t have seen him jumping excitedly when I held up the dog “seatbelt” before we left the house, or dancing around for his food, or on his morning walk, when he wanted to go the long way… They wouldn’t have seen him giving me sweet beagle kisses at the table, or snuggling with Bill. Obviously, Arran isn’t sorry to be alive.

In the end, I decided to keep my mouth shut. It wasn’t their business, anyway…

Before long, the vet called us into her office in Haus B, where we had the conversation about Arran’s slimmer physique. She drew some blood, then inserted the catheter and gave him his first dose. Then, we went back to a chair where she had set up a bed for Arran. He laid down and, just like a champ, took the next two IV push infusions. Half an hour later, we were done. Arran was happy to get into the car and go home, where he enjoyed his evening rations and a nap before his favorite person came home from work.

In the past few weeks, Arran has lost a couple of kilos, which he could easily afford to do. He gained a lot of weight during the lockdowns and was, at one point, up to about 19 kilos. Now he’s getting back to his fighting weight, but I think we’re going to either get him regular food, or feed him more of his senior food. Last week, he weighed 17.6 kilos– down from 17.8 the week prior, and yesterday, he was 17.2 kilos.

The vet asked if he was eating. I said, “Yes! He constantly wants to eat. Should I feed him more?” She said no, that he’s not too skinny yet. I guess the disease and the treatments are making him use more calories. That, and he’s moving more, because he’s not so lethargic.

Arran is still not obviously suffering from the treatments. Yes, he wants to eat all the time, but that was also true before he got sick. The one change is that now he’s more insistent, and he gets us up in the middle of the night because he’s hungry. This morning, he woke us at 2:30am. He wanted some of our breakfast a little later, too. Now, he’s gone back to bed, as I listen to a classic jazz song and wonder if I should try to record it.

I love fall. I like to savor these cozy days. Especially since I know that our time with sweet Arran is growing shorter. But I can’t say that I’m sorry we’re giving him this extra time. I think he’s grateful for this time, because he’s still engaged with life. I don’t regret treating him. I know that if we hadn’t done this, by now he would already be a memory.

Below are a few photos of Arran taken during her chemo treatment… This represents about a half an hour of his week. The rest of the time, he’s decidedly more cheerful and cute, as he appears in the last photo, sitting on the bench of our table. Two weeks ago, he couldn’t jump up there by himself. Now, he can jump up there, and on our bed, where he’s gone back to sleeping.

He’s not done fighting yet. So we’re going to help him for as long as he wants to fight.

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holidays

Pumpkin project!

Yesterday, since it was cloudy, Bill went to the local market to pick up some pumpkins. We have new German neighbors who have small children and they asked us to celebrate Halloween this year. So we obliged, although it wasn’t easy to find pumpkins. Halloween is becoming more and more popular in Germany, especially in areas were a lot of Americans live. Bil had to go to three stores to find suitable pumpkins for carving. The local farm near us was having a corn maze/Halloween fest, so he thought he might get lucky there. But there was nowhere to park! All the kids were celebrating Halloween!

I remember our first year in Germany, back in 2007. We were living in a hotel on Halloween, although it was our last night there, as we moved into our first German house on November 1. The following year, we had people ring our doorbell, but since we didn’t know if Germans celebrated Halloween, we were completely unprepared. Then in 2009, we had to move back to the States prematurely.

In 2014, we came back to Germany and lived in Jettingen. That year, we had candy, although I’m not sure if we carved a pumpkin. A pair of German teen boys in rather lame costumes rang our bell. That was it for trick or treaters. Ever since then, if we’ve been home, we have candy just in case, but we don’t usually bother with jack o’lanterns. Last year, we were Croatia on Halloween, which was a marvelous place to be. Croatia in the fall is glorious, as you can see here.

Anyway, below are some photos of our pumpkin project. I think they turned out okay. Bill is going to go get some American candy, and hopefully our neighbors will ring the doorbell tomorrow night. Otherwise, I’ll end up doing what I do every year for Halloween, and eat all the candy myself. God knows, I don’t need to be doing that! Our jack o’lanterns aren’t very menacing. I’m not that good at pumpkin carving.

We have pretty nice weather today. The sun is out, and it’s not too cold. We probably ought to go out and do something fun, but Bill is still resting up after his bout with COVID. Except for a little fatigue, he’s fine now, and will be headed back to in person work tomorrow. Meanwhile, our sweet Arran continues to improve on the medication he’s getting for lymphoma. Yesterday, he even started jumping on the bed again. The chemo regimen is obviously doing some good for him as he enjoys what will probably be his last fall season. We continue to cherish our time with him and marvel at what a trouper he is. I’m grateful that we’ll be able to enjoy his company for a little bit longer.

Today is also the first day of standard time. Next week, everybody in the States who change the clocks will be moving their clocks back, too. I think if we have to change the clocks, it’s better to do it before Halloween. That way, it’s dark enough for a proper Trick or Treat experience. That’s how it was when I was a kid, anyway.

Anyway, if you celebrate, Happy Halloween!

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Health, markets

Chemo, COVID, and another weekly market…

This week has really flown by. Here it is, Friday morning, and it’s time to write another blog post for my “travel/German living” blog.

Last time I posted, I mentioned that Bill wasn’t feeling well. In that post, I wrote that he was suffering from irritable bowel syndrome, fatigue from two back to back TDYs, and some kind of respiratory illness that wasn’t COVID. Well, it turned out we were wrong. Bill went to work on Monday, and learned that a couple of his colleagues who had been at the conference in Bavaria had come down with COVID. Since he still wasn’t feeling well himself, Bill decided to test. Sure enough, he had a positive result, so he’s been working from home for the rest of the week.

He’s actually feeling fine now, and never got very sick with the virus. He didn’t have a fever at all, never lost his sense of taste or smell, and aside from some coughing and fatigue, hasn’t been much worse for wear. Yesterday, because he’s over the virus, he took Arran in for his chemo treatment, and we attended the weekly market, although we made sure to stay on the periphery of the crowd. He’s working from home today, too, because his boss told him to, but he’s pretty much recovered from the sickness. I haven’t been sick at all, perhaps because I had COVID myself back in July. While Bill was at the vet’s office, he was masked, as everyone is required to be in any healthcare setting in Germany.

Arran is still doing well with his lymphoma treatment. His blood test didn’t reveal any progress, per se, toward technical remission, but we can see a difference in his energy level. For instance, a few days ago, I was eating a sandwich on my bed, and Arran managed to jump up on the bed by himself. He has pretty much quit doing that lately, but before he got sick, he always slept on our bed. He’s also been jumping up on the bench of our Eckbank Gruppe, which he always did when he was well. I know a lot of people wouldn’t want a dog sitting next to them on a bench or sleeping in bed with them, but for us, it’s a normal thing. I’m just glad Noyzi doesn’t do it, because he’s a lot bigger and hairier.

We had gorgeous weather yesterday for the market, so we went down for about an hour or so. We got some cheese, cold cuts, and beautiful produce. Maybe I’ll make a homemade tomato sauce today and we’ll make lasagne or manicotti. Of course, we also enjoyed some local wines, and waved to our neighbors. I really love the weekly market. I know the markets are common in larger towns, but our little neighborhood is unusually close knit, so the market is intimate and convivial.

Our town manager is always there to oversee everything, too. I think he does a great job. He’s very active on social media, and approachable. This is something we didn’t experience when we lived near Stuttgart. I didn’t know who the town managers were in our previous neighborhoods, nor did we have weekly events like we do in Breckenheim. But then, I don’t know if what we have in Breckenheim is the norm for the Wiesbaden area, either. I’ve noticed there’s been an uptick in events here just over the last year or so, but then, we did have to deal with COVID restrictions. Anyway, Bill and I both really like that they do these events here, and we have enjoyed meeting some of the locals with whom we share space.

Below are some photos from this week. First, are a few shots of our Arran, who is obviously feeling much better. Bill asked about the bill for his treatment so far, and the vet said there’s no pressure to settle up at this point. As Americans, we are allowed to use a “VAT” form, which exempts us from having to pay local taxes for the treatment. Whether or not to accept VAT forms is voluntary on the part of local merchants, since it involves paperwork for them. But it sure is nice for us when they do that, especially for expensive things like non-routine veterinary care, or big purchases like furniture.

This week, I read an article in the Washington Post about a woman who got expensive cancer treatment for her dog. She got a lot of rude comments from people, which I ranted about. Last night, she left me a very nice comment on my post, which you can read here. In any case, so far Arran is doing well, and we’ve been enjoying some priceless time with him. I also don’t expect that his care will cost as much as it would in the United States. As soon as we have a bill, I will confirm or deny that expectation for the curious.

And here are some shots from the market… Someone had some heavenly smelling bread. It smelled like garlic bread. I never did find the source, but they were also selling waffles with powdered sugar that reminded me of the early 90s, when I worked at Busch Gardens making waffle cones. I worked in “Germany”, and wore a dirndl. Little did I know what the future would hold.

Bill found some lovely Italian cheeses and cold cuts, as well as gorgeous, colorful produce… but I was there for the wine.

For some reason, the editor isn’t letting me put comments on the photos… Luckily, most of them are self explanatory. I did notice the Gastatte sign for the first time yesterday. Breckenheim has little signs on its historic buildings, as well as “stumbling stones” (Stolpersteine), placed in honor of local Jewish people who were victims of the Holocaust. The stones are now making appearances all over Europe. You can search my blog for more information on those.

Since Bill is feeling better, maybe we can get out of the house this weekend. We do have plans to carve pumpkins for Halloween this year, since we have new German neighbors with small children who requested it. I’ll post about that when the time comes. 😉

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Hessen

Arran’s second round of German style chemo… So far, so good!

As I wrote on my main blog yesterday, I was kind of dreading yesterday. When we still had Zane, I took him to the vet all the time for allergy shots. It got to be quite a grind, which I found kind of nervewracking. That was when we still lived near Stuttgart, and our vet was a several miles away. It wasn’t a big deal to drive there, obviously, though I don’t do a lot of driving anymore. I’m not sure why I’m like this now. Before I got married, I used to drive all the time. But then I got sucked into this stay at home wife gig, and I don’t get out much anymore. It’s not because I can’t go out, though… more like I choose not to. So, having to drive Arran the very short (even shorter) distance to the vet is kind of anxiety producing, especially in the COVID era.

I made a point of not getting to the vet too early yesterday. Noyzi demanded a walk, so I gave them one. Then I put Arran in his “seatbelt” harness and loaded him into the Volvo. Ordinarily, I would have driven my Mini, but it’s parked in the garage, and accessing it would mean moving the Volvo out of the driveway and getting my car out. And while Arran fits fine in the tiny back seat, getting him in the car when he’s mobility challenged, and there are only two doors, isn’t that easy. It’s a lot simpler to put him in the Volvo, since he doesn’t have to crawl over the driver’s seat to get in the backseat. I no longer have the upper body strength to simply drop the top and put him over the car door. There’s also a concrete barrier on our driveway that makes it harder to access the backseat.

We got to the vet at about fifteen minutes before our 11:00am appointment. I picked up a beeper from the receptionist and sat in the car with Arran until it went off. It was noticeably chillier this week than it was last week, although the skies were as overcast. Arran slowly ambled into Haus B, a part of the vet clinic I had never been in before. Arran’s regular vet wasn’t in this week, so another vet gave him his treatment. I liked her. Weirdly enough, she kind of reminded me of Mick Jagger. No, not necessarily because of her looks, but more in the way she carried herself. And her face and coloring bears a slight resemblance to his. I know that’s a weird observation, but I don’t mean it as a put down. I think Mick Jagger is an amazing force of nature! Anyway, she seemed somewhat easier to talk to, and less rushed. I don’t really know the vets at our office well, because Bill is the one who usually takes the dogs. But since Arran is getting chemo, I guess I’ll be getting to know them better.

The vet drew some blood to make sure Arran would be medically able to tolerate the chemo. After a few minutes, she showed me the results. Arran’s red blood cell count is still low, but his reticulocytes– immature red blood cells– are on the rise. That means that his body is responding to the anemia and making more red blood cells. In the meantime, “young” cells are being released into his bloodstream. This is a good finding, because it means that his bone marrow is still functioning and trying to repair itself. If there weren’t more reticulocytes being released, that would mean his body wasn’t responding and had “given up”– aplastic anemia. I’m sure in the short term, it would mean he’d need a blood transfusion and in the slightly longer term, it would mean he was on his way to the Rainbow Bridge.

After the happy news that Arran’s regular vet’s fear that his bone marrow was irreparably damaged (she had communicated this in an email to Bill) was incorrect, Arran got his second IV push of Vincristine. Haus B is a slightly less “house like” environment than the main office is, so I sat in an area next to a window and watched as many people brought their dogs for treatment. Dr. Konrad Blendinger, the man who, with his veterinarian wife, owns the practice is a vet who does highly specialized reproductive medicine for dogs. He mostly only sees dogs who are being bred, and it looked like some of his patients were waiting for him yesterday in Haus B. It was the first time I’d ever seen him in person, although I have seen him performing music in locally produced videos. I’ve noticed that part of German culture is having hobbies, and music is apparently one of his! We have that in common.

Arran was pretty calm during the chemo. He laid on his side and took the drugs like a champ, only managed to pull the cap off the port, which wasn’t a big deal. The female “Jagger” vet expressed mock dismay, then covered up the port until she was ready to administer the medication. After an hour or so, we were finished, and I loaded Arran into the car, asked for a bill (which wasn’t yet ready), and drove home. Bill came home a few hours later, and they had a lovely reunion!

The dogs were so happy to see Bill, as was I!

Arran has responded very well to the treatment so far. His lymph nodes have gone down; he’s stopped coughing and gasping; his poops are mostly very normal; and he’s eating like an Olympic athlete. He still can’t jump on the bed, but he clearly feels much better. We still don’t know how much this will cost, but it’s been so nice to see Arran behaving more like himself. To be very honest, I think if we hadn’t started treatment last week, he might not be here today. The disease was definitely starting to progress. My main goal was to make sure Arran wouldn’t die without Bill– his favorite person– by his side. Now, it looks like that will be what happens, but we aren’t sure when. But then, that would be true for anyone, wouldn’t it? As this week’s events in Ukraine have shown us, one never knows when death will occur.

Anyway, we’re just going to enjoy this time, and do what we can for our sweet Arran. I think this experience will teach us a lot, not just about canine cancer, but about cancer in general. The drugs he takes are the same as what many humans take when they have cancer.

Arran and his favorite person!
He sure looks good.

Not to leave out Noyzi, below is a video I made of him reacting to The Handmaid’s Tale, as Serena had her baby. He was very curious and empathetic. Noyzi is a true gentle giant.

Noyzi is a big, sweet, Balkan goofball.

And a couple of photos of our regal Kosovar rescue, Noyzi, who is now living his best life in Germany. He sure has come a long way!

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Health

German style chemotherapy!

Before I get accused of posting “clickbait”, I want to make it clear that this post is not about Bill or me. It’s about our elderly beagle mix, Arran, who was recently diagnosed with B cell lymphoma. I’ve been posting up to the minute updates on my main blog, but I wanted to post here for those who hit this blog because they’re specifically looking for information about life in Germany. I have a very different “audience” for this blog, although it seems like most of my readers come here to read about our trips to the nude spas. 😉

A week ago, I posted about how we were trying to arrange chemo for Arran to treat his cancer. Originally, we thought we’d rather just make him comfortable, because he’s already about 13 or 14 years old. We thought the vet would just prescribe prednisone or prednisolone for him, to help ease the symptoms of the lymphoma. For some reason, the vet said they didn’t usually do that. Then I noticed that Arran didn’t seem ready to go to the Rainbow Bridge. He was still pretty active, and B cell lymphoma supposedly responds to treatment better than T cell lymphoma does. I was also curious about canine chemo, since Arran is our fourth dog to have cancer and our second to have lymphoma. Our first lymphoma casualty was Zane, who died just one week post diagnosis.

Bill finally got ahold of the vet on Monday, and she ordered the necessary drugs for Arran. He’s been at Grafenwoehr all week, on a business trip. He will be gone again this coming week. I was very worried that Arran would get much sicker and die while Bill was gone. Everything I’ve read on the Internet tells me that Arran should have already died by now. But, as I’ve explained many times, Arran is a real fighter, and he’s not ready to go yet.

I brought Arran to the office on Thursday at 3:00, but had to stop by on Wednesday to get analgesics for him, as his lymph nodes had gotten so large that he was having trouble moving without pain. In Germany, COVID restrictions have been relaxed almost everywhere, except in doctors’ offices and other healthcare delivery facilities, and on trains and busses. So when we arrived on Thursday, I had to wait for the clinic to open, then get a beeper and wait outside to be called. I was the first one there, because I really wanted to get the appointment over with. I hate afternoon vet appointments. I find them exhausting. I’d rather go to the vet in the morning, so it’s done. When we had Zane, I was constantly taking him to the vet for allergy shots, so this is a familiar routine for me, except for the face masks, which are still required in doctors’ offices.

Arran went into the exam room and the vet quickly put in a catheter, then drew some blood. She later told us he was a bit anemic, which was concerning to her, although not all that uncommon for lymphoma patients. She told us to bring him in if he was in pain, short of breath, or had pale gums. Then she administered the first of several syringe vials of diluted Vincristine, which is a chemo drug. She explained the rest of the protocol to me and even printed out a schedule. Arran will come back for another dose of Vincristine on Thursday of the coming week. At home, he will get Prednisolone and Endoxan (known as Cytoxan in the US). The Endoxan is a chemo drug in pill form, and I’m supposed to wear gloves when I give it to him, and when I clean up his waste.

The vet asked about my schedule. I told her the only thing we have planned is for November 16th through the 20th. The 16th is our 20th wedding anniversary, so we are planning a trip to Ribeauville, France. The dogs will be coming with us. We have been to Ribeauville a bunch of times and have stayed in the apartment we rented several times. The owner is very dog friendly, so I feel comfortable in going there with the boys. I don’t care if we just sit there and drink wine and eat macaroons and madeleines. I would have liked to have planned something grander for the occasion, but there will be time for that later, when the chemo sessions are over. The effects of chemo, unfortunately, are temporary. But they will hopefully buy us some time.

After the first dose of Vincristine, we moved to an infusion room– a tiny little booth with chairs and an IV stand in it. It looked like the room had been built on to the side of the building, as there was a sconce on the wall that was obviously originally meant for outdoors. I thought maybe Arran would get an IV bag, but they used more syringes. It was surprisingly easy.

In the infusion room.
They made him a little bed.
Feeling fine last night!
He’s so happy Bill is home. He had sweet dreams.

About an hour later, we were finished, and Arran culminated the treatment by releasing a rancid fart. Thankfully, the tiny room had a window in it. The receptionist said we could pay next week, since the vet had to ask the owner of the practice how much the treatment would cost. We aren’t too concerned about the money, because vet care is cheaper here than it is in the US, and because we actually have the money to spend. Living in Germany has been surprisingly lucrative for us.

When we got home, Arran, who had been obviously ailing before the appointment, actually wanted his dinner. Much to my surprise, he willingly ate kibble for the first time in over a week. I had been giving him chicken all week, and he’d had a little bit of bloody diarrhea. I was a little worried about how he’d handle the chemo, but he just ate his dinner and went to bed. I had put a blanket on the floor, and he made a bed and fell fast asleep.

At about 1:00am, he woke me up, because he needed to pee. I let him out, and he wanted a snack. I gave him a little more kibble, and we went back to bed until 4:00am, when he needed to pee again. Then, at 6:00am, I got up and made coffee. Both dogs came down to the kitchen for their breakfast. Again, this was a change, because for the past few weeks, Arran has been increasingly reluctant to rise in the mornings, and hasn’t been wanting to eat his breakfast. But on Friday morning, it was like old times. Because it was raining, we didn’t go for a walk yesterday. However, he was obviously feeling much better. His lymph nodes shrank noticeably, and he was eager to eat. He never managed to jump up on the bed by himself, but he didn’t cry when I helped him up, as he did on Wednesday.

By Friday afternoon, Arran was looking really good. All week, he’d been waiting in the foyer, hoping Bill would come home. Bill has been away on business all week, though, so Arran would be left disappointed. Last night, Bill came home, and I got a video of the reunion. I would say it was worth the price of the chemo for that alone. If you look carefully at the featured photo, you can see that Arran’s lymph nodes in his hind legs are swollen. Those nodes have now shrunk significantly. One is no longer detectable, and the other is about half as big as it was. I gave him more Endoxan and Prednisolone today. These are the same drugs often used for humans, but in veterinary medicine, they are given in much smaller doses. The goal is preserve quality of life, rather than curing the disease. Even if we cured Arran, he’s old enough that he could die of natural causes, anyway. So far, we haven’t observed any truly bad side effects from the drugs, although they can and do cause side effects for some dogs.

What a change! This was taken last night. He’s obviously feeling a lot better.
He was so happy to see Bill!

There is a high speed animal hospital near us called Tierklinik Hofheim. I’ve mentioned it a few times, and we have used it for Zane and Arran, although Noyzi hasn’t been there yet. They have an oncology department. If Arran had a more complicated case, or was much younger, I’d probably take him there for treatment. They have the ability to get test results faster than our regular vet does, and they no doubt have a lot more experience with treating cancer. But, again, Arran is already an old guy, so we’re not inclined to be heroic. We just want to get him to a point at which we can both be with him when he’s ready to shove off of the mortal coil. If he can make it to January, and celebrate ten years with us, that would be icing on the cake. Many dogs who get chemo for B cell lymphoma survive for a year. I’m not sure that will happen for Arran, due to his age, and the fact that his treatment was a bit delayed.

I’m not sure if we have any plans for the rest of the day. The weather is pretty crappy today. It’s raining, although it’s not cold outside. So this will probably do it for today’s activities… I’ve already spent time on the phone talking to USAA again, because they declined a charge Bill and I both tried to make to pay for Ribeauville. Calling USAA is always an annoying experience, especially since the lady I spoke to answered the phone as if someone spiked her oatmeal with crack, or something. But, as I’m writing this, the doorbell rang, probably with the latex gloves I ordered. Arran barked, and hurried down the stairs, as if cancer had never darkened his door. So I’d say that so far, Arran is doing very well. It’s very nice to see!

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