The Assertive Cancer Patient

Now It's Rocky Friday ...

Thank you to everyone who wrote expressing concern about poor GB, who swallowed two large rocks last weekend and had emergency surgery on Monday to remove the larger one. (He threw up the 2-inch rock on my bedroom floor Sunday night.)

GB developed pneumonia from aspirating fluid into his lungs, and his esophagus is also damaged by the rocks and the attempts to get rid of them, so he is still at the vet. His doctor has treated him with cortisone and also antibiotics.

At first, we thought he would be home in a day or two, so when the vet said, "You can visit him," I said no, because I thought GB would think I was there to take him home and it would be tougher for him to have to stay.

But after three days of phone reports, I couldn't stand it, so I stopped by to see him yesterday.

They had him in a run, with blankets on the floor, and an IV in his right front leg for fluids. He hadn't been eating, but they gave him 2 tablespoons of food yesterday and he kept that down. I think that was the first food he'd had since this whole drama began on Sunday.

So I went into his run with him and sat down on the floor to cuddle him, and the pooch, all 70 pounds of him, crawled on my lap. He needed a hug. So I sat there stroking him as he wheezed and heaved, just kind of spasms at this point.

Talked to his vet, and asked the Big Question, "So, he will get better, right?" To be told, "Well, pneumonia is pretty serious."

Came home and hung out with Constant (Connie), my dog, for the rest of the day. Connie is not quite sure what is going on, he seems to be missing GB, and I can't explain it to him, obviously.

Here's a link to a post that a reader sent. It falls into several categories: humor, skin cancer, and also "dogs who eat things they shouldn't":

Her tombstone will read WAS SOLD TO BUTCHER

See also: Rocky Monday ...

@ Jeanne Sather 2008.

Rocky Monday ...

So I got home from my date last night with Car Guy (more on that later), and was getting ready for bed.

Younger Son's dog, GB, usually sleeps in my room. Connie sleeps there too, or not, depending on how well he is behaving ... In any case, as I was getting settled into bed, GB threw up, on the carpet I had professionally cleaned not two weeks ago, and there, among the usual ick was a rock.

A huge rock.

Two inches in size, in fact.

GB has done this before. Golden retrievers have a thing for eating weird stuff, including rocks. I put him in the back room, which has a tile floor, with Connie, and went to bed. But this morning the dear doggy was still gagging and couldn't eat his breakfast.

It had that train wreck feeling--inevitable. I called a friend (no car, remember? It's still with Car Guy) to take us to the vet, and the vet got us in for an emergency appointment. Took an X-ray, and there was an even bigger rock in the dog's gut. No way he is going to be able to get that one up, and no way it will pass through, because of its size.

The dog is scheduled for surgery this afternoon, and will probably stay two nights. I had to call Younger Son to tell him. I know he was upset, although he said he was fine.

Heck, I'm upset. Really stressed. And I'm leaving for an appt. in about two minutes with my dermatologist--my melanoma checkup.

Argh. Rocky Monday--could someone write me some lyrics?

What's this photo about? When I was at Third Place Books this weekend, I bought several magazines, including "Bark." I haven't read it yet, but it was sitting right there on the coffee table as I was calling the vet, with this teaser on the cover: When Dogs EAT Glue, Diapers, Coins & Toys: E.R. Tales

@ Jeanne Sather 2008.

... Feed a Cold

I woke up this morning feeling crummy, and decided I'd better cancel my volunteer gig at First Place School.

Then, as I was giving Constant, the Wonder Dog, his shower (needed since he came home from the dog ranch a week ago), I kept feeling dizzy and had to sit down a couple of times.

Now, the thing about feeling like this when you have cancer is that it's hard to tell if the problem is:

A. The cancer

B. The drugs

or:

C. Some garden-variety thing that everyone is getting.

So I waited a few hours, had coffee with a friend here instead of going out for it as we had planned, and worked on my blog for a bit. Then, sure enough, I started noticing cold symptoms. So now I can relax.

If you have cancer, you know what I'm talking about.

Now we come to the "feed a cold" part. This is what I'm eating for lunch.

It's just a package of Top Ramen (five for $1 at the QFC), dressed up with some cubes of tofu, an egg (poached in the broth), and a couple of spoonsful of miso, one red and one white. (Both kinds of miso are actually shades of brown, but in Japanese, they are red and white.)

For some reason, when I have a cold I tend to crave protein. That seems odd, but I go with my food cravings--except for the craving for a quart of green tea ice cream. I'm going to ignore that one.

The bowl is my special noodle bowl with red dragonflies painted on the side. It makes food taste better.

@ Jeanne Sather 2008.

Rainy Thursday

It's raining today, which is actually a good thing. The Pacific Northwest would not long be the green oasis that it is without a lot of rain.

My garden needs rain, too, even though this means I won't be working outside for a day or two until it stops. But I have seeds to start inside, so I may do that instead.

My cold is finally gone, except for the tiniest lingering cough, and my energy seems to be bouncing back. So I feel like I'm back on track with my life. Today, I'm painting the wood that is going to become trim around all the doorways in my living and dining rooms.

Once I get the wood both primed and painted, my handy-guy will cut it and nail it up for me. I could handle the nailing part myself, but not the cutting--I never get closer than six feet to power saws. They scare me. Ditto chain saws. A power sander or power drill are about the limit of my playing with power tools.

I walked Connie in the rain this morning and we both got pretty soaked. So I'm eating oatmeal with brown sugar as I write this, to warm up my insides.

Then I'm going to paint a few more boards (I'm doing this in the kitchen, with a drop cloth), take a sauna and shower, and head out for a couple of appointments.

Things that are hanging over my head:

--Still waiting for a call from my mechanic to let me know how much it is going to cost to get the Corvair back on the road.

--I need to call the U.S. Government and find out why my Medicare paperwork (card and forms to sign up for Part B) have not yet arrived. I'm paying about $400 a month more for my present health insurance than I calculate I will on Medicare, even with paying for Part B, Part D (drug coverage), and a supplemental policy through WSHIP (my present insurance).

That phone call will be tomorrow morning's task. You have to be in the right mood to take on these issues.

@ Jeanne Sather 2008.

Meet Gigi, Debra's Service Dog

After Debra, who lives in San Francisco, read my posts about service dogs, she went to her doctor and got a prescription for a service animal.

She already had the dog, Gigi, a French bulldog who is about five months old.

After Debra talked to San Francisco Animal Care and Control, however, she sent me an e-mail asking for my help, because SFACC told her she had to have a special tag identifying her dog as a service animal before she could take it with her to various public places.

I’m not sure if there was a charge for the special tag, but Debra was caught in a Catch-22 because she was told she could not get the special service dog tag until her dog had a regular dog tag and rabies shots, and Gigi was (and still is) too young for these. Gigi needs to be six months old to have her rabies shot and get a dog license.

“I told them I needed to start training her,” Debra wrote, “and they said there was nothing they could do until then. … They made me feel that it was illegal to have my pet identified as a service dog until then.”

I e-mailed Debra back, and said:

Debra--I'm in Seattle, but the law about service dogs is a national one. Your dog needs a regular dog license and rabies shots, of course, just as she would if she were a pet, but nothing more. I suggest you print out the page from the ADA, link below, and carry it with you. If you have any problems or questions beyond that, I would contact the ADA directly for help.

Who told you that you have to have "special tags," by the way?

Let me know what happens.

Here's the link. The contact info for the ADA is at the bottom of the page:

http://www.ada.gov/svcanimb.htm

I also offered to make the phone call for Debra, since she sounded stressed out in her e-mails.

Debra sent me another e-mail explaining that she had just finished a series of cyberknife treatments and was burnt out from those treatments and also from fighting to get her health insurance to approve the treatments. "I did not sleep for two days, e-mailing anyone I could to help me ... I would so appreciate it if you would call," she wrote.

So today I got on the phone and called the ADA help line, at 800-514-0301.

An aside: the recording at this number is one of the longest I have ever heard. If you want to speak to a real person, just press "7" and skip all the directions for getting various guidelines faxed or mailed to you.

The person I spoke to said that ID tags are not required for service dogs under federal law. In addition, she said, “Under federal law, certification is not required.”

I asked if federal law trumps a local law, like San Francisco's, and she said yes.

So, as far as I can tell, Debra can take Gigi wherever she chooses in the city of San Francisco without a special city dog tag identifying her as a service animal. Debra probably will want to carry a copy of the Web page of ADA rules for service animals that clearly states that ID tags or certification are not required for service animals.

Just for fun, I plan to call S.F. Animal Care and Control and ask them why they are making things difficult for disabled people. I'll post the answer once I get one.

Read more:

Cancer Dog

A Dog By Prescription

Want a Service Dog of Your Very Own?

Animals at the Office

@ Jeanne Sather 2007.

Beach Photos

I just downloaded about 30 photos from my digital camera, and I'm wondering what it means that I have more photos of the dog, Constant, than I do of Younger Son?

Younger Son's dog, GB the golden retriever, didn't make it into the frame at all.

And my attempts to capture bats in flight resulted in a series of black rectangles. Rats. Or, maybe, "Bats!"
[Bad pun alert.]

Connie and me on the deck of our hotel room.

Younger Son spent his time reading (The Iliad), eating, playing Risk against himself, running, eating, walking his dog, eating ... more eating.

Younger Son, the red speck, coming back from a run on the beach.

Connie against the landscape.

@ Jeanne Sather 2007.

From the Mailbox: Fellow Travelers, Dogs, and Old Friends

One of the things I love most about blogging is the e-mail I get from people I would never "meet" if I didn't have a blog.

In the past day or two, I've had e-mail from "fellow travelers," AKA partners of people with cancer; a woman who has questions about taking her dog out in public as a service dog; and an old friend I'd lost contact with. Actually, a number of old friends have found me through my blog and other writings on the Web, but this one is special, so I'll start there.

Old Friends
Vicki and I originally connected when she read Jeanne's Diary on the OnHealth Web site and contacted me through the attached bulletin board. We never met face to face, but corresponded by e-mail for years.

Here's her message:
Hi Jeanne: I guess we lost touch, and I was thinking about you today as I was playing around on the computer. I found your blog and just wanted to say Hi from Qualicum Beach. I'm glad to see you're still fighting the fight and you sound feisty as always!

All is well with me....10 years and counting. Life is good, albeit summer is strange this year, both here and in your neck of the woods.

Ten years. Love it. (This month is the anniversary of my diagnosis, for those of you who might be wondering, NINE years ago now.)

Fellow Travelers
I don't write much about the partners of people with cancer, probably because I don't have a partner, but a number of them read my blog, even though my primary audience is cancer patients with attitude.

And of course they are always welcome. I have a lot of sympathy for people in this situation, and I can imagine how tough it must be, although I do have very strong opinions about boundaries. (See Soapbox No. 1: Whose Disease Is This?)

Having said that, I was happy to hear from Amy, whose husband was diagnosed with immunoblastic t-cell lymphoma the day after Thanksgiving last year.

Amy writes, "He finished four rounds of hyper c-vad chemo and just completed a stem cell transplant last week. He's doing as well as can be expected, but the fallout of cancer is much more complicated than I ever imagined. Just scrolling through your blog was like a revelation, that what we've gone through is not unique. (Insurance issues, being treated badly by employers, friends who avoid us because who wants to picture themselves as a widow with young kids or with a sick spouse...)"

Amy also has a blog, about which she says, "My own blog touches on some of these things, but it's not my cancer, it's my husband's, so I'm pretty careful."

Read:
helloamylou

Amy also suggests that Breast Cancer Barbie needs a companion, maybe "Lymphoma Ken."

Personally, I think it should be "Prostate Cancer Ken"--hit the male business execs responsible for these stupid dolls right where it hurts. See if they think it helps them in their "cancer journey" (gag) to own a Prostate Cancer Ken. Or do they want one for their sons to help them cope with their fathers' cancer--the way the Breast Cancer Barbie was promoted as a gift for girls with a mother or grandmother going through breast cancer treatment.

It sounds pretty stupid when you reverse the genders, doesn't it?

I also heard from Ken Wachsberger, who I quoted in yesterday's post on academic publishing and copyright issues. Ken has a booklet for sale on his Web site for partners of women with breast cancer.

Ken says, "I wrote it during my wife's breast cancer adventure seven years ago. (She's clean
now, thank you.) As her support person, I found a lot of material about how I could help her but nothing about how I could keep sane while doing so. My booklet answers the question for others."

Here's the link:
Your Partner Has Breast Cancer?: 21 Ways to Keep Sane as a Support Person

I haven't read it yet, so maybe I'll ask Ken for a review copy, but from the description on the Web site it looks useful.

Cancer Dog Questions
After I wrote Cancer Dog and Want a Service Dog of Your Very Own?, I got a lot of e-mail and also comments on my blog from dog lovers who were thinking about training their dogs as service dogs.

I also received an e-mail from a woman named Debra in San Francisco who ran into some problems.

"I have gone to my doc this week and have gotten a scrip to have my pup a service animal," Debra writes. "I read on your site that this was enough to bring her everywhere...she is a french bulldog and very mellow....I was searching around and I have to register my dog before I can 'get special tags' to show she is a service dog.....well i am not able to do that because she does not have her rabies shot yet...i have to wait 2 months when she is 6 months....they told me I would not be able to get the tags until then and that she need to be registered first."

I wrote back and asked Debra WHO had told her that she needed special tags for her service dog. It sounded like it was someone in dog licensing in San Francisco city government. It is true that service dogs need shots and regular dog tags, just as pet dogs do, but I think federal law says that service dog owners don't need anything else.

So I also suggested that she take the page from the ADA Web site with her to discuss this again, and also contact the Office of Civil Rights, which oversees ADA and service dog issues. That link again is http://www.ada.gov/svcanimb.htm.

"My pup makes my heart lighter," Debra writes, "and she is real good for being so young ... I have never had a pup so well behaved. I guess she was what the docter ordered to keep me going."

@ Jeanne Sather 2007.

Want a Service Dog of Your Very Own?

A service dog, as defined by the U.S. Government, is a dog that is trained to perform tasks for people with disabilities. For those of us with cancer, the tasks we ask our service dogs to perform will vary--in Jill's case, it was to help her become more mobile, and to help with her depression. (See Cancer Dog.)

I got Constant because he makes me happy, gets me out for exercise, and helps keep depression at bay.

If you want a service dog, just follow these five steps:

1. Get a Prescription
Ask your oncologist or therapist to write you a prescription for a service dog. Carry this with you in case anyone challenges your right to have the dog with you in public places. (Chances are you won't need to show it very often, if at all, especially if your dog is wearing a vest and behaving appropriately.) Jill says people ask her about Pumpkin because they're curious, not because they object to his presence.

I asked Dr. Livingston to write me a prescription for a service dog back when Connie was a puppy for "mental health reasons," i.e., to help with my depression. I tucked the prescription away, and now, when I want to quote what it says, I can't find it.

Here's what Jill's prescription for her service dog says: A Dog By Prescription. Ask your doctor to write one that says something similar.

2. Choose a Dog
Don't just grab the cutest puppy in the litter and decide that it's going to be your service dog.

If you have a dog that you think would be a good service dog, consider having it evaluated by a professional--typically a dog trainer who works with therapy dogs and service animals. Not all good pets make good service dogs.

At a minimum, the dog needs to have the right temperament (calm, not easily startled, not overly protective or aggressive), be the right size (hard to imagine a St. Bernard as a service dog, despite their fame for alpine rescue work), and be well trained.

If you are going to get a new dog to be your service dog, have it evaluated by a dog trainer before you commit (or fall in love).

I think my wannabe service dog, Constant, is going to be an excellent service dog eventually, because he is bonded to me (I've had him since he was six weeks of age), smart, responsive, and he wants to please.

3. Train Your Dog
Decide how you are going to train your dog. Are you going to do it yourself? Take a class with the dog? Work with a dog trainer one-on-one? Or turn the animal over to a trainer to teach?

At a minimum, your dog needs to be able to pass the "canine good citizen" test, which means the dog will ALWAYS, on command, come, sit, stay, and lie down. It should also walk on a loose leash, and stay with someone else while you walk away.

When Jill takes Pumpkin into a restaurant or other public place, Pumpkin goes under the table and falls asleep.

There are a couple of reasons that Constant is not yet a service dog. The first is that he is still very young and full of energy. He is just two years old. The second is that I've been pretty tired because of treatment for the past year (up until my break from treatment started three months ago) and I haven't been able to give him enough exercise or work hard enough on his training.

Constant dominates GB, our golden retriever, and he was dominating me, according to the dog trainer I consulted a couple of months ago. She taught me how to show Connie that I'm the boss, and things are much better, but he still has a long way to go. I'm spending a lot of time with him this summer, and I expect that by the time he is three years old he'll be going with me as my service animal.

Don't kid yourself about your dog's behavior: Have the dog tested or evaluated by a professional before you start taking it with you as a service animal.

Of course, as part of the dog's training, you need to take it into public places and into stores. When I start doing this with Connie I'll make sure he's wearing a vest that identifies him as a service dog "in training," and I'll let the supermarket or store management know what I'm up to in advance.

4. Get a Vest
Jill's dog Pumpkin wears a service dog vest with patches from SitStay.com.

I'm going to measure Constant and order his vest today. The vests come in four colors: red, blue, green, and orange. I'd like to get orange, but blue is probably a better choice, psychologically.

5. Know the Rules
According to the Americans with Disabilities Act, "businesses and organizations that serve the public must allow people with disabilities to bring their service animals into all areas of the facility where customers are normally allowed to go. This federal law applies to all businesses open to the public, including restaurants, hotels, taxis and shuttles, grocery and department stores, hospitals and medical offices, theaters, health clubs, parks, and zoos."

In addition, businesses may ask if the animal is a service animal, but cannot require any kind of ID card. Nor can they ask about your disability.

Businesses such as restaurants are not allowed to isolate you from other patrons, or charge you extra fees, unless your dog causes damage, in a hotel room, for example.

Also note that "businesses that sell or prepare food must allow service animals in public areas even if state or local health codes prohibit animals on the premises."

I recommend printing out this page and carrying copies with you to give to business owners who question you. I also recommend a cheerful attitude: assume that people who question you are curious, or don't know the rules, not that they are hostile to you or to your dog.

If you have cancer and have a service dog, please write and tell me your story: jeanne.sather@gmail.com

Read more:

Cancer Dog

A Dog By Prescription

Animals at the Office

My friend Lisa’s post on her blog, The Tale of My Left Foot:
Sadie

Jennifer's post, on Inner Mayhem:
Puppy (and Kitty) Love

From Teresa, The Cheeky Librarian, AKA Ninja Librarian:
Best to face cancer with a dog at your side

Need more information? Contact the Delta Society.

Support this blog:

@ Jeanne Sather 2007.

Cancer Dog

My friend Jill, always an early adapter, was the first person I knew who had a service dog because of her cancer.

She is still the only person I know with cancer who has a service dog, although once I get Constant, my little wannabe, trained to that level, he will be No. 2 among my circle of friends.

Jill’s Story
Jill’s breast cancer metastasized to her bones in 2002, and she fell and broke a leg because of a met. She had surgery to pin the broken leg, then surgery to pin the other leg, to keep it from breaking as well, a few months later.

The metastases and the long recovery time meant that Jill and her husband had to abandon their plans to adopt a child. Jill was grieving and depressed, and her doctor referred her to “Dr. Judy,” a psychiatrist who works with breast cancer patients.

“Dr. Judy is the beginning of the story,” Jill says now. “Judy said, ‘You have a lot of love and energy to give and you need an outlet to give it. Would you consider a dog? I think you are a candidate for a service dog.’” She wrote Jill a prescription for a service dog.

Dr. Judy helped Jill find a dog. She suggested that Jill get a dog that was small enough that it couldn’t pull her off her feet while she was still recovering from the broken leg. Jill had a cocker spaniel when she was a child, and she decided she wanted a cocker.

She found Pumpkin, who was being cared for at a private rescue in Oregon, through PetFinder.com. Pumpkin is a Cavalier/cocker spaniel mix with freckles on his nose. He arrived at Passover, in April of 2003.

“He was 7 years old, freshly groomed, and so sweet,” Jill says. The rescue had taken care of Pumpkin’s vaccinations and microchip, and also neutered him.

Pumpkin’s Job
“The law says if you are disabled, you can have a service animal that does something for you that you can’t do for yourself,” Jill says. “Most are dogs, but you could have a ‘service turtle,’ I suppose.

“Pumpkin’s job is to keep me balanced on my own two feet and keep me mobile. At that time, I had trouble getting around. Needing to take my dog for a walk kept me moving.”

Once Pumpkin was trained to behave impeccably in public, Jill took him everywhere—to her support group, doctor’s appointments, the grocery store, out to lunch … even to treatment appointments.

Pumpkin wears a vest from SitStay.com that identifies him as a service dog, and also has a patch that invites people to ask to pet him. Unlike a guide dog for a blind person, which should not be distracted while it is working, socializing is good for Pumpkin. “It’s fine for Pumpkin to interact,” Jill says.

Good Dog
Service dogs do not need to be certified, but Jill prepared Pumpkin to take—and pass—the “canine good citizen” test, which is the same test that the Delta Society uses for therapy dogs, Jill says.

To pass, Pumpkin had to obey the following commands: sit, down, and stay. He also had to walk on a loose leash, greet a friendly stranger, and sit with someone else while Jill walked away.

Only this last requirement was difficult with Pumpkin, who gets anxious when he is separated from Jill, but he passed the test.

Pumpkin now has a certificate and a patch showing that he is a “good citizen.” When Jill and Pumpkin are in public together, Pumpkin goes under the table and “becomes a piece of furniture,” Jill says.

Semi-Retirement
Last year Jill stopped taking Pumpkin everywhere with her, although she still takes him to her support group and also to treatment appointments to “keep up his good habits.”

“I was feeling better,” she says, “and he’s 11 now. He gets to slow down.”

Read more:

A Dog By Prescription

Want a Service Dog of Your Very Own?

Animals at the Office

My friend Lisa’s post on her blog, The Tale of My Left Foot:
Sadie

Jennifer's post, on Inner Mayhem:
Puppy (and Kitty) Love

From Teresa, The Cheeky Librarian, AKA Ninja Librarian:
Best to face cancer with a dog at your side

Still to come:

Constant, the Wannabe Service Dog

If you have a post on your blog about cancer and an animal, please send me the link: jeanne.sather@gmail.com

Support this blog:

@ Jeanne Sather 2007.

A Dog By Prescription

Jill’s prescription for her service dog reads:

"Jill Cohen suffers from a serious medical disorder that impairs her quality of life and mobility. I have prescribed a service dog to assist her. "

Jill carries the prescription in her wallet and has an enlarged copy posted on her fridge.