I hope this picture doesn’t freak any of you out, but I can’t get over how beautifully he is healing – he’s going to have an “S” shaped scar, for “Superdog”, I am quite certain. His healing has been amazing in terms of the surgical site.
There have been a few other potholes in the road, however.
First and more importantly, Razzle is doing very well. That isn’t do say we haven’t had a few problems the last 36 hours. As the Fentanyl patch wore off? Down? Razzle became more restless, unable to be comfortable. I called last night (Thursday) and asked if we could increase his dose of Tramadol, as I felt he was having trouble managing his pain. We gave him an additional 25mg (he’s taking 100mg as the baseline dose) and that seemed to help and he slept mostly through the night with only a couple interruptions. But he was still clearly unhappy this morning and his temperature was fluctuating wildly. So, we flew off to see his surgeon, who looked him over and decided the drain to the amputation site and the rest of the patches and covers and bandages could come out and off. He was instantly relieved to have all that out and off and gone. A happy naked dog left the clinic.
He was fairly stable during the day, but clearly still not comfortable all the time. We’ve been eating well (cooking his Darwin’s with a couple eggs and some spinach or broccoli seems to be going happily gobbled down with peanut butter globs concealing drugs) and having really spectacular pees and poos (even bouncy poo thanks to adding coconut to every meal).
This evening, though while monitoring his temperature, it was up over 102.8, so we flew back to the vet. His muscles were tense, he was panting more and more heavily and he was in a lot of distress. Leaping to the most disastrous conclusion because that’s always such a productive habit (NOT), I was sure he was developing an infection from the Cisplantin therapy. Well, that what happens when you practice medicine without a license, you don’t have a clue what you’re talking about. Very nice vet, Alison R. at Animal Medical Center was quick to see he was in pain and our problem was the loss of the Fentanyl patch and he needed DRUGS! She gave him a shot, added codeine to his protocol and replaced his patch (HURRAH said Razzle). That was about an hour ago and he is sprawled on his bed zonked out of his mind and in dreamy happy vapor trail druggy land.
So, I learned a lot today. Hopefully, we can manage his pain more effectively going forward and I am going to be more proactive with ensuring his pain is managed before we worry about anything else.
Razzle has had lots of wonderful visitors the last few days, but has he goes into his “possible infection” phase from day 5 to day 10 of his chemotherapy, so the visitors will be cut down and we’ll try to keep his as quiet and germ free as we can.
I was thinking about pain tonight. Neither the ancient nor modern versions of the Hippocratic oath promises to “do no harm”. That's not surprising really. It is a standard that is impossible. For one thing, it could freeze a physician into not acting at all, as any action might cause possible harm and therefore to act could be to harm. Yet neither does either version of the Oath provide a requirement for the practitioner to “alleviate pain”. Yet, this is why the vast majority of us seek medical care of any kind. There are many admonitions in both versions of the oath, but they still fall short of the mark of what I think we expect or want from healing. The physicians best effort, to end suffering where they find it, to educate and to put the wants of the patient on an equal footing with the needs of the patient, might be a rational start.
While I may find how Razzle has faced his pain courageous, even inspiring, it is, at the core of it an experience neither he, nor any creature with access to modern medical care should ever have to endure. To be ill is stressful and frightening enough, pain is an additional torture that should never be added to it. He was not in acute distress and we were quickly able to resolve the dosage problems we had fallen into; but we all failed him in not being more constantly alert to this most paramount of needs – has his pain been alleviated?
Something well worth remembering, especially when we are talking about the inflicting of non-physical pain. There is neither a rational reason, nor, in the end, any excuse for inflicting pain of any kind, be it emotional, spiritual or physical. Those who find such actions entertaining, or amusing, or a part of their character for any reason should realize there is enough pain in the world without conjuring more; create and let loose that monster and it will destroy you.
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