This morning, Pat went out to breakfast with his caregiver, Sandra. Pancakes and bacon at his favorite breakfast place, The Pantry. While he was gone, I sat and cried. Our dog is sick and the doctors hadn't been able to figure out what was wrong, but while I was trying to enjoy a solitary breakfast, he started bleeding from the nose. Not profusely, but definitely not normal. When Pat and Sandra got back, he and I loaded Rex into the car--the big old dog actually jumped in by himself--and took off for the Santa Fe Emergency Veterinary Hospital. Kudos to them--I told the doctors that Pat has Alzheimer's and they were wonderful with him, very kind and gentle as they told us that Rex most likely has a rare neurological cancer.
There was the usual rundown about confirming the diagnosis with an MRI ($2500) and the possible benefit of radiation therapy (nearest available center is in Denver or Phoenix, cost would run into the several thousands). My mind first went to the "whatever it takes" place, not for me, but for Pat. Then I calmed down and remembered that we are dealing with a twelve year old dog who already has Addison's disease. Pat wept and wept, and so did I, because he's my dog, too. In the end, I told the doctor that we wouldn't be taking any heroic measures to treat Rex. I was afraid that Pat would push for treatment, but he didn't. In fact, the crying seemed to help him accept what is happening with his dear companion.
By the time we got home, Rex was perkier, eating toast treats from the table and wagging his tail. We relaxed the way you sometimes do during a crisis; not because it's over, but because there is a brief break in the unfolding drama. By four o'clock, Pat had forgotten that his dog has cancer. I had to explain it again and he had to be sad again. This is what I fear most of all--that I will continually have to remind him and that every time it will cause new grief. This time, though, he didn't cry, just got very quiet and sat still on the bed for a long time.
It's really hard for people with dementia to deal with uncertainty. Not that it's easy for anyone. But that feeling of being unmoored that's upsetting to all of us is catastrophic for someone whose mind doesn't process well. Ever since I told him ten days ago that I suspected that Rex is seriously ill, Pat has been less "here" than before, more given to night terrors and sudden terrifying loss of awareness of familiar surroundings. I worry that Rex's illness and death (probably in the next few weeks or months) will undo too many of the fragile synapses that hold Pat's brain together, plunging him into one of those rapid and steep down-steps that have marked his disease process.
I'm doing somatic therapy right now to keep myself together. Today, because of the emergency trip to the vet, I wasn't able to get Pat home before my session, so I dragged him along. The therapist is a wonderful earth-mothery French woman whose yoga practice has created a vast circle of calm around her. While Pat couldn't follow the relaxation directions she was giving us, he still was able to shift into a deeper state of peace. It made me wonder if there's some way to adapt such therapies to work with dementia patients. I will certainly take Pat with me to therapy again as Rex worsens and his decline in turn impacts Pat's dementia. I'm also going to try doing some of the breathing exercises with him, maybe get a relaxation tape to play to help him through the trauma. I'll let you know if it helps.
