Thursday, July 16, 2009

Making the (Cat) Call

Wed. July 15, 2009
After nearly 3 years and a dozen death threats, Maxine seems ready to go. She struggles to stay upright and wobbles on four bony legs. Her fur is thinning, gray-specked and no longer shiny. Her eyes look distant and hazy.

I don’t want to keep her here longer than she wants to be here. I don’t want her to suffer.

Max has fluid around her heart and lungs and digestive problems. This year the vet also found tumors. But she did not seem to be in pain and even purred at the vet that day, a definite first. She ate well and played with her mousy. She was not ready to go yet.

It's amazing she's lasted this long. After she was hospitalized in 2006 following a spewing spree that left her dehydrated, we worked out a regiment of steroid pills and Pepcid. Dr. Whisler gave her an estimated 3 to 6 months to live.

No heroic measures or invasive procedures. She wouldn’t want it that way. I wanted to maintain some dignity for my beautiful girl, who has been at my side for 15 years.

The 3 extra years meant sleepless nights when Max got sick or woke me up because she was hungry again, a sign that the steroids were working. Or she would fight or fuss with her new roommates, two rescued kittens we adopted that entertain and annoy her in equal measure.

I will let her go, I’ve said, if she will just tell me when it is the right time.

Last week was bad but she rebounded and started eating again. I left notes for the catsitter to that effect when we left town Thursday. She once again seemed to defy death.

Day one. “She seems normal,” texted our catsitter of several years and several long trips. “No problems.”

Day two, my cell phone didn’t get any text messages so I thought all was well.

Day three my husband picked up a facebook message from Saturday: “Hard time pilling Max today, she hid under bed. I had 2 resort 2 using broom 2 get her out. Got her pilled under dining room table. Gave shot, b/c she's grumpy.”

A broom? A pill and shot? The shot was to be given once a week instead of pills, an extra large dose if needed. The steroid reduces inflammation and makes her hungry; it’s not a happy pill. However, Maxine seemed fine when we got home Sunday night and happy to see us.

But not for long. She ate little and has not kept steroid pills down since we got back. She’s thrown up every night and morning. With no food in her system, a white foamy liquid comes out. I gave her Pepcid to settle her stomach, and she kept that down, thankfully.

Max has taken to hiding, under the bed or dining room table when I come out of the kitchen. She knows where the pills are. She’s made it clear she wants no more of them. I want to respect her decision.

But no more steroid pills… means the end is very near.

Max is on hunger strike rations. She eats to please me, but barely. She eats from my fingertips. She sips tuna juice. She licks gravy from Fancy Feast cans. Then she walks, crookedly, away.

I wonder when to call the vet. Reason for appointment? To put her to sleep.

It seems logical and humane but also awful --- scheduling her death.

Is it better to let her die at home or help make it peaceful and painless – and planned - with both of us present? The latter always made sense and I want to be there at the end to comfort her. And I want my husband to get us there and comfort me.

I had the vet’s number in front of me all morning and couldn't make the call. Is Thursday better or Friday? For Jack’s work schedule? For me? For Maxine? Either... Neither.

When I got myself together enough to call, it was 12:23. Uptown Animal Hospital closed at Noon. I sigh in relief, but I know it is temporary. I’ll be in this same place tomorrow.

Her face is still beautiful with big blue eyes, white eye liner and black mask. But her scrawny body is a shell of her former healthy self. She still purrs instantly when I pet the top of her head.

I look in her eyes and believe she is ready to go. I got the message, Max, thank you.

I thought I was ready to let her go... but this is still a hard call to make.

Postscript - Fri. July 17 - 10:00 a.m.
I've just returned from the vet, with an empty carrier. My girl is gone. She fell asleep purring with me and my husband at her side this morning. I am not making this up: the vet was crying when he came in the room. She was really skinny, he noted, as well as jaundiced and unsteady.

She was still so beautiful, even at the end, that it made the reality harder to believe. But she is gone and I am now on the roller coaster ride that is grief. Rest in peace, pussycat.

Monday, July 13, 2009

Perfectly… pigmented?

“So, what’s the deal… with your face?”

I hadn’t seen my brother in several months as our gang didn’t have our usual Easter gathering this year. He and his wife had arrived at our condo just a few minutes before he asked me this in the kitchen.

At first I didn’t know what he was talking about, or if he was serious. Then I realized what he meant… the dark blotches of skin on my face.

It was not a sunburn or patchy tan. I wish!

It was not rosacea or reddish-pink coloring on my cheeks, which I have had in the past from heat, alcohol or exercise. That always went away.

This site about rosacea - http://www.rosacea.org/patients/materials/triggers.php - lists just about everything I eat as a possible trigger. That’s why I’d ignored the problem till now.

It was not an allergic reaction, as my brother suspected. My sister in law has allergies that include cats, for which I gave her a Benadryl (as 3 felines roam our home). Again, I wish.

None of the above. These spots showed up in the last 9 months – and never went away.

Brown patches along my cheekbones almost to my ears, above my upper lip and, biggest and most obvious, a devil-horned shape in the middle of my forehead. The last one is the most disturbing – and distracting – when I look in the mirror each morning.

I keep hoping the spots will disappear and I’ll look in the mirror one day and see my old self. But I’m starting to lose hope. And seek help.

I look younger than my nearly 42 years and am still carded, which people tell me is a great compliment. My skin has been one of my best assets, until now.

For many years I’ve put lotion on my whole body after I shower and also on my face, particularly around my eyes, which have few signs of wrinkles. My “almost makeup” contains lotion and an SPF of 15 and I use it almost religiously.

My olive skin tends to brown easily and not burn. Except for a painful lapse in Tahiti and occasional minor breakouts, my skin and face have been healthy and happy.

But something happened after my last birthday. The pink cheeks turned beige then brown and other patches and spots appeared.

It is called “hyperpigmentation.”

The cause is unknown, it is often genetic, is exacerbated by sunshine, and once it shows up it’s there to stay. That’s what the aesthetician said at Allyu Spa - http://www.allyuspa.com/ - after an extensive 7-part, hour-long treatment and review under lamps.

“Your skin is perfectly healthy,” she said. “It’s not at all oily or dry, which is rare, and there is no visible sun damage.” Great, except for those big distracting brown spots.

A dermatologist might figure out the cause, she continued, but 90% of the time it is genetic (thanks, Mom?) and won’t go away on its own. Most derms use chemicals or lasers to lighten or remove spots.

According to a professional dermatologists site - http://www.aocd.org/skin/dermatologic_diseases/hyperpigmentation.html - the condition is called “melasma” and is most often caused by hormonal changes, often in pregnant women. Which I am not.

For more natural approaches, I could try salon products (expensive) or add a few drops of lemon to my lotion for lightening effect. There is also a succulent plant related to aloe the aesthetician called stonecrop or ‘chicks n’ hens’ that might be worth a try.

I’ve got lemons in the fridge and am fighting the urge to cut one open and juice it on my forehead.

First I’ll try the plant, which I picked up at Gethesmane last week - http://www.gethsemanegardens.com/ . It’s cuter than aloe with rounded leaves spreading from its center like a desert rose and small babies ("chicks") hanging on the sides. The leaves can be snapped open like aloe to reveal a cool liquid inside.

I’ve used it twice after washing my face and massaging it in to increase circulation (as my chiropractor suggested). This clearly isn’t Harry Potter magic and I've seen no changes yet.

I asked a friend about her dermatologist, highly recommended. It's good to have options and information. Rosacea and melasma are listed as treatable conditions on the derm's site, http://www.lincolnparkdermatology.com/ , so maybe that's a good sign. I'm going to make an appointment.

“You could also get a tan,” the aesthetician said, chuckling. “That would cover it up.”

I'm hitting the beach today with a friend. But I’m keeping tabs on those lemons, just in case.