Reflections....

 

Sadly, this is a poor photo of my regional library. After receiving an e-mail advising that my card was due to expire, I made a brief stop there during my Saturday errands to renew it. This took but a few minutes during which I was reminded just how pleasant it can be to work in or visit a library regardless of type. These days, I interact with the public library system in my community from either a home computer or a Kindle, and that is simply not as gratifying to me though it does save time, travel and money.

There was a point in my life when I was prepared to move across the country for a library         job and the possibility of entering a doctoral program. At fifty, I erroneously assumed I still had a lot of time in the workforce. Medical issues and a loss of the use of a leg put paid to those ideas and I spent the next few years learning life from a chair and re-organizing both my apartment and personal and professional priorities.

 Along the way, I also lost friends and loved ones to accidents, old age, illnesses and tragedies. This also re-configured the world and it was not at all as I had known it. Some shifts are small, others seismic. While I cannot claim any great epiphanies, I do feel and often react very differently now as a result of these experiences.

I seek a simpler life with fewer complications and human relationships, and that,
unfortunately, is not fully realized because as all but the most obtuse among us grasp, life remains complicated no matter how much we simplify. Though I have reduced possessions, rid myself of clutter and items no longer used or desired, routed out two individuals who were duplicitous, streamlined financial and other obligations and work at being frugal, my routines often reflect the medical needs of the last of four cats and my increasing desire for rest and privacy in the face of yet another looming loss.

Until Next Time...

ShSh...

That isn't the best sunset photo but it will have to do. It was snapped as I was on the way from my local produce stand to do errands the other day...

Things appear to have reached an even keel here at last. Jacob is eating, sleeping and doing all other bodily functions with greater regularity. For a creature with the equivalent age in human years of about eighty whose kidneys are failing slowly, this is important. With no less than six medications, he is comfortable and I am less anxious. Sleep has returned to this once bleary-eyed human, at least for now.

Apart from visiting the dentist, having a bit of a clear out getting bills paid off, the week has been unremarkable. The cleaner came yesterday so the flat is tip top. I'm now reading four books at once and have finished two. I would recommend Quiet, by Susan Cain.

It is chock full of interesting studies and information that helps dispel the
culturally-ingrained idea that being an introvert is less desirable or acceptable than is its counterpart. The book also explores how we, and I include myself in the introvert group, think about a range of things from our inner lives, relationships, work and money.

Because one's tendencies toward introversion begin in infancy and are present throughout the life span, parents and teachers may also benefit from this book. Among the many interesting points Cain and others make is that many people are introverts without being shy or socially anxious. While I recognize and appreciate my introversion, I am not shy and rarely experience anxiety. Those would have made my work in the professional world impossible. What I am, however, is quiet. I observe and take in and then decide if or to what degree to discuss or participate. The older I get, the more quiet around and within I desire.

As for viewing, I chose a reality series about life in the Alaskan Bush from Netflix this week because I wanted a peek at a place I will never be able to visit: the Arctic tundra. The series includes couples and singles and one large family whose mother is Inuit and who was raised in a small village near the Arctic Circle. The scenery was breathtaking and if there are any hunters among my readers, they should appreciate the numerous hunting expeditions required of a subsistence lifestyle. While I can see that living in the arctic requires stealth, independence, creativity and nerve, after listening for the umpteenth time to the remarks about independence and how people in the lower forty-eight have lost that, I started to feel like some of the folks in the series should take to a pulpit...

Happy Weekend!

Still Here...

This painting has been on the outside entrance to Jacob's veterinarian's office since it was a private practice. I have no idea who painted this but it is one of the nicer features of an otherwise clinical environment. The people who staff the place more than make up for that         in warmth and dedication.

Someone asked for an update. Jacob is eating with the aid of an appetite stimulant, pooping more frequently with the aid of both a laxative and a probiotic, taking an antibiotic for a second urinary tract infection, and an anti-nausea medication as needed. He sleeps more but also has periods of wakefulness and still loves as much attention as I can lavish upon him. Riding around on my lap or playing with his cat nip toy remain enjoyable as do belly rubs, though he is slowing down, eating less and seeking more quiet time in his crate.

As for me, he routinely awakens me in the small hours  so that by late morning, both of us need a nap. My sleep patterns have gone to hell and I am often tired completing the chores needed for us to live comfortably. I too find myself more desirous of quiet.

Home Again...

Monday turned out to be long...

Himself and I took a taxi ride to the vets in the afternoon. That was the high point. His relative quiet during our adventure in traffic escalated quickly upon entering the building and having his belly palpated. The vet, very gentle and soft-spoken, looked at me and asked whether he might possibly be defecating in a location other than his box as she felt very little. After reassurances that this was not the case, a side view radiograph confirmed that the boy was indeed full. Another enema was given while he howled in protest and I waited anxiously in another room.

That done, the vet and I went on to discuss his habits, diet, behavior and the contents of the radiograph. He is not a candidate for surgery to remove kidney stones. His water is passed out in copious amounts due to the state of his slowly declining kidneys, leaving little to facilitate transit through his intestine, hence the constipation. Wet food and pain medication were talked about and the vet asked permission to repeat his blood work and other tests to see where things are now versus three months ago. Her efforts were met with such overt hostility from Jacob that she was unable to do anything more and requested that he stay the night so that she could try again in the morning and get the results the next afternoon.

Things were eventually completed but the results did not arrive until the day after originally expected, and by then, my cat had had a somewhat lengthy staycation at Hotel VCA. He was found to have another urinary tract infection, so antibiotic therapy was started as was pain medication. Unfortunately, the compounded pain meds are liquid and even after telling this vet that I cannot shove things in his cheek without risk of injury, no other alternative was suggested.

I pill him with chicken flavored pockets and he has no problem with that. I will try putting the tuna flavored concoction on food or alone in a bowl but given his past track record and my lack of expertise at manipulating his mouth or being able to hold him still when he is annoyed, I hold out no hope of success.

Meanwhile, he still enjoys his food though I can now predict with reasonable certainty that in two to three days, this scenario will be supplanted by sluggishness and relative inappetence due to a full belly. We may once again be wending our way to the vets in search of subcutaneous fluids and the traumatic relief supplied via enema.

I can see that in the longer term these stop gap efforts, provided to assure comfort, will result in nothing but misery for us both, especially as I've not been taught to give fluids with needle and tube at home. My vet did tell me about an animal hospice, a practice that for a fee, sends a veterinarian to an animal's home to either provide limited palliative care or gentle euthanasia. They will also talk with pet guardians about determining the "right" time for the latter, hopefully reducing the fear and anxiety for the animal. I have made preliminary contact with the organization and have been assured by others I know that they are kind and compassionate to both guardian and pet.

For the moment, my precious boy is happy to be home, joyful in my lap and purring away.

Holy Crap...

It is almost 5 AM. Awakened by my cat, I've not been able to return to bed. He is enjoying a cleaning. In a few hours, we will once again see his vet for the second time since Friday. He has not emptied his bowels since the enema and I had to give him boiled chicken with rice to get him to begin eating again on Saturday, at which time he ate the equivalent of two days worth of food including the Royal Canin prescribed by his vet. Although he ate Sunday, it was in smaller amounts. Behaviorally, he appears alert, and enjoys time with me and his toys but he has gone off the wet food I was giving him, possibly because I put medicine in it that he refuses.

Constipation in cats is serious and apparently part of the symptom assortment associated with chronic kidney disease, a condition which is terminal and ultimately fatal. Symptom management is really the only course to take and as you have read, I am trying my best to assure him comfort and quality of life until the end. While some cats live for years following this diagnosis, others have only months and at almost sixteen, time is not on this boy's side, I am afraid.

I have read recently that caring for a cat with chronic kidney disease takes commitment and stamina on the part of the cats' guardian. I will follow his vet's recommendations and try my hand at making food for him if needed but having no previous experience with this, I'm learning as I go and it is tough to let go of the fear of what awaits and simply move through the days.