The first week sucks so bad.
I’m technically only on Day 5 of the first week, and it’s already been the longest and crappiest that I can remember in recent times. And that stands to reason: my cat is a walking time bomb. Of course that sucks. What’s surprising is the numerous, often excessively banal, ways in which the first week of a lymphoma diagnosis is a horror. So, without further ado, let’s just jump straight into this flaming shitpile with both feet.
- Your cat has cancer.I feel like this is self-explanatory. And yet it’s not, quite. Cancer is terrible (Fuck cancer) regardless of species. But there is a special kind of horror when, lying awake at night, you consider that a totally dependent being for which you bear responsibility is suffering and you have absolutely no way to explain what’s happening.There will never be a point when the verbal explanations you give–while snuggling a little furry noggin under your chin–will ever be received with comprehension. You have just been made aware that, even with a ragingly successful course of treatment, this will kill your buddy, and they will pass having never understood that the reason for the intermittent and ultimate discomfort was to get them as many comfortable hours as possible before the inevitable. They will never grasp that it was actually the highly unpleasant experience of you hauling them out from under the bed and shooting a pill down their throat that made the nausea subside and their dinner taste good.
There is no way to make them understand that the thousands of little short term discomforts are what make the return of relative normalcy possible. It will forever and for always be some crazy ass mystery to them, wherein the person they trusted most in life suddenly loses their mind and starts throwing them into a travel bucket every week to be poked with needles and endlessly groped, awakened, jostled, and pilled.
- The unholy pause before answering each and every call from the vet.Is this the regular daily update? Is it the return of some labs? Or the promised call, “if things change?” Is this the daily courtesy call from the billing department to inform you of your current balance and, presumably, make sure the value of your critter’s life hasn’t outpaced your credit card limit?Which call is this?
You don’t know. You will not know until you answer the phone and then you will not be able to un-know.
And that goddamn phone will ring from the vet at least three times a day. When it doesn’t ring, you will wish it would; when it does you will wish it hadn’t.
- You didn’t even know a cat could be that filthy.Oh, cats. Such fastidious creatures. Forever grooming themselves to soft, shiny perfection.Until they stop grooming because they feel like roadkill in a heatwave and become covered in a thin, vaguely sausage-smelling, film of drool, horked up lactulose, canned food, and whatever the hell is on the hospital floor.
- You will feel compelled to buy a backyard incinerator for your clothes.You will visit as much as possible–because you miss them, and also because they will not even think about eating if you aren’t around and, actually, they probably won’t eat even while you’re there but you will try anyway–and there will not always be a visiting room available, so you will sit on the floor in critical care and hold your filmy, sausage-scented kitten and rub your face all over his greasy fur.And only when you get home will you realize that you are coated in more biologicals than you can name, and you will remember the sign on his crate instructing vet staff that he has had chemo and they must double glove before cleaning the litterbox and you will simultaneously feel so, so miserably dirty and also so, so miserably miserable with the realization that your fastidious cat is actually living in this miasma.
And before you wonder what kind of back alley vet hospital I put my cat in, the place is spectacular and above reproach, but it just doesn’t matter because there is sickness and sadness tucked into every corner and you’d feel precisely the same coming from a human ICU.
- I have to pause my writing to give my cat his 4th and 5th medications of the day.It’s been an entire two hours since I last pilled him. It will be 3 more before I have to pill him again.[I am back and it was awful. It took 1 1/2 tablets of Cerenia just to get 1/2 tablet into him; he kept horking them up. There was St. Bernard-style drool. Now he won’t eat or snuggle.]
We have meds to chill out his immune system (prednisolone), and meds to counteract the ulcers that the meds to chill his immune system tend to cause (pepcid). We have anti-nausea meds (Cerenia), and meds to stimulate apetite (mirtrazapine). Liquids (lactulose) to soften the poop he cannot possibly be manufacturing because, despite the preceding two medications, he’s still eating far less than he should; and liquids (Flagyl) to unburden his liver of the task of filtering bacteria. And then there’s just an antibiotic (Clavamox) because, with a deliberately weakened immune system, pretty much any opportunistic infection can roll in and undue all you’ve just done to keep him alive.
- There are sundry complications nobody could warn you about.Encephalopathy, for example. It can happen when liver function is diminished. It yields a cat that physically resembles the one you brought in 2 days prior with what you thought was constipation, except that this new cat won’t make eye contact, doesn’t respond to his name, and seems to run on a spontaneously operated on-off switch variously walking around, agitated, and then flopping down to stare at the floor.There’s also the whole “not eating” thing, coupled with the “no pooping” thing. Or, hey, you could get the “pooping overly much” thing. And let’s not forget the ever-present “I need this oral medication out of me” hork-and-drool.
- Tubes and awkwardness.Have you ever had an IV? Do you remember how much those bastards hurt in a deep and bruisy way? Now imagine it in a little skinny kitten arm, which is attached to an increasingly skinny kitten that doesn’t understand that if he totters to the end of his tube slack and then tries to jump into a tub of laundry it will probably dislodge or, in the very least, move around in a way that you know has to hurt but which he will completely disregard in his semi-deranged, encephalopathic state.You get to watch.
- Discharge is as terrifying as it is thrilling.But you will not become privy to this truth until your ebullient self is sat down in a chair going over the seven medications your cat requires and when he requires them–which will have no rational relationship to whatever your schedule was previously– in addition to how the 25 weeks of chemotherapy and weekly labs will work, what side effects to monitor, what side effects to call about, what side effects will likely be transient.You will suddenly become aware of the fact that you are removing a chemical-laden and highly-altered creature from the one place that will actually know what to do with him in the event of a crisis that you may or may not even recognize as such.
- You have a new religion and it’s called anxiety.Why is your cat lying like that? Why are they lying there? Why won’t they eat more than that? Are they peeing? How do you parse “lethargy” from “small mammal who’s just been through hell and needs a weeks worth of naps?” Is he spending his day under the bed because he is deeply miserable and calling upon his evolutionary tradition of hiding to die, or is he just hoping you won’t come after him with the pill gun again? Is this normal? Is that normal? Is this the new normal which is, by definition, abnormal but in a non-life threatening way? Should you have done this? Are you overblowing the amount of suffering that is probably happening right now?Do you have any control over anything at all? Did you ever?
- Snuggles.Snuggles assume a status so singularly magical–maybe they don’t hate you, possibly they aren’t feeling too awful, perhaps you haven’t asked them to bear more than they can reasonably do–that they alone have the singular power to negate all of the questioning, fear, frustration, and sadness brought by items 1-9.But they won’t always happen because your critter won’t always feel like draping himself over your chest or shoving his furry head under your chin. Sometimes, despite best efforts, they will feel like lying under the bed and giving you the space to contemplate, in deep and alarming detail, each and every preceding item.
And you have to give them that space because you don’t have any other option. You can duct tape them to your pillow, or super glue them into your kneepits.
Prior to all of this, I’d discussed the humanity of chemo with the oncologist. My specific concern was that I not torture Mort for my own selfish means, and he assured me that that was never the aim of this course of action. But perhaps the suckiest enumerated suck (or maybe it’s the Giant Suck that ties all the smaller sucks together) is that it just might not work.
There is, objectively, some minimal suffering (in the grand scheme) expected in the first week because you are starting with a sick cat. Even though the goal of the chemo is to reverse the liver damage and move toward–and hopefully achieve–remission, which will make him feel ever better, you still have to get over the first week. Of course, once you do get to day 8 and beyond, there is never any guarantee that it will work.
And if it doesn’t work, if he just gets worse, then his last weeks with us will have been a suckfest relative to all the preceding weeks, which is what I hoped to avoid by making this gamble in the first place.