Dear Shaun T

Dear Shaun T,

I can’t say if I’m getting ripped. I look the same to me. (Body dysmorphia, much? Nah, I just can’t tell close up.) First I did your Insanity workout and I truly thought it was IN-sane. Now I’m in the Beta phase of T-25, and all I can say is that it kicks my ass to insanity and beyond. I thought 25 minute workouts would be a cakewalk after Insanity. Hell, most of the time those workouts near the end were a full hour. What I didn’t realize was that all those breaks in Insanity are a Godsend and the lack of breaks in T-25 is cruel and unusual punishment. My forearms are quivering as I write this and sweat is dripping down my ribs. My headband is soaked. I feel like I’ve been beat up a little.

I hope to hell I’m getting fit, that’s all I can say. Not because I want some ripped body everyone will envy, but because I want to be strong to live long for my daughters. Arghhh!

How to Stop Coughing

For those of you who know I am a fan of Vicks™ on the feet, and think that this post is going to reiterate that, think again. I have something better that works like a charm. It seems magic, it works so well. It works for adults as well as children.

A couple of years ago during a particularly bad cold where I could not stop coughing no matter what, I wanted to determine what a cough was exactly so that perhaps I could then figure out how to stop it. I had been coughing for days, couldn’t sleep, and was sick to death of the constant tickling in my throat and ache in my head from coughing and coughing and coughing.

I figured out that a lot of cough is a reflex designed to prevent pulmonary aspiration, promote the movement of cilia in the lungs, and to clear airway debris. The reflex is partially triggered by blood in the throat. The purpose behind plasters (covering the chest or feet with different ingredients) to stop coughs is to pull blood away from the vessels into the throat. The point then, of putting Vicks™ or its equivalent on the chest or feet is to draw blood away from the throat, thereby relieving the cough.

I became a major fan of the Vicks™ approach because it worked so well on my baby daughter, who was age one at the time. I figured this out and was suffering mightily from a cold as well. I had given her the children’s version of cough medicine and it wasn’t working any better than the adult version was working for me. My research also brought up medical study after medical study showing how ineffective cough medicine really is. When I put Vicks on my baby’s feet, her coughs would stop within a minute. It was miraculous. She would be sleeping peacefully within minutes.

Yet the Vicks™ approach did not always work so well for me during a particularly bad cold this fall. I have a friend who complained it did not work for her at all. Lying awake coughing one night, I pondered this. Why would it work so well for small children and not adults? The answer it seemed to me was that the soles of the feet of adults are thicker than those of small children. One part of the Vicks™ on the feet approach that I did not like was that I had to spread it on really thick and cover my feet with socks, otherwise the sheets would get covered in petroleum jelly, the ingredient in Vicks™ that holds it together. I scanned my body, considering all the places where blood vessels would be near the surface that would take blood away from the neck. I realized that the wrists are just about perfect. The veins are right there near the surface of the skin, and wrists are far away from the neck.

I started putting Vicks™ on my wrists. It worked much better than feet. However, there was still the issue of petroleum jelly getting all over everything and leaving an oily residue, even after washing. The ingredients in Vicks are camphor, menthol, and eucalyptus. (Incidentally, I never actually used the Vicks™ brand because it is stupidly expensive and the generic version is exactly the same thing.)

Then one afternoon my teenage daughter pointed out that the ingredients in pain relieving cream (aka BenGay™, Icy Hot™, Mentholatum Deep Heat™, and the lot) are virtually identical, except without the petroleum jelly. We had a couple of tubes of generic pain relieving cream. The next time Milla had a cold, she used this on her wrists and claimed it worked better than anything we had used to date. The ingredients are camphor, menthol, and methyl salicylate, which is essentially wintergreen oil. The best part about this stuff is that it is extremely cheap (I paid $2.39 for a 4 ounce tube), and because the veins in the wrist are so close to the surface of the skin, you do not need much to get a result. The cream is not greasy and doesn’t leave any residue on the clothes. Plus the wintergreen smells good. I was also able to purchase a menthol stick designed for sore muscles, which is the best approach of all. Menthol has become our new coughing charm.

My 5-year-old has had a cold for about a week. She sleeps with me and started coughing several nights ago. I keep a stick of menthol rub on the bedside table. She coughs, I rub a small amount on her wrists, the coughing stops in under 20 seconds and she stays asleep for several hours. It’s miraculous. One night, I felt a tickle in my throat that kept on long enough I thought it would erupt in a huge cough. I rubbed on a small amount of menthol. The tickle disappeared. We are both getting sleep, and sleep is the best remedy to cure the cold that causes the cough in the first place.

One small caution: menthol is painful if you get it in your eyes. Be sure to wear long sleeves and cover your wrists after applying so that if your arm is up near your face, you don’t get it in your eyes. I’ve applied it to the inside of the elbow with the same success as the wrists, but with less risk of getting the menthol into the membranes of the eyes.

This works. I can’t recommend it enough. Want to stop a cough? Put menthol on your wrists or anywhere else you see veins near the surface of your skin. It works.

Interestingly, over the summer, we spent a weekend at the coast. I’d had a bit of a niggling cough off and on. Nothing major, but irritating periodically. I did not bring any sort of menthol to the beach with us. Lying there awake with the niggling cough, I considered what else might work. I had read that toothpaste has menthol in it, and it certainly has peppermint oil, which is the original ingredient in menthol. Worn out I figured, why not? I got up, got the travel toothpaste, and smeared some on my wrists. The cough ceased. Both nights we were there it worked. I slept and the cough was never able to really take hold.

One thing to note, if your cough is caused by inflamed lungs, smoking, or something more chronic, this won’t work. This is for the cough that is caused by blood in the blood vessels of the throat. If the cough is caused by something other than blood in the blood vessels in the throat, this is not the remedy.

If you try this, let me know how it worked for you in the comments section. I’m sure others would love to hear of your experience as well.

Beets Turn Urine Pink

I don’t love beets. I love most vegetables, including many that others don’t generally like, but not beets. It is because of this that I have not eaten many beets in my life and I did not know that eating beets could turn one’s urine pink or red. I had no clue. Last Friday, when my 3 year old went potty and her poop and pee was red, I assumed she had blood in her stool, freaked, and called her doctor. The advice nurse asked a bunch of questions, but not whether she had eaten beets, and then said I should take her to urgent care the next morning (this was because it was after hours on Friday).

Four hours later, my daughter went potty again. This time she only peed and it was red. Further freaking, as this meant the redness came from pee and not poop, and could thus be related to kidneys and whatnot. Again a call. This time, advice nurse advised we go to urgent care that night. As it was 9:30, the only urgent care in our network was a half hour drive away. Yowza.

We all bundled into the car (we all being me, Milla, and Isabel) and headed out to the middle of nowhere to sit in a waiting room. We were finally escorted back and Isabel was urged to pee. She could not. They gave her apple juice. She peed. They tested it. No more pink and no issues. They could not find anything. Finally, someone asked if she had eaten beets. Well, I did not know. She had been to preschool earlier in the day. Although they were not normally on the Friday, perhaps she had eaten beets. The doctor sent us home with 2 prescriptions for bottom cream and a directive to go to our primary doctor as soon as possible during the regular week.

The next morning I called her preschool and left a message asking if she had eaten beets. We were not able to get into the doctor until Wednesday. In the meantime, no more pink pee and preschool did not return my call (she told me later while apologizing for not calling back that she rarely checks her home line messages–oops!). On Wednesday, while waiting for our dear doctor, I decided to call preschool again, this time the owner’s mobile phone. Lo and behold, it turned out that my darling daughter had indeed eaten beets.

In case you didn’t know it, eating beets turns one’s pee and poop pink or red. This is my public service announcement for the day (or maybe it is a pubic service announcement, but that is a really bad pun).

Autumn — Chapter 15

Read Autumn — Chapter 14

In spring of 2003, I graduated from law school. I studied for and completed the bar exam. After taking the test but before getting the results, I was hired by a law firm. Whether I would keep the job was contingent upon my having passed the bar. The firm was in NE Portland, a forty minute drive from our country suburb house in the middle of nowhere.

The reality of consequences was gradually squeezing me into the accepting that some decisions can impact a life for a long time. Less than three years earlier, during my first term in law school, I discovered with a panic that perhaps I had made a grave error. Yet the cost of that error was already well over ten-thousand dollars. If I quit, I would have to repay that sum, and if I wasn’t practicing law, how would I do that? And so I soldiered on.

My dismay grew the remainder of that year. However, second year was an improvement, and I began to believe perhaps the error was not so disastrous as I first thought. By graduation and beyond, I had returned to my original assessment, that I should never have gone to law school. Only after completion I was much further in debt, and much more discomposed. While I loved the academic rigor of law school, I was not enamored of the practice of law. I began to see the entire enterprise as one magnificent, horrendously expensive mistake.

Simultaneously, I was coming to terms with personal consequences as well. I knew three months after meeting Bjorn that we were not the most suitable pair. We were simply completely different. We could spend forty-five minutes arguing a point, only to discover we were arguing the same side. I was extremely energetic, always on the move, and constantly trying new things. Bjorn took life at a slower pace. He preferred hanging out at home and watching sports on television to buzzing around to various events. When we bought the first house, even though it was brand new, I wanted to dive in and start new projects, fixing it up. Bjorn liked it fine the way it was. About our only real connection was the love we jointly shared for our daughter.

Life was forcing me to take a good, hard look at the choices I had made, often on the fly, and determine whether a course correction was in order. I was driving nearly 45 minutes in one direction to my job. I didn’t hate the job, but I didn’t love it either, and making that commute seemed not worth it. I was living in a house and neighborhood with others who did not share my values, my politics, or much of anything except real estate. And sadly, I knew I was no longer in love with the father of my child, and nor was he in love with me. House linked to career linked to relationship, a concatenation of choices was leading me down the path to misery. Change was in order.

Bjorn and I had discussed ending our relationship several times over the course of a year. Early in the pre-dawn hours of the new year, after leaving a New Year’s Eve party at a friend’s house in Salem, the two of us were rehashing the menu from the evening as we drove along the winding country roads in the dark.

I was always the health nut, eliminating high fructose corn syrup and partially hydrogenated oil years before it became commonplace to do so. Bjorn liked junk food and fast food, and didn’t feel bad about it or any need to eat any differently. The party food had been mostly junk food and I was lamenting the lack of healthy snacks. I was also hungry.

“If you would just eat the junk, there wouldn’t be a problem,” Bjorn informed me, driving down the blackened, curved highway under the cold, winter moon and low, shredded clouds.

“I don’t have a problem,” I retorted. “We are just different. This is what I have been saying for months now. This is just one of many reasons why I do not think we are good together or for each other.” The passenger seat where I sat was reclined back, nearly touching the car seat holding a sleeping Milla. I slumped there, trying to make myself comfortable.

Bjorn didn’t say anything for a long time, such a long time in fact that I began almost to doze off. Then out of the silence he said, “You’re right.”

And with that, we ended our relationship of five and a half years.

Even though we were no longer a couple, neither of us immediately moved out and on. We had recently decided to sell the country suburb house and move into Portland. We had been looking for a house together, and I simply switched and began looking for a house on my own. Bjorn had been working as an engineer, but wanted to move into another area of engineering entirely, an area in which he was unlikely to find employment in the Portland area. He had begun sending out resumes to companies in other cities.

I wanted an old house, preferably a bungalow. I had been looking and looking, but this was the beginning of the housing bubble and prices were starting to get really steep. It was still possible to find affordable houses, but they usually came with another sort of price in that they were further out, in a less desirable neighborhood, or needed a lot of work. If it needed work, that was fine with me. I relished the opportunity. I was less willing to live further out, and I would not even consider some of the more troublesome neighborhoods because it would be just me and Milla living there. We had the dogs, but there was only so much they could do, and I didn’t want them to get hurt either. Often a neighborhood looked fine on the outside, but Portland had been experiencing an influx of Russian and Mexican gangs. No thanks.

After only a few weeks of searching, I found my house. Built in 1920, it needed tons of cosmetic work, but was structurally quite sound. With a few changes, the house would be perfect for us. It also had a lovely, floral back yard, as well as a side yard already fenced and lined with bark chips for the dogs. The support beams under the eaves were carved with loops and bows. This house was charming and perfect, so I bought it.

I had major plans for renovating and started immediately, before we even moved in. Bjorn moved to the house as well, and the two of us demolished the kitchen. It was the only place in the house that was truly awful. The counters were covered with tiny brown tiles that had not been installed properly. There was more grout than tile and each swipe of a sponge brought up a handful of dust, dirt, and goo.

In the four and a half years I lived in that house, I made many changes:  I installed an entirely new kitchen, put in a new kitchen window with rising double panes, to replace the former single-paned window that did not open at all, a travesty in a kitchen. I replaced the floors in the kitchen with new tiles. I removed the ugly, industrial grey tile in the bathroom, covering the floor with small, square white tiles. I removed a wall in the second room that opened into a small room with no real purpose, creating one giant bedroom. In that larger room, I installed a closet and discovered space above the stairs in the wall and turned it into a cupboard, using period knobs for the doors. I built a wall along the far side of the bigger second room, then opened a door into the master bedroom, creating a walk-in closet in a room that formerly had no closet at all.

While making the place for the door, I discovered newspapers from 1925 under the wallpaper advertising “Paris Frocks for Only $25.99!” I moved the front door from the master bedroom back into the living room where it belonged. I designed and installed built-in bookshelves in the living room, matching the woodwork at the base and along the top edge with the woodwork throughout the house. I painted the entire interior of the house with many lovely colors. I replaced all the light fixtures with period fixtures, and replaced a couple of windows that were no longer functional.

I also removed the jungle that covered the front of the house and built a rock wall, then covered everything in flowers. This was quite a chore as there was a 75-foot tall camellia bush that was so close to the house, it hung over the roof. I advertised the bush for free to anyone who would come and remove it. Two men arrived with a trailer and tools and excavated it over the course of a week, before driving it away on a flatbed trailer. There were also many scrubby azaleas who found new homes via the internet. For some reason, someone had installed sheep fencing in the front yard between the camellia and the maple tree near the sidewalk. Twisted and rusting, it was covered in ivy that used the sheep fencing as a ladder to higher reaches in the trees. All of it I removed and replaced with grass and smaller shrubs and flowers. I built a rock wall along the sidewalk, dragging the stones in three carloads from a rock quarry nearby.

Every job was done with the period of the house in mind, and in the end, it was charming and engaging. It was the perfect project. I did not have the money to hire contractors for most of the work, and therefore I did it all myself. I hired an electrician to replace the wiring and update that, and my dad installed the new bathtub fixtures and the front door, but everything else was done with my own two hands. It was a lot of work, but I loved that house and loved the end result.

Four months after I bought the house, Bjorn was offered a job in Florida doing exactly the kind of engineering he wanted, designing medical implants. Within three weeks of the job offer, he packed his truck and set off, leaving me alone with our daughter and the dogs.

On the one hand, I was relieved to let go of the tension between us. On the other, life became much more difficult. First there was the house. Even though it was a project of love, it was still a lot of work, especially for a full-time, working single mother. Milla was attending kindergarten and would go to aftercare there after school. Because of the hours at aftercare, I had to cut back one hour per day at the office, leaving at 5 instead of 6. This did not change my workload, only the hours I sat in the office doing it. In spite of the fact that the workload remained unchanged, the firm cut my pay, which I could barely afford.

I was also now the only person available to ensure Autumn was given her daily insulin shots twice every day. No matter where I was in the evening, I had to plan to ensure Autumn was medicated. I chose 7:15 as the time for these shots because it was early enough in the morning that I had not yet left for work, late enough that it would not be horrible to wake up to on the weekend, and early enough in the evenings that I could still do something after.

At times, I would take her with me in the car if I had to be somewhere and could not be home to give her a shot, a cooler in tow for the insulin, which had to be refrigerated. I also had to be careful not to shake the bottle because this could cause the insulin to become unstable and unusable.

In spite of the difficulties, we managed and forged a comfortable routine. Six months after Bjorn moved away, I left the firm and started my own practice. This brought its own stresses, but it was still easier setting my own time and getting work done at odd hours. I was freed up to attend more events at Milla’s school during the day, and it gave me much more flexibility for dealing with Autumn.

Over the next year, we settled into our lives with Bjorn far away and working at my new practice. I worked on the house on weekends and some afternoons during the week.

I took both dogs out of the house nearly every day. We lived near a dog park with a wide field where the dogs could run without leashes. Even on wet days, I would go and let them romp in the muddy grass, then wipe their paws before having them ride in the back of the car to home.

Autumn couldn’t get up into the car by herself, so I would lift her and get her situated. She would ride, watching the world go by, tongue lolling, ears perked, her happy face on. She loved car rides. Molly didn’t mind the car, but she preferred curling up in the corner or on the back seat.

Autumn actually didn’t seem to notice the poking of the needle into the skin at the back of her neck anymore. Every shot was followed immediately by food and she soon figured out that my shuffling around in the refrigerator door meant food was soon to be had, so she would wait right at my heels, eyes up, perky and expectant, waiting for that shot.

Needles. The funny thing about giving a shot is that the first few times you do it, it’s terrifying to think of the pain it’s inflicting. After you’ve given fifty shots, then a hundred, then several hundred, you can do it in your sleep. I suppose it’s like that for anything new. There is just something rather odd about doing something that becomes so familiar that is actually poking into another living body.

I will never forget those little orange tipped needles. I bought them in bulk from various pharmacy stores. I got to know where the deals were. The shocking thing was the difference in price from one store to the next, for the exact same needles of the same brand. It gave me some insight into what diabetics or others with chronic medical conditions face every day. The same box of needles would be ten dollars less than the cost somewhere else. The cheapest I found were about $17 for a hundred needles (they had to be thrown away after each use), but I found places that sold them for $33 for an identical box. I had the benefit of being strong and fit, so driving to another store where I knew the needles were cheaper was a fairly simple proposition. I could see how a mostly housebound senior would have a lot of difficulty shopping around.

After administering shots to Autumn twice daily for over a year, giving the shots became mundane and completely routine. On weekend mornings, I would wake up, stumble to the kitchen, roll the bottle in my hands, pull the shot, give it to her, feed her, and head back to bed, all in about three minutes flat. I don’t think I even really woke up. All the dogs knew the wake-up time, and if for some reason there was no alarm and I failed to awaken, one of them was guaranteed to rouse me from sleep.

One morning on a Saturday, I staggered into the kitchen, pulled the shot, and the phone rang. I squinted at the caller id, wondering sluggishly who would call at 7 a.m.on a Saturday. There was no way I could read the screen. I am ridiculously farsighted and my eyes were full of sleep.

I answered the call. It was Officer So-and-So from the Milwaukie Police Department. Did I have a golden colored dog? I informed him that I did, looking blindly around the kitchen for the neck I’d planned to shove a needle into not thirty seconds previously.

The officer went on to say that a yellow dog had been seen “wandering in a daze” down the road. She looked lost and starving. He responded to the call and found my number on her collar. He offered to bring her to me.

I explained that she had diabetes and that this was why she was so thin, that I had no idea she was out, that she was an escape artist of the highest order, and that I would be most grateful if he returned her to me. And please, I begged, don’t feed her anything.

Five minutes later, Autumn walked in the door, that diabetic-glazed look in her eye. I poked the shot into her neck, barely glancing down, I had done it so many times. I talked to the officer for ten more minutes, telling him Autumn’s story and about her magical ability to get out of the yard, and thanked him profusely as he drove off. I did not mention that I had failed to replace her underground fence collar after her bath the previous evening.

I was grateful Autumn was back, but I was really glad I did not get a “Dog at Large” ticket. Those can be expensive. I knew. Autumn had given them to me before. Even though the dog yard was fenced with underground wiring, it did not guard against escapes out the front or back doors, and I lived with a 5-year-old who had a habit of running out without making sure the latch had clicked. Autumn knew this and followed Milla around, waiting for any opportunity to slip out the door.

I was also extremely grateful he had not given her any food. On one occasion when Autumn escaped, a well-meaning yet misguided neighbor fed her two huge bowls of food before she keeled over in the woman’s kitchen. Why she waited to call me until after giving my dog a meal I’ll never know. Maybe she thought I was starving her on purpose or something, as if someone who was careful enough to tag a dog would be careless enough not to feed it.

In any case, when I went to retrieve Autumn from the neighbor’s house, the lady started to scold me for letting my dog get so thin, but I cut her off and explained that she had a chronic illness and that the food she gave her could have killed her, which is why she had keeled over.

I wanted to scream, “Why would you feed someone else’s dog, you idiot?” but did not. She didn’t know, and she thought she was helping. I used my glucose monitor to check Autumn’s blood. I ran the test, gave her an insulin shot, and she was back to normal within a half an hour. After that incident I went to the pet store and bought a tag that read, “I have a disease. DO NOT FEED ME!”

The glucose meter was a godsend and really the only part of all the illness-related activities Autumn endured that she seemed really to abhor. Other than testing urine, it was the best way for me to get a reading on Autumn’s insulin levels, especially if she had broken into the trash cupboard and found something to eat, or escaped and gotten something.

We had a strict food routine in the house whereby any food-based garbage went into the compost bucket, which was kept on a high shelf with a lid. When it was full it went into the compost bin out back, away from the dog area. The rest of our waste was separated into two containers, one for trash and the other for recycling. Autumn loved to get into the trash version and lick through whatever was in there, such as butter wrappers or soiled plastic wrap. Once the new cabinets were installed in the kitchen, I put in a double-garbage-can rack, placing the recycling in the front bin, and the trash in the back. There was a childproof latch on the door. When that was closed and the trash in the back, she was not able to get into it. However, Milla had a knack for leaving the door open and the whole thing pulled out. Autumn would then remove the can from the rack and go through whatever was inside.

One time shortly after we moved in, I arrived home to discover that Autumn had gnawed through the bottom corner of one of the kitchen boxes sitting stacked and unpacked on the kitchen floor. She had discovered all the dry good baking items and ate them. Molly had joined in on that escapade. I caught her because I discovered powdered sugar on her ears and muzzle. Naughty things.

Another time both dogs managed to get onto the table and eat a pan of chocolate cake.  I had heard the warnings that chocolate supposedly killed dogs, but this simply was not the case.  I read somewhere that it was only dogs who had an allergy that had to worry about eating it, but who wants to be the person making this discovery the first time?  It makes sense to keep the chocolate away just in case your dog is the one who is allergic.

However, potential life-threatening allergies did not stop my dogs from climbing on the table and eating an entire chocolate cake.  When Dan and I lived at his parent’s, Murphee climbed onto the island in the kitchen and ate a pan of brownies.  In all cases the worst thing that happened was the dogs came away with some really nasty gas, and we no longer had any dessert.  Apparently none of them suffered from chocolate allergy.

The glucose meter was a big help for these non-diabetic dog food eating sprees. However, in order to use the meter, I had to obtain a drop of Autumn’s blood. One end of the meter had a sharp lancet with which to pierce her skin. At the other end of the meter was a test strip onto which I smeared the blood to obtain a glucose reading. Autumn hated the pricking part. There was not any part of her body where it was easy to get a blood sample, mainly because she was furry. Only her lips and the pads of her paws were bare. The lips had to hurt; she yelped whenever I tried drawing blood from them, the skin was so thin and soft. But the pads of her paws were thick and extremely difficult to pierce enough to get blood. When I was able to poke them hard enough, it usually caused way more bleeding than was necessary for the meter, and this made her cry out as well. Digging that deep into the pads was painful. For this reason I only used the test when I knew she had eaten something she should not have. In addition the test strips were really expensive, so I didn’t want to use them up quickly. Humans would use the meters daily, because they could control their levels fairly precisely with diet. Autumn could only eat her prescription diabetic dog food, so it wasn’t necessary to monitor all the time.

Autumn was always so patient with the medical interventions she had to endure, but the lancets and subsequent rubbings were the one procedure for which she refused to sit still or comply. She would pull away and yelp, making it that much more difficult to get blood. But she was a dog – as much as I told her it would all be over soon, she just couldn’t get it. Sometimes I would be frustrated because she had gotten into something and made a huge mess, and then wouldn’t sit still so I could check her blood.

“If you wouldn’t get into anything, I wouldn’t have to do this,” I would scold, obviously more for my benefit than for hers.

I would read the meter and if the levels were high, give her more insulin. On occasion, the meter simply read HI, in its blocky digital letters. This meant her glucose levels were so high, they were off the chart, and insulin was required immediately.

Within a few months after her diagnosis, I noticed tiny white flecks in Autumn’s eyes. The flecks increased as the weeks progressed. I went online and discovered that Autumn was developing diabetic cataracts, a condition that is extremely common. I read somewhere that 75% of dogs with diabetes develop cataracts, and that their presence did not necessarily imply glucose levels were not under control.

In a normal eye, the lens is round, clear, and hard. It is connected by fibers that move so the eye can focus. It is enclosed in a capsule and gets fluids from the eye. The lens does not have its own blood supply. One of the fluids the lens absorbs is glucose. If there is too much glucose, the excess is converted into the sugars sorbitol and fructose. Sorbitol and fructose pull water into the lens which makes the lens cloudy, and a cataract is formed.

Some dogs develop complete cataracts fairly quickly after their diagnosis. Autumn’s developed slowly in comparison to some of the stories I read, and her cataracts were never completely solidly white; they were slightly less opaque than that. However, a year after the diagnosis, she could not really see. She would tilt her head and look at me as if she were peeking out the side of her eye, trying to see around the cataract. A couple of times she ran into the doorframe around the back door, but she quickly adapted and learned where her world was at. I could have had the vet perform surgeries to remove the cataracts, but we discussed it and ruled it out. The cost was over $1000 per eye, and the average life span of a dog with diabetes is two years from diagnosis. Even if Autumn lived another three years, the result did not justify the expense or the upheaval of a surgery. Blind dogs adapt quite well to living without sight, and Autumn was no exception.

After Autumn had been living with diabetes for nearly two years, she was almost completely blind, but she was lively. I would take her to the dog park and throw frisbees and sticks for her. I would set her up, touching her muzzle with whatever I was throwing, then guiding her head in the direction of my toss. Autumn would head out and look until she found what I’d thrown. Her sense of smell was fully intact, and she would find anything, no matter how far I had thrown it, as long as I pointed her in the right direction. She loved the game, turning and running right back to me to throw again, in that familiar trot she had inherited from Cody. She wore out easily though, and would lie down to shred the stick after only three or four passes letting me know she had had enough.

Read Autumn — Chapter 16

Autumn — Chapter 14

Read Autumn — Chapter 13

I remember the color of the light in the room the night Autumn first tried to jump on my bed and failed, golden yellow, soft, and warm. It was late and we were getting ready for bed. I was already in bed, reading. Autumn usually came and asked if she could lie at the foot of the bed. In the middle of the night, she did not ask, just jumped up on the bed, curling up at our feet, or coming to the head where even in sleep I would lift the covers for her to clamber to the bottom near my feet. But in the evenings, she pretended to ask before coming up.

That night, Milla was snuggled next to me in the warm down comforter. I was sitting upright, my book propped on my knees. Autumn came over and made an attempt to jump on the bed. She could not make it. She tried again. Foiled again. Finally I arose and put her on the bed. Must be her hips, I thought, and thought nothing more of it.

Over the next several days, she appeared to gradually deteriorate before our eyes. As October closed and November opened, she lost weight and strength. She seemed also to have another bladder infection and drank water excessively.

With interstitial cystitis, Autumn always drank more than the other dogs. I thought this was what was going on, that she was having an exceptionally bad bout of interstitial cystitis, and it was causing her to lose weight, but I thought she should still go to the vet. Again. I made the necessary appointment and three weeks after her first failed attempt to jump on the bed, I took her in to see the doctor.

She had lost seventeen pounds. I could tell the vet was very worried. He wanted to run a number of tests, but thought cancer might be the cause. He could see no other major possibility for the dramatic decline in weight. There was the possibility of diabetes mellitus, he suggested, but I thought this unlikely because she had tested negative for it before. Cushing’s also, but this had also been negative. He offered to run a battery of blood tests to start. If the results from the first set of tests were negative, he would run a second set. Then a third. We would continue testing until we figured out what was happening.

I handed Autumn’s leash to the doctor so he could take her back to the lab. She was not happy and leaned her head towards me, pulling the leash away from the doctor. I pet her head and kissed her and told her everything would be fine. She kept pulling towards me as the doctor led her away. How many times in her life had I watched her disappear behind a door in a veterinarian’s office? How many times did watching the scene cause my heart to constrict and tears of anguish to form behind my eyes? It did not matter how often I had experienced this, my heart always ached as she was led away from me.

I sat in the sterile waiting room of the doctor’s office, staring at the mismatched tiles beneath my shoes. I liked this doctor. He was not Dr. Fletcher, but no one could be him to me. Yet this doctor was kind and honest, and he explained things to me as if I had a brain. The biggest problem with the clinic was that it was in a town about fifteen miles from our home, so trips there were a bit out of the way.

In the waiting area was a giant cage with three kittens in it. Milla was thrilled with these kittens and played with them as we waited. A fat, orange, office cat came through and asked to be petted. It was not very friendly though, and scratched if you rubbed it too long, so Milla left it in favor of the kittens.

Milla ran through the lobby, her blonde curls bouncing, babbling and telling me about the babies. One of the kittens was a light grey color, its fur almost bluish. “See the blue kitty?” she asked me, pointing to it.

“That kitty is blue!” I responded, reaching out to give her a hug. She let me snuggle her for only a moment before running off to the other side of the counter, searching again for the scratching cat.

A half hour later, the door through which the doctor had taken Autumn swung open and the doctor stepped through. His diagnosis was quick:  Autumn had diabetes mellitus.

Diabetes mellitus, also known as impaired glucose homeostasis, is a group of metabolic disorders with one common manifestation:  hyperglycemia. Chronic hyperglycemia causes damage to the eyes, kidneys, nerves, heart and blood vessels. It is a horrible disease and because of the manner in which it keeps the patient from absorbing food, causes gradual starvation. It results from defects in insulin secretion, or action, or both.

The disease was first identified in the ancient world as a disease associated with “sweet urine” and excessive muscle loss. The elevated levels of blood glucose cause the glucose to build up in the urine. Blood glucose levels are normally controlled by insulin, a hormone produced by the pancreas, which lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level. In patients with diabetes, the absence or insufficient production of insulin causes hyperglycemia. Basically, diabetics have too many sugars in their blood and no way to filter them out. It is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime. And Autumn had it. Little did I realize how much this diagnosis would drastically change our lives.

Years after all of this, I came to believe that the medical problems Autumn experienced arose from problems with her adrenal glands.  At the time Autumn was alive, no one really knew what caused interstitial cystitis, but I’ve learned that recent research shows a link to adrenal malfunction. All along the doctors thought she had Cushing’s disease, although she never tested positive for it. And diabetes is one of the symptoms of a long-term Cushing’s dog. Considering Cushing’s is an adrenal malfunction and Autumn’s diseases were all manifestations of adrenal malfunction, I think it’s a safe assumption that this gland did not work properly for her, or else hers was covered in tumors, causing it to keep from doing its job.

The doctor started Autumn on low doses of insulin twice daily. He also wanted us to change her food to a prescription version for diabetics.

“What about her IC?” I queried?

“IC won’t kill her,” he answered. “Diabetes can and will. You will want to do everything you can to lengthen her life span and make her as comfortable as possible during that time. If she eats the wrong food, she could get really sick because she her body cannot filter out the sugars. This can cause all kinds of problems, from blindness to heart failure.”

I got it. Autumn would have to eat what she had to in order to survive the diabetes, IC be damned.

At first, it was somewhat of a struggle to settle into the routine of taking care of a diabetic dog. It took several trips to the vet to get her insulin levels right. We had started her on one type of dog food that she would not eat, probably because it tasted like sawdust, and kind of looked like it too. None of the dogs would eat it. I tried a couple of other brands before I found something she would eat. All of these dog foods were prescription foods and exorbitantly expensive. It was frustrating to buy a bag of dog food that cost nearly one-hundred dollars for a twenty pound bag, only to have every canine in our house turn its nose up at it.

I also had to concern myself with the ingredients of whatever dog food because certain of them would trigger IC episodes. Even though diabetes trumped IC in determining what would land on Autumn’s plate, that didn’t mean I would choose the worst of them and end up causing her unnecessary pain.

It was a struggle to figure out how to manage the diabetes. Because she would not eat most of the foods I would buy, Autumn would either tear down the house getting into trash or escape and go eat someone else’s. This led to several diabetic episodes where Autumn would escape, then wander home, glassy-eyed and practically catatonic.

At the time of her diagnosis, we were living in the country suburb where all the houses looked exactly the same. Shortly after purchasing the house, we installed landscaping and whatnot for the side and back yards. While doing this, we decided to add a sprinkler system to the entire property. Then we fenced a special side yard just for the dogs. Ever since we owned Poppy we had used dog doors to allow the dogs to go out to relieve themselves. These had proved to be a godsend when Autumn starting having bladder troubles. If there was a chance she could make it outside, she certainly tried.

In the new house, we installed dog doors into the garage and out to the doggy yard. This yard ran the entire length of the house, and was fenced on two sides by cedar plank fencing five feet tall. We then installed chain link fencing between the dog yard and our back yard. We placed river rock up the length of one side of the yard, and grass on the other, with paver bricks between the two and along the base of all the fences. The bricks under the fences were fixed into place with cement. Our thinking was that this would prevent Autumn from being able to dig out and under the fence. We thought the cedar planks, placed side by side, would prevent her from squeezing out. Same with the chain link. Basically, this fence was a dog fortress from which we believed she would never escape.

We were wrong. First, Autumn removed the boards from the cedar plank fencing. We nailed it back up and then nailed boards along the base on the outside. She then removed a corner of the chain link fence. This blew our minds. Her teeth in front were all broken in half from ripping off boards and fencing. Once we repaired that hole, she started in on the brick pavers under the fences.

This was the last straw. After Autumn tore a hole in the pavers and cedar fencing, escaping into the neighborhood and getting into someone’s trash, then coming home stoned on blood sugar, I had had enough. I immediately got into my car, drove to the pet store, and bought an underground electric fence, the kind with collars that shocked the dog if it went near it.

For years I had resisted these kinds of containment systems. I thought they were cruel, shocking the poor dog in the neck, but this was ridiculous. A shock was less traumatic than being smashed by a car.

We installed our fence and sent the dogs out into the yard. We set the range on the wire to two feet. This meant that four feet out from the fence, the collar would start beeping. As the dogs moved closer to the wire, the beeping became louder and faster, more insistent. Then, at two feet out from the wire, the collar gave them a shock.

It worked. It worked so amazingly well, I wished I had installed it years earlier. After two or three shocks, all the dogs stopped going near the fence the second they heard the beeps. Autumn would go to the faster beeps, but then she would stop. She was no dummy.

I no longer thought the fences were cruel. It kept my dog contained and out of the way of cars and other dangers lurking about in the big, bad world. It also kept her from getting out and into food that would cause her to get sicker.

All of the other dogs gradually figured out where the line of the fence was at and never even waited for the beep. They stayed away. When I bought a new house less than a year later, I installed the fence in the dog run area there, and it worked then too, to the point that neither of the other dogs needed to wear the shock collar when they went outside.

It was never this way with Autumn. If she did not wear that collar, she escaped, no exceptions. But she did respect the collar and would not risk shocking herself to get out of the yard ever again.

One major plus to managing the fence situation was that I was able to stabilize Autumn’s insulin injections. Once her blood sugar stopped fluctuating because her food intake was controlled, it was easier to figure out where it needed to be and to maintain its levels.

One rainy Sunday afternoon several months after her diagnosis, but before we installed the underground fence, Autumn escaped and got into something, causing a diabetic episode. These episodes scared me. Autumn would return from wherever she had run off to, listless, her eyes staring off into space. I called it her sugar coma.

It was bound to happen that Autumn would get into something on a day when the vet was not open. She didn’t schedule her medical issues around the hours our vet was working. The result was that I ended up driving her into Portland to a corporate vet’s office in a national pet store chain. I had resisted these offices because I fundamentally disagreed with many of their policies. They tried to sell nearly everyone “prevention plans,” claiming the services cost less with the plan, but they charged more for those services in the first place, and seemed only to ensure the corporation would line its pockets on a regular basis, especially since as a large buyer, it most likely got discounts on many of the products. I also knew from my few vet friends that the wages paid to vets were low and the hours unstable. Overall, as is typical in many such conglomerates, profit drove its motives above all else, and I didn’t like that.

That said, the nice thing about such offices is that they are open many more hours than most smaller establishments. The vet we had been going to was open on Saturday, but not on Sunday. If we needed care on Sunday, they directed us to the emergency vet clinics in downtown Portland or downtown Salem, as they had when we thought Autumn’s stomach was twisted. It was one thing to pay an exorbitant price for such a visit at 3 in the morning, it was quite another in the middle of the day on a Sunday.

I dragged Autumn in to have her hooked up to an IV and get her blood sugars stabilized. After running all the tests, the clinic didn’t even bother trying to sell me their plan. They knew they would make way more money on me just based on Autumn’s many problems.

Yet I loved the doctor. His name was Dr. Horner and he was the closest thing to Dr. Fletcher I had found yet. Because I had read so much medical literature, and spent many hours discussing these issues with Dr. Fletcher, I was well versed in a lot of what was going on with Autumn metabolically. Dr. Horner seemed to sense this, and discussed her case with me at a precise, technical level. He was also extremely kind, and gentle with my dog. Over the years I have taken many animals to see Dr. Horner, and it doesn’t matter if it’s a rat, or a dog, or a lizard, he is always compassionate in his handling of animals.

While I had a good working relationship with the vet we had been using, his office was fifteen miles southwest of our house, towards Salem in a town called Woodburn. Not much later, I moved to Portland, and the new house was even further from the doctor in Woodburn. Once we moved, it was easy to slip into using Dr. Horner as our primary vet rather than the office that was so far away.

Read Autumn — Chapter 15

Autumn — Chapter 12

Read Autumn — Chapter 11

Summers in the West Linn house were extremely pleasant. The enormous cherry tree in the front yard kept the house nearly fully shaded. There were windows covering two entire walls in the living room, and a full corner of our bedroom. A large picture window opened onto the dining room. In warm months, we opened all these windows, allowing a gentle breeze to move throughout the rooms. In combination with the shade of the cherry tree, the effect was comfortable and gratifying.

Because of the grandfather clause allowing livestock on the property, we owned two ducks and had brought my old, childhood, bay pony named Lady to the house from my parent’s. Swaybacked and ancient, she kept the grass behind the house mowed and blackberry vines in check. I set up a hammock between two trees in the backyard, and would lie between them with a book while Milla roamed the yard with the dogs and Lady.

I was lying in this hammock the afternoon of Autumn’s bladder scope, waiting for the call from the vet telling us to come and bring her home and, I hoped, some diagnosis.

Finally, at about three in the afternoon, the specialist’s office called to say Autumn was ready to go home. The receptionist informed me that the specialist would call me to discuss the case.

I gathered up my book and hefted myself out of the hammock, pulled Milla from the sandbox, wiping sand from her hands and knees, and headed through the house and out to the car. The specialist’s office was in another Portland suburb, about twenty minutes from our house.

When I arrived at the specialist’s office, Autumn was woozy, but none the worse for wear from her experience. The office told me the specialist would call me later with the results. Seriously? Dang, this was taking a long time.

On the drive home, my mobile phone rang. I plugged in my corded headphones and answered. It was the specialist.

“Your dog’s bladder looked like world war three,” she told me soberly. “I’ve never seen anything like it. The inside of her bladder wall was a mess. I cleaned some off some of the loose tissue, so she should not have any further bleeding.”

She went on to say that there wasn’t a lot of information out there about why this happened. The doctor didn’t know the exact cause of Autumn’s troubles. She said in cases like this, it was believed that stress brought it on. Antibiotics would not help, and actually could make it worse, so she wanted me to stop giving Autumn antibiotics. The good news was that there was no evidence of cancer, and no indication that anything was going on that would kill her. The bad news was there wasn’t much more that she could tell me, and there was not a lot that could be done.

I thanked her and hung up the phone, then called Dr. Fletcher and left him a message, and called Debbie and Bjorn. I was so relieved that the diagnosis wasn’t death.

Over the next several years, Autumn had several other similar such bleeding bladder episodes, and they all occurred when she was stressed, even when the stress was good. One such incident occurred when I took Milla and the dogs for a weekend at the beach. We rented an oceanfront motel cabin with a hot tub in the room.

Autumn adored the beach. She would run herself ragged, chase sea birds, and gambol and play in the edge of the ocean. Most of the places we liked to visit along the Oregon coast were located at the mouths of creeks or streams emptying into the sea. Autumn would race back and forth through these waterways, soaking herself and anyone nearby.

In spite of the fact that Autumn loved the beach, her bladder issue came back with full force while we were there. Luckily the motel room was covered in synthetic wood flooring, making it easy to clean her accidents, but I could not take her anywhere in the car, and liberally covered the seats with towels before heading home in case she leaked blood or urine. I gave Autumn one of the painkillers prescribed by the vet because the episodes were painful, and simply waited for it to pass.

A couple of years after Autumn was scoped, and after many bleeding bladder episodes, I was visiting my mom’s house. My mom is something of a magazine addict, and keeps dozens of them around the house and in the bathroom at any given time.

While there, I picked up a Lady’s Home Journal and thumbed through it when one of the headlines caught my eye. It said something like “Bladder Problems Nearly Ended my Life,” or some such thing so dramatic. I read through the article and became increasingly excited.

The author of the article had experienced what seemed to be bladder infection after bladder infection. The infections were extremely painful, and grew worse, not better, with antibiotics. She often leaked blood. Nothing helped, and as time wore on, she lost her job and was in nearly constant pain. After years of struggle and torment, a doctor scoped her bladder and saw that the inside was shredded, exactly as the vet had described Autumn’s. It was only after all of this that the woman was diagnosed with a condition called interstitial cystitis, often called IC.

Finally, I too had a name for Autumn’s condition.

The article said that there was no cure for IC. In some cases in humans surgery could remove some of the damage to the bladder wall, but these surgeries were rare, and I knew in Autumn’s case we could probably never afford it, even if it were possible. It also stated that the best way to maintain the condition was through diet. Certain foods were triggers that could make the condition worse. And, as I had already determined from trial and error, stress was one of the biggest culprits in causing an episode.

The article referenced a website for humans suffering from IC. Later that evening after I returned home, I found the site and read everything there, and then searched further, thrilled to have found something that matched Autumn’s situation exactly. I also discovered what I had been figuring out by accident: bland foods were best, as was minimizing stress.

I called Dr. Fletcher and told him what I found and how. He knew of IC because he said it was common in cats. He had recently read a journal article about it, and reiterated that diet was the best means of maintenance. He also pointed out that studies showed that the binders in commercially prepared foods were one of the worst things for Autumn to eat, and suggested I look at natural foods to help with her disorder.

After reading everything I could get my hands on about IC and talking to Dr. Fletcher, I began purchasing 10 pound tubes of ground turkey and 20 pound bags of rice and cooking Autumn’s dinner every night. We had experimented with this diet before in an effort to calm Poppy’s skin problems, but it had not helped. However, I was willing to try it if it would help Autumn to feel better. Everything I read about IC said the episodes were very painful. I could only imagine how this felt for an animal who could not describe for me how she was feeling.

Of all the discoveries I made when Autumn was ill, the revelation that her bladder issue had a name and diagnosis was the most gratifying. Finally I had a name for the condition. Finally I had a list of triggers that made it worse. Finally, though nominal, I had some sense of how to manage it. I could actually make a difference and help her live more comfortably. This made all our lives more manageable in the long run. It wasn’t a perfect situation, but now I understood Autumn’s issues and was able to control things for the most part, which was a huge relief.

Read Autumn — Chapter 13

Booby Squishing

Today I went in for my annual booby squishing appointment.  Having been a “victim” of breast cancer, I have to have them every year.  Compared to the one where the cancer was initially discovered, these are a cake walk.  In that initial visit, the doctors could see some specks at the top of the film and therefore assumed the specks were in my armpit.  They spent the next hour and a half attempting to squish my skinny shoulder into the mammogram machine.  It did not work.  It hurt.  Finally they figured out that it was possible that the specks could be on the other side of my breast, towards the center of my chest.  One try at that location and voila!  Pay dirt.  A lesson learned that day that has since been reiterated is that mammograms are easier if one is fleshier.  There is more flesh to grab in the flat, plastic jaws.

Today’s mammogram was relatively simple.  I knew from previous visits that mammogram appointments mean waiting around, so I brought some knitting. This visit was in the new “Safeway Cancer Center.”  I hate it when medical facilities or sporting facilities or any facility that isn’t what is being used is named for some corporation.  If I go into a grocery store and it is called Safeway, fine.  If I go into an office supply store and it is called Staples, so be it.  However, I don’t want to go somewhere that is going to squish my boobs and have it called Safeway.  It’s too much of a non-sequitur.  But as is often the case, I digress.

The new booby squishing center was clearly designed with the needs of women in mind.  In fact, it looked like they got together a focus group from Lifetime television and Oprah to create a calm, breathable space, in calm, mellow colors, with calm, earthy tones.  All of this is spoken in a calm, monotone voice.  One enters a lovely, spacious lobby with a fountain.  Let the deep breathing and Ohms begin.  You are escorted into a high-ceilinged, glass-enclosed waiting area.  Nearly immediately you are called back into the “guest space” –a nice name for another waiting room.  But wait, there’s more!  This space is lavishly furnished with low-slung chairs and sofas.  Surrounding this loungey place are all the doors to the little rooms where one leaves one’s top attire and personal belongings in a locker.  Each “guest” has a personal escort to show them their own special dressing room.  This person then informs them that there is coffee and tea in the corner for them while they wait.  Dutifully, the guests remove their top garments, lock all of it in the specially-designed wooden locker (nothing like the banging metal contraption I had in high school, these are sleek, wooden, and smell brand-new).  One exits the personal dressing room to wait in the low-slung chairs.  Calm, watery, pan flute music fills the air, further adding to the illusion that one is away at a spa, awaiting a massage and relaxation, rather than waiting to have one’s boobs squashed beyond recognition.  All of it is an illusion to distract us from the fact we are squishing our boobs to catch cancer.  A couple of the women, when they spoke, betrayed in their quivering voices the fear that this could be their fate. I wanted to let them know that sometimes, it really isn’t all that bad, even when the mammogram is positive, but I remained quiet, focusing on my knitting.

For me, nearly immediately upon sitting after changing out of my top clothes, my escort came to take me back for the actual booby squishing.  She performed her duties, creating the ethereal, opaque half moons from my breasts.  I find it intriguing that mammogram photos are so moon-like when the moon has long been considered the planetary body for women.

I had a mammogram a year ago.  At that time, Isabel was about three months old.  When the plastic plate slid into place on the top of my right breast, milk squirted out in about five different directions.  I loved that.  It seems so appropriate that my gland was doing what it was supposed to while taking the photos.  Today, my breast was emptier, Isabel having just supped shortly prior to my appointment.  No milk came out at all.  When no milk flowed, I realized I actually had hoped that it would.

After the photo-taking, my mammogram technician escorted me back to the waiting area.  I gathered up my knitting, grabbed a cup of tea, and waited. And waited some more.  During this time, a dozen women came through in the same pattern.  The escort brought them in, showed them their dressing room, they sat for a moment ensconced in their pond-green dressing gown, then were called away, only to return shortly to wait and wait. In the meantime, some who had been there were called into their dressing room for a “private discussion.”  I say private in quotes because we could all hear what was being said, that the films were clear and we will see you next year.

I expected this, that my films would be clear.  Then I thought for a moment, what if they’re not? What if they call me back to squish me some more?  I imagined me telling them that I knew something was up because this is what happened last time:  they called me back for more and more and more, flattening and pressing and prodding my flesh.  I imagined that if this were the case then 2011 would begin as awfully as so many of the last years have, and I wondered if this is how life would always be, and then I realized I was going a little off the loony end and returned back to the spa room with it’s trickling music, low light, and women in green gowns.

And no, they did not take me back for more squishing.  My escort called my name, called me to my dressing room, and let me know the films were fine and they would see me next year.  All was well.

I liked this place, this woman spa space for boob squishing. I could have sat there and knitted all day.  As I waited with the other women, the only thing missing was some womanly conversation.  If that had been present, the illusion would have been complete.  As it was, this missing piece kept it from being all it could have been, but still it was all right.  Let some grocery corporation pay to keep us from contemplating why it is exactly we’re hanging out with strangers and squishing our boobs in a modern day female communal space, creating moons and attempting to avert disaster.  Whatever works, right?