Coffee heat rising

Health care

Gratitude(?)

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Over at A Gai Shan Life, Revanche is climbing back from her recent shocking loss and, I suppose, from the equally shocking (potentially) good news. Resonating off a theme launched by eemusings, she lists several things she’s grateful for and asks readers to join in.

Just now, I must say, I’m finding it difficult to evince much gratitude.

The modern medicine that recently has made Revanche’s life more comfortable has disrupted my life Big Time. I’ve been cut up, half-healed, infected, bloated with hematoma, ruptured and bleeding, in pain, sickened by drugs, and waiting to be cut up again since the end of June, and whether Dr. P manages to “get it all” on her next fishing expedition or whether she has to lob the boob off altogether, the nightmare is not going to end much before the middle of December. If the surgery ends with success (heh…) on October 15, I will then have to heal up again — a month or so — and then be subjected to at least three or four weeks of radiation therapy, which will be followed by some weeks of debilitating fatigue. And God only knows how long it will take to get over that!

The longer the mess goes on, the more evident it becomes that the disruption, pain, and distress were utterly unnecessary, the result of massive overtreatment of women’s breast issues institutionalized within our  healthcare system. As each day passes, I learn how many more women have gone through some or all of this ordeal. The number is huge, many more than the one in eight who are said to develop breast cancer over the course of a lifetime. That is because women who do not have and probably will never have breast cancer are being subjected to the same treatment they would get if they did have cancer: mutilating surgeries, risk-fraught radiation therapy, and chemotherapy, all in the name of prophylaxis.

Sorry. I don’t feel grateful for that at all. Yes, I’m glad I don’t have cancer, but I very much doubt that an extremely indolent growth that, if you believe Dr. P on the rate at which these things expand, has resided harmlessly in my body for a good ten or fifteen years, would ever have developed into cancer. And if it did, it could have been treated then, in exactly the same way it’s being treated now — only for an actual reason.

I’m grateful this happened while the stock market is up, so I can take money out of retirement savings without totally raping what little remains of my future. Like unto “grateful it isn’t cancer when it clearly was not cancer, is not cancer, and probably never would have become cancer,” that’s a pretty piss-poor target of gratitude. Gee, I’m so glad I had plenty of money to be taken away from me pointlessly by doctors, hospitals, cancer centers, household help, pool help, yard help, dog help.

I’m grateful my business partner was here to cover for me. I’d have lost my shirt three ways from Sunday if she weren’t picking up my work. As it is, I’m probably going to lose one lucrative account, because that project simply cannot be done without my contribution, and I’m too sick to do it. The plan to expand The Copyeditor’s Desk into indie publishing is down in flames. I can’t even get my act together to build the website Jesse established for it, much less actually do any work.

I’m grateful my son has kindly taken uncountable hours of time off work to drag me back and forth to surgery after surgery. But I’m not the slightest bit grateful that I had to ask him to do that, and that I have no other resource to take the pressure off him.

I’m grateful that the corgi breeder who charged me $1,200 for Ruby will probably let me return her, now that I’m too sick to take care of her and that she’s decided to turn Cassie into a doormat. No refund, of course; nor will there be refunds for the astonishing amounts of cash outlay on vet bills, special UTI dog food, dog gates, dog crates, dog leashes, dog collars, dog harness, the wrought-iron gate to keep her out of the pool, and on and on and on and on. I’m grateful my son has taken her off my hands for a couple of weeks. I’m not grateful at all that I’m going to have to take her back where she will be kenneled for heaven knows how long, and that I probably would have had to do so even if the boob fiasco had never happened.

I’m grateful the weather is cooling a little. And that there are no disclaimers to that one.

So… Gratitude? Mixed. Very mixed. Tepid, one might say.

This poor youngling for whom we do sing Bye, bye, lully, lullay.
This poor youngling for whom we do sing
Bye, bye, lully, lullay.

 

 

So, Where Were We?

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Where were we, indeed? I’ve lost track. But this morning a tiny  bit of normalcy trickled back into life: My accountant friend and I drove out to the weekly meeting of the Scottsdale Business Association, the business group that we’ve taken to calling “The Breakfast Club.” Business leads do get exchanged, but in such a low-key way as to be virtually unnoticeable.

Really. They do! Today I gave Francis the Gardener, who runs an upscale concierge service, leads to two of the Valley’s highest-end Realtors, one of whom went to graduate school with me. She quit at the master’s level to take up the practice of real estate. Some punkins are a great deal smarter than the rest of the vegetables in the patch.

If you’d like to see how the 1 percent lives, check out her featured listings.

Okay, that was a distraction. Where were we?

So it was pleasant and soothing to see my old bidness friends again. It’s a convenable and cheering group to spend time with, even when we’re grutching about the sad state of national and international affairs. Being too sick to go to those meetings or to choir has pretty much isolated me from humanity and that alone is demoralizing.

Yesterday the cough that prevented The Surgeon from doing the work she needed to do with me under a general anaesthesia got lots worse. So I betook myself to the precincts of the high-powered pulmonologist who treated the bronchitis I enjoyed two years ago; got in on the very day with his partner.

This guy diagnosed what ails me as a viral bronchitis. He wrote a prescription for codeine with Phenargan.

In the course of telling him how I came to this pass and why I was swallowing the pills I carried in to his office, I mentioned that I’m on cephalexin for a supposed breast infection that The Surgeon says is not an infection and allegedly proved it when she vacuumed out my boob.

He said, “If you don’t have an infection, why are you still taking an antibiotic?”

I said, “Because she told me to take the rest of it.”

“Why?”

Why? Trust me, dude, I was in no condition to ask questions! “I don’t know. Maybe she meant it prophylactically.”

“I think you should stop taking it. Don’t take any more of this.”

Oh. God. All. Mighty

So now once again we’ve got two heavy hitters dispensing diametrically opposite advice.

The Phenargan in the cough med he prescribed dried out my mouth and throat so much I couldn’t swallow. At all. Thinking my tongue was swelling, along about 11  last night I called 911. The paramedic felt that it could not be an allergic reaction because it had been so long since I took the drug; she thought it was a reaction to the Phenargan and so connected me with Poison Control, whose CSR opined likewise.

Lovely.

I’m prone to laryngeal spasms, a peculiarly disturbing quirk. They block off one’s breathing so that you can’t even gasp out your address to the 911 set, to say nothing of telling them what’s wrong. If you relish moments of sheer, unadulterated terror, try one of those in the dark of the night when you’re all alone.

So I decided I’d better not lay my head on the pillow or dast to go to sleep. So worked until about 3 a.m., when exhaustion won out. Then it was up at 6 to feed the dog and get ready to shoot out the door for the meeting.

At any rate, I got through 13 pages of a client’s project before accursed Wyrd did one of its infamous catastrophic crashes and lost two pages of it. Probably the re-do of those two pages was better than the first effort.

Just got a call back from the pulmonologist’s office; he wrote an Rx for Robitussin with codeine, which should do the trick. Still waiting to hear from The Surgeon’s underling on the question of why I’m being asked to take five more days of a powerful antibiotic if I never had an infection in the first place.

§ § §

In the absence of Ruby the Corgi Pup, Cassie the Corgi has come back to life. As we scribble, she’s in full Ball Pestering Mode, to her great delight. Pup had brought a stop to playing with Ball — in the first place because she grabs it away from Cassie and threatens to kill her if she comes anywhere near the thing, and in the second because I had to pick all the balls up and put them away (i.e., lose them) because she chews mightily on them — tennis balls are very dangerous to dogs that want to chew them up. Cassie does not chew balls, nor does she hold them in her mouth for any length of time. She picks them up and throws them (no joke — she actually can pitch one of those things clear across the room) at the sucker who gets started with her.

Cassie is eating her food in peace. Cassie is getting unmolested doggie walks — the last couple of days I’ve been able to crawl around the neighborhood, which I’ve not been able to do while trying to manipulate Pup with a boob that hurts at every tug and hurts even more every time I have to bend over. Cassie is resting beside my chair again (she was relegated to the back bathroom, where she went to hide).

She’s still not back to normal. She may never go back to normal.

What to do with Ruby remains to be seen. My son still has her, but he has said he doesn’t want to keep her permanently. I can’t deal with a puppy in my present condition, and it appears this isn’t going to get better for quite a long time. So I suppose she’ll have to go back to the breeder. And that is a whole ’nother difficult and depressing project to launch and see through. Just haven’t had the strength or the heart to get in touch with the woman.

But I guess that’s gonna have to be done pretty soon.

 

UPDATE to the Latest Chapter

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So after my long grutch about today’s adventures, I talked with my former brother-in-sin, who happens to have been the premier cardiac anaesthesiologist in the Pacific Northwest until he retired a few years ago.

I’d emailed the details of today’s misadventure to him — my earlier post today was based on that message. In response, he called on the phone.

He said that either kind of respiratory infection — upper or lower — poses certain kinds of risks of complication with anaesthesia. If I had a lower respiratory infection, he would not have done it. If I had an upper respiratory infection, he would have done it. He figured I have an upper respiratory infection (you and I would call that “a cold”), said it was very easy to tell (I was never examined), and he thought the surgery should have proceeded.

“Is it a teaching hospital?” he asked.

“Sure,” I said. “It’s the Mayo.”

“Well, the problem with teaching hospitals is that you can get into turf wars.”

Shee-ut. What IS it that I can NOT shake the dust of academia from my feet?

He says she should have cleaned out the hematoma, infection, whatever when she did the excision. I said that’s exactly what she intended to do: that was why I was there!

He said it was a shame I had to go through the clean-out  conscious — that it’s a painful procedure.

I said well, it sure wasn’t any fun, but it wasn’t that bad…not the sort of thing that would cause you to scream for help.

He said, “You are one tough bitch.”

Heee! There are those who think I’m a bitch, all right. But tough? Meh!

Unnumbered Chapter from the Never-Ending Story

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So by 11 a.m. I staggered back into the house after today’s adventure in the Mayo’s high-powered operating arena. The scheduled surgery did not happen, a conflict of opinion among the distinguished doctors did happen, and I enjoyed a painful but interesting procedure to scour out the inside of my boob.

Here’s what happened.

Bright & early today, we (i.e., me and wonder-surgeon Dr. P, who despite my endless complaints does have a sterling national reputation) had scheduled the third attempt to excise enough boob tissue to obtain clear margins on an encapsulated papillary carcinoma which has proven to be significantly larger than indicated by repeated mammography and ultrasound. Assuming the pathology reports continue to show no sign of invasive cancer, the next surgery, if this fails again, will be a simple mastectomy.

Meanwhile, though, after the last surgery,  I developed what appeared to be an infection: redness, heat, swelling, pain. Two (much lesser!) doctors diagnosed this as an infection, but Dr. P felt it was a large hematoma that had filled the surgical cavity. Nevertheless, I’ve been on cephalexin since the 4th, with apparent improvement.

Okay, come 6 a.m. we’re on track to try again. However….

On Thursday I started to come down with a cold. By Friday it felt like someone had stuck a blowtorch down my throat, and I was running a fever ranging from 99.5 to 100 degrees (“normal” for me is about 98.4, so that’s pretty high). Saturday the sore throat cleared, leaving a congested cough and a lot of post-nasal drip (unclear whether the cough proceeds from the chest, or is only a response to the throat irritation from the little nasal waterfall, but it’s probably the latter). Sunday the fever drops into the more or less normal range — 98.4 to 99, up and down). It’s worth knowing that before the virus came along, the temp would spike off and on to 99.5; Dr. P said that was consistent with a surgical hematoma in the breast.

Today I show up to be prepped and of course tell them about this new development..

Nursing staff and her resident believe the procecdure, which requires me to be knocked out with anaesthesia, will be canceled. Dr. P begs to differ. She says we should go ahead and orders her staff to Make It So.

Now one Dr. M, a gray-bearded anaesthesiologist who looks fully senior and wise as the ages, appears on the scene and asks if I’ve had a fever. I tell him about the 100-degree spikes on Friday and Saturday. He thinks about this for approximately three seconds and then says, “It would be foolish to proceed.”

I personally do not argue, because that’s my own private opinion, which as everyone knows is infallible.

Dr. P resurfaces, and she is peeved. She disagrees, but since the man is simply not going to do it, she’s now stymied. She reschedules the excision attempt, but while I’m there she hauls me into the OR to clean out the boob under a local. When she opens the thing up to suction out the fluids, she finds no pus or other indication of infection — just a lot of old, stale blood. She expresses her satisfaction that her diagnosis is now proven correct: not an infection. I think, uh huh… after I’ve been swallowing cephalexin 4x a day for the past week or ten days, and the red areas that concerned the other two docs have receded to the point of disappearance. On the other hand, the incision split open on Thursday; the hematoma has been quietly draining since  then, and that also could account for the apparent improvement.

She administered an IV antibiotic, suctioned and cleaned with élan, treated the wound directly with antibiotic, and closed with antibiotic-laced sutures.

The procedure was pretty painful despite liberal amounts of Lidocaine. At one point my blood pressure, which is usually in the 130s/80, went up to 297/120. It dropped fairly quickly into the 150s, which itself is unacceptable but at least not a sign of an impending stroke. The nurse said pain often causes BP to go through the roof. Hope that’s all it is…but now to add to my  joy I’ve got to go back to measuring my GD blood pressure twice a day, a pain in the tuchus and yet another source of daily worry.

Temp is 99.6, not good. The cough is nastier than it was this morning. But after an oxycodone and an afternoon of sleep (interrupted by only two phone calls…), the pain is receding some and the swelling is to a large extent reduced, though there’s still some hard stuff in there that feels like the hematoma…I’m afraid it’s probably still bleeding inside.

Given that the cough is now worse and I’m gagging up stuff that’s choking me, I’m glad the anaesthesiologist brought a stop to the craziness. But it means I’ve STILL got two procedures to endure, at the very least. And what do you bet something else comes up to require another one?

We should get a blog pool going on here… How many more fun procedures before this comes to an end? Cast your bets, ladies and gentlemen!

Angels Are Singing

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…and they sing Bach cantatas.

Our choir director offered to help out. The cupboard was about bare, and so I said it sure would be nice if someone could get me some groceries. I wanted some prepared food that I don’t have to put together — I’m just not up for cooking and so have about stopped eating, except for some ice cream that’s still in the freezer — but it needs to be low in sodium: a contradiction in terms.

When he made a run on Sprouts, he therefore read the labels on the frozen and canned foods and was startled to discover how much salt virtually all prepared foods contain. Result: he bought a fresh chicken and made a big pot of chicken soup for me!!!

How awesome is that?

More surgery scheduled for the crack of dawn tomorrow.

I don’t believe it’s going to take place. I  have a cold — came down with an awful sore throat late last week, and now have a miserable hacking cough. The temp is down to normal just now — five a.m., when your body is close to corpsehood anyway — but it’s been spiking up and down. Last night it was up around 100, high for me because my “normal” is well under 98.6. Impossible to know whether that’s from the cold or the breast infection. Probably a little of both.

Friday the incision split open, and it’s been oozing blood and icky stuff ever since. I tried to cover it with pads from CVS but that didn’t work — it just soaked right through my clothes. Looked like I was going to have to sleep on the tile floors to avoid ruining several hundred dollars worth of sheets, pillows, and blankets, to say nothing of the mattress.

But my son came to the rescue. He brought his buddy who’s a PA and now a third-year medical student. This excellent young man showed up with packages of surgical dressing and antiseptic detergent. He dressed the wound and taped down the surgical dressing so the gunk couldn’t get out.

So at least I was able to sleep in my bed.

I have no idea what the Mayo surgeon is going to do. This infection needs to be cleaned out and the incision resutured. It’s hard to imagine any anaesthetist would knock out a person who’s sitting there coughing her head off. About the best she’s going to be able to do, I imagine, is clean it out under a local and then have me come back for more gouging at a later date.

When I say there’s no end to this, I ain’t kidding.

Meanwhile, I sent the pup to my son’s house. I can no longer deal with two dogs, one of them an adolescent.

And, come to think of it, neither can Cassie.

That puppy has totally  beaten Cassie down. Pup is so dominant that she just thrashes Cassie, who’s taken to spending all her time hiding in the bathroom. Whenever she comes out, Ruby jumps all over her and bites at her.  Cassie can’t play with her toys, she can’t come out in front with me and chase Ball (because we can’t get out around the puppy), and I’ve been too sick to take either of them for a walk — which because of the broiling heat wouldn’t have been possible anyway until the past few days. Poor old dog’s coat was just sticky with puppy slobber. I can’t lift her into the tub to wash her, but did manage to brush her and brush her until all the loose hair came out, and with of it most of the crispy dog drool.

So I”ve made up my mind that Pup goes. I’ll ask my son if he would like to have her. In fact, I did so last night — he thinks I’m not in my right mind and refused. After the surgery is done, I’ll ask him again, and if he again declines, she’s going back to the breeder.

Godlmighty.

If I’d had any idea a locomotive was bearing down on me, the last thing I’d have done would’ve been to get a puppy.

Pup hasn’t had her rabies shots. When it was time for them, she was too sick to take rabies shots — the vets’ offices refused to administer them.  And for the past weeks I’ve been too sick and too preoccupied  to deal with it.

The sheer amount of money I’ve had to spend on that little dog boggles the brain. Latest cost was $850 to install a fence to keep her out of the pool area. But the vet bills! My god. I don’t even want to think about tallying them up.

Between the vets and the Mayo, my bank account is about cleaned out.  So, the plan to get a new car is now junk.

I called the mechanic and told him that thing has got to keep running for at least another two or three years (it’s 14 years old now…). He’s going to come and get it on Friday if I can’t drive it by then, and they’ll service it and try to shore it up against the tide of age.

I’d put off the regular service thinking that this summer I’d trade it in, so that’ll be another expensive bill.

One good thing: at the suggestion of a FaM reader, I did re-check the county’s rules about who qualifies for a property tax freeze. I’d thought my income was a couple of hundred dollars past the cut-off. But lo! They’ve raised the threshold! I’m just under the income limit!

You have to produce a utility bill to prove you’ve been in your house for two years. Of course, everyone has two years worth of utility bills laying around the house, right? So whenever I recover (if I do), I’ll have to get on the horn to Salt River Project, Southwest Gas, and the city water dept and try to persuade one of them to mail me a copy of a two- or three-year-old bill. Then, it’ll be another joust with bureaucracy.

Wish I’d known that earlier. Property taxes were lowered during the Recession-That-Was-Not-a-Depression, and if I’d wangled a freeze then, I wouldn’t be shelling out over two grand a year for the privilege of living in my paid-off home.

{sigh} I think this is about the roughest patch I’ve ever been through — since my mother died of cancer, anyway. Certainly beggars the divorce and beggars getting laid off the job. But I can’t complain. Much, much worse things could happen. All you have to do is look to the left and look to the right to find people who are in a worse predicament than yours.

Dispatches from Hell: Update

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Okay, so here’s where we’re at now:

Yesterday, after I talked with Dr. C, my regular gynecologist whose practice resides at St. Joseph’s, I reported to the Mayo radiation oncologist that Dr. P., the surgeon, had referred me to. Let’s call him Dr. W. He agreed with Dr. C that the breast was infected and seconded Dr. C’s advice to continue on the cephalexin.

The Mayo uses a newer, shorter regimen of radiation — three to four weeks, rather than five to seven weeks. Dr. C had advised me to ask whether they used an “intense” (which she characterized as shorter) or a “weak” radiation treatment and said that Medicare does not cover the so-called “intense” version. When asked whether Medicare would cover this three- to four-week regimen, Dr. W. did not know.

And believe you me, you can NOT get a straight answer out of the Mayo as to whether anything is or is not covered by Medicare!

So now I have to track that down. Since the Mayo doesn’t accept Medicare assignment, though, it may be best to get this done at St. Joe’s or at the even closer venue, John C. Lincoln — and in fact, today I need to check with Young Dr. Kildare about that. YDK is pretty proactive and he does have the advantage (even in this day and age!!) of owning a male voice.

Dr. W. wants to put me on a five-year regimen of tamoxifen.

Charming.

Dr. P has said repeatedly that tamoxifen would not be necessary. But then she said a mastectomy would be not necessary…radiation would be not necessary…cefalexin would be not be necessary…. Hmmmmm….

No two doctors have the same advice, which indicates that few of them have the same understanding of the DCIS disease process, if it is a disease process — some doctors believe it is not, necessarily.

I called the Mayo early in the afternoon to put off the surgery scheduled for Monday. And come evening, Dr. P herself called in person to beg me NOT to put it off. She said assuming it is an infection — clearly Dr. W’s opinion had registered with her — then the worst thing to do would be to put off the surgery, because an effective treatment is surgical: to go in there and clean it out. I don’t know if that’s so; can’t find anything on the Web one way or the other on surgical treatment of breast infection, but haven’t tried very hard so far. She really laid on the pressure, and by then — it was six or seven o’clock at night — I was just wrung out. So I folded. The surgery is still on for Monday unless Dr. C calls back today and is even more adamant to the contrary.

On the other hand, I have no intention of taking tamoxifen. Because… Indeed I have found plenty of peer-reviewed, randomized studies that show radiation alone is as effective in preventing recurrences as radiation plus tamoxifen. And tamoxifen’s side effects are markedly more baleful than radiation’s: osteoporosis (already got that; don’t need more) and uterine cancer, among others.

Meanwhile, I now have appointments next week with Dr. W2, a medical oncologist recommended by Dr. C, Dr. W3, with a surgeon recommended by Dr. C., and finally with Young Dr. Kildare, whose redoubtable common sense I will need by the time I get through with yet another surgery on my boob and consultations with two heavy hitters in scary specialties.

Dizzying, isn’t it?

This morning, however, I’m feeling somewhat better. A lot better, actually.

Missing just two doses of the cephalexin doesn’t seem to have done much harm. This morning it seems to be chugging right along. Dr. W (radiation oncologist) outlined the area of infection with an indelible marker so I could see, in a mirror, whether it was spreading or shrinking, and by dawn’s early light the inflamed area had receded visibly. The hundred-degree temp was down to normal — under 98.6 for moi — and I felt much less debilitated.

At three in the morning I managed to finish a project for one client. How well the work was done remains to be seen, but at least I reached a point where I could declare it done. More incoming got finished later this morning. And another project just batted back to me about 5 seconds ago.

Meanwhile, since I’m as certain as I’m sitting here that the next step will be a mastectomy, I figured I’d better learn something about that.

Did you realize you can get lymphedema even from a lumpectomy? I knew it was a common nasty aftereffect of mastectomy but was not told a simple lumpectomy could cause it. Wouldn’t it be nice if these folks would give you the full story about what to expect?

Anyway, Dr. P and Dr C are both pushing for reconstruction — Dr. C not as hard, but still lobbying gently. So that in particular was the topic of this morning’s ventures into the Wonderful World of the Web.

Holy sh!t.

From what I can tell — from every site and journal article I visited — breast reconstruction is More Surgery Waiting to Happen. To say nothing of more complications, more infections, more pain, more stress, and more misery. The results under the best of conditions are far from optimal. To create a fake breast from your own tissue, gobs of flesh have to be gouged out of your belly, your back, your buttock, or your thigh, creating yet another surgical wound for you to recover from, causing potential muscle weakness and nerve damage, and adding an extra mutilation to the one on  your chest. Silicone and saline implants often fail, complicate future mammograms, and on average have to be replaced(!!) within ten years.

Unless you’re actively on the prowl for a man or are SO narcissistically wrapped up in your body image that you simply must have a fake thing sticking out of your chest to make you feel whole, reconstruction appears to be a choice that’s likely to lead to an unsatisfactory result.

Doctors — including those of the female persuasion — assume that most women indeed are thus narcissistically wrapped up in their body image and so tend to urge patients to undergo this violent and often troubling surgery on the theory that they’ll feel better psychologically if they can look in their mirror and see a decorative lump perched on their chest.

What should I find as my jaw was bouncing off the floor but the website of an organization that advocates for women who do not want reconstruction.  Hallelujah, brothers and sisters.

They have photos of women who have had single or double mastectomies, in the altogether (well…waist up) and in various costumes. And gee. They don’t look horrible at all. Unless you had known these women before their surgery, you’d  never know they were boob-free, especially if they were fairly small-breasted to begin with. Which (after the 30-pound weight loss) I happen to be.

The group argues forcefully for acceptance of the breast-free state, at least for women who have the self-confidence to accept themselves as they are.

So I felt much encouraged by that.

A simple mastectomy is apparently no worse than the lumpectomy, which, when uncomplicated by an infection or a hemotoma or a seroma or whatEVER the hell it is, goes very easily.

And speaking of going, now it’s off to Whole Foods. Last time I was there I spotted large rolls of lamb cooked up for dogs. We’re running low on the pooch chow, and you can be sure that I am NOT going to feel like whipping up another eight to sixteen pounds of cooked dog food anytime soon. Pup has developed ear infections that the vet thinks represent a food allergy, probably to beef or one of the grains I put in the dog food. Beef is a common allergen, but anything’s possible. Right after I’d laid in enough food to last the dogs through what I imagined would be the duration, he announced that I should quit feeding her beef and give her chicken instead.

Not gonna happen, doc!

This stuff at WF is grain-free, so if I pick up enough and it’s also cow-free, it will give a chance to see if she’s allergic to something I’m feeding her. If her ears don’t improve, then we’ll know she has either an air-borne allergy or an infection. And if I get enough to last her for a couple of weeks and feed Cassie the stuff in the freezer, there should be enough food to carry them through a good three weeks.

À bientôt, then.