Ahnung: Cancer update

Ahnung getting ready to head to hospice to visit her friend 'R'

We met with Ahnung's oncologist yesterday at the Blaine Bluepearl Veterinary. I am so grateful for the incredible care Ahnung is getting from her health care team both at Lake Harriet Veterinary and Bluepearl Veterinary. Her x-rays and records were sent over to Bluepearl and Dr. Husbands had reviewed her records before we even arrived. He spent an hour with us going over all of our options and giving Ahnung a thorough check :)

Without a biopsy or surgery and actually getting to the nodules in her lungs there is no way to know 100% if it is cancer. With her history, however, he said he is 90% certain that it is cancer. I opted not to go down the path of any additional invasive procedures for my sweet girl. My gut tells me it is cancer and I don't need to have her go through any additional procedures to confirm that ... after going through all the various options, and after consulting with my vet and just sitting with what feels right to give Ahnung the best chances while honoring her quality of life I decided to take a combo approach, combining eastern and western. Ahnung has started on 2 supplements: CurcuVet and a Green Tea extract. She will be starting I'm-Yunity early next week (this is a compound derived from a mushroom and has been shown to lengthen survival time in dogs with cancer: http://www.upenn.edu/pennnews/news/compound-derived-mushroom-lengthens-survival-time-dogs-cancer-penn-vet-study-finds). She will also be starting a low-dose chemotherapy treatment early next week where I have been told most dogs do not have any side effects from the treatment. It is a low dose continuous oral at home chemotherapy treatment geared towards blocking blood vessel growth of cancer cells.

Waiting to get on the elevator at hospice

Dr. Husbands was honest and upfront that there is no cure. Our goal is to shrink the tumors, or at minimum to slow the progression/growth. He indicated that a reasonable expectation for how much time a dog may have who comes in with metastasis to their lungs is 2-3 months. He went on to say, however, that there are exceptions. I know that if there is going to be an exception it will be my precious Ahnung. Unfortunately she lost another pound and now weighs 56 lbs. She has been getting even more treats and I am hoping we can stop the weight loss. Fortunately her appetite is as voracious as ever. And tonight after dinner I took my juicer out and she was ready for her dose of raw cabbage juice -- tonight I decided to add celery and a sprinkle of apple :)

Today Ahnung was her usual happy, tail-wagging, spunky self. She ran around the back yard like a crazy dog with Legacy and rolled around in the dirt :) And then we decided to visit our friend in hospice. We had a wonderful visit with our friend who was excited to see Ahnung. When he arrived he was napping so we had to knock on his door. I apologized for waking him up and he said 'I can nap anytime, but it's not every day I get a cute dog coming to visit me!" :) We sat and chatted for almost an hour while Ahnung helped lick the crumbs off of his floor and then walking over to his bedside to rest her head on his leg. I asked how he was feeling and he said he has good days and not so good days. His wife is also at the same facility and is also in hospice. He tells me, "I feel better when my wife feels better; when she doesn't feel good then I don't feel good." He goes on to tell how they met in highschool  .. how they've been married for 68 years and how she has been his only girl :) He smiles when he tells me how she would write him letters every day when he was in the military serving in Asia and then goes on to say, "My country has been good to me. They have taken good care of me." He knows I just returned from the Philippines and asks me lots of questions. And then he shares more about what he did after he left the army, his kids and how he will soon be turning 91!! ;-) As I sit and listen to him with Ahnung laying quietly by our side I feel blessed to be sharing time with him. His gratitude and positive attitude for the life he has lived and for those who are helping him today reminds me of our dear friend 'M' who told me many times, "I've had a good life."

Waiting for her friend 'R' to let her in!! :)

Today, as I spent time with our friend in hospice it touched me on an even deeper level. The time we share is not just about walking the final stage of our friend's life ... my volunteer work in hospice is now as much about walking the final stage of Ahnung's life and all of us sharing, collectively, i  learning to embrace what is to come and most importantly to live life to the fullest in the present moment ... because the present moment is all we have.

I would be lying if I said my heart doesn't hurt and feel like it's being ripped to shreds when I fast forward and think about when Ahnung won't be here with me. The truth is, I can't imagine my life without her. I am constantly telling myself to focus on the moment and to be here, to simply be here in the moment with Ahnung. She is happy today. She is full of life today. She is full of love.

I believe in the power of prayer and positive/healing energy, so please continue to keep Ahnung in your thoughts and prayers.

With heartfelt gratitude,
Marilou & Ahnung
... and her siblings Legacy, Missy and Mister too :)

Ahnung's cancer has spread ...

I returned from the Philippines on Thanksgiving night. It was a whirlwind trip and I was exhausted  after traveling for over 24 hours. Legacy greeted me in the car as he came along for the ride to the airport with Jenny. When I got home I was greeted by my other pups: Mister, Missy and Ahnung. I noticed right away how Ahnung looked like she had lost weight. As it turned out, we had an appointment this week for her 3 month cancer check up at Lake Harriet Vet. On Monday we were to go in so they could draw blood for her full blood workup. Then on Wednesday we had an appointment with Dr. Cathy. We went in on Monday and we checked her weight ... she had lost 4 lbs since her last visit to the vet a few months ago. Other than her weight loss Ahnung was not showing any symptoms. She was full of life, had a strong appetite, and enjoying her morning ritual of perusing the big back yard and rough housing with Legacy. I've been checking her regularly as well for any new lumps or bumps. Over the summer she had an ultrasound done as well and we confirmed she had no tumors in her spleen or lower organs. I've been able to catch the first two cancers because she had lumps. I noticed the lump by her nipple in July, 2011 and had surgery immediately to remove the lump and had clear margins. I noticed the lump on her neck/back and the lump was aggressively removed in April of this year and the reports also indicated a clear margin. But this past surgery was very hard on her and took a long time for her incision to heal. In April was had a Celebration of Life party for her ... what a gift to have had so many friends come together to honor her and to have a healing prayer circle led by my friend Merry Sawdey.

Since April I have been doing everything I possibly can for my girl ... we've been going in for 3 month cancer check ups and full blood work. Our plan is to have chest x-rays every 6 months and after the ultrasound was done over the summer I decided to also add ultrasounds to her plan. I have thanked Ahnung for giving me the signs .... the lumps on her mammary chain and her neck/back have allowed me to physically see the tumor .. to catch the cancer early. Since April I have struggled with the knowing that there is probably cancer in her body and I just can't see it. It's at a cellular level and my way to combat it is to do everything I can to build up her immune system and to create an environment in her body that is not conducive for cancer cells to thrive. We are so grateful to the staff at Lake Harriet Veterinary for the incredible love, compassion and care they have given to Ahnung. She has been on chinese herbs, fish oil and mushroom supplements since April along with following an anti-cancer diet. She also gets to enjoy raw cabbage juice with me :)

Ahnung after her surgery in April to remove the tumor in her neck/back

So yesterday Ahnung and I met with Dr. Cathy. We weighed her again and she had lost almost a pound since her visit on Monday. Dr. Cathy was happy to tell me her blood work came back great! Everything was in the normal range. She checked her out and nothing indicated any issues or problems. I shared my concern about her weight loss. Dr. Cathy agreed. Knowing her history with cancer she recommended chest x-rays. I asked if metastasis of cancer to her lungs could be happening even if she has no symptoms (other than unexplained weight loss) and her blood work is normal. 'Yes' was the answer I got. So off she went to the back to get 3 radiograph views. Of course, she got lots of hugs and treats from the awesome staff while she was there :)

Yesterday late afternoon I got a call from Dr. Cathy. They had sent the chest x-rays out for a second opinion from a radiologist and the results had come back. My heart just sank when the words metastasis to her lungs came out. My entire world came crashing down. So much of the conversation is a blur as much as I tried to listen. We are meeting with Ahnung's oncologist at 2 pm today to go over options. As much as I knew in my gut that this was coming, I am not ready for this. I am not ready to say goodbye to Ahnung. I am not ready to lose a part of me, a part of my soul. Today we are scheduled to visit her friend 'R' in hospice. We have been volunteering as a team in hospice and we have walked the final journey with so many. Today when we go and visit our friend I now know that we are actively begin to walk the final journey, not only with 'R' but also with my sweet Ahnung.

Ahnung and Legacy ... best friends and soul mates :)

I pray this morning for the strength to be at peace with wherever my path with Ahnung needs to go. I pray for courage to stand by her and to allow her to walk her final journey with life, joy and playfulness. And I thank my precious girl for bringing Legacy into our lives and for showing me that playful puppy side of her. There is nothing more joyful for me than to watch Ahnung and Legacy play chase and roll around in dirt every morning.

I don't know how much more time I have with Ahnung. What I do know is that I will cherish every moment I have with her. I will hold her and I will love her with every fiber of my being.

Here's a video I created back in April after her Celebration of Life party ...

Keep my sweet Ahnung safe ....

Sweet Ahnung ....

Tomorrow I leave for the Philippines. I will be visiting my mom and will also be attending the funeral of one of my aunt's who died suddenly and unexpectedly from a heart attack (rest in peace Auntie Norma -- you will be missed by many) ... It's been a while since i've been to the Philippines; it's been a while since i've traveled as my own health has held me back from traveling, as well as the health of Ahnung. But I knew I had to make a trip back home before the end of the year to see my mother. Little did I know that it would also end up being a trip for my auntie's funeral.

I must confess I am worried about being out of the country even though it's only for a week. I worry of being so far away from my sweet Ahnung. I worry her cancer will come back with a vengeance when I am gone. I'm also hoping that my health holds out and that I don't have any issues while I am out of the country. My doctors have given me the okay to travel.

I am extremely grateful to my friend Jenny for taking care of my babies while I am gone ... well, at least 3 of them (Ahnung, Missy and Legacy). Mister will get to go and hang out with auntie Laura :)

Dear sweet Ahnung .... continue to keep those cancer cells at bay and know that your mom will be with you in spirit even though she will be on the other side of the globe :) I'll see you in a week sweet girl ... take good care of your crazy brother Legacy and your sister Missy :)

My heart speaks again

I was fortunate enough to catch this image in northern Minnesota of an eagle perched on a branch a few years ago. I was mesmerized for the 15 minutes or so where I was blessed to be in the presence of such an amazing spirit. I return today to this image, as I am reminded, to slow down and pay attention to my heart which has been calling out to me to listen ...

I haven't written much about my health. It's been intentional. For several years I feel like my life has been filled with doctor visits, surgeries, medical procedures and tests and an onslaught of health challenges. Even though I haven't written or talked much about my health lately, the reality of my health challenges remains an undercurrent in my life. Similarly, I walk this delicate balance with Ahnung with her two bouts with aggressive cancer, and learning to find some semblance of peace in the midst of an incredible amount of uncertainty. I can't change what life has placed in my path, but what I can change and control is what I choose to focus on ... and for me, it's been to focus on what makes me feel alive and all of the work I am doing in animal welfare here in Minnesota and the hospice volunteer work that Ahnung and I do as a team.

Unfortunately these past few days my heart is speaking out to me again. I saw my electrophysiologist/cardiologist in April of this year. It's been 16 months since my heart procedure and when he told me it could be a year, 2 years or 10 years before the symptoms from my left ventricular noncompaction (a heart condition that will most likely lead to heart failure) would surface. For the past month or so i've had occasional bouts of heart palpitations and waking up in the middle of the night from my heart feeling like it's going to hop out of my chest. But they've been sporadic and infrequent enough that I figured it's just a blip :) I've also had increased fatigue but i've been telling myself it's probably from stress, and I just accommodate by going to bed early and getting more sleep. But now with increased palpitations, which are always worse at night, it makes it hard to get sleep. For the past three nights it's been persistent and consistent. I'm waking up every couple hours at night like I used to back in 2011 before my heart procedure (although last night I got a streak of 5 straight hours of sleep for which I am extremely grateful for!). I've also had this feeling of heart burn ... so yesterday I caved and I called my doctor's office. On Friday I go in to have a holter monitor put on me so they can check the rhythm of my heart and to see if i'm having significant PVCs again (pre ventricular contractions ... essentially when your heart starts beating from the wrong place in your heart and it feels like a skipped beat). I will then be meeting with my cardiologist on the 24th.

These past few days as my heart has been speaking out I am reminded of the fragileness of life; i am reminded of all the uncertainty that flows in the undercurrent of my life's journey; i am reminded of how I must embrace uncertainty with as much zest, life, wisdom and passion as my sweet Ahnung.

Summer is coming to an end, and leaves will be changing colors soon. Seasons. There is a time and a place for everything. 

Before actress Gildna Radner died of ovarian cancer at the age of 42, she said, "I wanted a perfect ending ... Now I've learned, the hard way, that some poems don't rhyme, and some stories don't have a clear beginning, middle, and end. Life is about not knowing, having to change, taking the moment and making the best of it, without knowing what's going to happen next. Delicious Ambiguity."

As my heart continues to speak to me, may I approach whatever is in store for me, with curiosity and acceptance of a life filled with 'Delicious Ambiguity.'

The ebbs and flows of life and emotions

I took time yesterday to simply Be .. my list of 'To Dos' went by the wayside. I needed time to Be with my grief, to Be with Ahnung (aka 'Star -- Good Girl'), to Be with 'M' in spirit, to Be with all the emotions that arise from the loss of someone who has touched your heart, to Be with my tears and to Be with feelings, of which so many of my emotions I found myself wanting to label and to judge, and then I heard a wiser voice say ... 'Just Be, with all of it.'

I regretted not having the chance to bring my ipod to M's room and play for her classical guitar and harp music. I wanted to share with her the music of Roberto Aussel, an incredible Argentinian classical guitarist I had the chance to watch perform in concert many, many years ago when I lived in St. Louis, Missouri. I wanted to share with 'M' music that had touched my soul decades ago. I was sure, it too would touch her soul. Simply watching her talk about classical music, about how that was one regret she had, that she could play the harp or the guitar ... but then she would quickly turn her regret around, "But that's okay, I can listen to it and I can appreciate it." And she would smile. I miss her smile; i miss her optimism; i miss her positive outlook and attitude; i miss the incredible kindness she showed to her roommate; i miss her gratitude of everything; i miss how she lit up when Ahnung would walk in the room; i miss how she would smile every time she said 'Star .. Good Girl' and how proud she was to have Ahnung's calendar hanging on her wall. I miss her stories of her family; i miss telling her all about the many animals rescued from Leech Lake Reservation week after week; i miss her energy, her presence, her wisdom. I miss how she would always tell me how much Star loved to come visit her and how happy she was and how much she loves seeing her tail wag.

Taking a short break on our walk

Yesterday, I needed to give room in my heart to remember 'M'. When the reminder in my calendar popped up for us to visit 'M' I realized we were going to visit 'M' but it would just be in a different form. Ahnung and I headed off to the Hyland Reserve nature trails by my house and went for a slow, leisurely walk ... I listened to Roberto Aussel (classical guitar baroque music) on my ipod and I asked 'M' to come join us for our walk .... The three of us had the most beautiful nature walk and I had the chance to thank 'M' for the gift of her friendship.  It was a quiet day for me ... lots of tears, lots of reflection, and yes, lots of gratitude. I know that by volunteering in hospice that I am choosing to walk the final journey with a friend. It's an honor, a gift and a privilege. And yes, it's hard when we have to say goodbye. I also know that I must make room for the sadness and the grief, and I must let it come out in whatever shape or form it needs to ... yesterday it gushed out and now the pain comes in waves. I think the pain of losing 'M' also brought up a lot of another emotions from other losses ... funny, isn't it, how everything in our lives our interconnected.

Ahnung has a been a precious gift to me. She is a gift to so many others in the work she does as a therapy dog and an ambassador for homeless dogs.

Ahnung and I are called to do this work .... and we are grateful for the gift of new friends and for the privilege to walk alongside our friends as they journey into a new way of being.

I created the following short video in memory and in honor of our friend 'M'. As I watch the video and listen to the beautiful classical guitar music of Roberto Aussel, I feel M's presence with me ... with the nature photographs I have taken over the years I remind myself that when someone dies, they haven't really left us ... they are forever in our hearts ... sprinkled everywhere throughout this magnificent world ....

"M" .... A bright new star on a Blue Moon

At 5:54 this morning I received an email from my volunteer coordinator at Allina, "M' passed away peacefully at 1 am this morning. I could feel this pain in my heart. I was hoping I could see "M" today at Abbott. She was taken there yesterday after she fell and broke part of her right femur.

On Monday, Ahnung and I went to visit 'M'. We didn't bring any White Castle burgers on this trip because we had been told she was continuing to decline and to be honest, I felt like we were on the final stretch. The last visit we had I brought White Castle burgers, and yes, she ate all of it and loved it, but she was clearly not feeling well. On Monday, Ahnung and I were planning to simply be there with her while she slept. Instead, we were in for an amazing surprise ... I shared the following on my facebook wall after our visit on Monday:

"Miracles do happen! ... today, I was expecting a very different visit with 'M'. Instead, Ahnung and I had the most incredible visit .. here are my notes to the Allina volunteer coordinator from today's visit: ... When Ahnung and I got to the patient's room she was sleeping. We walked in and sat next to her for a little while. As we were moving around she woke up. She immediately said, "Star Good Girl." Much to my surprise the patient was doing very well on our visit. We had a very nice visit and chatted for about an hour (her roommate was there for a large portion of our visit and also participated in our conversation). The patient said she hasn't been feeling well (nausea and tingly pain across her chest). She said the meds have been helping her. She said she has trouble sleeping at night as her mind keeps going. I asked her what she is thinking about and she said she remembers so many things, like her kindergarten teacher. She said she's remembering a lot of things from a long time ago. We talked about her twin brothers, how she's the last of the her siblings to be alive, how she loves music and wishes she had learned how to play an instrument. She especially loves the harp, violin and guitar ... and classical music. We then shifted to food!! :) She once again started talking about White Castle burgers and was remembering how delicious the White Castle burger she had from when I brought some over last Friday. I learned that both the patient and her roommate prefer the White Castle burgers with cheese so I promised I would bring them cheeseburgers next time. She asked me if I would ever eat one of them and I said that Star would have my share ... she said, 'You don't know what you're missing!' and smiled. She said there's just no burger like White Castle burgers!! We had an absolutely wonderful visit and she was very happy to see us (especially Star!!) .. she said Star can come visit her every day! I told her that we would be coming more often to visit :)

She also asked about the animals up at Leech Lake Reservation. How many did we rescue last week? How she hopes they all find good homes ... I never imagined I would be given the gift of another visit with such wonderful conversations .... We engaged in great conversation with her roommate .... her roommate is a HUGE Twins fan, and I brought her a present (a Twins gnome) from Jenny and told her ... "from one Twins fan to another!" She was wearing her Twins outfit, put on her Twins cap and held onto the Twins gnome and posed for me so I could take a picture. She was smiling from ear to ear ♥ And the two happy roomies held hands and posed for me so that I would have a picture of the two of them :)"

 'M' gave me such an incredible gift. Her smile when we would walk in her room ... her soft, gentle voice saying 'My Star ... my Star Good Girl" makes me smile. How she would tell me "it's all about attitude. I've had a good life." She would've been 90 on December 22nd. I told her we would have a big birthday party for her. She said she couldn't leave her room. I told her not to worry, I would bring the party to her! On our last visit, she talked about how she loves music and how she wishes she had learned to play an instrument .. she loves the harp, classical/acoustic guitar and the violin. I was planning on bringing my ipod with me and playing music for her. On Monday when I told her Star and I would be coming back soon and that it's okay if she doesn't feel well and just wants to sleep ... that we would just hang out with her. She looked at me and said, "will you just come sit with me? You and Star can come as often as you want. In fact, you can stay here all the time ... Star is such a good girl. She's the best dog in the world. We need more big therapy dogs ..." My heart smiles every time I think of 'M.' I love how she would share stories of her family, of what makes her happy ... she was very proud of her nieces, nephews, grandkids. One of her grandaughters was a screen writer and actress and she was very proud of how she tackled a very difficult topic, domestic violence. "It's a sad ending," she tells me, "the woman doesn't leave and she dies in the end." She goes on, "But it's an important story and it will help other women." She tells me how much she loved to read and write. She tells me how much fun she had as a kid, and on our last visit shared many memories of early childhood. 

On Monday I never imagined I would have the gift of another visit with her where she seemed so full of life. After watching her steadily decline for the past couple of weeks I didn't think we would have the kind of conversations we had when we first started visit in July. Monday was truly a miracle. In some ways, my gut was saying ... is she giving us this precious gift before she leaves us? Ahnung always sleeps upstairs and never comes in my bedroom with me. Ahnung sleeps upstairs or wherever she chooses to sleep. Last night was different. She came into my bedroom and wanted to sleep with me. I think she knew 'M' was leaving ... and i'm not surprised my dear friend 'M' waited till 1:00 am so that the day she leaves this world is on a Blue Moon, a rare event when we have two full moons in a month. 

As my heart filled with pain and grief when I received the news of M's passing, I momentarily asked myself, "Why? Why do I do this? Why do I volunteer in hospice? Why do I set myself up to be hurt?" I've been crying this morning and my heart hurts. But I can hear M's voice telling me it's okay, she's had a good life. I can hear her asking me about the animals up at Leech Lake Reservation. I can hear her happy that Star is no longer having to fend for herself and that she's safe, and that we belong together. The pain in my heart is as great as the joy 'M' gave to both of us. This morning I knew what I needed to do was to honor 'M', to give myself time and space to grieve and feel the pain of her loss ... and yes, for me, I needed to write. I need for others to hear bits of her story. I need for the world to know that a beautiful, wise spirit has passed on. Thank you 'M' for all you have given to so many in this world. Thank you for the gift of allowing us to walk alongside of you in the final leg of your journey .. a journey you walked with such love, kindness, dignity and grace. And so the answer to why Ahnung and I volunteer in hospice returned after I allowed the tears to flow. Death is as much a part of the cycle of life ... it's not something to fear. It's as much a part of the cycle of life, and 'M' lived it all the way to the end. She also told me over and over again, what a gift it was for her to have Star come visit her. So I know in my heart that part of Ahnung's work is to give comfort and joy to those on their final stage of their journey.

Hold On

To what is good

even if it is a handful of earth.

Hold on to what you believe

even if it is a tree which stands by itself.

Hold on to what you must do

even if it is a long way from here.

Hold on to life

even when it is easier letting go.

Hold on to my hand

even when I have gone away from you.

~ Pueblo blessing

So tonight, on a Blue Moon, I will celebrate the life of an incredible woman ... a woman who touched my heart and a woman who called my Ahnung "Star Good Girl" ... because tonight, when I look up into the night skies, I will know the brightest star out there will be our friend. 

Rest well dear friend. You will forever be in our hearts.

Circle of Life

Ahnung visiting her friend 'M' in hospice

The past few days have been filled with ups and downs ... the rollercoaster of life came down with full force: new life, loss, uncertainty, fear, hope. This morning I decided I needed to make room in my heart, and to slow down and to honor all that has happened in 48 hours.

Ahnung at the vet (her BIG belly!)

Early Thursday morning I noticed Ahnung's belly was HUGE ... hard and distended. I lost my dog Shen to spleen cancer in September, 2006. By the time she showed any symptoms it was too late. I feared the worse with Ahnung with her history of two previous cancers in less than a year. Has the cancer spread to her spleen? I immediately took her to my vet (and that morning all my appointments for the day were cancelled including my own doctor's appointment). Fortunately she was acting her usual perky self. X-rays were done to check and see what was inside that huge distended belly. The doctor comes back to tell me it appears Ahnung found some food somewhere and ate LOTS of it!! I later discovered that she found the secret stash of food in a spare room. Yes, the nung-nung All You Can Eat Buffet! I sighed a huge sigh of relief. The vet went on to tell me they were sending the x-rays off for a radiologist to review and to ensure that they weren't missing anything. We had just been at the vet on Wednesday for them to draw blood from Ahnung. We are on our 3 month cancer check up. Two hours after I return home I get a call from the vet. The radiologist has reviewed her x-rays and concurs that there is massive amounts of food and gas, but also indicates Ahnung's spleen is enlarged and prominent. My heart sinks. We discuss options and I tell the vet I'm not willing to take any chances with my girl. "The only way we will know for sure what is going on and if there are any tumors or masses or abnormalities is with an abdominal ultrasound." Ahnung is scheduled for an ultrasound Friday morning. For the rest of the day I am worried ... she had a lumpectomy in July, 2011 after being diagnosed with mammary cancer; in April, 2012 she had major surgery on her neck/back to remove a tumor and was diagnosed with invasive adenosquamous carcinoma. Both cancers were removed with good margins but both were determined to be aggressive cancers. Ahnung has blessed me with the gift of allowing me to catch the cancer early. I've caught the tumors. I pray daily for Ahnung. I ask her to guide me and to help me stay ahead of the cancer. I pray for the cancer to leave her body. I ask her to give me signs ... but deep down I worry that if the cancer is in her spleen or liver how will I ever know. Did she eat a massive amount of food to guide me to her spleen? Is she trying to tell me something. I look into her eyes and I tell her, "I am listening sweet girl .. I am listening with every fiber of my being."

On Friday morning I take Ahnung in for her ultrasound. She's busy winning the hearts of the staff at Blue Pearle Veterinary and others in the waiting area. As soon as anyone comes over to her she rolls over to let them know, "belly rubs please!" They take her back and i'm waiting outside for an hour and a half. I flash back to September 14, 2006 when I'm sitting in the waiting area of the University of Minneosta with my dog Shen having an ultrasound done. The doctor comes to get me and has a very somber look on her face. I know it's not good. "I'm sorry, it's not good. It appears the cancer has spread." I'm not ready to let Shen go and even though the doctor tells me anything we do now is palliative. I opt for surgery and the very next day Shen goes through surgery. The cancer has spread everywhere and after two blood transfusions I make the decision to let her go. And I rush back to the U to be with her and hold her as she crosses over the bridge (to read Shen's story: http://mariloureflects.blogspot.com/2009/09/shen-3-years-later.html).

As I'm waiting for Ahnung in the waiting room I am filled with the anguish of previous losses and the potential of losing Ahnung. No matter how hard I try to stay in the moment I can't. The thought of not having Ahnung by my side is a pain I simply cannot fathom.

Ahnung napping under 'M's bed after eating her 2 burgers!

90 minutes later the doctor comes out. She has a relaxed look on her face. She smiles and tells me everything looks good. I can feel tears welling up in my eyes ... yes, tears of joy. The doctor goes on, "Ahnung has an enlarged spleen (and apparently some dogs just do) but she does not see any masses or tumors or abnormalities and the blood flow is good." She said she also checked out all her other organs in the area and they also all look good. She is aware of Ahnung's cancer history and I share with her my concern of cancer spreading to her spleen and not being able to catch it early enough. She tells me that adding ultrasounds to her cancer screening is an option. She would recommend having it done every 6 months. So Ahnung's cancer screening plan has been adjusted: every 3 months we go in for blood work and check ups with her vet; every 6 months she will have a chest x-ray and ultrasound done; and she will continue on her Chinese herbs, fish oil capsules, wild mushroom supplements and anti-cancer diet. So for this 3 month cancer check up, Ahnung got a clean bill of health. Her blood work came back normal, her lymph nodes all feel normal, the small lump near her incision is scar tissue.

Ahnung snarfs down her burgers

We normally visit our friend 'M' in hospice on Thursdays but we had to postpone our visit. I call 'M' on Thursday to let her know that Ahnung and I will be coming by to visit her on Friday and will be bringing White Castle burgers and a Coke for her as we promised. 'M' sounds weak on the phone but says she is looking forward to seeing us, and yes, especially Star Good Girl :)

On Friday lunch time I swing by White Castle's drive through to pick up 6 burgers and a Coke. I never would've imagined myself going through a White Castle drive through. I know 'M's roommate also loves White Castle burgers (she tells me she started eating them when she was 12 years old!). On the drive to see 'M' my car smells like burgers and onions. I had also promised Ahnung she would get to enjoy one or two after her ultrasound :) We walk into 'M's room and she is sound asleep. She looks tired and weak. She hears us come in, opens her eyes, smiles and softly says, 'Star Good Girl.' Ahnung goes to the side of 'M's bed as she always does and waits to get pets and strokes on her head. 'M' is noticeably weaker and tired. She can barely keep her eyes open. I tell her I have White Castle burgers and a coke for her, and ask her if she's hungry. She responds, 'Even if i'm not hungry i'm eating my burger!' I give her roommate a couple burgers and then help 'M' with her burger. It takes her a long time to eat her burger, and she periodically drifts off and closes her eyes. Ahnung is staring at me saying 'Don't forget about me and the burgers you promised me!!' So of course, I give Ahnung her burgers and she snarfs 2 of them .. no chewing just 2 big swallows for each burger!!

'M' finishes her burger!

For most of our visit we sit quietly next to M's bed. She opens her eyes at one point and says "I'm sorry i'm not very sociable today." I tell her, "It's okay. Just close your eyes and rest. Your body needs rest. Star and I are happy to just be here with you. In fact, Star likes to sleep a lot too and right now she's sleeping with half her body under your bed. I also get tired easily and need to sleep a lot ... we'll just come and hang out with you and take naps!" 'M' smiles and says, "You don't know how much that means to me .... maybe you and Star should just come for a sleepover." I smile and I let her know that we are happy to just be there with her. We stay by her side for a while and 'M' continues to drift off to sleep for most of our visit. She opens her eyes periodically and looks for Ahnung ... when Ahnung stands up to get her pats and strokes on her head, 'M' says, "Star, Good Girl ... the best dog in the world," and she drifts back off to sleep.

'M' has wiggled her way into my heart in the two months we have been visiting her. She has given us a priceless and precious gift of allowing us to walk by her side as she enters the final stage of her journey. I would be lying if I said my heart doesn't hurt to think of the day when Ahnung and I will no longer be able to visit her ... our visits have gone from ones of lots of conversation to visits of simply being there, and being present for her so when she opens her eyes she sees us there by her side. The grace, dignity, gratitude and love that fills her heart is a gift I will always hold in my heart.

Two of the pups from Red Lake Rez

And during this period, animal rescue work continues. On Friday, 1 mama dog and her six 1 week old pups and 3 other 8 week puppies make their way from Leech Lake Reservation up to Animal Allies in Duluth. They will be cared for and vetted and when they are ready, will be placed up for adoption. On Saturday, a huge transport makes it way to the cities from northern Minnesota (Red Lake Reservation and Leech Lake Reservation) -- in total 29 dogs make their way to rescues and shelters in the cities ... 22 puppies and 7 dogs. And on Saturday we also experience loss as we welcome two bright new stars into the night skies. In the palm of our hands, how is it possible that we can experience so many emotions at the same instance: love, grief/loss and ending of life, celebration of new life, uncertainty, hope, fear, anger? How can our hearts hold all the emotions that sometimes feel like they are ripping our hearts to shreds while at the same time filling our hearts with so much hope and love?

Petula's 3 day old pups ... Petula had her pups in the Leech Lake impound on Thursday (1 was still born and 5

 survived)

So this morning as my heart is filled with so many emotions from the past 48 hours, I realize I must pause. I must honor all that I feel in my heart .. the joy, the pain, the fear and the hope.

"To go in the dark with a light is to know the light.

To know the dark, go dark. Go without sight,

and find that the dark, too, blooms and sings,

and is traveled by dark feet and dark wings."

~ Wendell Berry