Event #2: The Black Pee Incident

We were still trying to learn how to force feed Jax and administer subcutaneous fluids using an IV bag (at this point on a daily basis) when another major event occurred that further derailed my blogging.

One day in early May of 2016, my step-son, Travis (who was 22 at the time) came downstairs to the kitchen and said, “Mom, does my chest look swollen to you?”

It was beyond swollen.  It was as if he was trying to be silly and look like he had boobs – only the left side was way bigger than the right side.  I said, “Yeah, what the hell?”  He told me that he had worked out really hard the day before and he could barely extend his arms away from his body.  I told him to drink lots of water and take ibuprofen.  No big deal, I thought.

Later that night he yelled down from upstairs, “Mom!  Could you come look at this?  Is this bad?  This is my pee.”  He was holding one of our drinking glasses, which was filled with a black liquid.  I blinked a couple of times and stood there in a stupor for a good minute.  I was having trouble processing the information I had just received and didn’t know whether to be more shocked by the fact that he had just peed into one of our drinking glasses, or the fact that his pee was as black as Coke.  My maternal instincts finally kicked in and I focused in on the fact that something was very wrong with his body.

A trip to the emergency room revealed that he had rhabdomyolysis.  (“Rhabdomyolysis is a rare condition that occurs when muscle cells burst and leak their contents into the bloodstream. This can cause an array of problems including weakness, muscle soreness, and dark or brown urine. The damage can be so severe that it may lead to kidney injury.” Source: www.health.harvard.edu/blog)  Travis’ creatine kinase (CK) levels were the highest in the hospital’s recorded history.  He was sort of proud of that.

He was admitted to the hospital and put on IV fluids for 7 full days while they watched and waited for his CK levels to come down to normal.  [Of note, my advice to him earlier that first day was only partly correct.  It was good for him to drink water, but ibuprofen is NOT recommended because it may worsen kidney function.  Source: www.health.harvard.edu/blog]

His CK levels did eventually come down, he returned home, and we resumed our “normal” life until August of that same year…

A Series of Unfortunate Events - Event #1: Jax

It is fitting that the last entry I posted in Feb 2016 was titled "Stop!".  I stopped writing for nearly 3 years.  The reason?  A series of unfortunate events.

Maybe I shouldn't call them "unfortunate".  Each event came with one of those cliche experiences of "growing" or becoming "stronger" or whatever positive descriptor you want to add.  But, the bottom line was that these events knocked the hell out of my routine and disrupted my entire life.

Event #1:  Jax

Shortly after my last post, my precious kitty, Jax, went into acute renal failure due to kidney stones.  The vet at the emergency room told us, "Unfortunately, he has what we call big kidney-small kidney syndrome, meaning that one of his kidneys is very small and atrophied, most likely due to a prior kidney stone and his other functional kidney is very large, due to having to compensate for the loss of the other kidney.  It is his large, functional kidney that is blocked with 3 kidney stones."  The vet's expressionless face told me all I needed to know about the gravity of the situation.  "We can administer IV fluids to try to flush out the stones..."  They talked of other heroic measures, costing in the range of 50 thousand dollars to conduct a kidney transplant, but we knew that was out of the question.

So, we admitted Jax to the hospital where they stuck tubes into his tiny veins and pumped him full of fluid.  We visited him every day.  We held his limp body and talked soothingly to him, promising him everything would be okay.  We laid hands on him and asked God to heal him.  I had never "laid hands" on anyone or anything ever before.  Over the course of 3 days, he had produced very little urine.  On the 4th day, the vet told us they had done all they could for Jax.  They had inserted a catheter into his leg in anticipation that we would agree to euthanize him.

My husband, Jim, and I agonized over this decision.  Jax was only 5 years old.  But, youth does not promise immunity to death.  I was working from home that day and Jim was at work downtown.  We were IMing about what to do.  I happened to glance out the sliding glass door onto the gray, cold day and in that moment, I saw something.  It was a white feather floating down from the sky.  I typed, "OMG!  I just saw a feather float down from the sky!  Hold on, let me go out and see if that was really what it was...."  I had noted from inside the house the spot on the ground where I thought the feather had landed.  In my pajamas and house shoes, I ran outside to the spot I thought I had seen it land.  Patchy snow covered the ground, making it difficult to discern any white object from the odd white shapes of melting snow.  But there, on the ground, at the spot I sought, lay a large white feather.  My heart swelled with hope!  I picked up the feather and ran back inside.  I typed back to Jim, "It is!  It's a feather!  He's going to live!  I've got to call them [the vet] and tell them we want to pick him up and bring him home."  Jim agreed.

Jim hurried home and we went over together to pick Jax up.  His hind leg was bandaged where they had had the catheter ready to go.  His little shaved arms were bruised from all of the needles that had been poked in him.  His hair was falling out and he was so weak, he could barely stand on his own power.  Nevertheless, we felt certain of our decision.  At worst, if he was going to die, we wanted him to die at home - not at that hospital.

We brought him home and laid him on the love seat in the family room, covering him with blankets.  There was a feeling of understanding we had that this night would be the turning point, one way or the other.  Nothing had changed from when we had taken him to the hospital.  As far as the doctors knew, he had not passed the stones.  He was not producing much urine - certainly nothing in proper ratio to the amount of fluid they had pumped into him.  We prayed over him.  My heart was breaking.  I didn't want to leave his side.  I certainly did not want to leave him in the dark downstairs all alone overnight.  So, I decided to sleep on the couch just a few feet away from him that night.

In the morning, I opened my eyes and looked over to the love seat.  I could see him still wrapped in the blankets.  He hadn't moved.  I crawled over to him and snuggled my face down into his fur.  He was breathing!  He opened his eyes and looked at me.  My eyes filled with tears.  He had lived through the night.

The next few months were filled with challenging times trying to nurse Jax back to health and learn how to care for a cat with chronic kidney disease (also known as a "CKD kitty").  I discovered this website: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease, which taught us what to do.  I credit the website's author, with helping us save Jax's life.  Today, nearly 3 years later, Jax is healthy and happy.  We have a fairly complex routine of treating all of his food with aluminum hydroxide (binds the phosphorus from the protein in his food and prevents it from entering his bloodstream - phosphorus is a kidney toxin) and every third day administering oral medications (Cerenia (antinausea) and ranitidine (antacid)) and subcutaneous fluids (100 mls - helps flush out his kidneys).

The TV pastor, Joel Osteen, has a saying, "Are you willing to take on the burden with the blessing?"  It does, indeed, seem like each blessing comes with a burden of some kind or another.  Caring for Jax's special medical needs can often feel like a burden, but all I have to do to see the blessing is to remember that fateful day of the feather, the tenuous moments of that long night by Jax's side, and the joy the next morning when he still had the gift of life.