greetings from barfland, a bilious place in which i haven't spent much time in recent years; chuck has always been the sort of cat who pukes after eating too quickly, but in general he paces himself and our floors and bedding go unscathed. the scene changed dramatically on monday night after we decided to take the leap and start him on prednisone (which would rule out biopsy as a diagnostic option but would hopefully stimulate his appetite and support the effect of leukeran, his oral chemo); a few hours later he threw up all the food his appetite stimulant (mirtazapine, prescribed on friday) had coaxed into his stomach and more water than i'd have thought he was capable of holding. okay, we thought, starting a steroid regimen is rough. maybe it'll be better in the morning. we gave him his second dose, and another dose of mirtazapine, before leaving for work yesterday; he'd thrown all of that up by the time we got home. we spoke to our oncologist yesterday evening and she said it was alright to discontinue the prednisone, since he'd only had two doses. i felt good about that, at least until he was spectacularly sick again at two this morning. my sweet, stoic cat, the one who seemed slinkier than he'd been but otherwise my shadow as he always is, was absent from his customary spot on the bathroom sink (where he perches while i take my morning shower) today. now we all feel like throwing up, and joe and i are due to be out of town for a week as of this friday.
i called the specialist again this morning, full of questions from a feline lymphoma message board, and she agreed to prescribe zofran, an anti-nausea medication. she worries that his vomiting is a result of disease progression rather than a lousy response to prednisone - he might, for example, have switched up to large-cell lymphoma - and she thinks we should have his "official" one-month-or-so-on-chemo ultrasound before we go away rather than after we get back. i agree; though a technician from her office will be petsitting for us and seeing chuck every day, i hate the idea of leaving questions unanswered when his condition is changing so rapidly. i hate the idea of leaving at all, actually, but you don't need to hear about the place in my head where i fantasize about eating uncancellable travel arrangements and spending a week begging chuck to come out of the bedroom closet.
and what if he does have large-cell lymphoma? joe and i assumed that it was something we didn't need to know, since we were almost sure we wouldn't want to compromise his quality of life by bringing him across town for weekly IV therapy. there are other options, our specialist says. we could give him a $500 one-time, subcutaneous shot of elspar, a chemo drug which has minimal side effects and is apparently quite effective for large-cell; if it works (and it works quickly, she says; we'd see changes in a few days), we'd have "backed into" a diagnosis. we could then consider other oral agents, too - CCNU (lomustine), for example, or cytoxan - agents she doesn't want to put on the table unless we know what we're facing for sure. IV chemo is not the only path, prednisone is not a dead end, the decisions do not stop and grieving for the living is a waste of time.
as i waited for the train on the lower east side this morning i thought about how chuck seemed like a changeling, as if fairies had come in the night and swapped him out for their black cat. maybe he's making it easier for me, i thought, being someone else so i won't remember who i'm losing. but i am not losing. grieving for the living is a waste of time.