Yum!

Who knew that mustard was such a wonderful dipping sauce for both apples AND peanut butter sandwiches!

And, those holes in the back of baseball hats are really meant for your eyes!

My child is so hip.

Chilled to the bone...one more time

Contrary to most in the world, I love the cold weather. There is something comforting about bundling up in layers and hunkering down for a good cold spell. It's a good time to read a book (though I haven't done that PG - post-Graeme), watch movies (haven't done much of that either), and cook big meals (ditto). I love a good cozy day in the house. DC offers some opportunities for cold comfort, but it's always about 2 months less than my bones need. So, today was a welcome surprise. After 2 days of 75 degree weather earlier in the week we were treated to 30 degree temps and a light dusting of snow. We celebrated by a walk to an unnamed coffee shop. Graeme kicked through the snow and learned about black ice.

Not much Knox Knews to report. He is tolerating the oral chemo well and has good energy. He got sick last night and has tried to eat the plants (an unwelcome behavior from his pre-diagnosis days). We’re not sure what to make of it, so are just keeping an eye on him, as usual.

Graeme and his routines

Maureen, our nanny, stayed with Graeme this past Friday night while Steve and I went to the Hawk n' Dove to pick our Nationals games with the rest of the group with whom we split season tickets. Maureen reported that at 6:55 (we usually start his bedtime routine at 7pm) he went to the stairs to head up for bed. He climbed the stairs, went to the bathroom, and pointed to his toothbrush (which is crazy, since he screams every time I go near his mouth with it). Maureen gave it to him, but then said, "Graeme, I don't know where the toothpaste is located." He then proceeded to climb on to the toilet and open the drawer in the vanity where she was able to retrieve the toothpaste.

Maureen also reported that yesterday she took all three boys under her watch to the park and told them, "we'll be here for one hour." At exactly one hour, Graeme stopped what he was doing and started walking home. Brilliant, eh? She then said that he went into the house, headed to the bathroom, and tried to take his pants off to go pee in the toilet, which is what she makes the older two boys do after an outing. He loves to do whatever William (3) and Major (4) do. I suppose I could go with this interest in the toilet. Seems like momma isn't ready for the developmental milestone. I'm sure the seasoned parents are saying, "ha, she thinks it's this easy."

Let the treatments begin

We started Knox on an oral chemotherapy (cytoxan) this morning. We decided to add this to his current treatment of prednisone (steroid) in the hopes that it will help shrink the tumor and buy us some more quality time, without causing any uncomfortable side effects. The oral chemo is administered every other day at home and he doesn't need to be monitored as closely as with full blown chemo. Our trip to the hospital to have his staples removed yesterday confirmed with us that weekly chemo treatments are not in Knox's best interest. We dragged Maddie along with us on the visit for several reasons. First, we had Knox tested for feline leukemia. Many cats with lymphoma also test positive for feline leukemia (my understanding is that it is a different form of leukemia than what we see in humans). Feline leukemia is highly contagious and therefore if Knox tested positive we would have had Maddie tested as well. Fortunately, Knox's test came back negative. (The test results are ready in 10 minutes.) Second, we wanted Maddie to pick up the smells of the hospital in hopes that she would refrain from attacking Knox upon his return home. It sort of worked. She's hissed at him a few times (probably because she's pissed that she now has to endure unnecessary trips to the vet), but nothing like we experienced when bringing him home from surgery. Unfortunately for Maddie, this means she's going to need to go with us on future visits. This also means that we are going to have to find child care on those future visits. It's next to impossible to handle two meowing, irritated cats and one crying, irritated child amongst two stewing, irritated adults. Oh, and Maddie peed all over her carrier on the trip to the hospital and Knox pooped all over his on the way home. I truly feel sorry for the cats (and myself) and we will minimize these visits to the extent possible.

Knox seems to be slightly uncomfortable after the chemo pill. I'm guessing it could be a low-grade nausea. We are watching him closely. I'm still a bit torn about giving him the chemo. It is not going to cure him and really the only purpose is to buy US some more quality time with him. Seems selfish for him to endure any side effects for my own gain.

Knox's Massage Chair

Knox LOVES to get massages in the special chair he adopted for just this very purpose. It's a canvas folding chair that I've had since college. He jumps into the chair and squeaks/begs for us to rub the underside of the chair while he writhes around....thoroughly enjoying himself. It's quite a sight, and needless to say we indulge him whenever he asks. Sometimes he'll run down to the chair as soon as we get home and cry until we give him a massage. A sign that he's feeling well is his recent requests for massages.

Knox also went poking around for mice yesterday. Another sign that he's feeling better. He hasn't played with his mice in months (much of this due to us being distracted by the 19 month old in the house). Last night he started reaching underneath the bookshelves looking for mice he might have shoved under there eons ago. I quickly ran to get some mice to toss for him - he's not consistent about retrieval so I grabbed a handful. It is so nice to see him feeling good.

We met with Knox's internist on Tuesday to discuss more treatment options. It wasn't a very satisfying conversation, probably in part due to the limitations we face. The doctor was seemed to be "selling" chemo, which irritated me, but he was also up-front about what I consider to be a dismal prognosis even with a successful chemo treatment. I spoke to another vet (a friend's father) who flat-out said that he wouldn't do chemo on Knox given the short life expectancy even if the treatment is successful.

We are torn. We want to give Knox the best possible chance for long-term survival, but we want to do so in a way that gives him the greatest quality of life. I'm afraid that weekly chemo treatments will adversely affect his quality of life. We talked and cried and discussed tonight and have decided to call our very kind primary care vet tomorrow to see if he can lend any additional insights. My friend Jena pointed out the differences in some of the sub-specialities and we are considering seeking out a real oncologist (our specialist is an internist who can administer chemo, as opposed to someone who specializes in the treatment of cancer). I'm not sure the answers will be much different, but at least we will know that we've covered all of our bases.

It is certainly an awesome responsibility to have another living creature's life in your hands like this. For some reason this feels weightier than even caring for Graeme.

(The top picture is the pile of mice we found under an overstuffed chair when we moved it. Knox and Maddie had shoved them all around to the point where they couldn't reach them anymore. The bottom picture shows Knox mid-massage.)

Graeme's Buddy

Graeme had a visit from his buddy, Simon, this past weekend. Simon and his parents, Alyssa and Jeff (maybe if I hotlink his blog he'll post), lived directly behind us until this past June when they relocated to Maine. Simon and Graeme are about 2 months apart in age and have known each other since about 25 weeks gestation. While Alyssa and Jeff have lived behind us as long as we've been in Fairlington, we only connected with them once we noticed that we were each pregnant. And connect we did. We immediately found lots of common ground with the R's and ended up spending many an afternoon hanging out in the grassy area between our homes. Jeff would toss the ball for the dog while we'd chat about social issues, quirky neighbors, jobs, books, whatever. Alyssa and I went for coffee weekly with the boys and talked daily about sleep habits, eating habits, teething, crying, poop, use of pacifiers (for Graeme and Simon, that is)....things new moms are want to discuss. It was so fabulous to have someone *literally* in my backyard to share the new parenting experience. Alyssa and Steve shared a running interest and Steve felt very honored when she asked him to run the last 5 miles or so in her first marathon this past November. Jeff and I shared an interest in how nuts we thought/think are spouses are for their fitness obsession.

At any rate, I was despondent when they decided to relocate to Maine to try a slower paced lifestyle and be near family. It seems as though every 6 months or so we are recruiting for a new set of friends due to moves like these, but this one was the hardest by far and left a huge hole in my day-to-day life.

(The bottom picture is from Elissa's 2nd birthday party this past Friday. Elissa is Simon and Graeme's pal from across the street. Graeme, Simon, and Elissa have known each other since birth.)

(More Knox Knews tomorrow. )

Diagnosis

After a nail-biting afternoon we received a call from Knox's Internist, Dr. Kilrain, to discuss the results of his biopsy. Knox has lymphoma, or cancer of the lymph system. We are just now starting to read about this type of cancer and gathering more questions along the way. Lymphoma is the good news out of a bad situation because it's treatable. Here's what we know now.

Lymphoma is a rapidly growing cancer and he's likely only to have had it for a few weeks or months (which debunks our original theory that he's had a stomach tumor his entire life). One theory is that chronic irritation or inflammation of the digestive system can eventually lead to lymphoma. This seems to fix Knox best.

As for treatment, we have four options:

1. Do nothing - life expectancy of 4-6 weeks
2. Treat with steroids (prednisone) - life expectancy of 2-3 months
3. Treat with steroids and an oral chemotherapy - life expectancy is a bit longer than #2
4. Treat with a full chemotherapy regime - life expectancy of 8-9 months

The steroid treatment has no adverse affect on cats and hence is the "no-brainer" treatment option, per Dr. Kilrain. It works to kill the tumor and should help to make him feel better right away. The oral chemo may have mild side affects and requires a some monitoring of his blood count. The full blown chemo regime involves weekly treatments for 6 weeks, followed by a tapering of treatments over the following 8 to 10 weeks. The treatments are mostly short (~30 minutes), but require blood draws and an IV drip, and can cause side affects such as nausea and vomiting (just the symptoms we are trying to cure - how ironic).

We started Knox on steroids last night. (I'm sure there are some jokes to insert here, but I'm not feeling very funny at the moment.) We were able to fill the prescription at our local Safeway, which felt kind of cool. "Prescription pickup for Knox Maguire, please." We are thinking and discussing what, if any, additional treatments we want to try. Our primary concern is making Knox comfortable and giving him the highest quality of life possible.

For now, Knox definitely seems to be feeling better. He spends more and more time in his kitty hammock and he spent the entire night sleeping on Steve, something he hasn't done in over a week. His appetite is not great and he's probably only getting about half the calories he really needs, but he's not vomiting so we continue to offer very small amounts of food every two hours. He has probably gained a few ounces since his surgery and seems to have a modest amount of energy.

He continues to bring us great joy. We spend as much time as we can petting him and talking to him and he gives us lots of dreamy stares and purrs frequently. Graeme loves to visit Knox in the closet and often will just sit for a minute or two with his hand on Knox's back. Knox has taught Graeme "gentle", for sure. Today, Graeme took a book to Knox and turned a few pages. I'm sure Knox enjoyed it. I cried.

Steve and I are doing OK. This is a very surreal experience and we continue to take each day one at a time.

Thank you, again and again, for all of your love and support.

Hammock- Take 2

I was able to get a couple of pictures of Knox in the hammock this morning. He LOVES the sun and heating himself up to about 120 degrees. I took the pictures while Graeme was sleeping. Though, I should admit that earlier in the day Graeme found the Vicks again - and rubbed it throughout his hair. Yes, I've learned my lesson and it (the Vicks) is now on a high shelf. Meanwhile half of Graeme's head is beautiful wild curls and the other half is a sticky oil slick.

Out of the closet

Knox came out of the closet yesterday - literally. He didn't eat much yesterday, which had us worried. We decided to give him one of his appetite stimulants and it worked. He wandered out of the closet about 30 minutes later looking for some grub. He looks so skinny to me. I'm sure much of it is due to the fact that his belly is shorn, along with one of his front paws, but he's probably hovering right around 10 pounds - or 3 pounds shy of his normal weight.

When I woke to give him food at both 1 am and 5 am he was missing from the closet. Eeks - where did he go? I found him wandering around the house, again, looking for food.

Today was his most active day. I found him in his window hammock at one point, another favorite spot. The thought of him jumping 3.5 feet to reach the hammock with 18 staples in his belly makes he nervous, but he obviously felt up for it. I planned to take a picture of him in the hammock, but after admiring his feat I found that Graeme had smeared Vicks Vapor Rub all over his face. By the time I finished cleaning my menthol-smelling son Knox had retreated to the closet.