The last few weeks

I keep replaying the last few weeks of Knox's life in my mind. I'm not sure if I'm afraid I'll forget them, or if they are just the freshest memories and therefore closest to the surface. Either way, by writing them down I'll both preserve those weeks and hopefully move them to a different part of my brain so that I can focus on the other aspects of his life.

About 2 weeks ago we took Knox in for a check-up. Two weeks prior to this appointment the doctor had felt the tumor and was concerned that the chemo was no longer working. We had increased his steroid by 50% and by all accounts he had a great two weeks. But, at the appointment on May 14 the tumor was still present and Knox had lost about 0.5 pounds, both were a concern. The doctor did not immediately check Knox's blood, which in hindsight we realize was a sign that he thought the end was near. Our routine had always been a blood check first to make sure his white blood cell count was OK. We decided to try a new chemo and had his blood count checked.

We gave Knox the new chemo on a Tuesday and he never really recovered. I not sure if the chemo was too strong or the tumor was growing too fast. Either way, he laid low and didn't eat much for the remainder of that week. By Saturday we had decided to call the vet and were feeding him canned tuna and chicken - anything to get him to eat. He had a great day that Sunday, so we didn't call the vet on Monday, assuming that maybe the nausea from the chemo had worn off. Unfortunately, Monday was not a good day, so I called on Tuesday. The vet prescribed an anti-nausea medication that we started immediately. It didn't do a bit of good. On Tuesday, Maureen, our nanny, was here, and she said he had good energy. He even leaped on her back, which was one of his old tricks. Despite the fact that this trick elicits shrieks from the receiver and deep claw marks, I was secretly overjoyed because it was an old habit we hadn't seen in a few weeks. Unfortunately, he still wasn't eating and seemed dangerously skinny.

I was home all day Thursday and he did not seem comfortable at all. He spent most of his time sort of hunched on all fours in the basement. I couldn't get him to eat and when he did he vomited. Thursday night Steve and I had a long talk about maybe this was the time. We did not want him to suffer. I had always told Knox to tell me when he was ready and I felt like he was giving us the signs. Steve decided to spend the night on the futon in the basement with Knox. It was one of the best decisions we've made because it gave them some very good quality time together. Knox cuddled up next to Steve's body and slept, a priceless gift. On Friday morning Steve and I confirmed that it was time. Knox was appearing listless.

I made the horrible call to the vet on Friday morning. They were kind and sympathetic. Our specialist vet was out so they recommended that we call our primary care vet, Dr. Dugan at Capital Cat Care. Dr. Dugan was also off, but they had other doctors on duty. I randomly chose Dr. Hernandez. The office was so very kind and worked with me to choose the right time. We considered having his put to sleep at home so that we could avoid the dreaded car ride that he hates. In the end we couldn't find a time that worked for everyone, so we decided to take Knox to their office at 4PM.

Knox, Graeme and I tried to spend some time outside. It was a gorgeous, sunny day. The kind of day Knox loved. We walked the familiar path Knox had created over the last few weeks. However, when we got to the far end of the courtyard Knox retreated under a pine tree and lay down. I knew this wasn't a good sign. We sat together for a while and then I took him home. That was his last walk. He spent the rest of the day on the ottoman, just lying on his side or on the back of our overstuffed chair, a favorite spot on one of Steve's fleece coats. He didn't sleep. I'm not sure if he was soaking us up as much as we were him, or if he was too uncomfortable. I tried to get him to drink some water, but didn't force any food on him.

Steve came home from work around 12:30. We put Graeme down for a nap and then just sat together in the living room with Knox, crying and hugging and talking. I cherish those last few hours. Maureen came over around 3PM to stay with Graeme. When it was time to leave we took Knox out to the patio where he just laid on the warm bricks. I brought Madison out to say good-bye. She sniffed him a few times and then rolled around on the bricks next to him. She knew. She's probably long known it was time.

Steve and I then drove over to Capital Cat Care. Knox was nervous on the car ride. He hates the car and we felt nauseous for putting him through one more ride. Steve was able to calm him and hold him for most of the ride. Once inside the office Knox started panting. He was hot, stressed and sick. After a few minutes of holding him and stroking his paw (something I always did in the mornings when he slept with us) he relaxed. We took care of the paperwork and then went into a room. Dr. Hernandez couldn't have been more kind and understanding. They weighed Knox and he was down to 8.15 pounds, a dangerously low weight. They explained the procedure and then took him to be sedated. I always hated when they took him for any kind of procedure. I would never let Graeme go for a procedure alone and I felt the same about Knox. But, I didn't protest. We heard Knox give a yell, his last cry, probably when they inserted the catheter. They then brought him back to us and Steve held him tightly. We were able to say good-bye. I whispered in his ear how much we loved him and would miss him and asked him to protect us. Whenever we left the house for a trip Steve would tell Knox to protect the house. It was fitting then for us to ask him to continue to protect us forever. He then took his last breath and his body relaxed peacefully into Steve's arms.

We were able to hold him and weep loudly for as long as we needed. I took a few clippings of his fur. One from behind his ears where the fur was the softest and one from his hind quarter with his distinctive markings. We then nuzzled him one last time before saying good-bye.

We are having him cremated so that he can always be with us.

Steve and I then held each other tightly and drove to our wedding site along the Potomac. It was a fitting place to spend some time. We talked about our wedding day and the last five years with Knox. It seems like such a fleeting time, but packed with so much love and laughter that I consider myself to be lucky to have this family.

Raw

It feels as though a layer has been peeled away and the protective coat that I carry around is missing. The trees seem greener, the air smells denser, the sounds are more intense, and I seem to notice the tiny ants moving across the sidewalk and the leaves moving to and fro in the wind. I suppose this is what happens when you are hit in the core. As painful as it feels some moments, it seems appropriate to be engaging all of my senses in ways that make them appear dormant on a "regular" day.

Knox Maguire September 3, 2001-May 25, 2007

It is with deep sadness that I report that Knox died today. At some point I'll write a fitting tribute, but right now I only feel sadness.

Knox has not been doing well for the last few weeks. His appetite has decreased, his energy level was low and he slowly stopped doing some of his favorite activities, such as playing mouse and getting massages. We've been cajoling him into eating and offering tuna and chicken, but about 4 days ago he stopped eating altogether. What few bites I did get into him he immediately vomited. While his energy was OK at times, on a whole he has not seemed well. Yesterday I spent the full day with him and he seemed uncomfortable. Steve and I had a long talk last night and decided that this might be the time. My heart told me it was, but I couldn't wrap my brain around it. Steve spent the night in the basement with Knox where he has spent much of the last week. Knox gave Steve a priceless gift of sleeping next to him like he used to. Today Graeme, Knox and I spent some time enjoying the beautiful weather, but when Knox retreated to a lay under a tree I knew this was the right decision. We were able to just be together as a family for the last few hours of Knox's life, time I treasure.

At 4PM Steve held Knox tightly and I whispered in his ear while he took his last breath.

It's time to say good-bye

We are saying good-bye to Knox today. It's time. Graeme and I are going to spend the day outside with him, doing what he loves best...sniffing the grass and enjoying the sun. I'm not sure how else to say good-bye to the most loving and patient animal I've ever met. Keep us in your thoughts, please.

The First Cut

I finally acquiesced to Steve's patient requests that we cut Graeme's hair. Graeme handled it like a champ, though he rightfully expressed some reservation with a stranger wielding scissors near his head. With the comfort of Daddy nearby he allowed Pat, the experienced barber at the local shop, work his magic and Graeme emerged looking like a little boy. I handled it surprisingly well. Frankly, he's the most adorable little boy I've ever seen, so how could I not love the cut? (The above images show before, during and after the cut.)

Visit with Grandpa Bill

My dad came for a visit last weekend, and Graeme was immediately smitten with him. We don't see my dad that often so I wasn't sure how Graeme would respond. I showed him pictures in advance and we talked about Grandpa Bill, and as soon as my dad walked in the door Graeme was excited. He proceeded to drag him around the house and neighborhood all weekend, demanding "Bill, sit", "Bill, read", "Bill, show". The latter means he wants you to turn on a TV show for him (sigh). It was a good visit. Dad and I saw Bodies: The Exhibition, a well-done exhibit of preserved human bodies. I had my own private biology lesson, as dad formerly taught high school biology (and yes, he was my biology teacher). Somehow viewing the human anatomy with my father was much less embarrassing at age 38 than it was at 16.

Our plans for November include...

...eating turkey, celebrating Steve's 41st birthday, and having a baby.

Knox Knews

We took Knox to the vet today for a check-up. If you recall, the doctor felt the tumor two weeks ago, we modified his medications a bit, and today's visit was to check on how Knox and the tumor are doing. The news wasn't as good as I had hoped. Knox has had a really good 2 weeks with minimal vomiting, so I anticipated that the tumor would have shrunk and we'd be given a go-ahead to wait another month before checking in again. Well, not only hasn't the tumor changed but Knox has also lost a noticeable amount of weight. He's down to 9.4 pounds. While the tumor hasn't increased in size, the weight loss adds a new worry. Knox's good week probably means the increased medication is making him feel better, but medically he isn't doing any better, and by some measures he's doing worse. To put some perspective on the weight, at peak health he weighed about 13 pounds and when he was diagnosed with lymphoma in late February he weighed 10.8 pounds.

We decided to try a new chemotherapy. These tumors are very aggressive and quickly become resistant to chemo. Starting tomorrow we will give him a new drug (can't remember the name and I'm too lazy to run upstairs to look at the label) that you administer orally every 3 weeks. He'll need to have blood draws every 10 days or so. This is a stronger drug and we need to make sure his blood counts don't go haywire. We, of course, are also concerned about the increased monitoring. Knox hates the car and today's ride felt particularly difficult with Knox getting very sick and then drooling profusely. Meanwhile Madison howled the entire time. Oh, and Madison has been vomiting lately too.

Today feels heavy. I'm sad, but enjoying Knox as much as possible. You really wouldn't know he's sick and that remains our focus.

Learning to discipline

We've reached a point with Graeme where I think it is in his best interest (and ours) to introduce discipline into our lives. I knew this wouldn't be my strong suit. Not because I don't believe in it, I do. But, if my experience parenting Knox and Madison provides any foreshadowing, I don't discipline well. Before we adopted the cats we vowed to keep them off the furniture and forbid any scratching. Anyone who has been to our house knows that is not uncommon to have a cat wander across the table mid-meal or sit on the counter while we cook. And, they regularly ignore my pleas to stop eating the plants or to stop clawing the caned chairs.

Like much of our parenting style, we don't really subscribe to any one philosophy which means that I lack guidance beyond my own intuition when it comes to disciplining Graeme. I thought a simple "no" would do the trick (ah, the experienced parents laugh yet again at my naivete). So, when Graeme was gouging the wood floors by dragging the gate across them repeatedly I found myself saying "no" with more force and volume than seemed necessary. (He doesn't have a hearing problem, as far as we know.) It wasn't long before I was yelling, and realized that this just isn't working. Prying his hands off the gate and removing him from the situation brought on a meltdown of epic proportions and it then took 20 minutes to restore order. By then we were both exhausted, and irritated. This incident with a different trigger - sometimes it was hitting mama, sometimes it was throwing a toy across the room - has led me to the realization that we need to try something different. As of today, I've instituted the 1 minute policy. When Graeme is doing something he shouldn't then I remove him or the object for one minute. When he starts hitting me he must get off my lap for 1 minute. When he throws a toy, I remove it for 1 minute. I figure that 1 minute is an eternity for him (and me when he's crying) and with consistency it will hopefully provide a meaningful enough consequence that he will cease the offensive behavior.

How's it working? Well, I've used my new tool twice and he protested loudly both times, but then sort of seemed to move on. Who knows if this will work? Like all of parenting I'm sure it will be a series of trials and errors. I hope to be able to report out on my successes soon...and if not, when my voice is hoarse you'll know that I've reverted back to the old standby - yelling.