Ella was diagnosed with Syringomyelia and taught me more in her short life about how to live life to the fullest, love with all your heart, and learn from each other.
Tuesday, September 7, 2010
Ella Update. New Decisions
I met with Ella's neurologist today to go over her recent MRI results and to talk about what to do for her future. Before meeting with him, i wanted to get as much information as possible. I posted on forums and asked if they could offer me any insite. When people first learn their dog has SM, they want to know what to do. Surgery/medical management. I have people contact me about Ella and ask what they should do. I have always said that the decision is really only something they can make. You can not compare each dog because it is so different with each dog.
I wanted information and i know that the decision will ultimately be up to me. I would like to say that even with Ella's surgery not giving the results that i had hoped for, i would not change it. The reason i decided to have surgery was because i felt her SM was progressing fast and she was medication seemed to not help. Today i know i was right. Even with surgery which initially released the pressure and allowed for the csf fluid to flow and with several medications, Ella did not improve. In fact she is worse than she was before. If i did not have the surgery would she even be with me now? I dont think so.
Ella having the MRI proved what i had been fearing and even though it was not good, i have the information that many people do not. I needed this because of Ella's progression. There are many things i learned today and one thing is how i have said many times the variations with each dog. One thing i wanted to ask about was the size of her syrinx which i had learned had increased in size. There is hope that surgery will reduce the size but in Ella's case it grew from .35 to .53. That is a pretty big difference in such a short period of time.
My question to Dr. Brofman was that i have read studies with dogs with larger syrinx size and even Ella has a friend with a syrinx .9 (who just had surgery) but Ella seemed much different. He told me they have determined that it is not the size that is as much a factor but the location. Ella's is located at the top and at the worse place. He said this is why she can show different symptoms.
I knew progression was bad, location bad, medication not doing what it should so i asked about alternative therapy. I actually learned a lot about this from a couple of people but he said that this is not a solution. I would like to point out that it was not because he does not believe in it because he actiually will give Ella accupuncture, but Ella really needs something more.
He talked about another surgery that would be done to remove the scar tissue that is blocking the CSF flow. He said the risk would be if the the scar tissue has attached which he will not know until surgery. If that is the case he would have to carefully scrape or remove each tissue. This is where risk comes in. it could cause complications that result in perminant neurological damage. It is not a given and i asked what the odds were and he said that there could be swelling, hemeraging, but he could say it was not as much as i feared.
He would put in a bone cement to cover the space that was removed to help prevent scar tissue to develop again.
We briefly mentioned shunting which he said he would not consider.
So this is where my story is different. Many people dont know at first how their dog will react to medication. They dont know if it will even progress. I could say i am unlucky and wish Ella was like a lot of the others, but i am actually very lucky that i got the MRI because i know a lot of things that make it clear how fast this is for her and even with the subtle signs, i fear where she would be a month or months later.
Ella's neurologist is going to work with me and if i do decide on surgery, he will keep the cost as low as possible since he knows my financial situation.
I just found out all this information today and i would tell anyone who is going to make a serious decision to really think about it. I know i can not do nothing and watch her get worse and suffer more pain. Putting her through the risk of surgery is scary and i have to figure out is it the best thing for her.
Someone in my family said no one would blame you if you let her go. I know how much it put you through and how hard it was. It was shocking because the only thing that concerned me was not what it would put me through, but what it would put Ella through. Am i going to do this for her or for me? If she was old and not have the life i see in her would be one thing. It would be selfish to keep a dog barely alive just because i could not let her go.
Ella has a lot of life, love and so much to give. How in the world could i watch that slip away. I did put my life on hold and it has been tough on me, but looking at her and seeing her smile makes everything worth it. She saved my life. I am not going to give up. I am going to do everything i can (no matter if it is hard) for her. She is the most important thing and i care about her more than anything else