After a few days we felt confident enough to leave Minneapolis and head to Renée’s parents in Tennessee. A very, very long drive. Not ideal, but we couldn’t stay in a hotel forever no matter how nice it is – and the Canopy is very nice.
On the drive from Montauk (on the east coast just outside New York) to here, we loaded all our luggage in the back seats of the truck, partly as it was snowing heavily, and partly so it did not get stolen should we stop to sleep, or looted at the traffic lights as we navigated the Bronx (maybe I have watched too many movies?). This time I loaded the truck bed with our luggage and created an elevated bed on the rear seats for Alfred so he could see us in the front, and see out the windows. If I were 20lbs I’d have been happy back there.
Alfred has become a good traveller. He’s not keen on being on the road for long hours as it must be boring for him. Boston Terriers are very active dogs, also intelligent so they need things to do, however being in the USA he has already worked out long road trips mean fast food pit-stops. Food is the currency of all dogs, and he is clearly equating the truck with those. We have also been telling him we are going to see ‘Nanna and Papa’; he knows who they are and his head tilts every time we tell him.
Thankfully there were two of us to share the driving as it’s hard doing a 1,000 mile slog. Trying to align medication, food, fuel, toileting (human and dog), and driver swaps is key to a 15-hour drive not becoming a 20-hour nightmare. Our plan worked.
It was dark when we pulled up at the house at the foot of the Great Smoky Mountains. I turned off the engine and Alfred where we were. More head tilting and looking. I lifted him down from the truck and let him find the voice of Papa. Within 30 seconds he was jumping and dancing in delight at being reunited with his old friend last seen in London. An old friend whom he shares a passion for deli meat with.
Soon Alfred would discover more wonders; dogs are allowed in Home Depot and I’m sure he thinks that’s where I have been whenever he has waited in the car outside a supermarket. And Tennessee is a good place to be a dog with trees and wildlife everywhere. I keep seeing chipmunks, squirrels and deer in the garden here and Alfred is on their scent. I think the chipmunk has worked out he can’t see all that well and seems to be pushing his luck.
Tennessee would be our base for a while. Punctuated with a trip to Florida. We have a highly recommended vet here; Dr Stephanie Myres of the Lenoir City Animal Clinic. Stephanie has a Boston of her own called Annie. It is here where Alfred would receive his all important peptide and immunotherapy shots. Removing the tumour alone is not enough, a small part of it remained behind from the difficult surgery (around 3%) and gliomas are notorious for rapid regrowth. This is where the immunotherapy is targeted – a vaccine based on the cells of the actual tumour and designed to attack the cancer. The team at the University of Minnesota put together a detailed schedule for what shots happen when and shipped the treatment on dry ice to Lenoir City Animal Clinic, who then put it in the fridge ready for the months ahead.
The treatment, delivered by injections to the back of the neck, began weekly. Thursdays were peptide injection day (this part of the treatment wakes up the immune cell responses) and then on Fridays we returned for the immunotherapy injections (our main weapon against the tumour).
Despite this type of medicine being cutting edge, It all seems pretty easy. Alfred was a bit quiet on Fridays, no doubt feeling the effects of the immunotherapy vaccine in much the same way someone who gets a flu jab might feel off for a day or two. His neck was shaved and two targets drawn on with a Sharpie. This continued for some weeks before dropping to bi-weekly and then monthly visits. One of the times we pulled up outside, I opened the car door and he excitedly jumped out, only to realise we were at the vet, turn around and jump straight back in, pushing himself right into the corner at the back of the car. He probably didn’t appreciate how hard I was laughing.
Mid-way through the four month treatment schedule we received word from Dr Liz; she was not happy with some early data points on the latest version of the treatment Alfred was assigned. It appeared the combination of peptide and immunotherapy was not as effective as the previous one so the team in Minneapolis sent a revised pack out to the vet here. It is worrying to think his chances perhaps less after all this, but comforting to know Dr Liz had made the call to change mid-treatment. It is clear Alfred is more than a subject in this trial, and his wellbeing just as important as the data.
As the weeks and months pass, Alfred looks better and better. His scar now almost invisible, his vision in his right eye seems making small improvement. He is a riot of energy and fun. He came with us on a trip to see our new house in Florida, something back in January we never imagined he’d make. The enclosed garden we put at the top of our priority list for our new place; above a decent kitchen, and well before a garage (which for a serial car buyer is a big thing), is maybe not as perfect for Alfred as we thought. He spotted the ‘big bath’ in the centre of it and seems wary. He likes going for a walk around the neighbourhood with me, and is proving a big hit at the drive-thru morning coffee and croissant run. He likes the beach a lot. We sorted out a new car while in Miami too so we can ditch the Jeep Gladiator we have had since we arrived in February. Not that I don’t like it, just the opposite, it has been perfect.
Soon it was time for me to leave back for London. Alfred and Renée would remain here. We could have all returned and shipped the treatment on dry ice with us, and this was our original plan, but some of the circumstances changed and it now seems better to be in the same country as his medical team in Minneapolis and Knoxville. I was also mindful that should Alfred return to the UK, getting him back out would not be easy if the pandemic restrictions remain in place.
Leaving him was hard for me as I’m unsure how long he will live – his life may have been extended by four months, or he may have a year or two ahead. The risk of leaving being I may not be with him when his time ends, however my hope is we will have years together, and he certainly looks healthy right now. And I have pressing family and business issues back home, most important of all my mother who suffered a stroke around the same time Alfred became ill and has been in hospital ever since – with visitors banned due to the pandemic and our only contact via Zoom calls. She has just been approved to go home after over three months so I am keen to see her. I don’t want to get political, but I can’t help question the handling of the pandemic and the quality of those making decisions for us all; the impact they have had on our health, wealth and freedom. I’ve been lucky but many, many others have lost loved ones without being allowed to even say goodbye.
The next big checkpoint for Alfred will be on July the 6th when we will return to the University of Minnesota for an MRI four months after surgery. He has remained seizure free since surgery in early March, and unless he starts to show signs of change before then (as in seizures) the imaging is really the only way to gauge what is going on inside his brain. Renée and Alfred dropped me and my bag at Tyson Mcghee Airport and I flew back to London. No private jet this time. But a lot less stress knowing Alfred was doing OK. He’s in the very best of hands with Renée, and her parents. He might be fat when I return but he’ll be happy