Today Gus and I went to see Dr. Susanne Fariello, our vet. We have been working together for several months now to try to understand exactly what we could do for Gus, who has the dread megaesophagus, as the vets call it, to see what we could for him.

Suzanne – Dr.  Fariello –  has been a way for a month, and this meeting was an important summing up and review to decide if there was anything else we could do for Gus, and whether or not Maria and I are comfortable with the way in which we will have to live with him.

I was looking forward to the meeting, I was eager to tell Dr. Fariello about my experiments with food, muzzles, sitting upright, regurgitation vomiting the prognosis for Gus’s life with us.

The meeting was always a turning point in my mind, we would either commit to living with Gus and this disease, or we would pursue a different path – finding another home for him, trying extraordinary new measures, or even putting him down if we couldn’t live with the drama of the chronically ill dog and all of the emotional, financial and other baggage that comes with that.

Dr. Fariello weighed Gus, examined him thoroughly, looked into his eyes, felt his stomach, listened to a detailed account of my nutritional experiments, and the details of his frequent spit-ups, diarrhea, regurgitations and gagging on bile. Every time Gus eats anything but his regular food, he suffers for it.

I am especially grateful to her for helping Gus and guiding us through this stage of the disease. We both know she has done everything she could do, in as gracious and warm a way as possible. She respects us and the decisions we make, and has been helpful in teaching me so much about megaesophagus. We’re going to continue Gus’s monthly acupuncture treatments, they seem to help.

I told Dr. Fariello about stopping all of the medications and changing his diet several times. She was surprised and impressed. I said his stool was good, he had trouble gaining weight no matter how much he eat, and there seemed to be a great deal of acid reflux. But not as much vomiting and regurgitation as before, not nearly enough.

She said she thought we had done a great job.

Megaesophagus is a trouble-maker, it causes all kinds of pain and discomfort for dogs, quite often malnutrition, vomiting, stomach and digestive disorders,  and death. And he will eat absolutely anything he can find to eat.

We talked for over an hour, Dr. Fariello reviewed all of the records, performed some acupuncture,  and then came the discussion I was waiting for? So where are we know? What else can we do? Was this as far as we could go?

She sat across from me and looked me in the eye.

“I have this feeling,” I said ” both good and sad, “that this is as far as we can go? Is that right?”

She asked me if Maria and I could live with where we were now with Gus. Were we okay with it?

I said we were.

“Good,” she said, “because you took the words right out of my mouth. This is as good as it gets, ” she said.

We both agreed that we had tried everything we know to try. “I have nothing to offer you that you haven’t tried or done. There is no cure for megaesophagus, as you know. It is likely to get worse, and pneumonia and malnutrition are always a risk, and we have no tools to offer you or Gus.”

She didn’t have to repeat what she said before. Gus will not have full and healthy life. Once or twice a day, he spits up or gags. Once or twice a day, we clean it up. It is much better than before, and is stable for now.

I asked how much pain and suffering Gus was going to be feeling, and she said she didn’t know. With megaesophagus, dogs are often uncomfortable, Gus seems to be holding his own, but we don’t even know what causes the disease, let alone what can cure it.

I told her that Maria and I were in a place of love and acceptance with Gus, within limits. We weren’t going to devote our lives to caring for him, we would not accept interference with our work or way of life. We would not go into debt for him, or take him to expensive specialists.

We have already made a number of changes in our routine and our schedule, and Gus is adaptable and co-operative. Gus is a major presence in our home and life now, I can’t quite remember a time without him.

We do love him and are willing to accept the difficulties of the disease, and the challenges it presented to us, at least up to a point. I felt some sadness at this, for Gus’s sake. I know he is often uncomfortable, spitting up acidic matter so often. I can see it makes  him uncomfortable.

I am sorry he has a tough life a head of him. He is a good hearted, fun-loving guy.  I just think he deserved better as much as he loves life, but illness doesn’t only choose the unworthy.

Megaesophagus is not curable, there is no Disney ending ahead of us, no miracle cures on the horizon. Nor more magic nutritional potions. This is as good as it gets. This is the best we can do.

So it’s time to practice radical acceptance – this is life – and move ahead. This is no longer a crisis or emergency, This is now our life and his life. We embrace it and take responsibility for it. I am a fighter, and I hate to stand down. But we all need to do that at this point, I see that clearly.

And we will make the best of it. Gus has enriched our lives and taught me (Maria can speak for  herself) patience, love and acceptance of life as it is, not only as we would wish it to be.

Grace is about dealing with suffering and disappointment, I don’t seek a perfect life, I never asked for one, I don’t want one, it sounds empty and surreal to me.  I am not shocked by death and illness, my therapy work has taught me that much.

I love life in all of its richness and glory, ups and downs, heat and cold, light and dark. This is the foundation of a meaningful life. So, forward with Gus. This is as good as it gets, they say, but I have a hunch it may get better still, at least for awhile.