Thursday, March 18, 2010

All the Gory Details

I met with Dr. Daniels today, the cardio-thorasic surgeon.  I like him.
Kirsteen says he’s good-looking too.

The basic situation:  The lower lobe of my left lung has been deflated and shriveled for two years; this because of a tumor blocking/constricting the bronchial tube leading to it.  Dr. Daniels thinks the tumor is wrapped around the bronchial tube and constricting it, rather than growing on the inside and blocking it.  Irregardless, the shriveled lobe creates a space in the plural cavity which allows fluid to build up. (Secretions from the cancer cells, ick.)  It was constant at about a liter for a long time, but lately has increased...maybe double that.  All this fluid would normally drain into the lymphatic system, but I'm overloading it.  There's also a lot pressure inside my chest which makes me short of breath and pushes on my rib cage, esophagus, etc. causing everything from minor shoulder pain to acid reflux.

As I mentioned, they've dealt with this fluid, called a plural effusion, before; by sticking a giant needle through my back (with a local, thank you).  It looks like beer...seriously.  Pilsner is the specific shade they like to see.  I suppose it's because I'm living too damn long that they decided to deal with the effusion more definitively.

The plan is to put me to sleep, put me on a respirator and shut down my left lung.  They’ll make a small incision in my side, go into the plural cavity and drain all the fluid…then they’ll stick a camera on a tube in there.  They’ll probably stick a second one down my throat to look at the lung from the inside; see what that bronchial tube looks like.  Then they’ll try to re-inflate the lower lobe of my lung...pump air in just like a balloon. Whether or not they can determines what happens next.

If they can re-inflate the lung sufficiently, they’ll put some talc in there (yes, the mineral) which will cause inflammation of the plural linings of both my lung and my chest wall, causing them to stick together.  That would close up most of the space and, for various reasons, prevent both the buildup and production of fluid.  I’d have a drain in me for a few days afterward.

If they can’t re-inflate the lung, then they leave a drain in me…coming out my side where the incision will be.  I would have to periodically “tap” myself with a vacuum bottle. (Anybody care for a pint?)  If I’m producing a lot of fluid, it could start out a few times a week but it should diminish with time.  Dr. Daniels also said that keeping the cavity clear of fluid could help to re-inflate the lung over time and/or encourage my body to stop producing the fluid.

Either way I'll be in the hospital for a few days with a couple of weeks to recover.  Dr. Daniels didn’t feel there was a rush to get it done but I’m pretty uncomfortable (not in pain per se) and get out of breath really easily, so I asked to do it as soon as we could…perhaps next week.

I think I feel a little better knowing the plan.  Been freaking out a bit lately.

1 comment:

  1. Sounds like a good plan. You're in our thoughts all the time. Andy & Kay