Since before the actual discovery of the big C in my right lung, I’d been having some coughing, pain, and shortness of breath here and there. This is why we thought maybe I’d been walking around with a touch of pneumonia rather than with a dome sized lesion on the upper lobe of my right lung. The pain itself was bilateral for the most part, which lent itself even more to that theory.
After the surgery, I’d still been having those same symptoms. The PET scan showed fluid in the left lung (but all clear of any cancerous bits on the right, including a questionable lymph node near the trachea that the thoracic surgeon removed while removing the wedge fro the right lung). OK, we thought, a little fluid. That would jibe with what we figured, and would explain a lot. Another visit with the pulmonologist, amazingly set up very quickly for yesterday.
Now, I’m thinking, a touch of pneumonia. That means drugs, come back in 10 days after the cycle is complete. But as usual, it turned out to be far more complicated, given that I’m trying to squeeze more medical-related visits and procedures into these past five years than I’d ever had in all the previous years of my life combined. And I must say, that’s working out pretty well, so I have that going for me.
The pulmonologist thumped around on my back on both sides, and said you definitely have some fluid in there. I’d like to go ahead and drain it right now. This is not something I’ve ever had done before, so yet another brand new experience in dealing with cancer and all the assorted bullshit that goes with it. Fine, I say, we might as well get it over with. I figure it will be fairly quick.
To his credit, the doctor did warn me it might be painful as the fluid drained and the lung reexpanded. In addition, there was likely some inflammation in the lining, so as the fluid drained out, the inflamed tissue rubbing together would probably be very painful, at least for awhile.
The nurse brought in the tools – new word learned: thoracentesis! – along with a liter bottle and several test tubes. Keep in mind that a liter is just over a quart. This will be important later. They numbed up an area slightly below my left shoulder blade and a bit toward the spine, set a drape over me, and then….punched a hole in my back between a couple of ribs. Once into the fluid-filled area, they inserted a catheter, attached a tube, and started draining. I myself was sitting, leaning on a pillow over a table next to the exam table. Obviously I couldn’t see any of this going on. But boy, I felt it.
It’s a strange feeling to have liquid quite literally being pulled out of the body. From time to time I could feel bubbling as the fluid was outbound. It kept going on and on, and I really started to wonder: just how much fluid was he pulling out, anyway? To make things worse, the longer it went on, the more painful, internally, it became, and eventually, I was panting like a dog, and sweating profusely. The nurse brought in some cold towels, put one on my neck and started wiping my face down with another. At the point where I gasped, “I think I’m going to pass out.”, we went on for another minute or so, and then stopped. They pulled the catheter, slapped a bandage on, and when I sat up, the resulting pain was about as intense a pain I’ve ever felt. Combine that with an inability to breathe normally, and you have the makings of a panic attack, really.
Luckily, I told myself I wasn’t dying, and we managed to get me into a semi-reclined position to relax for a few minutes. It was then that I saw how much fluid they’d pulled out. The three test tubes were full, which I expected. What I did not expect was to see the entire liter bottle was also full, to the very top. Even if we hadn’t had to stop because of the pain, we’d had to have stopped because there was nothing else to hold more fluid.
The fluid was sent off to the lab, and I was sent off for a chest xray (which looked good – he said that was about 98% of the fluid, gone) and then a CT scan with contrast (for those of you who have been through this, you know that delightful feeling that you’re about to piss yourself that comes when they release the contrast into your system). The CT scan results we don’t have, but I have a followup appointment next week, at which point we’ll do another xray before talking to the doctor, to see where we stand.
The pain is still with me, although subsiding, slowly. The area where they punched a hole in my back is quite painful, but what can you expect after having a puncture wound deliberately introduced?
Today, a visit with the oncologist to go over the PET scan results with him, and to plot our course from here. That will likely just be a return to quarterly scans to make sure we’re still all clear.
Holy crap. (1) A human lung is smaller than a liter bottle, isn’t it? Or nearly? Are you keeping a magical wardrobe in there, just for holding fluid? (2) When I had my lumpectomy last year (which I feel like a jackass for whining about now) they gave me a local just to PUT IN THE FREAKING IV! The dentist numbs your entire head to fill a cavity. How can they impale your lung from the outside without some kind of painkiller?
Hey, we all have our whiny bits to get out. Besides, nothing that involves taking pieces of your body out of you is anything that doesn’t serve a measure of seriousness. Lately I feel like everything is (once again) revolving around crap floating around in my body that I absolutely should not have, and it’s both pissing me off and depressing me.
They did numb up my back with a local. It’s a weird thing, because he first numbed the dermis, then did a second shot through to just between the ribs. From there, he punched through the skin, between the ribs, and into the pleural space. That was kind of painful as he first punched through that last bit, but it was more painful as the glut of fluid drained out and the lung started expanding back into that space. As he explained it, this is due both to the expansion and also due to likely inflammation of the lining, so as the expansion occurs, you now have rubbing against that inflamed area. I swear, if I weren’t as old as I am, I’d go back to school and then head to medical school, because this stuff is quite fascinating. When it’s happening to someone else. Remarkably, the picture in this Wikipedia article is pretty much exactly how they had me set up, leaning over a table, with a tube sucking fluid out into a bottle. It’s kind of scary to read about the possible causes of the fluid (or worse, go to “pleural effusion” in Wikipedia to be even more frightened) building up, but having had a cough and pain before the surgery, then the surgery, albeit on the right and not the left side, Im expecting my medical mystery tour to continue when we go back on Tuesday for the results of the lab work on the fluid and the CT scan.
Oh, and typically, the capacity of the human lung is between 4-6 liters, with smaller people having smaller capacities, of course, and larger people tending to have more, just because they’re larger. It reminds me of something from high school. When I was in the band, and the jazz band, the latter group had the chance to have a session with the Navy’s jazz band, which was quite thrilling for us who were in that group. One of the trumpet players, while working with us, was talking about breathing control. For those of us who are (or were) brass players, he led us through various exercises, and then as we all gathered around, he said, in all seriousness, to a bunch of high schoolers, “Just remember, when you think you’re about to run out of air, you’re probably not. You’re always half tanked.” You can imagine how hilarious we found that to be. Looking at what I’ve learned now about the lungs, it’s clear he knew exactly what he was talking about, as most people do not use their full lung capacity. At the time, though, we laughed about that for months.