Monday, October 25, 2010
HOSPITAL, “THE ENDORPHINATOR” AND MORE TREATMENT
Welllll…..after my last post, I forgive myself for whining! Three days after posting that Blog, I found myself being admitted to Scripps Encinitas Hospital for what ended up being a 4 night “confinement.”
And now, it’s taken me SO long to update my blog, it seems like old news.
On the evening of Sunday, October 3rd, I found myself heading to the Emergency Room. I know I was feeling crummy, because I had my husband drive…I usually do ALL the driving. I had been feeling progressively worse throughout the day, and with an increasing fever, the on-call oncologist recommended I head in. I was given a CT scan, which revealed that my right lung was not functioning at all, and appeared to be surrounded or filled with fluid. I was scheduled for 2 procedures the next day: a bronchoscopy to look inside the lung, and a chest tube insertion to withdraw fluid. It was a LONG night, with my not being placed in a room until around 2 AM.
The bronchoscopy revealed nothing abnormal in the lung; all the fluid was in the pleural cavity (the pleura is a sheath that surrounds the lungs.) I’d already had the pleural cavity drained 4 times before, by a simpler procedure, called a thoracentesis. Normally, I could feel increasing pressure which told me I needed to get the fluid drained, but I hadn’t experienced that sensation this time. Within 2 hours of having the chest tube inserted, I noticed an improvement in my breathing and my energy. That night (Monday) I also had a transfusion because my hemoglobin measurement was low.
I credit the nurses with working with each other after my first night to coordinate the timing of IV hook-ups and changes with vital sign checks. I had many WONDERFUL nurses (RNs and LVNs), and then there was “Bad-attitude Anna,” who acted like everything she did was an imposition. I discovered that venting to my RN resulted in having me removed from Anna’s “care!” There is evidently no reason to put up with an LVN with an attitude!
Contrasting wonderfully with Anna was the staff member (nurse?), named Ben who wheeled me from emergency to my room on the 2nd floor. We conversed during the short (5 minute) trip through the halls and elevator, and he shared that he would be celebrating his birthday that evening, and that his wife would have a homemade carrot-cake, with homemade cream cheese frosting waiting for him at home. Of course, I commented on how wonderful that sounded…but little did I suspect that he would seek me out the next day to bring me a piece of his birthday cake! I think I made some of his co-workers jealous!
Another high point was a visit by a “Pet Ambassador,” an English Bulldog named “That One,” who was dressed up for Halloween as “The Endorphin-ator.” Isn’t he adorable!
As a result of my hospital stay, I got several “2nd opinions.” My right lung did not fully re-inflate after the fluid was removed, but that has evidently been the case after the prior thoracentesis procedures. My lung re-inflated by about 75%. This is sometimes called a trapped lung; the accumulation of fluid in the pleural space causes the lung to compress, and not re-expand, even after the fluid is removed. Four different doctors are still unable to come to a consensus as to the source of the blood I have been coughing up, since the fluid is building up in the area OUTSIDE the lung . Whatever the cause, surgery isn’t a reasonable investigative or corrective option, because I have active cancer.
The chest tube was removed Wednesday night 10/6, after draining about 1.8 liters from the right pleural space, with an understanding that the likelihood is high that the fluid will re-accumulate; it’s just a matter of when. I was told that if the pleural space refilled soon, I might consider having a semi-permanent pleural catheter (a PleureX catheter) installed, which would enable me to drain the fluid myself. Initially, one of my doctors indicated I needed to have it done before being discharged, but my thoracic surgeon fortunately recommended otherwise. This was something I need some time to digest and accept.
I was released Thursday afternoon, craving FRESH air, home-style cooking and undisturbed sleep.
Upon my discharge, I started keeping a daily log of my health, because I had noticed how hard it was to report on the chronology of symptoms based only on my memory. I felt wonderful and renewed for about a week. Unfortunately, within that time, I started observing that some of the symptoms were returning, starting with some wheezing and coughing (of blood.)
This past Thursday, two weeks after being discharged from the hospital, I had to have another liter of fluid drained from the pleural space. Fortunately, that fluid will be useful in determining the next line of treatment. A “cell block” spun from the fluid will be sent to a lab to look for tumor markers, which will enable a more targeted approach to my next chemo med. Not all patients with lung cancer exhibit the same tumor markers, and the presence of some markers indicates a stronger likelihood of response to specific chemo treatments.
I’ve spent all or part of the last 4 nights sleeping in the recliner. Last night, I was very discouraged; as the wheezing and fluid build-up was severe enough that I struggled to sleep even in the recliner…leaning against my back seems to exacerbate the problem. It’s almost a feeling of drowning in chest fluid, and the sound of fluid is audible to my husband next to me. I felt this sensation occasionally prior to going into the hospital. I finally managed to sleep for maybe 2 hours at a time (after midnight), going between the bed and the recliner. It wasn’t quite so bad on Friday, when I left a message for my oncologist, indicating I need to know who to direct my questions regarding the PleureX catheter. Unfortunately, he was out on Friday, and my symptoms worsened since then. So, the next step is to give another call to the oncologist’s office: I don’t want to wait until his usual late afternoon phone calls. I need to move ahead and get this fluid out so I can get some rest.
I wish the news was better, but I can manage to close on a humorous note. Those of you in my age group (and older) know that wearing reading glasses becomes an unfortunate necessity, as our arms get shorter and shorter (uh-huh.) It’s useful for some, including my husband, to have several pairs of glasses, as it makes it easier to find a pair when you need them. (uh-huh, yeah right…)
Well…it should work that way, but I don’t think a day goes by that I don’t hear my husband ask “where are my glasses” as he searches various rooms (in our very small house!) Unfortunately for him, he’s married to an easily amused and somewhat irreverent woman who embraces humor where it can be found. Look what I found in his office one day! I felt compelled to line them up for this snapshot, which I call “Where’s my Glasses?” (He wasn’t looking for them that day!)