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!)

10 comments:

  1. Jeez Linda, only you could follow up all that wonderful???? news about the pleural fluid with a belly laugh.... or maybe it's just my age (and glasses). We have several pair and I should photograph Glen wearing his strongest glasses with a magnifier taped to a lens. Only my Goober!
    Do you like pumpkin pie?

    ReplyDelete
  2. Sandy,
    So far, I've had 3 responses (the other 2 by e-mail)...and one of those also includes a funny story about glasses.
    I'll bet Glen looks adorable with the magnifier lens.
    YES...I LOVE pumpkin pie! Funny, I always say I don't care much for sweets, but I do like pumpkin pie, and carrot cake, and pineapple upside down cake, and lemon meringue! I don't care for chocolate, tho'!

    ReplyDelete
  3. I'm so glad to hear from you, LInda! Love the bulldog, BTW, he probably looks a lot like that mean nurse. Wait! Is he that mean nurse? I can't imagine what it must have taken out of you to write all that you have, I find just commenting on blogs a chore sometimes. Maybe that's cus I need to push my nose up against the monitor to see what I've written. My arms are getting shorter too. MUCH MUCH shorter. Take your time, girlfriend, don't try to do too much. (Well, THAT was dumb. Of course you know what you can and can't do.) Love you,
    Electra

    ReplyDelete
  4. I love lemon meringue too. When I was in college, I use to have a heart-of-lettuce salad every day in the cafeteria, and lemon meringue pie for desert. Years later I became a vegan and so I haven't had a piece in 30 years or so! I remember exactly how good it tasted tho. Mmmmmm!
    I use to take care of my neighbor, Mae until she died at 94. I did all her food shopping, which included LOTS of chocolate cake, chocolate candy and chocolate ice cream. I was so jealous! What I learned tho, was that I too, at 94 will be able to say "SCREW IT", and eat MY lemon meringue, and anything else I damn well please. Mae died eating her chocolate cake with a smile on her face. Thats how I want to enter heaven, with the taste of lemon meringue in my mouth. Mmmmmm!
    Oh- and I'm guilty of the glasses chaos as well. It drives my husband crazy when I'm wandering aimlessly thru every room of our (big) house futilely searching for eyes. It's such a waste of time and energy. I stubbornly refuse to succumb to the chain-around-my-neck thing. It's a stupid pride thing. That would mean I'm old. sigh...
    My visual of Glen's silly glasses set-up, gave me an idea tho. The jewelers use a cool head band thingy that has a magnifying lens on it that just flips down to the eyes, then up to the top of the head!! Now that sounds quite attractive, don't you think??? Hugs, Sunny

    ReplyDelete
  5. Electra,
    Don't insult the bull-dog, he was much more adorable than the mean nurse!

    Yup, I went WAY overboard when I typed the original blog (shortly after hospital-discharge), *then things changed, so the blog changed*--repeat between * and * a few times! In fact, something else changed about the time I "finalized" the blog...and I didn't bother adding it: I'm going in today to have the PleureX catheter installed. I'm hoping it gives me more constant relief!
    thanks for checking in, sweetie!

    ReplyDelete
  6. By the way-the best way to handle a mean LVN is to pee your bed. She may be pissed but she'll get the idea that you're in control :-).

    Your desk needs dusting...

    Love,
    Lindy

    ReplyDelete
  7. Lindy...YOU nailed it!

    I should have contacted you when I was dealing with Anna. One of my issues with her was that she was the ONLY nurse unwilling to take me the few steps around the corner to my private bathroom. (I had a private room and restroom.)

    (It meant she would have to take my IV line and pleural fluid collection device.) I had NO problems walking, I just needed help with my lines!

    She told me I had to use the commode in my room. The first time I had to do that was with an uncurtained window behind my bare butt…at night!

    The next AM, when I had to defecate, I told her I refused to use the commode for that, so she took me to my rest-room. After that, I figured I’d just tell her I had to defecate EVERY TIME.

    That helped me get my way, but it wasn’t nearly as pleasurable in conveying the message as your recommendation!!
    Ah, I do love you!
    Linda

    ReplyDelete
  8. Is it wrong of me to want to hunt down Anna and make her life miserable?

    ReplyDelete
  9. Aw, sis...thanks for being protective! No need to make Anna's life miserable, she seems to be doing a pretty thorough job of that herself.

    ReplyDelete
  10. ahhaaahhaaa, how did Tim's glasses end up in Clark's office???
    Aaah, Linda-my friend, thank you for taking the time to share with us what is happening. We want to know and, more importantly, we want to know what we can do for you.
    P.S. Thank goodness there were no pix of "behinds" in your blogs because you know "sweetheart" would have been motivated to share his!

    ReplyDelete

Please post your kind, considerate and thoughtful comments here.