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Lung surgery: a huge process, still ongoing

| greenboat

Wow — thanks to all my family and friends who’ve continued reaching out to me through this whole process! The good and healing intentions — and love — are like a pool of healing light.

It’s going to take me a while to pull my thoughts together on this one. I had surgery on Thursday 1/17/19. It was initially scheduled for 5:30 AM, then for 7:30, then (according to the surgeon) 9:30, and then, according to his office, 7:30. The actual time was something like 1:30–2:00 PM. Lots of time to sit around in a hospital gown, sipping from ice chips (“nothing by mouth after midnight”), Sweetie at my side. At one point. we considered going home — 1.5 miles away — for awhile, but there was a major snowstorm brewing, and it seemed best to stay where we were.

I had the same anesthesiologist as the for the previous lymph node procedure — so surprised he recognised me! — and  I was glad. He seems competent, informative and connected. So it was a breathing treatment, and other fol-de-rol, and then I was kissing Sweetie g’bye and sailing off to the OR. That last — and the fact that I don’t actually remember entering the OR (the doors opening on the bright white room, and…) that makes me think he might have started the happy juice a little early, due to my high BP. Or simply kindness.

And kindness was the word of the next few days. The pain control was well done — I had an “as needed” (every 15 minutes) fentanyl IV button, as well as, I assume, a trickle of whatever else to keep the overall pain down to a dull roar. There was no lack of pain — the incision was between my ribs, roughly from scapula to sternum — and they had spread the ribs to get at the lung and remove and the whole upper lobe. But all of the follow-up medical staff — who each introduced themselves in soft voices, as they came in to do whatever they had to do — were skilled and gentle, and were focused on my comfort as well as my health. I know I was damned cranky on at least a couple of occasions, but they remained kind and patient.

I’ve never been in an intensive care unit before, and I was there for five days. All my needs were taken care of, often before I realized them, and every request filled as best as possible. Everyone from the janitor to the dietitian to the nurses, the nursing aides, the pulmonary technicians — everyone who entered my room — was quiet, kind, and helpful. (The food was awful, but…)

Meanwhile, outdoors was a record-breaking stowstorm. I was insulated in all possible ways, and Sweetie made his way to my side every single day, bringing me home-made bread, flowers, love, kindness, and his presence.

On my last morning, they moved me from ICU to another unit for a couple of hours before discharge, and it was there that my surgeon removed the tube that drained my chest cavity. “This will only hurt a little…” “YEEEEAHHHHOOOOWWWWW!” Goddamn. He’s a fine surgeon, but “gentle” is not a descriptor I’d use for him.

I’ve been home for a little over a week now, and things are getting better. The pain is abating, bit by bit, and Sweetie and I are learning how to communicate about what we both need in this situation. It’s been an adjustment, but “kindness” is an understatement for his commitment. I’m still really, really short of breath, and out-of-it due to the heavy-duty pain drugs. I sleep a lot. Next week I have a follow-up with the oncologist, and then with the surgeon’s NP (hoping she’ll remove the staples!).

And an upcoming show to paint for! Hopefully I’ll get my website calendar fixed in time.

And my dad is home from several days in the other hospital, with pneumonia and subsidiary problems. So glad he’s better!

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Big day done, bigger day coming up

| greenboat

I was so dreading the chemical stress test! My late mother said she’d rather die than go through another one. And it was highly unpleasant… but only for about five minutes or so. I expect that Mother’s heart was in much worse shape than mine, when she went through it. I had no chest pain, no severe panic, or effects other than breathlessness and a very uncomfortable (full? hot? cold? Hard to describe) feeling in my muscles. There was an echocardiogram first, then another imaging involving a radioactive substance via IV and a camera that circled my upper abdomen. The tech had no name for the type of imaging when I asked. Then the chemical stressor was injected through the IV. I was already hooked up for an EKG, along with blood pressure monitor (BP very high, as usual for me in a medical setting) and then there was imaging again 20 minutes later. Before the last imaging, they gave me a cup of black coffee — my choice of caffeine source — which seemed counter-intuitive to me, but which they assured me would help my blood vessels readjust and make me feel better. True. Nice that they also brought Sweetie a cup of coffee in the waiting room. He’s always there with and for me.

The administering physician asked me about my cancer and the circumstances, and opined that I was very fortunate that my adenocarcinoma had been caught at stage 3 — that often they go to stage 4 before discovery: too late, really, for treatment. (Many thanks again to my pulmonologist!) She wished me well in the surgery, and from that I’d gather that the test results were good. I get the official results in a couple of days.

When we got home I immediately took a long nap, then had some lunch and called my dad (who is doing well at home), and took another long nap.

So: I’m scheduled for major lung surgery – a lobectomy, removal of the upper lobe of my right lung – on Thursday 1/17. My oncologist thinks that there is likely little or no malignancy left in the mass in that lobe: mostly dead tissue which shouldn’t be left there.

Surgery will be way too early in the morning, and I’ll be in the hospital for 3-4 days afterwards, then recovering at home for a month or two. If all goes well, I’ll then be cancer-free.

And my show with Chuck Haupt at Cooperative Gallery 213 is coming up in March!

Final stage of healing… a big step

| greenboat

We saw the oncologist on Christmas Eve, and the surgeon’s NP on Boxing Day. The consensus is that it’s time for a lobectomy — surgery to remove the upper lobe of my right lung, where the cancer has been. The oncologist thinks there may be little or no cancer left there after the chemotherapy — possibly just dead tissue — and since it’s been proven, over time, that there are no outlying cancers, it’s time for surgery to remove what was there. The tissue/tumor is too large for radiation, he says, but contained enough to remove. And it should eventually improve my breathing capacity. (So tired of being short of breath!) Scary stuff, but successful surgery should leave me cancer free, and the remaining two lobes should expand into the cavity to give me greater lung capacity again.

The surgeon (the one who did my lymph node biopsy, highly recommended by the oncologist) is off for the holiday week, so I can’t be sure of the procedure or schedule until I talk to him on or after January 2, but the oncologist believes access to the lung will be through the ribs rather than a cracked sternum, and it will entail 3-5 days in the hospital afterwards and a 4-month recovery. Looks to me like the soonest I can get into surgery will be mid-January (after my Jan. 10 cardiac work-up, fingers crossed I pass that), and I have a show at Cooperative Gallery 213 scheduled for the month of March. Pretty close. I will probably need help hanging that, or worst case, may need to find an artist-friend who can take my place.

So until surgery I’m going to be painting like crazy — and maybe matting and framing as well — for the show titled “Other Times, Other Places,” with co-exhibitor Chuck Haupt.

Meanwhile, my 89-year-old dad is in the hospital with either an infection in a surgical site, or a gouty arthritis post-surgical outbreak, or both, following carpal tunnel surgery. Hope to see him tomorrow. It was so good to have him — and two brothers, a sister-in-law, and a nephew and SO — here for Christmas Day.

More good news

| greenboat

We met with the surgeon on Wednesday, December 5. Sure enough, he was a bit off-putting at first — interrupting, not seeming to listen much — but by the time the consult was done, Sweetie and I decided he was a really interesting (and forceful!) character, and a trustworthy doctor. He was generously forthcoming with information, and cautiously optimistic about the outcome on the enlarged lymph node. (Also, unexpectedly and gently sympathetic about my tubal pregnancies in the 1980s — I’ve never experienced that with any other physician.) Biopsy surgery was set for the following Monday. Pre-surgical testing took up most of that Friday. On Monday morning I had a slightly sore throat, and we overslept a bit, but it was on with the show .

Wilson is not my favorite of the local/regional hospitals, but that’s where the surgeon practices. Pre-surgery, I felt well cared for by the nurses and the anestheseologist.  Sweetie stayed by me as long as he was allowed, and I was so glad to have him there. The procedure was pretty grisly — he made a 2″ cut in my neck, center-front, just over the collar bones, and inserted camera and sampler behind my sternum, down to the lymph node, took samples, then pulled everything out, and glued and bandaged my neck back together. Luckily it was under general anesthesia. They sent me home the same afternoon. The bruising and glue at the wound are pretty ugly (I took the bandage off on Thursday, as instructed), but I had pain for only a couple of days. I also came down with a bad cold on Tuesday.

BUT — there was no cancer in the lymph node!

Had there been cancer, surgery wouldn’t be an option. That means my oncologist and I have to come to a decision about whether I should have lung surgery (a really major undertaking) or continue some form of chemotherapy with radiation. The surgeon seems to favor surgery (no surprise, right?) but wants a cardiac work-up first, since I’m overweight and have a long family history of serious heart problems. He referred me to a cardiologist in his practice, who we’ve already seen… and who I don’t care for at all. But on with the testing — if it turns out that I do need a cardiologist in the future, it won’t be this guy.

I see my oncologist on Christmas Eve.

Next steps in the healing process

| greenboat

I saw my pulmonologist — the physician who found my cancer in the first place — on November 12, and he was upbeat. Delighted to see the report of the benign ovarian tumor, and pleased with the CPAP reports. My oncologist — with whom he’d gotten me the first appointment — is, he said, “the very best,” and he’s optimistic about my outcome. Thanks to my sweetie’s reminder, I thanked him for finding my lung cancer in the first place, with an aggressive series of tests.

Following a CT scan last week, I saw my oncologist three days ago — there’s no BAD news. Nothing has gotten worse… or better. He wants me to get a biopsy of the enlarged lymph node in my chest, to see if it’s malignant. Statistically, chances are that it is. But he’s hopeful that it’s not, because, as he said, “so far we’ve found that you’re not as sick as we thought you were.” (However, I’m still considered Stage 3.)

The thoracic surgeon’s office called yesterday with a schedule for a consult on the biopsy procedure — that will be the fifth of December, next week. I’d initially seen a surgeon in the same office — a physician both my husband and I felt good about — but he’s since left town to be closer to family in California. So I’ll be seeing a highly experienced physician my oncologist greatly respects, though he has some misgivings about the man’s personality — “people either love him or don’t.” We have yet to schedule the actual biopsy — an outpatient procedure done under general anesthesia. Beyond that, we’re most likely looking at modified chemo, plus radiation. Lung surgery is a possibility, down the road, but the oncologist isn’t sure at this point that it would be useful.

If the surgeon doesn’t seem helpful, we’ll seek a second opinion.

And meanwhile, I’ve pulled my lower back, twisting and bending in a bad way. Treating the spasms with capsaicin and naproxen — I surely wish my acupuncturist hadn’t left town!

Waiting to heal

| greenboat

So there were no malignancies found during my abdominal surgery — such a relief! — and now, not quite three weeks out, the laparoscopic incisions are healing. I’ve had a post-op check-up with the gynecological oncologist in Syracuse (hardly worth the 60-mile trip — she barely looked at my surgical sites, didn’t even touch me, just chatted about what she did and didn’t find during surgery — but she did have admiring words to say about my oncologist here) and a consultation with my Binghamton oncologist. I’ll be having a CT scan on the 20th, to see what’s happening with the lung tumor, and then he’ll come up with a plan for further treatment, depending on what the scan shows. There are a couple of possible paths: extended modified chemo, radiation, lung surgery, or a combination of all or some of those. Meanwhile, I tire easily (as always, these days!) and my cough seems to have worsened. Trying to push myself a bit — I am SO fat and out of shape — but also give myself time to heal from the surgery; the official timeline is six weeks. And I still ache internally. It’s a fine line to tread. Am I being lazy, wise, or self-indulgent? So hard to tell.

Silver linings

| greenboat

“I understand you had an adventure yesterday,” my brother said when he called this evening. Why yes, I did. Sweetie and I made an early-morning road trip to Crouse Memorial Hospital in Syracuse, and I had laparoscopic surgery — a hysterectomy and an oophorectomy (uterus and ovary), and a look-see at my lower bowel.

The good news: NO malignancies, and nothing to be seen on the bowel (it seems the PET-scan anomaly was simply an anomaly — a scan artifact). No large incision. No long-term stay dilemma for Sweetie. What this means: no bowel re-sectioning, no ovarian cancer, no metastasis of the lung cancer. All good news!

As I understand it, this means a possibility of surgery for the lung tumor since it isn’t wide-spread. Or, alternatively, long term chemotherapy. But first, we wait. Six weeks before any chemo, and a shorter time for recovery from the surgery itself.

…and forward.

| greenboat

So it seems I’ve finished (for now) with chemotherapy. Today I saw a gynecological oncologist in Syracuse for the hot-spot in/around my left half-ovary, and she’s scheduled me for surgery this coming Thursday, October 18. Yikes! There’s also a CT- and PET-scan anomaly in my lower bowel which will be evaluated — and perhaps surgically removed — then. She’s bringing in another surgeon for that part.

How long will I be under anesthesia and on the table? We don’t know yet. And how long will I be in the hospital at Crouse? We don’t know that yet either. Not do we know where my sweetie will be staying for all of this. But he insisted we bring CDs and reports of all the latest tests from Lourdes — although Broome Oncology had sent my records — and that helped. I’d had a CT-scan since those records had been sent.

Last night we had a mini-vacation at the Genesee Grande Hotel — around the corner from the doctor’s office building and Crouse Hospital — which was a bit difficult and disappointing, but altogether relaxing.

So, the results of my appointment:

We do know that I’ll be having a complete hysterectomy — whatever is left from my two tubal pregnancies in the mid-eighties — and that everything will be evaluated for malignancy and/or not. The results will point toward future treatment and/or surgery for my lung cancer.

We also know that the ovarian cyst and tumor didn’t respond to the chemotherapy I’ve gone through — which would also have been appropriate for ovarian cancer — so there’s a likelihood it’s neither ovarian cancer not a metastasis of the lung cancer.

Well, yeah — it still sucks. we may not be traveling south for my sweetie’s 72nd birthday on October 24 (bummer!). And we surely can’t host my family’s Thanksgiving this year, which we’ve enjoyed in several years past.

As a procrastinator, I’m inclined to drag my feet… but I suppose this suddenness is to the good (or so I’m told). But still… yikes.

Not so hot, thanks, but getting there

| greenboat

I’m going to post this blog on Facebook and to my email list, in hopes that my friends will sign up to follow my blog, and keep up with my healing process. It’s going to be a longer haul than I’d hoped.

Once more with the lung cancer. Just now I’m emerging from the misery of the  chemotherapy treatment last Wednesday, so I’m feeling hopeful again.

I’ve gone through five sessions of chemotherapy, every three weeks, and my lung tumor has stabilized — but is nowhere near gone. Every chemo session seems to be worse than the last, in terms of nasty side effects. I do still have my hair, though.

For those of you just now being acquainted with my illness, in June I was diagnosed with adenocarcinoma of the lung, thanks to an alert pulmonologist I was seeing for my sleep apnea and asthma. Also visible on the PET scan that confirmed my lung tumor was questionable activity in my left half-ovary (all I have, thanks to a couple of tubal pregnancies in the 1980s). My oncologist felt it important to treat the lung cancer first, with chemotherapy rather than surgery. A blood test he ordered showed that the ovarian activity was very likely (but not absolutely) not ovarian cancer. It could be a metastasis of the lung cancer, or unusual but benign activity. In any case, the chemo treatment protocol they’re using for the lung cancer would be useful on an ovarian cancer as well.

But here I am, at a medical standstill until I see a gynecological oncologist in Syracuse (60 miles up the road) in two weeks. She will most likely remove the ovary for biopsy, and will also check on a suspicious spot on my intestines nearby, shown by the latest CT scan. First I’ll have an ultrasound (what’s this, the third?) and a consult. A week later I’ll have a sixth chemo session, and we’ll see where we go from there depending on the OB/GYN’s recommendation.