Not a really good week

Well....Wednesday didn't bring very good news. Dr Henderson met me first after my MRI. The current MRI shows that I still have several significant lesions in my brain - all are still very small; but, they're still there and some appear active. He will need to compare this MRI to the one from Feb to determine if any are new. He will then determine if we have any treatment options.

Then, Dr Birdas (a thorasic surgeon) came in to see me about possible surgery. It seems that the docs think the fluid in my right lung is cancer-related rather than a cold. He explained a couple options and I indicated the one that I would prefer.

Einhorn has taken me off the Tarceva because he doesn't feel it is helping. I start an IV chemo - alimta - in 3 weeks.

They also took me off the lovenox (blood thinner) because I apparently have surgery tomorrow and because the clot in my lung has dissolved. So...no more daily shots in the belly.

The surgery tomorrow (Friday) is to remove fluid in my right lung. They will knock me out and go in my side between ribs to remove the fluid. Then, they will put talc in the area - yes, sterile talc. It helps the surgery incisions stick together and seal - I guess simple stitches perhaps don't work for the lungs. The procedure is called a talc pleurodesis.

After the surgery and recovery, I will be put in a room at IU Hospital for 3 to 4 days.

I saw another doc today while they were doing a couple hours of labs and tests. He indicated that they rate me as a high risk for surgery. However, this procedure is considered to be very low risk. So, I guess one balances the other.

So...ungodly early to the cancer center tomorrow - 5:30!!

Well...we made to the IUSCC right on time. Ugh!!

They took us back to registration for all the usual questions- name, birth date, what do you understand is being done, do you have questions?, etc.

Then, we waited for Dr Birdas - he was doing an emergency procedure at Wishard Hospital. About 9:00am, they got me into an operating room, started prepping me, explained the process to me and started the anesthesia. Other than the first IV, I was out for the entire procedure.

The next thing I remember is when they woke me up about 11:30. This was the first time I have ever been under general anesthesia and the first time I have had a breathing tube. Luckily, they removed the breathing tube almost immediately. Very uncomfortable. Once I am awake, they started working on me to be sure that I was OK. Then, I laid around in the recovery room waiting for a bed in the ICU. In the end, after a couple hours, it was clear that I wasn't going to ICU. Instead, I was moved to the PCU (progressive care unit) which was essentially a regular room with more significant staffing to check on me often and give me a similar type of intense care.

I had felt pretty good while in the recovery room. But, just about immediately at about 4:00, I started to feel very significant pain in my back between my shoulder blade and spine. It seems that this is basically the norm for this surgery. They started me on a PCA unit (push a button and I get a dose of pain meds -morphine). Even though Jill has always said this is the most effective pain med for her, it was very ineffective for me. Eventually, with dosage increases and additional doses, the morphine began to help to a partial extent. This afternoon, they added another pain med - don't remember the name. This one was much more effective. I am still in pain, but it is at least bearable.

Even with the pain meds, my back and right side are still very sore. I have two foot+ long chest tubes still draining fluid. Dr Birdas told me that they drained about 1/2 gallon of fluid during the surgery. And, the chest tubes have drained more than that this afternoon. As I understand it, the chest tubes will remain in my lung until they no longer drain fluid. At that time, they will pull the tubes and spray in more talc to finish sealing the surgery area.

So, I have survived the surgery!! And, it appears to have accomplished what it was supposed to. Jill spotted red in the tubes and the RN explained that it was blood and small blood clots. The RN explained that eliminating all of this fluid was the intent of the procedure. And, apparently, my recovery has gone very well. After several hours of outrageous pain, my condition has settled down and my pain is pretty much contained.

Finally, in the late AM, they released me to start drinking fluids and eating food - I ordered a lunch and plan to order dinner.

Also, this afternoon, several nurses helped me to get out of the big tangle of tubes and wires. I have had 2 chest tubes, a catheter, an IV in my right hand with 2 tubes of meds and 2 IV's in my left hand - each with 2-3 med connections. And, I have my oxygen tube. My legs have thigh-high compression socks and each leg has a device attached that massages my calf every minute or so. I am wired/tubed up like a Borg character from Star Trek. This enabled me to get out of bed so that I could sit in a chair for a few minutes. The nurses were able to change my bed linens - by this time I had been laying in this bed with these linens for something like 36 hours. It was a much needed change.

I saw the docs a couple times during the day. The procedure seems to have gone very well - just as hoped. They will now monitor me for perhaps another day or two. If all goes well, I would expect to be released Monday or Tuesday. It is possible that I might not need the portable O2 - or I should at least to dial it down to around 1 versus 3 or 4. It sure would be nice to be able to stop carrying the oxygen around.

Dr Einhorn came to see me today. He explained what we had accomplished and that we may start an IV chemo when I see him in 3 weeks. This chemo is called alimpta and, apparently, has had some success with situations like mine.

So...we continue to battle and to try different options.