Lung Cancer – Second Lobectomy

2008 Second Lobectomy

Finding out that I had to have another lobectomy was earth shattering. Meanwhile Dr. Gaissert, my surgeon, had moved to Massachusetts General Hospital and I had just seen him for a ten-year celebration before my 2008 yearly CT scan. I decided to send him my last scan which was done at my local hospital. I was stunned when he called me back. The local radiologist had not picked it up last year. There were two new primary lesions and they had been there for a year! They were in my upper left lung. From that point on I would never trust my local hospital again for anything major. In the future I would have all scans and tests done at Mass General Hospital.

There was no doubt that Dr. Gaissert would be my surgeon again. Would I need another lobectomy again? Would I need chemotherapy after? Radiation? It was a gut punch. This blindsided me. I didn’t have any symptoms!.

I wondered if I had any fire in me to fight these new parasites?  My mind took me to places that were much darker than I had ever experienced. But I didn’t want this to beat me!! I would fight this thing with every atom of my being. I was a survivor. So I chose to move out of my panic, depressed mode to the frenetic activity of an athlete who had decided that she would win the gold medal. I became unstoppable. I exercised six days a week, ate only low-fat, lean foods, fruits and vegetables. My husband said that cancer didn’t have a chance! I was a me tornado. And I was clearing a path to health with every step. No lobectomy would stop me.

During my visit to Massachusetts General Hospital my doctor told me that he would attempt to do VATS (videos assisted thoracoscopic surgery). I didn’t have to wait a long time for surgery. There was a cancellation on my surgeon’s schedule for a lobectomy a week after all of my tests were read. So soon! Too soon. I couldn’t believe that I had to go through a second operation again! My two lesions were considered new primary tumors, adenocarcinomas.

There would be more tubes, staples and feeling like a remnant of a human being for a while. I would have to endure round the clock blood pressure checks, temperatures, etc. But hey, I was a pro; I could do the hospital stint, not a problem. Being well versed in the art of hospitals I knew my way around! Pushing the buzzer for help was a cinch. I knew how to push my IV pole around. It was cumbersome but doable. Unfortunately I also knew that I’d need to pee every twenty minutes for as long as the IV fluids were in me. I’d also have to use the spirometer, a torturous device for helping to strengthen my lungs and expand my lungs. My library of hospital knowledge was unmatched! I was a pro!! Waiting for PET scan

I needed to get ready to go to Boston so I bought a small carry-on type bag for the hospital. I like that it was a neutral gray. It would go with anything! While I was trying to eliminate things from my list, my mind kept going back into the past, to my first operation, to the fears and worries. I wasn’t dry heaving anymore when I was anxious but my sweat glands worked just fine. I have a faint memory of the ride up. It was very dark and allowed me some privacy to acknowledge my fears without worrying Dave any more than he was.

Traumatic experiences seemed to follow me wherever I go, like an encroaching storm. They are hungry tape worms soaking up my mental health, loitering bullies messing with me. When the nurse in the pre-op room saw my expression she quickly hooked me up to an IV and she dimmed the lights and put on some soft music. Next came the anesthesiologist who gave me some Valium! Phew. Now they could get to work. The anesthesiologist then wheeled to another area, a brick horseshoe-shaped open cave where another anesthesiologist inserted a needle into my spine, a thoracic epidural that would guide a pain-killer into me for a few days, a slithering serum of delight. Finally I was wheeled in to the actual operating room. My surgeon was waiting for me and held my hand as I dropped off the edge of consciousness.

https://en.wikipedia.org/wiki/Lobectomy_(lung)

The next thing I knew I was in the recovery room, seven and a half hours later, with my oxygen mask snuggling my face. Evidently there were three lesions in all. My surgeon was able to remove one my lesions by VATS.  Unfortunately he had to revert to a lobectomy so that the second and third lesions could be removed. One of the lesions had penetrated my pleura!

An immense amount of pain in my upper chest greeted me when I woke up. I’d call it a #9 on the Richter scale of pain. I hadn’t had this with my first cancer and it was startling. Dr Gaissert suggested that one of the chest tube ends was rubbing against my chest wall. I don’t remember if they changed my position or increased my pain medication because the next thing I knew, when I next woke up, was in a wonderful place, the no pain room.

http://146.66.99.90/~lallo400/my20yearscancer/lung-cancer-survivor/

I had a private nurse for the first twelve hours. She gave me back rubs and feet rubs and she was just wonderful. By the second day I was in a haze, hallucinating my heart out. Up until that night, when I got a roommate, I hadn’t realized how much I had been hallucinating. My pain medications distorted reality and she looked like a monster with some sort of putty like substance spread around her mouth and nose, securing some tubes that came out of her mouth. I was a horror.

The next morning I could tell that they had lowered the amount of pain medication. My hallucinations had ended. I started anticipating what life would be like. I still didn’t have any pain at all! But I needed a blood transfusion and that very afternoon I received one. when dinner finally arrived my mouth  filled with the taste of iron ore, iron eggs, and fish sautéed in iron butter. No one explained to me that it was probably a component in the blood transfusion. I had to ask my nurse to take my flowers and put them outside my door, thinking that they were causing this noxious smell. But the smell crept into the room, like a crawling cloud of pollution every time someone came in.

When it was time to have my to have my chest tubes removed I panicked. A nurse who specialized in chest tube removal came in looking like she wasn’t going to eat me alive with pain. She was a pro and I hardly felt a thing. My regular nurse then removed my IV. Before removing the catheter the nurse told me that they remove all urine from my bladder with a special valve so that would be less of a chance of a urinary infection. Finally I was ready to go home when my nurse came in and said, “One more thing…” Ah Oh! I had to have Coumadin. Coumadin is a blood thinner and takes the place of Heparin that I had in my IV, along with antibiotics. The difference is that I had to inject myself in my stomach so I wouldn’t throw a clot and out myself!

Boy was I was ready to go home! Dave and I and my flowers and iron smell were off for home. I would need to see an Oncologist because I might need chemotherapy.

https://en.wikipedia.org/wiki/Pleural_cavity

The advantage of VATS over a thoracic lobectomy is that major chest wall muscles are not divided and ribs are not spread. This leads to reductions in the intensity and duration of post-operative pain and allows patients to return to full activity more quickly.” (https://en.wikipedia.org/wiki/VATS_lobectomy).

Here is a video that shows the steps for a lobectomy and a description of VATS. It’s well worth looking at it. It’s 25 minutes long. It does not show an actual operation, nor any inside organs. It is the top video called, “Your Lung Operation”,  https://www.youtube.com/watch?v=14w2D8g9Tg0&t=19s