Saturday, May 30, 2015

Good-Bye, Casamina

I would have a lung wedge procedure called VATS (video assisted thoracoscopy surgery) to remove one of the nodules in my right lung.  The doctor cautioned me ahead of time that the procedure was "not intended to be therapeutic, but diagnostic".  I understood that to mean that if cancer was present, removing one node would not cure me of it.

Though the thoracic surgeon initially thought I could be sent home on the same day as the surgery, he changed his mind when he discovered, while I was still on the operating table, that the first nodule he removed was only a lymph node.  He tried again, and this second attempt resulted in the node (known to me as Casamina) finding its way to pathology.  Surgery took place on a Friday; I would see my oncologist for the results on the following Wednesday.  Christmas was just around the corner, less than two weeks away.

I described the events I remembered from my  hospital stay:

Subject:  Blast: Story of a Lung Biopsy
Sent:  December 16, 2014 6:18 AM

Hello, Friends.

Please allow me to empty my brain...

I checked in at [the hospital] at 6:30 AM on Friday.  They were expecting me at 6:00 AM.  My bad.  I was given instructions on two separate occasions. I wrote them down each time, but didn't realize that the two arrival times didn't match.  I miss my brain very much!  We received a "Where are you?" phone call en-route, and upon arrival we were enveloped in urgency.  Surgery was to commence at 7:30 AM.  There was much to do before then.

I met some nurses who jabbed me with needles and started two IVs, each on the first try.  I met the anesthesiologist, who promised to pile on the anti-nausea meds.  [The thoracic surgeon] came in to mark my initials on the right side of my back with a thick marking pen.  He said that he thought I'd be able to go home that day.  Dr. Anesthesiologist wanted to start an arterial line, but the surgeon said that I wouldn't need it.

Patrick was allowed into the room just seconds before they wheeled me away.  I was unconscious before reaching the operating room.

I woke up two hours later as I was being wheeled into a huge room where my husband was waiting.  I asked whether this was a recovery room or a regular room.  "You have to spend the night," the worker said.  Someone took an x-ray of my chest.  I was aware of a clear, flexible tube with a dime-sized cross-section coming out of my side.  It hurt.  The tube fed into a portable suction box gizmo resting on the floor.  I kept falling asleep, then jolting awake.  My left arm was connected to an IV bag containing antibiotics.  My right arm sported a hep-lock.

I remember being asked to "rate (my) pain" over and over.  I remember that it hurt to breathe.  That's about it for the morning and early afternoon.

At 4:00 PM I was served broth and a popsicle.  By 6:00 PM they said I could have regular food.  I noticed that both I.V. lines were hep-locked (I don't remember this happening) and a nurse told me that I was free to "move about".  Hahaha, "free".  I managed to hobble to the restroom and then ever-so-carefully back to the bed.  Breathing with a chest tube was something of an adventure.  Shallow breathing was not a problem, but anything more than that was painful and scary.  The nurse told me that "coughing is good," and encouraged me to do that, but coughing was not good, it was freakish.  I coughed up all manner of unholy specimens.  gack.

I slept for a few hours, but woke at 5 AM in severe pain.  My back was in spasms and I could hardly breathe.  I tried to calm the heck down.  Didn't work.  I searched for the call-button and was barely able to whisper a pathetic plea for "something for pain".  A nurse came right away and asked me to rate my pain (again!).  I managed to convey the word, "Ten."  She left to get meds.  She injected a miraculous something into the hep-lock in my left hand.  Almost instantly both of my arms turned to lead, my shoulders dropped, and my brain went to mush.  The spasms stopped.  I slept.

Later that morning I met "Dr. Zorro" (he looked like Antonio Bandares), and the resident, "Dr. John Boy" (a Richard Thomas look-alike).  Zorro checked the suction box thingy, gave his blessing, and left.  John Boy announced that he would be removing the chest tube.  First, he clipped the sutures (ow! ow!  OW!) and then he ever-so-slowly began pulling the tube out.  The tube seemed to me to be about ten feet long.  Patrick, who was there and witnessed the whole horrible scene, says it was about one foot long.  If I had to describe how it felt, I would say that it felt exactly like somebody was pulling a large, long tube right out of my chest cavity, which is to say:  SO WEIRD.  John Boy said that the tube was only inserted "about 18 cm (7 in)".  What does he know?  He finished by dressing the gaping hole in my flesh.

After another chest x-ray, I was released from the hospital.  It was late afternoon.

I will see [oncology] later this week when the pathology report is ready.

For four days I focused on recovering from the surgery, and not on what the pathology findings might be.  Immediately preceding the operation, Patrick and I had specifically asked the surgeon to not divulge any opinion about what he might find during the surgery.  We explained to him that we preferred to wait until pathology reported its findings--we did not want another "abnormal tissue" report that turned out to be nothing.  Our desire was to go home in blissful ignorance.  The doctor indicated that he understood what we were asking.

Sadly, our request was not honored.  While I was in post-op, the doctor found Patrick in the waiting area and immediately reported, "It's cancer.  Pathology will tell us whether lung or colon, but it's definitely cancer."  I cannot begin to imagine the betrayal and sadness Patrick must've felt at that moment.  To my husband's credit, he courageously kept the doctor's comment to himself, knowing for certain that I wanted to hear the results only when they were confirmed by pathology.  Patrick unselfishly protected me from the devastating news and allowed me a few more hope-filled days before I too, would be faced with the reality that cancer had spread to my lungs.  I wasn't cured at all.  In fact, my prognosis was thoroughly, horribly grim.

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