Day 2- Hospital Stay 2

When I arrived at the hospital, Dr.Jones, the cardivascular thoracic surgeon, was in Cheryl's room reviewing her case notes. She does have a couple of small pulmonary embolisms (clots) in her lungs but they are not large enough to be the cause of her breathing difficulty. He feels that we need to drain the pleural effusions to give her some relief.

I had mentioned in yesterday's post about the procedure called pleurudesis where the fluid is drained and talc is puffed into the lung cavity to cause the lung to adhere to the lining and create scarring that will prevent further fluid effusion. Instead, Dr. Jones recommends that he insert PleurX catheters into both sides of her pleural cavity. With this procedure, the fluid will be suctioned out as it builds up and as the process is repeated, the lung will adhere to the lining and produce scarring similar to that of the pleuridesis. She will go home with vacuum bottles so we can drain the fluid a couple of times a day.This will go on for anywhere from a couple of weeks to a few months. The fluid buildup should be controlled by a combination of the scarring and the chemo pushing the cancer into remission.

As of now, her surgery should take place around 2PM today. He will do a quick scope before starting the catheter insertion to make sure that there is nothing else that he will have to deal with during the procedure.

Cheryl will most likely be in the hospital until Sunday or Monday. They want to make sure that the blood clots in the leg and lungs are being managed by medicine and also that he PleurX catheters are functioning properly. I will update later today after she comes out of surgery.

Good description of the PleurX procedure
http://www.bostonthoracicsurgery.com/handler.cfm?event=practice,template&cpid=24016

They took her down to surgery around 1:30 with plans to start around 2:30. Dr.Jones called up the room at 4:30 to say that Cheryl came through the procedure successfully. He placed PleurX Catheters in both lung cavities. He scoped her before inserting the caths and noted that he saw a number of nodules in the pleural lining on both sides. They finally brought her back to her room at 6:15. She can tell a difference in her breathing already. She is reasonably lucid but tends to doze off if not actively engaged in converation. I'm sure that when the anaesthesia wears off she will be doing much better.

While she was in recovery I had visits from the Nurse Social Worker and the Nurse Navigator. The Nurse Navigator gave me an orientation on care and draining of the PleurX catheters. She was very helpful and I feel confident that I will be able to take care of the procedure. It will need to be done every couple of days or whenever Cheryl begins to experience a buildup in pressure. When I asked how long we could expect to be doing the drains, she told me that in most cases- from now on. Welcome to our new normal.