[Day 643] Pleurodesis

The view from my room at USC Keck Hospital

The pleural effusion in my lung has covered my entire left lung. The last CT scan showed that the tumor has the probability of increasing the size, yet there are just too much fluid to tell exactly what’s going on.

With pleural effusion, there are a few options for treatments

  1. Thoracentesis — which essentially draining the fluid of of my lung manually like I did in February and April. However, this method does not work out very well since the fluid as accumulate a lot faster than the responsiveness of the drug
  2. PleurX Catheter Drainage — placing a tube inside the chest so that the patient can drain it at home periodically
  3. Pleurodesis — the most complex procedure yet effective way to treat the problem but require stay in hospital for couple days after the surgery

Pre-surgery

After discussing with my primary doctor, we decided that pleurodesis procedure is the best option since I already very tired with the pleural effusion in the past 2 years. He then recommend me to meet the surgeon, Dr. Elizabeth David. Very much like Dr. Nieva, she has the confidence and patience to explain to me through different options. I told her, “I trust you and USC Keck more than any other medical system in this entire world. So, please use your best judgement to make the decision as needed during the surgery”

The surgery date was set to be July 19th — which is only 3 days after our first meeting. We have a few pre-operation procedure that we need to complete. I sent a quick email to my team to inform about the surgery, wrapped up my work, and take care of a few legal things

I start taking pre-op medications and running a few test on Tuesday. My Echocardiography Test was the most interesting when the cardiologist could barely get any visual of my heart on the left. She then started moving to the right side and got better visual. I was quite shocked, but she told me my heart could be shifted due to the pleural effusion.

After almost two years of postponing the paperwork, I finally got my Advance Healthcare Directive and POLST (Provider Orders for Life-Sustaining Treatment) in place. USC Keck provided free notary public service for their patients — which saved me a ton of time.

I came into the hospital at 5am on July 19th, and the procedure started at 7.30am sharp.

Post-surgery

This is the third surgery in my life — and it’s the most painful one. I started feeling the pain the minute I gain my consciousness. I opened my eyes and didn’t see any familiar face. The nurse was very inconsiderate when she keeps chatting constantly with her colleagues rather than caring my well-being. I realized that I still in ICU and that’s why my family was not there. I gave me a sip of water after I asked her a few times and transfer me to my room.

The first time I tried to get up to use the rest-room is the hardest. I thought I could die from the pain. However, my doctor said I should get up and start walking. I managed to get myself to the toilet with the help of two nurses — who are a lot nicer than the one in ICU.

The next 72 hours post-surgery is the constant fights with the pain, I have to take Norco every 4–6 hours to manage the pains. My heart pressure constantly stayed at 90/60 or less. I managed to eat like normal yet the pain are just drive down my appetite. My doctor came to visit and told me the surgery went fine; however, my left lung was collapsed entirely, she has to create the scar between my lung and chest wall to stick them together mechanically. She also went ahead to place the tube inside my chest for the drainage. The total fluid they removed from my lung was about 2 litres.

I quickly realized that I didn’t not just have 1 procedure, it’s a 3-in-1 thing and I’m glad that I gave my doctor the total decision making power because things have gotten way more complexed than we expected.

-Rosemead, July 28th, 2018-