Wednesday, April 25, 2007
Good Recovery for Paul After Lung Cancer Surgery
Paul is showing a very good recovery today after undergoing four hours' surgery at the Cleveland Clinic yesterday. This morning his color was good and he chatted with Philip, Kim, and me quite readily. He asked me to print off crossword puzzles and bring them along next. This afternoon they removed him from the ICU to a room up on the ninth floor in the thoracic step-down constant nursing unit . There they will re-introduce him to getting back on his feet.
He had in effect two procedures. The first surveyed the lymph nodes in his right lung. Fortunately, they were fine. The second op opened his chest, spread apart the ribs, and removed the cancerous growth at the periphery of the left lung. In doing so, they took only ten percent-of the lung--a good outcome. Phil and Wendy spent most of the day with me yesterday and P and Kim visited this morning. We're very happy with the way things are going right now.
Because the Cleveland Clinic campus is so large I did a lot of walking yesterday and today--and don't feel any the worse for it, either! Last evening when I walked in front of the lobby of the Inter-Continental Hotel, I saw a group of people surrounding an elderly middle-eastern couple who were climbing into a large, black European-looking car. They looked very regal. (A lot of gold glistened about them). One chap in a long, black raincoat stepped menacingly toward me--a bodyguard I guess.
I fell into bed gratefully last night in the Guest House. License plates on cars in the lot came from nearly every state in the union, and while waiting around yesterday I talked with people from San Francisco, Idaho, Kentucky and places in between. I thought, well, Cleveland is a gloomy town much of the time, and the weather is nothing to write home about, but we have the Clinic right here--and that's worth a thousand blessings.
The TV in my room brought in Abu Dubai, Saudi Arabia, Kuwait--and a Syrian movie was playing on another channel.
A cousin, whose wife is recovering from a cancer removal under excellent British National Health care, expressed the following sentiments in an email today:-
"We have found that talking about the illness somehow lessens its bogeyman severity. Forgive me for doing so when you have your own concerns. "
(Thank you David. I agree and I think we share some of the same verbal genes).
Now I'm back home this evening caring for the cats. They don't seem to have missed me at all.
Love, and forgive me for running on, but it's good for my sanity and system.
Stephanie
Thursday, April 5, 2007
My Endoscopic Ultrasonography(EUS) Set for Next Monday
Sunday, February 25, 2007 around midnight, before falling asleep a very sudden feeling of nausea presented itself. That salty taste the precedes vomitting. Got to the bathroom in time for a rush of vomiting and diarrheal. Sat on the toilet with my face in a plastic bowl. Returned to bed, but repeat attacks followed. Finally only bile was left to come up. I became severely dehydrated. Paul called the Granger rescue unit to take me to Medina Hospital ER. I was there until about 11 a.m. the following day. Later I found they did an ultra sound and other tests, but because of the medication they gave me I slept through until mid-morning.
About a month earlier I had a similar attack, although not quite as severe, and went to the ER for that. Followed up with family physician, Dr. Hoynes, who suspected a flu bug going the rounds. The second attack gave him second thoughts and he recommended I see a local gastroenterologist, Dr. Bashour, in Medina.
Saw Dr. Bashour on March 6. Upon examination he said he suspected a blockage somewhere in the biliary tract--perhaps by an errant gallstone. (My gall bladder was removed in 1975). He also suggested possible hepatitis or even liver cirrhosis, based on my having had a blood transfusion in 1983 at the time of my hysterectomy. He wanted me to have a ERCP at Medina Hospital and set it up for March 12. I told him I had developed a sore throat and the feelings of a cold, but he paid no attention to that. He sent me to Medina Hospital for blood tests, but did not order xrays or scans. The blood tests revealed no hepatitis, but the scans revealed an enlarged liver duct.
The next day a full blown cold appeared and developed into a lung infection and near pneumonia by the end of the week. I canceled the ERCOP! I then had a chest xray done and that showed the lung infection. During the two weeks for the infection to go away I did some thinking and decided not to return to the Medina gastroenterologist and contacted the Cleveland Clinic where I got an apointment for June 4.An assistant there told me to have Dr. Hoynes order Cat scans and an ultra sound, and I had them done at Medina hospital. Dr. Hoynes said he would try to get me in sooner, but not hearing from him in two weeks I called the Clinic endoscopy department on April 3.
A very helpful assistant, Rachel, said they were booked weeks ahead. I told her how difficult it could be for me caring for Paul properly after his lung surgery--probably two weeks hence--if my gastro problem had not been dealt with. The following morning she called and said she had managed to get me a slot with Dr. Vaccaro on Monday the 9th. She said I had sounded so stressed she just had to help me out.
On the 9th in the morning I will have a consultation with Dr. Gregory Zaccaro gastroenterologist, followed by an endoscopic ultrasonography(EUS). Hopefully we will get some answers to why I had the two attacks and what's going on with my liver and esophagus.
The following day, Tuesday April 10, Paul has an all-day visit to the Clinic, seeing an oncologist, having heart stress tests, etc., and consulting with Dr. Sudish Murthy in the afternoon. Hope I'm able to go along with him.
About a month earlier I had a similar attack, although not quite as severe, and went to the ER for that. Followed up with family physician, Dr. Hoynes, who suspected a flu bug going the rounds. The second attack gave him second thoughts and he recommended I see a local gastroenterologist, Dr. Bashour, in Medina.
Saw Dr. Bashour on March 6. Upon examination he said he suspected a blockage somewhere in the biliary tract--perhaps by an errant gallstone. (My gall bladder was removed in 1975). He also suggested possible hepatitis or even liver cirrhosis, based on my having had a blood transfusion in 1983 at the time of my hysterectomy. He wanted me to have a ERCP at Medina Hospital and set it up for March 12. I told him I had developed a sore throat and the feelings of a cold, but he paid no attention to that. He sent me to Medina Hospital for blood tests, but did not order xrays or scans. The blood tests revealed no hepatitis, but the scans revealed an enlarged liver duct.
The next day a full blown cold appeared and developed into a lung infection and near pneumonia by the end of the week. I canceled the ERCOP! I then had a chest xray done and that showed the lung infection. During the two weeks for the infection to go away I did some thinking and decided not to return to the Medina gastroenterologist and contacted the Cleveland Clinic where I got an apointment for June 4.An assistant there told me to have Dr. Hoynes order Cat scans and an ultra sound, and I had them done at Medina hospital. Dr. Hoynes said he would try to get me in sooner, but not hearing from him in two weeks I called the Clinic endoscopy department on April 3.
A very helpful assistant, Rachel, said they were booked weeks ahead. I told her how difficult it could be for me caring for Paul properly after his lung surgery--probably two weeks hence--if my gastro problem had not been dealt with. The following morning she called and said she had managed to get me a slot with Dr. Vaccaro on Monday the 9th. She said I had sounded so stressed she just had to help me out.
On the 9th in the morning I will have a consultation with Dr. Gregory Zaccaro gastroenterologist, followed by an endoscopic ultrasonography(EUS). Hopefully we will get some answers to why I had the two attacks and what's going on with my liver and esophagus.
The following day, Tuesday April 10, Paul has an all-day visit to the Clinic, seeing an oncologist, having heart stress tests, etc., and consulting with Dr. Sudish Murthy in the afternoon. Hope I'm able to go along with him.
Tuesday, April 3, 2007
Paul's Visit to the Cleveland Clinic--April 2, 2007
Yesterday, April 2,we kept a full day's worth of appointments at the Clinic.
As it looks now, Paul will probably undergo lung surgery within the next two or three weeks at the Clinic's hospital.
Yesterday's tests included a molecular imaging procedure in the nuclear medicine department at the Main Hospital followed by a CAT scan of his brain in the radiology department . The afternoon was taken up first with three pulmonary function tests in the Crile building including a walking function that showed a need for oxygen, which the technician who walked with him supplied.
In the latter part of the afternoon we visited first Dr. Sudish C. Murthy, thoracic surgeon, and later Dr. Gildea, pulmonary disease specialist--he has been seeing Paul since 2004. Both have extensive biographies online at the Clinic website and are regarded as tops in their fields. They were liberal with their time, friendly, compassionate, and welcomed our questions and concerns. They were the exact opposite of the stereotypical arrogant specialist one finds in literature, movies and sometimes in real life!
Both had reviewed Paul's case file and earlier scan results (done in Medina), as well as the results from the morning's tests. Murthy's first concern was finding the exact spot on the left where Paul's cancerous growth is located. (The Medina scans weren't that good, and he has ordered another scan taken at the clinic next Tuesday). The options for Paul appear either surgery or radiation, or both.
As Murthy put it, in surgery we can't give up much lung tissue for an operation, and if the growth is in the middle of the lung it will present a difficulty because not only must the growth itself be removed, there must be enough lung tissue surrounding it to ensure that the cancer is removed properly. The result could be that the whole lung might have to be removed. If the growth is near the edge of the lung, it can be removed together with surrounding tissue, but even this would take some of the lung away. Any amount of lung tissue removed is serious for a patient suffering from interstitial lung disease
Radiation can burn away the growth, but collateral damage to the lung is a possibility.
Murthy wants Paul to have another CAT done at the clinic next Tuesday--to zoom in on the growth's position--and also a heart stress test on a treadmill to gauge the ability of the heart to handle the surgery. He pointed out that whichever therapy is chosen, we mustn't do the wrong things for the right reasons. We must expect Paul to have a reasonable chance to get through the therapy and have an expectation for an effective recovery with half a lung if that's what the picture turns out to be.
Our final visit for the day to Dr. Gildea yielded a difference in opinion. He is absolutely against radiation. for Paul's diseased lung. As he put it, "it could set off a firestorm in Paul's diseased lung." But he will conference with Murthy and they will bring other specialists into the debate and will come up with their best possible option.
For surgery, Paul will be in the hospital for about a week and recuperation time will take about eight weeks.
The Clinic resembles a small city. It has its own Intercontinental Hotel (God knows how much it costs to stay there--affordable anyway or the Saudi princes who come over for their regular checkups). We took used their own bus service--the greenline, blueline and whiteline run regularly between buildings. There are also indoor skywalks between buildings and for our last appointment I pushed Paul in a wheelchair from one building to another. Parking spaces for handicapped tags are close to the building and cost just $5 for the whole day. A Bon Pan cafe in the Crile building (where the pulmonary department is located) offers delicious food all day long.
Our next step is to keep the appointments for next Tuesday (April 10) for cat scan and heart stress tests. After they've been reviewed, the doctors should be able to come up with their next step.
As it looks now, Paul will probably undergo lung surgery within the next two or three weeks at the Clinic's hospital.
Yesterday's tests included a molecular imaging procedure in the nuclear medicine department at the Main Hospital followed by a CAT scan of his brain in the radiology department . The afternoon was taken up first with three pulmonary function tests in the Crile building including a walking function that showed a need for oxygen, which the technician who walked with him supplied.
In the latter part of the afternoon we visited first Dr. Sudish C. Murthy, thoracic surgeon, and later Dr. Gildea, pulmonary disease specialist--he has been seeing Paul since 2004. Both have extensive biographies online at the Clinic website and are regarded as tops in their fields. They were liberal with their time, friendly, compassionate, and welcomed our questions and concerns. They were the exact opposite of the stereotypical arrogant specialist one finds in literature, movies and sometimes in real life!
Both had reviewed Paul's case file and earlier scan results (done in Medina), as well as the results from the morning's tests. Murthy's first concern was finding the exact spot on the left where Paul's cancerous growth is located. (The Medina scans weren't that good, and he has ordered another scan taken at the clinic next Tuesday). The options for Paul appear either surgery or radiation, or both.
As Murthy put it, in surgery we can't give up much lung tissue for an operation, and if the growth is in the middle of the lung it will present a difficulty because not only must the growth itself be removed, there must be enough lung tissue surrounding it to ensure that the cancer is removed properly. The result could be that the whole lung might have to be removed. If the growth is near the edge of the lung, it can be removed together with surrounding tissue, but even this would take some of the lung away. Any amount of lung tissue removed is serious for a patient suffering from interstitial lung disease
Radiation can burn away the growth, but collateral damage to the lung is a possibility.
Murthy wants Paul to have another CAT done at the clinic next Tuesday--to zoom in on the growth's position--and also a heart stress test on a treadmill to gauge the ability of the heart to handle the surgery. He pointed out that whichever therapy is chosen, we mustn't do the wrong things for the right reasons. We must expect Paul to have a reasonable chance to get through the therapy and have an expectation for an effective recovery with half a lung if that's what the picture turns out to be.
Our final visit for the day to Dr. Gildea yielded a difference in opinion. He is absolutely against radiation. for Paul's diseased lung. As he put it, "it could set off a firestorm in Paul's diseased lung." But he will conference with Murthy and they will bring other specialists into the debate and will come up with their best possible option.
For surgery, Paul will be in the hospital for about a week and recuperation time will take about eight weeks.
The Clinic resembles a small city. It has its own Intercontinental Hotel (God knows how much it costs to stay there--affordable anyway or the Saudi princes who come over for their regular checkups). We took used their own bus service--the greenline, blueline and whiteline run regularly between buildings. There are also indoor skywalks between buildings and for our last appointment I pushed Paul in a wheelchair from one building to another. Parking spaces for handicapped tags are close to the building and cost just $5 for the whole day. A Bon Pan cafe in the Crile building (where the pulmonary department is located) offers delicious food all day long.
Our next step is to keep the appointments for next Tuesday (April 10) for cat scan and heart stress tests. After they've been reviewed, the doctors should be able to come up with their next step.
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