Tuesday, May 16, 2017

Meeting the Cardiothoracic Surgeon

Off to the surgeon!
I was quite fortunate to secure an appointment with the top cardio-thoracic surgeon, here in Boise, in a timely manner. Which is a great thing, as I am not a very patient, patient!

On our way to meet with him, I literally made myself ill! I was a bit dizzy in the head (more than usual), nauseous, heart pounding and shaky. I kept telling myself to breathe, and that I was just freaking myself out. Which my brain knew, but my body could not comprehend.

That is what I get for actually "thinking" about what "might" happen, as opposed to taking my typical approach to things; denial!

I guess I did not realize just how terrified I actually was until I started going over my list of questions for the surgeon. I quickly popped a meclazine into my mouth, and swallowed; I did not wish to throw up...lol

I thought it prudent to be prepared, but did not expect that it would affect me so greatly.

At any rate, I can thank the promptness of my medical experiences here, for not allowing me further time to freak out! As soon as I checked in, I was called back to the examining area, which means weight, blood pressure, how are you feeling, do you have.....etc.

This focused my brain to the present and calmed me down to some degree. Being that I have been dealing with these effusions, and cough, I have been to do doctors' office way more frequently than I have in years. This is NOT fun, to me!

I hate answering all of those questions because to be frank, I do not have a good answer for any of them. There is no yes or no for me, it is almost always "sometimes" and this sometimes is typically medication related. Sprycel is the reason for all of the sometimes answers such as do you have joint or muscle pain, back pain, shortness of breath, weight gain, weight loss, sleeplessness, changes in eyesight, etc, etc, you know the drill.....and it sucks, but that is the life of a person with chronic cancer; there is no good answer.

All of these answers are supposed to help the doctor determine your "health", but when these side effects are medication related, they do not present a clear picture. The only medications that I take on a regular basis are Sprycel and Levothyrozine (for thyroid, thanks to Sprycel), but my list of "as needed" is quite extensive, even though I only use these other medications when I am desperate. I am not a fan of taking drugs. Despite the fact that I have cancer, I am otherwise healthy.

Sorry for the left turn, back to the real reason I am here. Dr. Schoolfield comes in and turns his monitor to face me. He then starts showing  me my scan. I have to stop him and say, "Do I have a rind, or not?" lol He laughs and says, "No, I do not believe that you do."

CT Scan Images are fascinating!
With a sigh of relief, I am now able to focus on everything else that he has to say. He believes that I do not have a rind because when I was lying down for the CT Scan, the fluid in my pleural space was free flowing; meaning that it surrounded the lung and my lung was able to expand, to some degree. He feels that at this point, it is still able to expand, and that over time, it will.

He also believes that if I am to remain on Sprycel, that I should consider a pleuradesis to hopefully eliminate the area, in which the fluid currently collects. He explained the procedure where a sterile talc is put into the pleural space, after all of the fluid is surgically removed; this talc causes an irritation, which in turn causes scarring and adhesion of the lung, to the pleural sac, thus eliminating the possibility of fluid build up. Sounds like fun, huh?

He said that he believes there is a high probability that this would solve my pleural effusion issues, and I could remain on the drug that is currently controlling my chronic mylogenous leukemia. I did ask him what the likelihood of the effusion moving from my left lung to my right, or to the sac around my heart, and he said that "statistically" speaking he didn't believe that it would.

I also asked him the downside to the procedure and he said that there is a small chance that the adhesion's would not be perfectly consistent and that "pockets" could occur, allowing fluid to build up in those pockets, which would make it more difficult to remove, as the fluid would not be pooled, all in one area.

The one other thing to consider here, is that there may already be a lack of elasticity in my lung, which may prevent it from ever fully re-inflating again. This would not make me happy; but I would deal, and adjust.

He hopes that the fact that there was a rapid accumulation of fluid after the last thoracentesis, was possibly due to the fact that I had such a bad cough, that I was not able to be as active as I would have otherwise been, which may have prevented my lung from re-inflating like it should/could have.

All that being said, the current plan is to have an x-ray, the week before our trip, and if there is a large amount of fluid, to have a thoracentesis before I go. Lower my dose of Sprycel while I am gone, and to re-asses the situation when I get back.

I am currently leaning towards trying Bosulif before going the surgery route.

On a side note, we will be repeating the CT scan in three months to monitor the stupid nodules that appeared on my right lung; these suckers, for right now will not even enter my mind. I have already vanished them from my next scan!

Next up; leaving for Europe in two-ish weeks!

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Bricks for the Brave!!