Re: Update Re: Houston, We Have A Problem...

[Peggy Willocks <dwillocks@xxxxxxxxxxx>]

Murray - all I can think of right now is "The best laid plans of mice and
men . . ." but your smiling attitude will beat this!!  I am smiling, too
(it's contagious)

Peggy

----- Original Message -----
From: "Murray Charters" <mcharters@xxxxxxxxxxxxxx>
To: <PARKINSN@xxxxxxxxxxxxxxxxxxxx>
Sent: Thursday, August 14, 2003 3:05 AM
Subject: Update Re: Houston, We Have A Problem...


> Mornin' All,
>
> just a quick message to relay yesterday's happenings...
>
> * * *
>
> Brenda's and my day,
> she was with me all the way.
>
> We checked in at VGH Admitting around 12:00 Noon, Aug 13, 2003
>
> I was there for a routine out-patient procedure -  thoracentesis -
(draining of the pleural effusion that is
> restricting the capacity in my left lung).  I handed the admitting person
my wrist band from the previous week, my CARE
> Card, and checked in in a few minutes, (they were expectin' me) and
proceeded down one floor to a Day Bed area just
> down the hall from the Broncoscopy suite. Get yer duds off, put this
skimpy gown on backwards, old hat stuff!!  Wait
> for the porter t' wheel ya down the hall...
>
> Soon I was in the Broncoscopy suite, where I had a Broncoscopy last
Thurs., for biopsy of the tumor found in the upper
> lobe of my left lung.  Ahh.. there was a familiar face.  Anne hooked up
the ECG, applied the Blood Pressure Cuff, the
> finger clip monitor, and tested the equipment... Old hat!  Ready t'
roll....
>
> Dr. Ayas was to tap the pleural effusion on Wed. Aug. 13th. at 13:00
Hours...  He was late... 13 minutes... not that
> I'm superstitious...
>
> He intended to use a biopsy needle to drain 1 to 1.5 litres of fluid...
which would allow my lung to expand, restore
> temporarily my lung capacity, possibly allow me to rest a bit easier and
get a decent sleep...
>
> The  thoracentesis procedure also allows biopsy of the pleural effusion.
>
> Dr. Ayas explained the procedure and I signed the consent form.
>
> This was 'sposed t' be a quick outpatient procedure / roughly 1 hour plus
1 hour rest and observation, after which I
> would return home.
>
> They had me sit up, bend slightly forward over a bedside table.  He
prepped the area on my back, applied a local
> freezing and got started. That's when Parkinson's showed up in the form of
hypotension... Suddenly I felt dizzy, my
> blood pressure dropped, and my heart rate ticked down into the 30's...  I
had forgotten to warn them that I'd
> experienced hypotension before... I was probably somewhat dehydrated as
well... fasting, fluids only from the night
> before... I think I only had two glasses of water... one with each set of
Parkinson's meds... I'm sure I went pasty
> white... almost passed out!
>
> Now I needed an IV tap... and Oxygen... Sooooo ... lay back and relax,
suck up some Oxygen... IV tap in, wait....
>
> About an hour late we resumed the thoracentesis procedure... Things were
still not going as planned... Dr. Ayas had
> difficulty getting the fluid to drain... Finally we had about 750ml of
clear straw colored fluid... Not all that's in
> there, but enough for today...
>
> An imbalance between the venous-arterial pressure and the pressure within
the pleural space (oncotic pressure) causes
> transudative effusions. Transudates contain few protein cells and little
solid material content and have a clear, pale
> yellow color.
>
> Dr. Ayas explains that this fluid looks fine under the circumstances.
>
> In due course they wheeled me down the hall for a chest Xray to confirm
where we're at now... One from the front, one
> from the left side... Okay... "Kodak" moments are finit..  Back to the day
bed area for rest and observation... It's
> 15:30 now...
>
> I get apple juice and my Parkinson's meds at 16:00 right on time... (I
have my own meds and my 3 ring binder with me)
>
> Dr. Ayas reappears around 16:40... He has seen the Radiologist, the Xray
is Ok. and I can be discharged.
>
> Wait... Wait... we have a few questions... When will we be informed of the
results of this biopsy?  (perhaps Friday,
> but more likely Monday)
>
> If this biopsy is negative then is the 3 cm. (roughly) tumor in my lung
the primary cancer for sure? (the oncologist
> will make that diagnosis)...
>
> What do we call that tumor?  What type of cancer cells do I have so far?
(It is an "adenocarcinoma" probably in Stage
> 3A)
>
> HHHhhhmmmmmmmmm....
>
> adenocarcinoma, bronchiolo-alveolar
> A carcinoma thought to be derived from epithelium of terminal bronchioles,
in which the neoplastic tissue extends along
> the alveolar walls and grows in small masses within the alveoli.
Involvement may be uniformly diffuse and massive, or
> nodular, or lobular. The neoplastic cells are cuboidal or columnar and
form papillary structures. Mucin may be
> demonstrated in some of the cells and in the material in the alveoli,
which also includes denuded cells. Metastases in
> regional lymph nodes, and in even more distant sites, are known to occur,
but are infrequent.
> 
>
> What's next? (Wait for this biopsy, consult with the Oncologist)
>
> The IV comes out, the vital signs monitor is switched off, and I don my
street duds...
>
> It's 17:00 hours...
>
> I learned one small lesson... remember to think about Parkinson's and
hypotension when you have any hospital
> "procedure"...
>
> It is better to discuss this upfront and be fully prepared... (I had my 3
ring binder, we had briefly dicussed my meds,
> but hadn't considered hypotension or dehydration...
>
> I hope you all keep on smilin' and doin' your very best...
>
> I am!
>
> cheers ...... murray
>
>
> * * *
> Murray Charters <mcharters@xxxxxxxxxxxxxx>
> 
>
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