Time for a Thoracentesis

According to Wikipedia, a thoracentesis is an invasive procedure to remove fluid or air from the pleural space for diagnostic or therapeutic purposes.  As I've mentioned before, I have had pleural effusion in my left lung since my symptoms of stomach cancer started to arise in November 2011. At that time, it was small and not causing me any shortness of breath so there was no need to go in and drain the fluid.  It wasn't until after chemo infusion #5 that I started having shortness of breath.  I couldn't lay on my back to sleep as the pressure on my chest would not allow me to breath.  I had to sleep propped up on pills on my left side.  In the past, I would use Tylenol 3 to minimize my coughing associated with the pleural effusion with great success.  But since my doctor had now put me on morphine for pain, I wasn't allowed to use Tylenol 3 because of drug interactions.  I toughed it out as long as I could and finally told my oncologist that I would consider a thoracentesis if there was enough fluid in my fluid to be able to drain it.  After my therapy appointment on Monday, June 11th, I stopped by the Radiology department and checked in for my x-ray.  I was having pain in my neck from the suspected blood clot and this x-ray wasn't just the standing one.  I did the standing x-ray and then the tech had me lay on a fancy table on my side.  It was very uncomfortable.  I was having shortness of breath but the tech tried working as fast as she could.  Later in the afternoon, my oncologist called and confirmed that I have a large pleural effusion and she was sending a referral over to the Pulmonologist who would be performing the thoracentesis.  They should be calling me shortly to schedule the procedure for tomorrow.  I waited and waited but no one called.  In the morning, I waited and waited some more and still no call.  I sent an email to my oncologist and asked her to please follow up.  She emailed me back and said she reminded them and to expect a call soon.  Finally at 2pm, I got a call from the Pulmonologist's office and they asked me to come in at 4pm that afternoon.  My family from LA had just arrived and I wanted to go in Wednesday for the thoracentesis but the lady on the phone told me there was no other time for my doctor to do it so I agreed.  I took some liquid morphine before the appointment.  My cousin Delia drove me in with my aunt as my sister stayed behind with the rest of my family. I was also switching cable/internet companies and the tech was there so I needed my sister to keep an eye on him.

We arrive at the hospital and check in.  I was extremely nervous.  I had previously watch a video on the procedure on YouTube and it scared me. The patient was a guy so I figured he was being strong because he never flinched.  The thought of a cannula going through my back freaked me out.  I got called back and my cousin and aunt came with me.  I met Dr. Haq and he explained what was going on and updated me on the conversation he had with my oncologist regarding my situation.  I was on Coumadin and there's always that chance that I could bleed but since I had a blood clot in my neck, my doctor did not feel comfortable taking me off of my blood thinner.  Dr. Haq is an amazing doctor.  He told me he prayed for me the night before and it touched my heart.  He showed me my chest x-ray and I was amazed to see how much fluid I had in my lung.  No wonder I was short of breath! The doctor told me he expected to remove about a liter of fluid.  I joked around with him asking him if he had done this before, asking him if he had recently graduated from med school, and if he was selling used cars before this.  We all laughed. 

He left the room and allowed me to change into my hospital gown.  I had to have Delia help me undress since I was having pain in my neck and arm.  Once I was ready, Dr. Haq came back into the room along with Nurse Gail who would be assisting.  I sat in a chair with my arms resting on a stretcher.  Delia stood to my right holding my hand.  I squeezed tightly. Dr. Haq felt in between my ribs and used the tattoo of a Ganesh I have on my back as a reference to where he would be making the insertion.  He sterilized the area and then gave me a shot of Lidocaine to numb the area.  The shot hurt but then I started to think about the fact that I have my back completely covered in tattoos and how painful that was and I immediately got over it.  Dr. Haq started explaining to me step by step what he was doing I realized I couldn't handle him tell him what he was doing so I told him there was no need to and I'll do the talking. I distracted myself by talking about randoms things.  Then all of a sudden when the cannula went in, I let a bit of a scream out and jumped.  It felt like I had gotten electrocuted.  I've never been electrocuted, but I have been shocked by those toys that have a hidden shocking device installed. It was like that and I felt it in my abdomen.  Like a bolt going through my back and bouncing in my abdominal cavity.  It only lasted a couple of seconds and then I was fine.  The pain was very minimal.  Dr. Haq told me to tell him if I was having any pain or shortness of breath.  He said that when I start coughing, that would be his cue to stop.  Delia was able to peek over and see what he was doing and she said that after he had given me the Lidocaine shot, she had him insert a metal tube that looked scary. Thank God I wasn't able to see any of this.  I chatted with Delia as the fluid was being drained out my lung.  Dr. Haq collected one liter of fluid and started on another.  The bottle was filled up about a quarter of a way when I started coughing.  This means that my lung was starting to expand back into place.  He removed the tube and bandaged me up.  Nurse Gail applied pressure to the insertion site to minimize bleeding.  The fluid looked like apple juice with white foam on top.  Dr. Haq explained that the fluid would be sent to the lab to check for infection and other things.  There is a good chance that the fluid would come back, just like ascites, and there was nothing I could do to prevent this. 

Sorry for the bad pic but this is one liter of chest fluid.

My next stop was over in the Radiology department where I was to get a chest x-ray.  I held onto the bag which contained my chest fluid and I snuck a picture of it.  Nurse Gail wheeled me over and I checked in.  Gail walked across the hall to the lab to drop off my fluid.  A tech called in back shortly afterwards and I luckily it was just a standing standing x-ray.  Dr. Haq had told me to wait around afterwards for a minute while he took a look over the x-ray before I left.  He checked it out and gave me the ok.  Delia wheeled me into the dressing room and I put my dress back on with her assistance.  She drove me home where I sat in my recliner resting for a bit before dinner.  I was to take it easy, eat a light meal, and I couldn't shower for 24 hours.  If I had any complications, I was to call the advice nurse or head to the ER but luckily I didn't have any.  

Site of where cannula was inserted.

Even though I was completely freaked out by the thought of the procedure, it really was not bad at all.  And it wasn't painful.  I really do need to stop watching YouTube videos.  My oncologist told me to let her know if I had anymore issues with shortness of breath so we can drain my lung again.  And if I do need one done again, I won't be scared.  I'll just need to hold onto someone's hand and squeeze hard!