Catheter to the Back...Another Thoracentesis!

As scary as it sounds to have a catheter shoved into my back, I must be strong and get it done.  My life is miserable not being able to breathe right.  I am short of breathe even when I talk.  I am winded by the time I reach my 2nd floor apartment.  Something has got to give.  I am scheduled for a 2nd thoracentesis (my first one was in June) on Wednesday, July 18th, at 8:30am.  My sister, her boyfriend, and my cousin Delia all accompany me to my appointment.  I check in and wait to be called.  The night before I did not take my Lovenox shot, just in case.  I figured I needed my blood a little thicker so I wouldn't have an issue with bleeding.  The medical assistant, Maria, calls me to a room in the back where the procedure will take place and I take Delia with me. My sister and her boyfriend had gone grocery shopping for me and would meet us back at Kaiser.  I know how this is done so I'm not really scared, just anxious.

Very anxious!

Maria takes my vitals, gets a gown out for me, and has me sign a consent form.  Suddenly Dr. Haq appears and I am glad to see him.  He really is a great doctor.  We greet each other and I tell him about the shortness of breath that I have been having.  He logs into his computer and brings up my chest X-ray that I had taken on July 10th.  I am amazed at how much fluid is in the pleural cavity of my left lung.  This is called pleural effusion.  Dr. Haq explained to me that the fluid from my ascites seeps up into my pleural cavity and accumulates.  Therefore, since my ascites is ongoing and forever, the fluid will always make its way back up into my left pleural cavity and I will continue to need to have it drained.

My left lung shows fluid.  Shadow on right lung is my liver. 

Dr. Haq also clarified for me that the ascites fluid and fluid from my pleural effusion contain cancer cells.  So we're not sure actually if the cancer has spread to my lungs, we just know that there are cancer cells floating around in there.  That made me feel so much better.  I didn't need one more important organ in my body shutting down on me.  Dr. Haq knocked on my back with his hand and he showed me how he can hear where there is fluid in my lung.  That is one thing that I love about him.  He answers all my questions and also makes this a very educational experience for me.  Instead of a nurse today, Maria the medical assistant will be helping out.  I hope she's done this before.  They leave the room and allow me to change into my gown with Delia's help.  I'm all ready to go and they reenter and Dr. Haq asks me to verify my name and my medical record number and what procedure we are doing today.  He starts opening up the kit he will use.  

The tools used during the thoracentesis.

Not gonna lie...I'm scared!

Dr. Haq begins to sterilize my back.  He remembers from last time that he used that elephant's elbow as a point of reference (I have a Ganesh tattoo on my back).  He then tells me he is going to numb me with Lidocaine.  The shot stings a little but it's nothing.  Now all of a sudden without warning I feel a pinch.  I feel like I have gotten shocked and it echoed throughout my stomach.  It's such a crazy feeling.  There's no pain, it's just a bit uncomfortable for a few seconds.  I let out a scream and Maria gently places her hand on my arm and tells me it's going to be ok.  Meanwhile, I have Delia in front of me and I'm squeezing her hands like crazy.  Dr. Haq begins removing the fluid from my pleural cavity.  I make small talk to make the time fly and then we take a break for a second.  He tells me to let him know if there is any pain or shortness of breath.  So far I'm doing ok.  We have one bottle filled up and start on a second.  The key to stopping is when I start coughing.  Everything is being done behind my back, thank God, so I can't see what's going on.  Delia later tells me that, in the picture above with the tools, the long tube, at the very tip is metal and that is what goes into my back.  This makes me cringe.  I start to cough and Dr. Haq removes the catheter.  That part is painless.  He bandages me up and he places the bottles of fluid up on the tray for me.  

Bandage is where catheter site was.

That came out of my left pleural cavity!

I am just amazed at all the fluid that was in me.  He collected 1700cc's and that made me lose about 4 lbs.  My next step is to head on over to radiology to get a chest x-ray done.  This will show how much fluid has been removed and if the lung has re expanded, also, if the lung has collapsed during the procedure.  Maria sets me up with a wheel chair and she takes me on over to radiology.  We say our goodbyes and she drops off my fluid at the lab. It will be analyzed same as last time.  Since Dr. Haq is waiting, I get called back very quickly and the tech has me in two different positions for my chest x-ray. 

I'm ready for my chest x-ray!

Dr. Haq reviews my x-ray and tells me that everything is ok and that I'm free to go home.  He did discuss a couple of other options after I asked him if it looks like I'll be needing to come back on a monthly basis to get my lung drained.  He did bring up that there is a possibility that I can have a PleurX Catheter placed on the left side of my chest.  This would allow me to have my caregiver drain my pleural effusion at home.  After he spoke with my oncologist, they felt this was reasonable.   I had a few questions for him but overall I felt ok proceeding with this.  Dr. Haq told me that there was no rush to have the placement done and to let him know if I was having shortness of breath again so I can have another thoracentesis done.  

After leaving radiology, we stopped by the cafe and I ordered a coffee.  We walked outside to the car where my sister's boyfriend was waiting for us curbside.  All of a sudden I started to get sick.  I started to want to vomit.  My sister gave me a grocery bag and I vomited.  Delia reminded me that it was the cold air.  Last time, the cold air was very harsh on my lungs and I had the same symptoms.  We made it home safely and I changed into my pajamas to rest.  My lung re expands back into place but it takes me a good two days to finally feel good and not have any shortness of breath or discomfort. 

I'm happy that there is another solution but I wondered if it meant that I was just getting sicker and my pleural effusion was getting worse.  I just want to look as normal as possible.  Even though I may not be able to feel great all the time, I can do a pretty good job of faking it with make up and a nice outfit.  On July 18th, that day marked 6 months since I have been out of work and on disability.  My life has drastically changed.  I'm used to not working anymore.  I'm a warrior.  I have the hardest job of my life ever possible.  Knowing that 6 months has passed, I started to worry about the amount of time I have left.  The clock is ticking and there is nothing I can do about it.  What if I only have a year left? Year and a half? All I could think in my head was 'Damn...how could this be???'  I started to wonder about the things I still wanted to get done.  But then I brought myself back to reality.  Back to today.  Right now, in this moment.  I can't worry about the future.  So what if I have a year left.  No one really knows.  I could have 5 years left for all we know.  One thing I know for sure is that only God has that answer.  I can only trust that he is doing the right thing for me.  

Recovering in bed with Molly by my side.