Pleurodesesis

October 6, 2010

I left the hospital and returned home today. I was in the hospital for a pleurodesis. This is an painful procedure in which talc is sprayed into the rib cage to cause irritation between the parietal and layers of the pleura which closes off the space between them and prevents fluid from accumulation. That's a lot of big words which I had no prior knowledge of. One positive aspect of these recent events is that my medical vocabulary is rapidly expanding.

Earlier, in August, I started having difficulty breathing. Specifically, climbing the stairs to our bedroom and getting into bed left me breathless. Also, increasingly, I had difficulty finishing my workout at the gym and had to drop out. Clearly, this wasn't normal so I went back to the doctor for a checkup.

A chest x-ray showed an accumulation of fluid between the layers of tissue that line the lungs and chest cavity. The medical term for this is a pleural effusion. The fluid was drained by a procedure known as a thoracentesis in which a plastic catheter is inserted through the back and into the chest wall. The fluid is then vacuumed out. I had an accumulation of 2 liters of fluid. The result of all of this fluid is that the lung was crumbled into a small fist effectively closing off its ability to expand and take in air.

There are a number of reasons for a pleural effusion. The most common one is the failure of the left ventricle of the heart, also known as congestive heart failure. Leaky blood vessels are another cause of pleural effusion. Leaky blood vessels are caused because of lung diseases. Some of the most common causes are lung infections, tuberculosis, pneumonia, breast cancer and lung cancer. I was hoping for tuberculosis because it is easily treated.

Sadly, a PET scan and tissue biopsies showed lung cancer. I have a large tumor in my upper left lung chamber, another tumor in my left pelvic bone and multiple nodules in the chest cavity. Because of the number of nodules the tumors cannot be surgically removed. Also, the cancer is considered non-curable. All that can be done is to shrink the tumors and stop the cancer from spreading.

Without treatment the oncologist has estimated that I have 6 months of life remaining. The standard treatment is chemo which can lengthen that time to 5 years. However, other treatments are available which may give even better results. We are to visit with the oncologist again on the 18th of October for a treatment plan.

It goes without speaking that this is a surprising and sobering experience. Yet I am generally calm and resigned to my fate. Resigned is too fatalist, actually I look forward to the future with faith and a desire to use this experience for good. I know that there must be a way to turn this way into an uplifting experience.