…but if you try sometimes, well, you might find you get what you need.
This snippet of lyrics from the Rolling Stones kept going through my head yesterday while I waited in pre-op at Upper Chesapeake Medical Center for my turn to go to the operating room. I was there to have the dreaded PleurX indwelling catheter installed. It wasn’t what I wanted at all, but it turned out to be exactly what I needed after all.
Note: For those of you who are curious about a PleurX catheter and why it’s needed read on. If you’re not interested in detailed medical information skip down past the image and start reading again.
You may remember from past posts that my liver has been rather uncooperative for the last several months–since last summer when the cancer decided to take up residence there. Your liver is critical to your body’s overall functioning so this has not been good news at all. Since December I’ve had increasing bouts with pleural effusions. These collections of fluid gather in the pleura, a two-layered membrane that surrounds each lung to cushion and prevent friction as the lungs expand and contract. A small amount of pleural fluid resides between the layers to keep things moving well. Unfortunately, sometimes liver metastases can send extra fluid upward into the pleural space where it basically becomes trapped and pushes the lung upward. This in turn causes breathing problems and spreads cancerous cells. There are three solutions to the situation:
- Thoracentesis: I’ve had about half a dozen of these in two and a half years. It’s usually an outpatient procedure guided by ultrasound in which a surgeon inserts a needle into your back or side and uses a vacuum bottle to draw off the fluid. Theoretically, the lung will expand and all will be well. Sometimes, like with me, the fluid will return and eventually cause atelectasis (partial lung collapse). Relying on this procedure repeatedly puts one at risk for the fluid to collect in several discrete areas that makes drainage more difficult or impossible. Cancer is tricky.
- Pleuradesis: This is a permanent surgical solution that uses medicine, usually talc or doxycycline, to fuse the two layers together. This was what I had hoped to have, but my lung would not fully expand, so it was not an option. There are risks such as procedure failure, infection, etc., but then no medical treatment is without risk.
- PleurX catheter: This is a surgical procedure where the surgeon inserts an indwelling catheter into the pleura. The catheter hangs out of your body several inches, and you are able to work with a home health nurse or drain the catheter yourself using medical supplies and vacuum bottles delivered to your home. Eventually, the drainage should slow enough or stop completely, and the catheter is removed. My very excellent thoracic PA, Kevin, says that sometimes the pleura will even fuse on its own since the catheter is an irritant. I will do all I can to help that process by using my trusty spirometer.
No, it’s not what I wanted at all, but this morning my coloring was already better, and I have more energy. I have been able to eat more and move better; even stairs are easier. This is a good thing. Those who live with metastatic disease know that cancer can turn on a dime, and that disease progression is a reality that cannot be predicted. You learn to live in and for the moment. You begin to grasp the preciousness of each day. You treasure the texts, cards, small reminders of love and care, and some days you get a special lagniappe like I did when I arrived home from the hospital–a beautiful flower arrangement from our friends B and K. Thank you, friends, for making my day, my birthday, and my life so much brighter.
Whether you live with this precarious reality in your life, or whether your life is just peachy keen and dingle-dog-dandy, don’t take one breath for granted. The present moment is all any of us really have. Let us remind one another of that fact by not taking anyone for granted; love lavishly, serve generously, and give prodigally. The one with the most toys still dies but doesn’t get to take any of it along for the ride.