Surgery date is set

The good news is that we have scheduled surgery on my right lung for October 19, and I had a pulmonary function test and my pre-admission testing before we left the building yesterday, so that's out of the way. The bad news is more growth (and one supposedly new nodule), which eliminated the option to perform VATS. (VATS is video assisted thoracic surgery and is similar to laproscopic surgery in that the surgeon uses a small camera and surgical tools inserted through small incisions -- in this case, in the back.) The largest nodule is now 4.6 x 2.3 cm (1.8 x 0.9 inches) versus 3.1 x 2.1 cm (1.2 x 0.8 inches) only two months ago. Four other nodules in my right lung and one nodule in my left lung increased slightly in size. Now he will perform a thoracotomy, which involves an incision from my back to my front around my chest and separating my ribs. He hopes to remove the large nodule by doing a wedge resection, which would involve taking a piece of my lung with clean margins, but he thinks he will actually have to remove my entire upper right lobe (a lobectomy). The other nodules will be removed via wedge resections and he will feel around in the lung for any other nodules that the scans may have missed.

Sounds like a fun time, doesn't it??

While this was not the surgery I was hoping for, it's obviously the only option at this point. I had good reasons for waiting, and once we made the decision, we needed to live with it, so that's what we are doing. This type of surgery will allow him to get clean margins, which are necessary to prevent local spread of the disease. I think he will probably encourage me to have chemo to reduce the size of the nodules in the left lung before he considers doing surgery again, but he said he didn't want to discuss it until he sees how I tolerate this surgery.

He also fibbed. They cannot use my port for surgery. That means another IV line, which is not my favorite thing, plus I get an epidural in my spine. More fun.

Unfortunately, and this is partly my fault, my lung function is not great. As you all know, I don't exercise and therefore my lungs are very weak (aided and abetted by the nodules). I am now required to walk a mile (minimum) a day and use a spirometer 10 times in the morning, at midday and in the evening. (See a spirometer here: http://en.wikipedia.org/wiki/Spirometer) The first time I tried it (I'm inhaling on it), I couldn't move the blue disc on the left at all. How embarassing. This morning, after using it twice yesterday, I'm up to 1250. (Ed got it up to 3250.) I have a long way to go! I guess this just goes to prove that those of you who share my dislike for exercise should just suck it up and get moving. Otherwise, it could come back to haunt you.

The doctor is requiring me to have a stress test because he doesn't want "any surprises" involving my heart. I have one scheduled for October 5. At least I'll have more than 10 days of walking under my belt by then so I shouldn't be a total schlub. That will be the end of my testing before surgery. I will now be in the hospital for four days rather than two, but they will boot me out of bed Tuesday morning (Monday night will be spent in the recovery room). The nurse practioner who did the pre-admission testing told me that I will have to walk a mile at the hospital and use the spirometer starting Tuesday. They want to prevent pneumonia and other complications, so they are very aggressive on this front. Sounds like more fun.

So, now we begin the wait. I've been thinking about it a bit (and made the mistake of looking at a photo online of a thoractomy incision -- I recommend against it), but I'm sure not to go into a panic until the 18th. Until then, I need to cram 47 years of exercise into less than four weeks. Think I can do it? Not a chance, but I can do my best. Wish me luck.

I have a Zometa treatment tomorrow, but my chemo is done until sometime after surgery. I need to either talk to or see Dr. K to find out what my chemo options are now that we can see definitively that Gemzar is no longer working.

I hope all of you are enjoying a week with better news. Thanks for listening...