Two days, two doctors

I have to admit that despite just having seen the pulmonologist and the surgeon, some things we discussed are a blur. Nevertheless, we did get some answers to some of our questions (and there were questions we forgot to ask).

The pulmonologist has given me a bronchodialator (Symbicort) to try for two weeks to see if that gives me any more relief. He confirmed that it is the tumor pressing on the phrenic nerve that is causing the cough, but unlike the interventional radiologist that Dr. K spoke with, he feels that even if that nerve was permanently damaged or destroyed, the side effects would be minimal. Something to keep in mind.

He also agreed when I suggested it that CyberKnife might be an option to deal with the main tumor. As you may recall, we explored CyberKnife last year when we were dealing with the bone metastases, but decided to go with the experience of Dr. Yamada at MSKCC since we were dealing with my radiation close to my brain. We are going to schedule another appointment with the CyberKnife doctor and get his opinion on at least trying to debulk the tumor.

The surgeon said he thought he told us the possibility existed that the surgery would not be successful. Nope, you didn't. He explained that he absolutely could have performed the surgery to resect the tumor and has done a number of similar surgeries, but the issue was location. If things had not gone perfectly, he would have had to remove the entire right lung. Because I have metastases in the left lung already, he felt I needed all the lung capacity I could get for as long as possible. He wouldn't have wanted that chance taken on himself, therefore he didn't take that chance on me. He views every case individually to decide what's best for each particular patient, and while it was disappointing not to be able to remove the tumors, he did what he felt was best. He described himself as very aggressive, yet this was a decision he was comfortable having made. I was satisfied with that explanation.

He removed the steristrips and my incision looks pretty good. No stitches to be taken out, thank goodness. He then suggested that he would contact the pain management department at MSKCC to find out about numbing the phrenic nerve, as he did after surgery, to provide me with some relief from the cough. I don't know if I would be willing to have shots every five days (which is how long his shot lasted) for the foreseeable future, but we'll have to discuss that with whomever he puts us in touch with. He, too, thought CyberKnife was something to look into.

So that's the update for now. We'll set up an appointment to find out more about using CyberKnife on the main tumor and wait for Dr. K to call back with more information on the clinical trial. In the meantime, I am continuing my walks, taking naps when I need to, and trying to get some more calories into me. It will take time, but I should be back to feeling more normal soon.

Thanks for all the cards and e-mails. I really appreciate your support.

Nap time!