SPRING AGENDA - THORACIC SURGERY 05.24.24: Backstory

When we returned from Florida in March I couldn't foresee that the months of April and May would be mostly consist of medical appointments and preparation for surgery. Suddenly my self-imposed timeline took on real meaning: projects that require any kind of physical exertion are being completed now, rather than spread out over the summer.

A Little History

I'm a "rule follower" in most aspects of my life and I usually schedule the annual visit with my primary medical provider in the fall, so that I can update any immunizations at the same time. At last October's visit, I remembered to ask if I sill needed a lung CT scan (actually, I'd thought it was a chest X-ray), like previous imaging ordered periodically because of presumed benign lung nodules found a number of years ago. I hadn't had one since the COVID pandemic, but there was no reason to expect any change. And there wasn't.

However, a new “suspicious”, “spiculated” lung nodule about 1.5cm in diameter was seen in my right lung (middle lobe). I was immediately referred to pulmonologist Dr. Jennifer Wong sho ordered a PET scan and then a biopsy on December 13.  No malignancy was found in either the nodule or the lymph nodes. A full complement of tests uncovered no fungal or bacterial infection. I kind of forgot about the issue until we returned from Florida at the end of March.

I had a follow-up CT scan on April 4 and was somewhat surprised to learn that the nodule had increased in size a little, adding to the concern. Pulmonary function tests were all normal (I like to think “better than most!”) and I saw thoracic surgeon Dr. Rafael Santiago Andrade on April 18.  Since it was unlikely that anything would be gained from a repeat biopsy, Dr. Andrade recommended surgery, now scheduled for May 24, to remove the nodule and obtain a definitive diagnosis. The nodule will be tested for cancer, and if none is found, excision of the nodule will be sufficient. If it is malignant, the middle lobe will be removed in that same surgery. If the nodule is cancerous, it is stage 1A (very early). 

Scans, Tests and Pre-op

I've almost lost count of the number of medical appointments, scans and tests. Yesterday, I had the pre-op exam and the surgery will go on, as scheduled. I knew that Dr. Andrade would be out ot town -- he didn't want the surgery to be delayed until his return, so my appointment was with his partner, Dr. Amit Bhargave. Dr. Bhargave is as well credentialed as his Dr. Andade and very personable as well. I feel confident that I am (literally) in good hands.

I have an excellent care team. My awesome nurse practitioner Breanna McCarthy and other medical professionals have called me immediately after "alarming" news was published on my online chart. There's nothing like empathetic human contact to calm one's nerves -- everyone I've met has "soft" people skills as well as professional expertise.

Next Steps

Nothing much to do, except practice breathing with a volumetric spirometer, stay hydrated, rested and well nourished. Late in morning on May 24, Bob will come with me to M-Health Fairview University of Minnesota Hospital - East Bank, where I had the biopsy before Christmas.  This is major surgery, with some risks, but I am a good candidate, and I should get through it OK. I expect to be in the hospital overnight and activities will be restricted for a week or so. Recovery will probably take a month and full recovery up to three months, but I should be able to enjoy the summer.

While this seems like "bad news", like a true Minnesotan I know "it could be a lot worse" and am particularly aware that the only reason the nodule was found at all was because of my previous history. I'm an optimistic person and overall, I feel very upbeat.

Updates to follow.