Spring Agenda - Thoracic Surgery 05.24.24: T+7 - One Week Anniversary

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It's a good thing to have nothing to report. The pain is now more "nagging" than anything else, and if I can sit with pressure on the right side of my back I'm good. No more thoughts of  violent attacks with bats, clubs, knives or hammers.

I vacuumed the carpets and swiffered the floors yesterday, with no problems. I still tire easily but I'm gettting my stamina back too.

Any news about me was eclipsed by the Manhattan jury's verdict late this afternoon. Former President Donald Trump was convicted of 34 felony counts in his hush money trial.

Spring Agenda - Thoracic Surgery 05.24.24: T+6 - Turning Point?

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After crashing on Tuesday evening, I was careful yesterday and managed my activities quite well all day. Still, it's very frustrating -- nothing says "physical wreck" like wondering if you have enough energy to walk to the mailbox and back. I want to  have a little more empathy for people who have to live this way all the time, in circumstances far less pleasant than mine.

One of the thoracic surgery nurses called me yesterday and encouranged me to take a shower (duh -- done as soon as the post surgery 48 hours were up) and take off the bandages (the take-home instructions said something like "at your discretion", so I hadn't touched them). The dressing removal was a game changer. I immediately felt better with nothing pulling at the skin on my side and back. It sure made getting into bed less difficult.

I'm going to stop reporting on pain. I feel now as though I've been hammered with one of those meat tenderizer mallets. Pain didn't keep me awake. I did that all on my own, as I gradually regain the insomniac tendencies that cause me to bound out of bed at 5 AM. I'm not doing much bounding yet, but I got up at my usual early hour.

The only anxiety now is waiting for biopsy results. I was told yesterday that the timeframe is "7-10 business days". That takes us well into next week, when I have several follow-up medical appointments on Thursday and Friday. While I may not need more treatment if the nodule and/or lymph nodes were cancerous, I would like to know.

Spring Agenda - Thoracic Surgery 05.24.24: T+5

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Late evening seems to be my worst time.  I try not to get settled in bed to watch TV until after sunset (8:48 PM yesterday) and I'm exhausted by then. I was dismayed that it was still very painful to get myself re-positioned once Bob came in after the Timberwolves beat the Mavericks (Dallas; Game 4; 105-100). Crying jag until the last dose of Tylenol kicked in. 

I actually had a good night and felt somewhat refreshed when I woke at 3 AM. No more hunting knife in my back. The instrument of torture felt like a paint scraper or chisel, and I sensed some residual pain from last Friday's baseball bat. This morning I was up shortly after my usual 5 AM and I got back to doing my Spanish in the sunroom. I feel more like "me".

Today is beautiful, nothing like yesterday's intermittent showers. The sun is shining; the sky is blue. I'm listening to "Morning Joe" on MSNBC. The phrase "blocking and tackling", used in this segment in reference to the 2024 presidential campaign, seems to be applicable to my situation as well. Figuratively, of course.

Blocking and tackling. I can do this.

Spring Agenda - Thoracic Surgery 05.24.24: T+4

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Yesterday was a fine day. Several walks, a little drive in the country. Not much to do except look at the windows that need a good wash, and I window washing is a little beyond the limits of both my energy and physical ability right now. We seem to have a lot of rain every day, so this is probably not a good time for that project anyway.

Last night I had no trouble getting settled in bed. My wounds didn't bother me and the ribs felt pretty good too. Best of all, when I woke up at 3 AM, I had graduated from machete to hunting knife in the pain department. It's nearly noon on Tuesday, and the knife feels as though it's twisting around in my back but it's all very tolerable. I don't know how a twisting hunting knife can possibly be an improvement over a slashing machete, but it is, at least in this analogy.

The biggest challenge is cobbling together a good seating arrangement. So many sofas and chairs that other people find comfortable are too big for me and I need a straight back. I'm sitting with a firm foam cushion behind me, and I have an adjustable tray table in front.

We're good for now!

Spring Agenda - Thoracic Surgery 05.24.24: T+3 - Memorial Day

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Beautiful flowers from my brother Allan and sister-in-law Laurel yesterday. They really gave me a big lift on what could have been a challenging day.

I didn't do too much but was happy to walk around the west Upper 9th Place oval a couple of times for a grand total of about a quarter of a mile. Just a start, I guess. I don't want to be out in a crowd because of the risk of getting a cold or other virus, so I'm going to limit activity for a while. Yes, I should wear a mask but it's hard with glasses and I tend to hyperventilate, so it's out for now. Bob and I did get to Lund's & Byerly's, which was almost empty in mid-afternoon. Back to Mass next Sunday.

I woke up laughing at 2 AM, thinking about the first question I got about pain in the hospital. For some reason I didn't answer with the expected number between 0 (no pain) to 10 (worst pain ever), and got a strange look when I said it was llike I'd been hit by a baseball bat. A minute or so later, I revised the weapon to a golf club. Last night I felt "slashed by a machete" but am quite well just after 9 AM and the pain is very manageable, between 2 and 3. For the record, thoughts of violent weapons really came out of nowhere -- just the product of a wild imagination. 

My first shower felt wonderful on this Memorial Day. I'm watching stories about those who served and paid the price of freedom. As he has done in the past, former NATO Supreme Commander James G. Stavridis paraphrased the last phrase of the national anthem: we live in the "land of the free because of the brave."

Spring Agenda - Thoracic Surgery 05.24.24: T+2 - Not so Quick, Missy

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Yesterday was a great day. Most important, I wasn't dead or dying; next, I came through the surgery without a stroke or heart attack or any other awful event, and I seemed to be thinking as clearly as one can under difficult circumstances.

I had a light supper and enjoyed yet another popsicle before going to bed. And then ... a heavy ache exacerbated by the burden of fatigue hit me. I found myself watching the clock, waiting for 8:00 PM when I could take 1000 mg of Tylenol. Before bed, I decided to go for the gabapentin (common brand name is Neurontin -- one of those multi-use drugs that helps with nerve pain and for me, it acts as a sleep inducer) and methocarbamal (common brand name is Robaxin -- for muscle spasms, which I tend to have anyway, because of MS, I think).

Getting into bed was awful. I sat down too far from the head of the bed, and moving back felt as though as I was sliding over bumpy wood. We have an adjustable split king bed, so fortunately I could fool around with controls until I found a reasonably comfortable position. I whined and swore. Not my finest moment.

Finally I got settled, but the only thing that kept me for resorting to oxycodone was the thought that I'd have to start all over again with the bed. Now, I specifically avoid any kind of heavy duty painkiller because opiates not only confuse my mind but also give me a headache and nausea. So this is evidence of how desperate I had become. I tried to quiet my mind with a few Hail Marys and eventually fell asleep. I was awake for a couple of hours after 3:00 AM but woke this morning at seven, a full two hours after I usually get out of bed.

I can't take a shower until tomorrow but managed to get reasonably clean, and I thought of my wonderful nurse Alice who laughed when I told her I didn't want to smell. The anticoagulant shot in the abdomen (enoxaparin -- common brand name is Lovenox) was easy from years of experience with myself (Avonex for MS) and Fritz the cat (insulin for diabetes).

I'm sitting at the dining room table in a straight back chair with a pillow behind me, and that may be the best position, as it so often is. Feeling energetic again, so this should be a good day!

Spring Agenda - Thoracic Surgery 05.24.24: T+1 Discharge

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The day was almost shockingly easy. I was visited by three people on the thoracic team today at 7 AM and declared in good shape, probably ready for discharge sometime in the afternoon. The morning was filled with blood tests, a chest X-ray from a portable machine wheeled into my room, a session with a physical therapist, and many visits from my nursing team.

After being on a clear liquid diet since Thursday, including three delicious popsicles, I was allowed to have regular food. I ordered a roast beef sandwich on whole wheat bread with swiss cheese, lettuce and tomato (no condiments) and I've never had anything so delicious. A couple of graham crackers and vanilla pudding seemed like a goormet dessert. I also managed to down three cups of hospital coffee, not very good and I really wonder if there was any caffeine in them at all.

My wonderful nurse Alice told me at 12:45 PM that I was being kicked out, so I called Bob, who arrived 45 minutes later but ended up having to wait for about another 45 minutes until I was ready to go. Alice walked me to the pharmacy to pick up my prescriptions, and, for the first time ever, I walked out of a hospital instead of being wheeled.

I've been home for an hour or so and am enjoying a cup of my own Earl Gray tea. I do have some pain in my ribs on the right side, but Tylenol seems to work well on it. Since there won't be any news until I get a biopsy report, I probably won't have anything to blog about for a few days.

So, in the end, there wasn't much drama at all: just excellent medicine in a top medical facility.

Spring Agenda - Thoracic Surgery 05.24.24: T+1

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I was so wired, literally and figuratively, that I wondered if I would be able to sleep. I finally turned off the light after midnight and slept for about three hours. I've been up since about 3:30. So far I've had two popsicles since dinner on Thursday evening and the notation on my whiteboard hasn't changed from "clear" yet. I could use aslice of toast!

Otherwise I'm doing fine. I love hearing the nurses' stories. Jessica moved to Minneapolis at the age of  8 from Idaho, where she was a Mexican migrant worker. Jessica's mother, who speaks little English, has had a hard life. She's also worked several of those physically demanding meatpacking jobs. Jessica graciously spoke Spanish with me and complimented me on my fluency, even though I still had that colorless sound thatt seems to characterize my speech after surgery. I think I'm better this morning and am losing that one-cocktail-too-many vibe.

I no longer have supplemental oxygen and my dressings have been changed. I do feel a little tired but I think that will pass. I'm hoping to check off occupational and physical therapy today. I'm overwhelmed by the positive energy and prayers everyone who has lifted me up these last few days. No one could ask for more!

Spring Agenda - Thoracic Surgery 05.24.24: Surgery Today

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The day finally arrived. I woke up at my usual time and went through my usual morning routine – Spanish, Wordle, stock market review. Took the required shower (first one was last night) and cleaned the guest bathroom. Did a last load of laundry. Chris arrived shortly after 9:30 and headed with Bob and me to the hospital in non-rush hour traffic. Arrived before my 10:50 appointment and almostimmediately got into the pre-op routine. Bob and Chris were with me until I went into surgery at 2:30 -- they had a very long wait because I didn’t get out of surgery until 6:30 and weren't allowed to see me until just before visiting hours ended at 8:00. It was a very hard day for them, and I really appreciated their presence.

The biopsy during surgery was “inconclusive” for now. Someone on the medical team talked to Bob and Chris and said we’d have results in about a week. I think I’ll have a chance to talk to one of the two surgeons tomorrow, and I expect to be more “with the program” then, so I’ll have a clearer understanding of what’s ahead.

The right lung middle lobe was removed. I woke up from surgery quickly, though for the first seconds I thought I was in the recovery room from a previous surgery – not sure which one. I had ice chips  and apple juice, got my phone and laptop. The oxygen sensor on my left middle finger makes it hard to type and I fear that talk-to-text would require too many corrections. I finally got into a room at about 9, I think. I've been up already and am fairly stable, though I've been warned not to walk on my own.

Nurses and techs keep coming in to check and, well, test. I can read results on my online chart, and everything is normal so far. I'm still drinking juice and cooling my mouth with ice. My pain is minimal at 11 PM.I really feel as well as anyone could under the circumstances. I’ve texted a few people and talked with Bob. I’m sad that the Timberwolves lost Game 2 to the Mavericks. Thank you, friends, for all the texts, cards and good wishes. I couldn’t be a more fortunate person! Looking forward to a good day tomorrow and a more coherent post.

Spring Agenda - Thoracic Surgery 05.24.24: T-1

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I'm as ready as I can be. My main objective was to make it through the last couple of weeks without getting a cold -- and so far, so good. We've had a lot of rain in the last week and I have the probably mistaken idea that viruses are washed away and the air outside is clear and clean.

Yesterday evening we enjoyed a short visit from DIL Meggan, whose energy and positive attitude are energizing and encouraging. She and other family members will be spending the Memorial Day weekend in the Upper Peninsula. No weekend trip for us this year! As Bob joked yesterday, we'll be celebrating on the East Bank .

Spring Agenda - Thoracic Surgery 05.24.24: T-4

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In the last couple of weeks I've sent private messages to a number of friends and family, so that they wouldn't learn this rather news indirectly. I decided this morning that I just couldn't cover everyone so I"ll just stop now. On Thursday I'll post a link to this blog and go on from there.

I'd be ready to show up for surgery tomorrow if I got a call. I'd simply race through the things I want to get done before Friday, mostly involving various degrees of cleaning. What kind of pathetic person has a to-do list consisting of changing sheets, doing laundry, vacuuming, washing floors, and cleaning bathrooms? I see only one hand raised!

I've received so many positive messages from people that I feel a little overwhelmed. The "kindness of strangers" is  exceeded only by the warmth and care of those closest to me. So thank you all.

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.