Just like my kidneys, I never worried about my lungs. Even 1.5 years ago when a 'rounded atelectasis' was seen on my lower right lung, I did not think much about it at all. I am thinking a lot about it now.
It has slowly grown over the last 1.5 years, leading us to believe that it is not a rounded atelectasis but, rather, a carcinoid metastases. We still did not worry too much about it until yesterday. I went in for my routine visit with my local oncologist and he listened to my chest and could not detect any breath sounds in my right lung and said that there was a 'dull' sound when he tapped on it.
After my visit, he had me get a chest x-ray immediately to try and identify the reason for the sounds and that x-ray showed that I had significant pleural effusion on the right lobe. That is a fancy way of saying that the sack that contains the lung had a large build-up of fluid that was causing some of my shortness of breath.
Well, Friday morning, I was quickly referred to a pulminologist (is there a specialist I haven't seen yet???) who inserted a needle into my lung and drained off some fluid. By some, I mean 1500 milliliters. That two liter bottle of soda you just got at the store; it was three quarters of that. When draining fluid, he never draws more than 1800 milliliters and draining fluid starts to hurt as it goes longer so I had him stop before it was done.
When you drain fluid off of the lungs, there are three possibilities. First, you can have clear fluid which is usually not caused by any critical event but the reason for the fluid still needs to be found. Second, it can be cloudy which usually means that there is an infection of some sort. Third, it can be bloody which indicates one of tuberculosis, heart issues, or cancer. While we don't have the official answer yet, you know, just like I do, why my fluid was bloody.
We then did another chest x-ray to ensure that he had not punctured the lung and got another surprise. My lower lobe did not inflate and the esophagus deflected to the right side. What this means is that the area that was cleared of fluid did not re-inflate the lung and that the vacuum that was created, pulled my internal organs to the right. This indicates that I now have a collapsed right lower lung and that is something that will not repair itself with time. We also still saw a significant amount of fluid in the pleura so there is more fluid that can be drained but the collapsed lung means there is not any point...
What do we do at this point? I don't know. I believe that a lobectomy can be performed to prevent the cancer from spreading further in the lung and I am going to schedule an appointment with my doctors in New Orleans to consult with them. I do know that the prognosis with lung carcinoid is similar to that of my abdominal carcinoid but don't know if that assumes resection of the diseased lung. I do know that fluid will continue to accumulate and that we can go back and drain it again if the shortness of breath gets too bad.
So, when you see me walking exceptionally slowly into or from work at the MDIOC, it is not because I am being lazy but because I am trying not to lose my breath. Lack of lung capacity means many of my goals are probably out of reach at this point (don't think being moderately to severely anemic and having 2/3 lung capacity doesn't match up well with 14,000 feet of elevation). I don't know what the prognosis is at this point. I don't know what path we are taking. I don't know what to expect in the future and I don't know how this affects other plans.
What I do know is that I'm not dead yet. It is coming. It is closer than it was before but that is true for you too. It sucks. It is not fair. It is not fun. I hope that I can continue to annoy you and everyone else for years to come and I am going to finish this alphabet and then some.
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