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Mornin' All, just a quick message to relay yesterday's happenings... * * * Brenda's and my day, she was with me all the way. We checked in at VGH Admitting around 12:00 Noon, Aug 13, 2003 I was there for a routine out-patient procedure - thoracentesis - (draining of the pleural effusion that is restricting the capacity in my left lung). I handed the admitting person my wrist band from the previous week, my CARE Card, and checked in in a few minutes, (they were expectin' me) and proceeded down one floor to a Day Bed area just down the hall from the Broncoscopy suite. Get yer duds off, put this skimpy gown on backwards, old hat stuff!! Wait for the porter t' wheel ya down the hall... Soon I was in the Broncoscopy suite, where I had a Broncoscopy last Thurs., for biopsy of the tumor found in the upper lobe of my left lung. Ahh.. there was a familiar face. Anne hooked up the ECG, applied the Blood Pressure Cuff, the finger clip monitor, and tested the equipment... Old hat! Ready t' roll.... Dr. Ayas was to tap the pleural effusion on Wed. Aug. 13th. at 13:00 Hours... He was late... 13 minutes... not that I'm superstitious... He intended to use a biopsy needle to drain 1 to 1.5 litres of fluid... which would allow my lung to expand, restore temporarily my lung capacity, possibly allow me to rest a bit easier and get a decent sleep... The thoracentesis procedure also allows biopsy of the pleural effusion. Dr. Ayas explained the procedure and I signed the consent form. This was 'sposed t' be a quick outpatient procedure / roughly 1 hour plus 1 hour rest and observation, after which I would return home. They had me sit up, bend slightly forward over a bedside table. He prepped the area on my back, applied a local freezing and got started. That's when Parkinson's showed up in the form of hypotension... Suddenly I felt dizzy, my blood pressure dropped, and my heart rate ticked down into the 30's... I had forgotten to warn them that I'd experienced hypotension before... I was probably somewhat dehydrated as well... fasting, fluids only from the night before... I think I only had two glasses of water... one with each set of Parkinson's meds... I'm sure I went pasty white... almost passed out! Now I needed an IV tap... and Oxygen... Sooooo ... lay back and relax, suck up some Oxygen... IV tap in, wait.... About an hour late we resumed the thoracentesis procedure... Things were still not going as planned... Dr. Ayas had difficulty getting the fluid to drain... Finally we had about 750ml of clear straw colored fluid... Not all that's in there, but enough for today... An imbalance between the venous-arterial pressure and the pressure within the pleural space (oncotic pressure) causes transudative effusions. Transudates contain few protein cells and little solid material content and have a clear, pale yellow color. Dr. Ayas explains that this fluid looks fine under the circumstances. In due course they wheeled me down the hall for a chest Xray to confirm where we're at now... One from the front, one from the left side... Okay... "Kodak" moments are finit.. Back to the day bed area for rest and observation... It's 15:30 now... I get apple juice and my Parkinson's meds at 16:00 right on time... (I have my own meds and my 3 ring binder with me) Dr. Ayas reappears around 16:40... He has seen the Radiologist, the Xray is Ok. and I can be discharged. Wait... Wait... we have a few questions... When will we be informed of the results of this biopsy? (perhaps Friday, but more likely Monday) If this biopsy is negative then is the 3 cm. (roughly) tumor in my lung the primary cancer for sure? (the oncologist will make that diagnosis)... What do we call that tumor? What type of cancer cells do I have so far? (It is an "adenocarcinoma" probably in Stage 3A) HHHhhhmmmmmmmmm.... adenocarcinoma, bronchiolo-alveolar A carcinoma thought to be derived from epithelium of terminal bronchioles, in which the neoplastic tissue extends along the alveolar walls and grows in small masses within the alveoli. Involvement may be uniformly diffuse and massive, or nodular, or lobular. The neoplastic cells are cuboidal or columnar and form papillary structures. Mucin may be demonstrated in some of the cells and in the material in the alveoli, which also includes denuded cells. Metastases in regional lymph nodes, and in even more distant sites, are known to occur, but are infrequent. http://cancerweb.ncl.ac.uk/cgi-bin/omd?adenocarcinoma,+bronchiolo-alveolar What's next? (Wait for this biopsy, consult with the Oncologist) The IV comes out, the vital signs monitor is switched off, and I don my street duds... It's 17:00 hours... I learned one small lesson... remember to think about Parkinson's and hypotension when you have any hospital "procedure"... It is better to discuss this upfront and be fully prepared... (I had my 3 ring binder, we had briefly dicussed my meds, but hadn't considered hypotension or dehydration... I hope you all keep on smilin' and doin' your very best... I am! cheers ...... murray * * * Murray Charters <[log in to unmask]> http://www.geocities.com/murraycharters/ ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn