Just Another Manic Monday
8:30 AM
I received a call from St. Paul’s Hospital this morning. They have scheduled me to get a pleural lung drainage catheter installed tomorrow, Tuesday, at 7:30 AM. Only thirty minutes later, they called back asking me to come in as soon as possible for an X-ray and a consultation with the lung doctor (respirologist) who will be performing the procedure.
11:00 AM
The respirologist at St. Paul’s is concerned that draining the lungs may not actually stabilize the situation for my radiation treatments. He explained that as long as the lung remains collapsed, the fluid will simply keep accumulating.
He also gave me a sober warning: the drainage process itself—which I would have to undergo daily before every radiation session—is very painful because it creates a mechanical vacuum. He is hesitant to perform a procedure that may not be helpful in the long run. He was very kind and took the time to show me my X-rays, explaining my current condition in detail.
There is a discussion happening now between the respirologist and the radiation oncologist. I am heading to BC Cancer (BCC) to meet with him now.
3:00 PM
I’m currently at BCC waiting for the radiation oncologist to decide on the next steps. The goal is to perform palliative radiotherapy (symptom management) in the hope that the tumor will shrink enough to unblock the airway and allow the lung lobe to re-inflate.
We are looking at two main options:
1. Install the catheter: Drain the lungs before every radiation session so the tumor is in a consistent position. (Note: This would be painful due to the vacuum effect).
2. No drainage: Proceed with radiation and hope the lungs stay in a stable position despite the fluid. This depends on how much they are "floating."
Regardless of the choice, the cancer has progressed to the pleura (the lining of the lungs), which is what is generating the fluid. While my imaging at the end of October showed a "stable" condition, the cancer progressed sometime in November. Because of the pleural involvement, the dose of the fractional radiation will be reduced.
3:30 PM
The decision is in: We will continue with radiotherapy without the drainage. We will proceed with the fluid in place, targeting a narrow portion of the tumor near the airway daily throughout this week. It may or may not help, as the situation may not be reversible.. For the time being, no catheter will be installed.
I received a call from St. Paul’s Hospital this morning. They have scheduled me to get a pleural lung drainage catheter installed tomorrow, Tuesday, at 7:30 AM. Only thirty minutes later, they called back asking me to come in as soon as possible for an X-ray and a consultation with the lung doctor (respirologist) who will be performing the procedure.
11:00 AM
The respirologist at St. Paul’s is concerned that draining the lungs may not actually stabilize the situation for my radiation treatments. He explained that as long as the lung remains collapsed, the fluid will simply keep accumulating.
He also gave me a sober warning: the drainage process itself—which I would have to undergo daily before every radiation session—is very painful because it creates a mechanical vacuum. He is hesitant to perform a procedure that may not be helpful in the long run. He was very kind and took the time to show me my X-rays, explaining my current condition in detail.
There is a discussion happening now between the respirologist and the radiation oncologist. I am heading to BC Cancer (BCC) to meet with him now.
3:00 PM
I’m currently at BCC waiting for the radiation oncologist to decide on the next steps. The goal is to perform palliative radiotherapy (symptom management) in the hope that the tumor will shrink enough to unblock the airway and allow the lung lobe to re-inflate.
We are looking at two main options:
1. Install the catheter: Drain the lungs before every radiation session so the tumor is in a consistent position. (Note: This would be painful due to the vacuum effect).
2. No drainage: Proceed with radiation and hope the lungs stay in a stable position despite the fluid. This depends on how much they are "floating."
Regardless of the choice, the cancer has progressed to the pleura (the lining of the lungs), which is what is generating the fluid. While my imaging at the end of October showed a "stable" condition, the cancer progressed sometime in November. Because of the pleural involvement, the dose of the fractional radiation will be reduced.
3:30 PM
The decision is in: We will continue with radiotherapy without the drainage. We will proceed with the fluid in place, targeting a narrow portion of the tumor near the airway daily throughout this week. It may or may not help, as the situation may not be reversible.. For the time being, no catheter will be installed.