Lung surgery to remove metastasis

by Chris Battle, survivor on December 20, 2010

This article is cross posted from The Kidney Cancer Chronicles.

I am a windbag. Literally. I am watching a little plastic ball bubbling in water indicating, with each rattlish rise and fall, air escaping from my lungs.

We seem to be having trouble closing the hole the surgeon dug into my right lung. He stapled it together and all – actually, that’s a lie. He doesn’t staple the lung. He seals it with a kind of wet cement pasted along the incision where he removed the wedge of tissue, but the wedge is not closing properly. Therefore, air is still escaping from the lung. Which means that I’m still in the hospital with a rather large tube protruding from my ribs, which serves as a kind of release valve.

It is a transparent stretch of plastic tubing, about a centimeter in diameter, like anything you might find at a Home Deport. Or perhaps at a frat house, as it rather looks like a beer bong. If my lungs were filled with a delicious concoction of fermented barley and hops, I would be the most popular guy at the Delta Tau Chi House. Luckily, most of the patients here on the 3rd floor with me have had heart transplants, and their stamina for sustained partying is limited.

The chest tube is probably the most painful aspect of the surgery. As my friend and medical translator/adviser, Dr. Amy Abernethy, described it: The pain is to be expected due to the law of physics – some things give, some don’t. In this case, we have the tube jammed in between two of my ribs, which aren’t going anywhere; in between the tube and the ribs is nerve tissue. The nerve tissue must be the unhappy one to give, being squeezed and pinched by the tubing on one side and the rib on the other. Nerves are notorious for liking neither to be squeezed nor pinched, and so they are making themselves heard.

Luckily we have some exquisite pain meds. So good, in fact, that when the nurses bring in a new syringe of it to insert in the machine, it’s done with lock and key as if they are switching out diamonds at Lloyds Bank.

The physicians monitor the hole in my lung by watching the air escaping from the tube, which runs from my lung on one end to a boxy steel container on the other. Air and blood empty into this container. The box comes with a handy vacuum to help the drainage process along. It’s an interesting contraption, the box – small and white and cheerful-looking with bright art deco colors and shapes stamped on it. When you look at it, the wordy groovy comes to mind. It sits at my bedside but has a handle on the top, as if it were a briefcase, so that when I walk I can carry it with me. (Walking is required. You press your little clicker that shoots pain meds into your bloodstream and then hop on a walker waiting at your door and do laps around the ward.) The Personal Lung Briefcase has three windowed columns with measuring lines like rulers so that you can measure the volume of blood leakage in milliliters. It’s like looking at coral in a fishtank. Two and a half of the columns are currently filled, along with some blood swishing around in the tubing, like water caught in a sandbar when the tide has gone out.

On the left side of the briefcase is another fascinating window. This one is filled with brilliant aquablue water. Whenever I breathe, a white little plastic ball floating in the water tremors up and down, in synch with the rhythm of my breath. I inhale, and the water and ball drop; exhale, and they rise. The doctors will come in every so often and ask me to cough, which causes the water to splash. This, evidently, is the clearest indication of the magnitude of the hole in my lung. It’s annoying because they always ask me to cough repeatedly and it hurts like crazy. I can see the water splashing from my bedside, so why the repeat efforts? My theory is that they’re bored.

The good news is that the leakage does seem to be slowing. I’m told I’ll have to be here for at least another night, maybe two more. We’ll see.

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