Lower Right Lobe VATS Resection Recovery Experience

[Arthur]

Hello...Newbie "Arthur" here...

Seeking personal testimonies re: recovery experience from a VATS WEDGE RESECTION IN LOWER RIGHT LOBE... 

I am scheduled for surgery 4/29/19,  at Washington University/Siteman Cancer Center in St. Louis, and am still questioning this decision...

I am asymptomatic at this time, 1.7 cm single nodule, suspicion is adenocarcinoma,  first picked up on unrelated CAT scan,  stage 1. 

No pre-surgical biopsy recommended due to smallish size of nodule; collection of tissue would be insufficient to give conclusive result. 

My fear is that post-recovery from the wedge resection (a golf ball sized amount of tissue is proposed to be removed),  I will be more dibilibated than the surgeon will admit to me at this time. 

Looking forward to hearing your stories. 

Thanks for anything you can share, A.

[LexieCat]

Hi, Arthur,

VATS surgery is, as surgeries go, a virtual piece of cake.  My C-section hurt more and required a longer time to recover from than my VATS (mine removed the upper left lobe).  Actually, removal of the lobe, if the nodule is found to be cancerous, is the BEST way to completely eliminate the cancer.  My doctor did the wedge resection first to examine the nodule and then removed the remainder of the lobe (same surgery--they looked at it while I was still in surgery).  

Have you had a biopsy, or is there another reason they think the nodule is likely to be cancer?  Have you had a PET scan?  Sometimes (as in my case) they do the lobectomy without a biopsy due to the very suspicious appearance of the nodule (mine was spiculated).  Yours is quite a bit larger than mine was, though, so maybe they are going by size.  

My surgery was almost two years ago.  I was out with friends at a concert two weeks after the surgery.  I was taking long walks around the same time.  I have NO shortness of breath or any other lingering problems.  I feel great, and because my tumor turned out to be Stage 1b adenocarcinoma, all I need to do is go for scans every six months.  After this July, assuming that visit goes well, the scans will drop back to annual.

Cancer is always scary to deal with--especially lung cancer.  But yours is still small and an early "catch," it appears, so you may be one of the very fortunate.  One of the reasons lung cancer is so deadly is that it is often not found until there are symptoms, which means the cancer has already spread.  

Feel free to ask any questions.  But seriously, the surgery itself is nothing to get too stressed out about.  You will be back to normal in no time, most likely.

[LexieCat]

Sorry, I see you answered the biopsy question--read too fast.   

[BridgetO]

Hi Arthur and welcome,  My experience is pretty similar to LexiCat's. I had a lower right VATS  lobectomy in November 2016. My single nodule was smaller than yours. I was told it couldn't be biopsied by needle or bronchoscope because of the location, and also because of the location they had to  take the whole lobe and not just a wedge. The surgeon and the pulmonologist ageed it had the appearance of cancer on the CT scan . I had a PET scan but nothing lit up-- I understand this isn't unusual for small, slow growing tumors. Diagnosis after surgery was adenocarcinoma Stage 1a.

I was discharged from the hospital the day after the surgery, with a chest drain tube in place because I had an air leak. Some hospitals prefer to keep people in until the tube can come out. My tube was in for 10 days. The tube was uncomfortable, but I learned how to move carefully to avoid most pain. I was out walking around the neighborhoos  a couple of days after the surgery. My pain was minimal after the tube was out.

My surgeon told me that, unless I was planning to run a marathon, I probably wouldn't notice a difference in my lung capacity. This has been true. My lung sounds a little funny at times but it seems to work just fine. I'm fairly active, but not at all athletic. I walk a lot. I am "retired", sort of, but have been working part time recently. I was 72 at the time of surgery and didn't have any health problems, other than some long term side effects from treatment for  a prior unrelated cancer.

I don't feel like I'm at all debilitated. I hope this info is helpful to you. 

Bridget O

[Arthur]

Thanks Bridget, this is very helpful information.

Arthur

[Curt]

I commented on your other post but didn’t give much detail on my experience with a VATS lobectomy.  I had Stage 1 NSCLC Adenocarcinoma.  I am a 43 year old male in average physical health.  I had my surgery six weeks ago.  The recovery time is different for everyone.  I was really surprised how little difference I noticed with my breathing after surgery  when not being very active.  When I would go for walks I would notice it a little more.  Six weeks later I can be mildly active without an issue.  The biggest thing is when I do lose my breath it is harder to catch it.  I was in the hospital for three days.  I had the surgery at 4 pm and they had me up and walking the following day.  You will have three incisions on your side. One just under your armpit, one a bit lower than that for a chest tube and one on your back.  The incision for the chest tube was the most uncomfortable for me.  Once the tube was removed a lot of the discomfort was gone.  That incision still has some nerve  discomfort, not pain.  The incision under my arm had the most swelling and was the most painful.  That took about four weeks to feel better.  It was hard to put my arm down at my side completely.  I was back to work after four weeks.  Some suggestions and things to know.  

1. Exercise as much as you can pre surgery.  It will help build your lung capacity   

2. Walk as much as you can after surgery.  It will help build your lung capacity, reduce swelling and speed your recovery   

3. Use the spirometer breathing machine before surgery and after.  It helps build lung capacity before surgery and after it helped dry my lungs of any fluid.  

4. You will want to be propped up after surgery when in bed.  I used a wedge pillow.  I needed it for two weeks   

5. Have an arm chair close to your bed at home so you get up out of bed and spend most of your time in it or walking around.  I did that for about a week before venturing onto the couch.  

6. Get a small pillow that you can squeeze when you have to cough or sneeze.  I didn’t cough much right after surgery but they encourage you to in order to clear some of the fluid from your lungs that builds up during surgery.  I also held the pillow under my arm when walking around to keep my arm from resting on the incision.  I needed that about three weeks.  

7. I have a lump/tickle in my through that caused me to cough more now than at first.  After two weeks I felt some pulling inside when I coughed.  I cough now without any issues.  

8. You will be tired for a while after surgery.  In the days after surgery I slept a lot.  In  the weeks after I took a nap every day.  At this point I don’t need any naps but sleep about an hour more a night than I use to.  

Generally the surgery was not as bad as I thought it would be.  There was discomfort and pain but it was manageable with medication.  I was feeling a lot better after two weeks, four weeks I was out and about with some milder pain and discomfort and six week later I have some mild nerve discomfort and I’m about 80% back to my presurgery stamina.  I’ve made sure I am as active as possible.  The only residual things are the lump/tickle, some coughing from that and the need to be conscious of my breathing when active to make sure I don’t get too out of breath.  It’s more difficult to catch my breath.  I walk a mile and half on the treadmill, coach my kids baseball teams, go on bike rides with them and I played dodge ball and kickball with them last weekend. It has not changed my life in any discernible way.  I don’t require any follow up treatment.  Just periodic scans.  

I was scared before surgery too.  Now that I’ve gone through it I’m glad I decided to do it.  It is the most affective treatment for early stage lung cancer.  

[Arthur]

Thanks Curt for taking the time to explain all this. It is very helpful.

Arthur

[BridgetO]

Curt's advice is great!