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VATS Lobectomy today


Scruboak

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Diagnosed with “mucinous adenocarcinoma”  during a  VATS biopsy  morning so lost my left lower lobe.  Pain isn’t too bad - had an injection of something as a “ nerve block” according to the thoracic surgeon.   Really trying to keep up with the little breathing thingy. My brain isn’t working so well.  I expected a benign diagnosis after PET scan was negative back in March.  Feeling numb inside emotionally while this sinks in.  I think they’re talking about removing the chest tube tomorrow and being able to go home if no complications. That will help. Once the IV and this tube is out I will feel less like an invalid.  Thanks for listening!  Suzan

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Hi Scruboak,

Sorry to hear about your diagnosis, but glad you found us.  I had a VATS Lobectomy as well (lower-right lobe) and can understand everything you're feeling.  I also had a pet scan that was not abnormally high.  The nerve block you were given will take care of most pain for the first 16-24 hours.  During that time please remember to take your pain meds as prescribed.  I did not and when the pain came back it did so in a torrent.  By now they've had you up and sitting (at least, walking if possible) and over the next few days they will have you walking, using your spirometer device (Please use that often, it really helps) and they will measure how much air you are leaking as well as fluid buildup.  When those two elements resolve you will be sent home.  While in the hospital, eat well, stay hydrated and take your meds.  Once you get home you'll often feel a bit tired and it will be more comfortable for you to breath and rest if you create a wedge of pillows (or use a wedge pillow) to keep yourself mildly elevated.  It will take pressure off your chest and your breathing will be more fluid. You should rest when needed and get up and walk around as much as is comfortable for you.  You may also find that having a small pillow to place on the "surgery side" to provide back pressure can help when you need to caught and clear your lungs.  Again, please take your meds as prescribed and let the doctor know if you feel anything unexpected.  Sometimes a quick call to their office can put your mind at ease as well as letting the doctor adjust meds or your activity as needed.

You're on your way to healing now and it's time to look toward the future.  You did not mention if they plan any follow up chemo or if the surgery was enough for treatment (In my case it was).  If surgery is the only treatment needed now you'll likely have some follow up scans within the next month or two and then they will begin more periodic scans (likely every 6 months for the first year or two and then annually afterward).  Do things that can help you to feel better; emotionally and physically.  I don't know all your doctors told you, but let them explain your prognosis and how it changes over time (usually gets better with every clean scan).

Let me know if you have any questions or concerns that I can help with.

Lou

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It sounds like you're doing really well, Scruboak. Feeling numb emotionally is a normal reaction to being diagnosed with cancer,  especially when you weren't expecting it Lou has given you some excellent information and advice.  Hang in there!

Bridget O

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Got home last night.  I’m doing well for the most part. I had enough blood loss after the surgery that I got unit before going home. We live at 9000 feet and I was anxious about breathing up there - I think I’ll do fine but I’m soooo tired.  The final pathology report came back before I left and @LouT looks like I won’t need any radiation or chemo at this point. pT1b with no nodal or pleural involvement. Yay! I don’t know a lot about this form of adenocarcinoma and haven’t been really able to read much yet, but some of the stuff I have read talk about it coming back easily versus not coming back and it all depends on stage.

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I'm glad to hear that you won't need radiation or chemo now! I think mucinous is pretty rare. You might consider posting a topic in the NSCLC forum here, titled "Mucinous Adenocarcinome" and ask if anybody else had had it.

Bridget O

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Susan,

Good news all around. Surgery is our most effective treatment for NED and I do hope you recover quickly. Also good news about the non-need for further treatments. But, I do hope you are consulting with a medical oncologist for scheduled screening. Unfortunately, one of the frustrating concerns about our disease is how frequently it recurs after NED treatment. Here is something I wrote a while back that points to probability of recurrence.  

Stay the course,

Tom

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Glad to hear you’re home and have excellent test results.  In my case they did a set of follow up scans three months after surgery.  But as others said you need an oncologist and then you and they will determine the follow up schedule.  
 

You’ll be tired for a while so walk when you can rest in between and use the spirometer.   A few months ago my pulmonologist redid my pulmonary tests and I was shocked to hear that my lung function has improved over my pre-surgery results.  I used the spirometer and my treadmill everyday.  Build up slowly, stay hydrated and rest well and you’ll be happier in a few weeks.  

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I see the thoracic surgeon later this week.  I THOUGHT I heard her say that I would be following up with her rather than an oncologist but I’m hearing that I should have an oncologist, right? Some of the reading I have been able to do suggests that a KRAS mutation is highly likely for this type of adenocarcinoma but that it is uncommon to test for it at stage I cancer.  I don’t know what it even means to have a KRAS mutation. There is so much I don’t know, it’s hard to formulate questions! 
Thank you, all, for helping with this.  

I have been walking and breathing.  The level of fatigue surprises me.  I notice sitting upright is helpful to get a good breath. 
 

The mountains, pines, and aspens are super beautiful today and I am loving the space.

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Susan,

There are no hard and fast rules about who one follows up with. My preference is a medical oncologist (physician that is often titled hematologist and oncologist). Why? Because if there is a recurrence, you will almost certainly receive next treatments from a medical oncologist (MO).  So I would fine one now and let the MO devise a monitoring schedule (scan frequency).

Hopefully a one with targeted therapy expertise can address your KRAS issue. But, you should ask your surgeon if your tumor was sent for laboratory for bio marker testing. Here is more information on that subject: https://lungevity.org/for-patients-caregivers/lung-cancer-101/diagnosing-lung-cancer/biomarker-testing

Fatigue will gradually decline as you continue to be active. And yes, sitting is definitely easier than lying down. We invested in an electrically adjustable bed and high density foam mattress to allow me to sleep elevated. It is much easier for me to breathe in this position and my surgery was 16 years ago!

Stay the course.

Tom

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