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Malignant pleural effusion?


Minh

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Is it normal to have malignant pleural effusion after lobectomy? And do you also get fever while having effusion? 6 weeks after lobectomy, I have pleural effusion and also fever in the past 5 days. Covid checked negative. Has anyone had this issue after lobectomy? I am waiting for thoracentesis to be scheduled. Not sure what is going on! Could it be stage 4?
Help!!! I haven’t been able to have more than two weeks of peace since this cancer thing showed up in my life since 4/14/2021.

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Minh,

Normal and lung cancer are words I hesitate to use in the same sentence. That said, you might indeed have a pleural effusion, but until it is drained, you won't know if is malignant or not. When your effusion is drained, the pathologist will look at samples under a microscope and determine malignancy. So, yes you could have a pleural effusion, and yes they do occur after lobectomy, but no one can predict malignancy until after your effusion is drained.

I know, peace after lung cancer is a hard thing to achieve. But, you've been through a lot already in your treatment. Give yourself a break and relax a bit. Try not to worry until the test results are in hand.

Stay the course.

Tom 

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Thanks Tom for your kind and encouraging words!

I am just a little frustrated about my situation. It seems like I can’t catch a break in the past 8 months since my heart surgery and cancer diagnosis. I constantly have all kinds of dr appointments, testings, and procedures every week. I’ve seen all kinds of doctors from heart surgeons, thoracic surgeons, GI doctors, pulmonologists, cardiologists, urologists, endocrinologists, geneticists, ophthalmologists, and all kinds of Physician assistants and practitioner nurses. It seems like it will never end. Because I am taking blood thinner I can’t get my lung fluid drained right away. I have to be off of blood thinner for 5 days before they can do anything. So every time I have some procedures I have to wait 5 days. Waiting and more waiting is just killing me. Now I have to wait until next week to have the fluid drained. At the meantime, I can’t do anything but to lay here and take the beating with all kinds of discomfort symptoms such as fever, high blood pressure, high heart rate, fatigue, cough pains, loss of appetite, and shortness of breath.

thanks for listening! I am just total exhausted!

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Minh,

I completely understand your situation. In fact, I've experienced many treatment delays because of other medical complications. Just try and get some rest. You might ask your doctors for a sleep aid. That might help with your exhaustion.

Stay the course.

Tom

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Just checked myself into emergency room. New dx: pneumonia on the left lung. Large pleural effusion in right lung (the one I just had lobectomy 7 weeks ago). Treatment plan: IV antibiotics and thoracentesis. Oncologist may order test for pleural fluid malignancy. Not sure how long treatment plan will take.

That is all for now!

 

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Minh,

So very sorry to learn this. Treatment plan is a good one. Thoracentesis will immediately give your relief. Oncologist should (must) order pleural fluid test for malignancy.

Likely you'll spend about a week on antibiotics. The thoracentesis will be over in less than 30 minutes.

Stay the course.

Tom

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Interventional Radiologist cannot drain fluid because my effected lung looks like Swiss cheese with many little pockets that hold fluid. He gave up and claimed he cannot drain one pocket at a time. So I was sent back to central control. This is at my local hospital. Now I am waiting for the next plan.

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Minh,

So sorry to hear this.  It seems that when it rains it pours, doesn't it?  My hope is that your covid is Omicron (much less severe) and that you recover quickly and completely.  Has your doctor discussed monoclonal therapy with you?  I know someone who is immune-compromised (kidney transplant recipient) and she got the antibodies and said that it was a game changer for her.  Please check into this.

Lou

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Hi Lou,

They decided not to do anything with my covid and let my body takes care of it because I had 3 Pfizer shots including the booster. It feels strange when your doctor said we are not doing anything. But they do give me antibiotics for preventative measures because at this time they still not sure what I got. But they are looking into it. I have more CT scans here than anywhere else.

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Minh.  You have been through the ringer.  I have an effusion as well and no one has said anything.   Having tests and waiting for answers is true torture.  I’m to the point I don’t want any more tests.  Don’t want them to find anything else.  I’d ask about monoclonal therapy.  I’ve had c-diff twice since surgery and may have it again and will ask for this.  
good luck… this group does help!!

LRB

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Still in ER. They could not drain all the liquid because it’s multiloculated and thickening which means there are many small independent pockets of fluid in there. They still working on plans on how to drain them. Malignancy test result has not come back. They stopped antibiotics because it has not helped. Still have fever, high blood pressure, high resting heart rate, shortness of breath, and extreme fatigue.

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Finally they were able to drain lung fluid after about a week. During the first couple days they could not drain the fluid because it was loculated which means semi liquid pockets of fluid. I still have high resting heart rate of 110bpm which is equivalent to brisk walking. Every time I get up and walk for 20 feet my heart rate goes up to 135bpm and short of breath. ER doctors could not figure why, so they sent me home with beta blockers. I am basically bedridden at home. It’s a terrifying feeling when your heart can stop working because of being overworked or you can get stroke. ER doctor told me to go home and go see cardiologist. There isn’t anything else they can do. So I am laying in bed at home and not sure of what to do next.

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Minh,

I'm sorry to hear about your situation.  I am glad that they were able to get the fluid drained.  That's good to have done and behind you.  I can't comment on what is keeping your heart rate high.  After my lobectomy my heart rate was high for weeks afterward.  In my case the surgeon (thoracic surgeon specializing in heart and lung) told me that it can happen sometimes after thoracic surgery, especially involving the lungs.  I expressed how frightened I was to have a high rate for so long (like you it was a touch over 100) and he told me that since I had no underlying cardiac issues my heart can take the extra beats as he's had patients that went through this for months without damage.  I was glad to hear this because I was afraid to do my walking and workouts for the same reason as you; overworking my heart.  But over time my heart rate did go down and stabilize.  I'm not saying that you have the same situation, but just letting you know that you need to let them find out what the cause is so they can correct it and try to stay calm as possible.  ER docs deal with the immediate and are not going to do what a cardiologist will do for you.  Once you get to a cardiologist they can figure out what the cause is and address it for you.  Please hang in there and try not to be afraid...that only releases more epinephrine and raises heart rate.  You're in my thoughts. 

Lou

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Thanks Lou,

My resting heart rate is still about 105-110bpm and I am trying not to move around to keep it down. I am trying to get to see my cardiologist ASAP. It’s not easy because for some reasons my cardiologist group is very busy. I am only allowed to see him twice in a year. My next appointment is in June but I try to move it up. ER dr said it could be related to my prior heart surgery or covid 19 which could go away in couple of weeks or become permanent which required cardioversion. I just wonder how long did it take for your heart rate to go back to normal? 

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Minh,

In my case it took about 2-3 months before I got back to a lower heart rate.  Even after I didn't stay as low as I used to pre-surgery, but it was very respectable heart rate.

Lou

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