Gonna lose some lung tissue

jdd

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2019 has been the year of the hospital for me. Got a prostate biopsy at the end of last November (positive), and during that a bug somehow jumped from my colon to my blood. At first just mild, nagging fever, then it got really bad--in hospital two different times (couple weeks each) in later Jan/Feb. Kind of got better, kind of didn't. Went to another hospital (local uni one) since they'd found another issue when checking if my prostate had metastasized (lung spot, a different thing--not metastasis), and in checks for that they discovered the blood infection (fever) had damaged my aortic valve. (Please mr. jdd, step this way and lay down (immediate admission), don't go home, we can't be responsible if you do.) Two weeks later they split my sternum, heart-lung machine and all, and replaced my that valve. Stayed in hospital from mid-March to May 7th, since they wanted to continue IV drug for the blood infection to make sure it was gone (it is).

So next comes some surgery (on the 11th) on the lung spot, right upper lobe, or RUL as it is abbreviated in my google reading. The spot is actually visible on a couple CTs from five years ago (my bad crash), and has only changed ever so slowly since. It's now about 17mm on its long axis (CT)--still small. PET scans last December and mid-Aug do show a bright spot, meaning cancer, but as different docs have been saying all along, they won't know for sure exactly what it is till they can do lab work on it. The plan is to take out about a third of my RUL, and do some immediate lab work on it. If it's nothing, they stop there and close me back up; if it's "something", they take the rest of the RUL.

On the positive side, it's still quite small, and it's very slow moving. As one doc said, if it was the bad kind, you'd be dead already. Also, if I hadn't followed up by getting a biopsy for a high PSA number, which then led to some further tests, this would have gone undiscovered--so now it has been discovered, and will be cut out far earlier and smaller in size than if it got big enough to generate its own symptoms. In that sense, thanks to probable prostate cancer, I found out about it far earlier than I otherwise would have. Staging won't be done till about two weeks after surgery, but it's likely a version of stage I. Or it might be nothing. Fingers crossed.

So the last couple days I've been reading about how resection of a lobe affects things like VOmax and pulmonary capacity. There are quite a few papers (some too technical for me) that look that depending on which lung lobe it is, past history, etc. (I've never smoked, don't have emphysema/COPD) I guess I'll have to wait and see how the coming recovery goes--I doubt I'll be doing any actual riding till spring, tho the trainer might be given the okay.

My previous surgeries have been fixes/repairs so that I'd be as good as before (or almost), or that was the goal. This one will be different--they take something out, and I'll have to get along with what's left. Some of those research papers do mention that a remaining lobe can grow a little if an adjacent one is removed, but that's not a done deal by any means.

At least I'm retired, and don't have to (haven't had to) deal with a workplace while getting these things done. My wife still works, but her classes don't start till the end of the month, so this one is good timing for her, too. And hey, if this one goes okay, then maybe my prostate (which has been ignored/back-burnered all this year) will finally get its time in the spotlight!

(And I'm glad I'm in Japan for all this. I think I've gotten excellent care, and I'm not bankrupt.)
 
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kiwisimon

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In a way you're lucky you had the crash. It put you on the medical scanning track and they spot small stuff like this before it gets life threatening. Best wishes for a quick recovery.

Prostrate with a spotlight on it...... is that TMI for a family friendly forum? If you want to vent, do it here so your family and friends don't have to deal with a grumpy pissed off PIA.
 

jdd

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For the prostate, I've also chosen surgery, but it'll be via "da Vinci" robot. Not truly robotic, more machine-assisted--turning large movements of a surgeon's hands into small ones. (Not close to being scheduled for this tho.)

This is a quick video/demo sewing the skin back onto a grape:


Jump to the end for the surprise--which shows the space where it has all taken place.
 
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luka

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joining in the best wishes! also thanks for sharing too. human body is indeed fascinating, as well as the ways we've developed to maintain and upkeep it
 

Gunjira

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Nothing to add except maybe “Davinci would be proud”. I don’t know about Japan, but for Germany I just surveyed this method, which allows surgeons to get on par or beyond what the best hand operating surgeons can do. There less than a third of big hospitals are so equipped. You will be in good hands! All the best.
 

wexford

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How long do I have to wait before I can eat the grape? Amazing tech.
Wishing you a speedy recovery jdd.
 

jdd

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Nothing to add except maybe “Davinci would be proud”. I don’t know about Japan, but for Germany I just surveyed this method, which allows surgeons to get on par or beyond what the best hand operating surgeons can do. There less than a third of big hospitals are so equipped. You will be in good hands! All the best.
The da Vinci 'robot' assisted thing is why I initially switched hospitals (which in retrospect also turned out to be sooo excellent in other ways). I think there were three places in town that had this equipment, and this one was both the most convenient and has had it the longest (=practice)(大学病院).

But I gotta get thru this first surgery on the lung first. They've said I'll start rehab just after admission, which I think will be breath training, getting used to using a spirometer, and maybe some other things. I've read that the right upper lobe is the one you (mostly) use when at rest, that it is somehow comparatively central to (more commonly involved in?) light/normal breathing. Your air/O2 intake at that basic level doesn't really need to go further. So probably some retraining for breathing (some conscious attention to it) needed for a while if they do take out that whole lobe. Total speculation, but maybe that's the issue, and that some kind of activity/exercise will not be? Who knows. I'll just have to let this unfold.
 

OreoCookie

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@jdd
First of all, I am happy to hear that these issues have been diagnosed early, that you are in good hands and your family is taking care of you. But wow. I don't know whether I should congratulate you for being uberlucky or tell you how unlucky you are for getting sick in the first place. Please give us updates in this thread. I'll keep my fingers crossed for your surgery.
 

theBlob

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Sep 28, 2011
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Very sorry to read this Jdd. Wishing for a full and speedy recovery for you and hoping you’ll get back to full strength as soon as possible.

2019 has been the year of the hospital for me. Got a prostate biopsy at the end of last November (positive), and during that a bug somehow jumped from my colon to my blood. At first just mild, nagging fever, then it got really bad--in hospital two different times (couple weeks each) in later Jan/Feb. Kind of got better, kind of didn't. Went to another hospital (local uni one) since they'd found another issue when checking if my prostate had metastasized (lung spot, a different thing--not metastasis), and in checks for that they discovered the blood infection (fever) had damaged my aortic valve. (Please mr. jdd, step this way and lay down (immediate admission), don't go home, we can't be responsible if you do.) Two weeks later they split my sternum, heart-lung machine and all, and replaced my that valve. Stayed in hospital from mid-March to May 7th, since they wanted to continue IV drug for the blood infection to make sure it was gone (it is).

So next comes some surgery (on the 11th) on the lung spot, right upper lobe, or RUL as it is abbreviated in my google reading. The spot is actually visible on a couple CTs from five years ago (my bad crash), and has only changed ever so slowly since. It's now about 17mm on its long axis (CT)--still small. PET scans last December and mid-Aug do show a bright spot, meaning cancer, but as different docs have been saying all along, they won't know for sure exactly what it is till they can do lab work on it. The plan is to take out about a third of my RUL, and do some immediate lab work on it. If it's nothing, they stop there and close me back up; if it's "something", they take the rest of the RUL.

On the positive side, it's still quite small, and it's very slow moving. As one doc said, if it was the bad kind, you'd be dead already. Also, if I hadn't followed up by getting a biopsy for a high PSA number, which then led to some further tests, this would have gone undiscovered--so now it has been discovered, and will be cut out far earlier and smaller in size than if it got big enough to generate its own symptoms. In that sense, thanks to probable prostate cancer, I found out about it far earlier than I otherwise would have. Staging won't be done till about two weeks after surgery, but it's likely a version of stage I. Or it might be nothing. Fingers crossed.

So the last couple days I've been reading about how resection of a lobe affects things like VOmax and pulmonary capacity. There are quite a few papers (some too technical for me) that look that depending on which lung lobe it is, past history, etc. (I've never smoked, don't have emphysema/COPD) I guess I'll have to wait and see how the coming recovery goes--I doubt I'll be doing any actual riding till spring, tho the trainer might be given the okay.

My previous surgeries have been fixes/repairs so that I'd be as good as before (or almost), or that was the goal. This one will be different--they take something out, and I'll have to get along with what's left. Some of those research papers do mention that a remaining lobe can grow a little if an adjacent one is removed, but that's not a done deal by any means.

At least I'm retired, and don't have to (haven't had to) deal with a workplace while getting these things done. My wife still works, but her classes don't start till the end of the month, so this one is good timing for her, too. And hey, if this one goes okay, then maybe my prostate (which has been ignored/back-burnered all this year) will finally get its time in the spotlight!

(And I'm glad I'm in Japan for all this. I think I've gotten excellent care, and I'm not bankrupt.)
 
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jdd

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A quick check in: Surgery done yesterday, and after a night in ICU I'm back in my room. Doing pretty well and have already had a couple tubes removed. I feel better by the hour, except when I move too much. But they did find an adenocarcinoma (肺腺癌), so they removed the entire lobe (about 1/3 of the right lung), along with some lymph nodes (it's SOP to take them and check). Those results will take a week, maybe two. An initial 4cm slit between a couple ribs was lengthened to 8cm for better access, tho I don't think that makes much difference to recovery.

Here's one, the middle white spot where it's split open is the nasty part. And I've got more pics of bloody masses of tissue if anyone is interested. ;)

IMG_6481.JPG
 

OreoCookie

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Glad to hear your surgery went well. And speaking for myself, yeah, keep those gory pictures coming! For how long will you need to recover in the hospital?