Lung surgery


 

What is a VATS?

A VATS is a video assisted thoracic surgery and is less invasive than a traditional lung surgery.
For those who are not sensitive, here is a good video that talks about VATS and shows how they are performed:

First Right lung surgery

Pretesting

One week before the surgery, I had the following tests done:

- a blood test

- an EKG

- a lung X-ray

- a pulmonary function test

Here are the results for the pulmonary function test:

 I also met with an anesthesiologist who asked me about health and allergy history.

The day of the surgery

On the day of the surgery, I woke up at 3am in the morning. I was supposed to be at the hospital by 5:15am. I first went to registration where I had to sign a couple of papers and pay the insurance co-pay.

Then I was sent to a room to remove all my clothes and put a gown on. All my  personal items were put in a bag with my name on it.

A urine test was done to make sure I was not pregnant. Blood was also drawn because I had a cold and the doctors wanted to make sure I didn't have an infection.

I was then sent to the intensive care unit. The anesthesiology team explained grossly all the things they were going to do and where they would put needles (which included leg, both arms and back). They started with one arm before putting me to sleep. They put me to sleep by making me breath into a mask (it took a couple of seconds).

I woke up in the recovery room. There a nurse attended to me for several hours.

 I felt pressure in my right lung as soon as I woke up. My throat was painful. I could hardly talk. I don't know whether it was due to my cold or to the tube they put in my mouth during surgery.

Tubes were attached to my nose to deliver oxygen. A catherer was attached to my urinary tract to collect my urine. A chest tube was attached to my right side just at the bottom of the lungs to drain the blood from my right lung. A heart monitor was attached to different parts of my body. IV were attached to both arms. I was given fluids, antibiotics and pain medication through them. I could control the delivery of pain medication by pushing a button. Potassium was delivered through the IV and that was painful. I was not allowed to drink. I felt nauseous so the nurse added zofran to the IV. One pressure monitor was attached to my left arm and one to my right calf. Every couple of hours a lung X-ray was performed to monitor my right lung. Temperature, pulse and respirations were also monitored.

My right eye hurt so a eye specialist came to visit me and concluded I had a corneal abrasion (probably somebody scratched my eye by accident during the surgery). I was given an ocular lubricant, an artificial tears ophtalmic solution and moxifloxacin ophtalmic solution.

My family was allowed to visit me in the recovery room but one person at a time. At first, my son (5 years old) was not allowed in the area but then they let him in for a couple of minutes. He didn't understand what I was doing there at first. He thought I came to have my leg fixed.

Eventually, I was assigned a room.  Three other patients were in my room. Two nurses also had their desk in the room and they were monitoring the patients in perrmanence.

I was allowed to drink water. I was given an incentive spirometer to exercice my breathing. I had to breath through a nebulizer every 6 hours or so.

The catherer and the chest tube were removed around 5am the following morning. The oxygen was also removed. I had a urge to pee but couldn't pee at first. I kept on drinking water and eventually I could go (I used a bedpan).

A nurse came in the morning to wash my body. Then a physical therapist came to help me walk for 5 minutes or so. Afterwards, I stayed sitted for a while.

Eventually, the nurse removed all IVs and monitors. I walked some more. I was given a breakfast and a lunch. In the afternoon, I was allowed to go home.

I was given prescriptions for the followings medications:

- ocular lubricant to apply to right eye at bedtime

- artificial tears ophtalmic solution 1 drop to right eye 4 times a day

- moxifloxacin ophtalmic solution 0.5%, 1 drop to right eye 4 times a day times 4 days.

- fluticasone 44 micrograms oral inhaler, 1 puff inhaled twice a day as needed for shortness of breath

- senna conc. tablet,  tablet by mouth at bedtime as needed for constipation

- atrovent oral inhaler 2 puffs inhaled 4 times a day if needed for shortness of breath

- ultram 50MG  tablet by mouth every 6 hr as needed for pain

Results

Three tumors were removed from my right lung: the one expected and two tiny additional ones. The biggest tumor was in the lung and not in the lymph node. When the lung was deflated, the tumor did not touch the vena cava or the phrenic nerve. The resection was easy. VATS was used. 2 wedges were done in the right middle lobe. 1 wedge was done in the upper right lobe.

Scars

For the VATS, 3 openings were made. Here is how they look a week after surgery:

 

Pathology report

According to my oncologist, specimen D has positive margins as well as C.

How a CT scan looks 2 weeks after surgery

How a CT scan looks one month after surgery

First Left Lung surgery

Pretesting

 Hospital stay

As for my first right lung surgery, I had a video assisted surgery (VATS). I stayed 3 nights in the hospital until my surgeon was confortable enough to see my chest tube out. I was monitored every day with X-Rays to see if fluid was building up in my lung and to see if blood kept coming out of the chest tube.

I didn't have much pain so I didn't use any pain medication. I was given antibiotics and potassium through IV, heparin shots in the arm, pepcid to avoid reflux, stool softener, and albuterol via a nebulizer.

I had side effects from the albuterol, 2 days after starting it. Side effects included excessive saliva production, headache, fast heart beat, uncontrolled movements of stump, uncontrolled mouth sounds, inability to sleep, anger, nervousness, stuffy nose, muscle cramps in my toes, coughing and sweating. The drug did help my breathing. I felt like having an artificial pump in the lungs.

Pathology report

Operative report

Second Left Lung surgery 

What's different?

The surgeon warned me the recovery would be longer. In fact, it didn't feel that way. But she did have to perform an extensive pleurolysis because this was not my first surgery.

Also, she performed an intercoastal nerve block which I assume is the reason why I barely felt touch to my left breast for about a month. And it is probably also why I wasn't in pain after surgery. 

She performed a left upper lobe and a left lower lobe wedges.

I only stayed in the hospital one night. I did not need pain medication. They didn't give me albuterol this time because I claimed I was allergic to it. Instead they gave me some salty solution via the nebulizer. 

I did experience tachycardia, low blood pressure, uncontrolled jerking movement of my stump (which for some strange reason followed my heart beat) , muscle cramps in the toe and a recurring flap sound in my chest when laying down on my back.  

Pathology Report




Second Right Lung surgery

What's different?

This time, I was given an epidural. I did not experience any tachycardia and I assume this is related to the anesthesia. The pain was well controlled. I only spent one night in the hospital. I feel this was the easiest surgery to date. 

Nodule removed


What is a VATS?

First Right lung surgery

Pretesting

The day of the surgery

Results

Scars

Pathology report

How the CT scan looks 2 weeks after surgery

CT scan one month after surgery

1st Left lung surgery

Pretesting

Hospital stay

Pathology report

Operative report

2nd Left Lung Surgery

what's different?

Pathology Report