So when we last left our heroine, she had moved to the fifth floor south and endured a thoracentesis — draining of the lung via a needle through the back. What will happen next?! Dun-dun-DUUUNNNNN…
WORD OF WARNING: Some of the pictures I will be including in this post — and the ones that will come after — might be considered kind of graphic. I’m not going to post anything too gory but if you have absolutely no stomach for medical stuff at all, maybe you should look away.
So, at this point, things were looking up! I survived my thoracentesis and was about to be discharged. After a week and a half in the hospital, I was ready to go home. The only thing that worried me was the pain I was still experiencing: shooting, stabbing pain across my chest under my right breast. But that would get better, right? That wasn’t going to hold me up, yeah?
Friday morning rolled around and Dr. Patel came by. He, again, told me that I would probably be released that day. I asked him about the pain in my chest and he got that concerned expression that you never want to see on a doctor’s face. He said that he would have to look at my x-ray but that he didn’t expect it to be a problem.
It was a problem.
He came back later in the day to inform me that not only would I not be released but that I needed another lung drain due to a re-accumulation of fluid around my right lung. Part of me — most of me — was disappointed but I will admit that another part of me was relieved: I did not want to go home and deal with that kind of pain without a team of professionals ready to leap into action the moment I said ‘ow’. Plus, who wouldn’t want another thoracentesis?! I mean, why would I want to be at home living the high life when I could be in the hospital getting big needles stabbed through my back? Let me tell you, I was living the dream. I will pause for a moment now so you can spend some time seething with jealousy.
The thing to remember is that I was in the hospital not only for pneumonia but also to treat two pulmonary embolisms. One does this by thinning the blood to minimize the possibility of getting more clots. Therefore, I was getting blood thinners via shots in my belly and pills on a constant basis. However, to pull off a successful lung drain, the patient cannot be particularly .. bleed-y (that’s an official medical term, for reals). That meant that once the decision was made to do a lung drain, I would stop getting thinning medication so my blood could thicken up sufficiently. As such, the routine of the past week and a half went like this:
–Blood thinners, blood thinners, blood thinners!
–You need a lung drain!
–FULL-STOP ON THE BLOOD THINNERS! REVERSE COURSE! A-WHOOGA! A-WHOOGA! FILL HER WITH PLASMA — STAT!!
–Back to blood thinners, blood thinners, blood thinners!
–You need another lung drain!
–FULL-STOP ON THE BLOOD THINNERS AGAIN! REVERSE COURSE! A-WHOOGA! A-WHOOGA! FILL HER WITH PLASMA — STAT!!
As you can guess, the process of going from nice, thin blood to having blood thick enough to safely execute a thoracentesis does not happen overnight. Therefore, when my doctor told me that I needed another lung drain, I knew I was looking at several more days in the hospital before it could happen.
Monday came and went, my blood still too thin for my lung to be drained. I received two more uncomfortable — and borderline-painful — bags of plasma to hurry the process along. By Tuesday, I was ready. By Tuesday, it was go time.
You might remember me talking about my IV infiltration a few posts back. While I never became swollen like that again, my IV did have to be moved several times during the course of my stay. This was because I was getting constant fluids and my poor little wimpy veins were having trouble handling it. I had had an IV in the crook of both arms, the side of my wrist and the top of my hand. In addition, I was also getting blood drawn every day, sometimes multiple times a day. Between the IVs and the blood draws, there was a lot of Poke-Nina-With-Needles action going on. I think I was on my fourth IV location by that Tuesday morning and it had been in place for a few days already; the area was tender and it would hurt a bit whenever they needed to push medication.
When Dr. Patel arrived to perform the second lung drain, I mentioned my IV to him. He checked it out and agreed that it needed to be moved to a fresh location before the thoracentesis. The problem with that? I was kind of running out of places to have the IV; my arms displayed a stunning and colorful array of bruises that would make any junkie proud. The nurses tried, they really did. They even almost found a spot, too, but the vein collapsed. That’s when I heard the doctor say the word ‘jugular’.
Cue freak out.
I started to cry and hyperventilate instantaneously; Dr. Patel was immediately at my side, stroking back my hair and quietly assuring me that it would be okay, that it wouldn’t hurt, that it was just another vein. Only doctors are allowed to stick things into jugulars so this was something Dr. Patel had to do himself. This, at least, was comforting. Not that the nurses were inept but Dr. Patel was just so ridiculously kind and compassionate that having him involved with anything automatically lowered my fear quotient by at least fifty percent. Once he calmed me down to the point where I was breathing like a normal(ish) human being, he lowered my bed flat and got to the task of getting an IV inserted in my neck.
“Okay, here we go. Try not to move,” he told me. And then it was done.
I survived my first lung drain and a needle in the neck. The second lung drain should have been easy-peasy, right? Right. And at first, it was. I knew what to expect so I wasn’t scared (also: I used up any lingering fright on my jugular IV panic). Since the first one kind of hurt towards the end, they had increased my Dilaudid so I was feeling fiiiiine. However, a few minutes after the procedure started, Dr. Patel announced:
“This isn’t working.”
The first time, he had drained 1000 whatevers — milliliters? — of fluid from around my lung. This time, he could barely get forty. Forty. He was frustrated. I was frustrated. We both knew there was more than a mere 40 milliliters of fluid keeping me in the hospital. He told me that I needed a CT-scan guided thoracentesis so they would know exactly where to put the needle and that’s exactly what I got a few hours later.
CT-Scan Guided Thoracentesis
I was brought down to nuclear medicine again and the nurses and techs there got me set up on the CT-scan. After a while, the doctor arrived. I had thought that Dr. Patel would do it but no, someone else was driving the needle this time. I don’t remember his name but he was such a stereotypical specialist that he was almost a caricature: handsome, arrogant, rude to his ‘underlings’ and only incidentally aware of his patient. I imagined that when he got the call for my procedure, he untangled himself from some leggy bimbo, jumped into his ridiculously expensive car and threw the keys to the first person he saw as he pulled up to the hospital, mistaking them for the valet. He barked at the nurses and the techs, complained about why this wasn’t the way he liked it, why that wasn’t ready and barely spoke to me at all. I’m not saying that he was unkind to me — I think he even gave me a little pat on the shoulder before he began — but it was almost like an after-thought. I appreciate that he was very focused on what he was doing but I am not ashamed to admit that I missed Dr. Patel’s bedside manner.
The CT-scan guided lung drain wasn’t any more painful — nor any less painful — than the two bedside ones I had already endured. And, unfortunately, it wasn’t any more successful either.
“This isn’t working.”
The doctor put a drain in my back and inserted a catheter in the hopes that the fluid would make its way out overnight.
I was sent back to my room where Dr. Patel came to visit. He explained to me and Drew that the fluid around my lungs had taken on the consistency of Jell-O and that was why they were having so much difficulty. If it did not drain on its own by the next day, we would have to tackle with problem with surgery.
Go ahead and guess how that turned out…