This is the day before surgery and I am looking toward the operation and aftermath with great fear and trepidation, though intellectually I know the risks and pain will be controlled.
Dr. deHoyos will perform the surgery laparoscopically, unless there is some unexpected complication. (In that case he will resort to enlarging the incision, spreading the ribs to gain access.) He will make three small incisions. The longest incision will be less than 2″ long and will be used to insert the thoracoscope, a tiny TV camera on a tube. The other two will be used for instruments. After the operation, a tube will be inserted in one opening and left in place until fluid drainage stops. The other openings will be stitched closed.
How a surgeon can complete this procedure is a mystery to me. Besides severing the upper lobe from the lower lobe, there are bronchial tubes that must be severed and closed off as well as a multitude of blood vessels. Imagine completing these very delicate tasks with all of your visual feedback coming through a video screen.
At 7:30 AM tomorrow, I will report to the “Same Day Surgery Check-in” on the 5th floor of Galter at Northwestern Memorial Hospital. The surgery begins at 9:30 and should be complete in 3 to 4 hours. After surgery, I will be taken to recovery and from there to the ICU, where one typically stays for 12 to 24 hours.
To manage pain an epidural is often used immediately after surgery.
From the ICU, I will be taken to the Surgical Telemetry Floor on 16th floor of Feinberg for the remainder of the stay (4 to 7 days). So a typical stay from admission to discharge is 5 to 8 days. During my stay on the 16th floor I will definitely be mobile and am expected to get up and walk around the halls at least 5 times a day. I will be given deep breathing exercises to do for 10 minutes out of every hour I am awake. This helps avoid pneumonia and regain pulmonary function.
I will not be able to provide any updates until I can sit up and type, and Jana can bring my laptop. Since bad news travels fast, unless you here otherwise I will be doing fine.
Thanks for your support!
May 12th, 2008 at 12:16 am
Hi Charles,
You’ve done your homework and know what is expected after surgery, and why, so I expect you to be a model patient! The deep breathing and walking are the best things you can do for yourself to prevent complications.
I plan to come visit on Thu eve after I get my hair cut as I’ll only be a few blocks away unless I hear from Jana that you don’t want visitors.
Another reason they leave a chest tube in place at the end of the procedure, besides allowing anything to drain, is to help the remaining lung to re-expand to fill the space. Here’s a brief review of how the chest tube system works http://www.teleflexmedical.com/ucd/chest_drainage_systems.php
My best wishes as well as prayers are coming your way!
Sally
May 13th, 2008 at 1:07 pm
Hi Charles. I read your blog this morning and was glad to learn more. I am looking forward to your quick recovery from the surgery.
All the best,
Marcy