Approaching Lung Surgery

There is a tiny mass in the lower part of my right lung. I've had two CT scans, and the radiologists and doctors can't identify it from the pictures. Because of its very small size and placement, a needle biopsy is not possible - they have to go in and get it. The procedure is called video-assisted thoracoscopy. Three incisions are made in the right side; a camera goes into one, and instruments through the other two. The speck is removed and checked for malignancy, and if it's nothing important, they close me up. If it is cancer, they go ahead and remove part of the lung and the associated lymph glands - a partial thoracotomy. I won't know till I wake up.

Funny how I can sit here and type that so clinically. I think about it all the time, but I don't really face it. The last time I had surgery, I was fine until they wheeled me into the operating room - then I started to cry and kept crying until they put me out. Maybe that's what will happen again. Maybe that's the better way.

And that was outpatient surgery - in 1987. The procedure I'm facing now will be the most invasive and serious surgery of my life, even if it stops with the thoracoscopy. Afterward I'll have a catheter and chest tube for at least 24-48 hours. I'll be on opiates for pain. And I have no idea how this will all interact with the many medications I take for bipolar disorder, high cholesterol and hypertension.

So in the last several weeks I have been bombarded by changes and stressors:

• Added 100 mg Wellbutrin SR to my medications, and cut Celexa from 30 to 20 mg daily
• Started taking Tenoretic for high blood pressure - 50 mg of Atenolol, a beta blocker, and 25 mg of Chlorthalidone, a diuretic
• Doubled Zocor from 20 to 40 mg nightly, for high cholesterol
• Went on the South Beach Diet
• Was ordered to quit smoking and began wearing the Patch while tapering off cigarettes
• Tried to taper off caffeine
• And of course, was always aware of looming surgery ...

A couple of weeks ago I grew so tired I slept 27 hours out of a weekend. I tried changing my nighttime meds and had a hideous night that left me unable to go to work the next morning. Because of my poor sleep and tiredness, my pdoc added 5 mg Ambien nightly (a $50 copay!!) and bumped Celexa back up to 30 mg. That was great for about four days - then my GP doubled the beta blocker because my blood pressure hadn't gone down, and the tiredness returned.

I've given up on trying to become caffeine free - without caffeine I'm so tired and/or sleepy I can't function.

Through all this, I've been frantically training co-workers on jobs I alone knew how to do, and trying in evenings and weekends to get things done at home to prepare for my convalescence. Every night my body aches - possibly from the increased Zocor, probably due to anxiety that I'm not even admitting I have. And I just recalled that somewhere in my instructions from the thoracic surgeon it says to stop taking any painkillers except useless Tylenol a week before surgery.

As I write, it is a week before surgery. I can no longer take my nightly Naproxen.

This is also the day I was to have become smoke-free, but I had three cigarettes today. I couldn't stand it. Still, three is a big improvement over 15.

The next time I write, I'll be able to tell you whether I had the relatively simple thoracoscopy or the serious partial thoracotomy. I'll do my best to share with you the experiences of a person with bipolar disorder and fibromyalgia going through surgery.

Thinking positively - with any luck, I'll lose some extra weight!