Too little fluid for thoracentisis,yet collapsing lung??

legendsdaughter

Dad diagnosed with stage IV adenocarcinoma in October. He had a thoracentesis last month & removed 1.5L of fluid (told he had minimal to moderate amt of fluid). Had 2 transfusions, plus some platelets(were at 17) & some rbc's (hemo-6). Sent home with oxygen. Was doing Cispl./Alimta, then Carbo./Gemcitibine & now Taxotere.

I understand that the chemo kills the blood counts & in this in turn can cause trouble breathing. He just had a cat scan which shows his left lung is collapsing & there is also another pleural effusion on left side. He loses his breath quite often. The surgeon thinks that there isn't enough fluid for a Thoracentisis. I don't understand. Isn't the fluid partially to blame for the collaping lung, which would also cause trouble breathing? Won't removing the fluid possibly help re-expand the lung or will he need a pleurodesis?

Or is this the nature of the beast, known as Lung Cancer. At 8 months, post diagnosis, I believe he is at a critical stage. Do all lung cancer patients eventually need oxygen, or at least ex-smokers, due to years of the alveoli being destroyed. I try to find all the info possible so that I can ask the drs. questions but sometimes I get befuddled.
Trouble breathing: blood counts, pleural effusion & collapsing lung.
The doctor mentioned that we are trying taxotere now then if that stops working we'll try something else, then "we might have to call in hospice". Hearing that made my heart go to my stomach!
The survivors here are a great source of information & knowledge & I hope someone can clarify this for me. Thank you.

bubbliemrs

collapsed lung
My mom had small cell lung cancer, yes she also had "trouble breathing, low blood counts, pleural effusin and collapsed lung" as well. As a result,she had to have thoracentesis twice within a month until the doctors and our family decided to give her surgery to keep her lungs from collapsing.
From my experience with my mom, when the lung starts filling with fluid, then there isn't much the doctors can do anymore. Like you said, it is the natural progression for Lung Cancer.
From my resources, when a patient enters hospice, then that means he will only be able to get medication to help feel comfortable. He will not be treated with chemotherapy any longer. I refused to have my mom enter hospice care as long as I could.

The lung keeps filling with fluid to protect itself from the cancer cells, and yes, my mom had to be taken to the ER three times because she became short of breath due to her lung collapsing. They withdrew 2L of fluid the first time, and 1.5L of fluid the second time. Then we opted for surgery (talc pleurodesis) which put some sort of glue into the wall of her lung to keep it from collapsing. We did this surgery because the thoracentesis was so painful for my mom, it was painful to watch her moan in pain during this procedure. It got to a point where her lungs began filling with fluid the next morning after thoracentesis. Her onchologist said it would be safe and better for her.
But I noticed that her health never got better after the surgery.
Her primary physician recommended hospice but we refused to listen. Her onchologist wanted to keep on trying and we took his advice. But after talc pleurodesis surgery, she never recovered enough strength to continue with chemotherapy.
We ended up taking her to the ER again because she ended up with asperation where whatever liquid she took in went straight to her bronchial tube. The natural function where a little lid covers the bronchial tube didn't work anymore. That was the last time she was in the hospital....
We finally entered my mom into hospice and within a week, she passed away...
Looking at my experience with my mom, I'd say she had lived about a month and a half after her lung started filling with fluid.
I am not saying that it'll be the same with your dad. He may live longer than my mom. I just want to let you know, and believe me, I know that it's the most painful thing that you are experiencing right now, yet, sigh... start taking steps to prepare.
I personally think that it's important to prepare the patient as well, to make ammends, say goodbye, make memories for your family, and to prepare for the final hour.
My mom had a chance to do that, and I was able to be with her as she took her final breath. I know she is at peace.

legendsdaughter

bubbliemrs said:

collapsed lung
My mom had small cell lung cancer, yes she also had "trouble breathing, low blood counts, pleural effusin and collapsed lung" as well. As a result,she had to have thoracentesis twice within a month until the doctors and our family decided to give her surgery to keep her lungs from collapsing.
From my experience with my mom, when the lung starts filling with fluid, then there isn't much the doctors can do anymore. Like you said, it is the natural progression for Lung Cancer.
From my resources, when a patient enters hospice, then that means he will only be able to get medication to help feel comfortable. He will not be treated with chemotherapy any longer. I refused to have my mom enter hospice care as long as I could.

The lung keeps filling with fluid to protect itself from the cancer cells, and yes, my mom had to be taken to the ER three times because she became short of breath due to her lung collapsing. They withdrew 2L of fluid the first time, and 1.5L of fluid the second time. Then we opted for surgery (talc pleurodesis) which put some sort of glue into the wall of her lung to keep it from collapsing. We did this surgery because the thoracentesis was so painful for my mom, it was painful to watch her moan in pain during this procedure. It got to a point where her lungs began filling with fluid the next morning after thoracentesis. Her onchologist said it would be safe and better for her.
But I noticed that her health never got better after the surgery.
Her primary physician recommended hospice but we refused to listen. Her onchologist wanted to keep on trying and we took his advice. But after talc pleurodesis surgery, she never recovered enough strength to continue with chemotherapy.
We ended up taking her to the ER again because she ended up with asperation where whatever liquid she took in went straight to her bronchial tube. The natural function where a little lid covers the bronchial tube didn't work anymore. That was the last time she was in the hospital....
We finally entered my mom into hospice and within a week, she passed away...
Looking at my experience with my mom, I'd say she had lived about a month and a half after her lung started filling with fluid.
I am not saying that it'll be the same with your dad. He may live longer than my mom. I just want to let you know, and believe me, I know that it's the most painful thing that you are experiencing right now, yet, sigh... start taking steps to prepare.
I personally think that it's important to prepare the patient as well, to make ammends, say goodbye, make memories for your family, and to prepare for the final hour.
My mom had a chance to do that, and I was able to be with her as she took her final breath. I know she is at peace.

The truth hurts...but thanks
I am starting to feel sick.........thanks for you kind & informative words.
Went with dad to cardiothoracic surgeon yesterday & they wanted to do the pleurodesis but I wanted him to get his next chemo this Thursday & next, as it is a new chemo for him. Turns out his Onc concurrred. He was sent home with diuretics & potassium. This morning he went to the ER again with trouble breathing. I think his anxiety makes the breathing much worse.

Reading what you said made me feel ill although it's what I thought was going on with him.
The thing about the bronchial tube lid is interesting. I just read something about when lung cancer patients start going to the ER for trouble breathing it can be a 2-3 week life expectancy. Reading your response really hit home. I know that the information from people who have lived through this horrible disease is the most reliable even though every case is different. Dad has stage IV nsclc & was diagnosed in October. I know that he is past the median time of survival of 8 months & I am afraid that the end is quickly approaching.
I want him to get his chemo this Thursday but it doesn't look like he will be able to.

You sound like you were a great advocate for your mom , as I am with my dad. I am having a hard time because my grandmother (dad's mom), to whom I was the sole caregiver died last Saturday at 95. She was in hospice care also. My dad's brother died in March from Non Hodgkins. My kids have been shuffled around to hospitals & helping bring everyone to doctors' visits since school let out in June. I also have to have my grandmother's apartment cleaned out by August 9th. I am sitting here waiting for my 8year old's friend to hopefully take him so that I can go to the ER to see dad.
I think what you said about saying good bye is sooo important. My mom doesn't want to talk about anything regarding "the end". My mom is also dealing with some issues. She needs a knee replacement, is developing a bone abnormality in her foot from diabetes & has a lump in her breast which has to be checked out. She is also struggling as to whether or not to retire or take family leave right now so that they can have some time together. Mom & dad are 68 & 69, respectively.
Any more info from more survivors or family members wil be greatly appreciated.
I am still praying!

bubbliemrs

legendsdaughter said:

The truth hurts...but thanks
I am starting to feel sick.........thanks for you kind & informative words.
Went with dad to cardiothoracic surgeon yesterday & they wanted to do the pleurodesis but I wanted him to get his next chemo this Thursday & next, as it is a new chemo for him. Turns out his Onc concurrred. He was sent home with diuretics & potassium. This morning he went to the ER again with trouble breathing. I think his anxiety makes the breathing much worse.

Reading what you said made me feel ill although it's what I thought was going on with him.
The thing about the bronchial tube lid is interesting. I just read something about when lung cancer patients start going to the ER for trouble breathing it can be a 2-3 week life expectancy. Reading your response really hit home. I know that the information from people who have lived through this horrible disease is the most reliable even though every case is different. Dad has stage IV nsclc & was diagnosed in October. I know that he is past the median time of survival of 8 months & I am afraid that the end is quickly approaching.
I want him to get his chemo this Thursday but it doesn't look like he will be able to.

You sound like you were a great advocate for your mom , as I am with my dad. I am having a hard time because my grandmother (dad's mom), to whom I was the sole caregiver died last Saturday at 95. She was in hospice care also. My dad's brother died in March from Non Hodgkins. My kids have been shuffled around to hospitals & helping bring everyone to doctors' visits since school let out in June. I also have to have my grandmother's apartment cleaned out by August 9th. I am sitting here waiting for my 8year old's friend to hopefully take him so that I can go to the ER to see dad.
I think what you said about saying good bye is sooo important. My mom doesn't want to talk about anything regarding "the end". My mom is also dealing with some issues. She needs a knee replacement, is developing a bone abnormality in her foot from diabetes & has a lump in her breast which has to be checked out. She is also struggling as to whether or not to retire or take family leave right now so that they can have some time together. Mom & dad are 68 & 69, respectively.
Any more info from more survivors or family members wil be greatly appreciated.
I am still praying!

Dear Legends
My heart goes out to you, you have so much to try to bear. I think it's okay to ask for help from people around you, public resources, whereever you can find them. It must be so unbelievably difficult because you have issues still to settle for your grandmother, as well as grieving for your grandmother. I wish I can be there to hold your hand, to cry with you.... But don't feel like you have to take care of everything, if you have someone that can help you, let them. If you have to do it all by yourself, look for public resources. This is so much for you to bear alone...including your children...
I had a friend who also lost her dad by cancer. She has been such a strength and support for me. She cried with me and gave me lots of practical advice. Yes, even the difficult truths that I had to face. I wish there was someone like that for you.
I also held on to God. That's was all I could do, there wasn't anything else I could do. I was doing all that I could. I prayed everyday for a miracle. Yet, even during my difficult times, God gave me strength to go on, to take care of things, for my mom and dad. My dad had such a difficult time facing the fact that my mom was dying...
I will be praying for you in my heart. God bless you, and may He give you the strength and faith to go on.