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Gasping after lobectomy

PBJ Austin
Posts: 347
Joined: Mar 2009

I had my lobectomy on Sept 4, 2009 so I am still recovering. I wonder if anyone else had problems with gasping? By that I don't mean shortness of breath. What happens is for a split second it feels like something is blocking my airway so I gasp and jump. This does not always happen when I'm walking or doing something strenuous. I can't figure out what causes it, as it seems a bit arbitrary. It even happens when I am sleeping or just lying down. From the outside it looks like I'm burping or hiccuping. Did this happen to you? If so, how long did it take before it stopped? Thanks in advance.

Oceansand's picture
Oceansand
Posts: 12
Joined: Oct 2009

I had my right upper lobe removed June of this year. I also would gasp without any warning. Sometimes this was embrassing, especially at work. I told my doctors and they said it was normal. Gasping doesn't happen anymore, I'm guessing it lasted about 3 months. Sometimes now a tiny bit but unnoticeable. Like a little yawn. My lung specialist and surgeon told me it was nothing to be concerned with. I take Spriva and Advair every day, have ever since surgery. I really think yours with lessen in time. Good luck and take care.

PBJ Austin
Posts: 347
Joined: Mar 2009

This is what I love about this board, I don't feel so alone. :-)

It is sometimes embarassing when I gasp because it probably looks like I'm burping. I always jump a little and grab my chest. I don't do this on purpose, it's just a reflex. But if this is normal and temporary then I can handle it. Great info, thank you.

OncoSurge
Posts: 21
Joined: Oct 2009

I read about your EBUS and biopsy and PET in previous posting.
How have things turned out for you? I hope you are well.

PBJ Austin
Posts: 347
Joined: Mar 2009

In my other thread I said the surgery was not urgent as that's what I believed at the time. But within a week I became very sick with pneumonia, I was coughing up weird stuff inclucing blood, and the mass had grown. I was so sick and the mass was taking up most of the lobe so that's why surgery did become urgent. I was very lucky to have a wonderful surgeon. If anyone in Central Texas happens to be reading, I highly recommend Dr. Philip Rascoe of Scott and White Hospital. Path reports after surgery showed a serious bacterial infection was the cause of the mass.

I am still gasping from time to time but aside from that I'm feeling a lot better. I used to be an avid runner and I'm still not able to run. However I'm walking a lot faster and farther than I have in months. So while the body is still in a recovery phase, my mental state has never been better in my life.

I am so thankful to people on this board for all of your support through this difficult time. Although I did not have cancer I will remain part of the lung cancer forum so I can help others with questions about the biopsies and the lobectomy.

OncoSurge
Posts: 21
Joined: Oct 2009

I am really glad to hear things turned out OK. I am also glad you found a trained General Thoracic surgeon (especially one with MD Anderson training). Having lung surgery by a surgeon trained and focused in non-cardiac thoracic surgery is shown to provide better outcomes. Keep up the hard work and deep breathing.

soccerfreaks's picture
soccerfreaks
Posts: 2801
Joined: Sep 2006

Frankly, I would want to know the reason for this. If it is to be expected and is common, then the doctors must know the reason and must be able to explain it in a way that you can understand.

Following my lobectomy (lowest right lobe) in Jan of 08, I contracted MSSA (a cousin, I guess, of MRSA) and one of the toughest episodes I had was coming out of the bathroom with my pole and all of my pipes and box and so on, finding that I lost my breath completely.

We determined, unscientifically, that this happened because the toilet paper was in a nearly thief-proof metal box that required me to bend over for an inordinate amount of time (I like a clean butt :)).

At the time, it was rather alarming, and even now, when I bend over for a protracted period of time, I tend to have a shortness of breath. No one has clearly explained why that is so.

The theory that we all eventually agreed on was that I was 'blowing chunks' if you will, from within my lungs from time to time and that one rather large chunk got caught in my trachea. That may be so, as I had evidence of those 'chunks' over time. But it was not a definitive answer.

Due to your history of pneumonia and the lobectomy and so forth, I wonder if something of this nature is involved?

Regardless, I would be curious to hear what the professionals have to say about the cause of this, beyond 'don't worry about it, it happens to everybody'.

Best wishes.

Take care,

Joe

PBJ Austin
Posts: 347
Joined: Mar 2009

I would love to know why this is happening but so far I'm not getting any straight answers from the docs other than this is common and it will go away. That's always frustrating but I'm trying to have faith they are right. At this point I'm about 7 1/2 weeks out of surgery and I guess I'm lucky because the gasping only lasts a split second then it's over. The strange thing is the gasping is so arbitrary and it doesn't seem to matter what I'm doing.

soccerfreaks's picture
soccerfreaks
Posts: 2801
Joined: Sep 2006

I'm really glad to hear that you are doing so well PBJ! Congratulations!

As for the lack of an explanation, I wonder sometimes (in fact I'm pretty much convinced) that they think we are not up to understanding their medical mumbo-jumbo, when the truth is that not only are we up to it, but we want to know not just for our own edification but for others as well.

I remember, when finally being released from the care of my infectious disease doctor (post-MSSA episode) seeing a phrase that included the prefix cardio- in it. While not alarmed, this certainly piqued my curiousity. The infectious disease doc was kind enough to tell me that it was nothing, that it 'simply' meant my heart had shifted to the right a bit following the lobectomy!

Maybe I shouldn't have asked :).

Take care,

Joe

OncoSurge
Posts: 21
Joined: Oct 2009

For starters, I will say we will often fail to mention or specifically state when we may not really have an answer. For myself, I do not make this failing in any deliberate effort to pretend I know something or belittle my patients. I make this failing in error. I believe it represents a failure to communicate on our part. As in your case it may add to your discomfort. For that, I am sorry and hope to always do better. I advise patients to express to me if I am unclear or if they do not understand my answer to their questions.

I am going to give a generalized response to the concerns cited below.
__________________________________________________________
"...I would love to know why this is happening but so far I'm not getting any straight answers ...other than this is common and it will go away. ...At this point I'm about 7 1/2 weeks out of surgery and I guess I'm lucky because the gasping only lasts a split second then it's over..."
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To the concerns at hand, I ask that you forgive me if some of my numbers are off... I do not have the textbook before me. So, I am going by memory. From a surgical standpoint, we are generally concerned with a patient having adequate overall post-operative function to breath without a ventillator. The numbers do not really have day to day significance to a surgeon in and of themselves.... but they may represent an impact on the patient. The impact of lobectomy on breathing, gas exchange, etc... is long lasting.

If memory serves me correctly, the "textbook" immediate impact of thoracotomy lasting 8-12weeks include a decrease FRC 35%, FVC 60% and FEV1 60%. Lobectomy impact at 6-12 MONTHS decrease FVC 5-15%, decrease FEV1 10-25%.

The "surgery" itself (i.e. not including lung resection)impacts respiratory mechanics. Many theories exist to explain this. For example, the pain and/or nerve impingement between ribs will cause "splinting". The body adapts with time so one is not necessarily concious of the pain but still "splints". Now, add onto that the removal of lung function... i.e. lobectomy.

Ultimately, I wish you well and a good recovery. I am sorry you are having this discomfort/unpleasant gasping. I have heard of it from patients. It generally does go away. I am curious and would like to know what the mechanism/explanation is. Unfortunately, I have no specific explanation.

PBJ Austin
Posts: 347
Joined: Mar 2009

I appreciate all of your thoughtful replies and I'm glad you are a part of this board. It sounds like in a year or so I'll be close to where I once was. This is good news.

cabbott
Posts: 1048
Joined: Aug 2006

When I was recovering immediately after surgery, a survivor recommended I see a pulmonologist or a respiratory rehab specialist. It took me more than a year to finally get around to it. It seems like the surgeon is an expert in how to remove the cancer, a pulmonary oncologist is the chemo expert, a pulmonogist is the breathing expert, and the pulmonary rehab specialist can give you lots of help on recovering your breathing technique after surgery. I ended up with the pulmonologist who was able to help with the shortness of breath issue (possible COPD or maybe untreated asthma). The coughing is definately better thanks to the new meds which I take as needed. I just didn't know I needed them before. You may get more answers from either a pulmonologist or a respiratory rehab specialist too. If things don't clear up on their own in a timely manner, it might be worth a look see. Don't wait as long as I did...

C. Abbott

OncoSurge
Posts: 21
Joined: Oct 2009

RE:
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"...respiratory rehab specialist. ...the pulmonary rehab specialist can give you lots of help on recovering your breathing technique after surgery. I ended up with the pulmonologist who was able to help with the shortness of breath issue (possible COPD or maybe untreated asthma)..."
_______________________________________

I definately agree with involving a pulmonologist. He/she is usually involved with my patients as part of a multidiscipline approach. This is especially true given most have significant smoking history and associated disease. Post-operatively, each patient is seen by a respiratory therapist. They are evaluated and their post-operative rehab needs assessed at that point.

Obviously, each individuals needs and resources and access to specialist differ. But, if someone is having difficulty with breathing/etc... I do encourage reaching out for pulmonologist. Also, I hope you still have the different breathing devices used post-op in the hospital. I encourage folks to continue to use those long after they are discharged to home.

keep up the hard work, keep deep breathing and coughing,
OS

PBJ Austin
Posts: 347
Joined: Mar 2009

I have been working with a pulmonologist since the mass was found and he did most of my testing before surgery. I will be seeing him again on 11/16 for an X-Ray and a follow-up so I will ask about respiratory therapy. I am very fortunate not to have any history of smoking or exposure to second-hand smoke so maybe this will be a plus in my recovery.

I am still using the spirometer and I can go up to 1750. I don't know if that's good or bad at this point, (appx 2 months after surgery) does anyone know? If there are other lung excercises I s/b doing I would be very anxious to hear about it. I really want to get back to the way I was, or as close as possible.

Thanks again to everyone on this board for such great input.

PBJ Austin
Posts: 347
Joined: Mar 2009

I have been working with a pulmonologist since the mass was found and he did most of my testing before surgery. I will be seeing him again on 11/16 for an X-Ray and a follow-up so I will ask about respiratory therapy. I am very fortunate not to have any history of smoking or exposure to second-hand smoke so maybe this will be a plus in my recovery.

I am still using the spirometer and I can go up to 1750. I don't know if that's good or bad at this point, (appx 2 months after surgery) does anyone know? If there are other lung excercises I s/b doing I would be very anxious to hear about it. I really want to get back to the way I was, or as close as possible.

Thanks again to everyone on this board for such great input.

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