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Lung Biopsy Questions....

idlehunters's picture
idlehunters
Posts: 1792
Joined: Apr 2009

I went today for lung biopsy and fiducial placement for upcoming Cyberknife. I requested more...much more..Versed (twilight drug) this time around...as well as Fentanyl. Last time was a little rough as not much drug was used. This time the procedure was to be a little more complicated as they need to go thru my breast...into a section of ribs that have many nerve endings and then on to the lung. The doc said he would be using the same dosage as before but this procedure would be much more painful. Ya..that was great to hear. He said he CANNOT use more drug as I have to be alert enough to respond to commands like "hold your breath"... "breathe"..etc. The area my tumor is in will move as I breathe 1 to 2" and he cant just take a stab at hitting it...thus the breathing technics. Since I will be laying on my back I asked if they would put up a curtain so I cannot see them working.. He said no..not at all...as they will be working right there...below my chin...on my boob...I would have a front row seat..... SHUT UP!! No..no..no...I can't do this. I said ...you're not serious right??? oh...very serious. He said I did have the option of general anesthesia and would then sleep thru the whole thing.... WHAT??? I was told I did not have that option since I had to communicate. He said they would stop my breathing at the appropriate times. Downside to this???? Lung collapse to doing this under a general is REAL good. Heck, it's 50% with the twilight drug. Much more on general. So what would that mean??? A chest tube and 24 hr stay in the hospital. Whatever... I opted for the general anesthesia. They discharged me and now I am rescheduled for Nov. 23rd.... so IF the ole lung crashes...then I guess I will be spending Thanksgiving in the hospital.

Questions..... Anyone else face this in any way, shape, or form?....... I researched percentage of lung collapse WITH general anesthesia and without..could not find much..anyone privy to this info?.... I am also going to talk to the doc about NOT doing any biopsy or Fiducials. They can do Cyberknife without fiducials but it will eat up some good tissue...tho minimal...and I already know the tumor IS cancer so biopsy not necessary...they were only doing it since they would be in there anyway.

Soooooo..thats how my day has been..... how you all doin???

Jennie

jjaj133's picture
jjaj133
Posts: 869
Joined: Mar 2011

OMG Jenny, what a terrible choice you have to make. I have no experience except my sisters lung collasped and they just stuck a needle in her and blew it up again. that was many years ago.
Good luck I hope someone can help you. i am all about comfort.How ya gonna hold still and be in that much pain// I hate this friggin disease.
Love and prayers my friend.
Judy

janie1
Posts: 753
Joined: Apr 2011

I have no experience in this, but, I do know I would probably opt for the General. I wouldn't worry about Thanksgiving. I'd just be sooooo darn happy when that is behind me.
If they do general, then I may be neutral on the biopsy and the other. Would probably do what they think is best. May the next couple of weeks fly by for you, and then you can move forward (think about Christmas). :)

idlehunters's picture
idlehunters
Posts: 1792
Joined: Apr 2009

You are right....I am not going to worry about Thanksgiving.... I have grown daughters that can cook and do the entire dinner...and thats what really was bothering me. I may postpone THIS procedure until the last week of the monthas I have ANOTHER procedure that is needing even more immediate atention. ALL of my top teeth have rotted out....inside the gum...and are literally falling out. I have lost 2 now. All of my top teeth have porcelain crowns....which are still bautiful..BUT...nothing to hold them now that chemo rotted the tooth under them....... man...when it rains..it pours. SOOOOOO... I am at a point with that now where they want to do oral surgery and remove all top teeth and then slap a top plate in there that same day. They want to do this the Monday before Thanksgiving which means turkey day would still be out this year. Oh well..... stay tuned.......

Jennie

tommycat's picture
tommycat
Posts: 790
Joined: Aug 2011

You are NOT a sissy--holy crud, this is ALL a big deal. The surgery??? then Your teeth???
I have very little advice to offer except saying that I am holding out my hand to you....

idlehunters's picture
idlehunters
Posts: 1792
Joined: Apr 2009

awe..... thanks for having my back on the sissy thing! and I will take that hand....thank you!!!

Jennie

idlehunters's picture
idlehunters
Posts: 1792
Joined: Apr 2009

Yes..... I agree...what a frggin choice! I am a sissy...BIG sissy..and I don't do pain well but it's being awake and SEEING what they are doing and then my mind just gets stupid... I imagine all kinds of stuff that ain't happening..just what COULD happen... I definately do not need to be awake for this one. Thanks for thinking of me. It will all be good. Take care girlfriend...

Jennie

tanstaafl's picture
tanstaafl
Posts: 1292
Joined: Oct 2010

Thanks for letting us know the inside straight story on CK, Jennie. One would get the impression that if the fiducial placement goes easy, then Zzzzzzzzzzt a few times takes care of the CK procedures.
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CRC and chemo typically mean low vitamin D3 and/or calcium levels. We assume my wife was grossly vitamin D3 deficient at diagnosis. Early on she went 0 to 60, onto high dose supplements.

My wife and her teeth, before and initially on chemo, were doing ok at 17,000 iu of vitamin D3 with lots of bone building vitamin K2 (Osteo-K, 45 mg menaquinone-4 [MK4] with calcium) - she had normal range, above average amount of calcium in her blood. Going down to 12,000 iu D3 for a few months to get a stable blood level and out of MK4 (we tried 100-200 mcg MK7, didn't work), her teeth started to have slight problems, and her blood calcium levels went below average, very marginal. When we finally got the vitamin D blood test done, her vitamin D turned out to be in the "insufficient range" (less than 32 ng/L or 80 nmol/mL). So now I try to keep her blood calcium in the high average range, her vitamin D3 and K2 supplements are "very high", along with magnesium, and we carefully count the calcium content in her supplements to maintain normal range calcium (important, to avoid hypercalcemia). It looks like she might drop to hypocalcemia if she didn't do much D3, or anything.

MK4 (Vitamin K2) is a reason to check pro time for INR and may require a different blood thinner (e.g. coumadin, aka Warfarin, conflicts) even though MK4 properties are substantially different than vit K3. Our vitamin K2 experience is only with 5FU from UFT, leucovorin, cimetidine and a LOT of supplements, no experience with irinotecan, oxaliplatin, Erbitux or Avastin, all which need to be analyzed and okayed by a knowledgeable doctor, perhaps a cancer specialized naturopath with a stronger biochem interest. Then let us know, too.

Almost a year and a half straight on chemo, her teeth are doing fine, instead of the often found chemo rot from the inside. It looks like simple dissolution mechanics to me - the magnesium, vitamin C, D3 and K2 balanced with calcium management look like positive factors to me.

idlehunters's picture
idlehunters
Posts: 1792
Joined: Apr 2009

I hope all read your response to this thread. Even though there is no documented "proof" that chemo has a direct effect on your teeth.... a LOT of us have been there done that and KNOW what has rotted our teeth. My D3 level was 5 at DX so I agree with what you are saying. The combo of the above mentioned supplements with calcium has been successful in your wife's case. I will definately look into that. My bottom teeth are fine. I find that kind of strange. NONE of them have crowns and only the top teeth WITH crowns (10) were the ones that rotted....wonder if there is a connection there...hummmmm. Thanks for the input.

Jennie

tanstaafl's picture
tanstaafl
Posts: 1292
Joined: Oct 2010

On the outside of the teeth, going inward, some have claimed minimization or reversal of periodontal problems with nutrients like coQ10, vitamin C and niacin or enhanced mineral bathing including the salvia. Perhaps immune function too with all that vitamin D. Of course, I have to say, she's eaten lots less sugar and starch these days, since dx, too and not being a BRAT (well, some backsliding for a while on bread and fruit lately)...

There are other experiences that make me interested in the D3-K2-Calcium-Magnesium (and phosphorus levels) for tooth health, whether really blood ("inside") or salivary ("outside") contact in tooth preservation.

Some of the blood tests around diagnosis should show calcium, phosphorus, maybe magnesium, ditto the CBC blood work on chemo. D3 data while on chemo may be more scarce. Many Americans are way deficient on magnesium anyway. Guys' "coronaries" apparently too often were "shorting out" - so ER docs would jab them in the chest or heart with a magnesium chloride "supplement"; decades ago a former roommate mentioned that they can sit up disconcertingly fast after the jab. Think I'll take mine orally, thank you.

Sundanceh's picture
Sundanceh
Posts: 4408
Joined: Jun 2009

Hey Jen

I'm really sorry about what's happening to your teeth - know things were really getting "unhinged" right there at the end of CP. We can't get our doctors to acknowledge that "anything" comes from doing chemo - yet from the front lines, we are witnessing and many of us experiencing the truth of what treatments bring us.

I hope this new plate will 'beautify' your appearance and help you gobble down some groceries:)

As far as your other procedure - "Take a Nap." When you awake, it will be all over, but the cryin', LOL!

Knowing you like I do, you're liable to come unwound, hop up off that table and start directing the nurses and doctors around. He11, even if you voted to stay awake, the doctors would probably still "dim your lights" just so they could get some rest:)

LOL! LOL!

You know, I only want the best for you and I'm hoping it will come out successful. Between me and you, I think we could keep a mechanic on-staff full-time keeping us in enough running order to stay on the road:)

Love you - Craig

idlehunters's picture
idlehunters
Posts: 1792
Joined: Apr 2009

I'm gonna have to quit hanging out with you....you are getting to know me TOO well!!! LOL. I tried to tell them doctors that it would be in THEIR best interest to put me out. I want them to know I can be a HUGE beotchh so they better watch out! You act like you know that...LOL. This new plate HAS to make me look better cause it sure can't get any worse. I look like a crack addict..LOL...for real!

Luv ya too.... GO CARDS! LOL

Jen

Annabelle41415's picture
Annabelle41415
Posts: 6549
Joined: Feb 2009

What a terrible decision you have to make. Wow girl you have been going through so much. Can't give you any advice, but just wanting you to know that I'm praying and thinking of you. Bummer about your teeth too. They don't tell you that with the chemo, but just coming back from the dentist and the hygenist said my gums didn't bleed as much, well we all know it was from the chemo. Hang in there girlfriend.

Kim

idlehunters's picture
idlehunters
Posts: 1792
Joined: Apr 2009

You are such a sweetie! Ya know, on my very first post here a few years back.... you replied to my post....as you do to most every post. Thank you for that Kim..... I sure feel the love! You take care girlfriend!!!

Jennie

Lilmiss82's picture
Lilmiss82
Posts: 257
Joined: Dec 2009

I had my surgery for my lung biopsy back in aug/sept. I was completely out and they had to collapse my lung to get the sample. I stayed in the hospital for a week with a drain. There was the risk of my lung collapsing again while in recovery but fortunately that never happened. They made my incisions right in between my ribs and was told that this area is more sensitive than the abdomen and recovery would be more painful. They were absolutely right! To this day the incisions on the right side right were my bra hits they are still sore. I know that they had me blowing in the lung thing you you the one with the hose that you blow into and try to keep a ball at a certain number whatever it's called they had me using it as soon as I woke up to help and keep the lung expanded. Hope I make sense and more importantly helped you. :) Melissa

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