9/13/06
Got the results of the VQ test back today. Although I don't completely understand what they're talking about, I did look on the internet to see the reason for a VQ test and it said "The purpose of this test is to look for evidence of a blood clot in the lungs, called a pulmonary embolus, that lowers oxygen levels, causes shortness of breath, and sometimes is fatal. " The test results said, among other things, that "Low probability for pulmonary embolism". Whew!
My VQ test showed that my left lung got 64.4% of the blood flow and my right lung got 35.6%. It appears my lower third gets most, then my middle third, then finally my upper third. It appears there is decreased perfusion to the upper lobes bilaterally. The left and right upper thirds didn't get much at all. I haven't the foggiest idea of what all this means but it's interesting to read. It does appear to show that my upper lobes are just not doing the job they were hired to do!
The x-rays showed nothing new. The 9mm nodule is still wherever it was in 2003 so that is good, too. Lungs are hyperinflated (which is nothing new).
Okay, onward and upward with more tests on the 20th. I'm interested in seeing just what my PFT shows...especially since I've not had one since my little go-round with pneumonia in 2005.

9/15/06
I've been reading Cathy-MD's reports on her LVRS and I'm sort of having second thoughts about this. She says she's in quite a bit of pain (oh well, I can just moan and groan along with the best of them)...but she DID have a double LVRS operation. And it appears the pain is in the area of the drains...and I think one of those drains was in longer than usual. Bec-Saba said this is normal....so I guess I could manage it...as long as I don't sneeze or cough!
The lady from Dr. Cooper's office called today and he wants to see me at 12:30 next Wednesday instead of 2:00 so now we'll have the great shuffle around of the 4 tests remaining...6-minute walk, abg, ctscan and pft. I SHOULD have called them earlier in the week and told them I was available yesterday and today but.........I wonder if he wants to see me earlier so he can get an earlier start on his weekend??

9/25/06
I've been keeping my eye on Cathy-MD's journal on COPD2. Some of the stuff she said scared me but today she said she's feeling pretty darn good and the pain from the drains is minimizing daily. That is good.

9/26/06
'Tis the night before Dr. Cooper...and I'm nervous as all get out. Not nervous to talk to him but scared of what he's going to say. I am NOT brave enough to go through with this operation even if I am qualified. Chris, Colleen, BJ and Wes have been backing me up so well and right now I feel like I'm falling apart. I'm SCARED. I've just got to sit myself down and remind myself that tomorrow is JUST the talking part...not an operation, for pete's sake. Can't breathe...gotta' go get me an ativan and go to bed. If there was an absolute guarantee that if I go through with the operation, I WILL awake at the end, I don't think I'd be as worried. I'm not afraid of the operation but I sure am working myself into a tizzy worrying about SURVIVING the operation. Gad, and I'm supposed to be the calm one. This is so stupid. I don't think I will include this particular part in my posted journal 'cause it is dumb but it surely helps me to "talk" about it now. I DID start a list of questions to ask if YES and if NO. And I'm sitting here crying. What in the world happened to the "brave Penny" I used to be? Do we lose our courage as we age? No, I don't think so. I think we tend to be a bit afraid of the unknown is all. And, we're more aware of our own mortality. Like I said, if I KNEW I was going to come out of the anesthesia, I wouldn't be bothered at all. Well, now my nose is running so I'd best go play a game on the 'puter and hit the sack.

9/27/06

I have been declared a good candidate for LVRS by the LVRS King, himself...Dr. Cooper!!

So, where do I start? With all the testing done the previous 3 weeks, I finally had an appointment with Dr. Cooper this afternoon. But it was not in his office as I thought it would be...across a desk (you know, like they show on TV); it was in a regular old examination room...just like our docs have.

Okay, first things first. Went to the reception area on the 4th floor, Silverstein, at the U of P. This place was packed!! This is the reception area for LOTS of docs. Thankfully, no one was coughing, sneezing or anything and while there were probably about 30 people in there, it was nice and open...not packed in like sardines (like my own pcp's office waiting room!) I got to fill out 3 pages of medical questions....from birth date to drugs to operations in the past to allergies to health of blood-folk and on and on. It honestly sounded as if I was going to go under the knife today! After filling out that stuff, I was taken back to the examination room where an assistant weighed me, took my temp and BP. She left and there I sat...and of course, nothing particularly good to read. Gotta' learn to take my own book on these trips.

After I had read every chart on the wall and twiddled my thumbs for about 10 minutes, Rebecca (Dr. Cooper’s assistant) came in and asked more questions. She is a lovely young lady and quite personable. She got her information and around 1:30 came back with Dr. Cooper. He looks just like his picture (he was glad to hear this)...and has a lovely smile. Felt very comfortable with him immediately. We social-talked for a bit then he listened to my lungs then had Rebecca listen to my lungs. He asked her to listen to left rear upper then lower and asked what she heard. Then she listened to the right upper and lower. She said she could hear inhalation AND expiration in one section but only one or the other (I forget which) in the other. Then he had me go out in the hall and walk down to one end, turn around and walk to the other end (thank goodness it was a short hall ‘cause I forgot to turn my O2 up!) and then into the office where he listened some more and we talked some more. I can’t remember everything so what follows is just what I remembered and in no special order (darn, I wish I had taken that tape recorder along!)

First of all, I must do 3 months of intensive rehab (sound familiar, Colleen? LOL!) 5 days a week. He said treadmill is machine of choice. If I want to add upper arm/body exercise, that’s good but his goal is for me to walk 1 mile at 1 mph. Heck, I can do that now! This is directed to all of us...he said we have our choice...exercise or wheelchair. Well, that’s really putting it out there, huh?
When we’re exercising, we are supposed to increase our O2 to whatever it takes to keep the sats above 88. Exercise won’t kill us (as long as our hearts are okay!); neither will sob (although it sure feels that way sometimes).

8 days is average hospital stay time if all goes as planned...and then recuperation at home for as long as it takes (4or 5 weeks to be feeling well enough to go back to work).

FEV1 might not increase after LVRS but in most cases they do. I told him I didn’t care about the FEV1; I just wanted to stop being so sob.

One thing he said that did make me feel good is that I asked him about having a hysterectomy after this operation and whether, if I had it done at U of P, would he please confer with the surgeon and the anesthesiologist about my lung condition and what anesthesia I should/could have. He said “Most definitely”.

He asked whether I take a bath or shower and whether COPD was the cause of whatever. I said no.

Asked if I’ve had always had short hair or if it’s short because I can’t take care of it long. It’s always been short.

Do I cough? No.

How many times hospitalized? Just once.

He’s done 400 operations and the mortality rate is about 1 in 100. I asked him to let me know when he does the next 100th operation ‘cause I’d like to be in the next group!

Told him all about the 2 COPD boards. And you know what? Just about everything he told me (except for the actual operation) is stuff we already know from frequenting the boards. And yes, Chris, I did try very hard to keep my mouth shut and my mind open.

He tends to his patients after the LVRS. So it’s not a case of operate and forget. He visits each one rather often ‘cause he wants to make sure all is well for them.

He asked me if I would take part in a research thing they’re doing there regarding the movement of the lungs and rib cage during the various parts of sob. They evidently put you on a treadmill (with O2 if you need it) and put 80-some (at least that’s how many he said) sticky pads on you (like an EKG) and you just walk along and the 6 or 8 cameras in the room are recording this, that and the other thing. Obviously I agreed. Was going to do it today but it was getting late so I’ll go down next Wednesday.

I am not a good candidate for the upcoming stent trials they’re going to conduct. I didn’t ask why.

One of the things he had me do was turn my head all the way to the left then the right. Forgot to ask him why.

He asked if my feet swell at all. I told him during hot, humid weather or if I’ve been sitting with my legs crossed way too long. He feels this is a peripheral circulation problem and not a lung problem.

He said the first 90 days are the serious ones. If anyone dies of lung problems during the first 90 days, he would probably attribute it to the LVRS.

This whole session was about 1 hour! It was great. After he left the room, Rebecca took some information to set me up with a research program down here. I asked her how she likes working for him and her whole face lit up. I gather he’s very well respected at U of P. She told me more about the research thingy and told me to wear sneakers and sweatpants. Some woman evidently showed up in heels! I also told Rebecca about some people having quite a bit of pain with the drains and muscle soreness after the vats operation. She said that’s one of the reasons Dr. Cooper does the one down the sternum...there are few nerves and no muscles there. She also said then the drains can be inserted higher and they aren’t as affected by everyday movement.She's also going to try to get me into a rehab program up here...either St. Luke's or Palmerton. I'd rather St. Luke's 'cause it'd be much easier to get to (and closer) during the winter. We'll see.I will continue to add here as I remember bits and pieces of this meeting with Dr. Cooper. On the next pages, I would like to tell you about the research study I got "sweet talked" into, LOL!