Chapter 4 – The Tube

I left off my story discussing the chyle that I had drained twice now in my right lung. I went to the appointment with my pulmonologist on Tuesday April 17th, 2018.  I was not feeling amazing. My blood oxygen level after a 6 minute walk test was 90%. To give everyone a basis for comparison, in general, if your blood oxygen level is 88% or lower during a 6 minute walk test then you qualify for a prescription to use oxygen. After struggling and really not liking the whole procedure to drain the fluid from my lung, I surprised Josh and myself by opted to have it drained a third time. That was how sucky I felt. It is was old hat at that point, right! Hahaha! My pulmonologist was leaving the decision to me since earlier in the visit we spoke about getting the tube installed and how it was time to get that done since after 3 more days the fluid production still had not slowed down. The doctors had me eating a low-fat diet (25 grams or less a day) which was helping absolutely zero.  I said yes, and got through the fluid draining procedure with no issues.  I had my mind adapted to deal with it at that point! Third time really is a charm! My pulmonologist only drained about 70% of the fluid since it is better to have some fluid in the lung during the tube installation procedure. My pulmonologist was able to make me an appointment with the Interventional Radiology Department at Overlake in Bellevue the next day.  

The next morning, Wednesday, I woke up and checked in for my procedure at Overlake.  The previous day I had the chance to ask my pulmonologist all about the tube.  It was going to be ¼ inch in diameter and would come around the side of my rib cage from the back of my right lung and out the bottom right front side of torso. She said that it would be uncomfortable for a few weeks but eventually my body would adapt to it. My pulmonologist mentioned that it was typically a procedure they do for terminal patients towards the end of their life to drain fluid buildup from lung cancer, etc.  I asked how long I would need to have it and she said maybe up to 2 months.  “Wait what…2 months?  Oh man.  OK. That is a long time” I thought.  The intent of the tube was to be a stop gap until I could have pleurodesis surgery at the University of Washington with Dr. Michael Mulligan.  I would find out later that once they installed the tube all the doctors are pretty reluctant to take it out until they are absolutely done with you! The end of the tube had a valve that would connect up to a 1-liter bag that when opened would gravity drain down into the bag. I would need to keep it covered at all times under gauze and tegaderm.  I would be given quite a few draining and dressing kits that came with everything I would need, gauze, tape strips, alcohol wipes, gloves, tegaderm and a 1-liter drain bag.  I have included a figure of the whole kit. Here the website for it: Bard Aspira Pleural Drainage System I regrettably did not take a photo of myself with the tube sticking out of me. I think at the time I was not thinking about I would want a photo of this. Afterwards though I do regret that I never took a photo. Document all the craziness with photos and videos ladies!

They took me back to a hospital room and I got in a gown and waited to be called back for the procedure.  The nurse came in said she was going to put in two IV’s; one primary IV and a backup IV. I had her put the IV’s in my left arm at the inner elbow and near my hand. I am right-handed and wanted to make sure I had my right arm free after the procedure while I was in the hospital for a few hours. The procedure was done under conscious sedation and did not take long. This means that you aren’t put under fully but often times patients don’t even remember the procedure. That was the case for me. I remember the beginning and then waking up at the end as they were wheeling me back to my room. As they were setting up for the procedure I do remember that I was tilted so that my right side was elevated up at a 45 degree angle and my left arm was the bottom arm at my side restricting blood flow to my left arm a bit. Remember that position for Chapter 5.

Once in the hospital recovery room I remember that I was right away starting to feel nauseous. I had a barf bag but remember that I didn’t have to use it thank goodness. The nausea passed quickly and I was able to eat a bit of food.  They monitored me for a while before I was allowed to leave the hospital. They wanted to make sure my bowels were working. Typical situation after surgery.  

Sitting up in bed in that hospital room and having time to really let my new situation with the tube installed sink in, I remember thinking oh this is very uncomfortable. I could feel it every time I moved. That first time getting up out of bed…oh boy…that was interesting. There was a bit of pain when I tried to bend over but mostly it was just very uncomfortable. I could not bend forward at the waist any farther than maybe 20 degrees. I remember thinking, “OK I guess this is my new normal for a while.” How long it would actually be my new normal or what else would occur from the events of that day was still to be found out.