(Warning: skip the part on the thoracentesis procedure if you are squeamish)
If you have followed my blog, you know that my recovery from what doctors appear to call triple A surgery (Ascending Aortic Aneurysm) has been rocky. Energy levels have been low and pain high. I also seemed to have a wheeze over the past 10-11 days and a cough during the past few days. I could not tell, but thought maybe I was experiencing some shortness of breath – I knew I was breathing shallowly and could not seem to take a really deep breath. So, we went in for a chest x-ray yesterday. I was asked to wait and then called to the desk where they told me my doctor’s office was on the phone. The woman on the phone said that I was going to be admitted right away because I had Pleural Effusion around my right lung. I told her that I did not know what that meant and she explained. I sort of lost track after that and asked her to speak to my boyfriend.
So what is Pleural Effusion? Medline Plus says:
A pleural effusion is a buildup of fluid between the layers of tissue that line the lungs and chest cavity.”
“Your body produces pleural fluid in small amounts to lubricate the surfaces of the pleura, the thin tissue that lines the chest cavity and surrounds the lungs. A pleural effusion is an abnormal, excessive collection of this fluid.
- Chest pain, usually a sharp pain that is worse with cough or deep breaths
- Rapid breathing
- Shortness of breath
“Sometimes there are no symptoms.
So, I was admitted to the hospital. We waited for quite some time. At one point, my nurse whom I had not yet met, popped her head in and said “oh, you’re small”. It was so random that it made my boyfriend, the cardiologist and I laugh. She explained that the pulmonologist would perform the procedure in my room. Quite a while later, the pulmonology doctor came in. He was dressed in a very nice striped suit and a purple shirt. I was amazed given that he planned to extract fluid from my body and had on such nice clothing. Again with the small comments – the doctor explained that I had very small spaces between my ribs and that he would have to maneuver to get in between them. (as an aside, it made me wonder whether they primarily see large and/or obese patients) He explained every step in detail and told me what I would experience and what I should look out for. And then we began the Thoracentesis. So what is that?
According to the National Heart Lung and Blood Institute:
Thoracentesis (THOR-ah-sen-TE-sis) is a procedure to remove excess fluid in the space between the lungs and the chest wall. This space is called the pleural space.
Normally, the pleural space is filled with a small amount of fluid—about 4 teaspoons full. Some conditions—such as heart failure, lung infections, and tumors—can cause more fluid to build up. When this happens, it’s called a pleural effusion (PLUR-al e-FU-shun). A lot of extra fluid can press on the lungs, making it hard to breathe.
Doctors use thoracentesis to find the cause of a pleural effusion. The procedure also might be done to help you breathe easier. During the procedure, your doctor inserts a thin needle or plastic tube into the pleural space. He or she draws out excess fluid.
Your doctor may take only the amount of fluid needed to find the cause of the pleural effusion. However, if you have a lot of fluid in your pleural space, he or she may take more. This helps the lungs expand and take in more air, which allows you to breathe easier.
After the fluid is removed from your chest, it’s sent for testing. Once the cause of the pleural effusion is known, your doctor will plan treatment. For example, if an infection is causing the excess fluid, your doctor may prescribe antibiotics. If the cause is heart failure, you’ll be treated for that condition.
Thoracentesis usually takes 10–15 minutes. It may take longer if you have a lot of fluid in your pleural space. You’ll be watched for up to a few hours after the procedure for complications.
In case you are wondering, yes, they use local anesthesia – Lidocaine. And yes, it hurt a LOT. As he drew out the last 25% of the fluid (there was an incredible amount – I actually weighed 5 pounds less this morning), my collapsed lower half right lung began to expand and it hurt terribly. The pain was accompanied by coughing. Thank goodness for my boyfriend who allowed me to squeeze his fingers during the process.
Thirty minutes after the procedure, I felt slightly better. Sixty minutes, I felt a bit more relaxed and in less pain. At this point I even asked for apple juice. Two hours afterwards I had a snack and decided I was ready to be discharged.
I cannot explain how it feels to have breath restored. What I can tell you is that I had a light dinner when we arrived home, watched some television to settle myself down some more, took some acetaminophen (done with the narcotics), and slept better than I have slept since before my surgery. I awakened still in some discomfort (that continues this afternoon)…but I can breathe. I am thinking more clearly. Other than the soreness in my lunch and back, I am relatively pain-free. I have more energy. I am breathing deeply (with my mouth closed – no panting).
So, the answer is – a rocky road led to wonderful news. I feel so much better. I even unlocked the deadbolt on the front door by myself without kicking the door today. I am BACK!