April 2005: a lower left lobectomy

Just a note on chronology:  I am slowly, very slowly, recounting the first few months in which I was aware that I had lung cancer.  Should you desire to read this part of my journey in order, it would go like this thus far:

Clues before a missed diagnosis

Hearing the words “you have cancer”

What next: the week post diagnosis

April 2005:  a lower left lobectomy

I dressed up for our consultation with Dr. Douglas Mathisen at MGH on a sunny Thursday morning.  I wanted to go into his office projecting youth and vitality; as if I were auditioning for this surgery.  David and I were unbelievably anxious.  We had already heard that the bone scan and brain MRI showed no sign of metastases, positive indications that my lung cancer was still at an early stage. We hadn’t yet heard the results of the PET scan though, and that was one more hurdle to cross.

Finally my name was called and Doug Mathisen greeted us both with a hand shake, a good firm hand shake. Everything about Doug’s demeanor was comforting in a “I’ve got this under control” sort of way, and David and I both felt reassured.  We learned immediately that the PET scan had lit up like a christmas tree in the area of my tumor, but nowhere else.  While looking at an x-ray image of my lungs, Doug explained that although my tumor was quite large, he felt it could be surgically removed:  with one caveat. Prior to the lobectomy, but after I had already undergone general anesthesia, a number of lymph nodes would be removed from my thoracic region and immediately biopsied. If any were malignant, the surgery would be called off. Should they be benign, the lobectomy would proceed.

Surgery was scheduled for the following Thursday.  I was as close to elated as a person could be in these circumstances.  What I wanted was a chance, a fighting chance , and I had just been offered that.

The week passed slowly.  On Thursday morning we arrived at the hospital early.  I had thought to pin a note to my surgical johnnie that quoted from Shakespeare’s Macbeth, “Out, damned spot, out”, but I was afraid it might not follow surgical decorum.  I know I was shaking as they wheeled me down to surgery. Charmingly, introductions were made to the anesthesiologist and various personnel, although I would be unconcious within moments and remain so for the length of these brief relationships.

I awakened many hours later in the thoracic ICU.  Tubes snaked in and out of my body and inflatable boots rhythmically compressed my feet.  When able to speak, my first question was whether or not it had been the extended surgery. The answer was yes:  22 lymph nodes had been benign. Dr. Mathisen had removed the entire lower lobe of my left lung. Entry was from the back, and I had a large crescent shaped incision in the area of my left shoulder blade, as well as two smaller incisions fitted with drainage tubes.  To facilitate removal, my ribs had been spread and one of them had a section taken out for biopsy.

We now knew that the tumor was 5 cm at its greatest diameter.  It was very close to my heart, but the margins were clean.  I felt awful, but joyfully so.