VATs pre and post-op tips anyone?

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2/1/2011 2:11am
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Replies: 13

I am scheduled for VATs next Tuesday to remove a 2.1 cm lung nodule in my lower right lobe.  CT and PET/CT confirm it has doubled in size in 3 months and has high FDG uptake.  I know this surgery can be very straight forward and if all goes well, I can expect a fairly quick recovery.  I would appreciate positive feedback regarding things that might help this procedure go better or make me more prepared (please don't scare me!)  

So if you have had VATs and there is anything that you wished you had known ahead of time because it would have helped you pre or post op, please let me know.  Thanks!

Shari

Game on. I am going to win! (The thought I had when I heard the doctor say I had melanoma.)

Hi Shari,

I've had VATs twice, left and right sides, with multiple tumors taken out each time and both times had really no issues.   They have you up and walking around the hospital fairly quickly after surgery.  They will have you perform some coughing exercises while hugging a pillow, etc.  My hospital stays were quite short.   It's been a while but if I recall correctly the first surgery was at 7AM on a Friday and I was discharged the next day at about 3pm.  After both surgeries I was sore, but not really in any pain.  Although I was given aperscription for a very low dose of oxicodone, I only took tylenol.  Just follow the discharge orders to a T, ie: no lifting anything heavier than a quart of milk, walk around your house to get exercise and get the lungs to open up, cough reguarly as they outline, take it easy, etc.  My surgeons tell me I heal well - so results may vary, but after both surgeries I was able to work from home via computer within a day or so - my choice -  I was bored of TV.  I went back to work one week after the surgery.  My desk job wasn't taxing, no heavy lifting required, and I could get up and walk around and cough as instructed without issue - still following the discharge orders to a T.  

My biggest fears going into the first surgery:  1) Would I be in pain?   I wasn't.  In the hospital I had a pump that I really didn't need after the first 12 hours or so.  At home it was tylenol.  2) Would I breath normally after?  Yes, lung function is just fine.  3) What would scarring be like?  Minimal because VATS uses smaller incisions.   I rarely notice them or think about them  now.

You mentioned in another email using meditation, etc.  I used a meditation type of CD recommended actually by the pre-surgical nurses at my hospital.  Listened to it over and over several times leading up to the day of the surgery...took the CD and player to the hospital and listened to it post surgery....it helped.

Best of luck with your surgery and recovery....alot of us have been through it.  Hang in there!

Rocco - Stage IV Aug 2005.

Luke 1:37

Thank you, Rocco!  I really appreciate your feedback on your experience.  I have just the one nodule and my surgeon called last night to tell me it is in an easy location for removal.  He is saying a four day hospital stay, not sure why that is and will ask him at consult.  Can you give me the name of the CD you listened to?  It sounds like a good tool.

Shari

Game on. I am going to win! (The thought I had when I heard the doctor say I had melanoma.)

Thank you Rocco!  I just ordered it.  I have been listening to a physical wellness CD on my iPod but this CD sounds great. I will get it tomorrow, so have 5 day pre-op to listen.  I will add it to my iPod for surgery.  When I had the WLE on the bottom of my foot and left inguinals removed, I was under for 7 hours and they allowed me to listen to the iPod the entire time (or until the battery ran out).  I will do it again.  Am seeing my healer today for a customized recording to take with me as well. 

Stay well!  Blessings,

Shari

 

 

Game on. I am going to win! (The thought I had when I heard the doctor say I had melanoma.)

Hey Shari...

How was your vats surgery and recovery time? I am headed in on Tuesday for a similar procedure and trying not to freak out about it.

I have multiple tiny nodules on both lungs which is why I need to do a vats for biopsy vs needle biopsy. The surgeon said there are two on my left lung that bs thinks he can get to easily. So we will see.

www.melanomaandthecity.blogspot.com

"people will forget what you said, people will forget what you did, but people will never forget how you made them feel' Maya Angelou

Hi Erinmay22 (maybe Erin?),

 
I am down in Santa Monica, just arrived tonight, for my follow up with my surgeon. We live 4+ hours from here, so I did the surgery, then went home 5 days post-op, had my dermatologist remove my stitches and am now back for follow up.  If you live in or near the location of your VATs procedure, it has to be an advantage.  However, I did okay on the drive home as we planned ahead and I had pillows to cushion me, comfy clothes, an icepack, pain meds and Xanax (which even .5 mg can boost the pain relieving effects of the pain meds in my experience).  
 
Before I go any further, let me just say I am not pain tolerant, so lots of people have VATs and say it is no big deal.  I didn't have a biopsy, I had a 2 cm tumor and some margin tissue removed - not sure how different that is from a biopsy.  Also, I am 46, overweight and not in tip top shape like the athletes that responded to me.  If you are working out regularly, you are going to do better than I did and I think I am doing really well!  I improved dramatically once the stitches were out.
 
Post-op you don't feel much in recovery because you are well medicated and they administer lydocaine (sp??) internally.  It was painful but not unbearable.  I have had much worse surgery.  My biggest issue was once all the operative meds wore off, I had one of those pain med buttons I had to push to get med administered and I would doze off, then wake  up (no med had been  administered for awhile) and be in pain.  Once we identified the issue, I was put on long acting oral painkiller with Percocet and Xanax for breakthrough pain and I did do much better I requested to be discharged on my third day in hospital.  My dad drove in to meet us for breakfast the day after I was discharged, so obviously I was doing okay!
 
Follow their instructions - when they tell you to sit up and cough, do it.  And the more you can make yourself cough, the more stuff you cough up and though it is rough in the moment, the pay off is clearer breathing faster which is your goal!  Get up and out of bed as soon as you can.  Even just sitting in a chair, then take a little walk.  To speed recovery, keep your legs moving - rotate ankles, flex calves, point toes - learned this post-op three years ago and it works.  The more you can move, the better and the sooner you get out of the hospital (and away from all the icky hospital germs!)  Get LOTS of fluids in hospital and once you are home - helps thin the mucous and keep everything moving out.  Keep forcing the coughs at home.  Stretch and move around to help loosen everything up.
 
The goofy little plastic breathing apparatus they give you to strengthen lung capacity is really helpful to build up your breathing ability.  Use it!  I am three weeks post-op on Tuesday and still use it many times a day as it keeps me focused on breathing deeply and making progress!  I have not been able to wear a bra and have not been inclined to go shopping for some acceptable replacement (sports bra) so have been wearing a snug tanktop under my regular top, then a scarf and a jacket and I don't think it is noticeable.  (You know I am feeling pretty good if I am worried about wearing a bra!)
 
I was advised by one doc to get 80 to 100 grams of protein a day to help the wound and lung tissue heal.  I am a vegetarian so I have done shakes with protein powder.  Also 50 mg of zinc and lots of vitamin C (from juices) to boost healing.  And if you start getting shortness of breath, call your doctor!  I had this happen and it was a day when we had poor air quality, so I kind of dismissed it.  By the second day, it was worse and I had a fever.  Doctor immediately put me on antibiotics and breathing improved within 24 hours so likely had an infection brewing.  
 
I got the CD Rocco recommended and listened to it many times pre-op and post-op (there are different tracks for each).  Would recommend getting it even if you only have a couple days to listen. I hope your VATs goes well and something I have shared is helpful (and nothing made you anxious!) It is really amazing what they are able to do with surgery compared to what they were doing even a decade ago!!  Wishing you a quick recovery.
 
Blessings,
Shari

Game on. I am going to win! (The thought I had when I heard the doctor say I had melanoma.)

Hi Shari -

Thanks for the note back.  It was helpful!  I think my biggest fear going in was getting the epidural put in and everything else.  All in all it hasn't been too bad so far.  The procedure was done Tuesday morning.  It lasted about 45 min and they took a tiny 2mm nodule off my left lung.  The doctor did tell my sister that he thought they were malignant cells - but we'll wait for the final pathology report to come back early next week....  I do have several nodules on each lung.  Yikes!

I wouldn't say that I'm the most in shape person but seem to be healing ok.  I'm 32.  I live in Jersey City and had the procedure done at Sloan.  My sister isn't comfortable driving in NYC so we just took the subway in that morning and then had a car service drive us home.  With traffic it was about an hour.  They were going to discharge me after the first night, but after they clamped my test tube and released it there was some fluid movement when I was coughing - so they were afraid I might have a leak.  So they clamped it again and I stayed 1 more night.  I was given morphine to help me with pain.  The pain was much easier to tolerate once the chest tube was out.  That wasn't very pleasant at all.

I was told I shouldn't drive for 4 weeks!  Not sure how that is going to work out with my job, but I am going to work from home at least next week.  Right now I've just been trying to sleep and also get up and walk around.  Don't have a ton of energy but it's getting better.

Ok I should get some sleep.  I just took another pain pill after going most of the day without one and now I can barely keep my eyes open.  Oh and I'll look in to those meditation tapes.  Hope you're doing well. 

Erin

www.melanomaandthecity.blogspot.com

"people will forget what you said, people will forget what you did, but people will never forget how you made them feel' Maya Angelou

Hi Erin, 

I am glad things went well for you during the procedure.  It sounds like it was done very differently than mine.  I am wondering with an epidural if that means you were awake?  I was completely anestethetized and apparently was hard to knock out.  I know my chest tube was painful and it was a relief to have it out.  I think that it was removed  too early because I just had to have my lung drained Monday and they took 1100 ccs of fluid (doctor said he was amazed I looked so well and was walking around.  I was in pain but had no idea I had fluid and three differet doctors listened to me that day, all said I sounded clear, but pulmonery specialist felt my pain was excessive so ordered a chest x-ray).   I am doing MUCH better now that the fluid is diminished (not gone and am hoping it goes away!)  I was not told not to drive but I can't with the pain meds I am on.  I have continued to listen to the post-op portion of the cd.  

I wish you the best, whatever lies ahead.

Blessings,

Shari

 

 

 

Game on. I am going to win! (The thought I had when I heard the doctor say I had melanoma.)

Hi Shari -

Good to hear that you are doing better!  Yikes fluid on the lungs...  I've been worried about that as well!  Since I was only in there 2 days.  I think my procedure was a little smaller than yours.

The epidural they gave me was in case they had to do something more invasive.  Of course they put me under!  Oh god I would hate to go thru something like that without being completely out!  I really should look in to that CD.  I've been doing the breathing exercises and getting up and walking around.  Still feeling a bit dizzy but I think part of that is from the pain meds. 

Time for rest!  I feel like I've done a lot of sleeping lately! 

Erin

www.melanomaandthecity.blogspot.com

"people will forget what you said, people will forget what you did, but people will never forget how you made them feel' Maya Angelou

Hi Shari -

I had a VATS done in April 2009 and got thru it just fine. I was in the hospital 2 nights. As the other post said, I didn't experience too many adverse side effects. The chest will be sore, especially while the chest tube remains in. And the breathing exercises the first week or so after were a bit painful, but overall not bad. I took 3 days off work I believe.

I am fairly active (runner, skier etc) and have not noticed much if any difference in my breathing capacity. From time to time, I can feel the spot they operated on, but it isn't anything more than a little "tightness" in the lung, not painful at all.

Best of luck to you.

Wetterhorn

Thanks for the feedback!  I am feeling really good about this.  My insurance pre-cert came today and they authorized a one day hospital stay as "standard" so that leads me to believe this is not considered a major surgery.  (Of course, they will cover me for longer if necessary.)

Shari

Game on. I am going to win! (The thought I had when I heard the doctor say I had melanoma.)

Hey Everyone,

Thanks for all the info.  I'm having the lower left lobe removed via VATS on 3/14. 

The best thing is that soon after spring will be here and then I'll be set to get back  on the bicycle on a regular basis.  Today we had a brief warmup to the mid 50's so I inflated the tires and a bit of cool weather gear and headed off to the beach. 

Jerry from Cape Cod

It's about kickin' Melanoma's butt!

"Meh. Get on with it. Do not feed rabid monkeys. To fear is one thing. To let fear grab you by the tail and swing you around is another." in memory of NicOz

Hi Jerry,  that is awesome that you are a cyclist.  What I am hearing over and over is that those that are already in good shape and active do much better than those (like myself, unfortunately) that are not in good shape.  My VATs actually has motivated me to walk daily which sounds like nothing but wow, what a beneficial difference!!  The key to healing well after this procedure is BREATHING and deeply, which athletic people are already doing.

Sending positive energy for a successful surgery and quick recovery!  Great that you have your biking to look forward to.  Also, I would strongly recommend the cd Rocco mentions above.  Really well done (nothing "new agey" about it, very straight forward) and I feel like it diminished anxiety pre-op.

Blessings, Shari

Game on. I am going to win! (The thought I had when I heard the doctor say I had melanoma.)