Postby mpbser » Sat Mar 16, 2019 7:28 am
Here is the latest: So, there was an appointment for a CT scan on the MSK portal that did not make sense to me as CT scans do not accurately show spots in my husband's liver. Dr. Kemeny's office, when I asked about this appointment, seeking clarification about it, blurted back through the portal: "The CT scan is a baseline scan. It is required after surgery and yes you will get filled." Nothing about needing to view his chest or anything and sounded routine for the average patient (CTs being the norm for most stage IV colon cancer patients, except in people such as my husband for whom liver lesions cannot be seen in CT). As CT is only good for my husband when the chest needs to be analyzed, I wrote back reminding them that it was inappropriate in his case due to his habitus, except for surveillance of the chest. They deleted the appointment.
This morning, I see that the report from Tuesday's flow scan test was uploaded to the portal last night. It says that he has new bilateral small pleural effusions and compressive atelectasis (collapsed lung). Apparently, according to my Dr. Googling, this is very common in obese people who had upper abdominal surgery. Breathing and coughing exercises help resolve this, although no one had mentioned any of this at all to us.
I hand delivered husband's ECGs from day of surgery and day after to his local cardiologist yesterday with the plan to follow up with him on Monday. My husband and I spoke last night about how he had left his follow-up appointment with him unscheduled for the time being, so perhaps one is warranted in this case. Now that I have this information about the pleural effusions and compressive atelectasis, I think so. He (local cardiologist) can order a chest CT (chest Xray even better) if necessary, thus avoiding the issue of dealing with MSK CT appointments. They are ALWAYS many hours behind at the Manhattan location at which they scheduled him.
It would have been nice if his MSK cardiologist responded to my inquiry on Thursday: "Given the fact that this post liver surgery ECG is abnormal, should we have a follow up ECG done by husband’s local cardiologist?" She had insisted, against the surgeon's wishes, that they do intraoperative/perioperative ECG monitoring (monitor put into his left arm artery, bruising him all up something fierce) to make sure his heart was OK during and immediately after surgery, but I guess that is where her responsibility ends. Who oversees his cardiopulmonary issues now?
No idea. I know that our local hospital blood lab will do blood draws on "foreign" orders, e.g. from MSK, so I am now wondering if local radiology department will do the same. Will be a very busy Monday.
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED