VATS surgery/recovery

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roadrunner
Posts: 460
Joined: Sun Jan 12, 2020 8:46 pm

VATS surgery/recovery

Postby roadrunner » Thu Dec 02, 2021 2:03 pm

Hey guys:

I’m usually big on pontification, but now I have a question. For a long time we’ve been watching my two lung nodules. They have gone up and then down a bit. The subpleural nodule is now at 6.8mm (has fluctuated over time but has shown very slow growth overall over the last 1.5 years or so). Thus I am having VATS tomorrow to remove and biopsy it. There is a more central nodule that still appears stable, and we’ll use SBRT on that or perhaps just keep watching it, in part depending on the surgical pathology.

My question is: Any experiences or tips on VATS recovery? They’re telling me one day inside to resolve any air leaks, then my surgeon will remove the chest tube and send me home. I will try to push recovery hard and am working remotely anyhow, but does anyone have some wisdom or experience to impart on how to recover ASAP? Thanks for anything you’ve got.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

Markdale
Posts: 107
Joined: Wed Dec 02, 2020 4:45 pm

Re: VATS surgery/recovery

Postby Markdale » Thu Dec 02, 2021 4:16 pm

I had a thoracotomy. Soon as the drain tube is out start walking as much as possible, I was walking an hour twice a day it’ll help the lung expand. I haven't noticed much difference in lung capacity, however climbing stairs I noticed I was getting short of breathe in the first couple of months.
Coughing and sneezing will be painful in the first few weeks
09/20:Diagnosed after colonoscopy for bleeding.
MRI and ct scan confirmed tumor at rectosigmoid junction aswell as lung nodules in RLL (1X1.2cm) and RUL (3X.5cm)
10/20: LAR tumour t3n2m1 4/24 lymph nodes.
11/20: pet scan confirmed Mets
11/20: folfoxiri - 10/6/21. 12 rounds in total
1/1/21 thoracotomy 1 met removed
2/2022 sabr to 2 lung nodule
09/22 PET scan progression of sabr’d nodules
10/22 phase 1 trial bispecific antibody
9/23 added pd1 blocker
12/23 bilateral VATS all visible (7) lesions removed

stu
Posts: 1613
Joined: Sat Aug 17, 2013 5:46 pm

Re: VATS surgery/recovery

Postby stu » Thu Dec 02, 2021 5:17 pm

Hi ,
Compared to the other resections my mum had she found Vats a complete walk in the park .
She had one small incision around two inches just under her armpit !
She was on her feet walking up and down the corridor doing the breathing exercises by day two . And discharged the following day . She was fully independent in all aspects just resting when required and out and about within two weeks . Never looked back with no obvious impairment in her lung function . She was 73 at the time and now 79 . All remains good . She had two other nodules . One 7mm but no uptake on the PET .
They have remain unchanged .
All the very best .
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

roadrunner
Posts: 460
Joined: Sun Jan 12, 2020 8:46 pm

Re: VATS surgery/recovery

Postby roadrunner » Thu Dec 02, 2021 11:01 pm

Stu: Hope mine is as easy as your mum’s was! Thanks for the upbeat report, was a bit nervous.

Markdale: I’m going to try to push, and was running 2.5 to 3 miles last week, but I know from prior surgeries I’ll have a bit of a different outlook tomorrow, so I hope to get close to your walking totals soon.

Prayingforccr: The idea is to pull this one out and test it to see what systemic treatment might work best (if I choose to go that way). We’re going to do the other one with SBRT, or just watch it (it’s possible that it’s been going nowhere for a long time now (just went from 7mm to 6.3mm 15 months after last chemo)). It could have been wedged, but because central looked more like a segmentectomy or a lobectomy, and my oncologist and I agreed that because these are small it’d be better to try to keep from losing too much healthy tissue now.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

User avatar
Rob in PA
Posts: 2022
Joined: Wed Dec 09, 2009 9:16 pm
Location: Pennsylvania

Re: VATS surgery/recovery

Postby Rob in PA » Fri Dec 03, 2021 10:11 am

Roadrunner,
Walk, walk, walk.....and use your breathing exercise thingy (forget the name off hand).

I also had SBRT, but it was done prior to VATS because I had 4 lung nodules (2 in each side) and they would not do VATS until I got at least one lung cleared.

Worked well, still here :D

Rob
dx 11/07 crc IIIb @ 39
Xelox/Rad/ temp colostomy
LAR/J-pouch/ temp ileo
Folfox-8
Failed reversal
2/09 liver mets; liver resect/ileo reversal
Folfiri/Avastin - 12
2/11 5 lung mets
Folfiri/Avastin 2011
SBRT 3/12
Lung met 5/13/ said NO to more chemo
SBRT 8/13
2 lung mets 5/14, VATS 8/14, NED

roadrunner
Posts: 460
Joined: Sun Jan 12, 2020 8:46 pm

Re: VATS surgery/recovery

Postby roadrunner » Sat Dec 04, 2021 12:03 am

Thought I’d update this thread. In a holding pattern on the VATS. My surgeon had to cancel today. Will reschedule soon.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

stu
Posts: 1613
Joined: Sat Aug 17, 2013 5:46 pm

Re: VATS surgery/recovery

Postby stu » Tue Dec 07, 2021 4:26 pm

Such a shame but hopefully back on course soon !
I will look forward to hearing you are safely through .
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

roadrunner
Posts: 460
Joined: Sun Jan 12, 2020 8:46 pm

Re: VATS surgery/recovery

Postby roadrunner » Wed Dec 08, 2021 2:00 pm

Had the surgery this morning. So far so good. A bit sore, lots of lines and tubes. Once we get pathology we’ll proceed with the next sortie. Likely SBRT on the more central nodule. Then there’s the systemic therapy decision to make. Thanks everyone for the support! It means a lot.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

stu
Posts: 1613
Joined: Sat Aug 17, 2013 5:46 pm

Re: VATS surgery/recovery

Postby stu » Wed Dec 08, 2021 4:16 pm

Delighted to hear from you .
Great to hear you are safely through surgery .
Rest well and keep up the good work !
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

User avatar
beach sunrise
Posts: 1034
Joined: Thu Mar 05, 2020 7:14 pm

Re: VATS surgery/recovery

Postby beach sunrise » Wed Dec 08, 2021 5:02 pm

Great news to hear today!
Take care of yourself and Merry Christmas to you and family!
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

roadrunner
Posts: 460
Joined: Sun Jan 12, 2020 8:46 pm

Re: VATS surgery/recovery

Postby roadrunner » Wed Dec 08, 2021 6:12 pm

Stu: Thanks indeed! You are a wonder of this board, offering both warmth and truly uplifting stories and perspective for inspiration. Your good works are hugely appreciated.

Beach: Thanks and Merry Christmas to you as well! Honestly, I was unable to enjoy the lights, etc. until this little speed bump was past. Will focus on them in the space before the next one. Even snowed a little on the way in this a.m. (I was like: “Dang (or similar), we’re already late!” Not a thought (til now) on how pretty the icy mist was on the empty roads (5 a.m.).

Prayingforccr: Thank you for the kind words. And I wish you great good fortune with your new approach. Of course, I read about it when you first posted on it! I hope your success with your primary carries over to this way to attack the pulmonary mets.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

User avatar
CRguy
Posts: 10473
Joined: Sun Feb 10, 2008 6:00 pm

Re: VATS surgery/recovery

Postby CRguy » Thu Dec 09, 2021 12:42 am

roadrunner wrote:Had the surgery this morning. So far so good. A bit sore, lots of lines and tubes. Once we get pathology we’ll proceed with the next sortie. Likely SBRT on the more central nodule. Then there’s the systemic therapy decision to make. Thanks everyone for the support! It means a lot.

Heal well and heal gently !!!!
AND ... keep on ... KEEPIN' ON !

In Harmony with you on the Journey
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

roadrunner
Posts: 460
Joined: Sun Jan 12, 2020 8:46 pm

Re: VATS surgery/recovery

Postby roadrunner » Thu Dec 09, 2021 9:28 am

Thanks CRguy!

Update is that I went home the day of, so I’m going to call VATS an outpatient procedure :lol: Chest tube was unproductive so home I went. In the context of the tube removal, by the way, when medical people say “on the count of 3 I’m going to . . .” Be afraid. Very afraid. Worst thing I felt the whole time. But over in a second, so all good.

And this was despite nearly passing out on my first walk around the floor! Diagnosed after the fact as vasovagal syncope due to orthostatic hypotension or dehydration, surgical stress, or just who knows? I felt bad for the poor pulmonary therapist. We walked about 15 yards and I was like “Umm, I’m feeling a bit dizzy.” Then “I’m going to go down pretty soon.” (I’ve had similar episodes before; had one on the first chemo takedown.) We were in the middle of a huge, HARD, hallway with zero, well, zero anything, really. She started intensely measuring me up to see whether she could support a passed-out 6’2” guy (through my “glassy eyed state” I judged a firm “nope” to that one). Fortunately, some employees were sitting around having a lively chat in a little cluster of those office chairs with wheels and one of them saw the action and slid it over in seconds. Things started getting better after I sat down, and better yet when I got back to bed, but heart rate and blood pressure were impressively low for a bit. My room was suddenly filled with tons of people all talking at once and looking at my vitals, and the #2 doc on my surgeon’s team appeared out of nowhere as well. Always good to provide entertainment, of course.

After that, things went more according to plan. Even walked up a full floor of the parking garage on the way out. Now sore but not too bad. So far no Oxy, just Tylenol, though they gave me IV narcotics at first in the hospital. Plus they gave me a nerve block; single shot, turned down the catheter.

One thing I noticed. Several people on here said it’s great to have a recliner for the recovery. I was like: “I don’t really see the need for that, it’s just a couple of small incisions . . ..” Well, last night at about 3:30 a.m. I figured that one out. I did devise a decent gymnastic move where I raise myself from a supine position using only my right hand, but by the time I got to a seated position I forgot why I was sitting up in the first place and just wanted to lie back down again. Awesome.
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

utahgal7
Posts: 201
Joined: Fri Sep 11, 2020 12:04 pm

Re: VATS surgery/recovery

Postby utahgal7 » Thu Dec 09, 2021 9:45 am

roadrunner:

Good to hear that you are doing well after your surgery. Yes, I have heard that the chest tube is the worst part of VATS. Sorry, it was so painful for you. Have a wonderful holiday!


Paige
02/20 Rectal Cancer dx - 4 cm mass; located 9 cm from AV
03/20 CEA 2.7; 0.9; 1.4; 0.9; 0.9; 1.2; 1.0; 0.8; 1.1; 1.0; 1.1; 1.7; 1.8; 1.8
1.9; 2.4; 2.3; 2.8; 2.2, 2.8, 3.2; 3.0; 1.6; 2.0; 1.2
04/20 ST Radiation; 04/20 LAR surgery w/ileostomy; ypT3N1bM0; MSS, KRAS G12A
05/20 CAPEOX; 08/20 Ileostomy reversal
12/20 CT scan; lung nodules (watch and wait);
11/22 lung nodule biopsy positive for RC met;
1/23 VATS right lower lobe wedge resection
FOLFIRI 10 cycles

User avatar
CRguy
Posts: 10473
Joined: Sun Feb 10, 2008 6:00 pm

Re: VATS surgery/recovery

Postby CRguy » Thu Dec 09, 2021 11:57 pm

roadrunner wrote:Thanks CRguy!
Most welcome ... AND ...
just because you might appreciate my special sense of warped humor from days gone by ...
I offer my own recounting, of my own VATS experience :shock: :D :mrgreen:

Re: CRguy in da house ... outta da big house !

Cheers homie !!!
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far


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