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I am Fighting Cancer MD Anderson
Brian Nelson
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To Go To The Main Site Simply
Click on: www.IamFightingCancer.com
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http://www.PartyTentCity.com
Contact information for
this Website: You can find this site again by typing in the Google search engine the very unique word " 1diulFtraeH " which is " HeartFluid1 " backwards. Article Word Count MSW |
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You are at: http://www.IamFightingCancer.com/MDAnderson/Hospital9-7.html ud 09/07/2007 03:30 PM -0500 Bookmark this page now!
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Misspelled words used to find this page 1 of 5.Misspelled
words used to find this page 1 of 3.
MD Anderson Cancer
Center Houston, TX Texas. Pericarditis.
Pericardium
METASTIC NON-SMALL CELL
CARCINOMAHeart
Sack. Fluid Bloody, Prevention Cancer, Lung
Thoracentisis Lung
Procedure,
PLEURAL EFFUSION, Cancer, Diagnosis,
Pulmonary, Infarction Metastatic Asbestosis, Fluid, Diagnostic, Noninvasive
Techniques, Fluid Analysis, Etiology, Transudates, Thorascoscopy, Biopsy,
Pathophysiology, Cytologoy
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| Misspelled words used to find this page 2 of 5. |
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Brian Nelson September 6, 2007
Dear Dr O
Dear Dr. O,
Recapping partly for my own records because I can tend to forget details
as they are recalled here as follows. After 3 days in critical care I was moved to a normal MDA hospital room on the 12th floor. This includes a long weekend including labor day Monday where nothing new is done for the patient other than normal observation. On Tuesday Sept. 4 Dr. B from Cardiopulmonary came to my room with a portable Echo machine and checked my lung fluid level. His concept was that there was not enough lung fluid to justify a Denver Catheter. I asked to be released. He said he didn’t make those decisions. He just makes recommendations. I continued to ask various medical staff why I was not discharged then since there were no other tests or procedure for which we were waiting. On Wed. I continued to ask the reason for not being released. Finally I did get discharged about 2 pm. My visit in the hospital was very good. The staff was thorough, compassionate, pleasant and detailed. The food service was excellent. Regrettably I was given no exit instructions. No one sat me down, looked me in the eye and stated here is what is happening and here is where we are going. Therefore I am looking for lay answers to the following simple patient questions. I do not want to “cry wolf” needlessly. (I did cry wolf calling you via your PA SV 4 times in one day stating I as having trouble breathing but nevertheless my calls were never returned until the following day. That is unacceptable. Looking back with my heart condition I should have even yelled louder. Although it is over the dam it is not the first time it has happened and should be investigated. ) This patient information requests are:
1. What type of problems can
I expect from my heart? Sincerely, Brian Nelson |
![]() 2a Typical monitoring equipment, heart beat, Oxygen, Blood Pressure, |
![]() Daughter Meredith has something to say as she visits Dad at MD Anderson Cancer Center. . Note the neat red hat matching her dress. |
12![]() This mask is handy when you have to sneeze. It doesn't get all over everyone. |
![]() No Flash on this picture of Rosemary and Meredith. I should remove it but it is the only one I have of them with me. |
14![]() My hat keeps me warm preventing me from getting chilled where the keep the temperature sub zero to keep the germs from jumping around. |
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15![]() To moved the patient to another bed to transport to a different location everyone grabs the bottom sheet and gives Brian an air ride. |
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16![]() They empty bag is connected to the tube draining my Pericardium so my heart can expand normally. |
![]() The Pericardium draining bag is almost full. |
17![]() I am not quite naked. My left shoulder is covered. |
![]() That is Brian in the middle. Rare shots like you have always wanted to see. Does the yellow coat outrank the white coat? |
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Blue Box 1
Related Areas: Read more
about
pleural effusion and other problems that require
treatment.
Alternative names Fluid in the chest; Pleural
fluid
Definition
A pleural effusion is an
accumulation of fluid between the layers of the membrane that lines the lungs
and chest cavity.
Causes, incidence, and risk factors
Your body produces
pleural fluid in small amounts to lubricate the surfaces of the pleura, the thin
membrane that lines the chest cavity and surrounds the lungs. A pleural effusion
is an abnormal collection of this fluid.
Two different types of effusions can develop:
Symptoms
There may be no
symptoms.
Signs and tests
During a physical
examination, the doctor will listen to the sound of your breathing with a
stethoscope and may tap on your chest to listen for dullness.
The following tests may help to confirm a diagnosis: The cause and type of
pleural effusion is usually determined by
thoracentesis (a sample of fluid is removed with a needle inserted between
the ribs).
Treatment
Treatment may be
directed at removing the fluid, preventing its re-accumulation, or addressing
the underlying cause of the fluid buildup.
Therapeutic thoracentesis
may be done if the fluid collection is large and causing pressure, shortness of
breath, or other breathing problems, such as low oxygen levels.
Treatment of the underlying cause of the effusion then becomes the goal. For example, pleural
effusions caused by congestive heart failure are treated with diuretics and
other medications that treat heart failure. Pleural effusions caused by
infection are treated with antibiotics specific to the causative organism. In
patients with cancer or infections, the effusion is often treated by using a
chest tube to drain the fluid.
Chemotherapy,
radiation
therapy, or instilling medication within the chest that prevents
re-accumulation of fluid after drainage may be used in some cases.
Expectations (prognosis)
The expected outcome
depends upon the underlying disease.
Complications
Calling your health care
provider Call your health care
provider if symptoms suggestive of pleural effusion develop.
Call your provider or go to the emergency room if
shortness of breath or difficulty breathing occurs immediately after
thoracentesis.
Diagnosis
Treatment
Pleural
effusion
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Contents of this page:
Illustrations

Lungs

Respiratory system

Pleural cavity
Fluid Around the Lungs
(Malignant Pleural Effusion), ASCO's curriculum
A
pleural effusion is a condition where extra fluid builds up in
the pleural space, which is the space between
the edge of the lungs and the chest wall. A malignant pleural
effusion is caused by cancer that grows in the pleural space.
About half of people with cancer develop a pleural effusion.
More than 75% of people with a malignant pleural effusion have
lymphoma or cancers of the breast, lung, or ovary.
Symptoms
People with a pleural effusion may experience the following
symptoms:
The following tests may help diagnose a malignant pleural
effusion, determine the exact location of the pleural
effusion, or plan treatment:
A pleural effusion may require treatment in a hospital. The
most common treatment is to drain the malignant pleural fluid.
This may be done in several ways:
| Caption: Picture 1. Large, malignant, right-sided pleural effusion. | |
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Picture Type: X-RAY
Imaging Studies:
Failure of an effusion to layer on lateral decubitus films indicates loculated pleural fluid or some other etiology causing the increased pleural density.
Bilateral effusions accompanied by an enlarged heart shadow are usually caused by congestive heart failure. Pleural plaques and calcifications usually indicate previous asbestos exposure. Radiographic findings of pneumonia or malignancy suggest these processes as etiologies for the associated effusion.
Spiral CT angiography may be useful if pulmonary embolism is suspected as the cause of the effusion. Procedures:
Medical Care: Transudative effusions are usually managed by treating the underlying medical disorder. However, whether transudates or exudates, drain large pleural effusions if they are causing severe respiratory symptoms, even if the cause is understood and disease-specific treatment is available. The management of exudative effusions depends on the underlying etiology of the effusion. Pneumonia, malignancy, or TB causes most exudative pleural effusions, or effusions are deemed idiopathic. Drain complicated parapneumonic effusions and empyemas to avoid fibrosing pleuritis. Malignant effusions are usually drained to palliate symptoms and may require pleurodesis to prevent recurrence.
Surgical Care:
Video-assisted thoracoscopy with the patient under local or general anesthesia allows direct visualization and biopsy of the pleura for diagnosis of exudative effusions. Pleural sclerosis by insufflating talc directly onto the pleural surface using video-assisted thoracoscopy is an alternative to using talc slurries. Decortication is usually needed to remove a thick, inelastic pleural peel that restricts ventilation and produces progressive or refractory dyspnea. In patients with chronic, organizing parapneumonic pleural effusions, technically demanding operations might be required to drain loculated pleural fluid and to obliterate the pleural space. Surgically implanted pleuroperitoneal shunts are another treatment option for recurrent symptomatic effusions, most often in the setting of malignancy, but they are also used for management of chylous effusions. However, the shunts are prone to malfunction over time and can require surgical revision. In unusual cases, surgery might be required to close diaphragmatic defects (thereby preventing recurrent accumulation of pleural effusions in patients with ascites) and to ligate the thoracic duct to prevent reaccumulation of chylous effusions. Consultations:
Drainage of complicated effusions usually requires consultation with a pulmonologist, interventional radiologist, or thoracic surgeon, depending on the location of the effusion and the clinical situation. Diet:
Limiting oral fat intake might slow the accumulation of chylous effusions in some patients. Hyperalimentation or total parenteral nutrition can preserve nutritional stores and limit accumulation of the chylous effusion but probably should be restricted to patients in whom definitive therapy for the underlying cause of the chylous effusion is possible. Further Inpatient Care:
Repeat the chest radiographs when drainage falls below 100 mL/d to evaluate whether the effusion has been fully drained. If a large effusion persists radiographically, reevaluate the position of the chest catheter. If the catheter is positioned appropriately, consider injecting lytics through the chest tube to break up clots that may be obstructing drainage. Large air leaks (steady streams of air throughout the respiratory cycle) may be indications of loose connectors or of a drainage port on the catheter that has migrated out to the skin. Alternatively, they may indicate large bronchopleural fistulae. Consequently, dressings should be taken down and the position of the catheter inspected at the puncture site. Clamping the catheter at the skin helps determine whether the air leak is emanating from within the pleural cavity (in which case it stops when the tube is clamped) or from outside the chest (in which case the leak persists). Prognosis:
Parapneumonic effusions, when recognized and treated promptly, typically resolve without significant sequelae. However, untreated or inappropriately treated parapneumonic effusions may lead to constrictive fibrosis. Patient Education:
Medical/Legal Pitfalls:
Discharge or transfer of a patient with an unrecognized pneumothorax following thoracentesis
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Pericarditis
What is pericarditis? What causes pericarditis? Specific diseases known to cause pericarditis are listed below. These diseases damage the pericardium, thereby triggering the body's immune defenses to attack the pericardium tissue and cause pericarditis. These diseases include:
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Pericarditis & Pericardial Disease
What is Pericarditis & Pericardial Disease
Statistics SummaryAbout 20% of
myocardial
infarction patients develop pericarditis. Predisposing FactorsThe most common causes are viral infections and
myocardial
infarction. This varies to some extent with the causative factors. Pericarditis is
often without a clearly definable cause. Following an attack either from a
microorganism or infarction (heart
attack), acute inflammation results. The prognosis of uncomplicated pericarditis is generally good although
the disease can be difficult to treat and can become recurrent. When
complications such as effusion, constriction and tamponade develop the
disease becomes life threatening and survival rates decline - especially if
treatment to drain the effusion and allow the heart to pump adequately is
not done early.
Blood
tests: The underlying cause should be treated where possible (eg. bacterial
or
tuberculous causes,
renal
failure). |
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Blue Box
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