Brian Nelson
31 Gessner Rd.
Houston, TX  77024
713-467-3025 Fax  713-467-3192
Brian@NelsonIdeas.com
MDA Patient No.  646-782

September 6, 2007

Dear Dr  O
Thoracic Center
M.D. Anderson Cancer Center
Houston, TX 77024
713-792-6110 ,  Fax 713-794-4716

Dear Dr. O,
I was released from MDA  Hospital Wed. Sept. 5, 2007. I have some questions listed below. I appreciated  your one minute call my  from paging to you during my stay in the hospital. You indicated you were out of the country.  I assume others on your team were filling in for you during the 6 days I was in the MDA Hospital.

Recapping partly for my own records because I can tend to forget details as they are recalled  here as follows.
On Wednesday Aug. 29, 2007 I as given a Throacentisis by  the Cardiopulmonary  Center for  an excessive fluid build up in my left lung. The right lung also had fluid but less.
On Thursday August 30   was given a Echo Cardiogram by Helen at Cardiopulmonary.  I discussed my shortness of breath. She immediately suggested a quick look at my heart with the Echo.  It showed a significant build up of fluid in the Pericardium preventing the heart from normally sending blood to the rest of the body, therefore the shortness of breath.  Other staff immediately were called in to view the Echo live. It was agreed that I needed to be routed to the hospital via ER for quick admission. That went fine.   2 staff Dr’s and a fellow  in my ER room did what I think is called a Pericarditis.   450 ml of very  bloody pericardial fluid was removed initially.  Gravity flow continued for a day or 2 until the flow eventually ceased. The lab results showed it to be a METASTIC NON-SMALL CELL CARCINOMA. Then my right lung was drawn down with a Thoracentisis.

After 3 days in critical care I was moved to a normal MDA  hospital room on the 12^th 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?
2. What should I do when various heart  symptoms come up?
3. What type of problems can I expect from my lungs?
4. What should I do when various lung symptoms come up?
5. Why am a I waiting  15 days for an appointment with you when it was determined that METASTIC NON-SMALL CELL CARCINOMA were present in my  Pericardium? Do they just always go away and never come back? Do they have to be treated only when they grow larger.  
6. Is my body not able to handle chemo until after a certain delay time? Somewhere in my 67 years I was told to nip things in the bud or catch them early before they can grow. How is my thinking out of line?.   If so, then why was that not explained verbally and in writing prior to my discharge.
 7. Should my out of breath problem improve?
8. How long should I consider it normal to cough?
9. How much exercise should I do?
10. Can I cut the grass, shovel sand, use a sledge hammer or pound nails?
11.I gained 10 lbs in 5 days. I was 167 lbs going into the hospital.  Yesterday I came home  148 lbs.  The increased scale changes were a big signal to me.  Should I watch then daily in the future to recognize pleural effusion?
 13. Can I do any lifting?
14. Any ideas about my life span in this condition?

Sincerely,

Brian Nelson

What you are looking at is a Dr. on the left.  A Dr. on the right and Brian's back in the middle with surgical fabric on the outside.

If the Dr. penetrates the wrong area you could be in for big surprises.  Who's  idea was it to make the human bodies almost all the same so there would be an easy repair job. What if you  body was totally put together differently than everyone else's.  You would be the no. 1 Guinea Pig.

I hoped to stay just 5 days but it was 6 days before I could get discharged.