Bronchoscopy..and they're going to remove my upper left (LVRS)

So, a bronchoscopy this morning. Sneaked a half cup of coffee before the taxi arrived (you're not supposed to drink anything from midnight before). Quite uncomfortable, involving lots of water, probe down my throat into lungs etc but I don't remember much because of the sedative. It was to check if any of the four valves they put in my left upper lobe in February were leaking, which would explain that procedure's total lack of success. Bad news is that they're all working fine so that wasn't the problem. My consultant, Dr Jarad (praise be upon him) then visited me in the recovery room and said how did I feel about having my upper left lobe surgically removed? Well, how do you answer a question like that? :) It has the same effect as the valves should have had (creating more space for the functioning lung parts to expand into), only somewhat more invasive so I went with a tentative yes. After all, I'll still have four lobes left. So, that will happen sometime this winter. Nice to have a little project :)

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  • Hi, do you have Copd or something else?

  • COPD

  • Phew, glad I had my Bronchoscopy whilst still unconscious for a different surgery!!! Good luck for the lobe removal. xx

  • Sneaking half a cup of coffee wasn't very smart !!!! You could have ended up vomiting during the bronchcoscopy. You're lucky to have some surgical options left. Hope the lobectomy is successful.

  • It was only an expresso's worth and I knew that it was at least two hours before procedure and would have been 'processed' long before that! I'm pretty smart!

  • One time before a bronchoscopy, I took a sip of water by mistake and the consultant freaked out. Maybe he was making a fuss about nothing but he really made a big deal about it and said he'd just sent a patient back to the ward for doing the same thing. I'd hate to have seen his face if I's told hin I'd had a sneaky espresso :)

  • So sorry to hear you have to go through more surgery, sounds like you need some tlc...sending a hug,huff x

  • Hi notlocal,

    This sounds like your consultant and his team are doing all the right things.

    A thought......When they looked at the valves through the scope,and concluded that they were working OK, did that mean that there was little activity through the valves (meaning not much air going into the area supposed to be isolated, and therefore not much to come out, and so little activity), or a lot of air passing through the valves (outwards only), which would indicate collateral ventilation.

    If collateral ventilation is the problem, then that would explain why your lung didn't suck shut like it was supposed to.

    Assuming that you take your surgeon's advice, and go for the lobectomy, may I wish you a more successful outcome than with the valves.

  • He didn't go into details John and I wasn't really in a fit state to ask. Those white hospital appointment envelopes are going to be dropping through the door within a week and I'll ask when I see him again. Seemed pretty sure LVRS was the way to go.

  • Good luck with the op. Hopefully, it will be a big improvement for you. x

  • Good luck with the op, hope it works for u, take care x Sonia x

  • Thanks Sonia.

  • I am really sorry the procedure did not work for you and wish you well with the lobe removal. xx

  • I'd already written it all off Toci, then the consultant said that if a leaky valve was the culprit then it could be replaced and it could 'work'. It wasn't to be, so surgery is the next step.

    x

  • I remember your initial disappointment. I understand though that there can be quite a dramatic difference once the op is done. I hope all works out well for you. xx

  • my friend has just had this op done its early days yet it really is a major op i am having tests done at leeds to see whats best for me good luck what ever happens x

  • Tests, always tests! And best of luck to you too Jean.

  • thanks notlocal x

  • Good luck Notlocal,I,m hoping to have lung reduction surgery next year is that the same thing,I,m not too clued up on the technicalities? D.

  • yup, that sounds like the same thing FarmerD. Thanks for the wishes and the same to you!

  • I'm confused ..... if the valves are sealed & working, then the lobe must have collapsed. Assuming that to be the case, then surely physical surgery will have the exact same result - ie: create a cavity for the remaining functioning bits of lobes to expand into.

    My confusion ..... if the cavity created by the valves haven't improved things for you, how will the physical removal of a lobe be any different. Both procedures have the same effect, yes?

    As you know, my valves are working, the lobe has collapsed, but the remaining lobes are so damaged they merely hyperinflated to fill the void with mostly damaged lung .... no noticeable benefit to lung performance.

    I raised these very questions when they agreed the valves hadn't improved things & they started making noises about LVR surgery.

    After much prodding, poking, scanning & enough x-rays to make me glow in the dark, the consensus between my local consultant & the good folk at both Birmingham's Queen Elizabeth & The Royal Brompton was to remove the valves, re-inflate the collapsed lobe (which includes some good bits of lung) & use a load of coils to compress as many useless damaged bits of all lobes as they can. I don't have much good lung & if they removed a whole lobe then inevitably part of that lobe will be good, which I really can't afford to loose.

    .... Had I not questioned the logical obvious, I'd have had the LVR surgery by now ..... probably with no benefit.

    Problem now is I now have to wait for NICE to approve the coils ..... hopefully within the next few months.

    Sometimes it's good to question ...... & question & keep on questikning.

    It's the engineer in me.

  • Hi S,

    One thing I am sure about is that the lobe didn't collapse as planned, even though the valves are sealed and working (purpose of last week's bronchoscopy). The reasons for this are unclear to me at the moment but I suspect it is something to do with collateral ventilation, referred to by johnwr above. I came across a learned article in Thorax Journal thorax.bmj.com/content/61/5... which I am trying to understand at the mo. As you're an engineer it may be easier for you! Meanwhile I await my next hospital appointment letter. I'll keep you informed when I know more.

    Here's another Thorax article you may find interesting, written by the Brompton lot. thorax.bmj.com/content/69/1...

    Cheers, B

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