I was composing a nice lengthy response to Momshoe, and I realized that stuff has happened that might be worth an “up here” post.
So the run down:
After further meetings with the anesthesiologists and such, it’s a little freaky. Especially since I get the impression that the rheumatologist I saw — who did indeed call me back — wants absolutely nothing to do with it. But for once, thinking about the long term scary implications is far better than thinking about the short term ones. Things I wish I didn’t know, but am kinda glad I do: My throat will hurt more than the usual post-anesthesia scratchiness, because they use a much bigger tube. I am glad I know that. They use a bigger tube because they have to deflate each lung as they work in its general area. Wish I didn’t know that, except it does minimize risk of nicks and cuts, which I am glad I know.
Anesthesiologists are all glad I told them about the diabetes insipidus (I had to push to see them… nurse who did admissions testing assumed it was a blood sugar/insulin/pancreas related thing, not a “patient could dry out because they don’t make this antidiuretic hormone and then lose blood pressure and have heart failure while they have one functioning lung” situation). Endocrinologist cleared that I can take the fake antidiuretic hormone that morning and anesthesiologists now know to keep an extra close eye on that and administer it again prior to surgery.
Surgeons are treating it as though it is myasthenia gravis, so they’re using a nerve block in place of muscle relaxants during the surgery. This makes me happy, because I had such a bitch of a time last year when I was having this same sort of problem, and the idiots in the hospital insisted I was anxious. They could tell by looking at me (I kid you not, they said this before they pulled back the curtain and laid eyes on me the first time). I said I wasn’t. Mr. Shoe said, “I call bullshit [I know, Momshoe, your angelic son said that to a doctor who I don’t think was old enough to drive]. I’ve known my wife for a long time, and I’ve seen her anxious. This isn’t anxious. It’s her trying not to throw something at you.”
Anyway, the idiot doctors that time prescribed Ativan because I was obviously horribly anxious. I took it to shut them up, and hoped maybe they were right. Except… it got harder to breathe. Much harder. Ativan isn’t a true-blue muscle relaxant, but when my muscles aren’t responding right mostly anyway, it didn’t help. And muscle relaxants are bad when you have muscle issues associated with thymomas, I’ve learned.
I am fortunate that my surgeons are bright, and knew this. Before I asked.
So I go in next Thursday (Feb. 18th) around noon. I guess the whole deal takes a few hours, and then, because they need to be sure my lungs reinflate right and clear and everything’s hunky dory, I spend the night in the hospital. They usually stick you in ICU, unless a horrible convergence of events leaves no vacancies there, because there’s a higher nurse to patient ratio, and this is one of those things they prefer to err on the side of caution. The next day, they decide whether I can go home… I guess based on lung inflation and function and drainage behavior (there’s a lovely thought…)
Because what they’ll find in the tumor pathology could point to auto-immune mediated neuro-muscular, straight up autoimmune issues, neuro-immune-endocrine issues, bizarre blood issues, or a horribly confusing combination thereof, we then wait. The rheumatologist I just saw seems about as uninterested as humanly possible — and it’s obviously not going to be textbook from here, because there’s no freaking textbooks — so I need someone who actually wants to think about it. And that, friends, family, Romans, countrymen, and chocolate enthusiasts, is so much harder than it looks.