i asked a question last week. never got an answer

[sqaimy]

an "i don't know" would have been better than just ignoring my concern about my mother-in-law. have you of the procedure using the powder? could something different been done? refer back to my earlier post, from last week. I HAVE BEEN CHECKING IN EVERYDAY HOPING FO9R SOME KIND OF COMMENT.

[sqaimy]

thanks so much for your comments. it's helped me understand and not be so angry about the whole situation. she never even got the chance to start her cancer treatments and we were all hoping that she would and we would have more time with her. it all just seemed unreal and still does. the doctors wasn't telling us much and when the day before she died came they told us to be getting prepared.they turned her vent. up to 100% and we knew that was bad but we still wanted to believe amiracle would happen and she'd pull through. it was hard to see her like that. she started swellen in her last hours so bad that if we didn't know it was her we would not have recongized her. we found out about her cancer the 1st of dec. and she past away on feb.2.- thanks again for writing back

[AndyRRT]

As NJC states, Non-Small Cell Lung Cancer is a bad cancer. It is sometimes a very fast and aggressive type cancer that respond to chemo or radiation very poorly. With prolonged lung disease, especially an aninvading disease such as cancer, the pleura can fill up with fluid. This is called a pleural effusion. The fluid keeps building up and up and has no where else to go, so it puts pressure on the lung itself. This pressure prevents the lung from expanding. So the only way to remove the fluid is to drain it out with a needle (Thoracentesis. Sometimes a thoracentesis isn't enough. If the fluid just keeps building up, you need to add a chest tube for long term drainage.

Depending upon the condition of her pleural and how well it heals depends on when this fluid will stop building up. Mostlikely, her pleura was involved with the cancer or the cancer was simply irritating/instigating the fluid build up.

The procedure your mother-in-law had is called a "Pleural Sclerosis". What this does is, it uses either a powder (Talc) or other chemicals that will irritate the inside of the pluera to make the pleura adhere to itself PREVENTING any more fluid from building up. Its a rather simple procedure as well as a sterile procedure. It is unlikely that the sclerosis caused her pnuemonia. We are dealing with the OUTSIDE of her lung...not the inside where a pneumonia occurs.

Andy, RRT, CPFT

[National Jewish]

Non- small cell lung cancer is a bad cancer.  It responds poorly to chemotherapy and radiation.  While the infection was the final event, in truth it was the cancer that killed your mother-in-law.

Placing a specially formulated powder into the pleural space, the area between the lungs and the ribs, is a common practice.  It is done to keep the fluid from building up in the lungs.  This was appropriate in your mother-in-law's situation.  It almost never causes infection.  It is most likely that her lung infection was the result of the cancer partially blocking one of the airways of her lung.  That could lead to infection in both lungs.

Your description suggests that the doctors did the right thing in trying to make her more comfortable by keeping the fluid from building up.  That the fluid kept coming back suggests that the cancer was both in and around the outside of her lung.  The combination of cancer and infection could result in her oxygen level dropping.  In this situation the decision to place or not place a person on a ventilator is difficult.  It will vary from one person to another and the wishes of both the person and their family.