This morning was as tense as last night was long – so long.

Before Annie could undergo the drain procedure (Pleurodesis) she needed to be transferred to the respiratory ward. That transfer was supposed to take place at around supper time yesterday but actually didn’t occur until midnight. She’s in a much smaller ward but it is so very muggy and warm. There’s one other patient who will be leaving at 7:30pm this evening – at which point I hope to negotiate a switch so that Annie can have the window spot and get some much needed air in here!

I did feel for Annie because I was hoping she could get the best possible rest before the drain procedure but that wasn’t to be. It’s not a nice procedure. She’s had a drain before but that was back in 2007 and part of her surgery. At that time the drain collected the white blood cells…why?…well, I’m afraid this is just http://www.brokenchariots.wordpress.com and I didn’t even study biology at GCSE; you’d better visit http://www.wikipedia.com if you want to find that out! The other major difference then was that she had it done while in theatre; but this time they would conduct the procedure from her bedside while she was awake, beginning with three injections directly beneath the ribs and deep into her chest wall muscles. Following that, a long length of tube had to be inserted into the pleural cavity, until it reached an optimum spot to start vacuuming up the fluid.

I often say to Annie “If there was anyway I could take or participate in the pain of cancer or the treatment of its symptoms, I’d do it in a heartbeat.” I have no problems taking injections – honestly, I could easily fall asleep in the dentist chair. But when it comes to seeing injections go into something, I am seconds away from passing out. But, I wanted to do whatever I could to comfort Annie during the procedure and so I decided to stay right there with her as it happened. She was nervous and quietly teary before it even started. I continued to pray for Annie knowing that her Lord Jesus knew very well the pain of pierced hands and a pierced side.

Everything seemed to take for ever.

The entire procedure took about 30 minutes and not one of those minutes was relaxed or comfortable. An assortment of various size injections, tubes and nozzles were unpacked and carefully placed on a silver tray by the nurse; it felt as if that part took hours and hours. My stomach did not stop turning; I cannot imagine how it felt for Annie. It is a very precise procedure and we were forewarned that a number of things could go wrong. When I wasn’t looking at Annie, I meticulously attempted to study the nurse’s face for signs of stress or concern which also doubled up as a helpful distraction from what her hands were doing. I have no idea how the talc got in there but as the nurse tied stitches around the hole to keep it fixed in Annie’s chest wall, she announced a successful operation as the fluid started to ooze out into the container below.

Within five minutes, half a litre of an oily amber looking substance had been siphoned out of Annie. It’s quite something to behold and they estimate now that there is about two litres of this stuff. As well as wondering ‘How did she ever breathe with this stuff around her lungs?’ you also wonder ‘Why was it so hard to identify so much fluid from the CT scan?’ Only recently the consultants were not sure if the amount was considerable enough to drain. But we have learned from doctors that even the advanced CT scan images are very difficult to read and interpret – less like diagrams and more like stereograms it seems.

The first half a litre came out very quickly but the drain has to be stopped for a few hours in between. As the fluid leaves, the lung starts to expand back into the cavity that had previously been filled with the fluid. It sounds nice and normal and snug; the lung returning home where it belongs. It’s not. As the lung expands to fill the gap, Annie experiences sharp pain, tightness and acute shortness of breath – which we are told ‘is normal’ but painful and stressful all the same. They estimate that the complete drain cycle should take a minimum of two days. After that, they hope to refer Annie back to the hospice – hopefully a less painful trip ‘home’.

At the end of the procedure Annie said “Do you think the nurse thought I was a baby?” – referring to the silent tears that she cried during the procedure. “Annie, that nurse has no doubt seen a lot of patients but you’ve been a lot of patients.” As I watched Annie not only was I greatly uncomfortable but I was filled with courage because of her.

Thank you, Jesus for being Annie’s Rock.

She’s been very tired today but then that’s to be expected. But she’s looked fresher and it’s been lovely to see the return of her smile. It’s too early to state whether this procedure has ‘worked’ and certainly we’re not going to know if the talc insertion will be a success until all of the fluid is drained. However, what is very obvious at this stage is the reduction of the crackle in her breathing. And when you see that fluid and feel its weight, you cannot help but think this has to be a good thing to be freed of!

Thank you for the many Psalms, prayers and words of encouragement that many of you have texted and emailed. I am sorry that we were not so quick to respond but hopefully you appreciate the nature of our slower pace today – and perhaps over the next few days.

Our love in Jesus,

R&A