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Laparoscopic surgery to strip MAC infection from small area in lung

Posted by annagh @annagh, Aug 17 3:16pm

My ID doctor reported that CT scan is not just stable but improved after 7 months on 2 antibiotics. I’m great with that, but then he brought up the idea of laparoscopic surgery to “strip away” a small area where MAC is likely still hanging out so it can’t continue to release MAC into the rest of my lungs.

He’s not sure what is possible or advisable in my case, but thinks I might be a good candidate. I have agreed to a consultation with their surgeon at OHSU, who he says is conservative, but am not thrilled about the idea of surgery, especially since I’m doing so well at 80 years.

I went looking for information, of course, and what I found seems to suggest that this sort of surgery is for those for whom the drugs are not working. I should probably wait until I talk with the surgeon, but thought while I’m waiting, I’d put the question to this group. It might help me clarify my own questions for the discussion. Does anyone have any experience or knowledge of this sort of surgery?

Thanks,
Anna

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scoop | @scoop | Aug 18 3:00pm

33 minute mark for more info on surgery


Dr. John Mitchell discusses surgery

Great presentation by Dr. Huitt (retired)

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legacygsh1 | @legacygsh1 | Aug 19 3:47pm

Excellent presentations! Thanks for sharing.

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annagh | @annagh | Aug 20 6:44pm

Thanks for posting these Scoop. Dr. Huitt and Dr. Mitchell were both very complete and clear in their presentations. The area in my lung that Dr. Wintrop was pointing out is much smaller, and the 2 drug regiman I am on seems to be very effective, so I doubt I am a likely candidate for surgery. I have a consultation with a surgeon next week though and this background will be very helpful in following what he says as well as asking appropriate questions. VERY helpful! Thank you.
Anna

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legacygsh1 | @legacygsh1 | Aug 21 11:14am

I would be interested in hearing what the surgeon has to say after your appointment. I have a cavity, and Bronchiectasis was was told I might need to have surgery also.

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annagh | @annagh | Aug 23 11:59am
In reply to @legacygsh1 "I would be interested in hearing what the surgeon has to say after your appointment. I..." + (show)
Profile picture for legacygsh1 @legacygsh1

I would be interested in hearing what the surgeon has to say after your appointment. I have a cavity, and Bronchiectasis was was told I might need to have surgery also.

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@legacygsh1 I’ll be happy to share anything I learn.

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annagh | @annagh | Sep 3 9:41pm

To follow up as promised, I had my consultation with the surgeon at OHSU this week, but I’m not sure I have anything very helpful to report. In my case the surgery (partial lung resection) would involve removing a “wedge" of my right middle lobe where the MAC infection seems to be concentrated. That sounds a bit more than ID doctor’s description of “stripping away" this small area, (Semantics?) The surgeon said this would involve 3 small incisions, take an hour or two, and require a two to three day hospital stay (until the chest tube could be removed). I would then be restricted from lifting anything over 10 pounds for six weeks. He said it is pretty minimal as far as surgeries go.

Since I have only been on the antibiotics since January, and the CT scan in August already shows improvement, the surgeon recommends that I complete the year of antibiotics, see what the next CT scan looks like and consult again. So…not ruled out.

The purpose would be, as Dr. Winthrop had said, to keep the MAC in that spot where the antibiotics have trouble reaching it, from spreading to other parts of my lungs. In other words it would not improve my immediate condition/symptoms, but would hopefully prevent further spread.

Anna

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legacygsh1 | @legacygsh1 | Sep 4 10:55am
In reply to @annagh "To follow up as promised, I had my consultation with the surgeon at OHSU this week,..." + (show)
Profile picture for annagh @annagh

To follow up as promised, I had my consultation with the surgeon at OHSU this week, but I’m not sure I have anything very helpful to report. In my case the surgery (partial lung resection) would involve removing a “wedge" of my right middle lobe where the MAC infection seems to be concentrated. That sounds a bit more than ID doctor’s description of “stripping away" this small area, (Semantics?) The surgeon said this would involve 3 small incisions, take an hour or two, and require a two to three day hospital stay (until the chest tube could be removed). I would then be restricted from lifting anything over 10 pounds for six weeks. He said it is pretty minimal as far as surgeries go.

Since I have only been on the antibiotics since January, and the CT scan in August already shows improvement, the surgeon recommends that I complete the year of antibiotics, see what the next CT scan looks like and consult again. So…not ruled out.

The purpose would be, as Dr. Winthrop had said, to keep the MAC in that spot where the antibiotics have trouble reaching it, from spreading to other parts of my lungs. In other words it would not improve my immediate condition/symptoms, but would hopefully prevent further spread.

Anna

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@annagh thank you for getting back to me. Best to you with your decision.

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