No cause found for persistent pleural effusions

Posted by cindyconstien @cindyconstien, Dec 24, 2018

I have been treated for 2 years for pleural effusions. All fluid and blood work comes back clean – no cancer, infection, virus – nothing. They had been tapping both lungs and getting 1.5 to 2 liters from each side. The heart has been checked out (EKGs, Echos, stress tests) and there are no issues.
In April I had a bi lateral pleurodesis performed with biopsies from my left lung (no issues). They used talc and 7 months later I just had 1.8 liters drawn from the right lung. They believe the left side was moderately successful but the right side failed. I'm about to schedule a redo on the right, perhaps using the chemical option. I am also looking at possible "constrictive pericarditis" and will get another echo today, possibly leading to a heart cath to look closer.
I am a non smoker, relatively fit. I ran marathons and triathlons, ate appropriately, non diabetic. Only medication is for cholesterol management and inhalers to try to relieve my breathing discomfort.
I'd like to treat the cause – not the symptoms.

Any ideas?
Rob C.

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Sorry you're going through this. Our circumstances seem different, but yes I had some significant pain on occasion. They would take +/- 2 liters at a time from either lung, but a couple times I got a very sharp painful stab at the tap location. They decided not to draw down the fluid so much. Once my BP dropped so low they rushed me into the ER. They began to lower my head as soon as the tap was done to prevent the BP drop. The pleurodesis (talc) seems to have worked, breathing is better but not great. Last CT shows that the pockets of remaining fluid are holding steady or reducing. Good luck.

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Thanks for responding and the info. Rob, it helps. I don’t think my BP drops, haven’t checked it, but that could account for why I feel exhausted after we draw. I’m thinking we are only getting about half the fluid off before the pain starts. My breathing is not good but doesn’t seem to improve or worsen after we draw. Looks like we will just have to live with this for the time being and will continue to stop the draw when the pain starts. I’m still undecided about pleurodesis. Hoping to see a thoracic surgeon when we return home next month to further discuss pleurodesis. What color is the fluid when you draw and has the color changed? Mine is dark bloody color and remained consistent, except for when I had radiation on the left lung, and then it turned several shades darker. It has since returned to the previous color. Man, this stuff has sure been a life changer. I even gave up my motorcycle and haven’t been in a bar fight for almost 2 years LOL..Thanks again, take care of yourself.. Dutch

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