Ivan rocking it since 2003

[D.ap]

Ivan

Take it easy. There is time to challenge your lungs later. Moderation
Thanks for all the good info on X-ray comparisons.
Take care and good night

Debbie

[Ivan]

Whole day on the road (well, in the air) and I'm back home safely. Heading to the gym tomorrow, taking it easy obviously. I feel well, the feeling of exhaustion is gone.

Last night I blew 4L on the breather, I think my normal is 4.25L more or less. No longer coughing up blood (maybe tiny small black clots very rarely), and rarely coughing at all.

[D.ap]

Ivan
Sounds encouraging. Always good to be home no matter how young or old , huh?
What have you found to be the maximum size to be able to ablate with cryo?
Also why cryo and not radio?

Keep truckin. You are sounding great
Sincerely

Debbie

[Olga]

Deb - as always a very good question. We have actually defined the optimal size for the cryo this time - besides of the upper limit it also has a lower limit. The upper ones is defined by the size of the ablated zone they can create with the single needle (the min damage to the lung tissue) - it is about 30 mm (depends on the size of the needle they use) - it is the smaller size of the ice ball that can be created (I think that Dr.Littrup said something about the thinner needle that creates a smaller ice ball but I am not sure and it did not sound as his preferred choice by some reason). They aim to have about 10 mm of the frozen borders around the tumor and it makes the ideal size for the ablation by the single needle as 10-12 mm. If the tumor is bigger than that or is irregular in shape, they will use 2+ needles to cover the area. If the more is less than that, they will simply ablate more healthy tissue unnecessarily as they simply can not create the smaller size ice ball.
So as of now my understanding is that it is not beneficial for the patient to ablate the mets smaller than 10 mm as the size of the healthy tissue lost can be calculated as the ice ball size (always the same minimum) minus the met size. The max size is about 30 mm - they will use more needles and poke more holes and that increases the loss of the healthy tissue, damage where the needle passes and increases the chances of the complications and incomplete ablation.
Why cryo. There was an article published and I think there is a link in the cry section somewhere that cryo is the modality causes less adjacent structures damage in the lungs tissue setting, and can be used close to the trachea, heart, chest wall, intercoastal nerves and veins where any heat applications can not be used like RFA etc. We already had couple of ablations where other types could not be used at all - close to heart for example. After cryo the scars have better ability to dissipate almost without the traces left. There are some locations when RFA is about equal to cryo.

[cachabamba10]

I am glad everything went okay Ivan.

[Ivan]

Went to the gym today, did mostly stretching and a couple of very easy recovery type exercises. Did 30 minutes on the bike of my regular "easy" intensity. That was actually very hard. My heart rate was 20 bpm higher than usual at this intensity. I think another week and it will be 99% normal.

[D.ap]

Ivan

What is your at rest bpm? And your max bpm ? Good job with the exercise.
Your primary tumor was in your arm, right? Does the PET scan you do keep track of the primary surgical spot once a year ?
Do you swim? Swimming as I understand it is a good low impact type exercise..Easier on the bones.

Thanks
Take care

Debbie

[Ivan]

Minimum is around 40, maximum is around 185. No, I don't. My primary was really small and it was really easy to remove compared to some of the other people. Swimming - sometimes. For low impact, I prefer biking.

[D.ap]

I am trying to review and I am back into exercise as a health benefit Trying to recall those days. Hee hee
Your at rest bpm is low I think. You do yoga ?
Helps with good biofeedback ,huh?
Great work

Debbie

[MarietjievdMerwe]

Hats off to you, Ivan! A real trooper. Don't let this dreadful disease get the better of you.
Regards.

[Ivan]

Standard easy cardio workout, 500 calories in 30 minutes on a stationary bike.

Days after 2nd ablation Approx heart rate too high by (+-5)
6 26 - really hard
8 19 - hard but much easier than above
9 10 - moderate, quite easy

So today it almost felt normal. A few more days and I'll be hard pressed to tell anything had happened

[Ivan]

OK, so it's been two weeks, and I'm feeling 100% normal. My training is back to 100% intensity at the gym. I'd wager that my lungs are somewhere around 97-98% at this point. Another week and I'd be at 99-100%.

I did have some minor residual pain in the left lung yesterday during intense biking, but it went away rather quickly.

[Amanda]

Hi Ivan
I am happy you are back working out and feeling almost 100% ...

I am int he gym 5 days a week an I LOVE it lol I am not looking forward though to taking the time off for these two surgeries ... But, it has to happen! My trainer asked how long i would need to be out of the gym an of the weights and hard cardio :/ I have no idea to be honest.

Did you ever do Pilates?

[Ivan]

For a thoracotomy, it will take 2 weeks until you can start doing gentle stretches and range of motion exercises. 1-2 more weeks and you can start using light weights gradually. 2 more weeks and you can do 80-90% effort. Another week and you can go 100%. That's how I would approach it anyway. You can start stationary bike after 2 weeks or so, but be careful and go easy. You can work up a sweat. How much time will there be between the two surgeries? Also, you can most definitely handle it.

I feel 99% now. It's funny, R lung had 3 ablations but it's the L lung that has slight residual pain because the nodule was close to the chest wall. This re-iterates the importance of ablating peripheral nodules early before they grow and push right up against the chest wall.

[Amanda]

Hi Ivan,
the chest wall is hellish! They had to remove part of mine when they took the 4 inches of the 8th rib out and you are right it takes what feels like for eve to heal I am still not 100% four years later..

I dont know how far between the surgeries are going to be. maybe i should be four months apart to make sure i am 100% :/ what would you wait? I just want it to all be gone from vision for a little while at least... Who know what this dam sarcoma will do in the macro stages.

I am going to try and at least start to walk a lot after maybe three days? what do you think :/ Exercises is like a drug to me now lol It is even helping my body heal in ways i thought was not possible. It de stress an i cant list the other things there are to many.

Are you off all pain meds or are you like me having to take them for years like i am after my rib/lung/chest wall surgery on them every night :/ I take a small amount i am frightened to get addicted to them...

For a thoracotomy, it will take 2 weeks until you can start doing gentle stretches and range of motion exercises. 1-2 more weeks and you can start using light weights gradually. 2 more weeks and you can do 80-90% effort. Another week and you can go 100%. That's how I would approach it anyway. You can start stationary bike after 2 weeks or so, but be careful and go easy. You can work up a sweat. How much time will there be between the two surgeries? Also, you can most definitely handle it.

I feel 99% now. It's funny, R lung had 3 ablations but it's the L lung that has slight residual pain because the nodule was close to the chest wall. This re-iterates the importance of ablating peripheral nodules early before they grow and push right up against the chest wall.