Timothy Knaley

First post: May 4, 2019 Latest post: Apr 30, 2020

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Review:  Tim finally went to the doctor on Wednesday, 3/27/19 for pneumonia.  The doctor did not hear much on his right lung, so he sent him immediately to the emergency room.  They ordered a chest X-ray, CT scan and ultrasound.  They immediately started antibiotics for the pneumonia, too.  The next they told him they found a mass.  He was told that they need to do a thoracentesis to stage it.  A thoracentesis would also help to remove the fluid around the lung and help his breathing.  If cancer cells were found in the fluid around the lungs then that means he has stage IV cancer.  They also need to examine the cells to determine the type of cancer he has.  Unfortunately, the pulmonologist was very slow putting the order in for the thoracentesis.  He didn't get it until Friday afternoon around 2 pm, and due to the amount of time it takes to prep the slides he did not get the preliminary results until Monday.  In the mean time we learned that the way the tumor was growing it shows signs that it was small cell lung cancer.  We also found out Sunday that the CT scan showed nodules in the liver and spine.  The oncologists have been on board from the beginning, but pulmonology was the primary at that point.  Oncology was ready to start chemo as soon as they received written confirmation of the pathology results.  Monday we found out that the preliminary results were small cell, but they had to do more staining to double check the results before they submit the written report which happened Tuesday.  So April 2, 2019 he started his first chemo treatment.  He was given a steroid, decadron, an anti nausea medicine, aloxi, and two chemotherapy drugs, carboplatin and etoposide.  He took those the first day then etoposide and decadron the following two days.  His regimen was supposed to be chemo for 3 days every 21 days.  A new immunotherapy drug will be started on the 2nd round.  He did well with the treatments.  No nausea.



He had a set back on Sunday, 4/14/19.  His fever spiked to over 101 degrees.  He went into the emergency room and was admitted for pneumonia again.  He was started on antibiotics again and had a chest X-ray.  The next day, Monday, he was given another Thoracentesis.  Cultures did not show anything, so they gave him several antibiotics.  He stayed in the hospital until Easter, 4/21/19, and went home with a prescription for antibiotics.  By this time he was weaker, loosing his hair, changing taste buds and loosing his appetite.  His white blood cell counts bottomed out at 1.4 by Tuesday, 4/16/19, but started to come up after that.  A few days after he got home he did go back to work to help answering phones in dispatch.


He had a chest X-ray done on Friday, 4/26/19, because he felt like his lungs were filling up again.  They ordered a thoracentesis for Monday, 4/29/19.  The ultrasound performed before the thoracentesis showed that the fluid was several small pockets instead of a larger mass, so they decided not to do the procedure.  Tuesday, 4/30/19, he received a port in his upper right side to make it easier to receive chemo and IVs when necessary.  Since Saturday he has been having low grade fevers off and on in the afternoon and evenings.  On Tuesday night he had one that went up to 101 degrees, but he did not want to call the doctor especially since the fevers would go away by morning.


Wednesday early morning, 5/1/19, he went into oncology for his second round of chemo.  They took a blood sample and his vitals.  He had a fever of 101 degrees and his white blood cell count was very high indicating an infection.  The doctor sent him to the hospital to get a thoracentesis so the fluid can be examined.  Dr. Darnell, his oncologist, suspected he had a lung abscess.  This time when they did the ultrasound the PA noticed what appeared to be a gas pocket within the fluid, so instead of completing the procedure they sent him to get a CT scan.  He started to feel worse before the CT scan.  After the scan the thoracic doctors decided to do a chest tube to stay in and drain the fluid (pus) from the lung abscess.  They drained about a liter of fluid when they put the chest tube in and after three days about 1500 ml were drained out of the pleural sac.  His white blood cell count is back to normal and his temperature is normal.  Hes feeling better but a little loopy from the pain meds due to the chest tube which does not feel good.


His second round of chemo is on hold until the infection is better.

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