Coop Loop Procedure

I was warded on 12 Dec 2011 and discharged on 23 Dec 2011, a 12-day stay in the hospital.

A team member of my oncologist came to talk about the coop loop procedure.  She explained that they will be using a slightly larger tube so that after the fluid was drained from the pleural cavity, they will use the tube to pump in talc to 'glue' the pleural lining to the lungs.  This is to reduce the space in the pleural cavity so that, hopefully, the fluid will not build up so much as to compress against my lungs.

I had had coop loop procedure done before and I knew what to expect.  After the procedure, I was confined to bed as one of the tube was attached to the back of my left ribcage and the other end was connected to a container with markings to collect the fluid as it drained gradually.

Having had the coop loop procedure done at Singapore General Hospital, I then realised that it was very much different from that done at Changi General Hospital, where I struggled so hard to breathe after the procedure.

The tube was clogged up with debris, especially blood clots from the coop loop procedure, that the doctor had to flush it a couple of times to clear the blockage so that the fluid could drain again.

I had been told that after the talc had been pumped in, I had to lie for about half an hour each on my back, left and right to ensure that the mixture is as evenly spread out as possible.  When the fluid had stopped draining, the doctor tried to pump talc through the tube, but was unsuccessful and the mixture splashed all over.  After some time, she came back and told me that she was unable to pump the talc mixture in because they had used a smaller sized tube for the coop loop procedure.

I was given 2 options, to remove the tube and go home.  When the fluid builds up again, which is highly likely, then get warded, insert the tube, drain the fluid and try to pump the mixture in again.  The second option was to try pumping in a mixture that was finer than talc, but even then, there was no guarantee that this mixture could be pumped in.  I had endured 10 or so days of being confined to bed, unable to shower myself and all, that I was really put off by the thought of having to go through the same ordeal again when the fluid in my chest builds up.  So I told them I would go with the second option even though success was not guaranteed.  The doctor told me she would do it for me the next day as soon as the medicine was sent to my ward.

The following day, I waited and having seen no sign of my doctor, I asked the nurse if my medicine had been received.  She said it would not be so fast as the medicine contained cytotoxic contents or chemo drug.  Upon further questioning, she told me that I would have to be transferred to another ward for the procedure, and that was the oncology ward.  I did not understand.  The doctor had only told me that the finer powder contained antibiotics.  As far as I know, I can only relate antibiotics to the type that doctors generally prescribed if we have an infection.

I refused to be transferred to the onco ward and I refused to have the cytotoxic drug pumped into my chest.  I then asked the doctor about the side effects of this drug, which I found out to be Bleomycin.  She said it may cause lung fibrosis and also affect the kidneys.  While trying to persuade me to go for the procedure, the doctor mentioned that the talc powder also has the tendency to cause lung fibrosis.

The cancer had already metastasized to my liver, lungs and bones and I definitely do not want to add lung fibrosis to my list of problems.  As for my kidneys, I had taken alternative medication for nearly 4 years to have my kidneys repaired after the chemotherapy I had in 2008.  No way was I going to risk my kidneys to Bleomycin, and furthermore, my kidneys will face more damage as I most likely have to go for chemotherapy again to control the metastasis.

I was discharged without going for the procedure.