Another day, another thoracentesis

Levi's begged me to take pictures every time he's had a thoracentesis so that he can see what it looks like, but I've always been too afraid to ask the doctor's permission, assuming the answer would be no. Well, that was no problem for Levi's mom when she accompanied us to his last appointment, so now you can, like Levi, thank her for these shots.

He had the procedure repeated today, 12 days after the last time. From what he says the only pain is from the numbing shot. After the shot, a tube is inserted into his back, and the other end is stuck into a vacuum-sealed jar that sucks the fluid from his body. They regularly drain 1500-1800 mL (shown below) every two weeks.

This short post seems like a good place to document a few of the details we learned last week during our appointments at MD Anderson.

• The yellow color of Levi's lung fluid is normal, which was very encouraging to our Dr. He explained that cancerous fluid is usually blood-colored, and the fact that Levi's is normal seemed to give him hope that Levi's cancer might be more curable than that of others with adrenocortical carcinoma (ACC).
• ACC is an especially "sticky" form of cancer, so it is very difficult to remove from any organs it attaches to, and it is very difficult to kill.
• Depending on how much the tumor shrinks with chemo and whether or not it is actually touching any part of Levi's kidney, his kidney might be able to be saved and just the adrenal gland be removed. 
• ACC tumors are highly metabolic, which accounts for Levi feeling hot all the time. This is also likely the cause of his occasional flu-like symptoms that couldn't be correlated to anything else.
• Adrenal tumors can be functioning or non-functioning, meaning they can produce hormones in addition to the hormones produced by the adrenal glands. Levi's tumor (Timmy, as he affectionately calls it) is functioning, but it is only producing cortisol, which explains his increased blood pressure and heart rate. 
• Levi won't be able to take anti-inflammatory drugs like Ibuprofen or Aleve while he's on chemo, which may be difficult, considering these medicines have kept tumor-causing back spasms at bay, allowing him to sleep more than a few hours at a time for the last year. The chemo itself is supposed to have incredible anti-inflammatory effects, so we're hoping that will take care of the pain. It's nice to finally know what's been causing his nighttime back pain for so long!