Sunday, January 20, 2013

endobronchial ultrasound (EBUS) biopsy went flatline

EBUS biopsy drivers are promoting themselves increasingly all over social media as the next best thing since sliced bread for lung cancer.

But hold on a minute … last March while awakening from anesthesia after my EBUS ride at PinnacleHealth Hospital I learned I had flatlined for 20 seconds. 
Story only gets better months later when my new pulmonologists reviewing the PET Scan DVD that prompted this EBUS biopsy discover that the original radiologist who wrote the report was apparently a disciple of ‘chicken little’ that is he was not familiar with me, my history or possibly even lungs. 

The whole EBUS guided biopsy was supposed to be about ‘proper staging’ yet when I flatlined the EBUS was aborted before any biopsy was taken.

I already had a CT Guided Lung Biopsy of my left upper lobe confirming my 9 mm tumor as malignant and primary = Stage 1. See my lung cancer timeline above.

But because the disciple of ‘chicken little’ had seen a “right-sided subcarinal adenopathy" my thoracic surgeon, my oncologist and some nebulous entity called a tumor board charged into my right lung with a bronchoscope. (this mean looking thing to the left)

Now in hindsight I can raise my hand and ask how come "Bob" (that's what I've taken to calling this alleged "right-sided subcarinal adenopathy) was not visible on the CT Scan only two weeks earlier or on the x-ray weeks before that. Also with the gift of hindsight I am aware of the high false positive readings of PET Scans.  

Then I was just scared and lonely … knowing what I know now, it’s safer to get a second opinion. Have a pulmonologist, not a radiologist, re-read your PET Scan DVD before hopping on the EBUS and maybe never returning.

Knowing what I know now, the lack of 'survivor advice' in the beginning of trying to survive lung cancer was dangerous to my health. 

So what went wrong with this “minimally invasive outpatient procedure”?  … the hospital’s senior cardiac guy wanted me to know that I “definitely did not have a heart attack” and in his opinion there was nothing wrong with my heart.  His “best guess” was vasovagal response. The ‘vagus nerve’ runs right through where they were working with the bronchoscope. 

Personally I prefer to remember smiling at my daughter’s original wise crack, “Well, are you resurrected or a zombie?”

Patrick Leer
Health Activist:
Caregivingly Yours, MS Caregiver @


  1. What if that subcarinal node had been positive? You would have been glad you took the risk to have it diagnosed. No procedure is without risk, ever. It is a continual risk vs benefit assessment in medicine and the choice of whether to proceed is always yours.

    1. Thank you this is an excellent observation. In retrospect, a year later, I agree about the choice to proceed but in the beginning when my world was collapsing my mind was not on risk vs benefit - simply how long do I have to live? ... Medical professionals have their peer to peer consultations, what is lacking in the beginning is actual survivor to survivor consultation. Why?