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Keerat's Two Pneumothorax Experiences

I've had two spontaneous pneumothrax episodes. The first was when I was at work, when I felt my left chest and shoulder region go into a lot of pain. At first I thought that I'd pulled a muscle, but the chances of that happening while sitting seemed limited. I even thought it was a heart attack. At that time I was 19, and the possibility of that seemed very low. I thought I'd just sit it out and see if it went. The pain didn't subside, but I didn't think it was very severe. The previous night I'd been part of a crazy game involving push-ups, and I thought that this might have been a muscle related problem as a result of the previous nights activites.

I walked home under my own steam, and talked with a couple of my friends who thought that my theory was likely. I did a couple more push-ups thinking that if I worked the same muscles gain, the pain might susbide. I passed out and woke up the next morning with the pain slightly diminished, but still there. Over the next few days the pain slowly subsided. I later found out that this had been my first pneumothorax in my left lung that must have been minor since it managed to fix itself.

A few months later the same pain came back one night. I thought that it was possibly muscle problem again, but wanted to get it looked at by a doctor. It hurt a lot every time I inhaled and I had to sleep in a wierd angle to get the pain to abate. I woke up the next morning and decided that the pain was too severe to deal with. I dragged myself into my car and drove to the hospital where I sat in line to meet with a general practioner. The doctor took a look at me, felt my glands, checked my heart rate, blood pressure, breathing and couldn't diagnose what it was. I was sent to get an x-ray, and see a cardiologist. I got the x-ray, took it to the cardiologist who declared that I had a spontaneous pneumothorax. I asked to come again, but in English please. He told me that my lung had collapsed.

From the x-ray the collapse was pretty severe. When I told him about the previous incident he figured that the collapse then had been minor and that it had repaired itself. This situation needed attention though because the collapse was greater that 60% in the same lung. I was taken to the emergency room, where I sat. A few minutes later I was checked into a room, where I awaited surgery.

My doctor was fantastic. He let me see the complete procedure. He provided me an overview of the situation as well as the procedure that he was going to carry out. My lung had developed a hole and was leaking out air I breathed into my plural cavity with every breath that I was taking. The pluera is a thin layer that separates the lung from the chest wall and provides a lubricative and protective layer for the lungs to function within. Since the air was leaking out, it was exerting pressure on the lung and further collapsing. If we were to let the situation go unchecked, the lung would collapse completely and the collapse would then carry over to my right side and begin there too.

The first step would be to clear the air out of the pleural cavity. To do that he was going to insert a pipe through my rib cage,into the pleural cavity. The other end of this pipe was placed in a container of water on the ground so that air that came out of my cavity would bubble out of the water, while not letting anything back into my chest. A one way valve like they use when making wine. Then depending on whether they would find the hole in my lung, they'd patch it or go about some other procedure.

The doctor cut a line perpendicular to my rib cage on the left side about 4 inches below my arm. Then He inserted a kind of clamp looking device and proceeded to spread two of my ribs apart. Since I was under a ocal anasthetic I was watching the procedure while he was explaining what was going on. The muscle between he ribs is very strong and toget a pipe through it, it's got to be torn, which was why the clamp was going about doing.

The next step was to insert he pipe. The pipe consisted of the pipe itself, which had a tapering tip, and within the pipe was a long metal rod that kept the thing straight and provided an easy way to jam it between the two separated ribs. It felt really weird because when he rammed the pipe into my chest, my whole body shok, but I didn't feel any pain.

Then he connected the pipe to an extension that was attached to the water container. He told me to cough a couple of times. With every cough there was a bubbling within the container. The air within the pleural cavity now had a place to escape and my lung was slowly coming back to the regular size it was.

After two days, and a few x-rays the doctor decided that the lung had come back to it's correct size. However the problem was that the puncture within the lung that had resulted in the leak could not be found even with
a scan. I could either let the lung be, which would mean that if I was to have another pneumothorax, the lung would collapse again. Or, I could get a pleurodesis done. This procedure involves pouring a mixture of fluids into the plueral cavity. The fluids proceed to burn the pleura. As a result, there are open wounds that proceed to scar. Since the lung is in proximity to the pluera (now that the air from within the cavity has been drained), it gets stiched or scarred onto the chest wall. Thereby, if there's another pneomothorax the lung won't collapse since it's held by the chest wall.

My family and I decided with the doctor that the pleurodesis would be the best option. The fluids were poured into the cavity through the tube that had been been used to drain the air. Initially the pain killers within the fluids made me feel quite drunk and intoxicated. When they wore off through it was pretty painful. A day later, the pipe was removed. I had wanted a section of the pipe as a momento of what I'd been through, but the nurse who helped forgot this and I never got it.

It's been a couple of years ince the episode and I'm in pretty good shape. I play soccer whenever I can. I try to swim when it's possible. I look back at the incident as a hurdle that I got over. It hasn't left any mental scars- in fact I feel stronger now. The scar on my chest has healed quickly and is hardly visible. I stay away from cigarette smokers and smoke in any form. On some mornings I notice that my breathing is slightly different in my two lungs, but that goes away once I get under a hot shower. Maybe it's just a mental thing.

If you'd like to look at a couple of photographs of the x-rays take a look at: http://www.eden.rutgers.edu/~keerat/misc/pneumo/index.html

For any further information or comments, please feel free to email me at
keerat@eden.rutgers.edu

Experience Submitted March, 2001.