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A Rare And Severe Spontaneous/Tension Pneumothorax Experience

Hope I my writing in English is good enough, if not, cut me some slack will ya, I'm Dutch :)

About 6 years ago i had three partial Lung Collapses that resulted only in getting to the hospital and making a X-ray and a few days rest. I'm male and as I write this 32 years old and height is 1.93 meters, thin (90 kilo), smoker. The good part is that I also do a lot of sports and lead a pretty active life. I'm a police officer ( harbour police/Coastgard duties ) and the fact that this already happened to me three times made me very aware that there is no telling when it happens so for me it always made me feel good if someone was around or if some form of communication was present to alert somebody should it happen again. You could say that this was the first impact (S)PT had on my everyday life. My wife really got scared the first time that it happened, looking like a heart attack..the second and third I recognized easily, the symptons are so distinctive as you know too.

Today..exactly two years ago I started my new job at the harbour-police and was welcomed with a group of other officers with a speech of a police-commisionar. During that speech I felt I had another Pneumothorax and I could feel it was a big one. Can you imagine this, first day on the job and here we go again :) I had decided to sit it out and go to the hospital later that day. Yeah right, whitin one hour my ability to breathe was so diminished that I was on the virge to pass out. Ambulance was called and the paramedics would not listen to me, told them I was having a (S)PT and they were talking about a heart-attack, to be honest I was getting kind of worried too because you could simply feel this was a big one. In the hospital chest-tubes in and I was ready to go home :)

Not! The thoracic doctor told me that I had a severe 100 percent Lung Collapse and was grounded for 5 days to a hospitalbed, waterseal and boom, a 100 percent collapse again. Head surgeon told me that the Blebs were so numerous that they would skip the thorascopy and would do a pleurectomy, total removal of the pleural lever (don't know the exact English word) and possibly a portion of the lung removed too.

Now a pleurectomy here consists of a large incision (about 25 centimeters) on your back, with a device they widen the space between the ribs and remove the pleural thingie, roughen up the whole lung and paste it to the chest permanently, as i understood its near impossible to paste the smallest upper portion of the lung, no room to work :).

As I woke up in the Intensive Care a doctor told me all went well and the did not had to remove a part of my lung. To be honest I hardly heard what he said, the pain was so huge thaat i could barely speak. I saw on my left that i was hooked up to a pump to my spine that gave me a huge amount of morfine and I could almost scream because it did nothing. After about 15 minutes or so a brother came to me and I asked him for more painkillers, he laughed and told me I was already getting a huge amount. I could not laugh...I told him that I was at a breaking point and that he should not come any closer because I would grab him by the throat and force others that way to get me more painkillers. He was very annoyed and told me he was going to discuss my attitude with the head of Intensive Care, please do so I said. The head came after several minutes and warned me about my threathening the Intensive Care staff and I told him i was in agonizing pain. Annoyed lloking he checked the pump and the tube going to my back. I can still remember his face and famous word that he cried out: Fuck ! The tube was not connected and I had had zero morphine the bed was all wet, probably a happy bed :)

He was really mad at the Intensive Care Staff and gave me a seringe with some nice goodies in it, I passed out in about a minute or so and slept like a baby for the whole night :)

Now I dont know about a thorascopy but with a pleurectomy and a 25 centimeter scar on the back your ribs, all your ribs are bruised heavily and this hurts like hell. The next five days, Zillion X-rays and still no improvement to be seen on them...I was really getting worried because I could feel a second surgery coming up and was so scared they would take a part of the lung out, furthermore I was really heavily reacting on the part that I could not smoke, I did not think about smoking but unconsiously the mind is reacting, its the combination of my smoking-addiction and the given medication, woke up every morning crying, no particular reason really, just happened, depressive the works.

The doctors decided to take out the three tubes and put them on a different spot, geez here we go again, I agreed and they told me a student-surgeon would bring in the new tubes, at this time I couldn't care less, I wanted to go home so I agreed. The funny part about this was that when he brought in the first new tube he fainted, fell in front of me on the floor dead center, only time I really laughed :). Ah well it all did not help a bit only more pain, could feel the tubes as if they were placed in my neck.....so on to the next surgery, main goal was pasting upper portion of the lung or removing it. This time they succeeded and after 6 days all tubes removed. (Arrggh the pain of removing..) During this two and a half week put in and pulled out a total of nine tubes.

After a week I went back to the hospital for a check-up, was so scared they would find something "bad". After an Xray the surgeon looked at it with me and my wife, he told us that the upper part of the lung was still not pasted correctly and that this would have to be operated again if I started to have breathing trouble again, although he told us that there was a chance in a million that would happen because the lung is pasted for say 95 percent to the chest. I asked him for the worst case scenario, he told me the worst case is that you die, a PT in the remaining upper part of the lung has leakage and it's impossoble now the "press in" the lung so the leaking air starts to find other parts of your body, it could press in the neck, your pipe firmly shut and you just choke ! But remember, a million in one :)

On to the recovery at home, hellish pains all day all night, I slept in a chair for three months or so, my back always free from the chair, could not walk a 100 meters first few weeks after that it gradually went better. My wife taking care of me, a real heavy task for her. All the forum readers talk about how it affects their lives and my wife and I are sure one of them. This is the period I first started surfing the Web, huge phonebills but it got me trough the days and nights, it even calmed my wife her knowing that i had something to do the pass the time when she was working.

After four and a half months I wanted to go to work again, I got a call from a good friend telling me guy who lived in his block had gone berserk and smashed his neighbours windows. Because he had to work the nightshift and his wife and kid were somewhat scared he asked me if I could stay in his house for several hours. I agreed and went there stayed up until 4 am or so and fell asleep on the couch, around seven I decided to head back home, a short walk. After about 150 meters I felt it again, I could clearly feel it was the other lung and that was that, I passed out immediately for several minutes, next thing I hear is an ambulance arriving, This one was the worst of all, kept passing out several times various symptons but the most worrying was when i shortly woke up in the ambulance and I heard the paramedic saying to the driver that he was losing me. Next time I woke up was on a table and a brother putting in the tubes without aneastesia, agonizing pain, he told me " sorry but we have to be quick." within seconds a thoracic surgeon was in the room also. She told me I was a very lucky guy, I should not have come to the hospital 5 minutes later or it was over and out, a life threathening Tension-PT. After some X-rays and a special layer by layer photo (forgot the name) they advised a pleurectomy (full removal of the pleural thingie:) and instantly told me never to dive again, fly helicopters (except constantly low to the ground and slow speeds hehehe), no pressure masks whatsoever, even regular planes, however possible, preferably not. Furthermore they told me to stop smoking because if I ever got lung-cancer it would be near impossible to operate, it's do-able they said but we come into the operating room with axes instead of scalpel. Think about this....

I was amazed how relaxed I was and agreed to surgery off course. For your information, I was in a different hospital now. I told the thoracic surgeon that the only thing that bothered me was the pain again. He told me not to worry, he had something in mind for me, the device to widen the space between the ribs, he would widen the ribs a couple of milimeters and then stop for a few minutes, twist the wheels again and stop again and so on so on. The major benefit of this that the bruising of the ribs is reduced dramaticly and believe me it really did help, off course you still have all the pains of surgery, but the simple fact that the ribs don't hurt so much is just great, so all it takes is just a little patience from the surgeon point of view ( I guess surgeons see this differently, duh, valuable O-R time ). I recovered much faster, after one day intensive care and five days hospitalbed removal of the tubes and home I went, dramatically less morphine was at first terrifying because I did not want to go through the pain again, but the pain was so much less. And by the way a doctor came by every day and did several breathing exercises, also a little device with five balls in separate pipes, the trick is to keep all five balls afloat when you breath in it, it stretches the lungs enormously.

Within one and a half months I was up and running. This whole thing has taken about eight months and the doctors here say I was lucky, the amount of pain after surgery (pleurectomy) is quite often for life, allbeit in various degrees but always there. I still have pain but it's something that one can live with, I do not expect it to go away. Also I am tired much quicker and still have trouble sleeping on my back, this because they cut so much muscles on the back in surgery, after the first surgery i kept dropping things out of my hands never felt it coming justed dropped it, this by the was is periodically. For those who had a pleurectomy I advise to keep on doing sports, I know it's very annoying when your Lungs are fully attached to the chest and you are breathing heavily, but it stretches the lung and eases the pain (if you should have any:).

It is there every day and reminds you something went wrong with your body, I can strongly identify myself with the others in the forum being very reluctant to going to see a doctor when they feel something "out of the ordinairy". For those ppl I still would say, go, it's important and you dont have spare parts hanging in your closet....and yes you have to stop smoking, although it is being said that smoking is Not the instigator of a PT there are some who researched and found that smokers tend to have it more often than non-smokers, also it is said that if you have a PT and you are female, it stands a good chance the PT is combined with a tumor, malignant or not.

So what about the pressure masks...that turned out to be a big problem at first for me at my new job because we sometimes have to use it. If there were some explosion in the harbour and there were toxic gasses we would have to sail out of the area and in the meantime use the masks. After a little research we found that when using these masks you go from a normal 1 bar to 1.0035 bar, this should not be a problem, I used the masks several times now and I'm still here :). Dont even think about diving (with equipment).

The doctors say that they are sure you will get a PT when going to 2 bar and higher, its the area between 1.1 and 2.0 bar that they say they dont know what will happen, but my advise is not to check it out :)

One thing, very important I think, my wife was taking care for me for all those months and I later on realized she had hardly the time to get to terms with all that had happened, so the shock came after I was feeling better and that takes a lot of time to heal too, she is more scared that it will happen again than I am I sometimes think. I only hope that other ppl will realize that it takes enormous effort on part of the ppl that love you and take care of you. Ironically it has brought us together so much more, duh, a good after effect wouldn't you say so:)

So..what now time to actively stop letting it take over your mind, I try not to think about it and as days pass by I must say that despite the pain it has little effect on my mood, although sometimes it can really bug me. But it's getting better. You sometimes get reminded neway :) for example if you want a new mortgage and they ask about your medical history only to come back with a zillion other papers :).

Are you reading this sentence ? That means you have probably read the whole story, well you said you were interested and I give you the full story, I see some forum readers/writers putting their experiences in a mere five or six sentences, they clearly are not bored with the subject because you would not see a reaction from them in the forum, it has affected their lives greatly and so it should, a PT can be lethal, its as simple as that, I know of one person who died because of a PT on both sides at the same time. The Dutch word for a PT is "klaplong" :)