Thursday, December 12, 2013

Not Again: My Pneumothorax Recurred

Just when I thought I was on my way to full recovery, my world shattered when the ER doctor told me I needed another chest tube. My left lung collapsed again.

It was barely a month after I was discharged from the hospital due to spontaneous pneumothorax. My left lung collapsed because an inborn air cyst ruptured, which in turn caused the air I breathe to leak into my chest wall. After a week of needles, x-rays and a painful tube on my chest, my lung inflated back--I was sent home and advised to rest for three more weeks. Needless to say, I was back to work four weeks after my surgery, though I was still weak and had a bit of cough.


My cough got worse and after almost two weeks of taking the usual cough syrup, I finally asked my husband to take me to the ER for a checkup. I was worried that my pneumothorax would recur, but I have extremely high hopes that it's just a stubborn cough. Of course I was wrong. 

The "non-urgent" family doctor who attended to me at the ER was startled when he saw my chest x-ray, because my only complaint was my cough. I was asked to go the critical area at once. I was the only patient who walked in to this room--everyone else came in stretchers or wheelchairs. Like the first time, the doctors wanted to perform the surgery (close tube thoracostomy) right then and there, but because my vitals were stable, they agreed to wait for my surgeon who will perform the procedure in the OR. My emotions at the time were not stable at all, as anyone would've guessed.


Nothing could comfort me at that moment-- I dreaded the thought of having to go through another half hour or so awake while they insert a plastic tube on my left side. I tried to stop crying because the doctors told me that doing so will make it more difficult for me to breathe. I was worried about the hospital bill. Will my health card still cover this? We have barely recovered financially from the first surgery!


The situation at the OR was more stressful for me now compared to the first time. Maybe because not one bit of myself wanted to be there, but I had no other choice if I want to be well. I was in distress that they had to tie my left arm to make it easy for them to insert the chest tube while I squirmed and cried on the OR table. Well, I can't really feel the pain because of the local anesthesia, but I was aware of everything-- I heard every tinker of the instruments they used (and saw some of them), I knew when the tube passed a rib and I knew when it was in place. My cough was instantly gone the moment the tube was there, and water started flowing out of the tube and into the drain. Apparently, I had water in my chest too! It was creepy. My surgeon held my hand before the nurses moved me out of the OR and told me, "Okay na, ang tapang mo."


The sight of my husband and my friends waiting for me in my room was a relief. It was hard being in the surgery suite not knowing anyone but my surgeon, who also performed my first CTT.

The next few days were difficult. The chest tube was even more painful than I could remember. I had to undergo a CT scan while the tube was still there, which was very uncomfortable. A vacuum was also attached to my tube, to help drain remaining water. However, my left lung never inflated back-- I had a hole on my left lung that prevented it from becoming fully inflated.

Five days after my CTT, I had VATS (video-assisted thoracic surgery) to permanently address my pneumothorax. I underwent a bullectomy (to stitch up the hole on my lung, which was the size of a grape) and pleurodesis (to stick my lung to my chest wall and make sure it doesn't collapse again). The procedures took about an hour or two, I think. If I count the time I spent in preparation and recovery room, it was probably 3 hours. I was fully sedated, if that's any consolation.



I remember being woken up in the recovery room, and I felt nothing but pain and discomfort. I wanted to kick every person I see except that doing so would bring me more pain. I couldn't move much, too, and to my surprise, my chest tube was still there and it's more painful than ever. It's like someone played a bad joke on me in my sleep by pulling the tube out and putting it back in and moving it around.

I felt more sore than ever on my left side where the tube was. I found out later that the doctors actually removed it and put it back in. I still needed the tube to drain out remaining fluid and air. Also, pain haunted me for days-- even painkillers were too painful when administered! I felt every drop of antibiotics and pain killers that were administered intravenously. I had three incisions on my left and I couldn't decide which one was most painful.



The tube was pulled out about 4 days later. It was quick and painless. The only problem was that water leaked through the wound when I cough, laugh or do my thing in the toilet. And I really mean it when I say LEAK because my hospital gown and bed sheets needed to be changed when this happened! I spent about 12 days in the hospital this time, and I was advised to rest longer at home before going back to work.


Surprisingly, recovery at my parent's house wasn't as depressing as the first one. I remember not being able to sleep and crying in bed when I recall the surgery. Now that there are three to remember (one of which I was unconscious), my mind probably mixed them all up or supressed them well enough for me to even think of it before going to sleep. Also, my fears of it recurring have diminished, knowing that I underwent a more permanent solution to prevent my left lung from collapsing again. My doctors are also on the task of making sure that it never happens to my right lung. 




I have been on medications for six months, and on February 28th, I graduate from taking three (huge) tablets a day. I still feel some kind of pain and discomfort on my left chest. Because of this pain, I have never been aware in my entire life that I have lungs, but as the weeks go by I feel better. On March 3, I will have my first chest x-ray in a span of six months, and we'll see how my lung is faring (or sticking). I can't wait!