spontaneous pneumothorax
What is a spontaneous pneumothorax? The condition known as SP
is a lung collapse without evidence of trauma (punctures/wounds etc.) to
the chest. The condition most often occurs without obvious underlying
lung disease. In this instance, it is known as PSP or Primary
Spontaneous Pneumothorax. In most cases, primary spontaneous
pneumothorax results from the rupture of blebs (air-filled sac on the
lung). As a result, air escapes from the lung and enters the chest
cavity causing the lung to collapse. Depending on the severity of the
incident, various symptoms will be experienced within minutes of the
initial collapse. The reason why this occurs is unclear, although
spontaneous pneumothorax has been attributed to tall, thin men (between
20 and 40 years of age); smokers; and in some cases, women during their
menstrual cycles.
My experiences with Spontaneous pneumothorax
The junior nurses and doctors just don't like patients like me. I am the
nightmare patient. Not because I'm grouchy and rude although the
anesthetic has been known to make me swear at my poor mother post op,
but because I ask so many questions and doubt everything anybody does to
me.
In 1997 I was 18 and just finishing revising for my College exams (A
levels) and had my first SP on my left side, after several days of
trying to rest and get rid of this mysterious problem I went to the
doctor who blamed it on exam stress and sent me home. Another 2 weeks
went by and I returned to the doc explaining nothing had changed - they
listened to the left chest and advised going for xray.
The local hospital saw the sp and tried simple needle aspiration which
didn't do much. after a few more days of observation I had my first big
drain in. and what an experience that was - they gave me a drug that
made me pretty drunk and disorientated and a junior doc tried to insert
- he didn't know what he was doing and after taking an hour to complete
the procedure they then found out they did not have the right equipment
to attach to the drain. so I had a bodged water seal and no pump
available to suction the lung back up. God bless the NHS
After little success on the drain I was transferred to Harefield for an
operation - mechanical Pluerodesis and stapling. Woke up with self
service morphine. I got out after around 6-7 days and thought it would
all be over and done with.
3 months later whilst at university in my first few days I had another
sp on the other side (r). Went to a local hospital and was observed.
Recovered and left the hospital but was advised to have another
operation to prevent further sp's
Went back to Harefield and had the same operation on my right side. The
surgeon said it was very unlikely to trouble me again.
All went well for the next 7 years apart from the occasional partial
collapse which laid me out for a few days. then i had another sp that I
couldn't resolve with rest alone. I had another xray after 4 weeks of
suffering and was told to get to A+E urgently. this time i had private
medical insurance so I hoped for better treatment. The junior doctor
used a different drain this time round (smaller gauge). it felt easier
to cope with and wasn't as traumatic as the usual one's. I spent 7 days
on that drain with suction but nothing was improving. My new surgeon
decided to replace my drain with a larger one ! to my horror. After a
total of 15 days on suction they decided to operate again.
I transferred to St Anthony's where I had a Pleurectomy + stapling using
thoracotomy, I had 7 weeks off work and then reluctantly returned. The
next 2 months went ok, then I hit a bad patch again. I've not felt great
recently but I'm getting used to having slight setbacks through the
recovery process. The first time I had this happen back at college, it
took me a full year to return to my former self ! I'm hoping it will be
much quicker this time - I've learnt allot over the years about how to
manage the up's and down's. Sadly I have grown a passionate distaste for
the medical profession especially the surgeon's but that's a whole new
story.