As many of you recall, Hunter had a spontaneous pneumothorax two years ago. On Saturday he had another episode except for this time on the right side. Surgery was on Monday and he is making steady progress toward healing and full recovery. He just had an x-ray and the lung looks good and they have turned off what we call the bubble machine or an integrated chest drainage unit. His lung is now on what is called a water seal as long as there are no bubbles in the next 6 hours he will get the chest tube taken out tonight. If everything goes well he might get to go home tonight! Many of you have asked what causes this and what is the treatment? After experiencing it ourselves, talking to several doctors and research here is what we've found.
Spontaneous pneumothorax is an abnormal accumulation of air in the space between the lungs and the chest cavity (called the pleural space) that can result in the partial or complete collapse of a lung. Hunter has never had a full collapsed lung, but the one on his left side was almost halfway down. Spontaneous means the pneumothorax was not caused by an injury such as a rib fracture. Spontaneous pneumothorax is likely due to the formation of small sacs of air (blebs) in lung tissue that rupture, causing air to leak into the pleural space. Air in the pleural space creates pressure on the lung and can lead to its collapse. Hunter had a cluster of them on the left side that they removed and on the left side they found three. A person with this condition may feel chest pain on the side of the collapsed lung and shortness of breath.
Blebs may be present on an individual's lung (or lungs) for a long time before they rupture. Many things can cause a bleb to rupture, such as changes in air pressure or a very sudden deep breath. Often, people who experience a primary spontaneous pneumothorax have no prior sign of illness; the blebs themselves typically do not cause any symptoms and are visible only on medical imaging. Affected individuals may have one bleb to more than thirty blebs. Once a bleb ruptures and causes a pneumothorax, there is an estimated 13 to 60 percent chance that the condition will recur.
This condition is often found in tall. slim, male athletes. Researchers suggest that the rapid growth of the chest during growth spurts may increase the likelihood of forming blebs. Long-term smoking also greatly increases the risk of developing primary spontaneous pneumothorax in both men and women. We know for a fact that the later is not what caused Hunter's condition. What we have discovered is that Hunter is slim and an athlete but not necessarily tall. As they have taken x-rays of Hunter's chest they always miss a portion of his lungs. So one doctor finally told us to remind the technicians that he has very long lungs. So it made Dr. Holt deduce that possible in the growth of his lungs they may have formed because of the very small space in his chest cavity.
How do they fix this problem?
In some cases, a chest tube is placed in the chest wall to relieve the collapsed lung, however as the statistics say above if it has happened once you have a 60% chance of it happening again. So we decided to go ahead have the same procedure on the right side that they did on the left side.
The lung is collapsed and a thoracoscopy is performed. Basically three tiny incisions in the chest wall, one for the camera and the other for the tools. The blebs are found and cut out of the lung and stapled back together. Then the surgeon irritates the pleura (chest wall) with either a rough pad, gauze or a mechanical rotary brush. This is done so the lining of the lung adheres to the chest wall. This is done in case they missed a bleb or he may form another one. Since it adheres to the chest wall there is much less risk of him ever having a collapsed lung again.
Recovery is usually from 3 - 7 days in the hospital and a recovery time of 2 weeks before resuming normal activity.
Spontaneous pneumothorax is an abnormal accumulation of air in the space between the lungs and the chest cavity (called the pleural space) that can result in the partial or complete collapse of a lung. Hunter has never had a full collapsed lung, but the one on his left side was almost halfway down. Spontaneous means the pneumothorax was not caused by an injury such as a rib fracture. Spontaneous pneumothorax is likely due to the formation of small sacs of air (blebs) in lung tissue that rupture, causing air to leak into the pleural space. Air in the pleural space creates pressure on the lung and can lead to its collapse. Hunter had a cluster of them on the left side that they removed and on the left side they found three. A person with this condition may feel chest pain on the side of the collapsed lung and shortness of breath.
Blebs may be present on an individual's lung (or lungs) for a long time before they rupture. Many things can cause a bleb to rupture, such as changes in air pressure or a very sudden deep breath. Often, people who experience a primary spontaneous pneumothorax have no prior sign of illness; the blebs themselves typically do not cause any symptoms and are visible only on medical imaging. Affected individuals may have one bleb to more than thirty blebs. Once a bleb ruptures and causes a pneumothorax, there is an estimated 13 to 60 percent chance that the condition will recur.
This condition is often found in tall. slim, male athletes. Researchers suggest that the rapid growth of the chest during growth spurts may increase the likelihood of forming blebs. Long-term smoking also greatly increases the risk of developing primary spontaneous pneumothorax in both men and women. We know for a fact that the later is not what caused Hunter's condition. What we have discovered is that Hunter is slim and an athlete but not necessarily tall. As they have taken x-rays of Hunter's chest they always miss a portion of his lungs. So one doctor finally told us to remind the technicians that he has very long lungs. So it made Dr. Holt deduce that possible in the growth of his lungs they may have formed because of the very small space in his chest cavity.
How do they fix this problem?
In some cases, a chest tube is placed in the chest wall to relieve the collapsed lung, however as the statistics say above if it has happened once you have a 60% chance of it happening again. So we decided to go ahead have the same procedure on the right side that they did on the left side.
The lung is collapsed and a thoracoscopy is performed. Basically three tiny incisions in the chest wall, one for the camera and the other for the tools. The blebs are found and cut out of the lung and stapled back together. Then the surgeon irritates the pleura (chest wall) with either a rough pad, gauze or a mechanical rotary brush. This is done so the lining of the lung adheres to the chest wall. This is done in case they missed a bleb or he may form another one. Since it adheres to the chest wall there is much less risk of him ever having a collapsed lung again.
Recovery is usually from 3 - 7 days in the hospital and a recovery time of 2 weeks before resuming normal activity.
