whoa, my lung just collapsed--- again...

[Ross434]

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Yeah so this sucks really bad. I have the best weekend plannned (a 4 day weekend here), and now my lung pops again. I'm probably going to hide it from my parents until at least saturday, so i can maximize my school-missed time and minimize vacation missed time. If I can only withstand the symptoms for 3 days.

Do you think i'm risking my life or my health ??? I mean, i'm young, healthy, and in shape, I can probably survive on 1.5 lungs for a few days? correct?

 

[beanbean]

As someone who went through a couple of pneumothorax incidents, let me be the first to tell you to not mess around with it. Just because you may have had a small one the first time, you may not be so lucky this time. Get yourself to an ER and stop worrying about missing your "vacation" time. You may be "young and healthy", but you are also stupid if you don't get checked out now. Do a little research on tension pneumothorax if you have any doubts about where your priorities should be.

 

[Ross434]

yeah I looked up tension pneumothoraxes earlier, but really, wouldn't I be in agony if I had one?? Apart from feeling a tiny bit short of breath, I really can't even tell that anything has happened.

 

[Bridaddy]

unbelieveable there ross.

Is it worth potentially dying over?

Seems like a easy choice to me. "Young and health" people die all the time.

 

[Ross434]

hey just for the record-- last time I had one it was pretty bad (i collapsed from the pain), but I thought it was a pulled muscle or something (note that the pain stops after pressure is equalized, so I didn't notice it for a while afterwards) so I didn't go see the doctor for almost 2 weeks, and I was fine. I can wait a few days here.

 

[trauma_junky]

Ok, look!

Just take a 14 guage IV Cath (2 inch) and cut the fingers off a sterile gloove. Stich the IV through the tip of the finger and now you have a make shift flutter valve. Now prep with Iodine, 2nd intercostal space, mid clavicular, make sure to go on the superior edge of the third rib and decompress. Remove the needle and just explain to people you have a little leak when they hear the flutter. 😀

Really you need a 14 french trochar, so don't F around and get to the ER before you put so much pressure on your vena cava you go into cardiac arrest due to severe reduced preload, among other mechanisms.

It will only develope into a tension if you had an aveolar rupture, but what is bad about this as well is the emphysema that develops in the tissue reducing your vital capacity and tidal volume available for gas exchange.

If you start having puffy skin, thats bad too. It's Subcutaneous emphysema, it means you have an open pneumo, not to worry though, they usually only occur from traumatic incidences.

 

[fava]

wait -- take a moment to enlighten the clueless -- how is this happening to you guys?

i thought this happened when you, like, got stabbed or something.

what made your lung collapse?

 

[Ross434]

Its called spontaneous because it just happens on its own. Tall young, thin males (i'm 6'5", 150) are predisposed. And, i've had one before so 50% recurrence rate.

Most complications that occur with spontaneous pneumothoraxes are related to the cause of the event. Ie: if you get shot, the bullet could have damaged your heart in the process-- or, if you have a lung disease, it could be causing more damage than just the deflation.

 

[lattimer13]

Originally posted by Ross434
(i'm 6'5", 150)

😱 WEIGHTROOM!

 

[Jalby]

Here's my official diagnosis (I've done 2 weeks of the 5 week respiratory system, which should have covered this)

Sometimes, people get whats call bulles (bad spelling) An aveola will expand until it can be about 5 cm across and fillid with air. Sometimes, these pop, and you have a direct route for air to get from the lung to the interplural space, which would eliminte interplueral pressure and cause a pnuemothorax. These generally require surgery, and that's my guess with what will happen to the OP eventually.

 

[Idiopathic]

But, the surgery is not preventitive, it is purely post-pneumothorax treatment. When one gets a tension pneumo, there is a pleural flap, if you will, that allows air out, but not in. Thus, the air builds up outside the lung. All a spontaneous pneumo does is piss the lung off, not allowing the thoracic pressure to dictate filling, etc., since there is a little 'bleb' that pops. If you dont die, then you probably didnt need surgery😉

 

[Pre-Dent-David]

**** ross you arre skinny.

 

[12R34Y]

Trauma junkie,

subcutaneous emphysema is NOT only caused by an open pneumothorax. tracheal or bronchial injury will also cause this.

alveolar rupture is NOT the only thing that causes tension pneumo. that can also be caused by an open pneumo as well.

later

 

[trauma_junky]

I never said only! But it is the most common!!!

 

[The Pill Counter]

When one gets a tension pneumo, there is a pleural flap, if you will, that allows air out, but not in.

Isn't it that it allows air in, but not out, such that an expanding tension pneumothorax that leads to mediastinal shift, blah, blah...

You don't need surgery, just an underwater drain.

 

[Ross434]

Okay, so I decided to go in today to get it checked out. X-Rayed, it turns out it's less than 10% collapsed, so they decided not to do the chest tube or valve. Last time it was more like 60%. Because recurrence rate pretty much doubles every time you get a pneumo, they brought in the CT surgeon to talk about possible surgery options. So, i'm to wait a week, then come in and get the thoracoscopic pleurodesis surgery, along with two chest tubes, then wait in the hospital for 3 days with the nasty surgery side effects.

 

[The Pill Counter]

Good luck with the procedure Ross434.
Was tetracycline pleurodesis not a viable choice before opting for surgery?

 

[beanbean]

Good luck with your surgery. I also had a repeat pneumo, however, the damm thing wouldn't seal up on its own (even with a chest tube/ pleura-vac set up) and I required surgery. Unfortunately, this was 17 years ago and there was no laproscopic option - I had to have the whole big incision/ split open your ribs surgery. Fun times! The only thing that pisses me off is that I can never scuba dive!

 

[droliver]

Originally posted by The Pill Counter
Was tetracycline pleurodesis not a viable choice before opting for surgery?

Mechanical pleurodesis is a little less problematic if you're going to be there for thoracoscopy anyway. Contemporary tx. of these involves surgery rather then just instilling some sclerotic agent via a chest tube (ie. talc or tetracycline). The only times I've seen the talc done is for recurrent malignant effusions from lung or breast CA. Best case in scenarios like this is a single pulmonary bleb that you could tx. definatively with a thoracoscopic wedge resection, a pretty low morbidity procedure