Saturday, January 15, 2011

Pneumothorax

Right then.  First a brief anatomy lesson regarding Boyfriend's lung.  Right now it looks kind of like this:


Semi-deflated.  More deflated than that picture above, actually.

You see the hole in the lung, where the air is moving into the chest cavity?  That's a pneumothorax happening right there.  Normally the lungs are stuck to the walls of the chest cavity / thorax, but boyfriend experienced this painful separation of lung from chest-wall because he:

1) Smoked for 15 years, weakening the lung tissues, and even after 'quitting' continued to smoke occasionally at social events.
2) Is of a tall and lean build, grew like a rake as a kid.  Usually this rapid growth leads to thinner/weaker areas of lung tissue even in adulthood, which are more susceptible to damage be it from smoking, or other forces.  Being male also increases susceptibility to this problem, apparently.
3) Plays squash like a beast.  The man hits the ball with ridiculous force and snap.  He is a wound up spring, and squash was his tension release.  Unfortunately violent muscular contractions can cause a pnuemothroax, by tearing the lung away from the wall of the chest cavity and perforating it, allowing air to pass into the chest cavity.

The x-ray at the hospital showed that his lung had moved a full 5cm away from his chest-wall, resulting in pain, the feeling of pressure and breathlessness, and the risk the lung could detach itself more from the chest-wall.  It seems that 2 previous incidents of chest-pains were also smaller pneumothoraxs (which tend to resolve themselves over time.)  Though a cardiologist had been seen previously about the chest-pains, he hadn't thought to do an x-ray which is why we're just catching this now.

This (very painful) procedure was done at the hospital on Monday morning:


I know that's not the clearest drawing, that's a shoulder and arm sprouting off at the top there.  Essentially they made a hole all the way past the ribs and into the chest cavity and inserted a tube attached to a syringe with a 3 way valve.  This allowed them to suck all the errant air out with the hopes that the lung might start re-attaching itself.

But it didn't work.  It's not worse, which the doctors tell us is good, but it's not better, and so Boyfriend has been given some instructions.  He may do nothing, and I mean nothing for a month.  He may not fly for at least three months.  Within the next month, if he does very very little, the doctors are hopeful the situation will improve.  If it doesn't, a surgical intervention involving purposely irritating the outsides of the lungs is in the cards.  Any further chest pains, breathlessness and so on mean he must go directly to the hospital emergency ward.

The problem with all of this is that the reduced lung function caused by a pneumothorax can lead to oxygen deprivation, and cardiac arrest.  It's pretty important Boyfriend try to take care of this.  As there are a few factors that predispose Boyfriend to this, and as there is evidence that this has happened to Boyfriend before, there were also some more permanent instructions given by the doctor:

No smoking, ever again.
No squash, ever again.  No other explosive-force/violent sports or movements either.
And I will have to find a new dive-partner if I wish to learn SCUBA diving (which I do.)

After this month, if all is going well, he might be able to go for walks or help me carry the groceries, but we know we're staring at a quality of life change, and a big one for the next bit.  How much changes in the long run really depends on how things go, and whether his lung is willing to cooperate.  So, while we're doing our best to do very very little, if you wouldn't mind crossing your fingers for us for a second that'd be lovely.  Because really, pneumothorax?  Who the hell knew about THAT?

4 comments:

Jennifer said...

oh god, that sounds really painful and awkward and uncomfortable! really sorry. i hope he at least gets home soon so he can do "nothing" in the comfort of his own home. x

Jessica said...

He's here already, thank goodness. It's getting him to do very little that's the trick!

wildsleep said...

Oh my :(( I'm really sorry, I hope he begins to feel better and rests. All those lifestyle changes must be a real shock as well, in addition to all of this...

Really shocking. Sending you two positive vibes from over here <3

Jessica said...

Thanks :)

Fortunately a lot of the changes we have to make will fade away with things going back to almost normal provided he heals up well, but for now it's a little different than we're used to, for sure. Since he's a pretty active guy normally it's really been a game of finding good distractions to keep him doing just about nothing while not being bored to tears.

So far he's watched the first two seasons of Desperate Housewives, in a matter of days, lol.

Chitika