Spontaneous Pneumothorax

Up until the age of 18, apart from Pectus Carinatum I had no issues with my chest or breathing. I was in reasonable condition fitness wise and no other health concerns.

During October 2003, apart from being a bit run down through work, I was feeling relatively well. At the time I was working as an Assistant Manager in an entertainment complex. Early on a Saturday morning I bent down in work to brush up some glass into a pan and I felt a very strange sensation in my chest. A sensation which I can only describe as a bubbling sensation. I bent over a few times and each time the same thing happened. Although strange I ignored it thinking it was just indigestion or something. As the day continued I was feeling a little short of breath and a pressure sensation in my chest. I asked my girlfriend to pick me up something for indigestion thinking it was still this, however it didn’t really help.

Just before I left work for the day I went up a flight of stairs and by the time I got to the top, I could not catch my breath. Eventually, I managed to catch my breath and went slowly back down stairs. A friend of mine had come to pick me up from work and took me home. When I got home I was struggling to take anything more than a short shallow breath and had so much pressure in my chest I could not lye down or even lean over. I sat for about 30 minutes to see if things improved, but they did not.

My mum and girlfriend decided to take me to hospital to get checked out. I was taken straight into a cubicle where they ran some tests. As soon as my chest xray came back, they diagnosed me with a Tension Pneumothorax.

My left lung had developed a hole that was acting like a one way value and caused my left lung to fully collapse. Every time I breathed in, a little bit of air would escape from my lung into my chest cavity and get trapped. Throughout the day the air in my chest cavity had got so much it had pressured my left lung down to a size of about 10/20% of what it should be. There was so much pressure in my chest that it was pushing my heart over to the right and putting pressure on my right lung, risking that also collapsing.

I was rushed into an emergency theatre room, where they essentially put a value into my chest cavity to release the pressure. I was awake during this procedure as it needed to be done so quickly. As soon as this broke through my chest you could hear the air escaping like air from a balloon. Although in a lot of pain now, I could breathe.

Following on from releasing the pressure they needed to ensure the pressure did not build up again, so inserted a chest drain into my chest. The chest drain was a tube, about a centimetre thick that when straight into my chest. Attached to it was a drain with a small amount of water. The water acted as a value. Air could escape my chest through the chest drain, but not the other way around.

Now attached to a chest drain, a number of different fluids and a number of machines I was stable. After remaining in A&E for monitoring I was transferred to a ward. The initial plan with the hole in my lung was to give it some time to see if it would heal on its own (as most do). The chest drain would prevent a build up of pressure, and the multiple pain killers would keep me comfortable.

After 24 hours I was sent for another x-ray to see if my lung had improved. It came back as having improved a little but not as much as expected. They believed this was because the chest drain was too low down in my chest. There was still air collecting at the top of my chest cavity. A decision was made to insert a secondary chest drain which went through my armpit into the top of my chest.

The second chest drain helped to reduce the additional amount of excess air in my chest cavity. For the next two weeks it was a case of routine medications and painkillers, oxygen therapy and allowing my lung to heal with the support of the chest drains.

After two weeks my lung and breathing had improved enough to remove the chest drains. The x-rays showed my lung had re-inflated to its normal size. The chest drains also weren’t showing that any air was escaping. The chest drains were both removed. After a further 24 hours of observation after removing the chest drains, I was allowed home.

By this point I had been in hospital for a little shy of three weeks. At home I continued to rest and build back up my fitness levels and work on breathing exercises. All was well for the first week, so the second week I began to do a bit more.

Two weeks later I had a check up appointment. It was looking all good and x-ray was clear. However, that night I had a sudden pain in my chest. I slowly bent over to see if I could feel any movement in my chest, and yup there was bubbling. My breathing wasn’t being effected yet so I tried to calm down, thinking it was my over active mind. After an hour I got up and felt a bit breathless, bent over and it was now bubbling more.

We called the ward I was previously on and they told me to come straight back down. Once at the hospital a doctor listened to my chest and was also concerned the hole in my lung had returned. I went of a chest x-ray and this indeed confirmed my lung had once again collapsed. Not as severely as the first, but this was most probably because I reacted much quicker…

To Be Continued….

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