Well that was fun.

Pneumothorax

I am back, after a slightly uncomfortable couple of weeks, spent mostly in hospital, following another collapsed lung. So for your pleasure, here is the full story, including all gory details. And pictures where I can find them too.

Lets start on the 30th March, when I was looking forward to seeing Dogs (a new band I like) who were playing Mean Fiddler in London. I was looking forward to going out, getting very drunk and having fun. However about 9pm my chest started hurting a little, nothing too bad, but I laid off the booze a little and carried on enjoying the music, the pain got a little worse so I moved out the crowds and stood to the side for the rest of the gig.

After the gig, While everyone decided where they were going, I made an exit and decided that since I have a history of pneumothorax, I’d pop into Homerton Hospital when I got back home and just make sure it wasn’t a pneumothorax again. So I got to Stratford, picked up Claire and we went off to hospital. Where after an x-ray everything was apparently fine and it is probably just a bit of an infection following the cold I had…

So that was that then. Normal service resumed. Despite some pain I went to the Science Museum, saw a few good exhibitions, notably the Spitfire and History of Medicine exhibits. I must also return to see “Health Matters”. Apt.

Sunday however the pain was even worse so after a discussion with NHS direct who thought it might be some thoracic infection or something and told me to go back to Homerton that day. So I went back and after an hour or so finally saw a doctor, who sent me for another x-ray, however this time the results were rather different from the last time, showing a massive pneumothorax of my left lung. Again.

Pneumothorax X-Ray

You can see the lung has collapsed by the comparing both sides, where there appear to be little vessels (lung) all over the left but complete black on the right, and a larger white mass near the heart in the centre.

A pneumothorax in brief:

The lungs are lined with a double layer of membrane (the pleura) separating them from the wall of the chest. If air gets in between these two layers, called a pneumo (air) thorax (chest wall), this makes the lung collapse causing chest pain and making breathing difficult.

From BBC Health – http://www.bbc.co.uk/health/conditions/pneumothorax1.shtml

So anyway, now that the doctors finally knew what was wrong with me, it should have been a fairly straight forward few days. Not so for me though. First things first though, and on with the treatment.

After diagnosing the problem I was suddenly high on the A&E staff “to do list” and was rushed to “resus” to have a chest drain, or tube thoracostomy inserted into my left pleural space to relieve the pressure on my lung, empty the air and hopefully allow the lung to re-inflate itself.

My chest drain involved using local anaesthetic to numb an area below my left arm, deep into the muscle as well as the skin area. An incision into the skin and muscle is then made down to near the thoracic wall, and then using a metal guide, a tube is pushed through (with great force and a lot of pain!) until they actually burst through into my chest cavity. Ouch. Then a massive gush of air escaped from my pleural space, it was slightly easier to breathe and the tube was positioned, stured in place and dressed. I’ve a photo of the wound and tube on my phone, but can’t get it right now, I’ll try to add it soon.

So then followed a few uncomfortable days in Homerton Hospital, made only better my mother coming down and plenty of visits from friends and footballers alike.

However on Wednesday or Thursday the drain seemed to stop working, no more bubbles, and more pain. I was woken on Thursday morning by nurses with a temperature and obvious pain. The doctor on duty immediately called the London Chest Hospital and arranged asap transfer there for an operation to cure me. The chest drain appears to have become infected and caused the halt in recovery and pain and a fever, so later Thursday, the drain was removed (the most painful ordeal of the whole stay, this was way more painful than it should have been and was enough to never want a drain ever again) and I was transferred to the London Chest Hospital at Bethnal Green.

The London Chest Hospital was quieter than Homerton and I soon settled down, however soon the doctors came round and I found that it might not be Tuesday before I can be operated on, and during that wait I needed a chest drain. Bugger. So the drain was inserted, with a bit of drama when they struggled to get through my chest wall, but when they did, it exploded releasing a lot of fluid and blood and stuff. Tasty.

However later on after some x-rays and so on, I was told they would operate on Good Friday, the following day. That was a relief.

So after a final painful night of a chest drain (or so I thought) and a lot of pain, I was ready for the op. And after a while waiting, finding out I would wake with 2 chest drains, not just one and other assorted pre-op preparations I went off to the theatres, was knocked right out and the surgery began.

The surgery performed was a left pleurectomy, where I believe the surgeons opened me up on my back, and inserted a camera to assess the damage, then they aggravated the chest wall, resulting in the chest wall and lung sticking together much better and hopefully stopping any recurrence of a pneumothorax before re-inflating my lung, and stitching my up. I was also given 2 chest drains to get rid of any air or fluids left or building up after the operation. I can’t actually be sure what happened though – as I was asleep at the time.

After surgery I woke to mother and Claire, very out of it and not feeling great. A couple of days in the High Dependency Unit with an epidural for pain control, many drugs, anitbiotics and so on before I was transferred back to the normal ward, even getting my own room this time! Here I got through the days with pain killers, books and a little TV before finally, on Monday, 9th April 2007, the two chest drains were removed and I was discharged from the London Chest Hospital.

So I am now recovering at home, for a while, hopefully not too long, before getting back to work and shortly after that, getting back to football and cycling. Wish me luck, because I’ll probably need it!