Monday, February 27, 2006

I'm raiding the archives - still not feeling well enough to go out and take some new photos. I'll try to post a few old ones here and there as I'm healing up.

I took this one at the wrong ISO setting, so it's a bit noisy. But I like the geometric shapes. Purposely underexposed and tinted.

Friday, February 10, 2006

Spontaneous Lung Collapse - Part 2

(Read Part 1 if you haven't already. And be sure to go on to the newly-posted Part 3 after you're done.)

Saturday, January 21, I was laying on my side in bed waking up to just another lazy weekend. I rolled over onto my back and felt that now-familiar twinge on my left side - I think I said "uh oh" out loud. I got up and the pain was definitely real. I made some coffee, still hoping I had simply slept wrong but knowing that was probably not the case. I almost cried a little when I finally decided it was almost definitely another pneumothorax.

I went back to the bedroom and told my wife I might have a problem, and that she should get up because we might be going to the hospital. I took a shower because I knew it might be my last chance to do so for a while. All that said, I was not as worried as last time because I knew it was not my heart. Knowing what I know now, I should have been scared to death. The second pneumothorax is always worse than the first because it means surgery - and the surgery is hell.

We actually walked to the hospital - the same one that told me six months ago that I had costochondritis. I told them myself this time that I had a pneumothorax and that they needed to take a chest x-ray. Sure enough, my lung had collapsed to the size of a fist - a total collapse this time, even though the pain was probably a bit less than six months ago. I knew I'd be getting a chest tube, and I knew surgery would be an option, but thought I might skate by without it and be out of the hospital within a few days again. The ER doctor even said as much.

I was put on suction and sent up to a room, where three separate doctors eventually came and all said I should have the surgery. 50% chance of a recurrence without it, they said, and every time it makes it harder to treat with a tube because of the scar tissue. The hole was big this time and probably would need to be stapled anyway. After four days on suction the hole had not healed, and I suffered another collapse when they took me off suction to do a CAT scan in preparation for surgery. I was told I had basically no choice - I was not going to heal without intervention at that point.

The surgery involves making three small incisions in the chest wall and inserting a small TV camera. The remaining blebs are lasered off and any large holes in the lung are stapled closed. The lung and chest wall are then "roughed up" and a chemical powder poured over the lung to make it stick to the chest wall - all so that it doesn't move around as much after the surgery. The last two parts are apparently optional, but I didn't know that - some people do just get the blebs removed (a "bullectomy") and the holes stapled. This buys time but does not cure the problem - but at age 33, a little time may have been all I actually needed. Men over 40 generally do not have this problem.

The operating room was scary. All of my clothes were removed (I did have a sheet over me), and I was not allowed to bring contact lenses or glasses. Even my watch and wedding ring were removed. I felt utterly naked. The OR table itself was hard and barely wide enough to hold my body, with separate appendages to hold my arms - which were then clamped down. It was like something out of a sci-fi movie; not at all comforting. The anesthesiologist gave me oxygen and, after I reached a certain level of oxygenation, told me I'd be going to sleep now. I was out cold almost immediately.

In what seemed like an instant, I awoke in the recovery room in just intense pain and freezing cold. My wife and mother came in to look at me but I couldn't speak - not because of the effects of the anesthesia, but because of the pain. It felt like I had a Mac truck sitting on my chest, and I vaguely sensed a new chest tube somewhere in the area of my back. The recovery room doctors saw that I was awake and put a heater in my bed with me to warm me up, then gave me pain meds to dull the pain - only partially successfully. I was there for about 8 hours before being transferred back to my old floor. Luckily I didn't have to go to the ICU.

The next several days were pretty awful. I had, initially, four tubes coming out of me: a new chest tube, my IV line, a foley catheter, and an oxygen tube. The foley catheter was the worst - or as I like to call it, the "pee pipe". It was like some sort of medieval torture device. The way it works, you pretty much always feel like you have to go to the bathroom, and this gets worse as it fills up. Three separate times somebody almost ripped it out of me by mistake, not knowing it was there, causing me to literally scream out in pain.

I had a PCA pump so I could self-administer my pain meds, and I ran out of morphine by the second day. Now, this is the second time I've had one of these pumps (I had one during my last hospital stay too), and I'm learning that running out of morphine is basically the end of it. Oh, they'll try to get you more, but it takes hours, and then the pumps are designed with so many failsafes to prevent overdose that it almost takes a certified technician to replace the medicine. Forget about asking your average nurse to do it - all you'll end up with is a non-functional machine that incessantly beeps at you to tell you it's not working.

So by the second day my IV line was out and I was on percocet, a pain pill that's far less potent than morphine and that I was only allowed once every four hours. My pain was excruciating, especially in the back where my new chest tube was. And because it was now a weekend, that tube was in for a total of five days.

I eventually got the tube out, had another chest x-ray and was finally discharged. I felt pretty good, considering I'd had major surgery only a few days before. I was still a little gimpy, I couldn't stand up straight because of the stiffness inside my chest and my breathing was not exactly normal - I felt like I had less capacity than before. But I figured this would all get better.

Fast-forward 2 weeks to today. I feel exactly the same as the day I left the hospital. In fact, my prescription for Vicodin has run out and I'm off pain meds completely, so if anything I actually feel worse. My breathing is no better, the stiffness has not improved and my entire left side hurts all the way down to my left elbow. I've seen the doctor for a follow-up and he says this is all normal, and that I just need to wait and not push myself. But I'm getting depressed; I feel no improvement, and all I can do is sit around and watch TV. I'm worried about losing my job (I'm currently on disability) and we're just about to close on our first house - which I'm going to need to drive to do in just a few days.

I'm completely miserable, and feeling like I made a big mistake in electing for the full surgery vs. simply having my lung stapled up to buy some time. Worse, I know the same thing is just as likely to happen on the right, meaning I'll have to go through this all over again. The biggest thing I'm worried about right now, though, is that I will never get back to normal - that I'll have to live like this for the rest of my life. Like I said, I feel absolutely no improvement since the surgery. And that just sucks.

All I can do is wait and see what happens, and if there's still no improvement in another week, I'll call my doctor again. I wonder if there's some way to have this procedure reversed - to flush out that talc powder and unstick the lung from the chest wall. I'd rather live knowing I might need another chest tube someday than going through my entire life basically like an old man, unable to stand up straight, breathing heavily just from walking across the room, and in pain all the time.

I have always believed that as a society we are too reliant on medications and surgical procedures. I would urge anybody with this problem to do as little as possible. Don't make the same mistake I did. Don't let the doctors push you around. Tell them you want the minimum done to you that will make you better, especially if you're older than 30 and getting to the age where the chances of another collapsed lung start to lessen. But so far, this surgery has been a cure that's worse than the disease, and I now regret having done it. A chest tube is bad enough, but this is like 1,000 chest tubes over a one month period. I think it's better to just deal with your lung collapses as they come than making yourself completely miserable; the only way I can see this surgery being worth it is to save your life. And my situation was not life-threatening, yet my life may be changed forever from this operation.

Spontaneous Lung Collapse - Part 1

So you may have noticed that I haven't posted anything in any of my blogs for a while (especially if you're coming here from I've got a good excuse - three weeks ago, my left lung collapsed.

This is the second time this has happened. It's called a spontaneous pneumothorax, and while it can be life-threatening, it usually isn't. My first pneumothorax happened about six months ago, and was extremely scary. You see, for about the last fifteen years, I've had heart palpitations that have themselves caused more than a few doctor's visits (they never find anything wrong). I've also on occasion felt pressure in my chest, and thought these might be related. One morning, I woke up and felt an odd sensation in my chest - sort of a "fluttering", with a feeling of intense pressure, but no pain. Stupidly, I waited, thinking it might go away on its own - remember, I'd been to the doctor about this sort of thing several times, and they'd practically laughed me out of the office each time. I had developed a reputation as something of a hypochondriac, and had started to think of myself that way too.

But the feeling didn't go away, and when I woke up the next morning with severe chest pain, I immediately told my wife to call 911. I ended up in the hospital where the ER doctor gave me some good news - I had not had a heart attack, and in fact my heart was fine. I was diagnosed with costochondritis - literally arthritis of the chest wall - and sent home.

The pain lessened over the next week but never went away. I was having trouble breathing during this time and eventually made an appointment with my primary doctor. He did a chest x-ray (the hospital didn't) and actually became angry when he saw what he had immediately suspected - a pneumothorax in my left lung. Calling it a "classic case" due to my build and saying the hospital doctors were "stupid idiots" for missing it, he immediately sent me to another hospital and informed them that I was on my way with a partially (around 30%) collapsed lung.

If you're wondering what could cause such a thing, it's apparently fairly common in tall, thin males aged 20-40. Nobody's sure why, but they think it has to do with the lungs having too much room to move around in the chest cavity, which results in air "blebs" - literally air blisters on the surface of the lung, fed by tiny holes in the wall of the lung. When and if these pop, the lung may or may not collapse from the air pressure that's now outside the lung in the chest cavity.

The way your first spontaneous pneumothorax is treated is with a chest tube. You may have heard doctors on the TV show "ER" asking for this as they treat injured patients, but you probably don't know what it is. For an otherwise healthy and alert person, it is a nightmare in itself. The doctor first numbs an area on your side, then slices through your chest wall and inserts a 1/4" tube into your thoracic cavity (where your lungs are). During this process, you're rolled onto your side and your hand is literally taped to the bed above your head so you cannot move. The tube is then hooked up to a machine that provides suction, allowing the air that has caused the pressure in your chest to escape, and re-inflating the lung. The moment the suction is turned on is an interesting sensation, to say the least. Within seconds, the pressure is gone and the lung re-inflated - forcing an involuntary deep breath followed by uncontrollable coughing. Then the excruciating pain starts as your lung becomes reaccustomed to its natural position, and it only dissipates over about the next 30 minutes. But the chest tube itself causes a dull ache that never really goes away.

I was put in a room and kept on the tube for a day - my hospital stay was short ironically because I had delayed treatment for two weeks, allowing the hole in my lung to heal. The chest tube was removed and I was monitored for an additional day before being sent home. I moved around gingerly for the next few weeks, afraid of a recurrence and in pain from the incision (which eventually had to be treated with a steroid to calm it down). But eventually, I returned to normal - always cognizant that it could happen again, but actually a little relieved to know that it was not my heart and that it probably was not going to kill me.

But it did recur a few weeks ago, and this time was much worse. Read on for Part 2 and see what I'm going through right now.

Wednesday, February 08, 2006

My latest excuse - surgery!

It's been nearly three weeks since I've uploaded a new photo here, but I've got a good reason. Shortly after making my last post (in fact, the following morning), I woke up to discover that my left lung had spontaneously collapsed. This is the second time this has happened to me, and it resulted in a ten-day hospital stay accompanied by major surgery to (hopefully) finally fix the problem.

I'm currently back home on my couch, in pain. Once I'm feeling a little better I'll get back to taking and posting photos. Please bear with me in the meantime and do check back occasionally; I'm anxious to resume a normal life as soon as I can.

About This Blog

This is increasingly not a blog about Alphabet City, New York. I used to live in the East Village and work on Avenue B, but I no longer do. Why don't I change the name if I'm writing about Japan and video games and guitars? Because New Yorkers are well-rounded people with varied interests, and mine have gone increasingly off the rails over the years. And I don't feel like changing the name. I do still write about New York City sometimes.


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