Relapses just a week apart

Trainee Blebber Joined: 13 Feb 2010 Posts: 17

Hi!

I am a 25 years old male.

I got my first SP 6 or 7 Feb this year. I just had some funny feelings in my right chest, so I went to hospital. I should by the way add that I live temporarily abroad (La Palma, Canary Islands), but I am Swedish, so I don't understand the language very well (but I have had help from friends translating).

Anyway. I went to hospital 8 Feb, they diagnosed me with a 20% SP, and put me in hospital. 9 Feb they put in a needle to let the air out, but as this didn't get it all out, they put in drainage 10 Feb. 15 Feb I left hospital, and they told me to not fly, go to high altitude, swim or do heavy exercise for 1 month, and to rest at home for 2 days. So I was back at my studies after 2 days, and then, 22 Feb, I got the same sensations again. Went to hospital, <15% SP this time. No drainage, just rest.

They let me out on 1 March (after one week), and told me to rest in bed for 2-3 weeks. They suggested surgery, which cannot be done on my island, but my insurance company said that if I have to do surgery, I will have to go home to Sweden (by ambulance plane, or waiting until my travel restrictions finish). My insurance company although wanted a second opinion from another doctor, so they told me only 2 days after I left hospital to go with the early morning boat to Tenerife (yesterday), and go to a private hospital there. The doctor there discovers a 10% SP, so they put me in for observations. We immediately called the doctor from the first hospital, who told me to go to the university hospital as they can do the surgery, but the insurance company told me to stay at the private hospital to avoid sitting in emergencies for hours again.

I get lots of different medicines, anti-inflammatory, something else that I had to inspire through a nebulizer, antibiotics for some kind of urine infection I got while in hospital, etc...

Has anyone had experiences with relapses so shortly between? What do you think? Should I get a surgery? I also feel very confused on where I should get the surgery. Here on Tenerife, I have no friends (my friends on La Palma need to take boat or plane to visit), I understand the language poorly, I feel quite alone (even though I have a friend here now, who followed me and were allowed to stay over-night, but she will leave today). In Sweden I understand the language, which makes me trust the doctors more (because they can explain what they are doing and why), but it is a long journey home - 6 hours flying, but it can be done without flying, but will take 6 days (boat and lots of trains)...

Thanks a lot for any response!

Johan

Posted: Thu Mar 04, 2010 9:19 pm Post subject:

I would say, Stay were you are for now. Talk to your insurance people and see what they can do about flying you home. If they say that's were the surgery can be done.
Just about all ambulance planes or Jets can take care of you on the way.
You will need time to recover, so it might be better to be home.
As for your friends. I don't know. Sucks all the way around. The real thing is to get you better and up and running. Wink

Trainee Blebber Joined: 13 Feb 2010 Posts: 17

Hi again,

An update on what's happening to me:

I stayed in the hospital in Tenerife for a week, left Wednesday 1 week ago with no air left in the pleural cavity. The doctor gave me lots of different medicines: antibiotics, anti-inflammatory, cortison, asthma-medicine, anti-phlegm and a stomach protector. He told me to come back 11 days later for a check-up, which will be on Monday. Then he will decide if I need surgery or not, and surgery (VATS) will be done then and there if he says I need it (insurance will pay, even though I am not in Sweden).

However, two nights ago, I noticed the now so familiar bubbling again. Not very much pain, but I didn't have much pain on the previous occasions either. Pulse is fairly normal, I don't feel short of breath (but I am resting, so I shouldn't). I feel the funny sensations more when I lie down, so it is a bit difficult sleeping. I called the doctor and wondered if I should go to my local hospital for an x-ray, but he told me not to worry until I have more pain and/or breathlessness.

Now I am getting kind of paranoid, I start to imagine strange feelings on my left side as well (I am not really sure, but it feels just a little bit odd). If this is yet another relapse, is there any risk of this developing into a tension pneumothorax? How/when will I know, and is it to late when I do? Hospital is 15-20 minutes drive away, after finding a taxi. Is it really not dangerous before I feel pain?

I have one of these inspirometer devices to train my breathing with, and I noticed that my inspirational volume has gone down slightly from maybe 4 to 3.5 litres on average since I started feeling bubbles again.

Posted: Thu Mar 18, 2010 10:33 pm Post subject:

Hi Jolindbe,

I would definitely get checked out. I know of people who have had 80%collapses with no pain whatsoever. If you're feeling bubbling and are especially uncomfortable when lying down, I'd go. I understand about you feeling paranoid (and I think almost all of us have experienced this, especially in the beginning), but it's much better to be safe, right? If you are having a very small collapse, it might only be visible on CT scan and not on x-ray.

Hope this finds you feeling better....Let us know what you decide to do.

Mackie
_________________
41F, VATS w/mechanical pleurodesis and parietal/visceral pleurectomy-Sept. '08

Trainee Blebber Joined: 13 Feb 2010 Posts: 17

Hi Katrina and everyone else,

Thanks for replying. Sorry for not updating for so long time.
I have been to a couple of check-ups since my last posts, two scheduled and one in the middle of the night (when I felt breathless and had some mild pain). All X-rays have shown negative, so I suppose that I am recovering well Smile

However, I have still not dared to go up the mountain for astronomical observations. Normally, I would go up 3 nights per month, but I am still a bit scared, as I don't know if this caused it.

I get very different recommendations from my doctors. The doctors in the small hospital of La Palma (one pneumologist and one surgeon) tells me I should avoid going up the mountain (they aren't forbidding it, but they think it might be a bad idea). Actually, the first thing the pneumologist said to me was "Have you considered getting another profession?". However, my profession will not be as dependent on going up mountains in the future, this position on La Palma is just temporary, then I will move to Denmark for PhD studies. For the record, the highest mountain in Denmark is about 450 metres high...
They say flying is fine, but I don't understand the big difference, as it is more or less the same pressure change (the mountain is 2400 m, flying should be equivalent to 2500-3000 m).

However, the doctor in Tenerife, who is a thoractic surgeon, says "Live a normal life, do what you want. If you get another pneumothorax, we'll do surgery. Don't worry so much. Que sera sera."

So at the moment I feel very confused. Should I dare go up mountains again? Should I go home to Sweden as soon as possible?

I have also got contact with another guy who worked at another observatory here in La Palma 9 years ago, and got lots of SPs. His experience with the hospital here was very bad - he was operated in the middle of the night without anaesthetics, without understanding what happened. It took one year and four more operations for him to recover. This worries me a bit... However, they have said that they are not doing any SP surgeries at La Palma any more - I will be sent to Tenerife if that is needed.

Thanks for any support, tips, suggestions, etc.

Posted: Tue Apr 20, 2010 9:13 pm Post subject:

Only have time for a quick response right now...

I THINK the reason it's okay to fly, but not go up a mountain is that the airplane should be pressurized, but you're on your own going up the mountain. Someone else will probably know the answer for sure....

Stay well!

Mackie
_________________
41F, VATS w/mechanical pleurodesis and parietal/visceral pleurectomy-Sept. '08

Trainee Blebber Joined: 13 Feb 2010 Posts: 17

Aircrafts are not pressurized to the air pressure at sea level. At cruising altitude, they have more or less the same pressure as you would find on a 2500 m high mountain = my telescope-mountain.

Trainee Blebber Joined: 13 Feb 2010 Posts: 17

Just a short update: I am getting better and better (with a few small dips here and there, maybe psychological things caused by stress).
Today I went up to a place at 1460 m altitude, 1000 m lower than the telescope, and it was all fine. Today was also my first time driving a car and swimming in the sea since I got sick. I really feel that I am getting better now.
The 11 May I will go to the observatory for one night of observations. Hopefully that won't cause any problems, even though I am a bit nervous about it.

Trainee Blebber Joined: 13 Feb 2010 Posts: 17

Ok, things can change fast. The night before yesterday, I started to feel these funny clicks in the lung again. Went straight to hospiral, where they after a few hours wait concluded new SP (20%). Yesterday they installed a Heimlich valve, and I was flown in helicopter to the University hospital in Tenerife. I was told I was supposed to get surgery today, but due to more urgent patients I am currently waiting for a free slot.
They have replaced the Heimlich valve with a pleurivac.

This time the chest tube is from time to time horribly painful, especially in the back. The doctors say it is normal, and yesterday I got loads and loads of pain killers.

Posted: Thu May 06, 2010 1:07 pm Post subject:

Hang in there. Good luck with the procedure. Sorry it come back so fast. Sad

After they are done with you lets hope you get no more flats. Smile

Trainee Blebber Joined: 13 Feb 2010 Posts: 17

Ok, surgery was done Friday around 11am. I woke up at 2pm, and had to stay in the "wake-up room" until 1am. The pain wasn't too bad, but I felt a bit numb in the chest.

In the morning I got horrible pains in my side with every inhalation, could not stand it at all, and after 40 minutes of excruciating pain, they realised that the electrical plug for my epidural anaesthetic was pulled. After putting that back in, things went a bit better. Next step was nausea. The last thing I ate was my dinner on Thursday evening. When I started to get some tea on Saturday morning it all came back up, together with some stomach acid... I continued vomiting liquids through-out the Saturday, probably because of the morphine. Today they could reduce the morphine and my nausea got reduced. I could eat a little bit for lunch, and in a few hours it is time for dinner.

I have some hiccuping and/or burping which is a bit annoying because of the pain it inflicts. I also notice that my right side feels very stretched out when I try to stand straight (had the SP on the right side). I suppose that it is just to keep walking and doing breathing exercises on a regular basis and it will hopefully get back to normal. The doctor says that she will let me go home tomorrow if X-rays look good.