Post Pneumothorax: Your experiences please.

Meredydd · November 2007

Anyone here had a pneumothorax (collapsed lung in layman's terms)?

Had one a few weeks ago. Few days in hospital, and got advice there on when I could return to exercise.
Started cycling again this week. Gently. No great efforts, mainly flat with only small hills. Been walking before that, pretty much every day since I was discharged.
Generally feeling fine, and riding isn't taking too much out of me. But I have a nagging sensation in and around my shoulder / collar bone / upper chest, a bit like a stitch, which I'm sure is related, and which I had for when exercising for a while, few weeks, before the collapse. Fine riding last night, but it's there this morning.
Not getting a lot of info from the quacks, who are waiting for the follow-up x-rays in a couple of weeks.

I'm not worried by it, just wanted to check it against anyone else's experience if anyone else has some. I presume it's either sort of bruising, or it still resolving.

Anyone?

ut_och_cykla · November 2007

I would take it easy myself. Nagging pain might (only might mind!) be heart related especially as its execrcise related and was there before your lung collapse.

Having had lung problem I would stick to light duties/efforts until fully cleared/explained what the pain is.
Look after yourself!

Meredydd · November 2007

Cheers. Thanks for the thought.
Heart is in the clear. Even if symptoms got NHS Direct excited. ECGs fine - which was a bit of a foregone conclusion, but done in A+E anyway just to be on the safe side. The discomfort definately related to the lung.

It may seem an odd question to have asked here but spontaneous pneumothorax are suprisingly common amongst young otherwise fit and healthy men, particularly tall skinny ones, so seemed a fair chance that someone here might've some experience they could pass on.

fossyant · November 2007

It's probably related to the damage to your lung taking time to recover - take it easy and don't over do it....

I had a bank of ECG's earlier this year as a health check up, the doctor looked at the report and said....If I didn't know better, this says you are about to have a heart attack... :shock: :shock: :shock: :shock: :shock:

Don't worry she said, it's not unusual to have this when someone is pretty fit...... my husband has a similar readout.......phew.....

ut_och_cykla · November 2007

Yes we have a young lad in our cycling group - tall skinny, v.fit, ex-dancer who's had two sessions of partial collapsed lung. He was sore under his armpit for weeks afterwards but is now completely fine.

chrisw12 · November 2007

I've always wanted to tell my story on this, but no one on here ever asked

I did our Christmas hill climb a few years ago and whilst eating the clubs christmas lunch I experienced a sharp pain in my back. Next day I had what I'd call flu like symptons but much worse. Went to the gp's and he sent me for an x-ray. X-ray said I had a pneumothorax. Sent to hospital and after many many many needles, lung was drainned/pumped back up. At this point I 'think' I had some conflicting advice, some doctors said stay away from exercise but I'm sure the specialist said 'all exercise is good, go and win the tour son' Well that's what I thought she said and that's what I told everyone (in part that's what she did say.)

I don't know what caused it, it probably was the hill climb, but I didn't have any pain or symptons until a good 2 hours after

Four months later (April), I'm out doing some interval work. I come home and don't feel too great and suspect the same thing has happened (again though no pain during the ride!). Now I'm your hero type :oops:

so next day I rode a 30 mile tt. From the start I didn't feel too great but as said I was going for the Rambo award so I completed with quite a decent time with one lung. The drive hoime was very painfull, so straight to hospital again.

So another pneumothorax, more needles, I think there were 24 in all (hey I'm a maths teacher I like to count things ok :twisted: .) Each 'drain' took three?? and I think it took them 8 goes to get it to work over the course of a few days.

At this point I had cured my needle fear but I still didn't feel I'd done enough for the Rambo award so

Back on the bike and into training for the Welsh 12hr and 100 tt champs. Doctors were slightly p off with the number of needles used so put me on the waiting list for a 'glue operation' on the lung. Lucky me, beggining of August there'd been a few cancellations and I'm having the op. Some process where they irratate the lung so it sticks to the cavity wall. Well it worked, I became very irratable. A few days in hospital then a day home and I'm back on the bike. It's now very hard, this time recovery takes longer, I'm going so slow I get caught and overtaken by the postman in a training ride, but two weeks later I do the 100 and beginning of Sept I do the 12hr. :shock: I'm now indestructable by the way as I know no that one lung will never ever collapse 8)

Now the advice (of an idiot.) The way I see it, if you've had one, you'll probably have another, if you've got pain there, go and get it checked out. For me, I don't know if the second one was a result of the first, probably was, but since I'm not certain how the first one 'spontaeously collapsed', who knows. The feeling I got with the doctors is they don't really know what causes them in these situations. I could have stayed off the bike a lot longer and been ok, but who knows. Yeah, rest, but if I did it all again, I'd probably do it the same way and ride as early as I did.

By the way. I'm young, very good looking but not skinny, in fact very muscular (that's why they couldn't get the needles to work!)

Dan Smernicki · November 2007

I had a pneumothorax a few years ago, and although it recurred (spontaneously) once, it has never caused any real issues with riding. Everyone is different, and I would go with your doctor's advice on this, but as I understand it, there should be no long-term effects once it has healed. I've continued to have twinges like you describe - they are apparently caused by "adhesions" - the area of scar tissue caused by the original injury catching on the lining of the chest wall - and nothing to worry about unduly.
My doctor explained that pneumotharxes are most common amongst tall, slim fit men and nobody quite knows why...
Hope it all heals smoothly.

Meredydd · November 2007

Thanks for your replies everyone.

Chris, you trump me and then some. Until I read your story I was quite proud of the reaction of the house officer who admitted me when I told him that I'd stopped to catch my breath, walked for a bit and then run home - "Have you seen your x-rays!?!" Went for a three course dinner after that too, before finally going to hospital some 4 hours later.

Dan - thanks for the info, very reassurring - I was presuming it was something like that.

I took the weekend off this weekend. Generally knackered and a bit run down. Feeling better today so will most likely ride tonight and see how things feel. Will be making sure I see the gp once they've got the follow up x-rays, even though they reckon there's no need unless they highlight any abnormalities.
Putting weight on, which on top of year when I've ridden little one way and another ain't great.
Next question is whether I can go skiing in February.

jimmoffatt · November 2007

I was sprinting to win a race at Hillingdon in April of this year, crossed the line in second place but was clipped by the rider in third who threw his bike and caught my elbow. Down like a sack of spuds, somersaults and brought a load of others down with me. The guy who clipped me stayed up and was given second and I was given third :evil:

Anyway, the point of all this is that I did not feel too good and sat on the road for a bit. I couldn't breathe and the pain in my chest was bad. I thought I must have broken some ribs. I had virtually no skin or kit on my right hand side, wrecked helmet and covered in blood.

I was the only rider from my team in the race and I had to get somebody to help me because I couldn't even undo the skewers to get my wheels off to put the bike in the car. Got the bike in the car and drove 45 miles home around the M25. Frightened the life out of a guy serving petrol because I had to fill up and paid still in my shredded racing kit.

Got home and my wife took me straight to hospital. Road rash was cleaned but I had to wait for about 4 or 5 hours before I was properly seen and was told that I had broken a few ribs and had a collapsed lung.

They had to remove the air from the outer lining of the lung (pleural cavity). Hysterical because it was a Consultant and a trainee Doctor. The trainee was terrified of the Consultant and kept closing the tap when it should have been open and opening it when it should have been closed. It took ages to do it and in the end I told them that I would operate the tap because they kept blowing air into the pleural cavity instead of sucking it out

The consultant told me that exercise was the best thing to fully inflate the lung and I was on my turbo as soon as I got out of hospital, about 3 days after the crash. This was despite the threat of divorce lawyers.

It was in April and I have only just started feeling exaclty as I was before the crash, although I have raced and ridden half a dozen hard sportives. Still had a pain in my chest on the crash side until a couple of weeks ago and I put it down to the broken ribs rather than the lung. I went back to the hospital a couple of months ago and had loads of tests including an ECG and everything was fine but I was told that it can take up to a year before the lung is back to normal.

Meredydd: mine was not a spontaneous collapse but the same result and I expect that it will simply take a fair amount of time to fully heal.

Meredydd · November 2007

Thanks Jim.
That sounds horrendous. Glad you're feeling back to normal now.

The bit about the aspiration sounds familiar. Always like to think I've done my bit for NHS training when I've been in hospital. Chest drain was put in in A+E by someone clearly doing it for the first time, and with an audience of 5 or 6, juniour doctors, student nurses etc. Aspirated a couple of days later, as it wasn't fully resolved, by a junior reg overseen by a SHO, he, the reg, was more nervous about it than I was. Managed to screw up at the end and pop the plunger out of the syringe, but luckly the SHO had closed the valve.

I rode again last night and things are pretty uncomfortable today, but it's not giving me any problem breathing and doesn't feel at all like the collapse or residual unresolved bit did in that respect, so I guess it's just a case of getting on with it and waiting for it to come right.
Not much choice really, 'cause if I don't start riding regularly again soon I'm going to need a whole new wardrobe.

chrisw12 · November 2007

Seems like the doctors are having trouble with the aspirations all round then. It's not a nice experience but according to my wife, not half as painfull as giving birth :roll

Stig-OT-Dump · November 2007

To get a good medical opinion you could contact the hyperbaric medicine unit - http://www.hyperchamber.com/ (using a general number, not the emergency one).

A pneumothorax is a problem that can affect divers, they will know the best treatment and aftercare. I know one of their doctors is a bit of an expert on that sort of thing.

I have found them to be more than happy to help on a range of topics (although they were diving related) - and they always seem to be generous with their time and expertise.

Meredydd · November 2007

Thanks for the suggestion Stig.
I'm now in touch with a leading expert in respitory medicine so hoping to get good advice there.

Rode this weekend. Very, very slowly. Saturday was a real grovel. Yesterday was a little better. Think it's going to be a long old slog back to fitness, more thanks to asthma than the collapsed lung, but the one doesn't help the other.

Thanks everyone.

Stig-OT-Dump · November 2007

Hope it helped. Like I said, they were very good to me.

EmergBiker · November 2007

I'm usually on the blunt end of the needle with the pointy end going into the patient! It's helpful and interesting to read your experiences of pleural aspiration (the needle, 3-way tap and syringe method) and chest drains (if the aspiration doesn't work, or it's really big).

Aspiration is usually fairly well tolerated, but chest drains can be most unpleasant if not done well, i.e. with inadequate analgesia/local anaesthetic. The old method was to put a large drain in (up to the size of your little finger, or even more), but now most places should be using a minimally invasive technique which is far less painful. We use a drain smaller than a biro for simple pneumothoraces. The biggies are kept for draining blood, pus and mushrooms (long story).

Why shoulder pain? The pleura is the lining of the lung and chest cavity. Only the bit on the chest wall has pain receptors so that is where the discomfort is coming from. It is poorly localised by your brain, which often mistakes the pain to the shoulder, so that is probably where your discomfort is coming from (there a dull embryological reasons as well). Perhaps this may even be a good thing as you do want your lung to expand and reach the thoracic wall.

If you are concerned about a recurrence get more advice and possibly a chest X-ray.

If you get several recurrences then there are surgical options to strip the pleura completely (usually keyhole surgery), which will stop it happening again. Some people still inject talc into the pleural space to try and create an inflammatory reaction which will cause the lung to 'stick' to the chest wall.

Info on recurrence rates at http://thorax.bmj.com/cgi/content/abstract/52/9/805 though it's not a great study.

I hope you get well soon and enjoy getting back on the bike.

S

chrisw12 · November 2007

emergbiker: that's a great response, thanks for the info. and thanks all for the memories.

I had the talc in the end, I didn't know there was another procedure, I'm a bit disappointed, it sounds a bit more hi-tech, key hole surgery rather than talc!

Does this mean, for me, that this will never happen to the same lung again?

EmergBiker · November 2007

It's much less likely, but as the old saying goes "there are no 'always' and no 'nevers' in medicine".

bw

E

EmergBiker · November 2007

It's much less likely, but as the old saying goes "there are no 'always' and no 'nevers' in medicine".

bw

E

Meredydd · November 2007

EmergBiker thanks for the reply and the wishes. Very interesting stuff.

I'm back on the bike and it's gradually getting back to normal but still some way to go yet.
Follow up x-ray and consultants appointment next week.

Cheers.

Meredydd · January 2008

Had a second Tuesday night. Just when I was getting some fitness back and back to riding in earnest (50m rides on each of the preceeding weekends)
Tiny, tiny one, so not at all painful or worrisome, just that recognisable bubbling sensation in my chest. Took myself to A+E (after the usual preperations / procrastination), aspirated there, kept in over night, discharged mid-afternoon the next day. Attempted to set a new record for visitors with a constant procession of friends who work at the hospital.
Appointment with respiratory outpatients Friday and referred to Cardio-Thoracic surgery for operation.
Most likely resulting from having succumbed to a virus / cold that's beend doing the rounds, and that's increasingly getting to my chest - the cough that goes with it being enough of a strain for a pop.

So, I guess that's skiing at the end of Feb out of the equation - though I'll be sure to ask tomorrow ;-)

EddieC · February 2008

I've just been to the doctors with pains in left shoulder and in left side of my chest.
He is concerned that it maybe a pneumotharx (I'm all tall and skinny so fit the bill!) so am now awaiting results from the xray.

I hadn't even heard of it before but it's amazing what a few google searches reveal. Was initially very worried but by the looks of what I've read on here and elsewhere it does look to be successfully treatable.

Assuming this is the case, I was just wondering whether anyone who has recovered from this condition find that they can still perform to the same level they did previously?

Hopefully my wife doesn't read this as she'll be saying that's the least of my worries!!

jimmoffatt · February 2008

EddieC

I had mine last April (see posts above) and was riding well at the end of the year and even won a couple of races.

Bit wary in the bunch sprints though :shock:

Jim

chrisw12 · February 2008

EddieC wrote:

I've just been to the doctors with pains in left shoulder and in left side of my chest.
He is concerned that it maybe a pneumotharx (I'm all tall and skinny so fit the bill!) so am now awaiting results from the xray.

I hadn't even heard of it before but it's amazing what a few google searches reveal. Was initially very worried but by the looks of what I've read on here and elsewhere it does look to be successfully treatable.

Assuming this is the case, I was just wondering whether anyone who has recovered from this condition find that they can still perform to the same level they did previously?

Hopefully my wife doesn't read this as she'll be saying that's the least of my worries!!

Eddie re-read my original responses. As I said I have had no loss of ability/fitness/form since I've had the operation. I now feel a bit indestuctible as in theory the lung should never collapse. Saying that I only had a few months of training in between the first episode and the eventual operation and if I remember correctly, I became very cautious and very reluctant toi push myself, for example I refused to do hill climb events even though I'm a superstar at them (that's a complete lie. :roll: )

I suppose it's like any injury in that you become very cautious about doing it again.

Meredydd · April 2008

Hello all!

An update, in case anyone is interested.
Scanning the thread I see my last post was January just after I had the second. Since then I had a third, huge one in February, almost exactly a month later - ironically, immediately after being discharged from out-patients with a clean bill of health and before I'd even got off site. Spent 4 days in hospital with a drain in on suction. Ended any hope of going skiing, was discharged the day I was due to leave.
Prioritised for surgery and admitted a fortnight later. Proved to be relatively painless, not much worse than having a chest drain in anyway.

I'm now about 7-8 weeks post surgery and have just had my review. I've not cycled much further than the shops in 4 months. I've just started exercising again, with a running programme as it happens, and have been pleasantly suprised by how quickly I'm regaining fitness, despite not feeling quite 100%.
I think for cycling though it's going to be a long slog back to the endurance and the, little, power I had previously. Patience will doubtless be the most valuable of virtues.

Post Pneumothorax: Your experiences please.

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