My Pneumothorax Diary - Part 2

So what went down? After my last post, I saw my thoracic surgeon from NUH and he gave me the lowdown on what to expect for my surgery. He was very against a pleurodesis which uses talc to adhere the lung to the chest wall and suggested a VATS pleurectomy (full removal of the pleural lining to adhere to the lung instead). 🫁

He spent 45 minutes with me explaining everything in great detail and never once dismissed my suspicions that I could be having a ‘rare’ form called catamenial pneumothorax, where endometriosis causes holes elsewhere in your body, like in my diaphragm, which lead to the lung collapses.

Instead, he prepped me for the possibility of finding them and an additional procedure called a diaphragmatic plication (folding my affected diaphragm and suturing it to form a thicker wall and closing the holes). This then led to a bunch of hospital visits (blood tests, echocardiogram, anaesthetist checkup, final pre-op consult). This was over about a month after my last pneumothorax which was probably to give it time to heal properly before surgery. All this time, I went back to work and did all I could to prep my kids (school and my own) for their exams while clearing all the admin stuff for the end of the year. Somehow, doing that helped to keep my mind off things and kept me grounded.

18/10

The day of the operation. I was told to fast from 4am the previous day and to report at 10am (doc and nurse said different things 😖). So I ate whatever I wanted at 10pm the previous day and that was it. Boy did I regret not having some kopi O at 4am. While waiting in my operation gown at the clinic, I started having the worst caffeine headache. I couldn’t drink any water whatsoever or take any panadol. I had to bear with it till almost 2+pm where I finally went in for my op. (So for those scheduled for this, please get your cup of Joe beforehand.)

My anaesthetists (yes plural) were so reassuring and lovely. I remember them telling me their names and how they would take good care of me. To not be afraid. I must admit, I wasn’t though. I trusted that God would take me safely through it. When they injected the stuff to knock me out, they told me it would kick in soon and I could immediately feel the waves of unconsciousness sweep over me before the complete silence.

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I woke up to the worst pain I have ever experienced in my life and that’s saying a lot considering I have had 2 caesarean sections. All in all, my operation was extended by an hour inclusive of recovery time and I only made it back to my ward around 7ish. My husband told

me how worried he was when this happened and that the surgeon found many holes in my diaphragm. I had to have the diaphragmatic plication after all. A lot of people say that they were talking nonsense when coming out of the anaesthesia but I was thankfully pretty coherent. My family members just looked aghast because they had never seen me that way before, drifting in and out of consciousness mid-sentence. My throat was terribly sore because of the intubation tube they took out post-surgery. The whole night was punctuated by groans and moans, moments of lapsing into unconsciousness and then consciousness. I had a morphine PCA (patient-controlled analgesia) so I could ease the pain whenever I needed for over 3 days. There was a Jackson-Pratt chest drainage tube to help me drain blood and water so as to prevent infection.

The drain was only removed on Day 5 and I was released to go home on Day 6. Every single day started with a mandatory xray and blood test. There were days where I had to do more than 1 xray. I lost count of the number of pricks and bruises on my hands and arms.

This post is getting way too long so I’ll continue in Part 3.