The story: After an afternoon swim practice, I felt a remarkably sharp pain in the back of my left shoulder blade. A few minutes later, more pain spread around to the front of my chest, up into my neck, into my left shoulder, and eventually down my left arm. In a local hospital emergency room, an X-ray showed that my left lung had collapsed. Doctors initially inserted a large needle through my chest into the chest cavity to release the pressure of built up air (this is what they did to Mark Wahlberg’s character in the movie “We Three Kings”). The next morning, however, a chest X-ray revealed that my lung was collapsed 80%. My chest X-ray looked very much like the one shown during the intro credits of the TV show “Scrubs”, except that while my right lung was fully expanded and healthy, the left lung was the size of a baby’s fist. My pulmonologist, Dr. Pasdar, was not pleased.
Dr. Pasdar quickly inserted a chest tube to reinflate the lung. Chest tube insertions are notoriously painful, and this one was no exception, but for now all I’ll say is that 5 days later I was very relieved when the chest tube was removed and I could leave the hospital. Unfortunately, one month later - after continued pain, infection, and other complications - thoracic surgeon Dr. Kaiser performed a “Pleurodesis” surgery to repair my lung at The Hospital of the University of Pennsylvania.
During the Pleurodesis surgery, Dr. Kaiser used a scalpel and other special tools to scrape the surface of the lung. The purpose of this surgery is in essence to damage the lung, causing bleeding and scarring, which hopefully will prevent the lung from collapsing in the future. This type of surgery is usually done with the assistance of a tiny video camera and is known as VATS (Video Assisted Thoracic Surgery). While I was under anesthesia, Dr. Kaiser cut three small incisions, each about one inch long, on the left side of my chest. He then placed a video scope through one incision and used the other two incisions to operate on my lung. Dr. Kaiser said he also removed several congenital blebs (weak spots on the lung) which likely caused the initial lung collapse. During the recovery period, I had two chest tubes, which is typical after any lung surgery. The chest tubes are attached to a machine, a Pleurovac, which lightly suctions air through the tubes. The chest tubes and Pleurovac keep the lung inflated while it heals from surgery. The tubes also allow blood to drain from the chest cavity. When the lung has finally healed, usually 4 or 5 days after a Pleurodesis surgery, the tubes are removed and the patient is free to go. Thus, 5 days after the surgery, my tubes were removed and I was released from the hospital. I recovered very quickly and was back to full activity, even swimming and diving again, within a month.
Unfortunately, over the next 15 years my lungs would continue to collapse, resulting in many more surgeries and complications. It was a long time before I came to understand the cause of my lung collapses. People like me have a genetic condition that causes weak spots to form at the top of the lungs. The weak spots are known as "blebs". If an inflated balloon gets a hole, even one the size of a pinhole, it would begin to deflate. This is similar to what happens when a lung collapses. If a weak spot or tiny hole in the lung causes an air leak, the lung will collapse. This is known as a spontaneous lung collapse, or, as the doctors would call it: a "spontaneous pneumothorax". While this condition is widely believed to be genetic, researchers have yet to identify the gene that causes weak spots (blebs) to form on lungs.