42 Days With A Chest Tube + Permanent Nerve Damage
After more than a year of repeated, small collapses on my right lung, my surgeon performed a complete Pleurectomy at Cedars Sinai Hospital in Los Angeles. I had already undergone a Pleurectomy on the left lung 7 months earlier (described in Surgery #4). Like last time, the purpose of the surgery was to remove the lining of the lung (the pleura), in order to cause significant damage and scarring, which in turn "strengthens" the lung.
After any lung surgery, two chest tubes are left in place to keep the lung inflated while it heals. Once the lung heals (typically 4 to 6 days later), the tubes are removed and the lung can function on its own. If a chest tube is removed before the lung fully heals, the lung will collapse. Unfortunately, I was stuck with a chest tube for 42 days because my lung did not properly heal after surgery. Six days after surgery, my surgeon removed one chest tube. He then attached the second chest tube to a Heimlich valve, so that I could be released from the hospital. Thus began a very unusual chapter in my life.
42 Days With A Chest Tube:
The surgery was on December 12 of 2005 and by the 19th I was back in my apartment. Every morning I would wake up and cough, under orders from my surgeon. If my coughing caused a vibration in the Heimlich valve, it meant that my lung was still leaking air, which meant the chest tube had to stay in. By Christmas, my family members were taking turns, one at a time, flying from Philadelphia to LA to take care of me. I spent a very peculiar 6 weeks isolated inside my apartment in Los Angeles with a chest tube and Heimlich valve stitched into my chest. On New Years Eve, I took a picture of my unpleasant looking situation, with chest tube, valve, and stitches visible, and sent it to my friend Steve. "Happy New Years!" read the subject of my email. Steve emailed back two days later claiming he accidentally made my image the screen saver on his dad's computer. Nothing was going right for me.
Even after 42 days, I never became accustomed to the hard plastic tube which entered through my ribs and went 18cm deep inside my chest cavity. I strongly disliked changing the bandage and cleaning the wound every day. I often felt nauseated and in a lot of pain, although I later learned that most of my pain was from nerve damage and not from the tube itself. Following strict orders from my surgeon, I took slow but frequent walks around the grounds of my apartment complex, terrified that someone would bump into me and accidentally knock the tube or valve loose. My lung's "persistent air leak" finally healed after 40 days, and two days later the last chest tube was removed.
Nerve Damage:
Unfortunately, during this ordeal I had very bad pain in the right side of my chest. Once the chest tube was removed, the pain persisted and I immediately was seen by pain specialists at Cedar Sinai Pain Center who told me I had extensive nerve damage throughout the right side of my chest. The nerve damage was so widespread that they made me get an MRI to make sure I didn't have a spinal cord injury. Spinal injuries ruled out, I was told that nerve damage might improve slowly during the first 1 to 3 years, but after that it would not improve. I was scared by this prognosis, because at that time I could not stand up straight and I walked with a significant "Quasimoto" hunch. During the first 7 months, the nerve pain in my chest was so severe that I slept sitting up in a rented hospital bed. The muscles in my right abdomen completely atrophied, and have never grown back, because the nerves leading to them were also damaged or severed during the surgery. Because the nerves on the right side of my chest were greatly impaired, the rib cage on this side did not expand properly, and my upper body eventually became slightly twisted. This eventually led to back problems and muscle spasms. I still have very significant nerve damage in my ribs which makes the right side of my chest feel like it has been filled in with cement. The right side of my chest is also constantly sore with what feels like the pain of a deep bruise. I also cannot feel any skin on the right side of my chest, though this does not bother me.
I went through a long and frustrating two years of treatment for nerve pain, some of which I discuss further here. While none of the many medicines and novacaine/steroid injections provided relief, I eventually benefited from physical therapy and physical manipulation by an osteopath. I underwent physical therapy three times a week for 18 months before I was finally strong enough and healthy enough to re-start my music career.
This surgery, recovery period, and the physical rehabilitation provided the inspiration for my song "Make a Miracle Happen" (www.dannfuria.com/miracle)
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