My lung collapsed, and I need advice...PLEASE

[schleifdog]

I am a dedicated amateur tuba player (mostly sousaphone), and two weeks ago, I was struck with a spontaneous primary pneumothorax of the right side.

Non-medical terms: my right lung spontaneously collapsed. PLEASE let me know if you know anything about this, and what it means for how long til I can play tuba again.
If you're familiar with the condition, here's a few more details that could help you give me some advice:
-My lung did not heal on its own after five days with a chest tube in place.
-As a result, the doctors proceded with surgery, a pleurectomy, to remove any remaining blebs and pull the lung back into contact with the pleural lining.

I have heard everything from two weeks to six months, and the doctors haven't been able to help. I ask "How long til I can play tuba again?" and they just kind of laugh and say, "that's not the question we usually get when this happens to someone."

Please help! Playing the tuba is my major creative outlet; one of the main things in the world that makes me happy, and not knowing how long I'll have to stay away from it is driving me crazy and making me seriously depressed. My brass band is like a second family to me and not being able to play with them is horrible.

Thank you for any help you can offer
-Dan

[trseaman]

Sounds like a scary condition, best wishes and get well soon...

Tim

[XtremeEuph]

Very sorry that happened, lets hope you at least can eventually play tuba sometime soon.


Get Well



Kevin

[schleifdog]

Thanks for some quick responses and encouraging thoughts.

I just wanted to clarify what I'm asking for, based on Brian's response:
"No one on this board can answer that for you, not even if they have had a situation similar to yours and are a collapsed lung specialist at their day job. Only your doctors will be familiar enough with YOUR situation to be qualified to help you answer this question."

I know that no one here can give me the perfect answer for my situation, but I hope that someone who's experienced this, or knows someone who's experienced this, might be able to tell me about their experience.

I hope to at least be able to develop a better sense of the range of healing times (I know I can do better than two weeks to six months). And if people give me their stories, I can also associate the different points in that range with the various complications and levels of severity that i may or may not have experienced.

-dan

[Paul S]

.......I have heard everything from two weeks to six months, and the doctors haven't been able to help. I ask "How long til I can play tuba again?" and they just kind of laugh and say, "that's not the question we usually get when this happens to someone.".....
-Dan

Dan,
Although I can not relate to your condition directly, I had several blood clots in my leg break loose and hit my lungs on Good Friday in April of this year. Even after a life flight and week stay in an ICU, I was on heavy oxygen at home for a few weeks as I recovered.

My doctors gave me a similar estimate to yours but encouraged me to use my tuba breathing exercises to get my lungs back in condition. The respiratory therapists that I worked with adjusted my lung recovery exercises to use my tuba mouthpiece, my Inspiron spirometer both upright as an inhalation meter and turned upside down with the mouthpiece attached as a blowing exercise, and my Powerlung breathing trainer to get me back as quickly as possible.

It will take some time but I would think that you should be able to incorporate playing into your recovery as well. Your mindset is everything and a good respiratory therapist is the next best thing. Do not rush things but do try to push yourself along so that you make a little more progress each day. I was able to start playing after about a month but I know I am going to be continuing to strengthen for a long time yet to come. Spending time each day with breathing exercises is actually something we all should have in our practice regimens at any means.

Good Luck!

[Alex F]

Unless they are musicians themselves, most MDs are not going to be sensitive to your musical needs. In fact, my extensive experience with the medical profession indicates that they care little about what you do outside their office.

There are a number of specialty practices that deal with folks in the performing arts. One such practice is here at Northwestern University in Chicago. I believe there's one in Cleveland as well, and there are others. If continued playing is vital to you, as it appears it is, ask your doctor for a referral, or do some research on your own.

Here are some links to try:

http://www.artsmed.org/

http://departments.ithaca.edu/pt/facsta ... ingartsmed

http://medicine.iupui.edu/perart.html

http://www.medschool.northwestern.edu/n ... c-med.html

This last link talks about the NU program, I could not find a direct link. Dr. Alice Brandfonbrener, the wife of my late father's cardiologist, runs the program.

I hope this helps. Best wishes to you.

[schleifdog]

Your age, lifestyle, including diet and a logical supposition for how this happened are all things that it would be important to know.

Sure, I'm 24 years old, eat well and don't smoke, nor am I overweight. I have a fairly stressful schedule.

a logical supposition for how this happened

Now what I'm about to write is elementary to anyone familiar with spontaneous pneumothorax, but sounds ridiculous to anyone who's new to the subject:

When I said "spontaneous" pneumothorax, I meant it. According to all the literature, this can happen somewhat randomly to otherwise healthy, tall, thin males in their twenties. That's me.

My doctor, is, in fact, convinced that at best, tuba playing might have contributed, but only by bringing it on faster, not really as a primary cause.

[Rick Denney]

When I said "spontaneous" pneumothorax, I meant it. According to all the literature, this can happen somewhat randomly to otherwise healthy, tall, thin males in their twenties. That's me.

I know a fellow who had the same condition during a run. He was very healthy and reasonably fit, and was in the same tall and thin category associated with this condition. I'll send him a message asking him how long it took him to feel like he'd recovered. He won't have any reference to tuba playing, but it'll at least give you one data point.

Rick "stay tuned" Denney

[brianf]

Where are you located? If you are near So. Calf, there is a resiratory specialist I know who plays the euphonium. He'd be the one to set up an appointment with. Email me off the list.

[Mitch]

As posted - nothing here should stand in place of the advice of your physician(s).

I suffered a tension pneumo in 2000 as a complication arising from an episode of protracted, biphasic anaphylactic shock. My lungs wouldn't release air, so every inhalation, whether while conscious or unconscious/assisted, increased the pressure in my lungs until a rupture released air into the thoracic cavity. Unlike the spontaneous variety, tension pneumo is a life-threatening condition that will not resolve on its own. Add that to the other things and by the time they called my folks who lived 4 hours away, they told them I wasn't expected to last as long as it would take them to get there.

The first measurement of my vital capacity after this episode was 1.7 liters (I had been at 5.2). It took a while to get back to normal (place your arguments here about 'normal'). But, I played a gig about a month after I was out of the hospital. It wasn't easy; I couldn't come close to filling a 5-liter bag at the time. It was frustrating in that I knew how I used to be able to play, how long I could make a phrase, etc., but my body just couldn't do it. But I could play.

I knew someone (a tubist) who suffered from a few spontaneous pnemo's, and eventually worked with a surgeon who performed a procedure to reattach the lung to the chest wall. I believe it was the same physician who took the effort to research for this tubist and could find nothing in the literature stating that playing an instrument was the cause of a spontaneous pnemo.

I had improvement from regular use of the incentive spirometer and a form of physical therapy for the musculature on my left side. I probably felt more discomfort/limitation from the "stab wound" where they put in the chest tube (one of the dr.'s described cutting for a chest tube as "the single-most barbaric thing we do in the e.r.). It was a while before I felt like I could comfortably experience expansion on my left side.

I don't know about the other devices, but the incentive spirometer is not a device that's supposed to expand your capacity. The inventor of the incentive spirometer is a friend of mine I came to know shortly after this episode. It was developed out of a study exploring the high incidence of post-operative pneumonia in the 60's. It was developed to give patients a visualizer for inhaling to a certain point (hence the name). Patients who'd been through thoracic surgery were more likely to take shallow breaths for a long period of time, which leads to collapse of the lower alveolar branches, which leads to retention/collection of fluid in the lungs, which can lead to pneumonia. Simply taking a deep enough breath re-inflates those alveoli, which prevents the condition.

Be sure to follow up with your physician(s) to monitor and watch for blebs as much as is possible and the potential ensuing problems.

Beyond that, pace yourself sensibly. While yours is a situation that doesn't offer any warning or symptoms prior to occurence, I can't help but think that as long as the lining of the lung didn't tear or rupture, you should be on the fast track to recovery, relatively speaking.

[tubatooter1940]

When I spent 9 days in the hospital with a five-way heart bypass, the lung specialist and his crew had at me, as well. The heart surgeon cut the tissue that anchored my lung muscles when they sawed my breastbone in two. I would have understood had they explained it to me. All I knew is I needed the oxygen mask to breathe the first week.
I had to walk three miles a day by the second month after surgery and trying to go up hills too soon set me back and delayed my healing. Nobody told me I needed to walk on the straight and level.
I see now I should have Googled up my condition on my computer and done some research on my own before my surgery.
I won't make the same mistake if there is a next time.

[Rick Denney]

stay tuned

Okay, I heard back from my colleague. His episode also required surgery. He was riding his bike (he is a recreational cyclist) in two weeks, and he felt back to normal in about six. He says the only last effects were the scars, and those "make him look tough".

Whether his case was more severe, less severe, or similar to yours I have no clue, but like said, it's a data point.

Rick "noting that my friend didn't measure his comeback in tuba terms" Denney

[schleifdog]

Thank you to everyone who's taken the time to respond! Every bit of sympathy and advice helps.

-Dan

[windshieldbug]

I know it's not the same, but after my crash I had pneumonia which required them to cut one of my lugs open. After a reasonable time for healing, I can still play (and believe me, air is the least of my problems now).

I did have to put away the horns I had been using professionally in the orchestra and restart with my 184 quintet horn, but I would hazard a very unprofessional opinion that playing is still in the cards. Just let yourself get better, then take your time.

When I use one of my old horns now, my stand-mate complains that he can't hear himself play...

[Donn]

In case any fourth-hand, anonymous medical advice is called for at this point --

I mentioned this matter to the lady of the house, who asked a co-worker who is a pulmonologist, who asked another pulmonologist ...

His thought was that as long as he is ex-tubated and not in pain, it should be fine to play again.

He also told us of a piece composed in the 19th century (he suspected Berlioz) where there was a tuba part that required the piece to be played in a supine position. Apparently the notes were to be played so long and so loud, that they were in fear of the player fainting.