The "Star-Shaped" Lung Collapse
May, 2005: Just hours after moving into a new apartment on Sawtelle Blvd in Los Angeles, my left lung collapsed. This collapse was more painful, frightening, and debilitating than any previous collapse. I was alone and incapacitated by the pain and shortness of breath, so I called 911. An ambulance brought me to St. John's Hospital in Santa Monica. A CAT Scan revealed a 40% collapse and I was soon introduced to Dr. Ward Houck, the first surgeon who ever took time to explain what my condition meant and precisely what he was going to do to help. Dr. Houck told me that my lung had actually collapsed into the shape of a star. While the majority of the lung had collapsed, tiny pieces of my lung were still stuck to the roof of my chest cavity. This occurred because an operation years earlier had surgically attached my left lung to the roof of my chest cavity (a "Pleurodesis" lung surgery). Therefore, while most of the scars had since loosened their grip, some of them remained, resulting in the unusual "star-shaped" lung collapse. Unfortunately, this awkwardly collapsed lung resulted in even worse pain than usual. Doctors at St. John's kept me on heavy doses of dilaudid and morphine for two days, until Dr. Houck finally had the chance to operate.
The Pleurectomy:
Dr. Houck performed a complete Pleurectomy on my left lung. During my previous surgeries, doctors had scraped the surface of the lung with a scalpel to cause bleeding and scarring. During a Pleurectomy, Dr. Houck tore off the lining of the lung to cause even more extensive bleeding and scarring. It may sound unusual that I use the word "tore" but every time Houck described the procedure, this is exactly the term he used (rather than "remove", "cut" or some other more friendly sounding verb). Anyway, the more scarring a lung surgery creates, the stronger the lung becomes, and the less likely it is to collapse in the future. This type of surgery is only used when a patient like me suffers multiple, repeat collapse lungs, and when the first round of surgeries have failed. The lining of the lung is known as the pleura, hence the surgery is called a Pleurectomy.
While all lung surgeries are very painful, this was the most painful of the five I underwent. The pleura is terribly sensitive and my surgeon later described a Pleurectomy as a "brutal procedure". While it was surprising to hear such candor, I appreciated his honesty and felt more secure knowing that I was not a "wimp" for having felt so much pain throughout my recovery. I also had complications from this surgery. During the first three days after the surgery, I bled a lot and received four blood transfusions. I also shook and shivered uncontrollably for some period of time which caused further blood loss and increased pain. I did not have an epidural (I was told later that an epidural is commonly used for this type of surgery). Also, when doctors switched me from IV morphine to Vicodin pills, I had a very bad reaction and threw up for 18 hours. The Vicodin also caused frighteningly vivid hallucinations. Once nausea set in, I was unable to hold down any form of pain killer. As is often the case, once post-surgery pain spiraled out of control it was difficult to manage.
I don't merely list these things to complain or to show off what I've been through. I use them as illustrations of one of the most important things I've learned through all my hospital experiences, which is that very frequently a surgery or hospital stay leads to further, unanticipated problems. If side effects and complications are minimized, the patient's hospital stay will be shorter and more pleasant, but it is extremely difficult to predict or anticipate the problems and glitches that occur along the way. I imagine that most people who have been through any type of surgery or hospital stay can attest to this.
Behind The Music:
This collapsed lung episode was also memorable because the LAFD and EMT responders could not find me in my apartment and I was left helpless for quite some time. 911 also put me on hold when I called them. This experience and the resulting surgery are chronicled vividly in my song: "That High" (www.dannfuria.com/thathigh).
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