My son had a follow-up appointment today. Everthing looks great and he is set to have his Nuss bar removed in the summer of 2014. I must reiterate that his surgeons did a remarkable job, especially because his pectus excavatum was so severe. All praise and glory to God!
This month, January, marks the halfway point for my son’s bar removal. Eighteen months down, eighteen months to go. Deo Gratias!
I pioneered a Christmas toy collection, along with my immediate family and my very generous siblings(three brothers and one sister). Today, we contributed books, stuffed animals and multiple toys that I will soon deliver to the philantrophy department for the precious children at the CMC, Augusta.
Donald Nuss, MD and the Nuss Procedure were featured in the July 22, 2002 issue of U.S. News & World Report. Dr. Nuss is pictured on the cover
Pediatric surgeon Donald Nuss, a native of South Africa, is a pioneer in the treatment of a chest wall deformity known as pectus excavatum, or sunken chest. Over the past two decades, Nuss has spared more than 1,000 children significant pain, blood loss and recovery time and also held workshops to educate doctors around the world on his Nuss procedure.
For over 25 years he was a partner in CHKD(Children’s Hospital of the King’s Daughter) surgical group’s Pediatric Surgery and was a professor at Eastern Virginia Medical School, Nuss completed medical school, residency and fellowship programs in South Africa as well as a fellowship at the Mayo Graduate School of Medicine. In 1987, he invented the Nuss Procedure for pectus excavatum by inserting a slim, curved steel bar through two tiny incisions in the patient’s chest side walls, correcting bone alignment without extensive cutting or bone removal. His groundbreaking work since has earned repeated recognition from top surgeons and national media outlets. Today, Dr. Nuss is a surgeon-in-chief emeritus and continues to counsel surgeons around the world in caring for patients with chest wall deformities.
As I previously corraborated, the pain from Nuss surgery can be quite profound. My son was in the hospital for six days following his sugery. For pain management, he utilized a self administered IV morphine drip for the first three days and then transitioned to oral pain relief medications. Because of necessary interruptions, the first night was a sleepless one, maybe three hours of sleep at best, for both of us, followed by four/five hours of sleep on subsequent nights. Yet, he caught up on sleep during the day. By the third day, he was getting stronger and more alert, thus, he was walking the halls with the beneficence of his special big brother pushing the IV pole.
I recall that I felt an incredible close bond with other parents that I met who also had a child in the Children’s Medical Center. Even though we were in a sense strangers, I felt deeply connected with them, resultant from each of us similarly experiencing the anguish of having a precious child hospitalized. I have assuredly emerged from this experience with a heightened level of compassion, especially, for children who suffer.
On day six, he was released from the hospital.The first night at home, he slept in his bed, on his back, with a wedge pillow for his head and fluffy blankets on each side of his chest. He needed help getting out of bed for several months. After several months, he began to get out of bed on his own, by putting his hands under one knee and pulling himself up. On occasion, he feels stiff upon awakening and needs a small push to assist in pulling himself up. He could only sleep on his back for a while, yet, after approximately ten months, he was able to sleep on either side without pain.
Once at home, there were only a few minor setbacks. One of his stiches did not dissolve and became slightly infected and he was treated with antibiotics. Also, the incision on the stabilizer side did not heal as prompt as the other incision, consequently, requiring roughly four months to close and heal properly.
For pain management at home, he took Motrin for one week and that was it! By then, he only experienced pain upon sneezing, laughing , or lifting his hands above his head. It seems like an unlikely problem, yet laughing did cause concern. My son endured a lot of pain when he laughed, so I had to curtail my sense of humor for four months. Believe it, or not, I began to feel blue from not being able to laugh, but I surely didn’t want him to experience any pain. Sometimes, I would inadvertantly cause him to laugh and I had to apologize. From my son supressing his laughter for so long, everything began to appear comical to him and sometimes he would literally need to run out of a room to stop laughing. Some good news, he can now laugh without pain! Because lifting his hands above his head was painful, he wore his bathing/swim suit in the shower, so that I could help him wash his hair for the first few months post surgery. Whenever he feels the urge to sneeze, he attempts to supress it.
It has now been 15 months since his Nuss Operation. For follow-up, he visits the Pediatric Thoracic Surgeons every three months, the Pediatric Cardiologist and Optamoligist once yearly. And, he will visit the Pediatric Orthopedic Surgeon, if needed, because he continues to experience posture(slumping) challenges.
The operation for correction starts with general anesthesia and preparation for the management of pain after the operation. Two lateral incisions are made on either side of the chest for insertion of a curved steel bar under the sternum. A separate, small lateral incision is made to allow for a thoracoscope (small camera) for direct visualization as the bar is passed under the sternum. It is then fixed to the ribs on either side and the incisions are closed and dressed. The bar is not visible from the outside and stays in place for a minimum of three years before removal.
Pectus message board http://www.pectusinfo.com/board/
Pectus International http://www.facebook.com/pages/PectusInternational/206954435984637
Another great link where Nuss patients share their personal stories through informational videos
Medical Alert Bracelet- Inscription should read:
Pectus Excavatum– Steel Bar In Place Under Sternum
(*CPR can be administered with bar in place, yet, chest compressions should be utilized with greater force)-(Defibrillation for cardiac arrhytmias may be performed. Anterior/posterior paddle placement is necessary to deliver adequate electrical charge.)