Pectus Excavatum Journal

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.