I wish I could have responded sooner but I was travelling. Smoking, and smoking cannabis have been implicated in the development of spontaneous pneumothorax in young (otherwise healthy) patients. Note that ultrasonography is the only radiographic modality that allows patients with nonarrhythmogenic cardiac arrest to continue undergoing resuscitation while clinicians search for easily reversible causes of asystole or pulseless electrical activity (PEA). 98 (7):579-90. If the answer is an open thoracotomy – I would definitely seek another surgeon. Please see your family physician regarding this cough. I have recently had a spontaneous pneumathorax and was submitted to hospital. I am older but had 5. I have been told from 2 weeks to 2 months by different doctors. The lung is made up of lung tissue itself (consisting of alveoli, bronchi and bronchioles) and a thin, membranous covering called the pleura.  This covering serves to prevent inhaled air from travelling from the lung to the area inside the thoracic cavity.  ‘Blebs’ are blister-like air pockets that form on the surface of the lung.  Bulla (or Bullae for pleural) is the term used for air-filled cavities within the lung tissue. (These studies are considered the strongest evidence available). Urgent care centers and walk in clinics are great for cuts, and colds but not specialty care. As for flying, due to the pressure I would tell you to follow medical advice. After his last surgery which is in June 2013, he is feeling pain in his chest areas. [Medline]. What may have caused this illness to come about? You sound like a wonderful, caring and supportive brother, which is something he needs right now. Any useful information on this would be appreciated. Other important points to keep in mind include the following: A study by Chen et al found that pleural abrasion with minocycline pleurodesis was as effective as apical pleurectomy for patients with PSP with high recurrence risk. The sealant also reportedly shortens the duration of postoperative alveolar air leaks. Unfortunately, there is not enough published literature to be able to delineate or determine the extent of the risk (or how often this occurs). [Medline]. My question is to all of you is, can the Emphysematous Blep do more damage in the two months prior to me being told on 10/7/2013. Thank you for all the information here! The surgeon said that was it for surgery’s. VATS is an alternative to thoracotomy and is performed with the patient under general anesthesia using a camera and small trocar access ports. When a patient is on positive-pressure ventilation and normal respiratory function is preserved, routinely follow up decompressed tension pneumothoraces by watching for recurrence of the condition. Severe acute respiratory syndrome complicated by spontaneous pneumothorax. Givens ML, Ayotte K, Manifold C. Needle thoracostomy: implications of computed tomography chest wall thickness. 35(2):144-5. This was the 4th time I had to be hospitalized. It depends on the cause of bleb. 2004 Mar. I am (obviously) not a legal consultant – but serum studies would provide a more definitive answer, so maybe you can steer the case that way. My 17-y.o. Consult your surgeon rather. Two questions: Would doing the blebectomy and the Pectus bar placement for his Pectus Excavatum at the same time be advisable? Secondhand smoke gave me a bleb, which burst and collapsed my lung. 2007 Oct. 132(4):1146-50. Good luck. However, tetracycline no longer is available for pleurodesis because of stringent manufacturing requirements. The room had flooded several years ago and they cut out the walls but did not replace the floor. Is that a bad idea? Delayed tension pneumothorax complicating central venous catheterization and positive pressure ventilation. Early article suggesting VATS for treatment of spontaneous pneumothorax (1997). Evidently the pleurodesis helps prevent other collapses, but it also causes problems with future surgeries on that lung. Surgery for pneumothorax. Her right lung was collapsing and when chest tubes didn’t work docs finally declared surgery. I dont know what to do, i havent s lot of energy at the moment, im off work – help. (Removing the TB may be your best option, if you fail treatment again). Thus, this procedure is considerably less invasive and less expensive, but it is also less effective, particularly in inexperienced hands. [Medline]. 2007 Jan. 188 (1):37-41. I do get shortness of breath when walking up a lot of stairs and have pain often in my right upper to mid back. http://www.ncbi.nlm.nih.gov/pubmed/22692754, http://thorax.bmj.com/content/53/suppl_2/S20.long. J Trauma. I had my blebs stapled and an abrasive rub to attach my lung to my chest wall 2 years ago. Most paramedics are trained and protocolized to perform needle decompression for immediate relief of a tension pneumothorax. [Medline]. Zhang M, Liu ZH, Yang JX, Gan JX, Xu SW, You XD, et al. BMJ. My doctor has never mentioned or (as far as I know) ever investigated any underlying causes of theese blebs, they have all just said they dont know why they are there. Again these are minor never keeping him out for more then two weeks then being fine for a couple months at a time. However, any plain radiograph (chest x-ray) would have shown a pneumothorax during your previous admission. Chest tubes are invasive but the young recover remarkably fast. Nonetheless, its derivatives minocycline and doxycycline have been shown to be successful sclerosing agents. Clearly, the use of analgesics can provide patient comfort until the thoracostomy tube is removed. 12(4):268-72. They wrote me off as a drug seeker. When I applied for surgery at UW medical center for another surgery, they declined to do it, saying because of the old surgery I was possibly too scarred to benefit from another resection. Unfortunately, other than smoking cessation (for current smokers), there is no known diet, medication or other lifestyle changes that can prevent bleb rupture. Without knowing much more about him or the severity of his blebs, it’s hard to say. Risk factors and treatment. Removing such clothing items from the wound may facilitate decompression of a tension pneumothorax. [Medline]. Simple aspiration versus chest-tube insertion in the management of primary spontaneous pneumothorax: a systematic review. There are currently some procedures that are less invasive then the resection surgeons used to do, but I believe the type of operation depends on the individual, the seriousness of their condition, location of bullae, previous operations…etc. [70]. [Medline]. The main diagnostic and therapeutic indications for medical thoracoscopy are pleural effusions and pneumothorax. Symptomatic but clinically stable - Treatment is guided by local resources and conventions for the site of care; the British Thoracic Society (BTS) advocated for simple aspiration and deferring hospitalization in primary spontaneous pneumothorax (PSP) as initial management if the patient is stable, Clinically fragile - Treatment is guided by local practice patterns for air evacuation and observation; comorbid conditions may preclude observation because of decreased cardiopulmonary reserve, Life-threatening - Pneumothorax that causes hemodynamic instability is life-threatening and must be treated immediately with tube thoracostomy; all documents and recommendations call for intervention if a patient is unstable, Very likely to resolve - Small pneumothorax in a hemodynamically stable patient without significant parenchymal lung disease; small iatrogenic pneumothorax, May resolve - Large pneumothorax in a normal lung (eg, PSP or iatrogenic pneumothorax), Unlikely to resolve - Secondary pneumothorax, enlarging pneumothorax (suggests a continuing air leak), Will not resolve, could be fatal - Tension pneumothorax; unrecognized air leak, Unlikely to recur - Iatrogenic pneumothorax in normal lung, May recur, but patient will likely be clinically stable, May recur and the patient may be clinically unstable, but emergency care is readily accessible, Very likely to recur - Diffuse and progressive pulmonary pathology (eg, lymphangioleiomyomatosis [LAM]), Recurrence could be life-threatening - Poor cardiopulmonary reserve, limited access to emergency medical care, Outpatient care - This can occur in asymptomatic patients or those with a small pneumothorax and reliable follow-up, Emergency department (ED) care - Prolonged periods of observation are inefficient and clinically suboptimal; efficacy studies of manual aspiration and placement of one-way valves performed in EDs are an attempt to address these practical issues, Inpatient care - This site of care is generally selected when high-flow oxygen is needed, the pneumothorax is larger but the patient is stable, or comorbidities increase concern about risk or follow-up; the average hospital stay is 2.8 days, Intensive care unit (ICU) - ICU treatment and observation is appropriate for patients who are unstable or intubated, At 0-6 hours - The ACCP Delphi consensus statement recommends observation in an ED for 6 hours, and discharge to home if a follow-up chest radiograph shows no enlargement of the lesion, in reliable patients, At 24-96 hours - Additional follow up in 2 days is recommended, with preference given to a 24-48 hour follow-up radiograph in the outpatient setting; outpatient follow-up during the 96-hour window is essential to distinguish between a resolved pneumothorax and one that needs evacuation; CT at this time distinguishes between PSP and secondary spontaneous pneumothorax (SSP), At 1 month - Full lung reexpansion can occur, on average, 3 weeks after the initial event, Persistent air leak for longer than 7 days, First-time presentation in a patient with a high-risk occupation (eg, diver, pilot), Patients with acquired immunodeficiency syndrome (AIDS) (often because of extensive underlying necrosis), Unacceptable risk of recurrent pneumothorax for patients with plans for extended stays at remote sites, Lymphangiomyomatosis, a condition causing a high risk of pneumothorax, Pulmonary edema (following lung reexpansion), Prolonged tube drainage and hospital stay, Prompt recognition and treatment of bronchopulmonary infections decreases the risk of progression to a pneumothorax, When subclavian vein cannulation is required, use the supraclavicular approach rather than the infraclavicular approach when possible to help decrease the likelihood of pneumothorax formation, The incidence of iatrogenic tension pneumothorax may be decreased with prophylactic insertion of a chest tube in patients with a simple pneumothorax that requires positive pressure ventilation, Pleurodesis decreases the risk of recurrence of spontaneous pneumothorax, as does thoracotomy or VATS to excise the bullae, Radiograph of a patient with a small spontaneous primary pneumothorax.