Chest Reconstructuion – Nuss Procedure
February 25, 2010 30 Comments
This is a completely off topic post about my personal life.
I’m now back at home after one week at hospital due to chest reconstruction.
Since my teens I’ve got Pectus Excavatum, a chest deformity where the chest bone is deformed and gives the chest a concave appearance.
Pectus affects about 1 out of 1000 people.
In my case, the PE was not only cosmetic, it also gave me chest pains when deep breathing and also putting pressure on my heart.
When I was a teen, the only way to fix the problem was to cut the ribcage open and cut everything off and then rebuild a new chest.
That alternative wasn’t very appealing to me so I did not do anything about it at that point.
However, now some 20ish years later, I found out about the Nuss procedure, a procedure where you implant a steel bar into the chest, putting preassure on the chest bone and ribcage from the inside and thus forcing a correct shape.
The Nuss procedure have apparently been around for some 10 years, but I guess there are no newsletters for that kind of information ;-)
The reason why I write this post is because I found it very hard to find information regarding Nuss for adults, e.g. information about how long I should expect to be off from work, and what results to expect from the procedure.
So here are some facts.
Age: 34
Pectus: Mild/Medium
Procedure duration: 1.5 H
Time in hospital: 6 days
Pain after procedure: Way less than expected, was up and walking the day after.
Current status: 9 days since procedure and I feel quite OK with some occasional pain spikes.
Putting on socks or getting in and out of the car is extremely painful.
And don’t even think about sneezing ;-)
Before images:
As can be seen on the “before images”, my chest bone was sunken into my chest by some 2-3cm.
After images one week post op:
These images are taken 9 days after the procedure.
The steel bar was inserted just below my man-boobs (where the tape is).
I will now have the bar for about 3 years before it is removed and hopefully the bones have been re-shaped by that time.
[Update]
After images, 4 months later
Changed my diet after the surgery, got rid of the worst parts of the pot belly.
X-Ray:
I guess I can’t get through airport security checks anymore…
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Interesting, never heard of Pectus Excavatum.
The procedure sounds painfull, hope it gets better :)
If you ever get stuck on a deserted island with a psychopath who needs a hammer, don’t tell him this particular story. ;-)
Amazing…
Get well and wishing you to be healthy from now on.
I’ve followed your blog for almost a year now, and am quite fond of your writing. I’m also a medical groupie, and was thrilled when I found your post linked by a medical blogger I follow.
Also glad that you’re doing well with the procedure. Given your description, I’m amazed that you can even survive coughing. Good for you!
I am following your blog for almost three years. I wish you must live long and make others happy.
Hello: My son will has a nuss procedure next july. Pls let me know if you had to do some exercises (phisical or respiratory) before the surgery. Thank you so much and hope you will be better soon.
@Loli
Hi, no I did’nt have to do any kind of exercise pre OP.
Altough, I’d recomend some gym workout, the stronger you are the easier it will be to stabilize the body and avoid some of the pain from the bar when moving.
Other than that I don’t think there is much one can do to prepare for the OP.
Just stock up with games and movies for the recovery :-)
Thanks a lot for your answer and wish you a prompt recovery.
Greetings from Venezuela!
who did your surgery and where? I’m in my 40′s and am looking for a Dr that will perform this procedure for me.
KB
It was DR. Erik Gyllstedt and DR. Oswaldo Fernandes in Örebro USÖ hospital Sweden.
if you need recomendations for other countries, I would recomend joining http://www.pectusinfo.com/board we pectus people have a community there.
You look great. My son is having the Nuss procedure in September this year. We have been on the pectusinfo board quite often recently. What is your user name on the board?
Thanks!
I’m “Roggan” at pectusinfo
Hi Roger, my boyfriend just had a nuss procedure and he’s now still recovering. What is your diet like postop? And did u have any constipation after the surgery. Thank you
@mel.
Hi, I was lucky and dindt get any problems after surgery, constipation is most likely due to the painkillers (morphine causes that)
I was only on painkillers for a week so no reaal sideeffects for me.
My new diet rules:
As little sugar as possible, no soda or sweet drinks at all.
High fiber content, eating Müisli/Bran-flakes morning and evening.
Only one real meal per day.
Thats pretty much it.
im having this done on november 2nd :) cant fucking wait!!! lifes been nasty with it. i know im only 17 but i guess there the years ur body should look best. he says sarcastically :|. i may actually go to the beach when asked now and go swimming and not have to make up some lame excuse like, nahhh the beach is crap i hate the sea. or nah swimming is boring i can have as much fun in the bath for less money. roll on the OP!!!
@Jordan congrats on getting the issue fixed at such an early age..
I missed out on all those years..
And I promise you, you will feel great once it is done!
I had some problem getting used to the new look at first.. but now, I love it and I hardly remember how it was to have the dent..
Hey. Im 14 years old and I have PE. I don’t think it is majorly bad but I am considering surgery. I don’t get chest pains but sometimes I struggle to take in deep breaths (quite rarely). I would be very happy if I could have surgery and it all go ok. But it worries me. I have heard that its painful and I can’t imagine the thought of having a metal bar inside me. Could someone who has had the surgery please answer a few questions.
How painful on a scale from 1-10?
Does it feel weird having the bar there?
How long until the pain is completely gone?
Are the results successful?
Please could you answer these few questions for me so I can think more about surgery.
Also it would be great for my PE to go because I have tried to build up my pectorals (I heard that increasing the muscle mass on the pectorals hides the PE) but I can’t due to the concave dip in my chest. It is extremely hard to build the lower pectorals. (I’ve tried bench presses, press-ups and all sorts of ways).
Please feel free to comment and more information on the surgery would be VERY helpful and I would appreciate it a lot.
Thanks guys.
@Conor
1)
Regarding pain, I would say it is very individual. some report incredible pain.
In my case it was quite OK, I were doing pushups one week post surgery..
2)
Not at all, I don’t even think about the bar nowdays.
I can feel the attachments on the sides and they can hurt a little bit when laughing or so.. but all in all, hardly noticable..
3)
About 4 months untill _completely_ gone.
I was back at work 1 month post surgery and at that point it was pretty ok.
4)
Yes, people can no longer tell that I’ve had PE..
And most importantly, all brain demons caused by the PE are gone, I can go shirtless on a beack or whatever..
Regarding building muscles… building bigger pecs will make your PE look _worse_
there are no muscles in the middle, so if you build muscles on the sides and there is a pit in the center, the pit will look even deeper…
That is the general observation atleast.
Thanks Roger. I heard that about building muscle on your pecs but that was after i already tried. I think im going to go to the doctors with it and see if i can get admitted through my GP. Hopefully i can get surgey and it all goes well. Hope you get better soon and thankyou.
hi, how did u recover so quick? im 32 and had the nuss procedure 3 and a half wks ago and ive been through hell. the time in the hospital gives me nightmares still, the pain was so bad and the morphine done my head in, i had big thick long drains coming out of my sides that lead down to 2 heavy boxes for 7 days, i felt like a robot and not human at all. ive hardly slept since ive had it done cos the bar pressure is is so bad, im a mess, i really regret having it done. 4 yrs ago i had scoliosis and had a massive operation to straighten my spine and after the long recovery i never got pain and now my back hurts and ive got quite big lumps either side of me where the bar connets and my breasts have been pushed so far apart and now i cant move them n the bottom half of them are completely knumb and the pectus is still there. ive got 3 children and cant do anything with them, it breaks my heart, im so exchausted i cant even go out. i need to knw if any1 else is suffering like this :-( x
Hi everyone !
I just went through nuss procedure at Royal Brompton Hospital in London . Procedure was done on 13/09/2010 morning and i was unconcious for 2 hours . When i woke up i was in svere pain and was not able to eat anything . My whole body was paining badly . If your GP does not send you to see a Consultant ( Suergon) you can contact the hospital from NHS website . Consultants are keen to listen and they will if you want do the operation . If the nuss procedure does not bring the best shape as you should have dreamed of you still have option to ask for Ravitch procedure on the same day as it is easy to do . But ravitich is quite a big operation surgeon will cut your chest fron middle ( 4-5) inches . I am still off work on sick note and i might start work next week it`s almost 2 months and i am still not 100% . SO PLEASE THINK CAREFULLY BEFORE YOU MAKE UP YOUR MIND . You can ask me any question on the process and direction . Bilal
Roger,
I recently had the Nuss procedure done–I’m 26 years old–and it went really well. I was just wondering if you run at all, and if so, how long did you wait after the surgery to start running again? I was in pretty good shape before the surgery, which helped a LOT with recovery, but I’m not sure about when I should start a running regimen again.
Hi again Roger :)
I have spoken to a doctor and he has offered me surgery, but I don’t think I am going to accept it because my PE is not severe’ he said it’s mild. So building upper body muscle should improve it according to the surgeon. Also I have found that when I put my shoulders back, straighten my posture and tense my stomach, My PE is very un-noticable. So I think I’m going to work extra hard to build that muscle mass :D
Thanks for the advice…
Conor :D
My son is 13 and he has PE which is causing him chest pain, we are seeing a cardioligist tomorrow. I don’t know much about all of this but after reading these posts, Im terrified for him. The initial doctor is recommending surgery. Does age have anything to do with the pain? What other options are out there for him?
@ emma
I also am 31 year female and am three and half weeks out from the Nuss surgery where i had one bar inserted. I have experienced what you have described and was wondering how did things turn out for you at this time? Wishing you well
Hi everyone, my names Nick Riggi, I’m currently 14 years old, male, I “had” pectus, I just got my nuss procedure done 1 week ago today, and I’m loving it, (I got 2 bars in, my was very severe) I have absolutely no pain, 1 – 10 my pain is -2,” I got the surgery Monday, August 8th, 2011, I left the hospital Sunday, August 14th, 2011, and I didn’t take anything for pain that last 2 days in the hospital, and I could have left the Thursday, August 11th, 2011….but you have to have a bowel movement before you can leave, and I didn’t.
But as I said, I got 2 bars because on the Hollar index (the rating of which your pectus is severe) to get the surgery you must have at least a 3.2 rating, mine was a 10.9, the most severe the had at this hospital. I was operated on at the Cincinnati Children’s Hospital but the #1 pectus surgeon in the United States, a Dr. Victor Garcia. He did a great job, but if you have an question please feel free to ask,
By the way, after surgery, once you are off your epidural block, do not the the following (from order not much pain to the most pain) No laughing, no coughing, sneezing, vomiting…on a pain scale, 1 – 10, laughing = 3, coughing = 5, sneezing = I haven’t sneezed yet but I believe would be somewhere around a 6 or 7, and vomiting = 15, yes 15, I vomited once off the epidural block because of a certain pain drug I was given, and the pain was excruciating, so if you feel like you are going to vomit, take deep, slow breathes, and if you can’t stop it, just pray and brace yourself, because I am no joker, the pain is deathly.
***Things I have trouble doing 1 week after surgery: Washing my hair in the shower, put on shoes, putting on socks, brushing/combing my hair. Getting up from a laying position is very, very, very hard, I can not do stairs very well, I must have my mom hold me hand, because it does hurt.
To everyone who is considering this surgery, it is very much worth it, also if possible try to contact Dr. Victor Garcia for an operation, I know not everyone can get to him but he’s worth it. (http://members.iinet.net.au/~broadstock/ipc/list.htm#usa) 1/2 way down the list is his contact information.
Good luck to everyone who is getting the surgery.
What size of bar’s did you have rikki?
Hi there Nick my son had Nuss Procedure on the 25 August 11 and he complains of a burning sensation which turns into a sudden pain did you experience anything similar to this described. ( Just behind one of the incissions.)
Anna to your post.. I am 23 and had surgery in october. I’m 5 weeks post op. I get that burning sensation to sharp pain in the same spot on my right side mostlly. The rest of the pain is okay. Not great but manageable. But that burning sensation comes from the muscle and the stabalizer, and let me tell you.. Worst pain ever felt in my life for those 2 seconds. Feels like ur muscle is on a stove. I don’t know what to do? Do you? Or anyone else
Sounds like I have same situation you had. But a little worse. Can’t find any info on drs who do nuss on adults. Please share any list you may have. Thanks.