So I took Drake to the doctor yesterday. Regular old pediatrician to take a "looksie" at a little old rash. And yes, it was a little bit, well allot of the Fifth Disease. A common childhood virus. I'm not sure about you and what your worries are as a parent or even as you yourself as a patient, but I always have in the back of my mind that when we go for something small or a "well visit", there is bound to have repercussions. You know, you/your child ends up sick the next day or wined up going back the following week for something else.
Anyway, as we (me and the doc) were finishing the conversation about D's rash and not too much to do about it, he brings up the sunken place in Drake's chest. His pectus excavatum!!! He proceeded to tell me there is a doctor at UNC who does this Nuss procedure and that the doctor who invented it is just in VA. He said the youngest patient was 8 years old, I said we have 4 more years to worry? I was told we will keep an eye on it and that there will probably be x-rays in D's near future. He wasn't sure he could wait 4 more. I love it when the docs throw a curve ball! I guess I'll be calling UNC soon :(
Needless to say there was lengthy discussion and here I am at 12:14 p.m. writing about it after reading about it on-line. Here's is the quickie info on what I found and what the doc had to fill me in on. UGH!!!
Nuss procedure
The Nuss procedure is a minimally-invasive procedure, invented by Dr. Donald Nuss for treating pectus excavatum. He developed it at Children's Hospital of The King's Daughters, in Norfolk, Virginia. The operation typically takes 45 minutes.
Through two small incisions in the side of the chest, an introducer is pushed along posterior to the sternum and ribs, and anterior to the heart and lungs. Then a concave stainless steel bar is slipped under the sternum, through the incisions in the side of the chest. A third, smaller incision is made to insert a thoracoscope (small camera) used to help guide the bar. Taller patients, older patients, or patients requiring extensive correction may receive two or more bars. All bars may be placed through two incisions or additional incisions may be made. The bar is then flipped, and the sternum pops out. To support the bar and keep it in place a metal plate called a stabilizer may be inserted with the bar on one side of the torso. PDS sutures may also be used in addition to the stabilizer. The stabilizer fits around the bar and into the ribcage. The bar and stabilizer are secured with sutures that dissolve in about six months. Some surgeons have achieved excellent results using only pericostal sutures, without the use of stabilizers.[1]:1276,1280 Eventually, the bar is secured with muscle tissue that regrows during the recovery time. Although initially recommended only for younger patients, the Nuss procedure is now commonly used on patients in their thirties and forties with excellent results
Recovery
Recovery time includes between four and five days in the hospital typically, depending upon the patient and how the operation went, followed by time at home to overcome the pain and to let the bar settle into place. Patients younger than fifteen often require only two to four weeks at home after being discharged from the hospital for recovery, but older children and adults typically require a much longer recovery period due to the decreased flexibility of their bones. Fully grown adults may require many months before they can resume normal activities, including work. For six to twenty-four hours after the operation, the patient will have a Foley catheter to minimize risk of movement that could displace bar, and because the epidural can interfere with normal urination. The patient also receives thoracic epidural analgesia in the back for two to five days depending on patient recovery.
For six weeks, there should be no running or strenuous physical activity, and lifting is limited to ten pounds or less. Walking for exercise, and breathing exercises are recommended. It is sometimes suggested that weight-training should be limited or eliminated for up to three months. Also, it is generally accepted to not play sports where impact to the chest is likely, such as hockey or boxing. However, aerobic sports are encouraged, as results after bar removal are best maintained in patients who have stimulated their cardiopulmonary systems while the bar is in place
The previous paragraph is what made me post about tonight... The ENTIRE paragraph is a BIG F%*#?@! JOKE! Again, UGH!!!
