pleurodesis / pneumothorax

[crash7]

What fun. In hospital with first ever spontaneous pneumothorax. They've got a tube in to suck out air and re-inflate lung. Just had a CT. initial read looks good. Waiting for big doc to come talk to me. Earlier, in day recommended physical pleurodesis to reduce likely hood of further events.

My AME doesn't think it's really necessary. Just need a clean CT and "...may resume normal activities " letter.

My question is, is it worth the pain and longer recovery in doing the procedure? This tube hurts like hell as it is.




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[FORANE]

Search for studies on "spontaneous pneumothorax recurrence rates" and "pleurodesis efficacy" such as this one:

http://thorax.bmj.com/content/early/2016/11/01/thoraxjnl-2015-207967

It finds a significant difference in recurrence rates:
Recurrence rates in patients with chest tube drainage only were between 26.1% and 50.1%.
Thoracoscopic talc poudrage (four studies (n=249)) provided recurrence rates of between 2.5% and 10.2%

 

[lbfjrmd]

maybe get a 2nd medical opinions from pulmonary and thoracic surgery!

 

[bbchien]

maybe get a 2nd medical opinions from pulmonary and thoracic surgery!

3rd doc to chime in. Second Opinion!

 

[crash7]

CT looked good. An X-ray this morning was good, so they actually pulled the tube. Aaaahhhh. So much better. Unless something crops up on my next X-ray, I should go home later today.
Now the big question: how long should I self ground before flying again? What stack of papers will I need at my next medical in a year?
Thanks for the replies. Been sitting here worrying about it all night.


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[lbfjrmd]

see https://www.faa.gov/about/office_or...uide/app_process/exam_tech/item35/amd/pleura/

another chest xray in a month then update FAA with a new medical application.

 

[CGChief]

Not fun at all. I had a spontaneous pneumothorax in December 2000. Luckily have not had a recurrence. The upshot is I stopped smoking.

 

[Rockymountain]

Someone posted the recurrence rates above, seems about right. If you were crew I would wait at least 2 weeks and have a follow up CXR showing complete resolution before flying. If you are the solo pilot, would probably wait at least 4 weeks with the same. The risk is having residual air in the pleural space, which will expand at altitude, cause pain, and possible even tear the lung away from the chest wall. Not good if you are the guys at the controls. If you had the typical symptoms, sharp chest pain and shortness of breath, if it occurs again expect the same symptoms. 1st time, reasonable to treat with a chest tube, second occurrence, usually buys a pleurodesis. That is the medical side. Would defer to the AME's for the FAA side.

 

[CGChief]

Someone posted the recurrence rates above, seems about right. If you were crew I would wait at least 2 weeks and have a follow up CXR showing complete resolution before flying. If you are the solo pilot, would probably wait at least 4 weeks with the same. The risk is having residual air in the pleural space, which will expand at altitude, cause pain, and possible even tear the lung away from the chest wall. Not good if you are the guys at the controls. If you had the typical symptoms, sharp chest pain and shortness of breath, if it occurs again expect the same symptoms. 1st time, reasonable to treat with a chest tube, second occurrence, usually buys a pleurodesis. That is the medical side. Would defer to the AME's for the FAA side.

When I had mine I had a chest tube installed. When released from the hospital they said no flying for 6 months.