Day of the surgery

     The morning of the surgery I went in at 4:45 a.m., they told me to wear loose close and no bra (I wouldn't be able to wear a bra for the next few weeks).  They do a pregnancy test, just routine, and then stick a bunch of IV's in you.  The nurse I had could not get the needle in my hand into the vein and poked me about 5 times before I told her that if she didn't get it the next time I wasn't having it, luckily 6th time was the charm!  They wheeled me into the Pre-Op room where they hold you until it's your time, at that point I said goodbye to my boyfriend and waited in the room till the doctor came to see me.  Dr. Mitchell then came in and measured my ribs so that he could shape the bar correctly for the size of my chest wall.  Then the Anesthesiologist came in and gave  me an epidural to numb my chest, surprisingly that hurt a lot less than the IV pokes in my hand.  They then took me to the surgery room and all I remember is counting backwards from 100 and only getting to 98.......

     As soon as I woke up I was in intense pain, it shocked me so much that I took a deep breath which was a bad idea.  I felt like something was just crushing my chest from all sides, nobody had noticed that I woke up yet, and then I started crying, which again was a very bad idea, I couldn't catch my breath from the crying and every time I breathed in it was a new wave of pain going through me.  The nurses had to quickly call the doctor back in to check on me and that is when he realized that my epidural had been turned down.  I guess while in the surgery my blood pressure started to get REALLY low so they turned the epidural down, when they wheeled me into Post-Op they forgot to turn it back up, so I woke up feeling A LOT!  Once they got that under control, which took 2 hours in Post-Op,  they were able to take me to my room.  A few hours later when the doctor came into my room he told me that he wanted me up and walking around in a few hours, I looked at him like he was CRAZY, I was in so much pain I couldn't even sit up in bed by myself and he wanted me to take a stroll around the hospital!  Even though I had drugs and an epidural I was still in shock with how much pain I was in, I didn't feel like eating anything so I just drank water, I tried to sleep through the pain but I couldn't get my muscles to relax so I would have 5 min cat naps throughout the day and that was it.  They told me I would be in the hospital for 2-3 days, I actually ended up being in there for 5 days!  On the 5th day they finally told me that they HAD to take the epidural out of my back or else I could get a serious infection and they made me go home.

     Being home was not any easier!  The doctor gave me some pain killers and nausea medicine but I was still in so much pain.  I had to sleep sitting up, laying down flat was too much pressure on my chest, and I would have to have someone sit me up cause I couldn't do it alone.  It was at this moment that I realized just how much I use my chest in everything that I do each day.  The doctor told me to get a lot of rest, but I wasn't able to sleep through the night for the first month, I would wake up every few hours in pain.  It wasn't until my Grandma came into town and saw how much pain I was in and called and got mad at my doctor that I got the pain meds I needed ha ha, go Grandma.  She figured out that I wasn't sleeping because my muscles were constantly contracting from the pain and without them relaxing they couldn't heal as fast.  So I was given muscle relaxers that day and that was the first time I slept through the entire night!! So if you have this surgery be sure to ask for muscle relaxers!!!!  My Aunt was also really nice and gave me a hot stone massage sitting up which actually helped relax me a lot.

                                                         
Just rubbing the hot stones on your back can feel really good, just a suggestion.  Once my muscles were able to relax I felt better and better each day.  With this surgery recovery is especially difficult because your chest is constantly moving, we have to breath we don't have a choice.  Normally when you break something the doctor will re-set it, cast it, and tell you to try your best not to move it until it heals right?  Well this is the same thing, your ribs have all been broken and detached from your sternum, they have reset it in the correct spot, but it can't hold still.  So your healing time takes 3 times as long as any other broken bone because it can't just hold still and heal itself.  (I hope that made sense).

Before the Surgery

     After I decided that I wanted to have the Nuss Procedure done to correct my Pectus Excavatum, I searched the area for a Doctor who has done this surgery, surprisingly there were a lot less choices than I thought.  I did find one that was in Provo which wasn't far from me at all.  His name is Dr. Mitchell and he is a Thoracic Surgeon at Intermountain Healthcare, on my first visit with him he told me that he had done the surgery a handful of times, but that I would be the oldest patient so far that he has done it on.  This didn't make me nervous at all because in my research I had found out that the majority of people with this condition are encouraged to get it fixed when they are young because your bones are still growing and the re-growth process would be much quicker and more effective.  Dr. Mitchell told me that the surgery itself has been done on much older patients than me with success so he was very confident in his ability to do the procedure on me.  He said that my bones were still very pliable (I guess meaning that they are flexible and not stiff) that I have a lot of elasticity from being very active which would make it easier for my body to heal. In my head I was thinking "Yes, working out everyday has finally paid off ha ha."  Before we could go forward though there were several tests that I had to do in order to determine if I was a good candidate.

     Before starting all of my testing, my Doctor told me that most of the time insurance companies considers this procedure as cosmetic and not medical therefore they won't cover any of it.  The only way to get them to cover the surgery is to prove that it is detrimental to your health and will cause problems if it isn't fixed.  They prove this by doing all of the tests Dr. Mitchell had me do.  One of the most important tests was called the 'Haller Index' test, this is basically where they measure the distance of the inside of your rib cage and divide it by the distance between your sternum and vertebrae.  A normal Haller index should be about 2.5, insurances will only cover this if yours is a 3.0 or higher.  Mine ended up being a 7!!!!  Can you believe it!!!  I sure couldn't, later I came to find out that my sternum was just over an inch away from my vertebrae which is insane!!

                                                         
                                     This is just an example of someone with a 3.58 (as soon as I find my picture I will post it).

     So after I completed all of my tests, I found out that my sternum was actually squishing my heart to one side and preventing my lungs from expanding all the way, which explained why I was always short of breathe even from just walking up the stairs.  Once they submitted these test, my insurance approved it and I set the date to have the procedure done.

    

A Little About Me!

     This Blog is for all the WOMEN out there who have Pectus Excavatum.  P.E (meaning hollowed chest) is the most common congenital deformity of the anterior wall of the chest, in which several ribs and the sternum grow abnormally. This produces a caved-in or sunken appearance of the chest.  It can either be present at birth or not develop until puberty. I hope to answer questions, give advice from my own personal experience and help all the women with this deformity feel beautiful and LOVE your body for how it is.

                                                            

     My name is Tara Fox, I am 26 years old and I have Pectus Excavatum.  I started noticing my chest indenting when i was in Junior High and it has progressively gotten worse since.  I always thought that it was just something that I was born with, I was the only one who had it, and that there wasn't anything that could be done about it.  When i was 23, I was working out in my basement, and after one of the exercises I just couldn't catch my breath, it was like I couldn't take a deep enough breath to get the oxygen I needed, I tried to sit down and that is when I passed out.  I knew this could not be good and so that is when I really started to do my research on P.E. and realized that what I had was a condition called Pectus Excavatum and that other people had it and it could possibly be fixed.

     In doing my research I have found that this condition is mostly in males and very few women.  In fact I was only able to find 3 women on youtube.com that had it.  This was hard because I needed advice from people with experience and I didn't have it.  Having P.E. as a women takes a toll on your self esteem, bras don't fit correctly, even if you have a decent cup size nobody can tell because it is sunken in.  Wearing swim suits for me was just a nightmare, especially when you come out of the water and your suit sticks to you and shows off your indent.  I never wanted to wear low cut shirts or anything that would show off my dent.  At the time that I was researching P.E. I was dating my soon to be husband Scott :) and I was so embarrassed just thinking about him seeing my chest that I really wanted to do whatever I could to fix it.  I know it sounds silly but like I said this condition really hit my self esteem hard.  So i started looking for ways to get this fixed so that  I could feel comfortable and beautiful for myself and my future husband.  I found that there are 2 surgical procedures, the Ravitch and the Nuss, or you can try physical therapy which didn't have a very high success rate.  The Ravitch procedure seemed a little too intense for me, they have to open your chest up and physically remove all of the cartilage connecting your ribs and sternum and then put a metal plate in there until it grows back.  Then you had to deal with the gnarly scar that it left across your whole chest.  In my head I thought that there were just too many things that would fix one problem but then cause another.  As I researched the Nuss procedure it seemed like this one was a surgery that I could handle better.

     The Nuss procedure is a minimally-invasive surgery (that does not mean it isn't painful!) through which two small incisions are made in the side of the chest, then a concave stainless steel bar is slipped under the sternum through the incisions in the side of the chest (it is kind of like a long steel nail file) The bar is then flipped, and the sternum pops out.  After speaking to my doctor and doing a lot of tests I decided to have this procedure done.  I will write more about my procedure in my next post.