11.21.2017

Post-procedural Pneumothorax, Pneumopericardium, Pneumomediastinum, and Subcutaneous Emphysema

That was my official diagnosis after surgery on October 31. They mean collapsed lung, air in the pericardium (surrounding the heart), air in the mediastinum (the central compartment of thoracic cavity), and air in the subcutaneous tissues (layer under the skin).

Still hard to understand? It's ok, it was for me, too. It means I had air all up in my shit!

So much air in my chest cavity, neck, and face that it partially collapsed both of my lungs, surrounded my heart and spine, and puffed out my chest, neck, shoulders, and face for ten days. And this all happened because the jet ventilator used during my usual tracheal dilation was too powerful. So, the air they were putting into my body ripped a hole in my trachea and leaked throughout my chest.

The procedure itself went fine. I woke up easily, I could breathe amazingly, and I was discharged in an hour. This was my sixteenth procedure in nine years. It all felt very standard and normal. But on 90-minute drive home I noticed that my neck felt more sore than usual. About fifteen minutes later, the left side of my neck started hurting. Twenty minutes after that my entire neck was swollen and my ears were plugged. I thought maybe they tweaked my neck on the surgical table. By the time I got home, I felt like crap. I was sore all over, I couldn't take deep breaths, and I couldn't swallow yogurt. YOGURT.

I really thought they pulled a muscle in my neck. Although he didn't mention anything after the procedure, Jacob called my surgeon to find out exactly what happened. The doctor said we needed to return to the hospital because it sounded like I had surgical emphysema and I needed X-rays immediately. Now that it was nearing rush hour, our 90-minute drive could take up to three hours. He told us to go to the nearby ER instead and he'd call ahead to explain the circumstances.

In the ER, I had chest and neck X-rays every six hours, was given antibiotics and pain meds via IV, got hooked up to a heart monitor, and was placed on oxygen. They wanted to transfer me to the hospital, but they were full. There were no beds in five hospitals in three counties! They said I'd be hanging out in a hallway and since I didn't need treatment yet, they'd keep me there for observation. We spent ten hours in a bed with a curtain divider before they moved us to a room at 1:00 am.

Meanwhile, my entire family had gathered at my house for our annual Halloween party and trick-or-treat fest. My neighborhood goes all out and we love spending this evening together. Thankfully, for my kids' sake, this went on as planned. My mom spent the night and after the party, my sister brought clothes, toothbrushes, and phone chargers to the ER for me and Jacob.

On Wednesday afternoon, I was transferred via ambulance (my first time!) to the hospital ten blocks away. I was finally examined and scoped and the cardio-thoracic surgeon and ENT doctor assured me that even though I was more swollen than ever, I wouldn't need intervention. If things weren't looking as good, they'd have to insert a tube into my chest to release some of the air to alleviate pressure on my lungs and heart. No thanks!

I was super concerned about my face and neck, but they kept blowing me off. I guess they were more worried about the function of my major organs. I get it now, but at the time, I was freaked! My mom said it looked like I had the mumps, except it was on both sides and I not just in my cheeks. I didn't have a neck! In fact, my neck was larger than my jaw. The creepiest part was that it made noise! If you pressed on my skin, it felt and sounded like Rice Krispies. Pockets of air would crackle and pop! I looked like Peter Griffin, but felt like Sloth.


Oh, did I mention I wasn't allowed to eat or drink? They weren't sure if I'd need another surgery, so they didn't want to me to have anything in my stomach. It was 8:00 pm and I hadn't eaten since noon the previous day. Though they couldn't see it, both doctors thought the hole in my trachea had repaired itself by then and we were just waiting for the air to dissipate. The cardio-thoracic doc said he really didn't think I'd need another procedure and finally let me eat. By that time the hospital kitchen was closed so Jacob bought some cheese and crackers and a Sprite to share. I was too tired to eat much anyway.

I continued X-rays throughout the night and they could see that I wasn't getting any worse. My vitals were stable the entire time, too. I was visited by more doctors on Thursday morning who decided that if my afternoon X-rays were the same or better, I could go home. Thank God it was the same! I was still incredibly sore and scared out of my mind, but I wanted to go home. Jacob helped me shower (because I couldn't move my neck or raise my hands above my shoulders), and I had to sleep on the couch in the family room (so I could sleep upright on our sectional), but I was so happy to be home.

On Friday morning, I had an appointment with my regular doctor to repeat X-rays and blood work. They finally showed a teeny, tiny improvement. My neck and face said otherwise, but the air in my chest looked better. I was told to stay on bed rest and come back Monday to do it all over again.

I stayed on the couch and felt pretty crappy. My kids came in every once in a while to talk or watch a show with me, but for the most part, they let me rest. In the evenings, Jacob and I watched movies or played board games. He even set up the living room Christmas tree! He's always been a day after Thanksgiving guy, but knew I needed some cheer. Finally on Sunday, I started to notice the swelling in my neck going down.

Monday's X-rays showed significant improvement and I was told I could wait until Friday to get checked again. Friday's results showed just a few bands of air behind my heart, but no longer surrounding it, and the air in my face and neck was totally gone. I'm not supposed to do anything strenuous for a while, and I got a little winded while running errands for a few days afterward, but I'm basically back to normal now.

And I'm scared to death about having surgery again in six months! I was in constant contact with my surgeon and anesthesiologist and they are perplexed. I've had this procedure done this way at least ten times before and never had an issue. It was just a freak thing. Thankfully, my chances of this happening again aren't increased because of this one time.

My friends and family were so awesome and thoughtful during all of this. We had babysitting and grocery shopping offers. People brought over dinner. A friend asked if she could go buy me a new book or CD. I had so many messages, texts and comments expressing thoughts and prayers. I really, really appreciate it! It was a crazy, scary journey and I'm so glad it's over.   

2 comments:

Audrey Louise said...

Oh my gosh, this is terrifying! I've never had to think about the things that could go wrong during/after surgery because I've only ever had my wisdom teeth out, but dang... I'm glad you're on the mend!
Was the air painful? I'm on medication for acid reflux and heartburn, and it treats the gas bubbles that get caught up in my torso. They hurt SO MUCH. Like I'm being stabbed. Did you have pain like that??
Owwww!

Misty said...

I'm so glad you're ok. Scary!