Research articles
It is not difficult for a medical professional to find research about pectus excavatum or carinatum and its surgical repair. Google scholar is free, and anyone can use it. Here is an important caveat:
Reading articles does not mean you know more about your heart and lungs than your physician. Most people (and I am including myself, and I am an RN, CCRN, which means I am certified in the critical care specialty) do not know more about their hearts and lungs than a physician. I did not do medical school, nor residency, nor fellowship. What I know about hemodynamics is very much more than the average joe, but what I know about hemodynamics is very much less than a cardiologist. However, most providers (doctors as well as nurse practitioners) are not up to date on pectus excavatum unless it's something they see enough. As a CCRN, I know squat about cancer, except that it's bad. We have so many specialists in medicine because no one person can know everything there is to know about everything. Which is why, as a patient, I'm going to a specialist cardiothoracic surgeon who has done many of both types of PEx surgeries, and therefore showing that I already have a biased opinion. Not all cardiothoracic surgeons agree on best treatment, either. One has described the "Nuss in adults is nothing but torture." Which is pretty strong. Below are articles I chose to read, and show my bias.
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I include journal articles, because just this month a kindly, very senior and experienced (+40 years) pulmonologist of my acquaintance told me that my pectus "doesn't affect me."
And I do it for the nurse practitioner at Planned Parenthood 25 years ago, who (out of the blue from my perspective) volunteered an opinion that I should go see a plastic surgeon. Eighteen year old student, broke and underemployed, comes to your clinic for her first annual gyne/breast exam and you tell her she should go get a boob job. Nice. And I post these for my first pulmonologist, who I would still be seeing if he hadn't gone on to be a medical director of an ICU in another state...He understood, and yet still (for the insurance companies) had to ask me if "there was any aspect of this that is cosmetic for you?" Because he still has to document that. And for the primary care physician I met in my 30s who angrily said to me, "Do you have any IDEA of what you're suggesting to do to yourself?!" Like, angry. It was bizarre. (Although her nurse practitioner, who was wonderful, actually started the research for me. Medical people did not use the internet at that time.) And even for the very kind and ridiculously smart pulmonologist that I now have in my back pocket, who said, "You know....it's painful...." and waited for my reaction. Yeah. I know. Really. I know. I've heard. I've heard cardiothoracic surgeons refuse to do the Nuss because it is "human torture." I'm aware that there's a risk of putting an inch-thick metal bar through my exposed cardiac muscle. Or either exposed lung. This isn't The Fun Way I Plan To Spend Next Summer for me, nor am I a masochist. Or a drama queen. What I want all of them to know is that there is some science to support that doing this surgery might make things better for me....possibly significantly. My ability to exercise is pretty small and feels painful right now. Painful. I get chest pains going up stairs. I'm a nonsmoking vegetarian 44 year old woman who is carrying about 15 lbs of extra weight on me. I live at elevation. I should not be having to rip breath into my lungs and having chest pain with the stupidest amount of exercise. Yeah it's gonna be painful. I'm hoping it is LESS painful than living in Colorado and being physically unable to get up into the mountains and enjoy them. I'm hoping it's less painful than dying slowly from gradual debilitation and inactivity and dependence. I think I'll put up with a month of pain if I can avoid that. Really. Foolishly or not, I have squared with the pain factor. I believed slow, degrading debilitation was inevitable until a month ago. I lived with that. Every day. I have been doing my homework since then. | ||||||||||||||||||||||||||||
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