Pectus Ex Cavitum

[d2dave]

Pectus Ex Cavitum.
This is the name of a condition that my eldest son had. It is a severe indent in his chest. He was born with this condition but it was very mild. We consulted the doctor who said it was nothing to worry about. As he grew it got a bit worse, but it wasn't until he had a massive growth spurt when he was 17 that it really got bad.

So we were referred to a specialist who deals with this. We were told that it is not life threatening but it had pushed his heart to one side, which then reduced his lung capacity.

There was a fairly new procedure which was been done. This involved fitting a curved piece of steel into the chest and then reversing the steel, which then pops the chest. This breaks all the cartilage that is in there, and pushes everything out. This bar, known as a pectus bar, is then left in the chest for three years.

Fitting is a fairly major job. They slit the side of the torso, deflate the lung on that side and start feeding the bar. When it gets halfway they then re inflate the lung and deflate the other. This then allows them to get the bar to the other side. It is then bolted at each end to the rib cage.

This procedure being so new the doctor had only none a half dozen or so, and had never done a removal. My son had this done three days after his 18th birthday, and had it removed two days after his 21st, two weeks ago.

Removal was a fairly easy procedure, removed Monday afternoon, discharged Tuesday morning, and back at work Thursday.

http://img6.imageshack.us/img6/2627/img3269comp.jpg (http://imageshack.us/photo/my-images/6/img3269comp.jpg/)

This is what it looked like pre operation.

http://img560.imageshack.us/img560/9527/sn850991comp.jpg (http://imageshack.us/photo/my-images/560/sn850991comp.jpg/)

Not long after operation.

http://img607.imageshack.us/img607/5870/img5802comp.jpg (http://imageshack.us/photo/my-images/607/img5802comp.jpg/)

This is the bar that was removed from his chest. This piece of steel cost 5K! This not the total cost of the operation, but the cost of this bar.

Prior to this procedure being used, to have this problem corrected they used to open the whole chest, a bit like open heart surgery.

Dave.

[digger]

Strewth!

I assume that the bone/cartledge etc have now adopted a normal shape and
grown in? Is there any long term effects?

I cannot imagine the pain of that initial operation... Im glad everything went well.

(at $5k what will you now use the bar for!?)

[iPom]

My brother and my son also have this condition. My brother's is fairly mild whereas my son's is similar to your son's.
My son Sam is now twenty so I guess it is too late for an operation...

I'm very pleased for your family that you have managed to achieve a result with the procedure....

[pfillery]

I had heard of someone else using a piece of surgical equipment that saved their life, like your son's bar, by having it made into jewelry that they could wear. not sure how sentimental you/he is, but this is one idea. They even had it fashioned into wedding bands when they got married. Stainless steel jewelry is common these days.

[scrambler]

Strewth! SNIP
(at $5k what will you now use the bar for!?)

Scrap metal. :eek:

Once inserted surgically it can't be re-used. For one thing the metal fatigue is pretty impressive. I've seen 1/2 inch thick steel bars which have fatigued through while supporting broken limbs.

Having been inserted in the chest, the bar has had something like 24 million stress cycles in the three years it's been there.

[x-box]

I dare say that's not steel, but a very high quality titanium. While titanium is a very cheap metal, the processing there-of is where it hurts the pocket. That piece will have been 100% porosity free and even x-ray'd to confirm that, etc etc. (same as hip replacement joints - very low tolerance for impurities/defects)
I deal with dental implants and they are just as expensive, mega $$ for a tiny piece of metal, but is it worth it?? YES.
Obviously hoping that your son is fine and everything working properly in his body, but the first photo of him with the cat gave me a chuckle..... the cat part that is....

[d2dave]

Quote from digger
I assume that the bone/cartledge etc have now adopted a normal shape and
grown in? Is there any long term effects?

I cannot imagine the pain of that initial operation... Im glad everything went well.

(at $5k what will you now use the bar for!?)

Almost normal, and no long term effects. It was very painfull but with an epidural and drugs was managed ok. I don't get to use the bar, he keeps it. He is car mad and a tyre lever has been discussed, more tongue in cheek as we know it would not be strong enough.

From ipom
My brother and my son also have this condition. My brother's is fairly mild whereas my son's is similar to your son's.
My son Sam is now twenty so I guess it is too late for an operation...

ipom. It is definately not too late for your son to have this. I would highly recommend it.
If you want more info send me a PM. I/we would be more than happy to discuss this with you on the phone. You can even talk directly to my son as well if you wish. Don't let the cost deter you. Our health insurance covered it, and if you don't have this, Medicare will.

From x-box
Obviously hoping that your son is fine and everything working properly in his body, but the first photo of him with the cat gave me a chuckle..... the cat part that is....

Louis. Yes all is good and working properly. I knew this thread would not finish without a comment on the cat.

As for the 5K cost. The doctor gets a kit that has about six different size bars in it, as well as some shaping tools. This costs $5K The doctor then uses the bar to suit the persons size and returns the rest. I reckon that they would then just replace the one bar and re sterilise the kit. This being the case, makes the one bar cost $5K.

Dave.

[JohnF]

I wish your son a speedy recovery, and you a merry Christmas, in the Bible, 3 John verse 2 is my Christmas wish for you, and your son too.

[rfurzer]

speedy recovery

[iPom]

Thanks Dave, my son is over in the UK, I'll be ringing his Mum this weekend to discuss the option you and your son took. She's a nurse so hopefully she'll be able to look at the procedure more closely...

Once again many thanks for giving an insight into this condition..

Dave