#thoracotomy

[seeingstarsseeingtheuniverse]

currently recovering from a pretty traumatic and painful surgery called a thoracotomy where they opened me up, moved my ribs, deflated my lung and took a bunch of cancer out from there, very very painful btw.

i then decided to go through the Jamie Tartt tag on here.

bad, bad idea on my part.

[doctordconline-blog]

23y Female victim. Stabbed multiple times through her chest. Right after she brought to ER she rapidly destabilized and her heart stopped beating. She was bleeding somewhere inside. While proceeding to CPR thoracic surgery consultant performed thoracentesis to check if the thoracic space is filled with blood. It was negative. The wounds were not like they were aiming to heart but for a slight possibility of cardiac laceration and tamponade was the only explanation for the situation. The patient was in the OR in a minute and being performed an open explorative thoracotomy. Cardiac tamponade then was verified. The surgeons then opened up pericardial fascia. Left atrium of the heart turned out to be wounded. That explained the rapidly failing heart. In this photo surgeons putting pressure on and suturing the wound. The bleeding was stopped successfully but it was too late to save the patient since she had lost too much blood by the time she was brought to hospital. 📸@ismail_sarbay #emergency #thoracotomy #lungs #pathology #anatomy #usmle #doctor #doctordconline #nhs #nurse #nursing #medicine #medlife @doctordconline #amc #plab

[faofinn]

Breathe In Breathe Out/ Panic! At The Disco/ I Think I Need a Dr - Whumptober Days 13/18/29

Little bit different this time, combined three prompts into a little ficlet. Enjoy!  

Fao got news of a vehicle being hit. Somehow they’d managed to find a weak spot in the armour and it was a mess. The medics first on scene wanted him there, so that’s where he went. They retrieved their casualties and started to make their way back to base, Fao doing the best he could to suture and stabilise in the back of a chinook. It was loud and unstable but he had a job to do and he’d damn well do it. 

But the resistant forces had somehow gotten their hands on something they shouldn't have. They found that one out the hard way. After the most almighty crash and the screaming of warping metal, the big helicopter pitched and went down. Fao and his crew shared a look. They knew they were as good as dead as they collided with the heat-baked earth.

The mayday call went out as soon as they were hit, detailing their location and the crew on board. Nobody held much hope, they all knew it was bad. 

Fao was thrown clear as they hit the ground, the force knocking him out but keeping him far enough away from the burning metal to keep him alive, for now. 

It was a mess when the second Chinook arrived, and all too silent. The metal was twisted and on fire, and there was no chance of any survivors there. They did a sweep around it, aware of the risks and just hoping for a miracle.

The blood and sand in Fao's mouth choked him, and he struggled to breathe, clawing at the ground and trying desperately to get some air. He coughed and retched and groaned, the smell of burning metal and fuel filling his nose. It was hot, too hot, and when he tried to open his eyes it was too bright, too. He was going to die, out here alone in the burning sun. That he knew for sure. The sand was going to choke him and he was going to die. 

“Wolfie? Wolfie!” Harrison dropped his kit next to him, relief at finding someone alive, and almost crying because it was Fao. “We've got you, mate.”

The voice was distant, distorted by the ringing in his ears, but Fao was vaguely aware of someone beside him. He still gasped for breath, and he panickedly reached out for them, trying to work out if they were real or not. 

“I'm here, don’t worry. Where’s hurting?”

Where? Everywhere? Fao didn't know. He couldn't breathe, couldn't think. It was too hot, too bright.

“It’s alright, yeah? Try relax, we’re gonna help.” He started to cut at Fao’s clothes, pushing Fao's hands off.

Fao tried to breathe, tried to relax. What if he died? What about Finn and their parents, what would they do. Suddenly it was too real and terrifying and all he wanted was Sheila with him, holding his hand. 

“Wolfie, come on. Look at me, mate.”

Fao forced his eyes open. They blurred with the sand and the sun and he could barely see, but he tried his best. He managed with a groan, wishing they'd focus.

“That’s it. Well done, you’re doing great.” He glanced up at the rest of the crew, a sombre look on his face as they shook their heads. “We’re gonna get you boarded and back to base, okay? Keep going for me, okay?”

He groaned, coughing again. It was getting harder and harder to breathe, his chest tight, but he couldn't find the words. The pain was getting worse and worse, everywhere. He wasn't even sure if he could speak.

Despite the mask on him, Fao was still obviously struggling. Harrison hesitated, torn between moving first or decompressing, weighing them both up. 

“Fuck it. I’m doing it now. I’m not having him arrest because of this. Pass me the kit?”

His colleague quickly passed it over, careful and confident. “There. On your left.”

“Fao, I’m gonna stick a needle in your chest, okay? Help you breathe.”

Fao groaned again, trying and failing to speak. 

“Sorry, mate.” He pressed down Fao’s bare chest, the landmarks of bones no longer together. “Sharp scratch.”

He didn't even feel the needle. Even when it was in it didn't help, either. A few breaths were easier, maybe, but it was still tight. 

He already knew the answer as he asked. “Any better?” 

He tries for as much of a negative noise as he can make, struggling. It was like he was slowly being suffocated. 

“You’re doing so well, just keep going.” He gestured behind him. “Lets go.”

“Ready when you are.” Came the reply. 

“Ready, Wolfie? We’re gonna get you back.” They lifted him carefully, trying to move fast but not jostle him. “Just hold on.”

“‘ome.” He managed to get out, the word distorted. 

“Back to Finn, yeah? We’ll get you sorted here, and you’ll be on the first flight back.”

Fao hummed. The pain was worse, everything was worse, but Finn would make things better. They all would.

“Wolfie, keep your eyes open. I know you can’t talk, but you gotta stay with us.”

He tried, squinting against the bright sun. It was hard, he wanted to sleep. Wanted to forget it all. Maybe it was just a dream. 

“Come on, you’re doing really well. Think of Finn, yeah? Won’t be long. You'll be back with Sheila too, you know how she fusses.”

It's all too familiar, echoes of his rugby injury all those years ago. But he'd had Sheila then, holding his hand and telling him it would be okay. He wanted her so badly now, longed for her to tell him she warned him about being careful. But she was miles and miles away and he was alone. 

They were quick to load him, setting up fluids and pushing them. His blood pressure was horrendous at best, and Harrison's sure he’s bleeding from somewhere, but there’s nothing they can really do until surgery. He just needed to keep him alive until then.

"Come on, Fao. Just hold on. You're going to be fine, gonna be back to Sheila and Finn, going to be fine." Harrison fussed over him. "I'm not going to go anywhere, so you're sure as hell aren't either. I've got you, I'm gonna keep you safe, nothing bad is gonna happen, not on my watch."

Fao started slipping, his breathing getting shallower and shallower as he fought against the building pressure in his chest. He coughed to try and help but it just hurt, and he became more and more aware of the pain. His breathing became more and more irregular, far too long between each breath. 

“Fao, no, please. Come on.” Harrison started to bag him as they set up for sedation and intubation. “We’re gonna sedate you, take control and give you a rest, okay? Just hold on. I've got you.”

He fought it, struggling against the hands all over him, the mask too tight over his face, pressing into his jaw. It was pain, pain, pain. He couldn’t breathe, he couldn’t breathe! If they put him out, he’d never wake up. The pressure in his chest got worse and worse, crushing him. They couldn’t sedate him, no. His good arm clawed at the people all over him, the monitoring, everything. He coughed, choking on the blood in his mouth again, retching again and again to no avail. This was it, this was how he died. Blood coating his tongue, the world unfocused and too bright. 

Harrison gave the nod to start the drugs, leaning into Fao's line of sight. "Fao, look at me."

He couldn’t. How could he? It was too much, he couldn’t breathe. Somewhere he recognised Harrison’s voice, but he struggled against it all, trying to grab onto something, anything.

“It’s alright, Fao, just relax. I’ve got you mate, promise. I’m gonna look after you, do my very best. We all know I’m only second best to you, yeah? You’ll be back in England before you know it.”

Fao grabbed at him, groaning. He couldn’t do this, couldn’t keep on like this. The pain was everywhere, distracting him, and get staying conscious was getting harder and harder. Pure fear was the only thing keeping him conscious, and he couldn’t even speak. 

"I know, I know." Harrison stared him in the eyes. "Wolfie, I promise you, I'm going to get you home. I'm going to do everything and I'm going to get you out of here. I need you to trust me. I know this is terrifying, but you need to slow your breathing down, relax, let us do the hard work for you. You'll be back in England before you know it."

He didn't really have a choice. Things were getting hazy, the oxygen mask pressed to his face making the pain worse and worse. His pelvis was agony too, all down his left leg, and numbness spreading where the pain didn't reach. His thoughts were a mess, and he struggled to slur out a help. 

But Harrison was there. Harrison would look after him, right? Tomcat. He was good. Surely he was safe. He wasn't sure if it was the pain or the meds but he began to slip, the blackness more and more inviting. His breathing stopped as he gave into it, the fight just gone. 

With Fao out, they all moved quickly. Every number they got from him was wrong, and it was only getting worse. His airway was secure as quickly as possible, but it wasn't exactly good. There wasn't any air entry for the most part of his lungs, and they’re not exactly left with much of a choice. Scalpel ready, they all agree to at least try a thoracotomy. It’s not like they could make it much worse, and they doubted he’d make it back to camp the way he was trending.

Seconds after knife to skin, his body finally gave up and he arrested, his numbers even worse and all the monitoring kicking off. 

“Shit! Fao, come on.” Harrison was on his chest immediately, feeling the mess of ribs under his hands and groaning. “How long?”

“Five minutes, they're waiting for us.”

“We’re not losing him. Not after Vixen. We can’t. I promised him.”

The others took a step back, ready to call it and leave it at that, but Harrison was having none of it. He grabbed tbe scalpel again.

"What are you doing?"

"What's it look like?" He hissed back. "I promised him."

"You did everything you could, Harrison. It's okay."

He shook his head and made the incision. They had to listen to him then, passing him equipment as he started the thoracotomy. He'd admit he wasn't the most proficient at them, but at the same time, Fao was dead. He really wasn't going to make it worse. 

Tension pneumothorax resolving, Harrison moved onto the heart. There was no obvious bleeding there, and still no output. He swallowed thickly. 

He took Fao's heart in his hands, willing it to start working as he squeezed it. Come on. Blood was pushed again, and Harrison could feel it soaking through his knees. He brushed it off, getting his colleague to clamp what they could and pack the rest.

He wasn't losing Fao. He couldn't. He was his best friend, more than that, really. At least, if they made it out.

They still couldn't shock him, but his lungs inflated more with each breath, everything slowly returning to where it should be. Clots were suctioned away, blood cleared from where it shouldn't.

This time, as they gave more blood, it didn't piss everywhere. 

"Thank fuck."

He continued his massage, praying to a god he didn't believe in, offering anything to get him out alive. Offering his life and limbs to get him back to the Daniels. They couldn't lose Fao. He couldn't lose Fao.

He felt it under his fingers, a sudden twitch, movement that hadn't been there before. With a frown, he continued. They weren't due a rhythm check just yet, and he wasn't going to prematurely stop. 

At the rhythm check, he breathed a sigh of relief. It was beating. He could feel the contraction under his fingers, the slow pulse of blood being pushed through. 

It wasn't much, but it was a pulse. It was Fao, and he was alive. 

The handover was quick and rushed, not much more to be said than already had been sent over. The crew hung around with him for a few minutes, trying to get him stabilised enough to get into theatre and survive it. 

Harrison took a step back from duty after that, the crew and his officers recognising he needed the time. Granted it, he paced outside of theatre, back and forth, back and forth, until someone snapped at him and told him to go get washed. It was only then that he realised how absolutely covered in blood he was, most of it Fao's, but a lot of it from the pack. They'd used more than normal, and Harrison had done more than he should, but none of that mattered.

Fao was alive.

[iwant---tobelieve]

I haven’t been able to roll over and lie on my front for a year because it really hurt my ribs after surgery. CHECK OUT MAH PROGRESS and my stupid happy smile 😂 I’m like a small baby hitting milestones! “Awww she rolled over for the first time! Quick quick someone get the camera!”

[iwant---tobelieve]

My back is so painful again at the moment. Not my actual back actually.. where I had my thoracotomy. It still gives me such trouble and it's uncomfortable and I wanna cry.

If anyone says 'oh we can fix you we just have to rearrange your ribs' tell them to get FUCKED it hurts

[iwant---tobelieve]

I am in pain. Like literal and metaphorical pain but right now the literal pain is killing me. If someone offers to perform rib surgery on you to make you pretty, say no. Trust me, this shit sucks. Is it worth it to look normal? On days the pain is minimal, yes. On all other days, no. The pain is fuckin' real.

[ptmasterguide]

Clamshell Thoracotomy

In this article, we will discuss Clamshell Thoracotomy (Case report). So, let’s get started. Schwannomas (neurilemmomas) are benign tumors arising from the Schwann cells of the neural sheath. They are typically well-encapsulated lesions and in the chest they are most commonly seen within the posterior mediastinum, often originating along the intercostal nerves. Several operative approaches have…

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[smashrhenae23]

I would love to know how many people actually get sleep the night before a surgery. It’s 2am and I will be woken up by the nurses around 5:30 or 6am, in order to shower and start getting prepped. I will be going under the knife for my second thoracotomy. They will be doing a lobectomy on my left lung, which is a removal of one of the lobes. Hopefully this will be the last speed bump in my long recovery.

This past September, I caught a cold and went to an urgent care center to see if I actually had COVID. Test was negative, but the doctor said I had bronchitis. No big deal, right? I used to get that type of stuff all of the time when I was young. About a week later, I went in to work and had to leave about an hour later since I felt like I couldn’t breathe. I had progressively been getting worse so I assumed I had COVID and that last test wasn’t right. I went to a different urgent care, and I was immediately put on oxygen. They did a COVID test (negative) and an X-ray. The X-ray showed that my entire left lung was whited out, and said they needed to call an ambulance to take me to the hospital (only 6 miles away 🙄). While at the hospital, they put in a chest tube. The doctor had told me that they didn’t get many people needing chest tubes and I would probably be sent to a bigger hospital. That was pretty much the last thing I remember before waking up in a hospital in Tulsa, OK....6 days later.

I was so confused and still highly medicated, and started begging for them to call my mom. I also was convinced that she had sent me there for punishment, and that they had taken me into outer space to do it. I hurt everywhere, didn’t understand why there were so many manchines, etc. My mom got there and explained what she could. I had been life flighted and put on life support. I went septic and had a thoracotomy to drain and clean out that lung. I had 3 chest tubes at that point. I had lost most function of my hand. I was on life support for 6 days and was told that they didn’t think I was going to survive that first night.

I spent 20 days in, was sent home, then came back 4 days later because I couldn’t breathe. I was admitted and spent another 14 days. At least I got to spend time with my daughter on her birthday when I was home those short 4 days. Altogether during those 34 days, I had a thoracotomy, thoracentisis, 6 chest tubes, a JP tube (draining from my stomach), 256 X-rays, 1 MRI, and 30 something CTs. They diagnosed me with Necrotizing Pneumonia, Necrotizing Pancreatitis, and they found a large pseudocyst. The pseudocyst went from behind my liver, up through a hole in my diaphragm, and was pushing up against my esophagus. I was sent home with IV antibiotics and I’m now on a 24 hour one while still going to work and taking care of my kids.

Which brings us to today. I started coughing up blood on January 2. Its been a constant, all day, bright red blood anywhere from the size of a quarter to a handful if I have a coughing fit. I spent this month going back and forth to see 4 of my doctors. I had a couple of CTs, xrays, labs, and a bronchoscopy. The doctors all said everything looks great and is getting better, but my left lobe is what is causing the blood. They believe it was just damaged too much during the previous stay.

I’m ready to get this over with. I’m also dreading the pain. They will go through my same scar that goes from under my armpit, around to about an inch away from my spine. It is still very tender. I’m not looking forward to the discomfort of the tubes, the box I have to carry around, the walks you have to take while in pain, the feel of the tubes being yanked out, etc. With how sick I was, I was told it would take at least a year of recovery. I’m just hoping this is my last surgery.

Anyways, wish me luck!

Ashley