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Thread: Thoracoplasty and suggestions for post-op????

  1. #1
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    Thoracoplasty and suggestions for post-op????

    My 15 yo daughter is having scoliosis surgery along with a thoracoplasty on July 2nd (40 days). I'm really concerned about the thoracoplasty even though she really needs it. She has a bad rib hump. I'm just worried about the whole chest tube, reduced lung capacity thing. Does anyone have any POSITIVE experiences with thoracoplasty?

    Also, does anyone have any suggestions for things that she may need at home post-op? We are looking for a new mattress for her - any suggestions on that? What about wedge pillows, certain types of chairs, etc?

    Her curves in October 2011:

    T - 50
    L - 43

    Not sure now.

  2. #2
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    Hi Jewelty

    Welcome to the forum

    I didnít have a thoracoplasty so I cannot comment. Maybe someone will chime in on this. I have had the chest tubes, actually quite a few tubes, and they are not something that you have to be worried about....

    I have a Tempurpedic (medium) and needed a foam topper as it wasnít soft enough. I would suggest a medium hard mattress, with a 4 inch latex foam topper. The mattress should not be hammocked. We feel stuff like that.....

    Also plenty of SOFT down pillows, I have about 15 of them.....

    Ed
    49 yr old male, now 59, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  3. #3
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    Jewelty
    I had a thoracoplasty along with my scoliosis surgery 2 years ago. i didnt even have A chest tube for mine. my breathing stayed about the same after the thoracoplasty. make sure you daughter dont lay on the side they does the thoracoplasty. that just for like 2 to 3 months
    Kara
    25
    Brace 4-15-05-5-25-06
    Posterior Spinal Fusion 3-10-10
    T4-L2
    Before 50T
    After 20T

  4. #4
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    Hi Jewlty

    I had a thoracoplasty when I was 17yrs old. I didn't find the chest tube caused me any problems, it was in a few days then removed. After a few days I was given this little machine that I had to blow into to try and raise the plastic balls inside the machine. I was told that this would get my lung capacity back so did the exercise a few times a day until I could raise all 3 of the balls to the top of the plastic cubes they were encasted in.
    I had a firm matress before but as my curve have started to move again I decided to get an orthopedic matress with a foam topper so this might be an idea if you were thinking of getting your daughter a new matress.

    I don't know how many ribs may be reduced but I had all my ribs on the right side reduced as my hump was at the back and around the side, under my right arm. I can lay on my right side now but after about 5 minutes its really uncomfortable.

    I didn't have a special chair but I do remember having to hug myself to hold my rib cage in when I needed to cough or sneeze to reduce the pain when I did this. I also remember now being able to lift my right arm for quite a while so I had my mum help me to wash my hair. I also didn't feel strong enough to drive for about 2-3 months.

    I don't know how things work where you live but if your daughter is having corrective surgery does the surgeon not want to see what results he/she gets and whether the rib hump reduces on its own? I had corrective surgery on my lower spine at 13yrs old but because the surgery didn't correct my top curve it was later decided that I should have a thoracoplasty.

    Jenna
    27 yr old Female.
    Scoliosis since 12yrs, fusion to lower curve in 1998, costioplast 2001 and further corrective surgery 26 July 2012.
    Now the proud owner of a very straight spine. T1- L5 fusion.
    Mr Dunsmuir, Orthopaedic Surgeon, LGI Leeds.

  5. #5
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    Thanks for your reply.

    You didn't feel that the foam topper was too soft? Was it one of those Temperpedic type toppers?

    Quote Originally Posted by titaniumed View Post
    Hi Jewelty

    Welcome to the forum

    I didnít have a thoracoplasty so I cannot comment. Maybe someone will chime in on this. I have had the chest tubes, actually quite a few tubes, and they are not something that you have to be worried about....

    I have a Tempurpedic (medium) and needed a foam topper as it wasnít soft enough. I would suggest a medium hard mattress, with a 4 inch latex foam topper. The mattress should not be hammocked. We feel stuff like that.....

    Also plenty of SOFT down pillows, I have about 15 of them.....

    Ed

  6. #6
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    Thanks for your reply, Jenna!

    It's good to know that you didn't experience much in the way of breathing problems.

    Also, the doctor would do the surgery without the thoracoplasty but we requested it because her rib hump is pretty prominent and she has a lot of pain associated with it. We also figured it would be easier to knock out both surgeries at the same time.

    Quote Originally Posted by Jenna.KB View Post
    Hi Jewlty

    I had a thoracoplasty when I was 17yrs old. I didn't find the chest tube caused me any problems, it was in a few days then removed. After a few days I was given this little machine that I had to blow into to try and raise the plastic balls inside the machine. I was told that this would get my lung capacity back so did the exercise a few times a day until I could raise all 3 of the balls to the top of the plastic cubes they were encasted in.
    I had a firm matress before but as my curve have started to move again I decided to get an orthopedic matress with a foam topper so this might be an idea if you were thinking of getting your daughter a new matress.

    I don't know how many ribs may be reduced but I had all my ribs on the right side reduced as my hump was at the back and around the side, under my right arm. I can lay on my right side now but after about 5 minutes its really uncomfortable.

    I didn't have a special chair but I do remember having to hug myself to hold my rib cage in when I needed to cough or sneeze to reduce the pain when I did this. I also remember now being able to lift my right arm for quite a while so I had my mum help me to wash my hair. I also didn't feel strong enough to drive for about 2-3 months.

    I don't know how things work where you live but if your daughter is having corrective surgery does the surgeon not want to see what results he/she gets and whether the rib hump reduces on its own? I had corrective surgery on my lower spine at 13yrs old but because the surgery didn't correct my top curve it was later decided that I should have a thoracoplasty.

    Jenna

  7. #7
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    Hi Jewelty...

    I didn't have a thoracoplasty, but know several adults who had them. They routinely describe them as the most painful part of the surgery, but all agreed that the pain went away after 6-8 weeks.

    Have you had multiple opinions? Thoracoplasties aren't done very much any more. The newer implants do a really good job of reducing the rib hump without thoracoplasty. I work with 5 surgeons who do a lot of deformity surgery, and I know of only 1 thoracoplasty done in the last 2-3 years. With that said, the child who had the thoracoplasty did great.

    Regards,
    Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  8. #8
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    Quote Originally Posted by jewelty View Post
    Thanks for your reply.

    You didn't feel that the foam topper was too soft? Was it one of those Temperpedic type toppers?
    The Tempurpedic is foam. Itís a really thick hunk of foam about 15 inches thick, but in my recovery, it wasnít soft enough.

    I had a broken shoulder and a huge anterior and posterior scar, so was quite delicate and needed really soft foam. Sleeping was a challenge....its hard to sleep in pain.

    If you search all the foam topper threads, most agree on 2-4 inches thick. I think 4 inches would receive a majority vote.

    My foam topper was removed from my bed at around 12 months post, and feel that the Tempurpedic is a great bed.

    If I was broke, I would sleep on a piece of latex foam 6 inches thick on a flat floor. They also come in handy for guests when you run out of bed space. Its way better than a couch to sleep on.

    I wouldnít buy any furniture now....I have a lazy boy I donít use anymore, thatís why I say this. Let her decide after a few months.

    Ed
    49 yr old male, now 59, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  9. #9
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    Quote Originally Posted by jewelty View Post
    Thanks for your reply, Jenna!

    It's good to know that you didn't experience much in the way of breathing problems.

    Also, the doctor would do the surgery without the thoracoplasty but we requested it because her rib hump is pretty prominent and she has a lot of pain associated with it. We also figured it would be easier to knock out both surgeries at the same time.
    Hi again,

    Just wondering if your daughter is having a full fusion? I had fusion to the bigger curve at 13yrs old then when the smaller curve at the top hadn't improved and my rib hump was causing pain and making me conscious because of how I looked I decided to have the thoracoplasty at 17yrs old but I will say that it was the most painful op I've had and I have had other surgeries not associated with scoliosis. If your daughter is having a part fusion then maybe a thoraplasty at the same time would be a good idea.

    I agree that it knocks both surgeries out at the same time but if she's having a full fusion, with the results people have achieved on the forum after full fusion she may not need to go through the pain of the thoracoplasty. She may want to have the full fusion then see if she needs the thoracoplasty after. As I only had lower fusion and my top curve has progressed so extremely it has undone the good work of my thoracoplasty and pushed my ribs back out at the side and the back.

    A while after my thoracoplasty I attended the hospital to visit a girl from my high school that was having surgery, they gave her a full fusion and the results were so good her rib hump disappeared. I was so pleased for her but also so upset that my surgeon only gave me part fusion and I needed to go through the thoracoplasty. I'm convinced if my surgeon had given me full fusion I wouldn't have needed the thoracoplasty.

    Whilst my situation is different to your daughters I now have to have full fusion but then have surgery on my ribs on the right side (where I had the thoracoplasty)to try and put them back to where they should be.

    I don't want to cause you any more confusion than necessary but thought I should be honest. Maybe ask what others experiences have been with a thoracoplasty but the fact I still have to squeeze myself when I cough or sneeze, can't lay on my right side and now my curve has undone the work it has made me regret the thoracoplasty.
    Ultimately the decision is with your daughter but I wanted to let you know how I feel. Hope you don't mind my honesty
    27 yr old Female.
    Scoliosis since 12yrs, fusion to lower curve in 1998, costioplast 2001 and further corrective surgery 26 July 2012.
    Now the proud owner of a very straight spine. T1- L5 fusion.
    Mr Dunsmuir, Orthopaedic Surgeon, LGI Leeds.

  10. #10
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    Hi again -

    Her sugeon's words "...fusion levels would probably be from T4 to La. Sometimes I have to go up to T2 (depending on the flexibility and size of the curve)"

    Quote Originally Posted by Jenna.KB View Post
    Hi again,

    Just wondering if your daughter is having a full fusion? I had fusion to the bigger curve at 13yrs old then when the smaller curve at the top hadn't improved and my rib hump was causing pain and making me conscious because of how I looked I decided to have the thoracoplasty at 17yrs old but I will say that it was the most painful op I've had and I have had other surgeries not associated with scoliosis. If your daughter is having a part fusion then maybe a thoraplasty at the same time would be a good idea.

    I agree that it knocks both surgeries out at the same time but if she's having a full fusion, with the results people have achieved on the forum after full fusion she may not need to go through the pain of the thoracoplasty. She may want to have the full fusion then see if she needs the thoracoplasty after. As I only had lower fusion and my top curve has progressed so extremely it has undone the good work of my thoracoplasty and pushed my ribs back out at the side and the back.

    A while after my thoracoplasty I attended the hospital to visit a girl from my high school that was having surgery, they gave her a full fusion and the results were so good her rib hump disappeared. I was so pleased for her but also so upset that my surgeon only gave me part fusion and I needed to go through the thoracoplasty. I'm convinced if my surgeon had given me full fusion I wouldn't have needed the thoracoplasty.

    Whilst my situation is different to your daughters I now have to have full fusion but then have surgery on my ribs on the right side (where I had the thoracoplasty)to try and put them back to where they should be.

    I don't want to cause you any more confusion than necessary but thought I should be honest. Maybe ask what others experiences have been with a thoracoplasty but the fact I still have to squeeze myself when I cough or sneeze, can't lay on my right side and now my curve has undone the work it has made me regret the thoracoplasty.
    Ultimately the decision is with your daughter but I wanted to let you know how I feel. Hope you don't mind my honesty

  11. #11
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    Quote Originally Posted by jewelty View Post
    Hi again -

    Her sugeon's words "...fusion levels would probably be from T4 to La. Sometimes I have to go up to T2 (depending on the flexibility and size of the curve)"
    Hi

    Sorry, I don't know what that means. My surgeon never talks in T or L language. I have an S type curve with a rod at the lower curve but now the top curve is so bad I'm having a full fusion with possible pelvis fixation.
    Is your daughters curve at the top or bottom? did the surgeon say he would put a rod on the curved part only or a full rod?
    27 yr old Female.
    Scoliosis since 12yrs, fusion to lower curve in 1998, costioplast 2001 and further corrective surgery 26 July 2012.
    Now the proud owner of a very straight spine. T1- L5 fusion.
    Mr Dunsmuir, Orthopaedic Surgeon, LGI Leeds.

  12. #12
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    Just chiming in here to support what Linda said. I know myself as well as several other people on the forum have had almost complete reduction of our rib humps without thoracoplasty because the pedicle (sp?) screws are so good at fixing rotation. Best of luck!

    Evelyn
    age 44
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke, T4 to S1 with pelvic fixation
    Not "confused" anymore, but don't know how to change my username.

  13. #13
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    Evelyn - Our doctor is using pedicle screws and some hooks. She's 15 and very self-conscious about her rib hump. Every shopping trip literally ends in tears. I would prefer to not have to do the additional surgery but at the same time, I want her to get the best correction possible without having to go back at a later date to do the thoracoplasty. Two surgeries - one recovery.

    Jenna - The T stands for Thoracic and the L is for Lumbar. She does have an S-curve with the prominence on her upper right back and some on the lower left.

  14. #14
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    Quote Originally Posted by jewelty View Post
    Evelyn - Our doctor is using pedicle screws and some hooks. She's 15 and very self-conscious about her rib hump. Every shopping trip literally ends in tears. I would prefer to not have to do the additional surgery but at the same time, I want her to get the best correction possible without having to go back at a later date to do the thoracoplasty. Two surgeries - one recovery.

    Jenna - The T stands for Thoracic and the L is for Lumbar. She does have an S-curve with the prominence on her upper right back and some on the lower left.
    Hi again,

    Her S curve sounds just like mine, prominent on the upper right and some on the lower left. Its definately a hard decision to make and who doesn't want two operations in one and only have the pain once. That's why I wanted a full fusion when I was 13yrs old but the surgeons said that at the time they were finding correcting the biggest curve corrected the smaller one so they didn't want to limit my mobility. Unfortunately I was one of the few that it didn't work for, I ended up with a thoracoplasty and now the work has been undone and I need a full fusion.

    I can completely sympathise with your daughter I was so conscious when I was younger and still find clothes dont fit properly, I have really long legs but a small torso so everything is too long or a waist belt is near my hips and makes me look wider than I am or I had a huge extra piece of material at the top of my back that sticks out. I hated cloth shopping and found that shoe shopping was much more fun, beware your daughter me end up with a shoe addiction like me :-)

    Is your daughter chatting to people with a similar dilema or of a similar age on the forum? Maybe start a new threat and ask what people's rib humps are like after similar fusion to what your daughter is to have. The results may make your daughter decide she only wants the one operation and one incision and hope for the same result.

    Looking at peoples full fusion post op pics I am really hopefully my rib hump will go down like theirs. I believe thoroplasts aren't as popular as they used to be because a large fusion normally takes the hump right away.

    Give my love to your daughter

    Jenna x
    27 yr old Female.
    Scoliosis since 12yrs, fusion to lower curve in 1998, costioplast 2001 and further corrective surgery 26 July 2012.
    Now the proud owner of a very straight spine. T1- L5 fusion.
    Mr Dunsmuir, Orthopaedic Surgeon, LGI Leeds.

  15. #15
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    [QUOTE=does anyone have any suggestions for things that she may need at home post-op? We are looking for a new mattress for her - any suggestions on that? What about wedge pillows, certain types of chairs, etc?[/QUOTE]

    Hi Jewelty - great that you're checking into all now - 2nding all recommendations on memory foam. Son has been sleeping on tempurpedic since surgery; that bed actually has the adjustible frame which was such a help in early recovery. I'd have wedge pillows if that's not possible. We had gotten a 3'' memory foam topper from Overstock - laid that on the back seat of our truck for the long ride home, then put on what was then his bed. Soft sheets - smoothed out all the time, otherwise he was very uncomfortable. Lots of pillows for lying on side now & again. He sat in the lazy boy, as well as upright chair w bed pillow down the back. Button-down soft pajamas, button down shirts, elastic waist shorts & pants - no zippers for a while. A plastic chair or stepstool for the shower, hand held shower - for whenever your surgeon permits it. Ensure w ice cream in it, fig newtons, graham crackers, peanut butter crackers, scrambled eggs, etc - expect her to lose 10% body weight - we got around that by trying to get his weight up in the weeks before surgery. Sprite. Also prune juice, pear juice, etc for constipation - pain killers bind them up horribly; the meds also cause nausea if taken on an empty stomach - even a handful of dry cereal or crackers is better than nothing. Walk & move around - best thing for the pain, unless dr tells you otherwise. For the hospital - nonslip socks, favorite stuffed animal or blanket - even at 14 Jacob appreciated a supersoft throw blanket from home & a (UF) Gator pillowpal.
    I can't say as to the surgery for the rip hump. Jacob had 2 that were very noticeable - they resolved with the scoli surgery. Have you consulted w any other scoli surgeon, to confirm the additional surgery? Hate to ask 40 days out, but it's reassuring when you find similar recommendations... Best of luck, please don't hesitate to pm or ask on here for anything. Oh - his lung capacity was compromised before surgery, he was given that lung exerciser someone mentioned earlier in the thread for a couple months after surgery.
    LeighAnn
    Mom of 14yo son diagnosed Oct 2011
    Surgery 1/3/12 w Dr. Geof Cronen,
    Tampa General Hospital T3 to L1
    Jacob's pre surg curves: T58 & L31 12/28/11
    photos & xrays in "First-Time Surgery" thread "Before & After"

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