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Lungs and Mortality - Part I

August 8th, 2007 | 5 min read

By Keith E. Buhler

Part I - The objective is to remove the air from around the lungs

I was eighteen the first time my lung collapsed. The ER doctor called it a “spontaneous pneumothorax.”

He said "Pneumothorax" is Latin for "lung collapse."  Then "spontaneous" must be Latin for "spontaneous." I was surprised to learn that the word "spontaneous" is actually in the medical description. It's sort of the official medical way of saying, “We have no official idea what the official medical cause of this lung collapse is."

The right lung is visible because it is smaller than the lung cavity

He said it happens to tall slender people. Guilty as charged. Apparently we skinny-folk have long, tapered lungs that thin at the top, allowing little blebs of flesh to occasionally (and spontaneously) burst, releasing air, and compromising the vacuum between your lung and lung wall. Most people don't realize it is this vacuum pressure in your lung cavity that keeps your lungs inflated. It's as if your lungs have been sucked into the lung wall from the outside, like a big bubble-gum bubble is sucked into your mouth after you pop it, or rather than being "held up" by air pushing from the inside, like a balloon.

I was sitting with my dad in his hotel room when it happened. At first it felt like a cramp in the muscle between my shoulder blade and spine. I tried to stretch the muscle or massage it to relieve the cramp, but I couldn’t seem to find which exact muscle was causing the discomfort. The painful sensation started as a pinpoint between my shoulder blades, then spread to the whole left side of my back. I later learned that this is what it feels like to have your lung tear away from the lung wall.

We went to Radio Shack to buy batteries. After about twenty minutes, the initial discomfort was no better, and it had spread to my whole right side. I told my dad. "I'm a little short of breath." We headed for the Emergency Room.

The ER doctor took a few X-rays, and said, “Come back if it gets any worse. Otherwise, it will take two or three weeks for your body to dispose of the excess air in your lung cavity.”

What was I supposed to say to that? "OK, I guess I’ll just wait two or three weeks then. Will it happen again?”

“Probably. If it has happened once, there is a 30% chance it will happen again.”

“Are there any kinds of activities I should avoid, to prevent it happening again?”

“No, it’s "spontaneous.” Though, often times people report occurances after diving into a pool.

"Great. No diving. Got it. Anything else?"

"Sometimes sneezing triggers it."

"OK, no more sneezing. Got it. Now, I was lifting weights last week."

"Oh, that shouldn't effect it."

"Weight-lifting is OK, got it."

"What were you doing when it happened?"

"Uh, sitting. Sitting slightly forward. Yup."

"Huh. Don't what to tell ya. It's spontaneous."

“Is it life-threatening?”

“No, in fact some people have multiple Spontaneous Pneumothoraces over the course of their lifetime, and never even know it until later. You’re working with one lung at 100%, and the other at about 70%, so you may not even notice it. Now, what can be dangerous is a "Tension Pneumothorax." That’s when the weight of one collapsed lung starts dragging the other lung down, creating a one-way valve that sucks air out without returning the favor. This causes both to collapse, as well as putting pressure on your heart. A few people have died from Tension Pneumothorax. But those are more rare.”

The worst it got, that first time, was uncomfortable or unpleasant. The “cramp”feeling extended into my entire back, and I couldn’t take a full breath without it hurting, sort of like the feeling you sometimes get after spending a week in the mountains, or after swimming in a highly chlorinated pool. But even accounting for the mild panic of realizing I was having trouble breathing, the hurt was never terrible. Thank God, I was with my dad, who took me to the emergency room. We got everything taken care of, and pretty well explained...