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PleuralEffusionLeftSide - fluid in my left lung = really not fun

It has been a month to the day since my heart surgery on August 19th, and a lot has happened since then, some of which is kind of informative so I thought I’d pass it along.

My original surgery went well, and as planned. My mitral valve was repaired utilizing a mini-sternotomy (meaning I have a 3in. (8cm) scar in my chest through which all the work was performed). Things progressed well in the hospital, and I was discharged on the following Sunday, August 24. Once at home, things seemed to progress as well until my parents left around the 27th, with some odd pains here and there, (par for the course).

Around the 29th, I started having a few pains that sort of came up out of the blue that didn’t seem right. The worst of which was a pain underneath my ribs on the heart side that would become a stabbing pain whenever I tried to breathe in a full breath. At the time I thought that this was a little normal, and was concerned that I wasn’t able to do my breathing exercises properly (which was also supposed to help re-inflate my lungs fully). Over Labor Day weekend, the pain (now pains) continued to worsen as did the fevers I was having (that were topping out at around 40 degrees celcius), and so we took a trip to the doctor.

Thoracentesis - the full liter of fluid removed today from my left lung. (1 Liter!)

On Tuesday, September 2, I was put on a short course of antibiotics (to catch anything that might be occurring), had several blood tests and a chest x-ray done, which revealed a substantial pleural effusion (http://en.wikipedia.org/wiki/Pleural_effusion) behind my left lung. A thoracentesis was performed and 1100cc of fluid was removed. Over the course of about 4 days, I continued to start feeling a little better, so I thought that I was kind of back on track to get better, thought it wasn’t a really striking improvement. By Wednesday, September 10th, my fevers were pretty much back again in full-force and I started to feel not so great again. In addition to the fevers, I was having some shortness of breath again, and getting out of bed in the morning was again a painful process.

I returned to the Dr. again on Monday, September 15th, and got another battery of blood tests and a chest X-Ray. The chest X-Ray didn’t really look much different than the week before, but this time I also spoke with a Infectious Disease specialist who sat down with me and went over my file and what had gone on since surgery. Her thought was that I was experiencing Dressler’s Syndrome (http://en.wikipedia.org/wiki/Dressler’s_syndrome), which pretty much made sense for all the known symptoms I had at that point. She ordered an echocardiogram to check for pericardial effusion, which was present.

Dressler’s syndrome, in my case presented itself with the pleural effusion, pericardial effusion, fevers, elevated white blood cell count, and the chest pains that I was having (particularly when changing incline (getting in/out of bed)). As of now I am on a hefty course of Ibuprofen, as Dressler’s is basically treated as high levels of inflammation, and have felt better and fever-free since I started on the Ibuprofen on September 15th. I’m not counting my chickens before they hatch, but this has at least been the longest period of perceived progress in my healing since my surgery, which is pretty awesome. I even forgot to take my regular pain killer for the surgery, Tramadol, yesterday and began to wonder what the achey-ness was that I was having in my chest – due to the other complications I hadn’t actually felt the pain from the surgery. I kept taking the pain killers during the other complications thinking that I needed them for those pains (even though they didn’t help), and so I had never even encountered the other chest pains!

Anyway, that is the news so far, brought to you by Dressler’s Syndrome. I’ll post progress again at some point hopefully sooner than a month away.