Blog

The Pectus Excavatum Blog is dedicated to conveying advice on how to deal with and improve the condition. It provides you with an opportunity to share your experiences or advice and ask any questions which you may have about the condition.


Patient Story: Nuss Surgery – the day before surgery

Here is a video about patient story:

Pectus Excavatum; a brief summery

Pectus Excavatum is a highly common congenital deformity affecting roughly 1 in every 300 people. It is not preventable, but treatment continues with various methods, including surgery. The Ravitch and Nuss surgical procedures are most commonly suggested to repair Pectus Excavatum. However, not all patients qualify for, or choose to have surgery, but continue to deal with their personal condition.

Many of those with Pectus Excavatum are unhappy with the way their chests look and seek options for treatment. Bracing options, physical therapy, and extensive exercise can have effective results for many patients. Many bracing products, custom made by a specialist or off-the-shelf, provide adequate support but lack the needed circumferential pressure to reduce rib flaring. Patients are advised to look for products which provide added compression to the protruding bone and disperses pressure evenly across and around the brace allowing for greater comfort and effective treatment.

The Use of Magnets to Treat Pectus Excavatum

Pectus Excavatum is the most common deformity of the chest wall, affecting roughly one in 300 people ? boys more so than girls. While sunken chest can be largely corrected with surgery, the procedure is highly invasive and extremely painful. Hence, many individuals won’t do it.

But a new method using magnets and an external brace, developed by Michael Harrison, a pediatric surgeon at the University of California, San Francisco’s Benioff Children’s Hospital, which could provide an effective alternative to the surgery.

People with Pectus Excavatum have chests that are concave. Sometimes, the condition is evident at birth, whilst other times, it develops gradually. In most cases, it is not life-threatening, but it can put pressure on the lungs and heart.

“They’ll tell you they get very fatigued when they exercise vigorously,” says University of Minnesota Medical School pediatric surgeon Daniel Saltzman. “In fact, there’s a vicious circle set where they don’t want to exercise so they sit out, play video games, things like that.”

But probably the worst part, at least from the perspective of a teenage boy, is how it looks. For 14-year-old Justin Rosales, it’s just embarrassing.

“I show my friends that I trust,” he says. “But not that much.”

Rosales is from Stockton, Calif. That’s in the Central Valley, where the average July temperature is 94 degrees. But Justin never swims without a T-shirt, says his father, because he’s embarrassed to show the indent in his chest.

Justin is an only child. His dad works two jobs, but the whole family drives an hour and a half to Benioff Children’s Hospital in San Francisco, where Justin is taking part in Harrison’s clinical trial for the new procedure. The magnet procedure is in its second Food and Drug Administration trial, with about 15 children taking part.

At the base of Justin’s concave chest is a small scar. He’s been implanted with a powerful magnet, just beneath the skin.

To demonstrate, Harrison held up a little refrigerator magnet, which snaped to Justin’s chest.

And that’s pretty much how it works. Every day and night for about two years, Justin will wear an external brace containing a second, powerful magnet. If all goes well, the magnets will attract each other with enough force to gradually pull Justin’s chest wall outwards.

Traditionally, doctors have used one of two surgeries to correct sunken chest. Saltzman, who operates on a few hundred patients a year, says both surgeries work well. But they’re major procedures, requiring hospital stays. And he says the pain can be quite profound.

Some surgical patients stay on pain medication for months.

“Many of us surgeons have seen children become addicted to opiate narcotics because of pain meds they have to use,” he says. “We’ve sent a couple to treatment to get them off their pain meds. It’s very, very hard to watch.”

So Saltzman is excited about the new technique that Harrison is developing. The magnets are virtually painless because they work gradually.

“The way to fix something that’s structurally malformed like that is not to rip the whole thing apart and put it together over a matter of hours,” Harrison says. “A better way to do it, and to think about it, is to fix it like the orthodontist does your kids’ teeth ? a tiny little bit, a millimeter every day.”

The key, says Saltzman, will be getting patients into care while their chest walls are still soft. Wait until after puberty, and it may be too late for the magnets to work.

He’s enthusiastic, he says, about any way to help these kids feel better about themselves.

“Once you repair the deformity and you see their self-esteem grow, like a flower opening when you water it, is spectacular,” he says. “It’s an amazing experience.”

Pectus Excavatum Q&A

Check out this great video on the minimally invasive methods to treat pectus excavatum, from Dr. Johns Hopkins and Dr. Fizan Abdullah.

Treatment of Pectus Excavatum: General Exercises & Posture

Pectus Excavatum treatment will benefit greatly from any sort of physical exercise. I personally know of a few people with Pectus Excavatum who joined the army and came out of it with an incredibly improved chest wall appearance.

They believe all that exercise and standing straight and marching helped incredibly. Posture is something that can have a huge impact on how bad or good your chest will appear and exercise can helkp to improve this greatly.

The best general exercises for improving your chest appearance are Running, Jogging, Swimming and Yoga.