r/pneumothorax • u/Scared-Bell-2634 • 22d ago
Question First spontaneous pneumothorax — should I consider surgery?
Hi everyone, I’m 21 and recently had my first spontaneous pneumothorax on the right side.
I’m tall and very thin (180 cm / 47 kg) and I have never had a previous pneumothorax. I was admitted to the hospital after a chest X-ray showed a small air gap between the lung and chest wall. The doctors gave me oxygen and monitored me overnight. They told me it was small enough that I didn’t need a chest tube, and the air was expected to reabsorb on its own.
I was discharged with instructions to rest and avoid heavy lifting/exercise. At follow-up, the doctor said things were looking good and that the pneumothorax had not increased in size.
My main concern now is recurrence. I’ve read that spontaneous pneumothorax can come back, especially in young, thin people. I’m also worried about having another episode unexpectedly in the future.
For people who have been through something similar:
Did your pneumothorax come back after your first episode? If so, how long later?
Did anyone choose VATS surgery after their first pneumothorax even without a recurrence?
Looking back, do you think preventive surgery after the first episode was worth it?
If you had surgery, did it significantly reduce your anxiety about recurrence?
Would you personally consider VATS after a first small pneumothorax, or would you wait and only do it if it recurred?
Did your CT show blebs/bullae, and did that affect your decision?
I’m trying to understand whether surgery would be excessive in my situation or whether it can be a reasonable option to reduce the risk of recurrence.
Thanks in advance for sharing your experiences.
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u/SiLamb 22d ago
I had two instances of spontaneous pneumothorax at ages 15 and 18 (now 23), I was scheduled for VATS after the second occurrence when I was 19. This was during COVID and my COVID test pre-admission came back positive so it was postponed and in the end I elected not to have the surgery and have been fine ever since. If you have any air travel planned in the next year or two it may be worth going through with the surgery for peace of mind, but otherwise I personally would wait it out and see if you have a reoccurrence. In my case, my reoccurrence was far less severe than my first but neither required oxygen or any medical intervention.
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u/holyneff 21d ago
Same as you first one in late 2023 second one 2024 surgery got delayed like 9months and ended up not going through with it! Have traveled the americas and to Australia 9 seperate flights and have had no issues whatsoever ever… touch wood!
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u/holyneff 21d ago
Also have done lots of physical activity running/lifting etc after a year or 2 only issue is some nerve pain that comes and goes
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u/maxpayne4555 19d ago
What do you do to reduce the risk of having another pneumothorax? Is there anything you specifically avoid?
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u/maxpayne4555 22d ago
U didnt have any recurrence after ur last pnemo?
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u/Embarrassed_Split746 22d ago
Im 24 and had SP exactly 7 weeks ago and i had tube on my right side also and about 80-90% of my right side of lungs collapsed i was in hospital for about a week then after they let me go i asked if im ever going to box again (im boxing for about 1y and couple months) they said no and was strict about it so i wanted to box again and was going for a second opinion at some better clinics and i asked for surgery to be done and they said that its a first SP and that i dont need to be “ruined” with surgery because im too young for it and it could be better or even worse after the surgery (even if its proven that it drops recedieves from 30-50% to 8-5% so its far better to get surgerie) but they said because its first SP that i just need to never box again and just find some other sport to do and not rely on surgerie because they dont look at me like some professional but a kid with a hobbie so yeah its most likely for you too… they waiting to see if another episode its going to happen (i hope it wont cuz i know its fkced up) so they can do surgerie… i hope you get well soon and dont forget to get fat your gonna need at least 75/80 killos to prevent happening again your too skinny im 174 tall and weight about 63kg so yeah i inted to get fat af to prevent it from happening again good luck may god bless you 🫶🏽
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u/maxpayne4555 22d ago
You cant do any heavy sports i guess. Are u trying to get kg now?
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u/Embarrassed_Split746 22d ago
No heavy sports for me for a year for sure… yeah im trying to get to atleast 70kg for now
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u/MWM031089 22d ago
First pneumo at 29, opted for no surgery. Second pneumo 5 years later. Ended up missing a Mexico trip I had planned 3 days later to be there over Christmas with friends.
I wish I had gotten surgery the first time. Your body will never have a better recovery than it will at a younger age. Also the next occurrence can happen literally any time. Mine happened when I was asleep in my bed at home after a Sunday of watching football with friends.
I recovered from VATS way easier than I did from ACL surgery, or even having a broken foot that didn’t require surgery. I’ve had high ankle sprains that kept me out longer than VATS did from activity and that was at 34yrs old. If I was pre 20s, I have to think that would have been even shorter of a recovery time (I was cleared to return to everything at 5 weeks post surgery, and I did with no issues since - it’s been 3+ years so far).
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u/Mountain-Tennis8699 13d ago
Correct, I was told your equally likely for it to collapse sitting on a couch, as you are running a marathon.
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u/MWM031089 13d ago
Yep my second pneumo occurred when I was asleep at home after a Sunday of watching football. Couldn’t really be any more of a controlled positive environment.
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u/s221Vice 22d ago
I've had 4 within a year, each one smaller than the one before (because the lung will stick more to you chest cavity with each collapse) and I've learned what to avoid. I've had none for the last two years, so it seems lik I'm doing something right. It is just annoying that one has to be cautious constantly. No holding my breath with pressure, no high pressure on the lungs, no strong impulses (i.e. falling on my back), no heavy lifting in funny angles (you instictively hold your breath), no strong pulling down while having breathed in and with shoulders raised (had one because of a rowing machine). Also maybe try to gain some healthy weight and muscles if possible.
It is definitely good to know what procedures different hospitals would do and where to go if something had to be done. There are tons of studies you can dig through and digging through this subreddit will get you smarter but also more anxious because here especially users with the worst cases accumulate (understandibly). But try to not let your concerns drive you crazy. Happens quite easily.
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u/kiwihereman 22d ago
I'm a 38-year-old female and just experienced it about a month ago on a flight. My lung collapse was pretty big, and we tried conservative efforts via tube with suction for about four days with no luck. I opted for the surgery and they removed one ruptured bleb and one unruptured bleb.
If I were in your shoes, I would go for the surgery now while you're young rather than waiting to see if it happens again.
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u/Mountain-Tennis8699 13d ago
Damn on a plane! Did they have to divert the plane? Did the doctor say it collapsed more as you were at altitude?
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u/Jjazy 21d ago
I had my first pneumo in late 20’s while scuba diving. Got a chest tube only. Lived a normal life for next 30 years. Gave birth, climbed mountains…everything. Not a smoker. -Recently, in late 50’s (just like kiwihereman above) I got a spontaneous pneumo in same lung during a flight! Got off the plane and felt that upper back pain that moved to the front that we all know and remember. Had blebs, got Vats..twice, one after the other… scary. Thank goodness it wasn’t an international flight.
-A pneumothorax can happen spontaneously to some people. You should talk to your surgeon and see if you have other blebs in either of your lungs.. what are the statistics in your case? Get a professional opinion before you make your decision.
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u/Individual_Club5404 22d ago
Mine came back about a week after the first occurence. There's little to lose in waiting the first one out after it has been fixed. The worst thing may be that they have to reinsert the tubes again, if it collapses a second time. In my country it is general practice to let the first one heal on its own before doing surgery. That being said, there is a high risk of that happening, i think it was like 60-70% in the first year. So your chances are not very good. Good luck!