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Suggest treatment for pain after a thoracoscopic pleurodesis due to THC

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Posted on Sat, 23 May 2015
Question: Hi, two years ago I had a spontaneous pneumothoarx followed by a chest tube. Upon follow up a week after release it had recollapsed and was treated with a thorascopic pleurodesis. I began smoking weed daily months after healing and I have stopped recently but have been experiencing pain. I know I shouldn't have been and do plan to stop permanently. Will I be in any trouble or risk any consequences if I were to go in and they detected THC? I believe my lung's been collapsed for 3 days. How dangerous is an untreated recollapse given my surgery? I can't feasibly go to see anyone for an additional three days. Thank you for any help.
doctor
Answered by Dr. Vivek Chail (41 minutes later)
Brief Answer:
Please get an X ray done immediately to confirm pneumothorax

Detailed Answer:
Hi XXXX,
Thanks for writing in.

I have read through your query in detail.
Please find my observations below.

1. A lung collapse is a serious concern and might be life threatening. When the lung collapses, gases are unable to be exchanged in the affected lung and the respiratory function is compromised.

2. However, in patients who have undergone pleurodesis, the subsequent lung collapse is more likely to be partial in nature and if it is confirmed to be a small pneumothorax then the patient does not require intervention and makes recovery with conservative treatment.

3. If you are experiencing an acute, sharp pain that starts in the upper back and in the shoulder blade area then most probably you are having a recurrent pneumothorax. The pain also spreads to the front of chest and your upper arms.

4. It is difficult to tell the severity of a pneumothorax from the pain experienced and doing a chest X ray is absolutely essential.

5. Since you feel that "your lung is collapsed since 3 days", therefore getting a X ray is important to know if your lung is really collapsed and if it will heal by itself or requires treatment. Waiting an additional 3 days will mean taking a risk if one of your lungs has a total collapse.

6. No tests for THC detection are required when looking for pneumothorax.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (26 minutes later)
Thank you Doctor for the fast response. The pain is off and on. A dull pain in my upper chest near shoulder blade that feels tight when I inhale deeply I also feel an almost numb sensation internally but continues to my back. I will get it checked tomorrow. I realize the site is for immediate concerns but as I have two questions left I was curious if you would be willing to answer them. In your opinion would the smoking have any caused any potential damage internally (besides the collapse)? And further would there be potential tar build up in the from the marijuana?

Thank you, XXXXXXX
doctor
Answered by Dr. Vivek Chail (1 hour later)
Brief Answer:
Smoking causes damage to lung structure and small air passages

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

1. It is possible that after pleurodesis some patients feel dull pain for few months to years after surgery as the pleura is supplied with rich nerve endings.

2. Keeping in mind the high incidence of recurrent pneumothorax, doing a X ray is important. Sometimes a small bulla might rupture and cause mild pneumothorax.

3. Smoking tobacco or marijuana can cause deposition of tar in the small air passages and make them firm and brittle. This depends on the frequency of smoking and the particles inhaled. Basically tar is an end product of smoking and it gets inhales as small particles and with increased smoking they form a layer coating the air passages.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Vivek Chail

Radiologist

Practicing since :2002

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Suggest treatment for pain after a thoracoscopic pleurodesis due to THC

Brief Answer: Please get an X ray done immediately to confirm pneumothorax Detailed Answer: Hi XXXX, Thanks for writing in. I have read through your query in detail. Please find my observations below. 1. A lung collapse is a serious concern and might be life threatening. When the lung collapses, gases are unable to be exchanged in the affected lung and the respiratory function is compromised. 2. However, in patients who have undergone pleurodesis, the subsequent lung collapse is more likely to be partial in nature and if it is confirmed to be a small pneumothorax then the patient does not require intervention and makes recovery with conservative treatment. 3. If you are experiencing an acute, sharp pain that starts in the upper back and in the shoulder blade area then most probably you are having a recurrent pneumothorax. The pain also spreads to the front of chest and your upper arms. 4. It is difficult to tell the severity of a pneumothorax from the pain experienced and doing a chest X ray is absolutely essential. 5. Since you feel that "your lung is collapsed since 3 days", therefore getting a X ray is important to know if your lung is really collapsed and if it will heal by itself or requires treatment. Waiting an additional 3 days will mean taking a risk if one of your lungs has a total collapse. 6. No tests for THC detection are required when looking for pneumothorax. Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek