Managing Recurrent Spontaneous Pneumothorax After Bilateral Pleurodesis - Pulmonology

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Managing recurrent spontaneous pneumothorax (RSP) after bilateral pleurodesis can be quite challenging, especially given your history of previous interventions and the current state of your lungs. It’s understandable to have concerns about the potential for serious complications, such as lung collapse, and the implications for activities like flying.

First, let’s address the concern about the risk of a significant lung collapse given the presence of adhesions (or pleural adhesions) from your previous pleurodesis. While adhesions can help stabilize the lung and prevent it from collapsing completely, they do not eliminate the risk of pneumothorax entirely. The fact that you have approximately 30% air leak on both sides indicates that there is still some degree of air escaping into the pleural space. In general, if the air leak is small and you are not experiencing significant respiratory distress, the body may be able to gradually reabsorb the air over time. However, it is crucial to monitor for any changes in your symptoms, particularly if you experience increased shortness of breath or chest pain, as these could indicate a worsening condition.

Regarding air travel, flying with a pneumothorax can be risky, especially if there is an existing air leak. Changes in cabin pressure during flight can exacerbate the situation, potentially leading to a more significant pneumothorax. It is advisable to consult with your healthcare provider before making any travel plans. They may recommend a chest X-ray or CT scan to assess the current state of your lungs and determine whether it is safe for you to fly.

Using supplemental oxygen can be beneficial, especially if you are experiencing any degree of hypoxia (low oxygen levels). Oxygen therapy can help improve oxygen saturation and alleviate some symptoms associated with lung issues. However, it is essential to use it under the guidance of a healthcare professional, as they can provide recommendations on the appropriate flow rate and duration of use.

As for the CT findings of a defect between the mediastinal aorta and pulmonary artery, this could indicate a variety of conditions, including congenital defects or acquired issues. The clinical significance of this finding would depend on its size, the presence of symptoms, and any associated conditions. Regular follow-up with your healthcare provider is essential to monitor this finding and assess whether it requires further investigation or intervention.

In summary, while the presence of adhesions may provide some protection against severe lung collapse, it does not eliminate the risk of complications from recurrent pneumothorax. It is crucial to stay vigilant for any changes in your symptoms and to consult with your healthcare provider regarding travel plans and the use of supplemental oxygen. Regular follow-up appointments are also important to monitor your lung health and any significant findings from imaging studies. Always prioritize your health and safety, and do not hesitate to seek medical attention if you have concerns about your condition.