Ongoing Breathlessness, Pain, and Fatigue Following Iatrogenic Pneumothorax
Greetings, everyone. I'm a 30-year-old female from New Zealand. In December 2020, I experienced a significant medical mishap when an attempt to administer a nerve block for a suspected broken rib resulted in a punctured middle lobe of my right lung. Within ten minutes, my lung had collapsed by more than 50%, leading to an emergency chest drain placement and subsequent transfer to a larger hospital. Unfortunately, this procedure also led to persistent intercostal neuralgia and severe upper back pain that has gone unrecognized. I continue to suffer from intense pain in my upper back, particularly in the exact area where the chest drain was placed. Although the drain was in place for four days and eventually facilitated the reinflation of my lung, my life has drastically changed since then. My oxygen saturation levels remained stable at about 94% prior to the drain insertion. However, in the five years following this incident, I've battled ongoing breathlessness, both during physical activity and at rest, along with intercostal discomfort, costochondritis, a diagnosed breathing pattern disorder—which has since been treated—and debilitating fatigue. I also grapple with severe PTSD, for which I have engaged in years of psychological therapy, though with minimal improvement. As a result of these ongoing issues, I have been unable to resume my professional duties, and daily tasks such as household chores are overwhelming due to my persistent breathlessness, pain, and fatigue. I find myself reliant on **ACC** for support, which has caused me considerable frustration. I've struggled with two spirometry tests, failing to inhale sufficiently for the necessary exhalation tests to yield a reading. Despite undergoing numerous blood tests that have all returned normal results, an ultrasound of my diaphragm also showed no abnormalities. While several X-rays have been completed over the years, none have indicated any issues. I’ve tried **Symbicort** without success and have occasionally found some relief with **Ventolin**. I have also undergone multiple 20mg tapering prednisone courses over 21 days, which have temporarily alleviated my breathlessness and fatigue, but their effectiveness has diminished over time. I consistently take iron supplements, as I have longstanding issues with low iron levels, coupled with a history of severe endometriosis. For pain management, I rely solely on paracetamol and occasionally take **Naproxen 500mg**. I tend to react poorly to many medications, so I limit my pharmaceutical use and prefer utilizing heat therapy, a TENS machine, and focusing on managing my discomfort as best as I can. What should my next steps be? I am perplexed as to why my breathlessness and fatigue show no signs of improvement, and I am frustrated that a clear cause remains elusive. Currently, **ACC** has argued there is no causal connection between my neuralgia, breathlessness, and the original iatrogenic pneumothorax injury, which feels illogical considering these issues were non-existent prior to the incident. My general practitioner has exhausted all suggestions, leaving us uncertain about potential referrals or next steps to gain clarity on my condition. I long to reclaim some semblance of my previous life. Before this incident, I was quite active—regularly engaging in gym workouts, pole dancing, horseback riding, running, and hiking through the challenging terrain of New Zealand. Now, I struggle with simple tasks like walking my dog to the end of the street or maneuvering a vacuum cleaner in my home.
Answers (1)
2/9/2026, 12:50:35 AM
OpenHealth AI
I'm truly sorry to hear about the ongoing challenges you're facing since your pneumothorax. It sounds like a very difficult journey, filled with pain, breathlessness, and frustration. Given the complexity of your situation, let's focus on some actionable steps to help manage your symptoms and improve your overall well-being.
Key Points:
- Monitoring and Addressing Breathing and Fatigue: It is essential to continue addressing the breathlessness and fatigue that you experience, focusing on gradually increasing your activity as tolerated.
- Pain Management: Finding effective pain relief strategies is crucial given your persistent pain, particularly in your upper back.
- Seek Comprehensive Support: Engaging with multi-disciplinary care may provide additional insights into your ongoing symptoms.
Explanation:
Your history indicates complex interactions between physical trauma, nerve pain, and breathing issues. Despite normal tests, the symptoms you're experiencing (breathlessness, pain, fatigue) can sometimes arise from a combination of factors like nerve damage, psychological stress (e.g., PTSD), and reduced activity levels. While the physical trauma is a clear initial trigger, chronic pain and breathlessness can sometimes develop into conditions that don’t show up in standard tests, yet significantly impact quality of life.
Next Steps:
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Breathing Exercises and Pulmonary Rehabilitation:
- Even though you have had issues with spirometry, working with a respiratory therapist could help you develop a tailored program to improve lung function and decrease breathlessness. They may provide breathing exercises focused on diaphragmatic breathing, which can be beneficial for managing your symptoms.
- Gentle activities like walking and stretching, as tolerated, could help enhance your endurance. Start small and aim for consistent, gradual increases in activity.
-
Pain Management Strategies:
- Since you've found some relief with heat therapy and the TENS machine, continue utilizing these methods. Additionally, consider wearing a supportive brace for your upper back if advised. If opportunities arise, you might explore physical therapy, which often includes targeted exercises that can help with both pain and breathlessness.
- Consult your healthcare provider about a referral to a pain specialist, who may offer advanced pain management techniques or alternative options beyond typical medications.
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Psychological Support:
- Since PTSD is a significant part of your experience, consider seeking specialized PTSD therapy, such as cognitive behavioral therapy (CBT) or eye movement desensitization and reprocessing (EMDR). These modalities can help develop coping mechanisms and reduce the impact of stress on your physical symptoms.
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Regular Follow-ups:
- Maintain close communication with your general practitioner regarding your ongoing symptoms. Request a multi-disciplinary approach, potentially involving a pain specialist, pulmonologist, and a psychologist familiar with chronic pain and PTSD.
- Seek clarification from ACC and document everything thoroughly, emphasizing how your symptoms developed post-incident.
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Lifestyle Adjustments:
- Continue with iron supplements as advised, focusing on dietary sources of iron like red meat, legumes, and fortified cereals, as long as they are well tolerated. Make sure to communicate with your doctor about your nutritional needs, especially due to endometriosis.
Conclusion:
I genuinely empathize with the challenges you're facing, but remember, there are strategies and professionals who can support you through this complex recovery process. Consistent follow-up and dedication to a tailored plan can gradually help restore some of the physical capabilities and emotional well-being you once enjoyed.
If you have questions about any specific interventions or need specific resources, feel free to ask!
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