This post isn’t going to be like my usual posts. I’m not talking about homeschooling or OT or even a parenting tip. I want to take a moment to tell you about my son’s recent surgery. I’m sharing because pectus excavatum is sort of rare, and it was hard to find resources about it.

Recognizing The Issue

At age 8, we realized my son’s chest was not flat like most people. Instead, it curved inward. It curved inward enough that I worried it was crushing his heart. I took him to pediatricians, orthopedic doctors, and family medicine doctors. No one knew what to do. All of them seemed to think that if he wasn’t struggling to do things, like walking up stairs, he was fine.  But I didn’t feel comfortable with that. None of them sent him for tests or told me what kind of doctor to see for this problem.

Finally, our chiropractor suggested I call the large children’s hospital near us and ask them who to see. The kind receptionist there helped me make an appointment with the head of Thoracic Surgery for Children’s National Hospital, Dr. Timothy Kane.

Finally, We Had An Answer

Dr. Kane explained that we were looking at a condition called pectus excavatum. These fancy Latin words just mean the chest is caved in. The chest can also curve outward, a condition called pectus carinatum. That requires a different kind of bracing and help.

In our case, the recommendation was for surgery at age 12. Each year, we had annual check-ups with Dr. Kane to ensure we were still on the right path.  At this year’s check-up, this year being the year he turned 12, we started to make plans for the surgery.

Getting ready

The surgery we agreed on is called a Nuss procedure. It involves placing a metal bar inside the chest to push it out and into place. The bar stays in the chest for a few years, through the significant growth spurts of the early teens. The bones eventually harden into place in the right position as the body matures. It is important to make sure the kid isn’t allergic to the metal before placing it.

Before the surgery, we had to do a CT scan, full cardiology workup and allergy testing for metal. Weeks of doctor’s appointments, lab work, and inconsistent allergy test results left us exhausted and anxious for the big day.

Post-Op

This X-ray shows where the bar sits inside the chest wall. It pushes out the sternum and wraps around the ribcage. It stops under the arms on both sides.

The surgery was a success! And while my son needed several days in the hospital for pain medication, within two weeks post-surgery he was up and back to a lot of his normal life. If he played sports, we would have been putting those off for another 6 weeks. But even with the bar in, once he healed, he can live a normal life.

Unfortunately, he did have a post-op infection. This infection resulted in another week in the hospital and a lot of antibiotics. It slowed his recovery, however, he is now back to his regular life and able to do all he did before.

We’ll be following up with his doctor annually for the next few years. And he will need another surgery to remove the bar when he’s about 16. We already are seeing improvements in his breathing and general well being.

As an aside, I can’t thank the doctors, nurses, and staff at Children’s National Hospital enough. If you need surgery for your child and it is reasonable to drive to a facility that is dedicated to children, I highly recommend you look into it.

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About the Author

Laura Sowdon, OTR/L is an occupational therapist, writer, speaker, educator and creator of the Five Senses Literature Lessons homeschool curriculum. She has worked as an occupational therapist with children in public and private schools, as well as private practice. Laura has taught and managed homeschool co-ops as well as homeschooling her own three children. Laura is dedicated to the idea of educating children at a pace that aligns with brain and physical development milestones and respects neurodiversity in all its forms.

1 thought on “Pectus Excavatum”

  1. […] honestly, between a move, a health crisis with one of the kids in the fall, and this pandemic, this is probably my worst homeschooling year, ever. We’ve […]

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