View Full Version : Collapsed Lung
Hi!
I am interested in joining the Special Forces upon graduation from college. I had a collapsed lung when I was sixteen years old. I received surgery for it the year after. Would this disqualify me from passing the Physical portion?
Kyobanim
01-25-2007, 21:08
Did you use the search button to locate the thread that addresses medical conditions and their ramifications?
The Reaper
01-25-2007, 21:15
Hey, W1cked.
Back to square one and read the stickies, as you were previously instructed.
Especially the one that pertains to SF physical requirements.
You might also review this recent thread, after you finish with the Intros and stickies.
http://www.professionalsoldiers.com/forums/showthread.php?t=13161
TR
I took your advice and found http://www.usapa.army.mil/pdffiles/r40%5F501.pdf.
It says that if it has been treated 3 years before I get examined, I am in the clear. Oh, and TR, I read the other post. I don't think my case will be like that. Once you get surgery for the collapsed lung, there is no chance it will ever come back on its own.
kachingchingpow
01-26-2007, 10:55
My lung blew after 4 months at the Q course. It was a spontaneous non-traumatic pneumo throrax, caused by a nasty cough from bronchitis that I had. My stubborness wouldn't risk getting recycled due to the cough, so I just sucked it up. (old age has taught me to be smarter about these things). I continued to hump a ruck for 3 days after it blew... at which point I was more scared than anything. The symptoms were exactly what everyone told me a heart attack felt like... sharp pain in the chest, numbing down the left arm, dizziness, cold sweats. I pretty much made my mind up that they were going to carry me out before I quit on my own. I told Highspeedmdd (one of the QP's here on the board) what was going on, and that I thought I might be having a problem with my heart. While lying down on my left side, he could hear my heart "glub-glub" from 5 feet away (I later found out that the sound was my heart beating into the blown lung). He urged me to go get checked. That next morning every step felt like it might be my last. That afternoon a chest tube was put in, I was med-terminated a few days later, and released back to my unit after a couple weeks.
The med-term (I still have the letter in my files) said that I could re-apply to the course after 6 months, (with all of the normal pre-requisites). There were no stipulations at the time that a prior pneumo thorax would disqualify me. In fact the SWC Surgeon said that it wasn't a condition that would keep me out.
I found that 6 months was about bare minimum for the lung to feel like it did prior. In the mean time I went to college at night, and worked for the government during the day. I remained with the 20th group for 4 years... put on a team and did the paper tab courses for a while. (it wasn't uncommon at the time for someone who had been to the Q, but med term'd to be on a team until they went back. not to mention I signed as an Echo and had been through AIMC). When the first SFAS class came online all non-tabbed were required to be in the newly developed NQP program that was formed as an SFAS prep school. In the end, life got complicated, I had to move out of state for a new job and never made it back to finish what I started.
The purpose of that level of detail is this... since that lung blew I've participated in what most would consider highly physical activities. I was running the 2 mile in low 11's, and could hump a ruck forever. I acheived that level of fitness 9-12 months after I had mine, and never had a problem since. My only advantage here was that I had an accurate gauge of my fitness prior to, and after my injury. If there's any doubt about how your lung has healed stay home, and don't chew up a slot that someone else can use. Be realistic about your capabilities and understand that nobody's life depends on you getting through the Q. However, getting out to a team and being a liability could cost lives. I was initially put on a scuba team, and was scrutinized by and counciled by our 18D. Not due to my ability or dedication, he was a great leader, but he was concerned that scuba and blown lungs don't mix. I tended to agree. It hurt deeply because I was a strong swimmer, lifeguarded as a teen, and wanted that slot badly. I requested to be reassigned not out of concern for me but for my team.
Surgicalcric
01-26-2007, 19:41
...I don't think my case will be like that. Once you get surgery for the collapsed lung, there is no chance it will ever come back on its own.
Pretty bold statement you made there. No chance huh? Is that based on your wealth of medical expertise?
There is more to consider than what YOU want, as kachingchingpow said. The team comes first. Think about that some...
Crip
swatsurgeon
01-27-2007, 09:00
I took your advice and found http://www.usapa.army.mil/pdffiles/r40%5F501.pdf.
It says that if it has been treated 3 years before I get examined, I am in the clear. Oh, and TR, I read the other post. I don't think my case will be like that. Once you get surgery for the collapsed lung, there is no chance it will ever come back on its own.
That is an incorrect statement....once operated on, there are significant intra-thoracic adhesions and a large acceleration/deceleration movement/injury may lacerate the lung tissue since it now has a 'fixed' point, i.e., the adhesion.
Be brave,be bold, but don't be ignorant of the potential risks in your future. Scar tissue IS AT BEST only 80-maybe 90% as strong as uninjured tissue...so if your surgeon or buddies told you that mis-information of 'no chance it will come back' than you better find new people to get better info from.
ss
It's a tangent, but an honest question:
What's the surgical process to reinflate a collapsed lung?
Eagle5US
01-27-2007, 09:57
It's a tangent, but an honest question:
What's the surgical process to reinflate a collapsed lung?
Chest tube...
Oh....and DITTO what Swatsurgeon said.
Eagle
Surgicalcric
01-27-2007, 10:05
Damn, Eagle beat me to it...
Crip
Doczilla
01-27-2007, 10:18
It's a tangent, but an honest question:
What's the surgical process to reinflate a collapsed lung?
Chest tube placement is usually all that is needed. The tube is placed with local anesthesia, +/- some sedative, but you are not usually put under general anesthesia for the procedure. A small incision is made in the rib cage and the tube is inserted into the pleural space between the lung and chest wall. This is connected to suction, water seal, or a flutter valve, which allows air to escape the pleural space without re-entering through the chest tube. The hole in the lung usually seals itself off, after which the chest tube is clamped. If the pneumothorax doesn't expand, then it's safe to remove the chest tube. There are some kits for doing this with essentially a large needle and catheter, which is a bit less painful and traumatic than placing a regular chest tube. For a simple non-traumatic pneumo, this may be a better option.
If the chest tube by itself does not succeed and the pneumothorax persists, then a thorascopic surgery is warranted to staple or resect the affected part of the lung. Other things that may be done include inducing scarring on the pleura to promote lung adhesion to the chest wall, though this is more typically done with people who have recurrent pneumothorax.
As SwatSurgeon said, there are people who have recurrent pneumothorax. Some are genetically predisposed to them, others get them as a result of acquired lung disease. But if it happened once, it can happen again.
'zilla
Doczilla
01-27-2007, 10:22
Dang, 2 replies while I was writing my post. I have to learn to type faster.
Sorry, gentlemen, didn't mean to step on your toes.
'zilla
Having no expertise in the medical field, I am simply stating what I had been told by my surgeon.
swatsurgeon
01-27-2007, 12:11
Having no expertise in the medical field, I am simply stating what I had been told by my surgeon.
Surgeons, and doctors in general are like opinions....everyone has at least one and sometimes they're right......LOL
oooh, I could have gone off on sooooooo many different directions with that one!!!!!!!!!
ss
*grin* Done chest tubes before. Just had been instructed for use on them if a needle thorcentisis was inadequate for a tension pneumo, or to help with a tension hemo as well.
Surgicalcric
01-28-2007, 10:47
Needle Thorocentesis doesnt reinflate the lung; its just a tool to buy some time, temporarily relieve the tension from within the thorax, til the patient can be moved to a safer location, or one more suited for placing chest tubes. The definitive treatment is still the tube thorocostomy.
Crip
swatsurgeon
01-28-2007, 11:07
Needle Thorocentesis doesnt reinflate the lung; its just a tool to buy some time, temporarily relieve the tension from within the thorax, til the patient can be moved to a safer location, or one more suited for placing chest tubes. The definitive treatment is still the tube thorocostomy.
Crip
Unless you are on positive pressure, i.e., a ventilator or are being bagged via an endo tracheal tube....another reason I like the one way valves we use (walmart fish tank) to not allow air back in once it escapes the pleural cavity. Most people tolerate a simple pneumothorax very well....don't like it for long periods of time, but generally can maintain adequate oxygenation and ventilation for awhile...it's the tension that gets you. We carry a Cook wire wrapped decompression neeedle since the standard jelco 16 G 5cm needles love to bend and kink...we teach and preach, once decompressed, re-eval and if ANY changes to RR, HR, BP, decompress again....and again....and again.
ss
Surgicalcric
01-28-2007, 20:24
Unless you are on positive pressure, i.e., a ventilator or are being bagged via an endo tracheal tube....another reason I like the one way valves we use (walmart fish tank) to not allow air back in once it escapes the pleural cavity. Most people tolerate a simple pneumothorax very well....don't like it for long periods of time, but generally can maintain adequate oxygenation and ventilation for awhile...it's the tension that gets you. We carry a Cook wire wrapped decompression neeedle since the standard jelco 16 G 5cm needles love to bend and kink...we teach and preach, once decompressed, re-eval and if ANY changes to RR, HR, BP, decompress again....and again....and again.
ss
Maybe I should have prefaced my previous with, "in the field," or "under fire." :p
Crip
RockyFarr
01-28-2007, 21:38
Check AR 40-501 (google for it). If it has been surgically repaired over three years ago then it would not be disqualifying. Asuming you only had only one.
Unless you are on positive pressure, i.e., a ventilator or are being bagged via an endo tracheal tube....another reason I like the one way valves we use (walmart fish tank) to not allow air back in once it escapes the pleural cavity. Most people tolerate a simple pneumothorax very well....don't like it for long periods of time, but generally can maintain adequate oxygenation and ventilation for awhile...it's the tension that gets you. We carry a Cook wire wrapped decompression neeedle since the standard jelco 16 G 5cm needles love to bend and kink...we teach and preach, once decompressed, re-eval and if ANY changes to RR, HR, BP, decompress again....and again....and again.
ss
10G with a flapper valve is what we would use. Obviously the proper definitive treatment is a chest tube, and we carried those as well. With a 1 way valve on a chest tube, why would you clamp it off? The doctors that taught me how to do the procedure said clamping is a bad thing...
swatsurgeon
01-29-2007, 13:33
10G with a flapper valve is what we would use. Obviously the proper definitive treatment is a chest tube, and we carried those as well. With a 1 way valve on a chest tube, why would you clamp it off? The doctors that taught me how to do the procedure said clamping is a bad thing...
clamping is a bad thing...the fish valve is for the 10G needle.
Doczilla
01-29-2007, 15:55
With a 1 way valve on a chest tube, why would you clamp it off? The doctors that taught me how to do the procedure said clamping is a bad thing...
The CT is clamped in preparation for removal, usually a few days after placement. By clamping it, you can get a repeat chest x-ray and see if the pneumo is growing again. If it isn't, the CT can be safely removed.
'zilla
You learn something any day... So you clamp it for a period prior to reassessment... ok, cool :) Makes sense.
They probably just told us never to clamp it solely because for all intents and purposes, clamping would be counterproductive in our level of care. We aren't doing Xrays to make sure it's working, we just hope to hear the flutter valve sound like a birthday kazoo and our patient be able to breath again.
Thanks!