‘Loneliest road I’ve walked’ – KZN mom’s sunken chest put pressure on her lungs and heart

It was only at the age of 31, while pregnant with her first baby, that Ingrid Dammann’s ever present healthcare condition – a sunken chest with a deeply dented breastbone – was finally identified as a serious concern requiring medical intervention.

Until that moment it was viewed as little more than a cosmetic problem – at worst a supraventricular arrhythmia or irregular heart rate, a small hiatal hernia or simply acid reflux.

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Six years and two pregnancies later, Dammann recalls that even though pectus excavatum (PE), as it was later diagnosed as, is the most common chest wall skeletal deformity, medical practitioners had previously not paid much attention to it.

Dammann: ‘Loneliest road I’ve ever walked’

“The phrase ‘there’s nothing wrong with you’ during many a medical investigation was the most frustrating verdict. It was, in retrospect, the loneliest road I’ve ever walked,” she said.

Dammann, who lives in Glencoe, near Dundee in KwaZulu-Natal with her husband and three children, spent the last month of her first pregnancy on bed rest, before her baby was born by caesarean section at 36 weeks.

“Prior to being confined to my bed, I could not drive myself to work without having to pull over due to dizziness and breathlessness.

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“As an occupational therapist, the active therapy sessions that I had with children caused the muscles in my upper and lower extremities to become completely stiff, leaving me gasping for air while fighting light-headedness,” she said.

“For the first time ever the specialists took my complaints seriously, but they still could not find clear answers to my problem.

“The symptoms I experienced during pregnancy did not disappear and my health did not return to what was considered ‘normal’ for me. My heart and my chest were more problematic than ever.”

Abnormal heart rhythm

While scouring the internet for a solution, Dammann found an electrophysiologist and a cardiothoracic surgeon and in 2019, at the age of 33, she had a cardiac ablation to treat her abnormal heart rhythm. Her problems were, however, not behind her as the root cause of her condition had not been resolved.

After ongoing research and reaching out to countless specialists, she finally received a positive response from cardiothoracic surgeon Dr Ivan Schewitz, a pioneer in his field credited with introducing thoracoscopic surgery as well as the minimally invasive repair of PE, using the Nuss procedure, to South Africa.

For Dammann, the consultation with Schewitz delivered the solution that she had been so desperately looking for over years but just after being scheduled for the Nuss procedure, she found out she was pregnant with her second child.

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“I decided to go through with it and was 16 weeks pregnant at the time I had the Nuss procedure. Though this may be controversial, for me it was well worth it even though, at times, it was most uncomfortable and painful,” said Dammann.

“PE is a congenital condition in which the breastbone has a distinctive and unusual inverted appearance. This is caused by the overgrowth of the cartilage adjacent to the breastbone which, when growing too fast, pushes the breastbone in.

“In Dammann’s case, her sunken chest put pressure on her lungs and heart,” noted Schewitz who practises primarily from Netcare Waterfall City Hospital in Midrand but also from a number of other Netcare hospitals around the country.

Nuss procedure

During the Nuss procedure, two small incisions are made on the side of the chest so that a stainless steel bar can be inserted behind the deformed breastbone from where it is attached to the outer edge of the ribs.

“In Ingrid’s case, two bars were inserted to correct the problem. It is disquieting that for so many years, this condition has been considered purely cosmetic. Not only does PE cause the chest to have a distinctive and unusual inverted appearance, but it tends to displace the heart to the left of the chest cavity, thereby compressing its right ventricle,” he added.

The stainless steel bars remained in place for just over three years to ensure the chest wall correction was stable and were recently removed.

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– news@citizen.co.za