How one surgery inspired a career in nursing

By Lisa Turni, surgical unit nurse manager, CHOC Children’s

lisa-turni-rn-choc-childrens
Lisa Turni, surgical unit nurse manager, CHOC Children’s

I’ve been a nurse for 18 years, but the seeds of my career were planted long before I put on my first pair of scrubs. Although I didn’t know it at the time, having surgery as a teenager would ultimately inspire my career path.

Growing up, I was an athlete and especially loved playing basketball. Although I was in good shape, I was always out of breath and would hyperventilate often. I felt insecure because I thought I was giving my best at practice.

When I was 14 years old, my mom took me to the pediatrician who initially assumed I had asthma. But when my doctor lifted my shirt to listen to my breathing, she noticed a depression in my chest. I had always known it was there, but I thought that’s just how my chest looked. He diagnosed me with pectus excavatum, commonly referred to as “sunken chest.” This is when the breastbone, or sternum, and some of the ribs grow abnormally and cause a depression in the middle of the chest. Pectus excavatum is the most common congenital chest wall abnormality in children. Many cases of pectus excavatum are found in the early teenage years because growth spurts during puberty can exacerbate the chest depression.

I was referred to a surgeon, who explained that the depression in my chest was pushing down on my heart and lungs, which make it harder for them to work properly, and harder for me to breathe properly. He told me that I would need surgery to correct the deformity in my chest wall. I hadn’t realized there was anything I could do to fix it. He explained that during surgery, he would make an incision across my chest and reshape my rib cartilage which would keep my breastbone in the correct position.

As my surgery date got closer, I became more aware of the depression in my chest, and the way I thought about and saw myself started to change.

At that age, kids at school can be harsh. Sometimes they would unknowingly ask hurtful questions like, “Oh, why does your chest look like that?”

I started to realize I was different. Not necessarily all of the kids and comments were mean, but I was aware that I stood out. I changed the types of bathing suits and clothing I wore to hide the depression in my chest, a behavior I now know is common among pectus excavatum patients.

A physical abnormality is an emotional thing to shoulder as a child. It can be hard for others to understand how much it can affect a child emotionally. When I became a nurse, I used that understanding to inform the care I provided to my patients.

My surgery went well, and although that occurred in the days before the minimally-invasive Nuss procedure was invented, my surgeon was able to “hide” my scar near my bra line so it wouldn’t show in bathing suits or other clothing. The scar became a badge of honor. It was a sign of my courage.

My hospital stay after surgery is what led me to pursue nursing. I knew from that hospital stay that I wanted to help other kids. Some of my providers during that time got frustrated with me because I couldn’t take a deep breath or cough due to pain. Even though pain management has improved tenfold in the years since, the way my care team acted toward me has made me want to always treat patients better than they did.

After eventually getting my bachelor’s degree in nursing, I came to CHOC Children’s Hospital as a travel nurse. As soon as I stepped foot inside CHOC, I knew it was my forever home because of the people and culture.

I worked my way up to nurse manager of the combined medical/surgical unit. Later, when we created separate medical and surgical units, I chose to stay in the surgical unit. Giving back and taking care of patients undergoing surgery is my way of making a difference. I have a special connection with patients undergoing pectus excavatum surgery.

Even though my surgery was over 20 years ago, I’ve found that many pectus patients have similar journeys. When I share my story with my patients, I let them know they are not alone. When I was younger, I didn’t know anyone else who had this condition or understood what my surgery felt like.

Now, I do my best to connect my pectus excavatum patients with one another for peer-to-peer support. In fact, at CHOC, we’re developing a mentor program where former pectus excavatum patients, along with scoliosis patients, are trained to meet with new patients prior to surgery, and help answer their questions and be part of their support system alongside clinical staff.

I also make sure to be there for my patients’ parents as well. Parents often feel guilty for not noticing how deep the chest depression had gotten – but how could they have known? By the time their kids are becoming teenagers, the period during which pectus excavatum becomes most pronounced, they’re no longer in charge of bathing them and they’re not often seeing them without a shirt. I can comfort them in a unique way because my mom had similar feelings.

They are also understandably worried about their child’s surgery and recovery, and they seem grateful to talk to someone who is so many years post-surgery without any major complications. Parents usually have a lot more questions for someone who has been through it, and I spend as much time with them as they need. Thanks to our new mentor program, it has been amazing to see connections made between our parents and patients, and what a huge support that has been for them.

I’m grateful that I had pectus excavatum because it shaped who I am as a person. When I was younger, I didn’t realize how powerful nursing could be. I’m grateful this has been my journey because it feels right to be able to give back and to help patients and their families.

Related posts:

  • What we’re thankful for this year: 2019
    The  physicians, nurses, staff and patients that make up the CHOC Children’s healthcare community have much to be thankful for this year. In addition to celebrating our 55th anniversary, expanding ...
  • Honoring the Veterans Among our Mighty Brigade
    This Veterans Day, CHOC Children’s wants to acknowledge the military veterans among our mighty brigade of clinicians and staff, and extend our heartfelt thanks for their service to our country. We ...
  • From CHOC mom to CHOC employee
    “You look like you could use a good cup of coffee,” Maria would say from time to time to a tired parent at CHOC Children’s at Mission Hospital. “Oh yes!” ...

What You Need to Know About Pectus Excavatum Surgery: Teen Mentors Explain

Having surgery is not easy, and no one knows that better than someone who has been through it.

CHOC Children’s patients who have undergone surgery for either pectus excavatum or scoliosis  have banded together to form a mentorship program for other patients who will be undergoing the same procedures. Teens and adolescents can connect with a trained mentor who knows what they’re going through and can help them navigate the physical and emotional aspects of surgery and recovery.

While it’s important to seek guidance from your medical team, sometimes as a teenager you just want to hear straight from other teens. We spoke with a few mentors who had the Nuss procedure to correct pectus excavatum (sunken chest), and they offered the following words of advice and encouragement.

What is one thing you wish you would have known before pectus excavatum surgery?

“I wish I would have known to just relax. I know it’s a hectic time; the number one tip from me is just to have a good night’s sleep and prepare. Bring all the essentials and more.”—Matthew H., now 17

Matthew-pectus-excavatum-tips
Matthew H.

“I wish I was more aware of the sudden diet change to ice chips during the first day of post-op care. I remember feeling uncomfortable about my inability to eat food or drink water a few hours after my procedure. If I knew how long I would be on ice chips after my procedure, I feel that I would’ve been able to push through it better than I remember.”—Matthew V., now 22

Matthew-v-pectus-excavatum-tips
Matthew V.

“The one thing I wish I had known before the surgery was how long each day actually was. You never really know how long a day actually is before you go through a surgery. I ended up only bringing my phone and a few books which I ended up rereading during my stay. There was only so much sleep I could get, and I found myself waiting for the next day; sometimes for hours at a time. If I could go back, I probably would have brought more things to occupy my time, not just my phone but also maybe my laptop, some movies and more books. My family and friends ended up being a really big part of my recovery and I can’t thank them enough. Their visits got me through the long days and I found myself up at night waiting for their next visit.”—Brandon, now 20

Brandon-pectus-excavatum-tips
Brandon

What modifications did you make after surgery?

“After surgery, I made sure to wear the most comfortable clothes and to have many pillows, especially since it’s impossible to lay on your side after the procedure.”—Matthew H.

“After surgery, I kept my phone near my bed so I could call one of my family members to help me get up every morning for the first two weeks. I also had to make sure that I was sleeping flat on my back and not turn over in my sleep. However, sleeping flat on my back in post-op helped me prepare for sleeping at home.”—Matthew V.

“We ended up actually propping my bed up a bit and angling it with pieces of wood. This made getting out of bed on my own a bit more manageable. I also developed a method of getting out of bed that I ended up using for almost two months after my surgery; I would bring my legs toward my chest with my hands while on my back and roll forward. This helped me avoid having to use my core to get up. Walking also became a pretty big part of my recovery experience. I would walk with my parents to the end of the neighborhood and back to try and regain some of my strength. I think the worst thing you can do for your recovery is to stay sedentary.”—Brandon

Knowing the recovery that comes with this surgery, would you choose to do it again?

“The month’s worth of pain is definitely worth a lifetime of improved quality of life. The month may seem like an eternity, but trust me, after the whole ordeal is over, you’ll be grateful that you’ve made the right decision.”—Matthew H.

“I would choose to do the surgery again. While it was a painful experience at first, the results you get from the procedure are well worth it.”—Matthew V.

“I would definitely do it again and I encourage anyone else reconsidering the surgery because of pain to do it. I ended up making a full recovery and I feel as if my lungs weren’t as limited after. I felt more comfortable doing sports and going out. The surgery made me feel more confident and comfortable in my own skin and in my opinion that’s worth the pain.”—Brandon

What advice would you give someone before their own surgery and hospital stay?

“If you’re a light sleeper, like me, make sure to bring earplugs or a speaker that can play white noise. There’s a lot of noise and that definitely affected my sleep time. Make sure you can swallow pills. I don’t know if it’s just me, but I couldn’t swallow the biggest pills the nurses gave me, so I had to use the pill crusher and that was not fun for 3 a.m. me. Eat a lot of food and walk around. I know after the surgery you may have a small appetite and not want to walk around. But eating more and walking around really sped up my recovery process. The spirometer really helps too. I left the hospital after four days.”—Matthew H.

“I would tell them that they’re in good hands and that the staff is very responsive and will take very good care of them. I’d also advise them to be patient with the recovery. Once the pain subsides, they’ll begin to feel the results.”–Matthew V.

“I would like to tell others considering the surgery that they aren’t alone. Dozens of us get these types of surgery at CHOC. You are in good hands, if not the best hands possible. Every person in the hospital – staff, nurses, doctors, etc. – is trying to make your stay at the hospital as comfortable as possible. While the surgery may seem like a really big leap of faith, just know that we’re all here for you and you can talk to any one of us, whether that’s staff or a patient. In the end we all want the same thing— for you, the patient, to feel better and recover as quickly as possible. So don’t feel alone, we’ll be here for you whenever you’re ready.”–Brandon

Learn more about having pectus excavatum surgery at CHOC

Related posts:

What You Need to Know About Spinal Fusion Surgery: Teen Mentors Explain

Having surgery is not easy, and no one knows that better than someone who has been through it.

CHOC Children’s patients who have undergone surgery for either scoliosis or pectus excavatum have banded together to form a mentorship program for other patients who will be undergoing the same procedures. Teens and adolescents can connect with a trained mentor who knows what they’re going through and help them navigate the physical and emotional aspects of surgery and recovery.

While it’s important to seek guidance from your medical team, sometimes as a teenager you just want to hear straight from other teens. We spoke with a few mentors who had spinal fusion surgery to correct scoliosis, and they offered the following words of advice and encouragement.

What is one thing you wish you would have known before scoliosis surgery?

“I wish I would have known that many people go through the same surgery and that I shouldn’t feel alone. I also wish I would have known that recovery may be hard at times and that you will get through it.”—Tyanna, now 20

tyanna-spinal-fusion-tips
Tyanna

“I wish I would have known how constipated the medicine would make me. I found that my constipation and stomach pain were bugging me more than my back pain, so I stopped taking the pain medicine pretty early. Also, the catheter sounded scary at first, but it was actually the most helpful thing ever since I didn’t have to worry about getting up to use the restroom.”—Jessica, now 19

jessica-spinal-fusion-tips
Jessica

“I wish I would have known that I would experience stomach pain as well as back pain. Knowing that would’ve helped me prepare for the pain rather than get nervous about it when I endured the nausea.”—Taylor, now 14

taylor-spinal-fusion-tips
Taylor

What modifications did you make after surgery?

“I slept with many more pillows around me. Once I got back to school, I brought a pillow to school to use for my back. Going out to restaurants, I would also bring a pillow to support and make my back feel more comfortable. After surgery, I wore mostly baggy clothing, so it was easier to take on and off.”—Tyanna

“I couldn’t carry a backpack, so my school library gave me a set of textbooks for home and a set for school, so I didn’t have to carry heavy books back and forth. I slept with a pillow under my knees when I was sleeping on my back. If I slept on my side, I would put a pillow between my knees and behind one shoulder.”—Jessica

“When I was in the hospital, I had to do physical therapy. The first thing I learned was the barrel roll. This taught me how to get out of bed comfortably and it really helped. I continued to do the roll for a few weeks after my surgery.”—Taylor

Knowing the recovery that comes with this surgery, would you choose to do it again?

“It was a little tough for me during the recovery time, but I know that since I have gone through it once, I would be able to go through it again if I had to. Although having this surgery and recovering was tough on me, it was one of the best decisions I had ever made in my life.”—Tyanna

“Some days were harder than others, but I had so much support from my nurses and family which made me feel so much better. If I had to do this surgery again, I probably would because it wasn’t as bad as I thought it would be and I recovered pretty fast the first time.”—Jessica

“It completely changed my life for the better. Although I don’t have much back flexibility anymore, living my life without the pain and the back braces has just made me such a happier person. Also, I became more confident. Before the surgery, I had a big hump on my back due to my curve and I was very self-conscious about it. Taking that hump away just made me more confident and I loved the way my back looked with my ‘battle scar.’”—Taylor

What advice would you give someone before their own surgery?

“I think that everyone has their own story and experiences with scoliosis, but I would just say, have a great support system and keep yourself surrounded by family and friends to keep you staying positive. Recovery may get hard at times; you just have to keep pushing through it and you will be healed and fully recovered in no time.”—Tyanna

“Wear your hair in French braids the day of surgery so you don’t have to worry about your hair when you’re at the hospital. Dry shampoo will be your best friend! Watch YouTube videos of scoliosis surgery recovery vlogs so you can have an idea of what it’s going to be like. Don’t compare yourself to others and don’t be hard on yourself if it’s taking longer than you thought it would to recover. You will get there in the end; just go at your own pace. It’s natural to feel fear going into surgery, but just go in with confidence and positivity.”—Jessica

“Stay strong. You may want to give up with your physical therapy, but you can’t. The more determined you are, the quicker your recovery will be. I know the pain will be tough. Just know you aren’t alone and there are people there to give you their love and support. You got this!”—Taylor

Learn more about having scoliosis surgery at CHOC

Related posts:

Living with Hyperhidrosis: Sarah’s Story

Not long ago, you could always find Sarah in long-sleeved shirts, even in the middle of the summer.

Sarah tends to get cold easily, but she had another reason for the long sleeves: she needed something to continually wipe the excess sweat from her hands.

“My sweat was probably two to three times the average person when they’re nervous,” Sarah says.

Sarah struggled doing normal activities. “It became really hard to manage when I got to middle school. I had to do more writing and I had more interaction with other kids.” Her school papers would get wet, and later when she was learning how to drive, the steering wheel would get wet from her hands.

sarah-hyperhidrosis-success
Children and teens with hyperhidrosis have excessive sweating regardless of the environmental temperature and emotional factors. a surgical treatment called endoscopic thoracic sympathectomy, or ETS surgery can help.

Sarah’s mom, Christine, remembers the problem when Sarah was just six years old when the family lived in Japan. “We were in downtown Tokyo and it was really crowded with people, and I went to hold her hand so I could keep track of her,” Christine says. “Sarah said to me, ‘It’s okay, you don’t have to hold my hand.’ She didn’t want me to hold her hand because of the sweat.”

It wasn’t until Sarah was 14, after visiting doctors across three different continents where the family lived, that they relocated to Orange County and finally received a diagnosis: hyperhidrosis. Children and teens with hyperhidrosis have excessive sweating regardless of the environmental temperature and emotional factors. They may have sweating in the hands (called palmar hyperhidrosis) as well as the feet, under the arms and the small of the back.

“If you can imagine your hands always being wet like you just stepped out of the shower, where you hold your hand up and the sweat drips off, that gives you an indication of how significant palmar hyperhidrosis can be,” according to Dr. Troy Reyna, CHOC Children’s pediatric general and thoracic surgeon.

Sarah was referred to a pediatric dermatologist and tried prescription medication, topical ointments and electrolysis (iontopherisis). After these treatments failed to help, the family came to Dr. Reyna, who specializes in a surgical treatment called endoscopic thoracic sympathectomy, or ETS surgery.

sarah-hyperhidrosis-excessive-sweating-ETS-surgery
For children and teens who suffer from hyperhidrosis, also known as excessive sweating, a surgical treatment called endoscopic thoracic sympathectomy, or ETS surgery can help.

“Dr. Reyna was very informative and understanding,” says Sarah’s dad, Rob. “We had an open consultation discussing options and alternatives and we were not asked to make a decision at that point. In fact, Dr. Reyna encouraged Sarah to do her own research and come to her own decision. We left it to Sarah, and after a couple weeks, she came to us and told us she wanted to have the surgery.”

ETS surgery involves making two small incisions on either side of the chest and cutting the specific nerve pathways that lead to the sweat glands in the hands. This minimally invasive procedure is often done on an outpatient basis.

“When I got home from surgery, I noticed that my hands had stopped sweating completely, and I was so excited,” Sarah says.

Sarah still has excess sweating in other areas like her feet and lower back. The condition does interfere with some aspects of her life, but it is more manageable now that her hands are dry.

“If someone else with this condition is thinking about the surgery, I would definitely tell them to look into it,” Sarah says. “You’re not able to do things a regular person can do, and that’s not really fair.”

This summer, Sarah is looking forward to traveling to Germany to visit her grandparents, attending her friend’s sweet 16 birthday party in New York City—and enjoying the warm weather in a short-sleeved T-shirt.

Learn more about palmar hyperhidrosis and ETS surgery

Related posts:

The Importance of a Pediatric Surgeon

Children are not just “little adults” and when possible, should be treated by a physician who is specially trained in pediatrics. Their physiology is different, and since they’re still developing, their organs are not always in exactly the same location. In this episode of CHOC Radio, Dr. David Gibbs, a pediatric surgeon and the director of trauma services at CHOC, discusses:

Hear more from Dr. Gibbs in this podcast:

CHOC Radio theme music by Pat Jacobs.

Related posts: