Michael V. – Dr. LoSasso's Oldest Nuss Patient Shares His Experience

I am writing this as a review of my experience with Dr. LoSasso, his team, and the Nuss Procedure.

I first noticed my pectus in middle school and, for most of my adult life, considered it solely a cosmetic issue. I believe the condition worsened as I aged. I searched online for corrective procedures and discovered both the Ravitch procedure and the Nuss procedure. I decided that the Ravitch procedure was not an option for me, as I was already in my late 40s when I began looking into corrective surgery.

After several years of research, I also learned that the pectus condition was likely compromising my heart and lung function. I began to view corrective surgery as a procedure that could dramatically improve the function of these two vital organs, not just address the cosmetic issue I had always believed it to be.

At this point, I began searching for a surgeon to consult with and discuss my interest in the procedure. I live in South Florida and naturally started by looking for a local surgeon. Most of the surgeons I found seemed to specialize in pediatric patients or those in their late teens and early 20s. Since I was well beyond that age range, I became a bit discouraged and expanded my search outside my local area.

Once again, there didn’t seem to be any surgeons who would be suitable for me. There were a couple I thought might be a good fit, but after contacting them, I was told they specialized in much younger patients. I continued my search and realized I would probably need to look throughout the entire state or even farther.

When I found Dr. LoSasso, I immediately knew that if I was a candidate for the procedure and he was willing to perform it, he was the surgeon I wanted. He was trained by Dr. Nuss, the founder of the procedure. He has also specialized in pectus patients since 1999 and has performed more than 1,400 Nuss procedures on patients of all ages, including those in their 40s and 50s.

My first communication with his office was a phone call with Georgia. She was very helpful and explained how the process would work, including a video consultation with Dr. LoSasso, several pre-operative screening procedures, and an in-person visit with the doctor.

I was extremely encouraged after my initial consultation with Dr. LoSasso and hearing about the extensive pre-operative testing he required. My initial thought was that Dr. LoSasso was leaving no stone unturned and that his attention to detail was at the highest level imaginable. Those impressions were confirmed when I eventually met him in person for my physical exam and pre-operative visit. I knew I had found the best of the best when it comes to the Nuss procedure.

I scheduled the surgery for July and traveled to New Jersey for the procedure along with my wife and daughter. We rented a condo near the hospital for our stay and the immediate post-operative period.

The Valley Hospital had only been open for a few months and, as expected, everything about it was state-of-the-art, brand new, and extremely clean. As I made my way through all of the pre-operative steps on the day of surgery, every person I came into contact with relayed the same message about Dr. LoSasso. To sum it up, they all said he was the best and that his attention to detail was second to none.

A few of them even seemed a bit intimidated when speaking about him and his expectations. Strictly adhering to his directives without deviation was what he expected from anyone involved in the care of his patients. This continued to reassure me that I was in good hands and definitely had the best surgeon performing this procedure.

After surgery, I was transferred to the ICU. All of Dr. LoSasso’s patients remain in the ICU until they are ready for discharge. The reason for this is the favorable nurse-to-patient ratio and the around-the-clock attention and monitoring. There were strict post-operative directives that every staff member adhered to.

Dr. LoSasso personally visited me every day to evaluate my progress until I was discharged from the hospital. As expected, even simple things like sitting up and walking were initially very difficult. However, with each passing day, things became a little easier. My surgery was on the 15th, and I was discharged on the 19th.

By the time I returned to the condo, I felt much better than I had just four days earlier when I arrived in the ICU. Daily tasks were by no means easy, as I was learning to function with three stainless steel bars in my chest while slowly trying to get back to normal.

After discharge, I continued taking several medications for pain management over the next three to four weeks. I was able to take short walks of five to seven minutes, two to three times per day, beginning only a day or two after leaving the hospital. I was cleared to return home on the 24th following my post-operative visit with Dr. LoSasso. I progressively increased my walking and was up to three 30-minute walks per day about two and a half weeks after surgery.

Once home, I became familiar with my new routine and restrictions during the rehabilitation period. I slept in a motorized recliner for the next six weeks because getting in and out of bed simply wasn’t possible yet. It also forced me to sleep on my back, as side and stomach sleeping were not permitted.

I began physical therapy just two weeks after surgery. Dr. LoSasso had developed a specific 16-week Nuss Procedure Rehabilitation Protocol. For the first two weeks, I attended therapy twice per week, and after that, two to three times per week until completion.

He recommended a physical therapy facility that specialized in sports injuries, and I was able to find one close to home. The rehabilitation protocol was a highly detailed plan developed by Dr. LoSasso in collaboration with a physical therapist.

The PT sessions were not always easy, but I knew what to expect based on previous discussions with Dr. LoSasso. Simple things like bathing and getting dressed were very challenging in the beginning. Even putting on and taking off a shirt was difficult. Just as I had experienced during the first two weeks after surgery, I continued to notice improvements each and every week.

Some of the restrictions outlined in the rehabilitation plan included no lifting more than 10 pounds, no bending, and no twisting. I developed a daily routine that included proper nutrition, walking on the treadmill two to three times per day, and attending physical therapy sessions throughout the week.

As I progressed through physical therapy, I was able to resume swimming about five weeks after surgery. I consulted with Dr. LoSasso, who recommended only breaststroke initially, as it would prevent twisting and avoid overhead reaching motions associated with freestyle swimming.

After seven weeks, I was able to return to yoga. During yoga, I had to be very mindful of positions my body was not ready for, mainly twisting movements and, obviously, lying face down. I modified many of the instructor’s directions to avoid exceeding my physical limitations. Just like everything else during recovery, yoga became easier with each passing week and month.

I continued physical therapy until about four months after surgery. I also incorporated sauna therapy and cold plunges beginning around 10 weeks after surgery. This seemed very helpful, as both can promote healing and reduce inflammation, along with providing numerous other benefits.

After three months, I was pretty much back to my pre-surgery day-to-day routine. However, I still had frequent reminders that I had three steel bars in my chest. I also had a long way to go in rebuilding my strength and reducing physical limitations.

Because I am a very active person, I had to pay close attention to my body as I resumed activities. If something became uncomfortable or painful, I learned to stop or slow down. As I mentioned earlier, things generally improved with time. There were a few occasions when I overdid things, whether through exercise or other physically demanding activities, and experienced discomfort similar to what I had early in recovery. When that happened, it was easily managed with Aleve or Motrin and typically lasted less than a week.

At six months, I had a follow-up appointment with Dr. LoSasso. During that visit, we discussed my progress and how things were going overall. He was very pleased with my recovery, especially considering my age and the fact that I had three bars in place.

At the time this review was written, I was nearly 11 months post-surgery. I continue to participate in a relatively intense hot yoga class two to three times per week. I also do contrast therapy, consisting of sauna followed by a cold plunge, at least twice per week. This has been very helpful in managing pain, discomfort, and inflammation.

In addition, I do circuit training that includes moderate weights, stair climbing, and pushing and pulling a weighted sled. I would like to swim more often than I currently do, but my schedule does not always allow for it.

The physical appearance after surgery is nothing short of amazing. I have also noticed that my endurance during physical activity is significantly better. During a work physical approximately nine months after surgery, I underwent a pulmonary capacity test and showed more than a 10% improvement compared to the previous year.

Throughout my recovery, I felt there was cardiovascular improvement, but this was the first measurable result I had seen. I still have daily reminders that my body is adjusting to the bars, but healing is a process. I am confident that as more time passes, these reminders will continue to decrease.

In conclusion, I would highly recommend Dr. LoSasso to anyone considering the Nuss Procedure. As I have mentioned several times, it was by no means an easy road. In my opinion, however, it was absolutely worth it, and my only regret is that I did not do it earlier in life.

That said, I believe things happen for a reason, and my path that led me to Dr. LoSasso was meant to be. Hopefully, this review provides a detailed, chronological timeline of what can be expected by a patient undergoing the procedure.