If you are a Pectus Excavatum patient and are thinking about the Nuss Procedure, you’ll want to start by classifying yourself based on your personal preference:
- I want the procedure done for cosmetic reasons.
- I want the procedure done for medical reasons.
- I want the procedure done for cosmetic and medical reasons.
You can start by going to your Primary Care doc or by going directly to a surgeon if your insurance allows. Either way, you’ll want to convey which category you fall in, because this will heavily influence the plan of action. For example, if you fall in category (1), your doctor may immediately send you for a CT scan and begin talking to you about the surgery. If you fall in category (2), your doctor will likely refer you to a cardiologist and pulmonologist for further physiological function exams such as an EKG, echocardiogram, pulmonary function test, or stress test.
Next, you’ll want to find a doctor.
This is the toughest part, based on my experience. Some primary care doctors haven’t even heard of it, others have multiple Pectus patients they see. There are some resources on the web to help you find doctors that treat Pectus, but they are not comprehensive. However, it might be a good place to start. For example, try searching on this website. You can never go wrong with going to a primary care doc and asking them to refer you to a colleague who might happen to more know about the condition.
Depending on which category you fall into, the next steps to take can vary.
If you’re in it for cosmetic reasons, you’ll want to ensure you’ll be able to afford surgery, as practically all health insurance policies do not cover the procedure for cosmetic reasons.
If you’re in it for medical reasons, you’ll want to explore thoroughly if the procedure is medically necessary. Of course, with every surgery comes some risks. Luckily with Nuss, the complications are rare. However, be sure that the procedure is medically necessary, as you’ll need to prove this to your insurance company. For example, if you have Cigna, you can check the policies here.
If you come to a point where your surgeon tells you that he/she could justify the surgery for medical reasons, but that he/she can’t guarantee that getting the procedure will alleviate any symptoms you are experiencing, what should you do? This is the hardest part about Nuss. There is lots controversial and varying evidence that makes physicians confused as to whether or not they should perform the procedure. Hence, they put in your hands to decide. The best thing to do if you get stuck at this point is to see multiple surgeons, each of which hopefully have some decent experience with the procedure. Start collecting different views from different doctors and see if some type of consensus can be made. If not, there are great communities of Pectus patients online that can share their stories, and you might be able to find someone with a similar story to yours.