Patient discussions
Patients with a primary spontaneous pneumothorax should understand that they are at risk of ipsilateral and contralateral pneumothoraces in the future. They should also be made aware that each recurrence increases their risk for subsequent ipsilateral pneumothoraces and that pleurodesis treatment can fail. These patients should, therefore, be instructed to seek immediate medical evaluation should their symptoms recur.
Patients with a secondary spontaneous pneumothorax should be advised that each recurrence increases their risk for subsequent ipsilateral pneumothoraces. Patients should also be made aware that their underlying lung disease may result in a contralateral pneumothorax and that pleurodesis treatment can fail. Patients should be instructed to seek immediate medical attention should their symptoms recur.
Advise smoking cessation. Risk of pneumothorax recurrence for people who smoke in the first year is as high as 32%. Smoking cessation reduces this risk fourfold.[8]
Patients can return to work and can resume normal physical activity once symptoms have resolved, unless they have a high-risk occupation (e.g., airline pilot).[98]
Patients should be counselled regarding the dangers of sudden barometric pressure changes that might occur with high-altitude activity or underwater diving. Patients who have had a pneumothorax should be discouraged from underwater diving permanently, unless a definitive preventative procedure has been accomplished. Patients should be instructed not to fly for at least 1 week after resolution of a pneumothorax. Resolution must be confirmed on chest x-ray.[17]
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