One Year After My Lung Collapsed
Today, 24 May, marks one year since I suffered primary spontaneous pneumothorax, better known as lung collapse, while in San Francisco for a startup builder event.
What began as a mysterious but intense chest pain that I started experiencing at Mountain View Caltrain station, soon escalated into an ER visit, surgery, and a week-long hospital stay.
One year on, I’m thankful to have fully recovered, and to be living a normal life. However, the treatment, recovery, and implications for my lifestyle and work, have profoundly impacted my past year, both in positive and negative ways.
So, I’m writing this piece to recount this experience and how it has shaped me. I hope this sharing of my experience will also useful to anyone who unfortunately goes through something similar.
Table of Contents
∘ how it happened on 24 May ‘23
∘ after the op
∘ the road to recovery
∘ unexpected blessings
∘ concluding thoughts
how it happened on 24 May ‘23
I had completed my National Service in the Singapore military on May 17 and traveled to Spain with my college friend Thomas until May 22. Then, I flew to San Francisco on May 23 to meet up with my college roommate Nathaniel, staying at his house while I attended a 3-day event as part of Buildspace’s Nights & Weekends startup accelerator program. (I nearly couldn’t enter the US as I had forgotten to apply for the ESTA to enter the US, but thankfully I was able to get last-minute approval!)
The next day, Nathaniel’s mom dropped me off at Mountain View Caltrain station so I could go to Fort Mason, San Francisco, to attend the Buildspace event. While on the Caltrain, I started feeling a pain in my chest, a pain I had never experienced before. It was particularly intense when I took a deep breath. My first thought was that I might be having a heart attack. I called my aunt, who had worked as an ER nurse, and she advised me to monitor the situation and take aspirin to see if it got better. After resting on the train ride, I arrived in San Francisco, and the pain became more bearable.
I decided to continue with my day, attending the Buildspace startup event, meeting several new people who had also built products, and receiving lots of cool swag. I even pitched my idea briefly to the Buildspace founder Farza, who gave me some quick advice on how to acquire users.
By 2 pm, the pain became more noticeable, and since the event’s schedule was relatively free (I was supposed to spend the rest of the day building), I decided to go home as a precaution (it was a 2+ hour trek home to Sunnyvale). I walked to CVS, bought aspirin, and took it. Walking up the hill to CVS made me out of breath quickly. I had to lean forward to lessen the pain and catch my breath, which made me realize something was quite wrong. I made the 2-hour trip back and was picked up by Nathaniel.
When I searched the web, I saw that a potential cause of chest pain could be a lung collapse, which matched my symptoms (pain getting worse when taking deep breaths, needing to lean forward to feel less pain, clicking sound when breathing). The other possibilities were a heart attack or pulmonary embolism. I immediately remembered my friend Kampton (Singapore’s high-jump record holder!) had suffered a lung collapse the previous year. So I video called him to ask about his symptoms, and he said, ‘Oh gosh, your symptoms are exactly the same as mine.’
That night, Nathaniel brought me to the ER, and I told the nurse, ‘I think my lung collapsed.’ Amused, the ER doctor said, ‘Hold on, young man, it could be several things, and we need to confirm it by doing some tests.’ They immediately did an X-ray, EEG, and CT scan. An hour later, the doctor came into the ER room and said, ‘Wow, it seems like your differential diagnosis was accurate. Your lung has indeed collapsed.’ Whatever momentary satisfaction I felt turned into anxiety and fear when the doctor detailed his treatment plan — sticking a chest tube into my chest cavity and hooking me up to a ‘suction’ machine to apply negative pressure to my chest cavity to reinflate my lung, which is what he proceeded to do.
With the chest tube in, it felt weird as I could feel the pressure induced by the machine making each breath more laborious. I could hear the constant sound of bubbles in the machine’s water container, signaling that air was escaping my right lung due to a small hole that caused the collapse. I was wheeled into a high-dependency ward, where the doctor said I would stay for several days. The hole in my right lung could close itself gradually, in which case I would be fine, but if not, we would have to consider surgery to close the hole.
Unfortunately, the hole did not close — I kept hearing the bubbles, a sound that I have definitely learned to dread (you know, the sound when you blow bubbles into a glass of water). On May 27, three days after entering the ER, the cardiothoracic surgeon Dr. Tomoki Oka visited me and explained that I needed surgery. More precisely, a blebectomy with pleurodesis, the former to plug the hole in my right lung, and the latter to stick my lung to the chest wall and mechanically irritate the pleural membrane to stimulate inflammation and scarring, helping the lung permanently stick to the chest wall to prevent recurrence. The surgery would take place the next morning, for 1.5 hours, using Video-assisted Thoracoscopic Surgery (VATS), involving robotic arms with cameras entering my chest cavity through two small chest incisions.
My friend Kampton told me that the recovery would be painful and that he was unable to sleep properly for several days. So I mentally prepared myself for this painful recovery. I asked the nurse countless questions — she reassured me that this surgeon had a really good track record of patients having pain-free recoveries.
The next morning, the nurse woke me up early to prep for the surgery. I still remember watching the beginning of the Monaco Grand Prix F1 race before I had to put on the surgical gown, and before long, I was wheeled into the operating theatre. The last thing I remember was the nurses telling me to relax and the burning sensation as they injected the anesthetics through my left hand’s IV.
after the op
It was a peaceful sleep. I gradually regained my sense of hearing, but initially finding it difficult to open my eyes. I didn’t feel any pain at all, and at one point, I was unsure if the surgery had already taken place. As the general anesthesia wore off, I felt like a deflating balloon in the sky slowly drifting back down to earth. ‘You did well!’ The encouragement from the nurse was soothing, but my heart rate was still elevated as I became hyper-alert to my new surroundings. They pushed me back to my hospital ward, and I felt like I was on a rocket ship (you know, in Mario Kart when you get the rocket boost and rapidly navigate left and right through the course without putting in any effort). Still finding it difficult to open my eyes and speak clearly, I asked my aunt to check the results of the F1 race. ‘What F1, F u man’ If I could, what my aunt said would have made me burst out in laughter. ‘Verstappen, then Alonso, Ocon, and Hamilton’ — amusement filled me as I realized that somehow Ferrari had yet again dropped the ball and Hamilton had overtaken Sainz, in Monaco of all places. My mind was truly back to normal.
What I did not hear, thankfully, was the sound of the bubbles. The hole in my lung had closed! The surgeon said that the surgery went smoothly and the hole was successfully removed. I just had to remain in the hospital for several more days until there was no more blood from the surgery being discharged from the chest tube.
I was assigned two painkillers, a stronger one and a weaker one, to manage the pain. To be honest, the pain was much less than I had expected, and I had peaceful sleep the next few days. It was difficult, though, to regain my normal motion, such as sitting upright on the bed, lying down using my good side, and walking to the toilet, as I had spent a week bedridden. It was mostly due to fear of moving too much and damaging something. I had to get two sessions from the occupational therapist.
And so, on May 31, one week after entering the ER, I was discharged. Feeling the sun and wind and breathing the fresh Mountain View air felt almost miraculous. The painkillers made me nauseous, and at one point, I had to ask my aunt to pull over after nearly wanting to throw up from the bumpy ride on El Camino Real. But we made our way home.
the road to recovery
I was advised against flying back to Singapore for at least four weeks, but out of caution, my family decided to wait an additional two weeks.
The recovery could only be described as miraculously smooth. The right side of my chest, where the surgery was done, ached for several days, as is expected after any surgery. Nevertheless, the painkillers managed to keep me very comfortable. I adapted quickly to sleeping on my back, even though I normally prefer to hug a bolster and face the side. I took multiple short walks a day around my aunt’s apartment complex, gradually becoming more comfortable breathing in the cool Bay air.
Within a week, any residual aching had faded away, and I was confident enough to get around San Francisco on the BART and Caltrain to meet my friends and attend AI events. Two weeks later, my non-exercise life was fully back to normal, and I could even gradually sleep on my side again. Towards the end of the month, I took hour-long walks, although climbing the San Bruno hills proved to be very laborious.
After an X-ray confirmed that my lung was healthy, I flew back to Singapore on July 6th. Though I was slightly anxious given the long flight, everything turned out fine, and I slowly eased back into my home environment. I visited a lung doctor back home who confirmed that my right lung was totally fine. However, he was concerned about whether anything similar might happen to my left lung, so he advised me to do a CT scan in November (six months after the initial incident).
In mid-July, I did my first light jog in two months. My breath felt heavier, and sometimes I worried about a weird tugging feeling in my chest area. However, the doctor and my friend Kampton reassured me that this was fully normal and due to the residual effects of the scarring in my lung and chest. I would say that my fitness had deteriorated significantly, but mainly due to the lack of exercise for over two months, rather than any long-lasting damage from the lung collapse and surgery. I got back into cycling in August. Now, I tend to do long, slow, Zone 2 runs to rebuild my aerobic capacity, partially because I’m still hesitant to fully strain my lungs.
In November, I went for the CT scan and was reassured by the doctor that everything looked good, and I didn’t need to see him for the next five years! He suggested building upper body muscle to slightly reduce the chances of recurrence. However, the weird tugging feelings in my chest would deter me from doing chest and abs exercises until January, and I have only recently (in April) regained the confidence to resume regular core workouts.
unexpected blessings
A year after my discharge, I find it miraculous to say that my life has been a net positive compared to if nothing had happened to me.
Firstly, by pushing back my full-time start date by 1.5 months, I had the whole of June and the first half of July to do whatever I wanted in the Bay. I lived the dream life of being an AI tech founder in the Bay, in the middle of the AI revolution. I attended AI hackathons at Berkeley, AI events in SF, and even tried (unsuccessfully) to find the OpenAI office (they moved…)!
Every day, I worked on my AI app, Podsmart, rapidly developing new features and overhauling my earlier, more amateurish implementations, for example I transitioned from using Bootstrap to Tailwind CSS — one of the many lessons I learned the hard way (read more in my blog post). I even managed to meet my co-founder in person for the first time, and we spent 2 days working together and making so much progress.
Looking back, I know for a fact that it’s infinitely harder to maintain a side hustle while working (worse, starting out) in a demanding full-time job. With only a handful of hours every week to devote to my app, the development speed has slowed considerably, sucking the intensity and vigor from this endeavour. Much time is now spent reacquainting myself with what I added last week to the ever-complexifying codebase. Features I rolled out in days last summer, now take months. Worse, I sometimes even end up developing in a loop. I might start working on a feature, then the intended functionality drifts over weeks. Months later, when I realize I need a new functionality, I often uncover perfectly relevant code I wrote months ago but never productionized.
Without this forced block of free time in June, this already unlikely journey down building an AI app would have become downright impossible to launch and sustain. It’s thus far from a hyperbole to say that without the lung collapse, I would never have discovered entrepreneurship.
Secondly, I was able to spend more time with my American college friends. The friends I made in college are so dear to me, and I was really sad to leave them when I graduated in December 2022. Spending a month in the Bay allowed me to hang out with friends like Tony, who spent his summer at Google in the Bay (I even got to visit Google’s incredible Mountain View campus!), and Joseph, who visited the Bay for the Fourth of July weekend.
This summer honestly felt like a dream — living as a tech founder in the Bay Area with some of my best college friends. It felt like my life was on pause, that I would forever remain in this liminal space between college and adult working life.
concluding thoughts
I’ve been truly blessed to have had this experience pan out the way it did. It served as a stark reminder of the frailty of life. In our bubble, chasing after ambition and achievement, we often get frustrated and anxious about one thing going wrong amidst countless blessings. Yet, we ignore the fact that a single issue with our health can make our lives as we know them vanish in an instant. Now, one year into adult working life, I need this reminder more than ever.
Thanks for reading this blog, and do reach out if you found this insightful, or if you want to find out more about me and what I do!
