How a life-changing chest surgery strengthened Matthew’s dream of becoming a doctor

Caring. Thoughtful. Patient. Calm. Those are the qualities that 20-year-old Matthew believes every good doctor needs.

They’re also how he describes Adam Alder, M.D., Chief of Surgery at Children’s Health℠ and Associate Professor at UT Southwestern – and how others might describe Matthew himself, a pre-med college student.

Being diagnosed with pectus excavatum

When Matthew visited his pulmonologist Steven Copenhaver, M.D., Pediatric Pulmonologist at Children’s Health and Associate Professor at UT Southwestern, for his asthma, he was referred to Dr. Alder, whose expertise includes surgical care for pectus and chest wall anomalies.

Matthew’s older brother had also been diagnosed with a sunken chest, or pectus excavatum, a condition that happens when growth of rib cartilage causes the breast bone (sternum) to move inward. “Pectus” (as it’s called for short) is a condition that runs in families – and occurs more often in boys.

At age 14, Dr. Alder confirmed Matthew had mild pectus – likely the reason his asthma seemed worse when playing competitive tennis. Because the condition often progresses during puberty, Dr. Alder recommended a follow-up visit in a few years.

At that visit, Dr. Alder ordered tests, including a CT scan of the chest, an EKG of the heart and a lung function test that showed Matthew’s case had become severe. The curve in his sternum was pressing on his heart and lungs, making it more difficult to breathe.

“My pectus didn’t look that bad on the outside, but my tests showed it was severe. So Dr. Alder recommended surgery,” says Matthew.

Understanding the risks and benefits

Dr. Alder never tells families they have to get surgery, but he helps them understand the potential benefits.

“It’s always a choice,” Dr. Alder says. “Without surgery, it’s still safe for kids to continue in sports. But research shows surgery almost always improves heart and lung function, which are compromised by anatomy.”

He explains that kids don’t have any way to know what it’s like to live in a different body or if they’re performing below their potential. “Kids have tremendous reserves of energy and can perform at a high-level even if they’re compromised. But our reserves often diminish with age and then, it can become a bigger deal to be compromised,” he says.

And some kids feel immediate results. “A lot of kids tell me, ‘I didn’t expect to feel different – but I do.’ They say they have more energy, can breathe more deeply and recover faster after exercise,” Dr. Alder says.

Deciding to have surgery

For Matthew, the decision came down to two things: easing his asthma and preventing rare but serious complications later in life, such as heart arrhythmias or reduced lung capacity.

“For me, the very low risks associated with surgery didn’t compare to the possibility of long-term complications or even disability,” he says.

His brother also encouraged him.

A constantly improving surgical experience

The Nuss procedure, the preferred surgery for pectus, straightens the curve of the chest bone without breaking or removing tissue. “We use hardware to restore natural shape and function,” explains Dr. Alder.

Matthew’s surgical team created custom-fitted metal bars for his chest. Over the next three years, Matthew’s repositioned chest wall would be supported in the correct position so it could stay in place permanently.

Matthew had two bars, unlike his brother who had one bar. “Patients today receive multiple bars linked together – allowing for faster recovery and return to activity,” says Dr. Alder. “Our new multi-bar technique lets patients return to activities and sports as soon as they feel ready because the bars pose only a small risk moving out of place.”

New pain-control methods also make for a less painful recovery. Instead of needing weeks of opioid pain medicine like his brother, Matthew’s pain was managed with cryotherapy, which numbs the chest nerves for two to four months.

Matthew’s surgical experience

Matthew describes the actual surgery as “smooth, successful and not stressful.”

He was given medicine to help him relax before anesthesia and the patient care coordinator at the Children’s Medical Center Plano helped him stay calm and comfortable. Just two hours after surgery, he was in recovery – and he went home the next day. His brother, by comparison, needed to stay in the hospital for four nights.

Physical therapists (PTs) and occupational therapists (OTs) made sure he knew how to brush his hair, put on his socks and shower – without bending and twisting too much.

“At home, I only needed one painkiller pill – total,” says Matthew. “The cryotherapy really worked.”

At first, Matthew noticed mild pressure in his chest, which quickly faded. And nearly three years later, he can feel – and see – the difference.

Having a chest bone that no longer looks sunken is a bonus, but as someone who “geeks out” on anatomy and physiology, that was never Matthew’s motivation.

“There’s lots of research showing kids feel better about their appearance after surgery,” says Dr. Alder. “That can boost wellbeing.

Looking ahead

Matthew is a busy pre-med student majoring in microbiology and immunology who spends his free time out of class working in an urgent care, volunteering, playing tennis and producing techno music.

He’s preparing to have his bar removed soon – and says he’s a little nervous and also excited.

“I had the privilege of actually observing Dr. Alder doing a few bar-removal surgeries,” says Matthew. “It was an honor to watch him and learn. Seeing the procedure brought my experience full circle.”

Watching surgery up close – one he’ll soon experience himself – only deepened his resolve to go into medicine.

Matthew looks forward to one day guiding patients with the same empathy and compassion that Dr. Alder has shown him.

“Right now, as a pre-med student, I’m shadowing and learning so much about different specialties. So far, my favorite has been anesthesia, Matthew says. “But no matter what specialty I choose, I know I want to help people, be part of constantly improving care – and have the kind of impact on others that Dr. Alder has had on me.”

Learn more

Pectus excavatum occurs in 1 in 1,000 kids. Learn more about the expert care we provide to kids of all ages (and young adults up to age 25) for every type of chest wall anomaly at our Center for Pectus and Chest Wall Anomalies – offering convenient care in both Dallas and Plano.

Want to learn more about the latest advancements in pectus surgery? Catch Dr. Alder in our “In the Know” video series or tune into our Pediatric Insights podcast to hear what makes our surgical care stand out.