By MARK MCGEE
He knew it was going to happen one day. He didn’t know when, but he knew whenever it happened it was going to be a disruption to his life.
His junior year at Cascade High School Zach Crosslin, a 6-foot-4 1/2 student-athlete, finally heard those words from a doctor no one wants to hear… “it’s time”.
The diagnosis all along had been pectus excavatum . The cure is chest wall reconstruction which was performed at Children’s Hospital at Erlanger in Chattanooga, Tenn.
“We had known about it for a long time,” Zach said. “When I was in elementary school I started seeing doctors about it.
“In middle school and high school sports I noticed I was having a real problem with my breathing so they decided it was best for me long-term to have the surgery and move on.”
Most medical books define pectus excavatum as “when the ribs and the breastbone (sternum) grow inward and form a dent in the chest. This gives the chest a concave (caved-in) appearance, which is why the condition is also called funnel chest or sunken chest. Sometimes, the lower ribs might flare out”.
“We started this journey when Zach was 10,” his mother Angie Crosslin said. “He has always been extremely tall in the 99th percentile for height.
“His pediatrician at the time sent us to Nashville for a consultation with a surgeon. His philosophy was he wanted to do the surgery between 10 and 13 years because it was an easier recovery.”
Angie and Zach’s father, Marty Crosslin, considered the option but decided it was best to wait.”
According to The Cleveland Clinic in the operation known as the Nuss procedure, “a surgeon makes two small incisions on either side of the chest. Then a custom-curved steel bar is installed under the sternum and is positioned to elevate the sternum. The bar is secured to the chest wall on each side to correct the depression.”
“Once they put the bar in it has to stay there three years,” Angie said. “We thought about what would happen if they put it in when he was 13 and took it out when he was 16 and then he grew again.
“We didn’t know what to do. We were a little concerned. We prayed about it. Somebody found out about Zach and through them we met someone who had just had his bar removed.
“He was 15 when it was done. He showed Zach his bar and his chest. We decided then to get a second opinion.”
So the Crosslins headed to Chattanooga where they met with Dr. Lisa Smith who specializes in chest surgery of this type.
“Dr. Smith had already worked with 80 patients with chest deformities at the clinic the year she saw Zach,” Angie said. “She spent about an hour with us. She said he was too young for the surgery at 13. I was thinking this was meant to be.
“She saw him yearly. Last January it was really affecting his lung function. He fatigued easily. He would bend over trying to catch his breath. “
The breathing problems were having an effect on Zach, especially in sports.
The cause of pectus excavatum is unknown though most experts point to genetics playing a role. On an average, it occurs once in every 300-to-400 children with the majority being males.
The recovery is several weeks along. He was not able to twist his body or bend at the waist for six weeks.
“I had two positions,” Zach said. “For six weeks I could either lie flat on my back or sit in a straight back chair.
“It was rough. As an athlete, you want to be out doing things. I wasn’t able to go outside. I couldn’t get in a car. I was pretty much in the house all summer. I was bored at times, but it went by faster than I expected.”
The physical recovery consumed him for several months.
“The first time I went outside to walk I took two or three steps and my legs had already given out because I had been lying down or sitting up for so long,” Zach said. “You don’t really realize how much muscle strength you lose.”
He was cleared to play sports after finishing weeks of rehab and getting the final approval of his doctor on Dec. 1 of last year.
“You have to be cautious when you first go out to- play again,” Zach said. “I took a charge and got hit in the chest my first game back. I kind of just laid there for a minute and then I got back up.
“We were playing Moore County in basketball. I thought there was no way I was going to get in the game. But in the fourth quarter, the coach looked at me and said, `are you ready?’ My original thought was no, but I changed it to yes.”
As a pitcher in baseball, the recovery was a little easier.
“I didn’t think I was going to be able to play anything for a while,” Zach said. “But in baseball I practiced twice a week this summer with a travel team, taking hitting lessons and playing basketball five times a week this summer.”
He has put baseball on hold to play for the Cascade golf team.
But the outcome has been all they could hope for with such a strong recovery.
“From a parent’s standpoint I would say it was the best decision we have ever made,” Angie said. “He has done extremely well. He is a warrior.”