Copyright ©2012 NPR. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.

LINDA WERTHEIMER, HOST:

This is MORNING EDITION, from NPR News. I'm Linda Wertheimer.

RENEE MONTAGNE, HOST:

And I'm Renee Montagne.

Today in Your Health, teaching teenagers how to drive safely without scaring them. First, though, let's hear about treating children with pectus excavatum. That's commonly known as sunken chest. It's the most common deformity of the chest wall, affecting roughly one in 500 people - boys much more often than girls. And while sunken chest can be corrected in surgery, that procedure carries with it a great deal of post-surgical pain.

From member station KQED in San Francisco, Amy Standen reports on an attempt at a gentler fix.

AMY STANDEN, BYLINE: Before he even meets a new sunken chest patient, Daniel Saltzman, a pediatric surgeon at the University of Minnesota Medical School, can spot them across the room.

DR. DANIEL SALTZMAN: They will sit with what I call the pectus posture, with their shoulders slumped and their arms crossing their chest. And their backs are very rounded.

STANDEN: Pectus excavatum kids have chests that are concave. In severe cases, kids sometimes joke that you could eat a bowl of cereal out of it. Sometimes, the condition is evident at birth. Other times, it develops over time. It's not life threatening, but it can put pressure on the lungs and the heart.

SALTZMAN: They get very fatigued when they exercise vigorously. In fact, there's a vicious circle that'll set where these kids don't want to exercise and so they tend to sit out and play more video games and things like that.

STANDEN: But probably the worst part, at least from the perspective of a teenage boy, is how it looks. For Justin Rosales, who is 14, it's just embarrassing.

JUSTIN ROSALES: I show my friends that I trust, but not that much.

STANDEN: Rosales is from Stockton, California. That's the Central Valley. Average July temperature: 94 degrees. But Justin never swims without a t-shirt, says his father, Carlos Rosales.

CARLOS ROSALES: He's very embarrassed about taking his shirt off in front of his friends or even family.

STANDEN: Justin is an only child. His dad works two jobs, but the whole family has driven an hour and a half to the Benioff Children's Hospital at the University of California San Francisco, where Justin is taking part in a clinical trial for a new procedure, developed by pediatric surgeon Michael Harrison.

DR. MICHAEL HARRISON: Do you mind taking your shirt off? You don't have to.

ROSALES: Oh, I don't mind.

STANDEN: At the base of Justin's concave chest is a small scar. He's been implanted with a powerful magnet just beneath the skin. To demonstrate, Harrison holds up a little refrigerator magnet, which snaps to Justin's chest.

HARRISON: You can just stick it to him.

STANDEN: Wow.

ROSALES: Oh, I didn't know you did. I was scared for a second.

STANDEN: And that's pretty much how this works. Every day and night for about two years, Justin will wear an external brace that contains a second, powerful magnet. If all goes well, the magnets will attract each other with enough force to gradually pull Justin's chest wall outwards. As Justin jokes with the doctors, his mom, Elizabeth, watches him carefully. She worries.

ELIZABETH ROSALES: I pray every single day for him.

STANDEN: Traditionally, doctors have used one of two surgeries to correct sunken chest. Daniel Saltzman, in Minnesota, operates on a few hundred pectus patients a year. And he says both surgeries work well. But they're major procedures, requiring hospital stays. And, he says...

SALTZMAN: The pain can be quite profound.

STANDEN: Some surgical patients stay on pain medications for months.

SALTZMAN: Many of us surgeons have seen some children become addicted to opiate narcotics because of the amount of pain medicines that they have to use. We've sent a couple children to treatment to get them off their pain medicines.

STANDEN: So Saltzman is excited about this new technique that Harrison, in San Francisco, is developing. The magnets are virtually painless, because they work gradually, which Harrison says is the whole point.

HARRISON: The way to fix something that's structurally malformed like that is not to rip the whole thing apart and put it together in over a matter of hours. A better way is to fix it like the orthodontist does your kids' teeth. A tiny little bit, a millimeter every day.

STANDEN: The key, says Saltzman, will be getting patients in while their chest walls are still soft. Wait until after puberty, and it may be too late for the magnets to work. He's enthusiastic, he says, about any way to help these kids feel better about themselves.

SALTZMAN: Once you repair the deformity and you see their self-esteem grow, like a flower opening on a morning, is spectacular. It's an amazing experience.

STANDEN: The magnet procedure is in its second FDA trial, which will treat about 15 kids.

For NPR News, I'm Amy Standen in San Francisco.

Copyright © 2012 NPR. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to NPR. This transcript is provided for personal, noncommercial use only, pursuant to our Terms of Use. Any other use requires NPR's prior permission. Visit our permissions page for further information.

NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR's programming is the audio.

Comments

 

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Support comes from: