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Successful Chest Wall Reconstruction Allows Patient to Pursue His Dreams

Zachary is only 18 years old, but has a calmness about him that makes him appear much older and wiser than his peers. He enjoys listening to music from the 40s and 50s, music not often appreciated by others his age. He loves the calm of the outdoors and he loves to hike.

About two years ago Zachary’s life was interrupted by overwhelming chest pain and breathing trouble. His local doctors were stumped and diagnosed him with athletic-induced asthma. Zachary’s mother Michelle suspected it was something more serious. As a chiropractor, Michelle had observed her son’s development over the years and noticed something different about his chest. His sternum seemed to curve inward more than normal, and she suspected his bone structure might be affecting his breathing and heart function. Zachary’s doctors were reluctant to explore different diagnoses for Zachary. Michelle had long known about Shriners Hospitals for Children — Northern California and decided to self-refer Zachary for a consultation.

Zachary met with Gary Raff, M.D., a cardiothoracic surgeon at the Northern California Shriners Hospital, and from the first appointment, Dr. Raff understood the severity of Zachary’s discomfort.

“At that first appointment, I was getting ready to tell our whole long story to try to convince the doctor of the severity of Zachary’s struggle,” said Michelle, "but Dr. Raff took one look at Zachary’s chest and knew it was something more than asthma. He was the first doctor to acknowledge Zachary’s condition and offer us hope.”

Dr. Raff is an expert in chest wall disorders and diagnosed Zachary with a rare condition called Currarino-Silverman syndrome. It is a condition where the sternum curves inward in an S-shape. Zachary’s sternum was applying pressure to his heart and lungs making it difficult for him to breathe, especially during physical activity.

Zachary had two surgeries that were two years apart to reshape his chest wall to an outward position and alleviate pressure on his organs. During Zachary’s first surgery doctors inserted a metal bar that would reshape his growing chest wall. Over the following two years Zachary was monitored by his surgical team and attended physical and occupational therapy sessions. Zachary’s doctors removed the metal bar during the second surgery. Zachary’s relief was immediate.

“After his final surgery he took a huge breath and said he felt amazing,” said Michelle. “He was so relieved to have no pressure on his heart and lungs.”

Post-surgery, he is easing back into his favorite activities including hiking. Zachary’s prognosis is excellent. Dr. Raff and Zachary’s medical team report that Zachary’s condition has been fully corrected, and he will be able to do anything he wants.

Michelle thanks Dr. Raff and Zachary’s Shriners Hospitals team for their medical expertise and willingness to answer all questions, even the small ones.

“Dr. Raff was really amazing,” said Michelle. “He was there with us through the whole diagnosis and treatment and was always there to help put Zachary at ease, and to calm me down. The nursing staff was also wonderful. A staff member was always available to answer all my concerns even in the middle of the night. They never discouraged us from picking up the phone.”

Zachary shared that he hopes to someday join the Army Rangers and travel the world. We asked Michelle if she supports this dream.  “Absolutely,” said Michelle. “I want Zachary to do anything he wants to. I want him to spread his wings. I want him to jump from airplanes if that’s what he wants to do. And we thank Shriners for making all that possible."

Zachary walking on a hike

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