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1397648 tn?1288146526
5 box Thorascoscope maze done on me 9/17
Hi all, just letting you all know I had this procedure done last Friday at Ohio State University Ross Heart Hospital. Dr Sirak is one of the innovators of this minimal invasive procedure. To save time and learn more you can go Ohioafib.com.

The advantage of this procedure over a typical ablation is it is much more affective on my condition, persistant, afib. It is more thorough and has better longterm results.It is definatley not a walk in the park. It is more invasive than the popular cardiac ablation, but as I said more affective on my type of afib, from the research I have done.

I am going to answer as many questions as I can in order to help people that are considering the procedure.

From what I have understood the procedure is " in network" in my United Healthcare insurance network. But I haven't seen any bills yet so only time will tell.
The worst part of the surgery is , to me, the feeling, weakness, and psycotic feeling from the  anethstetic and pain killers, I hate em! I actually hallucinated on them and they lingered for days. I did talk to others that have had surgery and they didn't have the same reaction , so it may be just me. I had essentially 2 nurses taking care of me in my room, one for general house keeping and care and the other a cardiac nurse. Both were professional and caring to the max. I also, being a single guy, developed a crush on my nurse in the OR, but I'll save that story for my buddys.
I have 10 incisions on my body, under my arms across my chest and 2 drain holes below my ribs. Small ones 1/2 inch long. Another concern I had was the whole BM issue, but I can report this morning I'm happy in that area.
I am on several meds for the shorterm. Mainly, as Dr Sirak told me, my heart has burns on it for the moment and need to heal, there will probably be inconsistant reactions to the inflammation over the next few weeks, but eventually I'll be taken off most or all the meds.

I'm not out playing tennis again, yet, but that is in my sites.

Any more questions? I'll be home the rest of the week and happy to let you know my experience.

Pete
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Page 18 of 18
1488678 tn?1288282561
Pete,

I let Dr. Sirak know weekly what and how I'm doing.  He keeps saying I'm on no restrictions.  I told him I wanted to ski a few weeks ago and his response was 'don't let me keep you from skiing'.  So, I'm off and running.  It's more the atrophy that's hard to get past and the reason I'm keeping my HR around 120 while working out rather than the usual 135 to 140.  With no stray beats so far...I'll take it!

Steve
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1397648 tn?1288146526
Just a note to say hi to everyone and hope all is well. I am in my 23rd week of recovery and was taken off coumadin last weekend. I am no longer on ny meds for the afib I had. I am working out and having a great time.

I hope everyone is doing as well and hope to hear for you all.
Pete
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Hey Pete!

I've been wondering how you and all the other 5 Boxers have been doing!  Glad to hear you are doing great and having no afib.  That's wonderful news!  Hope the other 5 Boxers are doing just as well!

Annie
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1569985 tn?1328251082
Could you give me Dr. Sirak's website?  And where does he practice?  and what exactly is the 5 box procedure?  I'm in paroxamal AFib, apparently moving toward persistent.  Spent 4 days in the hospital over Christmas and do not want to repeat that.  It sounds so good for you all to be back to good health with this procedure.  Guess I'm looking at my probable future and grateful to  have all this information with the experiences you 've shared.  I'd like to hear more about the 5 box.  Thanks.
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Hello:    Dr Sirak can be found by googling him at Ohio State University at Columbus, Ohio.  I had the TTM or 5 box procedure in November, 2010, and have dropped all meds except the coumadin.   Currently in NSR and am currently wearing a holter monitor to verify ongoing normal sinus rhythm.  If so, will drop the coumadin and be med free.  Hooray.  Good luck,   Wayne
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1397648 tn?1288146526
Hey there everyone!

Just wanted to drop in and see how everyone is doing these days. I have pretty much gone on to a yahoo site where there are people who have had the same procedure as me. I am doing really well these days. still in NSR and continue to be off all meds. Hope to hear from everyone that supported me during my recovery.

Take care all.
Pete
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Name is bill; scheduled Tuesday june 27 with dr sirak;  we have only spoken briefly on phone as i am from Connecticut.researched on 'net.
I had no second thoughts until this morning.  Have been  'permanently' in Afib, effectively asymptomatic, for 3+ years managed by 50 mg atenolol and of course the rat poison a/k/a coumidin.  i turn 50 next month in very good health other than managed 'severe' OSA( obstructuve sleep apnea).
I do what i want, feel bascially great, just a bit more tired than i should be.

due to a low CHAD score, if was NOT on coumidin for 6 months or more, and did go thru what appeared to be a TIA but was officially diagniosed as a very minor stroke in January 2011.

So, if any of you were me, would you endure even a procedure as 'good' as Dr Sirak's, or resign yourself to Afib and its risks possibly forever??
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I was in permanent AFib for over three years. I had my procedure ( totally thoroscopic mini maze ) performed at Kaiser in San Francisco. It was a breeze. In and out in four days. Three enjoyable weeks off work. I'd do it again without a moments hesitation. Have been in perfect NSR for six months. No longer worried about possible long term damage to my heart from continuous AFib. This procedure with Dr. Cain has produced a 96.8% success rate at the 6 months.

Mike in Walnut Creek, CA
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Forgot to add. Dr. Sirak was not my surgeon, but I believe he gets similar success rates for his patients.
Mike
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Good for you....!   I too am in the club of having a successful TTM procedure last November, 2010.  Still in NSR, no meds, no blood thinner.  Playing golf and tennis, plenty of energy and feeling good overall.  Stay well.

Wayne O
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1724098 tn?1309578205
I enjoyed reading about your successful five-box surgery. Congratulations! In the five box yahoo group I heard about someone who was racing up and down the hallways right after surgery. I had to come here and check it out for myself!

How long had you had the defibrillator in you? Was it because your heart was in danger of stopping? If so, no wonder you are so happy! How long had you been in AF prior to surgery? How are you doing now that you are a couple of weeks out? (sorry for all the questions.. curious!)

I had the five-box surgery with Dr. Sirak as well, on May 17. I was walking the halls of Ross the next day, and was released on the 19th. On the 20th I walked all over downtown Columbus. I celebrated my week anniversary by going for a 10 mile bike ride. So it sounds like we were both quite lucky and handled the surgery very well.

I was diagnosed with persistent AF in June 2010. I believe that I had had AF since around 1999, starting with night palpitations, but never went to a doctor to see what the problem was. Once diagnosed, I did the typical rate control followed by cardioversion. I stayed in rhythm for almost 5 months. After I went back into AF, it was going to be antiarrythmics... I decided I wanted the AF to be cured and signed up with Sirak.

Nice to meet you all!
Madge
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1724098 tn?1309578205
Did you have your surgery on June 27 as planned? I just joined this forum today... I wish I had seen your post earlier. I was similar to you... 50 years old, persistent afib, fairly asymptomatic (just the typical exercise fatigue that we all get used to). I wanted a cure and went to Dr. Sirak for it. I had my five box surgery on May 17.

So to answer your question... I would never permanently decide to live in AF! Let us know how you are doing. I hope you are having as easy a recovery as Bob and myself.

Madge
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It appears that you had your surgery more than a year ago.  Have you remained in NSR to date.  I am having my third electrocardioversion in two weeks and I am interested in having the 5 box surgery if it comes back out again.  The first electrocardioversion lasted 18 months the second 31 months.  Hoping this last longer.  I have persistent AF
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1397648 tn?1288146526
Yes I've enjoyed NSR for over a year now and it's been great. Dr Sirak is the best. If you e-mail him he will respond. Just go to OhioAfib.com.

Good Luck
Pete
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Thanks for responding.  May I ask you how was the surgery healing process.  Was it pain for a long period or short time.  I hate taking pain Meds.  Had shoulder surgery after slipping on ice and needed 4 pins.  Took pain Meds for one day.  Doc who did surgery could not believe I was not taking pain Meds.  

Thanks,
Joe
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I too am from MA but I am on Medicare with BC/BS supplement to pay what Medicare does not.  Wonder if the will reject me also even though they are not the primary insurance and now wondering if Medicare will also say it in the trial stages.
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1397648 tn?1288146526
Joe
There is a yahoo website where 5 Box alumni gather to discuss their experiences, research, recovery and as you can see from Glen, who is an alumni also, insurance issues. Glen can tell you more about it but it's at yahoo groups under afib 5 box I believe., I don't visit it as much now since I really have no questions and no longer have the issues I had previously. Plus there are many more people way more into it than I am.
My recovery was about 4 weeks before I could really feel normal again. Some others had a very fast recovery as you will see at th web site.

Good luck Joe.
Pete
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I see you had the five-box procedure and had to take anti arrythemia drugs after.  Are you better and are you off the drugs.  I want to have the surgery because I do not want to get on those drugs.  If you are better what was your full recovery time.

Thanks,
Joe
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996946 tn?1503252712
Hi Joe, no i did not have the 5-box, I had the traditional PVI ablation with Dr Andre Natale.  My heart did not settle down after my ablation Sept, 2010.  It took 3 mo. more of anti-arrhythmia meds and lots of prayer to finally say good-bye to a-fib.  Over the last 6 mo. or so I have had some short episodes of tachycardia but the last month or so I have had none of that either.  I have heard, as I'm sure you have, wonderful things about Dr. Sirak.  If you choose the Pulmonary Vein Isolation ablation I would highly recommend Dr. Natale in Austin, Tx.  Good Luck in which ever way you decide to go.  I am very glad I had the procedure done.
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Thanks for your response.  My AF is persistent.  Did you have same or paroymal.
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Has anyone gotten Blue Cross Blue Shield to pay for the 5 box maze ?
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996946 tn?1503252712
I had paroxsysmal a-fib which started out the first few years with 2-3 episodes a year and gradually increased to weekly episodes of 24-36 hr duration or longer.  Incredibly, I never had to be shocked back into NSR.  I was on many different anti-arrhythmia meds throughout the years and eventually every one of them would stop working.  I feel like my only way out was an ablation.  My Dr. might tackle persistent a-fib (do you have it 24-7?)  Some Dr.'s won't.  
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Yup...24/7.  I am wondering while in AF how much damage I am doing to my heart. Tomorrow I am going for an electrocardioversion.  This is my third one.  First one lasted 18 months and this last one 31 months.  Now I am hoping for at least 4 years and by that time some new innovative technology will be out.

Joed131
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how long did you have the cough?  brother-in-law had it done in december 2011 but still has the cough.  Ruth  
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Has anyone had a cough for weeks after the procedure?
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Have parox afib 17 years on and off and it's worsening fast. Had ablation 3rd week of Dec. but it came back in 2 months. My rate often stayed above 170 and this lasted 2.5 days. Hospital convinced diltiazem and digoxin converted me but I wonder why they took more than 2 days and my rate was so high. Having repeat ablation in a few days. Now have left ventricalular hypokinesis and hosp. says that might be from the ablation.

2 questions

1. Can a procedure in the atria affect ventrcles like that?
2. Would previous ablations mean I couldn't get the 5 box?
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1397648 tn?1288146526
I understand your plight. I strongly urge you to go to ohioafib.com and follow directions to contact them. Dr. Sarak will call you. The site will also tell you what you need to know about the 5 box. Good luck and keep me informed. Pete
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Thank you very much for writing back. I'll do what you suggest.
Do you know if any 5 box patients had previous ablations?
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1397648 tn?1288146526
There is a whole website, that you can join at ***@****. The people in this group have all had the 5box and we all keep tabs on how the other is doing. Dr Sirak also participates, yes that's right, the surgeon actually talks to us and offers solutions when appropriate.

Go to the group, you will find objective answers from the curator, Ken,great guy and support from everyone. See you there....
Pete
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1397648 tn?1288146526
I'm sorry to say the moderators at this site woun't let me send you an address to a forum that would help not only you but has helped many others. Thankfully they didn't catch the address for the Ohio State web site that we all belong to also. Just go there and they can direct you to the other site. There are many open minded people there that can and will support you.
good luck and as I said keep me informed.
Pete
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2022887 tn?1328726971
I'm thinking about having the 5 box done just found out about it yesterday saw my Dr. he thought I should go for it.  

I want to talk to anyone that has had an adverse reaction from it.
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2022887 tn?1328726971
I had my surgery August 1st 2012 I'm in NSR and came home August 6th at 9:30 PM.  I'm having some healing problems but will have my complete story in 30  days.
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1724098 tn?1309578205
Best of luck as you heal up from surgery! Glad to hear it went well, and I hope the healing goes as smoothly as possible.
Madge
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612551 tn?1450025775
Congratulations on your success.  It usually takes time, some times months, for the heart to heal - I do not know anything specific about your procedure.

Recovering an old thread/discussion isn't the best way to connect with the people who interacted on that thread.  Many of them got what they wanted and don't come back to see what else is being discussed.

Clearly this thread started by "Pete.." has a lot of information and views.  Perhaps you'll be able to get direct interaction with one or more of those by sending them a message. You can get to the message facility by "Clicking" on their "handle" on any of the posts made by them.

Good luck.
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Hi Pete, my name is David and I had the 5 box maze done on 9/11. unfortunately I'm still having many afib and flutter problems.  my doctors keep telling me to be patient and I am, but I'd be lying if I didn't say I expected faster results. I also on 7/11 had the catheter ablation, that unfortunately had no effect . you have no mention of them collapse your lungs to do the surgery, I am 54 and when the afib does hit I struggle with breathing  and the ability to walk any distance, but on good days, I get out of the house and take care of things that need to be done.
I'd like to follow your continued progress and speak more down the road to see how your recovery is going.
I have kept indepth details from the first day my afib began on March 21st. Example: Sept. I was in afib for 179 hours. Since my surgery I've been in afib 126 hours. Yes I am waiting as patiently as I can for this thing to take affect.
so let's get together sometime and compare notes, but in the meantime feel good and I hope for your speedy recovery !
David from Naples Florida.        
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1724098 tn?1309578205
Hi David,

I had the five box surgery in May 2011 and have had no afib since then. My recovery was super-quick and I had no issues. Heart monitoring shows that I have some ectopic beats (PVCs, skipped beats...) but I don't notice them at all. I am thankfully off all meds.

Just to be clear... you had the five box surgery by Dr. Sirak at Ohio State? If you are having problems and experiencing afib, I assume you are being helped by Dr. Sirak. It has only been a few weeks since your surgery. It can take a while for the heart to heal and the inflammation to clear up. Are you on an antiarrhythmic at this time? Were you in NSR when you left the hospital?

Your breathing will improve. I walked a lot after surgery and that seemed to help me. Everyone is different of course.

I hope the afib stops soon... let us know how you are doing.

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4494173 tn?1355435199
Hi Everyone!

I'm new to this website. My EP suggested that I consult Dr. Sirek after 2 failed PVA's. My AF is persistent and I'm on amiordarone. I spoke with Dr. Sirek and he sound confident that he can correct my problem. Any thoughts? What should I expect?
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2022887 tn?1328726971
They must be hanging their head in shame now that the 5 Box has a better % then any other maze.
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Hey everyone,

My FIBRILLATION was caused by a reaction to anesthesia, after 8 cardiac conversion and 1 failed Ablation in July 11th 2012, I had the 5 box maze done on Sep 11th 2012. Although all my major attacks have gone away, but then I was in FIBRILLATION 24/7 for the next 4 months, they very minor, but I never forgot I was in FIBRILLATION.

I could not take any deep breaths and had pain in my lower ribs (like one was busted).  Jan, 2013 I was having a lot of pain in my ribs and went into the emergency room, where they found my left lung was collapsed and my diaphragm had moved up under my ribs (that was the pain I was feeling)

On January 11th,2013 the decided to convert me again and that was successful, my HEART has been insinus and as of today still beating good.

Now I'm dealing with a collapsed lung with minimum chance of recovery...
Has anyone had to deal with a lung problem??? My surgeon stated " he either traumatised, paralyzed or clipped my PHRENIC Nerve. I've done a lot of reading and no one else has had to deal with this, but if you have I'd like to chat sometime! Also dealing with side reactions to drugs...

David from Naples Florida
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1724098 tn?1309578205
Hi David,

You have certainly been through a lot. I am glad that you are in sinus rhythm, but very sorry to hear about the collapsed lung and phrenic nerve damage. From what I understood, a couple of years ago (or so) Dr. Sirak modified his surgery to stay away from the phrenic nerve. I am wondering how this happened. Just to verify, you had the five box maze at Ohio State?
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1724098 tn?1309578205
Hi David,

I am very curious about this. Please let me know who your surgeon was.

Madge
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Hey Everyone,

I'm interested to learn if anyone has had this procedure done in Florida and if by who? The results as well???

I had the procedure done at Naples Community Hospital, my Thorasic Surgeon was Dr. Pascotto. I know this doctor has not preformed many of this procedure, but they were supposed to fly in a Proctor Surgeon from Utah who has preformed over a 1000 5 Box Maze surgeries and supervisor the 9.5 hour surgery. I never met the Proctor Surgeon (before, during or after) and his name does not appear on any of my paperwork, has anyone ever heard of this practice?

Just to catch you up on my case it appears the surgeon traumatised, paralyzed or clipped the Phrenic Nerve and now I have lost use of my left lung and my diaphragm has moved up under the rib cage (painful yes). Know one can tell me if it will repair it self they just keep asking me to be patient and say lets give it another 3 months.....

The procedure was preformed in Sept. 2012 after 4 months of minor fibrillation 24/7, they cardio converted me on January 11th,2013 and my heart has stayed in sinus, but this lung thing has me for a loss! That's my story in a nut shell.

David
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1724098 tn?1309578205
Hi David,

Thanks so much for clearing this story up for us. John Sirak at Ohio State in Columbus is the only surgeon I know who does the five box surgery. It requires very specialized skill and equipment. I am really surprised that someone offered you a five-box somewhere else. I do not know of a surgeon from Utah who does this surgery.,.. just Ohio.

The surgery shouldn't take 9.5 hours either. Mine was considered long (due to fibrotic tissue) at it was around 5-6 hours.

I do hope that the phrenic nerve heals. I have heard of that happening, although it could take a couple of years. I am so sorry for what you are going through.The five box is a great surgery, but has to be done by the right surgeon.

Can you ask your surgeon for more information? Get the name of the proctor from Utah and maybe we can all help you out with some research on this. You can also ask the surgeon for you surgical report.

Hang in there David... hoping you recover your lung function.
Madge
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1397648 tn?1288146526
Hi David

Everything Madge said is true. Please try/insist on getting names, specifics on what happened. Good luck.
Pete
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1724098 tn?1309578205
I've been wondering about this business of a proctor when it comes to surgery. Come to find out, it is exactly what the word proctor means... to monitor. A proctor monitors students who are taking an exam. A proctor surgeon monitors the surgeon who is performing the surgery, but does not participate in any way. From what I understand, the proctor does not scrub in. They are there to offer verbal guidance. In David's case, while a proctor may have been in the room, it was Dr. Pascotto who performed the surgery.

This is a good thing to know for any surgery. If the surgeon needs a proctor to be there, we might want to wait until he gains more experience.

David, I am very sorry about what happened to you. I am glad you are in sinus rhythm and I hope your phrenic nerve regenerates. Thank you for sharing your story, and please let us know how you are doing.
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Hello - hoping this thread is still alive?

I had a Five Box surgery with Dr Sirak 15 days ago on the 11th of June.

Unfortunately my Sino Atrial artery was damaged during the surgery which left me with a permanent pacemaker.

Recovery seemed to be going along fine till about 5 days ago when I developed a persistent dry cough that will not go away. Perhaps irritation from deflating the lungs I understand.

But most of all and what worries me at this point is that my heart will not go past about 90 BPM and that is with me huffing and puffing walking up a hill. My pacemaker's rate responce has already been tuned to reach higher without hyperventilating like I am.

So my question to all of you is after your own surgeries was your heart rate limited for awhile solely by post surgical inflammation? Also is you experienced dry cough how long sis it last for you and better yet was there a way to get rid of it?

Much thanks
-Ethan Summers
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how are you feeling any afib? i have had afib about 5 years not all the time would appreciate any information. Leaning towards 5 box thanks for your in put.
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i have afib and i have a cough doctor cannot give a answer. I have had for five years not all the time any one have any information about five box or any other please let me know. I am new here so thanks for your help.
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how are you feeling any afib? i have had afib about 5 years not all the time would appreciate any information. Leaning towards 5 box thanks for your in put.
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1982721 tn?1462924436
Hi Ken-- hoping you will see this. I had a mini-maze done with one incision and one chest tube on each side. I am a female. It has been 26 weeks since surgery and I am also still having "too much" intercostal pain. Noticeably the diaphragm as well but gastroenterology has ruled out any issue. I see your post is from 5 years ago, but can't help but ask if you recall how long this pain lasted for you, ie, did it ever go away? Thanks for reviewing my question (anyone else can chime in!) Dawn
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