Major League Pectus

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Ridgely Ingersoll

Tim1On August 15, when 18-year-old Chesapeake native Tim Melville signed a multi-million dollar contract to play major league baseball with the Kansas City Royals, his mother Valerie sent jubilant emails to his friends and family. One went to Tim’s caregivers at CHKD because, she says, “I truly believe that Tim wouldn’t have achieved all that he has if not for CHKD.”

Tim, at 6 feet 5 inches, is a pitcher. “I can’t remember him without a ball in his hand,” says Valerie. Her first inkling of his pitching ability came when Tim was just 8 years old. “We went to a baseball game where they had a pitching booth with a radar gun. He threw that ball 50 miles per hour.”

By age 10, Tim was on an elite travel team that competed in baseball tournaments in several states. The next year, however, something became noticeably wrong.

“I thought maybe he was developing asthma,” Valerie said. “He was having a really hard time with his breathing. Games would just wipe him out. Afterwards, when all the other kids went out for ice cream, Tim was so tired he just wanted to go home.”

“It was frustrating,” Tim says. “I would get really tired, especially running. I would try, but I just couldn’t make myself go any faster.”

Valerie had no idea what was causing Tim’s problems. Neither did the Melville’s family practice physicians. But one day, Valerie found the answer in her mail box … in a Kidstuff magazine of all places.

“Tim had a sunken chest. So did his Dad. We called it ‘puddle chest.’ There was a story in that issue about a ground-breaking surgery that a doctor at CHKD developed for children who had sunken chest.”

That ground-breaking surgery was the Nuss Procedure, developed by CHKD surgeon Donald Nuss to correct pectus excavatum, an abnormality of the rib cage that gives the chest a sunken appearance, like Tim’s “puddle chest.”

Tim2Tim says he was self-conscious about his chest. “I didn’t take my shirt off at the pool because kids would say stuff,” he remembers. But the Melvilles had no idea that Tim’s odd-looking chest might be to blame for his breathing problems and difficulty exercising.

“When I read that Kidstuff story,” Valerie continues, “something just clicked. I called Dr. Nuss’ office immediately. They read me a list of possible symptoms and it was like they were describing Tim’s problems exactly. Then they asked if I wanted to bring him in to have him evaluated. I said ‘yes’ and they asked if I needed a list of hotels. I laughed and told them, ‘I’m five miles down the road!’”

It turns out, Tim had a fairly significant case of pectus excavatum. “We measure the degree of the condition with a mathematical index based on CT scans,” says Dr. Nuss. “We recommend surgery for any cases with an index of 3.25 or greater. Tim’s index was a 4.8,” he said. “His chest wall was pressing down on his heart and lungs, making it very difficult for him to breathe and exert himself. Like many of our patients, Tim’s pectus excavatum grew more pronounced, and his symptoms increased proportionately during the growth spurt of early adolescence.”

In the spring of 2001, when Tim was 11, Dr. Nuss corrected his pectus excavatum by inserting a curved bar through tiny incisions in his sides. The bar pushed Tim’s sternum into a normal position and held it for several years until his bones hardened.

After his surgery and recuperation, Tim’s increased heart and lung capacity allowed his natural gifts to develop and flourish.

Just before Tim’s first year of high school, the Melville family moved to a suburb of St. Louis, where he became a bright light on the national high school baseball scene. College and pro scouts with pitch-clocking radar guns were a regular sight when he took the mound. Among his many national and regional awards were the Jackie Robinson Award as the National Player of the Year at the 2007 All-American High School Baseball Classic. In his senior year, he was recruited by the University of North Carolina at Chapel Hill.

But in August, just before school started, he decided to go pro and signed with the Kansas City Royals. The rest, we are sure, will be history.

“Having pectus surgery at CHKD definitely changed my life and my ability to play,” Tim said recently from Arizona, where he was playing “rookie ball” with other newly-signed players. “I can take my shirt off at the pool and in the locker room, and I can play a lot harder and a lot longer. I don’t think I’d be where I am today if I hadn’t had the surgery. It was a great thing for me.”

Dr. Nuss practices with CHKD Health System’s Pediatric Surgery.

This story was featured in the fourth quarter 2008 issue of KidStuff, a publication of Children's Hospital of The King's Daughters.

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