'My spare ribs were stopping me singing'

By Jane Elliott
Health reporter, BBC News

Maria's ribs were affecting her singing

Opera singer Maria Field is hoping to turn professional after surgeons discovered and removed two extra ribs.

Maria, 42, from Margate, had sung opera semi-professionally for 17 years, but was dogged by unexplained poor health that eventually stopped her singing.

"I always had problems," said Maria.

"Even as a child my mum kept taking me back to the GP. She thought there was something wrong with my heart because I was always very weak.

"I could not walk very far before I had to sit down, and as I got older I tried to push through it and just thought 'this is me'," she said.

"I would get very nauseous and could not carry shopping."

It used to break my heart when I heard opera and I couldn't even bring myself to sing around the house Maria Field

A decade ago, however, Maria's health deteriorated as her shoulder started to swell.

"Then my arm started to feel numb. My husband took me up to the emergency department and they did not know what it was - they actually asked me if I had been working out.

"They did a biopsy on my shoulder because they thought I had oedema (a build-up of excess fluid in the body).

"They tried everything. I had blood tests and they could not find anything. So I just left it and carried on with my life until six years ago when the swelling started to go round my neck and that was when it stopped me singing because it interfered with my voice," she said.

Took action

Maria, who did not start singing opera until she was 25, said it was when the swelling started to interfere with her beloved music she knew she had to act.

"I went back to the doctors and said 'you have got to find out what this is'. I saw more specialists who tried everything but said they still could not find anything wrong with me."

The body normally has 24 ribs - Maria had two extra

However, one specialist noticed there was something odd about Maria's shoulder and recommended an X-ray, which she had two years ago.

This revealed that she had a rare condition called 'Cervical Rib' - where there is an extra rib above the normal first rib.

In Maria's case, there were two extra ribs.

And it was recommended that she have them removed.

A typical human ribcage consists of 24 ribs, 12 on each side.

In May the soprano had one rib removed at the Royal Devon and Exeter hospital, by leading vascular surgeon Mr John Thompson, with the second one taken out last week.

Maria says the effect on her health has been dramatic.

"I could sing after the first operation because the swelling on my neck went then, but there was still a problem with my breathing so I had the other rib out last Wednesday.

"It is amazing how much better I feel.

"Before surgery I could not pull up my ribs and lift my diaphragm to sing but now I can sing so much higher and my stamina is better.

"I could be breathless and tired and it's only since having the operations that I have realised just how much the extra ribs had a negative effect on my health.

I was also aware that stakes were high in Maria's case because it would affect the future of her career John Thompson

"It used to break my heart when I heard opera and I couldn't even bring myself to sing around the house because I couldn't sing as well.

"I can't wait to get back singing professionally. Mr Thompson is my knight in shining armour, he saved my career."

Mr Thompson, who carried out the operation while listening to a CD of Maria's singing, said it had been a risky, but worthwhile operation.

"The risks were high with this procedure," he said. " I was also aware that stakes were high in Maria's case because it would affect the future of her career.

"Paralysis and bleeding were some of the risks associated with the removal of the bone," he added.

Operation risks

Chris Imray, consultant vascular and renal transplant surgeon at University Hospitals Coventry and Warwickshire NHS Trust (UHCW) said: "If you have an extra rib sometimes it causes no problems at all, but sometimes you can get something called a thoracic outlet syndrome where the way out from the chest is narrowed by the extra rib.

"If there is pressure on the artery you can get reduced blood flow and pressures on the vein and blockages of the vein or pain in the nerves of the arm.

"The concern of the surgeon is to avoid causing any nerve injury while doing the operation because there are quite big nerves, particularly the phrenic nerve, that run quite close.

"If that was damaged she would not be able to breathe as deeply," he added.