Chris Soto has always been physically active. Growing up in Alaska, he spent time hunting and playing sports.
During his teenage years, he noticed a small indentation in his chest. Soto had pectus excavatum, a chest wall deformity that curves the breastbone inward, creating a cup-like indentation in the sternum.
Luckily, it didn’t seem to give him any problems.
“Knowing what I know now, I was probably somewhat limited, and I just didn’t even know it,” he said. “It’s not like it hurt me, and I wasn’t worried about what it looked like. I would take my shirt off and go swimming and do whatever I wanted to do.”
As Soto got older, got married and had kids, he realized even more so that this physical difference wasn’t important.
“So what if you’re a little different?” said Soto. “It never really bothered me.”
In the fall of 2024, when Soto was 28 years old, he started feeling pressure in his chest.
“It was just kind of weird, I had never felt anything like it,” he said.
He tried to find answers as the pressure in his chest got more intense. Soto, who had never experienced anxiety before, started feeling anxious all the time.
“It wasn’t necessarily painful, but it made me terribly, terribly anxious,” he said. “Just a real visceral fear that something was wrong. It felt like I was having a heart attack.”
Although testing showed that his heart was fine, it didn’t feel fine – especially as time went on.
“It was getting to the point where after I’d exercise it felt like I was being crushed, like someone was standing on my chest,” he said.
Multiple scans and tests showed that everything was normal – aside from his pectus excavatum.
Soto, who lives in Montana, found a local thoracic surgeon who reviewed his case and told him that pectus excavatum was the culprit. After first being referred to a clinic in Arizona, Soto did his own research and found Katie Russell, MD at University of Utah Health.
One of Russell’s specialties is pectus excavatum. She and her team do around one hundred Nuss surgeries a year, a procedure where a metal bar is placed behind the ribcage in the chest to correct the deformity.
Soto had a virtual consultation with Russell to see if she and her team could help him.
“I basically had all the tests done and everything, so Dr. Russell looked at everything and told me she could help me,” he said.
After several more virtual appointments, Soto’s surgery was scheduled for May 2025. He and Russell met for the first time on the day of the surgery.
“When I actually met her in person she said, ‘oh wow, we can definitely help you out’,” he said. “All it really took was the right person looking at me.”
The Nuss procedure took several hours, and Soto required three bars which is unusual. Most patients only need two bars to lift the sternum and fix the deformity. The surgery was difficult.
“It takes a high amount of expertise to fix these older patients, and the reason we are so good at it is because we do such high volume every year,”
One in two hundred people have a chest wall deformity. In the past, these deformities were considered strictly cosmetic.
“We now know that chest wall deformities can put pressure on the heart and cause a lot of problems,” said Russell. “Patients start having a hard time with exercise and activity in general, and symptoms get worse over time.”
Because of this, the best time to get a chest wall deformity fixed is earlier rather than later.
“When a patient or parent notices it, they can come in and we can take care of them,” said Russell. “We usually do surgery in early adolescence, and we even have some non-operative things we can do before then for our younger patients.”
Although Soto is not alone in having the Nuss procedure in his late twenties, it’s less common to have the procedure at that age.
Keri Page, DNP, the program manager for the Utah Pectus Program, works with patients like Soto, leading up to and after surgery.
“I got to connect with Chris after his surgery to make sure his recovery was going well,” she said.
While Soto describes the first six months of recovery post-surgery as “not awesome,” it wasn’t as bad as he thought it would be. He would do it all over again if he had to. Not just for himself, but for his family. He and his wife have been married for six years and have two kids: a three year old boy and a one year old girl.
“I have my joy back because I can play with my kids and hold my kids,” he said. “Normally, I wrestle with my son and we out and do stuff, and I just love being a dad. I really lost that, especially the three months leading up to the surgery. That was probably the worst part for me.”
Over the past couple of months, Soto has started strength training his upper body and core again. He has also noticed a big improvement in his cardiovascular health and is feeling great overall.
“It’s been a heck of a journey,” he said.
Soto is a mechanic at St. Vincent’s HELP Flight Program in Billings, Montana. He helps maintain two helicopters and two airplanes.
While his job isn’t physically demanding, he lost some mobility and range of motion when he first returned to work.
“It’s not even that things are that heavy, everything is just at a weird angle,” he said. “None of it is sitting at a desk. You’re either in a helicopter or an airplane.”
Slowly but surely, he is getting back to doing even more of what he loves. He is hunting, hiking, and getting back into sports and living life.
“My last marching orders from Russell were to just keep on trucking,” he said.
