These people talking about the same issue may help.http://www.medicinenet.com/pneumothorax/discussion-265.htm

I wish I could, but even with a full history and a chance to view your x rays and pulmonary tests and a chance to examine you, the answer would not be a simple one.

I'm sorry you've had such a miserable course. It is unusual for someone to have such severe emphysema and COPD as such a young age, even in a smoker. Besides smoking, there may be other causes for your disease. These may include alpha-1 antitrypsin deficiency, certain connective tissue disorders (such as Marfan's), eosinophilic granulomas, infections, and genetics.It sounds like you had a pleurodesis and/or pleurectomy. The lungs and inner lining of the chest are covered by a thin membrane called the pleura. The pleurae allows the lungs to move freely during normal breathing. In recurrent pneumothorax (lung collapse) or pleural effusion (fluid around the lung), two procedures may be done. Pleurodesis is the process of injecting an irritant between the 2 pleura. The resulting inflammation causes scarring and eventual fusion of the pleurae. This procedure can be done either through chest tubes or using surgery.The other procedure is surgical pleurectomy, where the inner chest wall pleura is surgically removed. As with pleurodesis, this causes inflammation and also results in closure of the space. Pleurectomy is generally not performed for pneumothorax unless other treatments have failed.Unfortunately, the chest wall pleura is lined with many nerves. Pleural irritation (such as by inflammation) causes pain. Patients who have undergone both procedures often report severe pain. Doctors may be able to help reduce the amount of pain using drugs. However, the pain will not resolve until the inflammation improves, which takes time.