I had the VATS left upper lobectomy in February 2023. I went in on a Friday morning and went home Monday afternoon. I chose non-opioid pain management (because of fear of apneic breathing problems) and had an indwelling thoracic epidural catheter with patient controlled analgesic - where it delivers a steady amount by pump and you can push a button for a bolus. I felt the pain management was excellent. Through the entire post-operative stay I had to have two opioid doses for uncontrolled pain; dilaudid specifically -
The first dose was required because “hemodynamic stability” (pulse, BP etc) wasn’t achieved after 8 hours in the PACU. I was intermittently awake during that period but have no recall of any pain. The second dose was required because I had a pain crisis (10+ on 1-10 scale) on day two, due to a rhomboid/scapular muscle spasm. After pain boluses, muscle relaxer, gabapentin, NSAID and heat/cold failed - I accepted the dilaudid and it worked.
Otherwise, I felt the pain was more than manageable - far more manageable than when I had lumbar laminectomy or C-section. I removed the epidural myself from home a week later and mailed it back to the anesthesiologists. I used methocarbamol, gabapentin and ibuprofen as needed for the first week of home recovery but didn’t require them more than once daily and not at all after that first week. All of this is in reference to >pain< only. The most difficult post operative change for me was fatigue and SOB. I had experienced some SOB before surgery but fatigue has never been a problem for me.
SOB is greatly improved now with time and much intervention. *Be sure to do a full course of pulmonary rehab as soon as you’re fit for it!
Fatigue, however, remains a very difficult issue for me. Extremely frustrating!!
Even though we’re unique individuals, some factors can make a big difference in how things go so here’s some of my details FYI:
I am 59 y.o., diagnosed with NSCLC Stage 1a, was a heavy smoker for 40 years, tall, average weight, very physically active throughout my life, 2 autoimmune conditions; Grave’s disease (15+years) and bronchiectasis (18 months).
Best of health and luck to you!