Increasing pain over time after Video Assisted Thoracic Surgery

Hi Stan. Thank you for thinking of me. Well, I just missed you. I was in Rochester today and had a thorough CT scan, they turned me on my tummy even. Autoimmune tests were negative. The inflammatory marker is back to normal. The pleural effusion has decreased since the scan of 10/19. And my deep breath pain is much much less. Conclusion: The cause of the effusion is uncertain (probably viral) but with effusion improving, the likelihood of malignancy is considered extremely low......Well now I know what "pleural effusion" is.

I have multifocal lung cancer so have only had one surgery so far with no radiation or chemo. I have several more nodules now being monitored until right time to treat them. So I have not seen an oncologist yet

@vic83, how are you doing? Will you be fit to travel and make that trip afterall?

Thank you so much for your prompt reply StanKent. It is very informative. I have multifocal adenocarcinoma and lymph nodes OK for now. They were initially enlarged after surgery. But my CT scans find all kinds of other stuff, scarring, inflammation, interstitial disease.
But I have now had an interesting development. Last night I realized I felt good and this morning I woke up with little side pain and my deep breath pain is much improved. I knew that yesterday morning they gave me BENADRYL 50 mg injection and methylPREDNISolone 125 mg injection before doing the CT scan with contrast. I once had hives from contrast, so I always pre-medicate and then have no issues. Now a sudden side pain that goes away suddenly may not be unusual, but a long developing deep breath pain to decrease suddenly would seem unusual. I wonder if the dose of steroids helped.
The CT is locally done and not Mayo so not very deep on lungs but shows I have no other issues which is good. It is a challenge to coordinate testing between institutions. They can't compare to past results.

Your post has been reassuring to me. I had VATS in May for left lower lobectomy to remove a 1.5cm Adenocarcinoma. I did not even fill my script for pain pills but what I have had is rib and diaphragm pain consistently for 7 months now - EXCEPT when my Rheumatologist prescribed 20mg prednisone for an RA flare. My rib/diaphragm pain wasn’t just better - it was gone!! For the time I was on 20 mg and then 15 as I started tapering it was awesome. But when I tapered to 10 the benefit vaporized. I’ve said I felt like Cinderella.

So I know it is inflammation - which I didn’t know before. But I can’t live on Prednisone. I’ve had CTs , X-rays and nothing provides answers - so I assume it’s just stubborn inflammation.

Did your rib pain persist after the prednisone or did it resolve over time?

That was referring to pain after my first VAT surgery (RUL). The surgery was a walk in the park and needed little pain meds...but months later I developed pleurisy and related pain which is painful. The stuff they premedicated me for to do a CT scan with contrast (I get hives from contrast) was described as "industrial strength" by my Rheumatologist and I felt great after...then it ended.
With VAT surgery they go in between the ribs and disturb nerves and things. My Mayo surgeon says nerve problem can last up to a year or even sometimes be permanent. Mine all went away with first VAT surgery RUL but second one LUL had more problems - fractured rib for one. And it still is numb on that side (now 7 months).
Now I am taking Prednizone for radiation-pneumonitis and now tapering and hoping the EXTREME shortness of breath does not return.

To hear someone else describe the pattern I experience of immediate post surgical pain, then predictable nerve disruption pain, then this long-lasting rib/diaphragm painful restriction with deeper breathing, to be eliminated temporarily by Prednisone… well that was hopeful because it’s not unique to me.

Your post has been reassuring to me. I had VATS in May for left lower lobectomy to remove a 1.5cm Adenocarcinoma. I did not even fill my script for pain pills but what I have had is rib and diaphragm pain consistently for 7 months now - EXCEPT when my Rheumatologist prescribed 20mg prednisone for an RA flare. My rib/diaphragm pain wasn’t just better - it was gone!! For the time I was on 20 mg and then 15 as I started tapering it was awesome. But when I tapered to 10 the benefit vaporized. I’ve said I felt like Cinderella.

So I know it is inflammation - which I didn’t know before. But I can’t live on Prednisone. I’ve had CTs , X-rays and nothing provides answers - so I assume it’s just stubborn inflammation.

Did your rib pain persist after the prednisone or did it resolve over time?

To hear someone else describe the pattern I experience of immediate post surgical pain, then predictable nerve disruption pain, then this long-lasting rib/diaphragm painful restriction with deeper breathing, to be eliminated temporarily by Prednisone… well that was hopeful because it’s not unique to me.

I has the same experience. My surgery was on July 20th and I still have rib pain. Much better than a couple of months ago. I only wish my surgeon would have told me that this pain was probable so that I would have been mentally prepared. I thought something went wrong and then, by reading comments here, I realized that it is very common.

I would add that 1) My first VAT was not very painful, and I was off all pain meds in 5 days. The numbness below the breast lasted 4 months and then went away. It felt like I was wearing a belt. 2) My second VAT was a lot more painful (cracked rib). And I had prickly nerve pain. They gave me Gabapentin and that helped the pain a lot. It is still numb feeling (7 months out) but that doesn't bother me. Still feels like I have a belt around me. 3) I have somewhat more shortness of breath, and my chest feels stiff when I take a deep breath while standing, and sometimes a bit sore. I had the inflammation from radiation treatment so that impacts it.