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Increasing pain over time after Video Assisted Thoracic Surgery
I am wondering if anyone has had a similar experience. I had VAT surgery end December 2021 with wedge resection in right upper lobe. They removed a 3.1cm cancer stage 1b. I was off pain meds in five days. For two + months I had usual nerve pain under right rib. But it did go away. Then weeks later I noticed a slight soreness when I took a deep breath. Slowly this increased. My Pulmonologist said there was nothing on the CT scan to indicate a problem. But the pain has slowly increased and now after 9+ months it is a pain behind the breast which I certainly notice when I take a deep breath. My last CT scan was end October, but Pulmonologist made no comments Three days ago I started to have a pain on the right side below rib cage(not related to breathing). I can only see my Primary Care Physician next week and nurse triage said go to Urgent care to get things started. I am leaving for Europe in three weeks for a month and I sure do not want to have problems. Does such pain just come with thoracic surgery ???
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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.
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?
Hi Colleen. Thanks for asking. I did rebook for Jan15th and hope to make it. I am exercising to be in shape. Anything to get some time away from winter.
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1 Reaction@vic83, how are you doing? Will you be fit to travel and make that trip afterall?
Vic83, Hi. ... my history.....Hematology found splenic marginal zone lymphoma in June 2019. The CT at that time showed a small lung nodule in upper right lobe and follow up in Sept 2019 showed increase in size. They did a biopsy, and it was cancer, Hematology then referred me to Oncology and they did PET and MR and resulted in VAT lobectomy surgery in Oct 2019. I have follow up appointments with hematology and oncology every 6 months. Oncology found a small nodule in the lower left lobe in Oct 2021. They did PET but did not biopsy. I had VAT wedge resection surgery in November 2021. Both cancers were small and no chemo or radiation.
Seems like your situation is a bit different and your care and treatment in on a different path than mine. I hope things settle down for you. Keep us updated.
Hi Stan, if the effusion is gone, that can only be a positive. If your VAT surgery was last November, when was your first symptom or test indicating something amiss? I am wondering how long it took for you to get a diagnosis and get to that surgery.
I always read the radiologist's report as soon as it is posted. Such reports are very informative. Often, I read things the doctor had not emphasized during the visit. I guess the law was passed in 2016 and then implemented early 2020 mandating that doctors must post notes and test results. This facilitates being able to go between various clinics. And I am able to understand my medical situation much better.
Let me know how it goes....
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
Hello, I'm wondering how you have been this past week or so?
Also to let you know I was in Rochester yesterday and CT showed the pleural effusion was now gone and there were not any lung nodules of concern. This is just what I could understand from the Radiologist report. So we're feeling this is good news Next week I have appointments with the hematologist and oncologist and get their interpretation of the test results. Thanks
Stan
Interesting. We have similar complications. I too only have one lung with fluid, the right one where the wedge resection was done. And it is my right lung that hurts when I take a deep breath. This was my first surgery, and I am ten months out now. I too was not getting the exercise I needed because of the winter months and was nervous about going indoors. It led to deconditioning. Cardio rehab after April Stent really helped me get going again. Everyone wore masks and they clean the machines after every use. Walking helps! However, my shortness of breath has increased lately with the lung pain. I am awaiting the conclusion of my blood work from Rheumatologist to confirm or eliminate an autoimmune issue. Then they can decide next step - thoracentesis and maybe I have something unusual going on
I envy you your oxygen levels. Mine were 88-89 with light exercise in cardio rehab. I have 4 other lung nodules (ground glass to semi solid) being watched. With everything going on in my lungs I just don't know how much it all is compromising my abilities. I will have to ask. I have been reading about long Covid, I don't need that.
Fluid was only in the left side and was the same side as the November wedge resection surgery. Oxygen during the fluid time was 94 to 97. During exercise it stayed around 94. At times it would dip to 91-93. They felt my fluid was caused by my lymphoma. I then had lymphoma treatments in Aug and Sept. I think the fluid is now gone and breathing is back to what it was prior to my last surgery. I have appointments Nov 9 for lab and CT and hematology and oncology appointments the following week.
Are they scheduling a thoracentesis for you?
There is some news about long covid. Do the doctors feel any of the breathing stems from covid?
Another thought..... months after my 2019 (right upper) lobectomy, I felt good but had that shortness of breath and feel that internal surgical recovery actually takes a long time even though I felt ok. ..... and through that long recovery, didn't exercise enough to keep the heart in shape. For me, recovery is fast for the first month or two and gradually gets better but takes a year. After that, a deep breath still feels different...on both sides.