Increasing pain over time after Video Assisted Thoracic Surgery

Posted by vic83 @vic83, Oct 18, 2022

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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I will add that exercise. Thanks.

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Have been stretching in doorways and with a bar overhead - lie on floor, hold bar (I use a cane) straight up, then slowly move arms overhead as close to the floor as you can w/o pain. Doc says try cold packs and/or heat. Haven’t done that yet. I don’t have trouble breathing.

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@franciekid - seems we are twinsies in terms of our post surgical pain profile - still pain on deep breath. Still am gasping for breath when I bend over or lift anything or walk in the cold or walk up a modest incline. I sometimes get muscle pain on the other side - I suppose it’s some kind of contralateral pain from “guarding” against the primary pain.

Anyway, I have discovered no clever mitigation. But perhaps of either of us do, we can agree to share. One of the mentors suggested I check out videos on you tube. There’s a fair amount of yoga type stretching and “wall Pilates” and some fairly technical discussions on pulmonary rehab type activities. I’m trying to do band exercises but it doesn’t take long to be breathless.
What success have you had and what is your doc saying?

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Profile picture for franciekid @franciekid

I have been experiencing the same think almost 10 months after Robotic Assisted Thoracic Surgery. Also Stage 1b. In the past week or so, I have pain in my right side that almost feels bruised. Not sure if it’s scar tissue. I just had my quarterly CT scan and everything looks good. Hope you get to the bottom of this.

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For what it’s worth, I still have left side rib and diaphragm pain 8 mos after lower Left Vats lobectomy. For stage 1b N0 tumor.

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I have been experiencing the same think almost 10 months after Robotic Assisted Thoracic Surgery. Also Stage 1b. In the past week or so, I have pain in my right side that almost feels bruised. Not sure if it’s scar tissue. I just had my quarterly CT scan and everything looks good. Hope you get to the bottom of this.

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Profile picture for tashaharley @tashaharley

I am wondering about a similar problem. I had robotic surgery in late August to remove a secondary lobe. A previous surgery was done about a year and a half ago for NSCLC Stage 2A. That surgery went well and I felt fine after a couple of weeks. The second surgery last August was done because there was a spot on a CT scan that turned out to be just an infection, not a recurrence. Again, I felt fine after a few weeks. But about two weeks ago (mid-December) I had a sudden onset of bad pain. It feels like the pain post-surgery in the general area of the incision but it's much worse. It occurs only with movement--picking up a box, reaching for something off a high shelf, bending over. Has anyone had this happen? I'm a little nervous that it could be some new cancer, although I do recognize that my fear that I broke a rib because I now have bone cancer is almost comically catastrophic thinking.

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Hi @tashaharley, welcome to Mayo Connect. It is best to consult with your doctor, but this pain could be caused by a lot of things other than recurrence of the cancer. My team has told me that if the pain is waking me up in the middle of the night, then I should be sure to let them know right away. I agree that any new pain can be alarming, as cancer patients we can be on edge, so it doesn't hurt to consult with your doctors. I have ongoing hip pain that can wake me up, and I've had many radiologists note "degenerative changes" on my reports; a nice way to say that I'm getting older but it's not cancer.
How long ago was your last scan? Do you have one coming up soon?

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Profile picture for pb50 @pb50

Have you brought this to attention of your surgeon or pulmonologist? It is likely not recurrence but everyone gets paid to help you answer that question. So it’s not asking a favor to engage them. I say ring them up!

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Thanks! You're right. That will be my next step.

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Profile picture for tashaharley @tashaharley

I am wondering about a similar problem. I had robotic surgery in late August to remove a secondary lobe. A previous surgery was done about a year and a half ago for NSCLC Stage 2A. That surgery went well and I felt fine after a couple of weeks. The second surgery last August was done because there was a spot on a CT scan that turned out to be just an infection, not a recurrence. Again, I felt fine after a few weeks. But about two weeks ago (mid-December) I had a sudden onset of bad pain. It feels like the pain post-surgery in the general area of the incision but it's much worse. It occurs only with movement--picking up a box, reaching for something off a high shelf, bending over. Has anyone had this happen? I'm a little nervous that it could be some new cancer, although I do recognize that my fear that I broke a rib because I now have bone cancer is almost comically catastrophic thinking.

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Have you brought this to attention of your surgeon or pulmonologist? It is likely not recurrence but everyone gets paid to help you answer that question. So it’s not asking a favor to engage them. I say ring them up!

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I am wondering about a similar problem. I had robotic surgery in late August to remove a secondary lobe. A previous surgery was done about a year and a half ago for NSCLC Stage 2A. That surgery went well and I felt fine after a couple of weeks. The second surgery last August was done because there was a spot on a CT scan that turned out to be just an infection, not a recurrence. Again, I felt fine after a few weeks. But about two weeks ago (mid-December) I had a sudden onset of bad pain. It feels like the pain post-surgery in the general area of the incision but it's much worse. It occurs only with movement--picking up a box, reaching for something off a high shelf, bending over. Has anyone had this happen? I'm a little nervous that it could be some new cancer, although I do recognize that my fear that I broke a rib because I now have bone cancer is almost comically catastrophic thinking.

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Profile picture for vic83 @vic83

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.

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Yea me too. I went off meds the day before I left the hospital. I didn’t even fill the script for Oxy. I’m just averse To narcotics. And gabapentin gave me Psychotic dreams. I did charm them into a replacement muscle relaxer for flexoril. That helped me sleep.

And yes, I’ve described it as a belt, or Vice grip, Or paralyzed diaphragm. I think it’s easing ever so slightly .. can’t be sure it isn’t wishful thinking. My Rheumy also gave me Colchicine which had maybe an effect
Similar to Ibuprofen (which I cannot take) but too dangerous for mediocre benefit.

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