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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I had this procedure twice. Both in the Gonda Building. Each time was a different Pulmonologist. Dr Braun and Dr Utz. Was maybe a 45 minute procedure, or less.
Stan, thanks so much for your input- helps me see ahead. I saw the Rheumatologist today and he does not think it is autoimmune. He thinks I should do thoracentesis and will send his report to Mayo Pulmonologist. He did a recheck on my blood work and inflammation markers ESR and CRP are still quite elevated. He told me the Methylprednisolone they gave me in the ER is "industrial strength"!!! That is why I felt better! He gave me six-day dose to feel better now, but Steroids only mask things and need to know what the cause is. And things are getting worse. Not only do I have the side and deep breath pain for two weeks now, but for the last two days I have felt really rotten. I would expect that an analysis of the pleural fluid would be very significant not only for what ails me now but further info on my lung cancer. If it is an infection from bacteria, I have another problem as I got C-diff from amoxicillin and have avoided oral antibiotics since. My trip is off, so I am down in the dumps.
vic83
A couple times the deep breath pain about knocked me over. After the thoracentesis I could breath better and felt better. My fluid did return so after awhile I had some of the same problems but it was very gradual, it is hard to quantify when it happened and pain level change. So you'll have to see what the Pulmonologist can schedule. For me, it only took a couple days to schedule and complete the procedure. They test the fluid for alot of things and test results trickle in over the following week. Keep us updated. Sorry you had to postpone your trip to Italy. Mayo is a nice place, but expect Italy for a month would be much preferred over the Gonda Building 18th floor.
Thanks again for your insight. Did you have both lungs or just one lung involved and was it the surgical lung? What about your oxygen levels? Mine drop below 88 with moderate exercise.
And you said you can breathe normally now? I have been compensating for so long I don't remember normal. I am not sure what I should realistically expect.
My whole story started a year ago with mild shortness of breath: (Nov) bad CT & PET scans, (Dec) angiogram & blockage, VAT surgery, (Feb) Covid, (April ) Stent , cardio rehab , BPPV issue (May), Inflammatory arthritis (Aug) Covid again (Oct) Significant increase shortness of breath, pain with deep breath, new side pain, ER-CT shows pleural effusion, high inflammation markers.
I call Mayo Rochester my winter vacation -IT IS SOUTH of Twin Cities. And nice view from the 18th floor. But my friend's home has a view of the Mediterranean. I did rebook for January, and I got a better flight at least. Now Mayo please fix me.
Local Rheumatologist does not think it is autoimmune, but gave me 6-day MethylPREDNISolone last Friday and it is not doing anything.
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.
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.
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
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
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....
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.