pain to ribs front and back

[steve45]

Morning all I am now 10 months ivor lewis post op and still sore around rib cage front and back more so  of a night is this normal I spoke to the specialist nurse and was told it could be nerve ends and to take pain killers ,should I see my g.p. thanks Steve.

[brucemillar]

Steve

I am eighteen months post op (Transachial Oesohpagectomy).  I also suffer from very bad pain that starts under my left shoulder blade, then spreads around to my front left lower rib area when I walk.  I have seen all sorts of specialists with no improvement.  CT scans and a PET scan reveal no issues.  I have to take Dihydrocodeine Tablets to ease the pain and it is not getting better.  It is not getting worse either.

I am interested to hear how you get on.  I am told that my surgery did not involve my left arm being lifted during surgery which would rule this out as a cause.

Bruce

[steve45 in reply to brucemillar]

Thanks for your reply my arm was lifted for 6 hours .and a rib removed.

[AoifeMcC]

I get the bad pain when I eat too much even still or in certain weather - I ate too much last night and I suffered for it - I could not even let anyone know because my 4 and 6 year old children did not want to to go to bed last night and wanted to stay with mummy and daddy.

[brucemillar]

Steve

I have tried two lots of Epidurals into my spine to try and have the pain resolved.  These work but only for about two weeks then slowly but surely it creeps back again.

The worst for me is if I bend slightly forward for any length of time.  Washing the car is a killer for about two to three hours, then it will subside.

I am convinced it is nerve damage as a result of the surgery and am now hoping it will get better with time.

Eating too much is never good for me.  I don't get back pain.  But I do have to put my fingers down my throat to avoid being sick when/where, I don't want to be.  I can feel my stomach pulsating and forcing food upwards which is very uncomfortable.

[Aussiepete]

Hey Steve,

I'm 18 months post Ivor Lewis.  They went in through my right rib cage breaking a rib in the process,, collapsed my  right lung, etc.    

I've been in constant pain ever since.  It's exacerbated if I eat too much, don't eat enough or eat the wrong combination of foods.  My surgeon continues to tell me that there are no nerves in my stomach and that this is not possible.

The anaesthetist who supported my surgeon specialises in Pain management. I've seen him twice for this pain. His view is that my 4th, 5th and 6th intercostal nerves were damaged during the surgery and that this pain might be around for 18 months, 24 months or perhaps forever.

He's diagnosed Pregabalin 300mg Twice a day - this has helped quite a bit. I've tried stopping (cold turkey) the Pregabalin a few times but invariably end up in so much pain it's not funny.  He's since suggest weaning myself off it gradually instead of cold turkey. I've not tried this yet ...

He's also carried out Radio Therapy Nerve Ablation treatment twice. In both occasions the goal was to stimulate / restart the nerves.  This has worked to an extent. Immediately after the treatment I've had a significant reduction in pain. It gets better and then, within three months its back to the same level.

I'm genuinely not sure what to say here. It would be really useful to continue to compare notes....

I'd ask about Pregabalin. Explore Radio Frequency Ablation therapy. Apparently quite a few UK hospitals also offer/specialise in Pain Management - perhaps ask your GP about all of the above.

How often are you seeing your surgeon? How is he responding to your complaints about pain? Who is he? Where is he ?

[Sekyi in reply to Aussiepete]

Hi Aussiepete

I do have the same problem you have although I'm not sure about breaking the rib bit. Just like you I'm also on pregablin 150mg twice a day and I have relief all day if I stick with this dosage

Unlike you I have not been given the Radio Ablation thingy

Do you feel pains in your left leg as well 

Anyway just to let you know you're not alone

Thanks 

Sekyi

[Aussiepete in reply to Sekyi]

Hi Sekyi,

No pain in my leg. Just the rib cage and shoulder blade. Have you been to an osteopath for the leg? Have you ever suffered from sciatica? I did pre op but don't any more. I suspect mine came from being overweight which, I am no longer !

Talk to your GP/consultant about increasing dosage? 300mg BD is apparently The maximum... But you need to increase gradually because the side effects can be a bit tricky I.e. Confusion, nausea. 

Happy (not the right word) I'm not alone

[Rsw1fe]

I do feel for you, Steve 45, pain is so debilitating. Just an idea, but have you thought about a TENS machine (available from Boots I think) which is good for labour pains (only the early stage!) and also helped when I had a frozen shoulder. 

[Robotgirl]

Hi, I've had 23 surgeries and have had most of my stomach now removed...  I have the same issues you are describing except a lot of times they feel like muscle cramps...  I do not tolerate food well...  I have had two abdominal epidurals which only last a couple of weeks at a time also...  The anesthesiologist that did them said that most of the nerves in my abdominal area have been cut...  He also explained that some of the nerves go around to your back which could contribute to some of my back pain (I've also had a spinal fusion).  However, I can not take gaba because I cant hardly take in any solids...  I'm even having problems taking liquid Tylenol...  Anyway, I just wanted you to know that you aren't alone.  It hurts like crazy, but all we can do is to keep going...  I'll pray for you.  Pray I get some sleep again some day, lol...

[AlanWare in reply to Robotgirl]

I have had similar problems taking tablets. I found that inserting dihydrocodeine rectally usually works and is better than choking on them, or losing the them through vomiting. good luck.

 

[Bernadette100]

I am nearly 8 years post surgery and they went in through my left side, I have a pain in my ribs everyday, sometimes I forget and learn to live with it, I have had no treatment for the pain and have been told (forget who by) that it is where they cut through the ribs. Sometimes I do get down about the pain and I would be interested to hear what happens with you Steve, I wrote about this about 5 years ago.

[chris_usa]

I do think the Pain Management suggestion is a very good idea, and these specialists use a variety of techniques in managing pain.  There are medications (opiates, medicines for nerve pain, and others), but there are also nerve deadening procedures, acupuncture, massage, and a whole host of other options depending on the type, source, and severity of your pain.

In the US, Pain Management has a bit of a stigma attached to it, because some persons do abuse the system for the purpose of obtaining opiates.  Although I was hesitant to start pain management, it was the best decision I could have made.  I too have serious unexplained pain after esophagectomy, mine in the rear left hip bone into the thigh, along with nerve damage in the left thigh.  I shudder to think where I would be now if I had not gone to see them. 

The goal is certainly not to eliminate pain, as this is not a reasonable objective.  The goal is merely to make the pain manageable, to give at least some quality of life back.  And if you see pain management after esophagectomy. there will be no questions of your authenticity.  Sometimes the pain does end on its own after a time, but that is not a guarantee.  \wc

[Steve101]

Hello

My wife following her op also had excruciatingly painful rib pain after about 3 months due to nerve damage.  Most pain killers do not control pain due to nerve damage.. After reading a post on this site, we asked our GP to prescribe Gabopentin, which the GP did.  Where as no other pain killers helped, Gabopentin did the job, takes about 5 days to get in the system and start to work.

The nerves have now repaired themselves and my wife seldom needs to take gabopentin.

Good luck and best wishes.

Steve 

[MikeK]

Although it can be distressing at times nerve endings can take a long time to heal. I had my operation in February 2013 and still get various twinges particularly after doing any manual work. I had an old ski injury to my arm which took almost 5 years to settle down. Don't forget that the operation which we have had is very major trauma surgery.

[brucemillar]

Guys. Just to add. It is a Pain Management Consultant I am seeing in London Bridge. It is through this that I had my epidurals to try and numb the nerves. As I said earlier, it works for around two weeks then slowly creeps back to normal. 

My GP is hopeless. Since my diagnosis and surgery he defers everything to my surgeon. Suits me really as I have a great surgeon. 

[Bobdavies]

Hi Steve, same was happening to me, I spoke to my Macmillan nurse in plymouth and she said it was due to them cutting the nerve on your right abdo/ chest and they have prescribed me 20 mg amitriptyline for the nerve pain, it’s because your nerve has been cut but it is sending electric pulses trying to find the end of your nerves. It helps with your sleeping too.

Good luck