Ongoing pain following injection. 71 year old male with Wegener's.

[lfu2]

I have been having a bit of a rough time of it over these last six months. October 2016 I had rib injuries due to excess coughing, (the pain is with me yet) and in December I was diagnosed with pneumonia after a routine x-ray. There is an infection in my right lower lung.... either a pneumonial infection or a Wegener's induced infection. I was also having problems with breathlessness and coughing during this period.

This involved the first of four visits as an inpatient to hospital over a period of three months. I was discharged on February 21st. During my last visit I was given a bronchoscopy which discovered a narrowing of the two main bronchio-tubes; one in each lung, and a date has now been set for surgery as to the fitting of two stents.

During my stays in the chest/lung ward, I, and every other patient, was given an injection of enoxaparin for possible blood clots. These were administered every day and were usually in the belly. Because of my problems with rib injuries I had my injections in the upper arm. I did not have any problems with these injections.... but on the last occasion (on my discharge day) the injection hurt. The injected substance also hurt, and the pain was still there when the needle was withdrawn. Because I was leaving the ward within the following two hours I didn't mention this.... I still have the pain now (a burning sensation), almost two weeks later. It comes and goes. The pain can change from mild to severe and can wake me up from a deep sleep. It is not well controlled with painkillers. I have been to my GP with the problem but there is nothing to see on the site at all, and no diagnosis was made.

I have checked all sources myself and my most likely answer is that the needle hit a nerve. The pain has now radiated into my right shoulder. I am seeing my GP again next week.

So.... has anyone ever had this? If so, what was the outcome? How long did the pain last for? Eagerly awaiting replies.

[Nadine99]

Hello, I notice that you haven't had any replies. I certainly don't know of anything useful about your problem but just wanted you to know that you're not ignored. A lot of people have got to the Patient Symposium so maybe not so many people have seen your post. Anyone with any insight to this will surely respond to you. Best wishes

[lfu2 in reply to Nadine99]

Thank you Nadine99. x

[Suzym2u Moderator Vasculitis UK]

Is the WG under control? What medication are you taking at the moment?

[lfu2 in reply to Suzym2u]

Wegener's has been reasonably stable over this past 2 years. I am having the first signs of a flare now. I have an appointment with various consultants this Wednesday to decide a way forward. It has been mentioned that a change in medication is possible. I am taking all the normal medications..... steroids, folic, rituximab, methotrexate, etc. The pneumonia and breathlessness are extra complications and need dealing with quickly. The burning pain in my arm, although not the most pressing thing at the moment, is beginning to get me down.... there seems to be no let up at all. Thank you for your interest. x

[Suzym2u Moderator Vasculitis UK in reply to lfu2]

How often do you gave the RTX? Where are you seen if you don't mind me asking? Please let us know how things go for you on Wednesday.

[lfu2 in reply to Suzym2u]

I am seen at Chaple-Allerton in Leeds under Prof Emery. Rituximab is usually every 6 months. I will update you after Wednesday.

[lfu2]

Consultation was positive. Attention was spotlighted upon the upcoming operation for bronchial stent/dilation. If another infection occurs in the meantime I will be admitted to hospital but the procedure will be carried out anyway.... it will not be put off. On the medication side it is possible I will be continuing with Rituximab AND Cyclophosphamide. This to be discussed in depth with Rheumatology. Although inflammation is present in the lungs it is recommended that there should be no increase in steroid dose so as not to compromise procedure.

I asked about the cough, which is a bugbear, but no relief from antibiotics is allowed. After the wide range of antibiotics I have had, they are hesitant about introducing another one..... so three weeks of coughing is in line, unless I can find some natural, non invasive way of controlling it. Basically the phlegm produced is too large/lumpy to get past the reduced diameter of the bronchial tube. it gets discharged in small pieces only. After the distress caused the last time with coughing too forcefully (burst blood vessel) I am taking this very carefully.