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Wednesday, August 20, 2014
Recovery from thorocotomy
I am eight months post thorocotomy to remove part of my left lung due to a staph infection. I still have stiffness at all times and pain when I try to sleep. What is this still happening? How concerned should I be? It does not seem right. I am especially concerned since I have COPD due to chronic and severe allergies. What type of follow-up did I need? Thank you.
Post-thoracotomy pain is, unfortunately, fairly common. The most common cause is damage to the intercostal nerve (that runs between the ribs) during surgery. This is the reason that thoracic specialists utilize minimally invasive surgery (VATS) as frequently as possible. However, there remain situations where a thoracotomy is required. Typically, your thoracic surgeon would manage the pain initially. If it persists, then it is the practice of many surgeons to refer you to a pain specialist. I recommend doing this. The specialist may be an anesthesiologist, an internist, or another individual with interest and specialty training in pain management. They may offer adjustment in your medications, trials of other medications, invasive procedures (e.g. intercostal nerve blocks), or even alternative pain management strategies. Also, pain that is present 8 months after surgery may still diminish in the future as the nerves heal.
Michael F Reed, MD
Assistant Professor of Surgery
College of Medicine
University of Cincinnati