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Medical Forum / Diseases and Disorders / Breast Cancer / April 2004

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Nerve pain?

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Teddy - 17 Apr 2004 11:46 GMT
Anyone else have this? My surgery was 3 weeks ago and I'm having alot of
pain in my arm. The surgeon said it was from nerve damage and no pain
killer would help. Please let me know if you know of anything that would
help.  I slept 3 hours last night and one hour the night before.
Sandy L - 17 Apr 2004 12:27 GMT
> Anyone else have this? My surgery was 3 weeks ago and I'm having alot of
> pain in my arm. The surgeon said it was from nerve damage and no pain
> killer would help. Please let me know if you know of anything that would
> help.  I slept 3 hours last night and one hour the night before.

That isn't quite true.  Neurontin (gabapentin) in doses of 900 to 1,800
mg/day (divided) often helps neurogenic pain.  Opiates also help.
Opiates will not make the pain go away but will make it more tolerable.
Physicians worry, sometimes too much, about addiction with chronic use
of opiates; the riskof addiction is said to be about 1% in people using
opiates for chronic pain.  Considering that 10% of the general
population is said to be addicted to alcohol, that's not too bad.
Mary Fisher - 17 Apr 2004 12:29 GMT
> Anyone else have this? My surgery was 3 weeks ago and I'm having alot of
> pain in my arm. The surgeon said it was from nerve damage and no pain
> killer would help. Please let me know if you know of anything that would
> help.  I slept 3 hours last night and one hour the night before.

I found that diclofenac took the edge off it - it was offered by the nurses
while I ws in hospital.

The immediate post operative awful pain does go - but be prepared for never
having an entirely pain free arm again. You might though, there's no telling
:-) I occasionally have a little pain in my arm (six years after) but it
doesn't bother me.

When I can't sleep (for various reasons, not necessarily pain) I listen to
the little radio under my pillow, through an ear plug so that it doesn't
disturb my husband. Usually that has a soporific effect, I rarely hear the
end of an interesting item.

Take heart.

Mary
Kaye301 - 24 Apr 2004 19:49 GMT
Mary wrote: <<  but be prepared for never
having an entirely pain free arm again. You might though, there's no telling
:-) I occasionally have a little pain in my arm (six years after) but it
doesn't bother me. >>

Hi Mary---guess I was one of the lucky ones.  I have absolutely no pain in my
arm on the side where malignant nodes were removed, even though I have
developed a good case of lymphedema.  There may be a few reasons for the lack
of pain.  One might be was that I did the exercises immediately from the start
to help prevent scar tissue build-up and continue to do them.  In addition my
surgeon game me the choice of having a nerve in that area cut.  I opted for
that because I didn't want nerve pain.  I have M.S. and once had a bout of
nerve pain in my thigh after I gave myself an injection there.  It felt like
someone was ripping a large bandage that was stuck to my hairs in that area.
Of course there was no bandage.  The pain came from out-of-the-blue and
occurred many times daily for a few months.  So, when my surgeon asked if I
wanted the nerve cut to avoid possible pain--I agreed.  I do have some lack of
feeling in that area -- which I had been warned about before she cut--but there
is not and has never been any pain.
ABdikjse - 17 Apr 2004 23:46 GMT
Hi Teddy,

You didn't indicate whether you had a lumpectomy or mastectomy, but I
understand the former tends to hurt longer than the latter.

I don't entirely agree with your surgeon. Yes, it may be from nerve damage, but
I've found an OTC cream that's composed of salicylic acid, called Aspercreme)
to be extremely helpful and soothing.

Good luck to you; hope this helps.
Lady8
Teddy - 18 Apr 2004 14:28 GMT
It was a mastectomy but the incision doesn't hurt. It's inside my upper
arm on the inside that is extremly sore. Another doc said my surgeon was
wrong to ignore my pain esp. this soon after surgery. (putting that
politely)  My lymph nodes incision hurts (it looks wadded up) and my
chest and back hurt also. I've had back pain for 42 years but since
surgery it seems worse. i didnt get any sleep last night at all.
ABdikjse - 18 Apr 2004 18:43 GMT
<<My lymph nodes incision hurts (it looks wadded up) and my
chest and back hurt also. I've had back pain for 42 years but since
surgery it seems worse. i didnt get any sleep last night at all. >>

OK... Mastectomy I know a little more about -- had a double, myself.

My incision didn't hurt either, but yes, for a while inside upper arm DID hurt
-- a lot.  It still does if I sleep in the wrong position. -- Top of shoulder
still feels bruised if I push on it, too. But it does get better.

Am 5 years out and it still occasionally hurts when I overuse my arm. Sometimes
there is a very sharp pain that I've come to think of as one of the titanium
clips that they use to tie those nerve endings together (instead of absorbable
sutures they used to use). Not all of it goes away, but most of it does, and
that 'hurt' lessens considerably over time.

The Aspercreme or its equivalent, softly stroked into the skin CAN and does
help. -- Yours may be in the extreme (these things happen, unfortunately) but
I've found that many of us have that "wadded up" feeling <and look> especially
in the beginning -- it's how our bodies mend after being cut sometimes. ---
Mastectomy bra makers even allow for that by providing 'balancing' inserts so
the other side is a full, too.

Try sleeping in an elevated position, that's something that helped me. (I used
a 'wedge' pillow).

Guess what I'm saying is -- unless you're infected (which DOES need to be
checked and treated) this pain can be considered 'normal' for post surgery.--
Aspirin or one of the other anti-inflammatories can help. -- It isn't fun, and
at first sleep can be a real problem, but that too eases with time.

Yes, your back can hurt too; all the nerves going around your chest tie-into
the spinal column (hope I'm explaining this right) so there can be
'telegraphed' pain that can take your breath away.I
went racing into the ER thinking I was having a heart attack. Wasn't, it was
just a nerve spasm, but scared the heck out of me. -- I don't know that
everyone suffers such horrendous nerve spasms, but think that spasming is
considered part of the 'healing' too.

Maria Weiss' book, "There is life after breast cancer" talks about such things
and might bring you some comfort, as does Susan Love's Breast Book. It helps to
understand what you're dealing with, of course.

I was fortunate in that my surgeon prepared me for what you're experiencing, so
it wasn't as frightening. I'm sorry yours wasn't as comprehensive.

I'm also sorry you can't sleep; sorry that you hurt. Know that it WILL get
better, but when our doctors tell us we should be 'healed' in say, 6 weeks,
they're only talking the skin scars, not the interior that can take a while. --
I CAN tell you it gets better.

Bless you; hang in there!
Lady8
Mary Fisher - 18 Apr 2004 20:56 GMT
> <<My lymph nodes incision hurts (it looks wadded up) and my
> chest and back hurt also. I've had back pain for 42 years but since
[quoted text clipped - 49 lines]
> Bless you; hang in there!
> Lady8

I can't snip such a sensible - and beautiful - post. It deserves to be read
again and again.

Mary
A. P. Thorsen - 19 Apr 2004 14:14 GMT
> It was a mastectomy but the incision doesn't hurt. It's inside my upper
> arm on the inside that is extremly sore. Another doc said my surgeon was
> wrong to ignore my pain esp. this soon after surgery. (putting that
> politely)  My lymph nodes incision hurts (it looks wadded up) and my
> chest and back hurt also. I've had back pain for 42 years but since
> surgery it seems worse. i didnt get any sleep last night at all.

I didn't have a lot of upper arm pain after my mastectomy/axillary
disection, but did have back troubles beyond what I had ever had before
(. . . resulting in extra bone scans, of course!).    I'm thinking that,
in part, the surgical discomfort causes postural or muscular
perturbations (holding your body oddly to "protect" the painful area),
in addition to any true directly-surgically-caused pain.

There were two things that I found very helpful:  Massage therapy
(significant improvement *immediately*, and even better long term
results), and exercise (both stretching to unkink things, then other
exercise to improve blood flow & strengthen the muscles).

At first, I was not able to lie on my stomach for massage, but my
massage therapist was able to do a *lot* with me on my back.  Be sure to
find someone professionally trained in therapeutic massage, not just
relaxation massage.

Stretching and exercise may be uncomfortable at first, but you just move
as far as you can without straining, do so regularly (daily or more) and
persistently.

These things may not directly help nerve pain, but do help the secondary
tightness & pain.  I hope your discomfort will resolve soon!

Ann T.
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Teddy - 21 Apr 2004 00:59 GMT
I went to the plastic surgeon yeterday he told me to start exercising
the arm as that would help the pain. Then went to the oncologist who
said not to start exercizing until we had the nerve inflamation under
control. He then prescribed pain mds and Neurontin. I got 7 hours sleep
last night-thank goodness! Was so tired of crying and going OwOwOw all
the time
Kaye301 - 24 Apr 2004 19:51 GMT
Teddy wrote: <<  It's inside my upper
arm on the inside that is extremly sore. Another doc said my surgeon was
wrong to ignore my pain esp. this soon after surgery. (putting that
politely)  My lymph nodes incision hurts (it looks wadded up) and my
chest and back hurt also. >>

That is the area that for me is now numb because the surgeon did cut the
nerve--my choice.  My understanding is that as the nerve grows back it may be
painful but think, although am not certain, that that pain will lessen in time
as the nerve grows back.
 
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