How painful is the isotope injection before you go to Lymph node surgery?

[Latinme]

I read a lot on how painful the injection that the nuclear medicine gave you 8 hours before you go to surgery for the Sentinel Lymph Node biopsy. Please give me an sincere answer. Sometimes I can't tolerate pain. The doctor said they can't give you any pain killer because will affect the test.

[CCF-RN,MSN-JS]

Dear Latinme, In checking with our collegues in Nuclear Medicine who do the injections of the isotopes their experience has been that with this injection there is some stinging as the isotope is injected (this is due to the volume of fluid being injected into the tissue, not because of the isotope itself), the stinging lasts only a short amount of time.  They do 4 injections around the site of the lesion, after first numbing the area.  Everyone has different levels of pain tolerance, however, for the most part this procedure is well tolerated.  After the injections the patient lies on a flat table for about an hour then scans are taken.

[susan m k]

For me, that was the most painful experience of my life.  Why can't a woman be given general anesthesia?  I do not understand this.  Good luck, Susan

[Belleview Teacher]

I had the injections and found it tolerable.  There was some pain, but not to the point of making me cry or want to scream.Also, the pain is very short in duration. You also have to massage the breast to help distribute the material to the nodes. All in all, there was discomfort, but it was bearable.

[Twocapes]

I don't remember any pain.  I had to massage the breast area "before" the injection because they used a numbing gel called Emgel.

[dorisdaughter]

I found the injections (I think 4 separate needles) to be very painful -- though, as anoher commenter pointed out, the worst pain does not last too long (though my breast throbbed during the massaging) which is a good thing, because I can't imagine that pain on a sustained basis.  The radiologist who performed this procedure on me was in a real hurry, barely paid attention to me because she was too busy scolding the tech and also didn't inform me about any pain.  I wrote a letter of compliant about her.  Also, I have been told that the pain factor can be mitigated by the skill/care of the practitioner, so don't be too taken aback by the "painful experience" comments -- you could wind up with minimal pain and obviously it's well worth going through to get the result you need.  Good luck to you.

[Liz S]

I had the wire localization and nuclear injection at the same time and had no pain whatsoever......and know of 3 other women who's experience was the same.  Good Luck.

[ritavv]

Maybe it was the lidocane for the wire localization, but I had no pain with the isotope injection.  I was sitting up while I waited for the scan.  They recommended that I move my arm around to help get the isotope to drain to the node.

[deevee]

The 2 of the 3 injections were the most painful experience in my life.  I was not given any numbing and I was not prepared for the amount of pain I experienced (my body shook and my eyes teared).  Another lady also voiced her complaint about the pain and radiology started using a topical anesthetic and finally found they could use lidocaine without affecting the effectiveness of the procedure.  (I asked why they hadn't been using a local anesthectic earlier and the answer was that's how they learned the procedure.)  You should not have to go through the procedure without any anesthetic.  I hope your doctor can get updated information on numbing for this procedure.  Good luck!

[Alexis in Virginia]

ask about lidocane and maybe see if you can go somewhere they use it if you have a real problem tolerating pain.  I found it brought some tears to my eyes but mostly because the injections are slow and in a sesitive area and there are 4 of them.  I thought it was painful but tolerable but I do tolerate pain pretty well so it wasn't really an issue for me.  The pain only lasted during the injection and was I was fine afterwards.  At the very least maybe you can take tylenol to help with the discomfort before and after the procedure?  ASk you surgeon as well as the radiologist.

[Anajo]

For me this experience was EXTREMELY painful; I was screaming.  I wish I had been warned in advance and could have applied some Lidocaine or something an hour in advance.  I was given some cream to rub on the area, but I had no idea what was in store for me.

[kasey10]

it has been almost 2 years since I had that procedure and just reading your responses to the pain aspect of it makes it very clear that the training the technicians receive is far from
consistent. Some of you were permitted some type of numbing agent. Some were not. Some were allowed to sit up and others required to lie down. Some were advised to massage the breast to help distribute the isotope solution towards the lymph nodes. Others were told nothing. In my own case, i was not offered any numbing agent.  I was not told to massage the breast. But the two technicians that worked with me were the most compassionate persons I could have asked for. The pain was unbearable. I cried terribly. I seemed to not be able to control my feet from kicking and pleaded with them to please stop. The one administering the injection kept apologizing for the pain. The other kept holding my hand and saying soothing words over and over. I think that women should be asked beforehand about their pain and if they would like something before the procedure. The whole procedure wasn't explained thoroughly beforehand by my surgeon.  But then neither was the stereotactic biopsy my first surgeon performed. I suspect that if they told us everything about these procedures they'd never get us to do them! But training the technicians better and more compassionately would be an improvement for all women unfortunate enough to have to endure these type tests.  In December I will be a two year survivor of breast cancer. It was caught early enough for me to have choices about my treatment. Partly because of these tests.

[Marta500]

Unbelivable pain!!!!!!
I told my surgeon before, I do not want to feel any pain. He was smiling ang gave me Valium., Sad it will be OK.
The radilogist applied cream on my breast, and sad, I will feel pain. I told him NO, I do not want to feel pain, I clearly discuss this with my surgeon.
I had to wait, they called him down from the operating room. When he came down I told him what is going on? He called the anastesioligist to come to radiology, but she refused. Than I told my doctor, cancel the surgery, I will go somewhere else.
Than the ansthesiologist ordered for me Dilaudid tablets. took 1 hr. to get it, because it is a controlled narcoticum, so needed 2 signature. He told me I scrood up the whole hospital scedule,
and I told him, He scrood himself. after a wait of 30 minutes, to let the narcotic work, they started the injections. The 1st was painfull but I was able to tolerate. the 2nd and the 3rd was untolerable, I told them, if the 3rd not working, they can not give me the 4th, I am going home. The 3rd was OK, I did not need the 4th. I was screeming, crying, from anger, why did they do this to me, When I specifically asked for no pain.
So it is painfull ladies.

[sfernando]

I had this done on Wednesday, so it is very fresh in my memory. They did not offer any numbing lotion or medicine of any kind. The doctor was discussing a new procedure with the nurse -- injecting a double dose in the nipple and areola, and not around the biopsy incision. There was supposedly better results traveling to the lymph nodes with this method of entry. I was told that each injection would consist of two parts, the first part like a tb test, and the second like a bee sting.

The first part felt like a monster mutant bee sting, yes, and it was painful, though bearable. The second part was not bearable, though each injection lasted only a few seconds, maybe 30 at most, it seemed like several minutes. I told the doctor that I don't care, because I'm through with this procedure, but that she should offer some sort of pain relief before giving those injections. She said she didn't know it would hurt because it was the first time they did the procedure at this hospital. Well, I said, I can see someone less able to tolerate pain jumping off the table or passing out. I suppose that if I would have screamed, she may have taken me a little more seriously. I could tell that she didn't believe me.

Then I was placed under that picture table thing, and my body temp fell, and blankets were piled on me. 40 minutes, and no traveling of that isotope at all, so they let me have a 2 minute break, where I stood up walked around and tried to get warm. After that, everything went quick. I don't know if it was the pain that dropped my metabolism, but from it's intensity, I wouldn't doubt it.

I hope the next person that doctor injects via her "new procedure", will be offered pain meds. If not, I hope that doctor remembers me when she gets a woman screaming hysterically and/or jumping off the table. I can handle pain, and had no narcotics after my latest surgery due to an intollerance/allergy, and am doing fine, so I know most people would not have stayed still.

My opinion -- take any pain relief that they offer.

[hldc]

A related discussion, nuclear injection pain was started.