PAIN after modified radical mastectomy

I had surgery 12 days ago for Lobular carcinoma.  It was a modified radical.  (Nodes removed also)
I did well while in the hospital.  And seemed to hurt less than now after I returned to my home.
My queston now is,  How long should the pain go on?  I am taking one and one-half Lortab 5mg/500mg  every 4 hours.  I need the Lortabs because the pain is quite a bit.  Is this normal 12 days after surgery?  (I did have a lot of flesh taken off, because I have very large breasts.) The pain is under my are where the stitches are, and in the middle, where the nipple was.  At times I have random sharp stabs of pain around other places on  my breast, and on my upper arm.  Are these nerves that have been damaged?I just want to know is this is the norm?

[CCF-RN,MSN-rf]

Dear Seven7:  It is not abnormal for pain to persist into the healing process.  Scar tissue can form as well.  If your pain does not begin to resolve, you should let your surgeon know.  He/She may want to examine you to be sure all is healing okay.  There is some nerve damage that occurs during mastectomy.  Usually, this results in numbness along the incision and breast area, rather than pain.

[PG]

With all due respect, the answer you recieved to your question was quite incomplete, and is about what I would expect from someone with no first hand personal experience.  

The surgery you had was a brutal assault on your body - many nerves and blood vessels and lymphatics were severed.  Your skin was peeled away from your body from your collarbone all the way down to the bottom of your ribs, and all the removed tissue was cut, ripped and burned away from its attachment to bones, muscles and facia.  Since you had axillary dissection, probably the nerve providing sensation to the back of your arm was also severed.  You now have raw nerve endings all over your entire chest and armpit area, and as your body attempts to heal itself these severed nerve stubs get caught up in the developing scar tissue.

If numbness at the incision site were the worst thing you could expect, how nice that would be!  I'm over a year past my mastectomy, and I still have unpleasant stabs, burning and crawling sensations.  I could only wish for numbness! Instead I'm left with just enough sensation to be very unpleasant - any pressure at all on my sternum sends electric jolts across my chest.  Often, it still feels like the removed breast is still there, with a chain wrapped around it and slowly tightening.

I'm told all this is normal.I think Surgeons need to be a whole lot more honest and graphic about what they are doing to people so we know what to expect.

[Crystal85]

I am really sorry that anyone have a bad experience with mastectomy.  It is not always that way.

I have had modified radical mastectomy with sentinel node biopsy (10 and 4 nodes respectively) on two seperate occasions.  The pain was at a minimum and with the second I took only over the counter Tylenol even while in the hospital.  I experience no permanent nerve damage and have lost no feeling.  In both instances I had almost full range of motion back within a week to 10 days.

With the first mastectomy, I had more pain during the healing process.  This lessened and subsided over about a 2 month period. It is a different experience for everyone.  My sister had nerves healing in her arm area for about a year due to more extensive axillary sampling.

It has been six months since my last mastectomy, nine months since the first.  I still continue to exercise to strenghthen my upper arms.

Very best wishes to all,
Crystal

[grandma2]

I had a radical mastectomy March 11/02.  With the radical they leave enough skin to do an implant after everything is back to normal and as I am stage 111 I well need 6 mons or more of chemo and then radiation directed at the sight.  I had alot of arm and left chest pain (on the side where I had the mastectomy) and found I was in need of pain killers for quite some time and even at a month up the road the chest wall was still quite painful.   I still have some chest wall pain and numbness on the chest as well as under the arm.   I have full range of movement but I tire quickly so I use caution when it comes to heavy work as I know I could injure myself quickly.   At this point I have not returned to work as an LPN and am concerned about the heavy lefting in my job.  To me if I have pain take a painkiller if you need it as hopefully we well never have to do this again, and use caution on heavy lefting, vaccuming, and anything that can aggrevate the arm.   It is pretty early for you to do your normal work load at this point.  I was told to be cautious to prevent lymphodema.

[jhall52]

I had MRM 8-12-98 with reconstruction done at time of surgery. Flap site was taken from abdominal region. Besides intense pain one experiences with abdominal surgery, I remember (after I was out of ICU) waking with a feeling of being branded on my right shoulder. I finally figured out it was the snaps on the back of my gown. Anytime my bare right shoulder touched the medal, it felt like the snap was red hot. This passed in a day or so, but I did go on to develop a frozen right shoulder. I had some inner forearm cording. Approximately 1-1/2 years after surgery, I developed lymphedema. I have not been pain free since my MRM. Pain radiates from right lattismus muscles, to right shoulder and down outside of arm, intensifying ring finger and baby finger. Some prickling sensation, mostly deep bone-like ache. Burning feeling in the lats. Tried pain management...stellite injections twice, trigger point injections...both with no relief. Have been put on Neurontin, but only 300 mg. twice a day without relief. Tried Bextra, no relief. Am now on 20 mg. amitriptylline at bedtime plus 10 mg. Ambien. I do sleep but no help with the pain. It gets so depressing sometimes.

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