Mastectomy pain

[Prettyangelface]

2 weeks ago I had a double mastectomy and when I wake up in the mornings, the pain is so severe. It feels like my chest muscles are tightening up. Now I have a throbbing pain in my right chest that comes and goes. When will this pain ever go away??

[Fernando Roque, MD]

Hi.  I have had post-mastectomy patients who have pain which does not seem to respond to the usual pain medications.  What I've found is that with several of these patients, part of the pain is neuropathic in origin (pain due to damage to nerves because of the mastectomy).  Addition of another drug which directly controls neuropathic pain, such as gabapentin (Neurontin) or pregabalin (Lyrica) usually eases the symptom.  This may work for you.  You can use heating pads, for as long as you do not apply excessive heat and macerate the tissue surrounding the wound.

[Prettyangelface]

I am taking percocet 10/325 just once a day and already I have seemed to develop a tolerance to it. Neither ibuprofen nor acetaminophen help me. I have young kids and am pretty much alone so I can't take narcotics during the day. I just saw the surgeon 2 days ago and there are no overt signs of infection. I'm just wondering if this pain is normal and if there is anything I can take or do in the meantime. Are heating pads okay? It seems to hurt more when I am cold.

[Fernando Roque, MD]

Hi.  It takes around 4-5 weeks for the mastectomy wound to heal fully.  The pain should go away by that time.  Are you taking any pain medications right now?  If the pain is persistent and severe, you may want to go back to your doctor to get additional pain medicines or have your current medication changed.  It might also be wise to have the wound checked for signs of infection. Sometimes pain on the operative site is the first sign of an infection in the area.