extreme chest pain post cabg 12 weeks

The patient is post (double) bypass 12 weeks. She experienced heart spasms which resulted in a cath.that detected 2 blockages.   As with any surgery ever experienced, each week you progress and feel better.  At about 4 weeks she felt as if she had turned the corner so to speak, on the way to recovery.  However week 5 started with a slow progression backwards.  She is a 45 year old white female, normal weight, with no other significant health problems.  Her chief complaint is varying degrees of severe chest discomfort.  Mostly, she feels it is muscular-skeletal centered in the sternal area (with a weak left arm accompanied with dull aches) but it is often extremely painful. After repeat visits to CT surgeon,  She has tried ice, heat, medrol dose paks, motrin, celebrex and of course nar. pain meds.   Nothing seems to be making the pain improve!  It's just hanging around....preventing full recovery. (i.e. cardiac rehab)  Beginning to worry it might be more than just obvious sternal issues, she spoke with her cardiologist regarding this contnued pain and his lack of regard was dissapointing!  She then consulted her internist.  A CT scan of chest with contrast, plain film chest xrays, and extensive bloodwork shows nothing remarkable with the exception of an elevated sed rate.  He has sent her to a nuerologist who wants her to try Lyrica? Is she expecting too much too soon?  The patient is most frustrated as she thought her age, health, normal weight would be an advantage to recovering from this surgery? DO YOU HAVE ANY IDEAS? Do you have any ideas regarding the situation perhaps the Drs. may be missing?  Does this sound common?   She is considering consulting another cadiologist and/or larger medical (teaching) institution at this point. Your remarks would be appreciated. Thank you

[Archibald S Miller III, MD,FACS]

I am Dr. Arch Miller and am on the reconstructive surgery forum. The problem could be a low grade sternal infection, or an unstable sternum. Does she have motion of her sternum? Does she have any clicking or rubbing sounds? Does exercise make it worse/ If these are true, then instability is likely the issue and she will need to consider if she wants to try to stabilize her sternum. There is a new procedure and it can be viewed at the wb site rapidsternalclosure.com. This gives excellent stability and has worked on others. Though new, the device has already been used over 500 times with excellent results. You may contact me at my office for referrals, or questions.Respectfully,

                arch s miller ms md facs