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Excruciating pain after surgery
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Excruciating pain after surgery

My mother has been suffering chronic pain in her upper arm (shoulder area). This pain started after she had exploratory surgery to remove a cancerous tumor (lieomya sarcoma) located on her uerter, a teratoma tumor (located in the lower abdomen), and a complete historectomy. I can't understand why she is having pain in her arm, when the surgery had nothing to do with her arm. She has had several x-rays, MRI's CT Scan's she has seen neurologists, chiropractors etc., no one has been able to help her and these doctor bills are horrific. Every test she has had reveals nothing! She describes the pain as sharp, throbbing pains kind of like a tooth ache. She has taken several meds for nerve pain, arthritis, muscle relaxers, they all just seem to make her sleep or drowsy, but the pain is still there. She is only 53 and has had a very healthy, active life until now. It is painful to watch her live in this condition. She is in so much pain, she is contemplating amputating her arm. I'm almost convinced that this is some type of nerve pain, it will sometimes start at her shoulder and go through her pinky and index finger. Any suggestions on what to do next?
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Avatar_n_tn
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.      
    I am sorry to hear about your mothers cancer diagnoses, I can not tell you from the data that you provided where the pain is coming from, but I can outline several possibilities.  It is possible to have pain in the shoulder area after an abdominal procedure due to refered pain (the area under the diaphram is connected to nerves so that an insult in that area can cause pain that is felt in the shoulder).  One common reason that this happens is an infection/tumor in the ovary.  I would make sure that the diaphram/upper abdomen was explored/imaged for any sign of infection/additional cancer due to your current pain.  Another possibility is a brachial plexus injury sustained due to positioning during surgery.  In abdominal surgeries the arms are often placed over the head, and under anesthesia/paralysis more pressure than intended can be placed on nerves.  The fact that the pain seems to shoot down her arm and into the fingers suggest a brachial plexus injury is possible.  For this possibility I would suggest an EMG (nerve muscle test) to evaluate the brachial plexus.  The final possibilty is that your pain may be due to a metastatic focus of tumor that is tracking along the nerves, in the spine, in the brain or in the shoulder itself.  You have mentioned some MRIs etc, but if you have not have a brain, entire spine and chest/arm MRI with Contrast, this may be helpful.  I suspect medications for neuropathic pain such as neurontin, elavil, lyrica, cymbalta etc will be most effective.
I hope this has been helpful.
5 Comments
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Avatar_n_tn
Does the pain feel like it's burning (like your being set on fire from the inside out),does your Mums arm turn either blue or red and feel either hotter or colder than the opposite side.Has she noticed if it hurts from something such as a strong breeze blowing on it or even her clothes rubbing on her arm.Has she had any changes in the amount your arm sweats, swelling, spasms or shaking.
I asked this cos I've got a condition called complex regional pain syndrome (aka reflex sympathetic dystrophy) which can start up after an injury or after surgery.It's a condition of the sympathetic nervous system and means that the pain receptors don't turn off like they normally would after an injury or surgery has healed (basically your brain thinks that there is still something wrong causing it to hurt along with some or all of the other symptoms aswell.
I hope that your Mum manages to get it sorted out though
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Avatar_n_tn
Acupuncture offers some relief, and physical therapy.I try to stay busy,and do not focus on the pain or cause.
I will always be in pain,therefore at 54,all body parts are very important.

To amputate is there still the possibility the brain will still generate the pain such as service men and/or women and car accident victims who have lost a limb?

Your mother is stronger than she thinks and be sure and keep enforcing that. For me, just to know that it is not just in my head, that this is a bonafide medical problem is like the difference between night and day.
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Avatar_n_tn
Sorry for your mom,  Just a question, did your mom have laproscropic surgery?  if she did they inject the stomach area with a gas to blow up the stomach and see inside better.  The after effects of the gas they use can in some people cause severe pain, and most especially in the shoulder/arm area for some reasons.  Maybe your mom can try some anti-gas medicince to see if this works.  I only know this because my sister had laproscopic surgery on her ovary to remove cysts.  She woke up with severe pain in her shoulder and she was given medicince to relieve this, she also had to stay overnight because she couldnt go home with the pain.  Please inquire about this, it cant hurt.  Wish your mom well.
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Avatar_n_tn
i am a 57 active woman..I do not know of my comment will help. I have 3 herniated dics in my thorasic and they do not want to do a distectomy because one might not take accoording to my neuro surgeon,,,,went into emergency room for severe pain in my arm,shoulder..it seemed everywhere and was unbearable..the vicodin my doctor gave me for my back was like taking nothing..its was major,unbearable pain..they took xrays and said i had bursitus....heat and ice...it did not help..i have only been to the emergency room once in my life..i went back 2 more times..the pain was so severe ..they ordered an mri..the results were bursitus,torn rotator cuff and stiff arm from the pain..the doctor gave me a shot[ant-enflamitory ,cortisone....after 10 days my pain was bearable and much better...much better...i do not know if this applies to you but the shot made me stop walking the floor in excruciating pain and i have use of my arm now to some degree..it has been 2 month and i am still almost pain free..i do not think my problem is solved but the pain is almost gone...have you considered getting a cortisone shot? it will not tell you what the pain is from..but i will tell you that after 10 days the pain started going away quickly and has stayed away for 2 months..i hope you ask your doctor if this might be an option for you....it was a miracle shot for me or i might have had my arm removed as well to get rid of the pain..it is that bad..my doctor told me it just masks the symtoms (symptoms) ...but that is ok...i can do things now when i had the pain that was all i thought about ..it was that severe...i hope this might help you...i hope so...good luck .........
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