Thoracotomy for Chronic Empeyma

[mkiloman]

I developed what can only be described as the king daddy of chronic empeyma in March of 2011.  After having a thoracotomy, and full decortication of my right lung, I am experiencing constant, chronic, severe pain.  I have done some extensive research on this procedure, and from what I have read, my case was severe, to say the least.  I was in surgury for 5-1/2 hours, requiring 4 units of blood, and the surgeon who performed the procedure described my chest cavity as looking like "a bomb went off in your chest."  I am a 40 year old male who was in superior physical condition prior to the pneumonia and empeyma.  I am now struggling with post thoracotomy pain syndrome, with the only treatment being opiates.  My question is..... what is the alternative to years of dependence on opiates?  I have read some information on Nerve blockers and other treatments, but it is very unspecific.  My quality of life is suffering greatly as I am either A.  on opiates and feeling OK... or B.  not on opiates per doctors wishes and feeling horrible.....   Is there another answer?

[207Gypsy602]

Hi there,
I just posted on another post about what happened to me, much like what you have had. My surgery was 16.5 hours, they got me open and had to wait for a specialist to come finish, as it was too much. The link is http://www.medhelp.org/posts/Pain-Management/post-thoracotomy-pain/show/3124?personal_page_id=2351133#post_7288508
I hope you can find some help, and something that will work for you. I would suggest a pain clink in a major city that deals a lot with Thoracotomy, at least some contact with them.

Good luck!

[mkiloman]

Ok, I have now seen a Pain Management Physician.  As usual, the reaction to my suffering was substatially less than I had hoped.  The doctor in question was fairly young, and had very little experience with post Thoracotomy pain..if any.  I got the standard eye rolls when describing the 5 month roller coaster of narcotic pain relievers that I've been dealing with.  He did suggest a course of epidural injections which "may or may not work".  I find myself very reluctant to submit to spinal injections, whose possible complications include bleeding, infection, and paralysis.  I was given literature on the injections, which seem to be specific to lower back and leg pain, not to post surgery pain, from which I suffer.  I think it goes without saying that this seems like a last resort, and I would only agree to this if performed by a specialist with a proven track record of treating my specific pain.  In the meantime, I have to content with Internal Medecine physicians who may or may not continue to prescribe me opioids (oxycodone), which have been my only source of relief in the 5 months post surgery.  The main problem i have is living in a rural area with limited medical resources.  I had to travel 3-1/2 hours by car to the nearest capable thoracic surgeons in order to save my life.  It is looking more and more like I will have to travel the 3-1/2 hours back to where my surgery was performed and try to get some answers from Thoracic specialists, who may be able to refer me to someone who can help me.   Essentially, your advice is well heeded, and I will seek as many opinions as it takes to get some relief.

If anyone reading this has similar experiences, I would appreciate your response and information.

Thank you

[Tuckamore]

Hello and Welcome to the Pain Management Forum. I am very sorry to hear about all you have gone through.... and now the Chronic Pain that you are experiencing.

I don't know much about Thoracotomies. I do know about Chronic Pain! There are treatments for Chronic Chest Pain which I think your pain would fall under. Are you being treated by a PMP (Pain Management Physician)? If not I suggest that you consult with one.

I know that states vary and your state may not have PMPs that prescribe opiates for Chronic Pain Patients. However they should still have PMP that treat Chronic Pain. If you are under the care of a PMP and your pain is not well controlled and/or alternative treatments have not been offered it may be time to seek a second opinion.

I don't understand "B".  Your physician should care about your quality of life. If he/she is not comfortable prescribing opiates when required again it may be time to seek another opinion. I think your "other answer" will come from a consult or two with other physicians.

Please keep in touch and let us know how you are doing. I will be interested to hear how you are doing.

Best of Luck and Please Take Care,
~Tuck