Aortic repair is a highly invasive procedure. I imagine you would still have pain.
Your surgeons will know how long pain lasts on average, but not everyone is average.
Your pain is unmanaged, and you are probably under medicated. So, if they won't treat with adequate and appropriate opioid medication, demand that they refer you to pain medicine, now.
I am not on any pain medication at the moment. Why is it so important to take any? I understand that it benefits quality of life, but my question is whether there is a more kind of a once and for all solution to my problem.
This last surgery was my fourth aortic procedure. I've started at the age of 2 and am now 37. Have had coarctation repair, valve replacement, ascending aneurysm and this recent one. Overall 2 sternotomies and 2 left side thoracotomies. The pain I'm experiencing now though is incomparably more excruciating than anything in the past. I don't mind being in pain as long as I know it will come to an end. That's why this time I'm a bit worried because I came across opinions such as "it could last up to 3 years" and -even worse- "it will never really go away". In general I'm also a little hesitating when it comes to pain meds; I haven't had any as far for any of my previous surgeries -even though I'm extremely sensitive to pain. Knowing that it will eventually withdraw I prefer patience. But, as I said before, this time I'm a little confused with the various opinions on this.
Thanks for taking the time to give me such a detailed and clear approach to my problem. It really is confusing as the variety of opinions keep increasing every time one seeks for help.
My idea was always to endure pain, not only as a matter of virtue, but following a theory I came across –and accepted- that the body knows how to fight/deal with pain itself. So, if one “shuts down” this natural mechanism of body’s reaction against pain by taking pain meds then the result is somewhere between slower healing to not complete healing. This theory is a little contrary to what you have stated: “Unmanaged pain is of concern because it can lead to chronic pain syndrome”, which is something I haven’t heard until now. This new thesis impelled me to give your post the “Best Answer award” as it puts me into a new perspective in which I feel that I need to do a little more research so as to see whether I need to review my thoughts on treating pain.
In 2013 I had my 3rd aortic surgery (2nd sternotomy) and after 3 months I really returned to my no-pain past reality. So, till then my tactic in dealing with pain by enduring it was still working perfectly. This time, however, I am facing a degree of pain I haven’t had before and the possibility of “missing a chance” to deal with it the right way, because of misinformation, spurred me on to asking other people who might have had the same or similar experience how they came out of it, if they ever did.
Overall, please accept a great thank you with deep appreciation for your kind help. I will speak with my physicians about all these and hopefully we’ll find a way to deal with my condition.
Hello again, I had a phone consultation with my surgeon and his suggestion is that I get intercostal nerve-block injections. The procedure will be completed in 3 sessions starting with 6 injections at the first session (3 on the back from where the nerves originate and 3 on the front where they end). The 2nd & 3rd sessions will consist of 2-3 injections each. The sessions will have a time space of few days to few weeks between them, depending on the effect of each session. Normally after completion of the procedure I should have results from significant pain relief (for a long period of time) to permanent solution of my problem. Do you have any experience on this type of treatment?
No my friend, I'm sorry -- It sounds like you're still suffering.
I have no experience with thoracic pain like this. However, I've heard from many people with similar problems.
I think I left my interventional pain book in the car, so I'll look up these procedures later and give you some info.
In the meantime, see what Johns Hopkins and others have to say:
(Here's an insurance group that doesn't want to pay for them -- "no medical necessity")
(Here's some bad news...)
(Here's a study of post surgical pain in the chest wall, controlled with either nerve blocks or epidural morphine...
They conclude that the patients hurt no matter which way they try to manage pain -- this may not apply to your problem, but then again, it may.
Finally, what I consider a balanced presentation from multiple practitioners based on their experience:
This looks to be a difficult decision because of mixed outcomes. Remember, all patients are different.
Keep me informed. I'll be here if you have questions.
Thank you so much. These links are great. At least now I know what I'm looking for. I am still trying to find someone who can do this, but it's not so easy after all... Will keep in touch.