unresolved thorocotomy pain

Good evening everyone! I had a thorocotomy 2 years ago because I had a golf ball size nodule dead center of my right lung. They tried to biopsy it but they couldn't reach it and then my lung collapsed. I decided to have it removed. Lung cancer was the reason for my parents passing.
A week after the surgery I got an infection in the surgical site. Had to go back in the hospital.The infection was down to my rib cage and drs told me I had e coli in my wound. So it was 3 months with a wound vac,picc in my arm ( 2 antibiotics I had to administer every 8 hrs) and a visiting nurse every 2 days.
I could not take a bath,shower so I washed up at a sink. As of now I have had pain for 2 years. I was refered to pain management and he put me on vicodin but it didn't touch it. Then came steroid injections which were injected wherever it hurt. I had over 10 of there around the site,my left breast and shoulder blade. Did not work so he tried a nerve block. 2 days later I am at the e r because the pain was so bad. So back to pain dr. I am now on exalgo 12 mgs 1x per day,hyslinga 20 mgs1x per day and nucynta every 12 hrs.
Pain is not going away.
I am so depressed and tired of hurting. I feel so defected.

I saw a cardio-thorasic surgeon per pain management. He said scar tissue has grown around the nerves. He reccomends surgery (50--50). He would remove what he could, call in a plastic surgeon to put a graph over the wound so it doesn't pucker anymore. Right now, the site looks like a fist indentation. No other way to explain it.

Those are all awesome narcotics used to treat pain however they don't work on nerve related pain issues and there are several good meds specifically for nerve pain such as lyrica,cymbalta,neurontin and a few others used off label. That's what most of us here are on one of those and or being treated for neuropathy associated with nerve damage or impingement. Not sure why he didn't have you on one but I would ask.

As for the surgery they're talking about and the 50/50? We don't see many that get helped by re-entering a scar thats already shown to be highly prone to create scar tissue and adhesions. I would give that a lot of thought.

Michelle: I am someone who had surgery to remove scar tissue that entrapped nerve endings, much as you are considering, with a good/positive outcome.

My situation is somewhat different but may offer you a glimmer of hope.

I had surgery for a torn ACL ligament (knee). Due to surgical complications (swelling within the fascia), a second surgery was performed about 48 hours later. My body overly responded, with a proliferation of scar tissue. The scar became deeply imbedded, much as you are describing with your scar. Scar tissue tethered soft tissue and the newly repaired anterior cruciate ligament; scar tissue also embedded many sensory nerve endings. The result was a highly hypersensitive joint and associated trophic skin changes (bright, shiny, taut skin) . . . reflex sympathetic dystrophy.

The pain was agonizing. Even the light touch of a bed sheet on my leg was excruciating.

You may have pain associated with reflex sympathetic dystrophy.

What worked for me:
• Attention to keep the joint moving. Despite pain, I remained vigilant to maintain active range of motion. Pendulum movement for your arm (dangling the arm at your side, gentle circular motion of the shoulder) will help to keep soft tissue and muscles from constricting. Constriction of soft tissue and muscle can become its own source of pain.

• Prescription of Neurotin (gabapentin). I am small/petite (80 lbs), and found that 100 mg 4 x a day was adequate for me. Dosing the Neurotin though out the day more effective for me than two-time a day dosing.

• Arthroscopic surgery to "clean-out" the knee joint, careful removal of intra-articular scar tissue. Scar tissue had formed thick bands. I make the analogy of releasing several tight rubber bands.

Key to the success of this procedure, I feel, was in finding an outstanding surgeon. The surgeon understood the precarious nature of surgery on a joint already angered by surgical trauma and resultant reflex sympathetic dystrophy. His approach was laser-focused to minimize any additional trauma to the joint.

Today, my knee has full range of motion and is pain free. The agony of nerve endings embedded in scar tissue (and subsequent RSD) is a distant memory.

I hope for you a positive outcome and a comfortable body space.