Post Mastectomy Pain Syndrome (PMPS)
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mlp730, somewhere in this thread i have written about the wonderful pain treatment team i have of two drs that i see, the nursing staff, the pain pyschologist, and i just finished 6 months of pt. the nerve blocks really helped. but the problem is, they needed to put them in the same spot in my neck, which you cant do for lengthy periods of time over and over. the nerve block shots hurt when they go in, sometimes i feel it into my shoulder. the dr has to feel around the neck to find the right spot/nerve, and make sure he does not hit the main artery going thru there cuz you cant have the shot go to the brain.sometimes the pushing on the neck gave me muscle bruising. some of the immediate side effects i had was droop eyes/face/mouth,feeling like my arm was a wet noodle (which my dr and i now call "noodily", breathing was sometimes difficult (it felt like i was having an asthma attack but wasnt), and i had difficulty swallowing. Those would wear off in a few hours. The nurses would not release me until i could swallow and i passed the period of time where i wouldnt black out. I also tried trigger (cortisone) injections where the nerve block wouldnt reach like below the armpit and around the back side a bit, one time they worked, one time they didn't so the pain from that was too much for me to consider doing it again because it didn't work the second time.
I am also on four medications for pain. gabapentin, tramadol (vicodin does not work well on my nerve pain, and the one nurse said she hears that from other patients) , i cant remember the name of the other pill they put me on and to be honest, im too lazy to get up to go look at the bottle lol, and i take amitriptolyne at night to help sleep and works with pain.
I had an iv lidocaine infusion a few weeks ago. That worked really nice. but the lidocaine goes to the brain and it was really hard for me to come out of. it took 3-4 days before i felt it gone. but i have a hard time coming out of anesthesia anyway so its not surprising. the nurse has to be in the room the entire time becuase something can go wrong with the heart as well and was hooked up to an ekg. i dont remember anything after a certain point til i was fully awake, but i guess my breathing got so shallow i kept setting off the oxygen alarms. the nurse would just tell me to breathe and i would breathe. i have no memory of this. my pain counselor says those are given out once a month and have success with some people to be pain free. its really working on the left side and chest area. the right side still give me trouble.
hopefully i wish all women could have such a good pain team as i do. my docs tell me, they keep trying til they find what works for me. the pain counselor is excellent too. i had only had chronic pain since jan and i met him in aug and what a help he is.he is excellent, excellent!
oh and about the meds, my drs let me adjust them according to how tired and loupy i feel (within reason, of course) and let me figure out the best times to take them. i used to take my night pills around 10 pm, but was having such a hard time waking in the morning. i started taking them around 8 pm and mornings are much better now.
good luck to you!!! and dont forget a good pt therapistthat was so important to me , cuz along with severe PMPS, i aslo had horrible scar tissue adhesions that i didnt know i had across my chest, to my side, all over where they cut etc. plus the touching and massaging helps desensitize those over active nerve endings
i also have stretchings and exercises to do at home, but i have to admit, im kind of lazy about them. my partner also does some stretching/massage on me too since im not in pt anymore.
i now have the all clear to do some light yoga, but i know my limitations and got the name of an instructor who is equipped to deal with pmps patients. i will be starting that after i heal good enough from my hysterectomy next month.
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mycinnamon - Wow, I hope my outcome is as good as yours. I forget what it is like to live without pain and discomfort. My family doc put me on cymbalta for depression - I was having meltdowns every night. As you well know, chronic pain can get the best of you. I'm struggling with this med though. I just started it but it kept me awake the first few nights so I started taking it earlier. My doc now has increased the dosage but I just don't like the way it makes me feel so I'm going to cut it back. The nerve blocks sound a bit scarey though.
I just finished PT with a lymphedema therapist (not that I have that) but she was highly recommended. The massage therapy felt great but wasn't seeing any difference in my pain levels. She recommended going the Pain Clinic route and going back to PT later if necessary.
I am also having an MRI Monday that my family doc has ordered to see if there is anything else going on. As you can see, my support system has been my GP, not my surgeons. My PS suggested a personal trainer and begin lifting weights!!
I do stretching exercises and am pretty faithful. My range of motion is ok but nothing is pain free.
Thanks for your info and will keep you posted.
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after 4-5 years, my pain seems to be less lately. Sometimes it goes away for a bit and then returns, but it feels as if finally the nerve isn't as active. I use lidocaine cream. But one other thing that may be helping ... I bought an app for my phone w/yoga poses. I think i'ts "all in Yoga." They have beginner to advanced, with written instructions, a voice that reads how to do it, and each has a video of how the pose is done. Even the beginnining poses feel much more aggressive stretches than just "stretching." I can feel all the muscles in my chest wall and arms really stretching out. It also helps w/ the aches from the meds. It might be not connected at all, it might be that my pain is just dormant right now, or maybe it's finally gone away. But I'm really surprised at how much better I feel.
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Hello Ladies,
I had a BPMX on March of this year, Immediate Reconwith Te's, Exchange surgery for Silocone Implants on July, and Nipple Recon earlier this month with flap procedure and Tatoos. I am a Hospice RN and deal with people with pain every day. Nothing could have prepared me for the pain that I am still in. From day one after Mastectomy, I experienced Neuropathic Pain ( Nerve Pain). After Exchange...it was still there, now, eight months, it is still there. I still am taking 2.5 mg of valium at night along with Soma. By the end of the work day, I feel as if my Implants weigh 500 pounds, also, itching, shooting, and burning pain, moew on one side than the other. After Nipple Recon, 3 weeks ago, was treated with massive doses of antibiotics due to red and swollen right breast, infection cleared, now I have a bilateral breast rash that is most likely yeast...is it ever going to end? My PS through Kaiser is saying that it is "time" that I am off off all meds, that it has been, quote, long enough! Do you all feel that I should contact my BS? Any ideas, suggestions would be appreciated.
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@Rnjules-My suggection would likely land me in jail...I've also been living with pain since my MX and ALND. It's been 2 1/2 years... 50% of women who have had MX live with chronic, forever pain. Nobody in the medical industry acknowledges this. It's time for change.
I'm hoping to get surgery done to build a new breast and get rid of the heavy, although small implant, at the Miami breast center. Dr. Khouri has pioneered what seems to me to be the way of the future. I'm praying it will reduce the pain.
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@rnjules - I had similar pain issues for about 18 months after my BMX...My onc, BS and PS would never address the pain issues...it was not until I found a pain management doctor who really listened that I was able to get relief. I was dx'd with CRPS (complex regional pain syndrome) and was given non-naroctic rx's to help shut down the over stimulated nerves and help my muscles relax. After 8 months I was able to slowly wean off the rx's and still am pain free (from nerve pain...I do have LE so I am affected by that in my trunc and arms). Please look into finding a pain management doctor that works with cancer patients.
Best wishes!
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@o2bhealthy - Reading your post gives me hope!! I too have had pain for 2 years now since my BMX. I had an infection that I was hospitalized for during TE phase, revision to the the right breast, capsulectomy and finally deconstructed thinking the pain was the implants. I had my first consult with a pain management dr last week who seems like he is truly interested and concerned in helping me find relief. Right now, the only thing that takes the edge off the discomfort is percocet. I am scheduled to have a nerve block on 11/21 and so hoping for some positive results. Have you ever had this? He has also mentioned trigger point injections as a possibility. He prescribed Lyrica but I haven't started taking it, a bit nervous of all the side affects. Has anyone ever used this and if so, any relief??
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No nerve blockers or injections here but there were several ladies in my pain management doc's office who had the injections and it worked for them...I was put on Nortriptlyine 50mg and Zanaflex 5mg every night.
Happy to give hope - I remember stumbling across this thread and just bursting into tears of relief knowing I was not crazy and there is hope...happy to pass it on!
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I have posted on here in a lot of detail of what my marvelous pain clinic team has been doing for me. The latest drug they tried is working wonderfully! Once a month now, I get an IV Licocaine infusion. For three days, I am very tired, loopy, and depressed as the lidocaine goes to the brain with the IV. But for three almost four weeks, in combination with my other drug regimen, my pain is almost gone! I still have to rest between arm activities, but its more of an ache than pain. I like these better than the nerve block shots to the neck. But I have learned that they can not put the EKG patches anywhere on the upper trunk of my body. I was in tears when they took them off where I have hypersenisitivity...it felt like I was being burned. So the nurse marked my chart for me, but I need to remind them just in case. The goal of the IV lidocaine is that eventually I won't need it.I sleep through it. The first time, I started breathing so shallow I kept setting off the oxygen sensor and the nurse told me to breathe and I did (I have no memory of it).
Here is the list of medications I take daily
2400 mg of gabapentin (600 mg four times a day)
Metaxzlone comes in 800 mg tablets and I currently take 1/2 at bedtime, but I can take up to three 1/2 pills a day
Amitriptilyne, 25 mg at bedtime
Tramadol 50 mg, every 4-6 hours as needed for pain. I was on vicodin which really didn't seem to work for my pain. Tramadol is awesome for acute pain I have during the day. If I am active and active means to me walking the dog, doing garden work, cleaning, etc.(anything I use a lot of arm movements for), I take about two of these a day and they work really well. Tramadol, according to my pain dr. was invented as a substitute for the addictive vicodin. Tramadol is not suppose to be addicting.
I will let you know that I am loopy, and have a drugged feeling quite often, but I am not able to work, so for me, I have reached a medication level that combats most of the pain, but am still able to function enough for what I do around the house and yard. It is a process of trial and error to find what works. I had been getting cortisone trigger point injections on the right side (which is my worse side) under the armpit area and around the back but they were too painful for the little amount of relief I get. The first time they worked good, second time no help.
I finished my total of 6 months of occupational therapy. I also had scar tissue adhesions across the chest to the sides. The two laides who worked on me wonderful. But it took a long time before they could really work on me til the pain subsided. I have excercises and stretches I can do at home. I am having a hysterectomy in a few weeks and after that I plan on doing yoga and some excercises at the YMCA that I like in OT.
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RNjules: Instead, ask your PS to refer you to a Pain Mgt specialist. They are the ones to address PMPS. I would ask specifically for either Jamie Miles, MD at Kaiser/Woodland Hills or Patricia Harrison, MD at Kaiser Sunset. Woodland Hills is closer for you.
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I thought my pain had finally gone away, and now it's back these past few days. How many of you think the pain is related to your implants?
My PT says that many of her patients with implants complain, then when they have DIEPs, they don't need to come to her anymore. So I'd be interested if anyone here has a DIEP and is still complaining of the pain.
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Totally agree with going to a pain clinic rather than BS. My experience has been that they are more interested in helping find the source of pain as well as finding ways to relief it. After 2 yrs of chronic pain, I am getting nerve blocks on the 21st. I'm so hoping this is the trick!
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I read a great article about Post Mastectomy Pain Syndrome on this site:
http://mycomfortquest.com/beprepared/Factor-1.html
It discusses the reasons the pain persists such as there being a feedback loop between injured sensory nerves and the emotional pain centers of the brain which results in interpreting pain signals as much worse than they really are.
It discusses innovative treatment interventions.
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Caitlin, it seems as if you're trying to direct people to a site selling pillows. All your other posts are about the pillows. That's in violation of the rules here.
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I just had one of my chest wall for severe pain but it was done on my back.
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Bird - my pain was not on the scar line but I have LE and PMPS and have had three MRI's. All were done while on my stomach with my foobs hanging down in open space and my arms above my head. I was highly medicated on Valium and steroids each time due to reactions to the contrast and fear of small spaces. Honestly I cannot remember much but I would defiantly ask for some med's to help your get through the procedure. I actually slept through most of the last MRI
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Reading pages back, I smiled seeing I had posted on this thread as I consider in January a mx/lumpectomy. It was fear of the pain possible PMPS that pushed me to then get a lumpectomy rather than a mx. Here I am again with a similiar dilema except this time it's deciding on a uni- or bilateral mx. I have no choice this time. The R breast hast to go...especially after 3 now dx. Because I've been dx with RSD or chronic pain syndrome in my right hand, I'm at higher risk for symphetic pain syndrome. I've also been dx with 4 to 5 frozen shoulders. After both sentinal node dissections I'd had either web cording and montors syndrome. The pain doctor (anesthelogist) said that I had a symphetic nervous disorder...although now I'm not sure they consider it a disorder? Although when I feel pain on one side of my body, I also feel in on the other. Even now when my lumpectomy scar on the right side burns, I feel it in the same location on the left breast. My lumpectomies scars hurt, surges of pain and burns to this day...not horrible...but it does.
All to say one of the reasons I'm anxious about a mastectomy, especially a blmx is being dx with PMPS. It seems as if it can happen it will happen to me. I wanted to do the fat grapting but the only one that seems to do the whole breast is Miami. Going to Miami is not an option for me. I've contacted a plastic surgeon who does fat grafting, but he only does it for lumpectomies...He has never done a whole breast. I had hoped the fat grafting would be less painful than TE & implants.
So...someone called me to see Dr. Gabreil who uses botox to ellievate the pain problem. I was ready to go with another plastic surgeon and bc surgeon. Because of the botox possibly being an answer to a possible pain problem, I changed surgeons. I spoke with a lady who had the procedure done, blmx with the botox. She had the TE and in 6 weeks the exchange implant. She said she had no problems with pain in her arms or chest area. The whole ordeal was pretty easy.
I'm hoping the botox is the answer for me. This team of doctors in Vancouver Washington are the only ones doing the botox. The botox is still under a atrial study. I feel so fortunate to be so close to where this doctor is and to have something that addresses the pain problem.
I spoke with this lady again tonight. I was wondering, due to pain and recovery time, if to just do the uni. She put my spirit at rest and I may just go ahead and do the blmx.
She said after the study that more and more women will have the advantage of botox, which may very well solve our pain problems.
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Personally I would decline the botox...I don't like the idea of injecting toxic substances into my already traumatized body. I know a lot of women find it 'acceptable' to inject poison into their faces to reduce wrinkles, but, I'm not one of them. I was also considering a bmx. I went with a uni mx and am glad I did. I don't know where you live but there are other doctors who are doing the 'microfat garfting'. There is a forum topic on this website which lists the doctors and where to find them.
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makingway, I hear you. I don't like injecting poison in my body either. But, I don't like the idea of dealing with PMPS. From what I understand very little is injected into the pec muscles which stops the spasms. They only do it once. The botox relaxes the tramatized pec muscles. So far there's been no problems with the women in this study. I've read the fat grafting thread and someone from there gave me a couple of names. I've contacted the one in my area and he's never done a whole breast...only with implants and lumpectomies.
If it turns out that the TE's are painful, I will have them removed. The ps said because of little pain he is able to put the implants in sooner. I hate the idea of implants. This whole process is bothersome, but I have to do it.
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mlp730,
I had lots of nerve block shots over the summer. I had them twice a week at first, then weekly, then every other week. They worked ok. But when they started to wear off, I'd hurt again. They aren't fun. One doctor would push and feel around my neck to find the artery, so he'd know where it was and not inject into that.The nurse would hold my neck and push, while the dr. injected the lidocain. Sometimes it would really hurt. I would hurt from my neck to the shoulder.I couldn't really cry cuz I didn't want to move my neck and move the needle. At times, my throat hurt for days from all the pushing on it, like it was bruised. There are some things that happened to me right after the shot...breathing would get difficult, swallowing was difficult, the side of the face where the shot was given would droop, especially the eye and and mouth. I needed to wait there for some time, so they could monitor me and make sure that I could swallow before I left. Those side effects would wear off in a matter or hours.You will need a driver to take you home.
They could only do so many shots in the same spot. So the next course was IV lidocaine infusions. Those seemed to work much better, but have more side effects that lasted longer. Since it is cold out now, I don't have to do as much with my arms, so I have not needed anything more than my usual meds.
Good luck with your nerve block shots and let us know how it goes and how you are doing.
Oh, and when it hurts...remember to concentrate on breathing. That is what they taught me. Belly breathing and concentrate on breathing thru the belly.
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evebarry, It is just not matectomies that can give PMPS. Lumpectomies plus node dissection can also trigger PMPS. The PMPS name can be misleading. The American Cancer Society has a small paragraph written about and states that,"Some women have problems with nerve (neuropathic) pain in the chest wall, armpit, and/or arm after surgery that doesn't go away over time. This is called post-mastectomy pain syndrome (PMPS) because it was first described in women who had mastectomies, but it occurs after breast-conserving therapy, as well."
It also says,"PMPS is thought to be linked to damage done to the nerves in the armpit and chest during surgery. But the causes are not known. Women who are younger, had a full ALND (not just SLNB), or who were treated with radiation after surgery are more likely to have problems with PMPS."
My pain doctor and breast surgeon told me that nerves were nicked during the node dissection and that is what is causing my PMPS in certain areas.
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I had the nerve block yesterday but so far feel very little relief. I'm told that it can take up to a week to see a difference so we'll see. I feel like I've found a dr. that is genuinely concerned about helping me get a quality life back. If the nerve block doesn't work along with taking Lyrica now, he has suggested Botox injections to help with the "iron bra" feeling I continue to have. I don't like the idea of "poison" in my body either but two years of chronic pain has been beating me and I'll try anything at this point. This dr. also is an anesthesiologist in a pain clinic. Even if I don't feel better physically, mentally, it is a good feeling having a doctor with a plan b. My surgeons have continued to tell me for over 2 yrs that this is so rare and they've never had it happen before. My BS told me he has been a surgeon for 35 yrs and never had this in a patient. Somehow find this hard to believe!!
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I am 5 months post-surgery performed at Mayo, and am in shock by this extreme pain. My surgery was complicated by tumors with dermal involvement (NINE hours, 7 hours=mastectomy and 2 hours=reconstruction). I have been through 48 physical therapy appointments with a lymphedema specialist. I do the prescribed exercises by PT. I do not have lympedema in my arm; however, physiotrist states I have mild lymphedema in chest/breast and axilla. He has suggested Botox in pec muscles for my extreme pain.
I have severe pain similar to what you all have described above . . . iron bra, pressure in right breast so painful I want to have implant removed, pain down right side, right shoulder is curving forward, the big hunk of webbing/cording that I developed (from removal of 19 lymph nodes) also feels ripped, the therapists cannot even snap any more cords because no small cords left, there is just one giant, thick cord growing out of my armpit where the incision from lymph node dissection is located! My PT feels so bad for me they don't know what to do. So I have PMPS and AWS (Axillary Webbing Syndrome) that does NOT appear to be going away any day soon. It sure would have been nice to have had a heads up to these obviously obvious side effects resulting from breast cancer surgery.
I asked my lovely breast onc surgeon at Mayo if the web/cord could be surgically removed, she said no --it could make things worse. She said I am the only patient that has ever asked her this.
I have pain everywhere on right side: shoulder, pec muscle, breast, armpit, down my arm, and it's getting worse. I can get through the day with very limited exertion with just feeling "uncomfortable" without pain meds, but by dinner, I am in tears.
I had to double my pain meds last night, and all I could do is cry while my husband held me not knowing what to do.
My plastic surgeon hasn't been very helpful in my tearful opinion, and I'm now being referred on to a senior plastic surgeon. I had some major pain in the fold of my right breast from the minute I woke up, and the hard as a rock right breast was like that from the beginning, like the pocket was too small, and the fold is stitched into my chest muscle so tight my breast and skin on lower torso will barely move. I had a double mastectomy and the left breast is fine with absolutely no pain!!! During my consultation, the PS discussed that he would be giving me botox injections during the surgery, but he never did, and couldn't give me an answer why not. Now that I am in severe pain, he didn't even offer. Another doctor made the suggestion of Botox in pec muscles.
There seems to be some controversy/difference of doctor opinion regarding the immediate reconstruction with Direct One-Stage implant with alloderm.
My pain started as soon as I woke up from surgery. My right breast was hard as a rock even 8 weeks post surgery. So I make a video showing how hard the right breast was and would not move, as compared to the left. I sent the video to the PS. I did this because I wanted to demonstrate that it was like this BEFORE radiation which I started the day after I did the video. I am now 5 weeks post radiation (and had radiation fatigue/flu so bad that I did not get out of bed for days, except to go to radiation, and the fatigue was still gripping me four weeks after radiation.) My breast does not look any different, but PS still went and stated in notes that radiation causing problem. So my right breast had 8 weeks to "rest" before it got radiation.
Big question for all of you if you made it through all my rambling.
With all the pain you are dealing with, how are you all tolerating the TAMOXIFEN? I was on it for 10 days prior to radiation, and my local radiation onc discontinued it because she prefers her patients not take it during radiation treatment. Well, thank God for that, because just during the 10 days I was on it (my heart was also monitored while taking it), I was nauseated and vomited, but got over that after a few days and taking it after dinner instead. But, the side effect of Tamox that hit me hard was about five days after starting it, I had INTENSE pain in my hips, knees, legs. I could barely walk (I am a former runner, and thin, and outdoor lover.) The rad onc said it was the Tamox and I would need to take NSAIDS. (My cardiologists have always warned me to stay away from NSAIDS.)
BTW, I have a rare heart problem, so all the local PS docs that I keep getting second opinions from are running from me - I'm a high risk patient and have to have surgeries performed in a major hospital with operating rooms for open heart if complications happened - so no surgery centers or suburban hospitals can do breast revision surgery for me.
My med onc is starting me back on the Tamox in 3 weeks, at half the dose to start, and will titrate to full dose (20 mg) after a few weeks. I AM IN SO MUCH PAIN NOW, I AM DREADING TAKING TAMOX BECAUSE I CAN STILL FEEL THE PAIN IT CAUSED IN MY LEGS JUST THINKING ABOUT IT. I really, really want to be positive about tamox and it's added survival benefits, but the pain in my upper right chest/breast/shoulder, etc. is more than I can bear as it is.
So how adherent are you with anti-hormone drugs with having PMPS???
Also, someone earlier in these posts mentioned a doctor at MD Anderson. I was already considering going there for a fifth "second opinion." It sounds like I need to give up on PS, and look for a pain doctor in a major pain center who "appreciates" PMPS, so I have some backing to educate my local PCP (who I trust, but just needs to really understand this). I feel like all that doctors, friends, and family think about with regard to breast cancer is we'll help you keep your strength through the radiation and chemo, and then you'll be fine when you finish it, and you'll just move on and life is normal again.
And even some breast cancer survivors don't understand why I'm so "down" and not moving on and why I had an extended leave of absence from work. They have never heard of PMPS or AWS, and that includes my kind PCP/family doc.
Doesn't the Komen foundation have any advocacy efforts established for these two very real risks/side effects/problems (PMPS & AWS) of breast cancer patients??? Just go Google or PubMed all this, and there are numerous medical journal articles about it!
Even the Mayo Clinic patient education materials have NO mention of AWS, and I was not informed about it by anyone there (and there is much compassionate care there). So that's what's so sad about this -- if a world reknowned health institution like Mayo is overlooking these two syndromes, then we have a SL of advocacy work ahead of us. (StepUpSpeakOut.org has done a wonderful job with lymphedema and AWS). Are there any PMPS organizations with major websites available?
I've learned a lot from all of you sharing your pain experiences on this post, and my heart goes out to each and every one of you. Very Heartfelt Blessings to you all!
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PinkHeart - [[[[[[hugs]]]]]] You may have seen this but I want to post it here in case you haven't:
http://www.stepup-speakout.org/Cording_and_Axillary_Web_Syndrome.htm
Have you visited the Lymphedema thread here on bco? There is a wealth information there and women that can help you. I was and still am appalled at the ignorance of so many of these big name clinics that still deny that LE is as prevalent as it is. Mayo is great for some things but horrible when it comes to helping women with LE.
Kira and Binney4 are two ladies in the LE forum that know their stuff and may be able to offer some advice for you. I don't have cording but I do have LE, mainly in my fingers and hands. LE therapists vary in their knowledge and if this therapist isn't helping you, it may be time to find another one. Here is a link that may help.
http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm
I hope you find someone who can help you soon! It's bad enough to go through everything we've already gone through ... add the pain and the LE .... sometimes the weight of it becomes almost unbearable.
[[[[[hugs]]]]]]
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Did I ever post this? Seems like I posted it once before, but it bears repeating. A study published in August, 2011:
Plastic & Reconstructive Surgery: August 2011 - Volume 128 - Issue 2 - pp 349-352 doi: 10.1097/PRS.0b013e31821e70e7Breast: Original Articles
AUTOLOGOUS FAT GRAFTING IN POST-MASTECTOMY PAIN SYNDROME
Abstract Background: Mastectomy with axillary dissection is still one of the most common procedures in oncologic surgery. Unfortunately, a condition of neuropathic pain, termed postmastectomy pain syndrome, can appear after mastectomy. Although evidence regarding the epidemiology of postmastectomy pain syndrome is well researched, an effective therapy is still unknown. The aim of this study was to assess the clinical effectiveness of lipoaspirate graft in the treatment of postmastectomy pain syndrome.Methods: From February of 2006 to August of 2008, a total of 113 patients affected by postmastectomy pain syndrome and severe scar retractions were enrolled for this clinical study. Seventy-two patients were treated with autologous fat grafted in painful scars, and 41 patients did not undergo any further surgical procedure. Pain assessment was performed using a visual analogue scale before and after treatment, with a mean follow-up of 13 months. In addition, antalgic drug intake was recorded in the 34 patients who received a surgical treatment. Results were analyzed using the Wilcoxon rank sum test.Results: A significant decrease in pain according to the visual analogue scale was detected in patients treated with autologous fat graft (3.23-point reduction, p = 0.0005). Twenty-eight of 34 patients stopped their analgesic therapy with a significant follow-up (13 months).Conclusions: Autologous fat grafting is a safe, relatively noninvasive, and rapid surgical procedure. The authors' results suggest its effectiveness for treatment of postmastectomy pain syndrome.
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I wonder WHY fat grafting works for pain--does it have something to do with the stem cells in the fat?
Re: botox injections...I had botox injected into my pec muscles when I had my expanders put in. I felt minimal pain, but I could also NOT contract my chest muscles for basic things like sneezing and looking over my shoulder when backing up the car. It's more of a muscle paralytic than a nerve paralytic, I think.
Of all the topics here at BCO, this one breaks my heart second-most (Stage 4 being the worst, to me.) The pain that comes out of the blue, so misunderstood, so intense--it's horrible. And that a surgeon would imply when it's "time" for someone to be off pain meds just pisses me off. PMPS is a very complex situation, perhaps a form of CRPS. It needs to be managed by qualified pain docotrs.
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Was your dr.your BS or PS? Sounds like the attitude of both my drs. That's why I moved on to a pain clinic where I am seeing a dr with hope that he can help me. Feeling better mentally has helped me cope a bit better with the pain. I'm not saying the pain has gone away but I now have a dr. who wants to try other things to improve my quality of life.
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Haven't been on this thread for a while as no new info. Since my BMX in Aug. 2010 I've had upper back pain and have been through a whole slew of diagnoses and treatments. Now I think the PS my have it right.
When I saw him last week I mentioned that after I've been up doing things with my arms for a while I start to get back pain. I've also noticed that my bra gets so tight I have to get it off right away. He feels it is swelling in the breast area that causes referred pain to my back.
Of course that explains why it feels better if I put on a tight camisole. I can also kind of prevent it by wearing a compression camisole from the start. But I still have back pain after working for a while on anything.
My hobby, quilting, requires a lot of arm movement, ironing, cutting--all things that make it all worse. I do feel pretty bad that I'm now sort of limited. But the thing is, I'm so vain and I like the implants so much I'd rather keep them and work with the problem.
Anyway, if this helps anyone I'm happy for that. I take Vicodin, about one a day but it's only mildly effective. The NSAIDS wipe out my stomach and don't work well either. I guess it's just a mechanical problem.
The good part? I'll never be able to vacuum again!
Lynda
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Anne...how long did the pec muscle paralizing go on? Doesn't it wear off by the time you get your implants? I' just don't want to risk getting PMPS... Because the PS I does botox is the only reason I chose him...other than everyone seems to think he's a miracle worker. I don't think I could live on pain meds...tried it with rsd pain...I was the walking dead. I felt half asleep all day. I need to focus for my job.
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dragonfly- could the swelling in your chest be lymphedema??? I have LE in my trunc and arms and when I am swollen I have a lot of pain issues. Check out the Lymphedema forum - there is some great information there...pain meds did not help my LE pain unless there is an anti inflammatory aspect to the drug...
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