Pain management 5 days post UMX

Diles
Diles Member Posts: 8
edited March 2020 in Pain

Hi all,

I’m about 5 days out from a left UMX/sentinel node biopsy without reconstruction. I’m having a fair amount of pain that seems to randomly come and go and I’m having some issues getting pain meds from my surgeon. Initially they prescribed 8 pills of hydrocodone 7.5/325 and very grudgingly prescribed 4 more as a refill and said they would not prescribe any more than that.

Feeling like I need to budget my pain medication is causing me a substantial amount of stress but I also keep hearing about people who had my surgery who never needed anything stronger than Tylenol. I sort of resent being treated like a drug seeker but also question why I seem to have more pain than normal. Maybe I’m just a wuss

Has anyone had this experience? Any advice?


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Comments

  • Beesie
    Beesie Member Posts: 12,240
    edited March 2020

    Diles, different people have different amounts of pain. And the SNB in particular can cause shooting pains - not constant, but when the pain hits, it can be brutal.

    Having said that, doctors are very careful these days to not over-prescribe opioids because they are so addictive. Since you've been told that you won't be getting any more hydrocone, have you asked if there is anything else that they can prescribe that is stronger than an OTC pain killer, but not an opioid? And have they advised you about what to do about the pain, or asked to see you to ensure that you are healing well and that there is no infection?

    As a suggestion, the hospital nurse at my facility said that after a few days on an opioid (if needed), if still in pain, we could switch to a combo of Tylenol and Advil. I would never have put two different pain meds together, but I asked my home care nurse about it and she agreed that it's a good combo. I've used it and it works great for me - much better than either Tylenol alone or Advil alone. So you might ask about that. My hospital said not to use ibuprofen until 3 days after surgery, but you are past that so it should be okay unless there is a physical reason why you can't or shouldn't be taking ibuprofen.

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  • flashlight
    flashlight Member Posts: 698
    edited March 2020

    Diles, I didn't have a UMX, but after my lumpectomy I found gabapentin 100mg really helped with those shooting nerve pains. My BS gave me 5 capsules for 5 nights and refused to give me a refill due to hospital policy. I emailed my primary and she agreed I needed it and called it in to my pharmacy. I just had a total hysterectomy. I was told to take 800mg of Ibuprofen every 8 hours, one Tylenol every 6. The pain was bad only for 3days then tolerable. I ended up taking the ibuprofen twice a day with ES Tylenol in-between. The hospital seems to have discharge pain medications for what you had done, not for the pain/discomfort individuals might have. Your primary doctor should be able to help you.

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  • BellasMomToo
    BellasMomToo Member Posts: 305
    edited March 2020

    Diles: When I had my UMX and SNB, my BS used a 'nerve/pain block' so I felt very little pain afterwards. I was given a RX for about 4 days of Norco, but I really didn't need it. ES Tylenol helped with my minimal pain.

    Don't think you're a wuss. If your surgeon didn't use a nerve/pain block, then of course you would feel more pain afterwards.

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  • Doggielover73
    Doggielover73 Member Posts: 19
    edited March 2020

    Diles, I had a very similar experience after my lumpectomy and bilateral oncoplastic reduction. i had extreme pain for 3 days post op and my PS refused to give me any meds post surgery other than Tylenol or Motrin. The recovery nurse finally got a resident to prescribe tramadol (which actually did nothing until day 4) I called their office everyday and they continued to refuse me... I also was made to feel like I was “drug seeking”. It was so incredibly upsetting to me, these medications were developed for post op pain and I believe a few days would have allowed me to have a much more comfortable recovery. I am having a BMX in a week and am so nervous that I will be in pain again after the nerve block wears off

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  • LiveLoveLaugh2020
    LiveLoveLaugh2020 Member Posts: 322
    edited March 2020

    Diles you are not a wimp. I was in a lot of pain post bil MX after the nerve block wore off (I also had 2 surgeries in 1 week). I was also only given a few pills and I think it's absurd. This is a major surgery. Most men can't even take a cold, imagine if they had to go through something like this?

    I don't agree with the amount of post op pain meds that are given. People shouldn't be made to feel guilty/made out to seem as if they were drug seekers. The medical system is very advanced these days and you can see when and how often someone is prescribed meds. (Therefore they would know those who are guilty). This is a totally different situation where these meds are needed for some!

    Luckily after having to have to go through the second surgery a week later my PS office prescribed more meds.

    I am not someone that likes to take medication at all but when you need them you need them. I hope you start feeling better soon!

    Were you given any muscle relaxers?

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  • HeartShapedBox
    HeartShapedBox Member Posts: 172
    edited March 2020

    Diles, I too had bad pain after surgery and my BS begrudgingly gave me 7 pills. I suffered badly for a couple weeks before meeting with my MO, who willingly offered a decent sized prescription (finally!) with the caveat that if I needed more at any point I would need to sign a pain contract with him. Ask your MO or primary care Dr- I think besides overreaction to opioid addiciton (who needs opiods, if not people fresh out of surgery?!?) surgeons (who don't spend as much time with us long term thus aren't well suited to supervise med "abuse") are more leery of prescribing pain meds than the DR's who can " keep an eye on us".

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  • Diles
    Diles Member Posts: 8
    edited March 2020

    Thank you all so much for your responses. I am reassured but also saddened that I am not the only one to go through this. I think there is a lot that medicine doesn’t understand about pain and how it is experienced differently by different people.

    You all have given me a lot of great advice. I will ask about Gabapentin for nerve pain and contact my PCP about pain meds. HeartShapedBox, that is a great insight about why surgeons are more careful about prescribing opioids, and LiveLaughLove2020, I have noticed how male members of my family have been treated differently after surgery (never questioned about requesting refills on pain meds, etc).

    Doggielover73, I agree it’s very upsetting to be treated that way, almost as upsetting as the pain itself. I wonder if some of the advice provided here might help after your BMX. Maybe your primary care doctor would be more receptive. Sending lots of positive energy your way for that!

    I’m supposed to get my final UMX/SLNB path results tomorrow, I’m hoping I won’t need any more nodes removed..




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  • Doggielover73
    Doggielover73 Member Posts: 19
    edited March 2020

    Diles, the wait is so hard for those path reports, glad yours is coming back today, good vibes coming your way! I have already spoken with my Gyn for a backup plan after surgery, she’s the best

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  • DebAL
    DebAL Member Posts: 877
    edited March 2020

    Diles, hang in there. You are not a wuss. The ibuprofen/Tylenol is a good combination. I was also prescribed flexeril which is a muscle relaxant. I wish I would have taken it more often from the beginning DUH but I didn't. Some of the pain we experience is musculature in nature. Once I threw that in along with the ibuprofen/ Tylenol it was much better. Take care

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  • Diles
    Diles Member Posts: 8
    edited March 2020

    Thanks, DebAL! I’ll ask about flexeril.

    Just as an update, I had my first follow-up today (negative nodes, thankfully), and when I told the NP about my continuing pain issues, she told me that one of my drains was situated right where I was having a lot of pain and swelling. (When I asked her about it the day after the surgery, she didn’t mention that and only told me that I was “hyper-aware” and needed to “stop looking for problems.”) There has to be a better way to communicate with patients! Anyway, I’m cautiously optimistic that the pain will improve now that the drain is out.

    Thanks again for the responses, I appreciate your support!

    Did anyone have increasing pain when they started PT? I’m hoping that will help too but unsure if it’ll be rough in the short-term

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  • Doggielover73
    Doggielover73 Member Posts: 19
    edited March 2020

    is flexeril the best for pain post surgery? I’d much rather have that than narcotic. I’m very nervous about my pain not being controlled after this surgery like my last!

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  • Nana2-8
    Nana2-8 Member Posts: 66
    edited March 2020

    Diles - I hope each day is becoming better for you. I'm sincerely interested in your recovery and adjustments since I am anticipating much the same sort of surgery. We all learn from each other. So happy to hear there was no node involvement. Please continue to update....or private message me. Thanks, and good luck.

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  • Diles
    Diles Member Posts: 8
    edited March 2020

    Nana2-8, I believe that the drain is causing the bulk of the pain, so I’m cautiously optimistic that things will improve when it’s removed.

    That being said, I’ve learned that it’s hard to predict the experience that anyone will have going through this.

    It seems to be the more common experience that women find the pain mostly manageable - I truly hope that is the case for you.

    IF you do end up experiencing pain that you find unmanageable, be prepared to do some advocating for yourself. I’m in healthcare, and have a number of theories of why some women experience more pain than others. At the end of the day, we know very little about pain science.

    Hopefully your doctors would never do this, but don’t let them make you feel bad about asking for more or different pain management, as devastating as it can be to be made to feel like a drug-seeker by a doctor you trust. And don’t be afraid to reach out - The advice I’ve received from the folks here has been really helpful.

    Feel free to message me anytime


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  • abc54321
    abc54321 Member Posts: 35
    edited March 2020

    Diles, I had surgery March 13th - mastectomy and lymph nodes. I was given a nerve block and went home the same day. I felt amazing for about 2-3 days, then the discomfort from the tight bandage kicked in. I think it was really pressing on one or both of the drains, and it was hard to breathe. Last night we unwrapped the ace bandage and now it's wrapped snug, but not breath constricting.

    I see the surgeon tomorrow and hope the drains come out, but output volume is still a little high. When do you think you will get yours out?

    All I was given for pain was Advil 600 mg and Tylenol, 500 mg. I took them as directed, but they upset my stomach at that amount, so I've backed off and now there's a pain like an icepick on my side (suspecting a drain). I would have loved to have another nerve block, but I guess they don't want you to overdo, and I would because you feel So Good when you are out of pain.

    Someday there will be a meter that doctors can use to measure the amount of pain each patient feels, because everyone is different. You are NOT a wuss. Pain can cause a delay in healing, so it's important to keep it at least tolerable.

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  • Diles
    Diles Member Posts: 8
    edited March 2020

    abc54321, thanks for the support and I'm so sorry you're going through this pain. I imagine you have gotten your drains out by now, and I hope you experienced some relief. I certainly did! I think those drains can be pretty rough on the surrounding tissue.

    Unfortunately, I've developed some pretty intense nerve pain in that whole area (chest, armpit, back of my upper arm). I have mostly given up on getting help on this from my surgeon and have started researching gabapentin and other options through my PCP. .

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  • bcincolorado
    bcincolorado Member Posts: 5,758
    edited March 2020

    Good. See if you can referred to physical therapy when the whole virus thing slows down as well. I was able to see someone who specialized in helping breast surgery patients and my therapy also included about 15 or 20 minutes of massage of the area to help get those muscles loose as well which can cause pain as well. Check with your insurance and your docs about the possibility for you.

    Meanwhile I was also told to try ice packs and often used put those on the area where it hurt for a few minutes (only about 5 or 10 minutes max). It kind of numbs the area and may help calm things down and cause less pain for you.

    Definitely try the combo of OTC pain stuff mentioned as well.

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