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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18671
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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A year ago last May I had a lobectomy, right lobe and part

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A year ago last May I had a lobectomy, right lobe and part of the second. Surgery went
extremely well but I have had a quasi severe pain under right breast upper rib cage which often radiates to left side. I have had to be on pain pills ever since. I have recently had
two injections in my back by a pain management doc but to no avail. I have had all kinds
of tests which show nothing. Any suggestions?
It will help if you could provide some further information:
What medicines have been tried to help with the pain?
Do you take any other medicines for any other medical problems?
Customer: replied 4 years ago.

Gabapentin (?) Had a terrible reaction....had to stop

Lyrica - Another reaction similar to Gabapentin.....had to stop

Then I was sent to a pain management doc.

I take Advair, Flonase, a blood pressure water pill and a cholesterol pill

Thank you for the additional information.

The usual reason for persistent pain after surgery such as you describe is because the surgery affected a nerve, causing it to fire abnormally, even though there is no condition that is making the nerve perceive pain. It is also possible to develop pain from inflammation that has developed along the site of surgery, but the nerve pain would be more likely.

The treatments that have been tried to this point also suggest that the doctor also thought that this was the cause of the pain, because the gabapentin and pregabalin are anti-seizure medicines that work to relieve nerve pain by suppressing the firing of the nerve. These medicines are used for a wide variety of chronic pain syndromes, but are particularly helpful in nerve mediated pain. A nerve block is another reasonable option to try, although it obviously did not help in your case.

The next option that would usually be considered would be to use a different class of medicine that also may suppress the firing of the nerves carrying the pain message. There are some other anti-seizure medicines that can be used, such as carbamazepine, but since you reacted to the previous anti-seizure medicines, it would be reasonable to try a different class of medicine. There are several antidepressants that also have been shown to help ease nerve mediated pain, such as nortriptyline and duloxetine, and using one of these medicines would be the option that I would usually attempt next.

If you have any further questions, please let me know.
Customer: replied 4 years ago.

Thank you for the suggestions I will mention them to my doctor and see

what he says.

I have had a cough for years for which I take Hydrocodone but these shots seem to have taken care of them.

It is good that the cough is better, but hopefully you can tolerate one of these medicines and get some relief from the pain.
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