Thoracotomy

Definition

Thoracotomy is the process of making of an incision (cut) into the chest wall.

Purpose

A physician gains access to the chest cavity (called the thorax) by cutting through the chest wall. Reasons for the entry are varied. Thoracotomy allows for study of the condition of the lungs; removal of a lung or part of a lung; removal of a rib; and examination, treatment, or removal of any organs in the chest cavity. Thoracotomy also provides access to the heart, esophagus, diaphragm, and the portion of the aorta that passes through the chest cavity.

Lung cancer is the most common cancer requiring a thoracotomy. Tumors and metastatic growths can be removed through the incision (a procedure called resection). A biopsy, or tissue sample, can also be taken through the incision, and examined under a microscope for evidence of abnormal cells.

A resuscitative or emergency thoracotomy may be performed to resuscitate a patient who is near death as a result of a chest injury. An emergency thoracotomy provides access to the chest cavity to control injury-related bleeding from the heart, cardiac compressions to restore a normal heart rhythm, or to relieve pressure on the heart caused by cardiac tamponade (accumulation of fluid in the space between the heart's muscle and outer lining).

Demographics

Thoracotomy may be performed to diagnose or treat a variety of conditions; therefore, no data exist as to the overall incidence of the procedure. Lung cancer, a common reason for thoracotomy, is diagnosed in approximately 172,000 people each year and affects more men than women (91,800 diagnoses in men compared to 80,100 in women).

Description

The thoracotomy incision may be made on the side, under the arm (axillary thoracotomy); on the front, through the breastbone (median sternotomy); slanting from the back to the side (posterolateral thoracotomy); or under the breast (anterolateral thoracotomy). The exact location of the cut depends on the reason for the surgery. In some cases, the physician is able to make the incision between ribs (called an intercostal approach) to minimize cuts through bone, nerves, and muscle. The incision may range from just under 5 in (12.7 cm) to 10 in (25 cm).

During the surgery, a tube is passed through the trachea. It usually has a branch to each lung. One lung is deflated for examination and surgery, while the other one is inflated with the assistance of a mechanical device (a ventilator).

A number of different procedures may be commenced at this point. A lobectomy removes an entire lobe or section of a lung (the right lung has three lobes and the left lung has two). It may be done to remove cancer that is contained by a lobe. A segmentectomy , or wedge resection, removes a wedge-shaped piece of lung smaller than a lobe. Alternatively, the entire lung may be removed during a pneumonectomy .

In the case of an emergency thoracotomy, the procedure performed depends on the type and extent of injury. The heart may be exposed so that direct cardiac compressions can be performed; the physician may use one hand or both hands to manually pump blood through the heart. Internal paddles of a defibrillating machine may be applied directly to the heart to restore normal cardiac rhythms. Injuries to the heart causing excessive bleeding (hemorrhaging) may be closed with staples or stitches.

Once the procedure that required the incision is completed, the chest wall is closed. The layers of skin, muscle, and other tissues are closed with stitches or staples. If the breastbone was cut (as in the case of a median sternotomy), it is stitched back together with wire.

Diagnosis/Preparation

Patients are told not to eat after midnight the night before surgery. The advice is important because vomiting during surgery can cause serious complications or death. For surgery in which a general anesthetic is used, the gag reflex is often lost for several hours or longer, making it much more likely that food will enter the lungs if vomiting occurs.

For a thoracotomy, the patient lies on his or her side with one arm raised (A). An incision is cut into the skin of the ribcage (B). Muscle layers are cut, and a rib may be removed to gain access to the cavity. (C). Retractors hold the ribs apart, exposing the lung (D). After any repairs are made, the cut rib is replaced and held in place with special materials (E). Layers of muscle and skin are stitched. (

Illustration by GGS Inc.

)

Patients must tell their physicians about all known allergies so that the safest anesthetics can be selected. Older patients must be evaluated for heart ailments before surgery because of the additional strain on that organ.

Aftercare

Opening the chest cavity means cutting through skin, muscle, nerves, and sometimes bone. It is a major procedure that often involves a hospital stay of five to seven days. The skin around the drainage tube to the thoracic cavity must be kept clean, and the tube must be kept unblocked.

The pressure differences that are set up in the thoracic cavity by the movement of the diaphragm (the large muscle at the base of the thorax) make it possible for the lungs to expand and contract. If the pressure in the chest cavity changes abruptly, the lungs can collapse. Any fluid that collects in the cavity puts a patient at risk for infection and reduced lung function, or even collapse (called a pneumothorax). Thus, any entry to the chest usually requires that a chest tube remain in place for several days after the incision is closed.

The first two days after surgery may be spent in the intensive care unit (ICU) of the hospital. A variety of tubes, catheters, and monitors may be required after surgery.

Risks

The rich supply of blood vessels to the lungs makes hemorrhage a risk; a blood transfusion may become necessary during surgery. General anesthesia carries such risks as nausea, vomiting, headache, blood pressure issues, or allergic reaction. After a thoracotomy, there may be drainage from the incision. There is also the risk of infection; the patient must learn how to keep the incision clean and dry as it heals.

After the chest tube is removed, the patient is vulnerable to pneumothorax. Physicians strive to reduce the risk of collapse by timing the removal of the tube. Doing so at the end of inspiration (breathing in) or the end of expiration (breathing out) poses less risk. Deep breathing exercises and coughing should be emphasized as an important way that patients can improve healing and prevent pneumonia.

Normal results

The results following thoracotomy depend on the reasons why it was performed. If a biopsy was taken during the surgery, a normal result would indicate that no cancerous cells are present in the tissue sample. The procedure may indicate that further treatment is necessary; for example, if cancer was detected, chemotherapy, radiation therapy, or more surgery may be recommended.

Morbidity and mortality

One study following lung cancer patients undergoing thoracotomy found that 10–15% of patients experienced heartbeat irregularities, readmittance to the ICU, or partial or full lung collapse; 5–10% experienced pneumonia or extended use of the ventilator (greater than 48 hours); and up to 5% experienced wound infection, accumulation of pus in the chest cavity, or blood clots in the lung. The mortality rate in the study was 5.8%, with patients dying as a result of the cancer itself or of postoperative complications.

Alternatives

Video-assisted thoracic surgery (VATS) is a less invasive alternative to thoracotomy. Also called thoracoscopy, VATS involves the insertion of a thoracoscope (a thin, lighted tube) into a small incision through the chest wall. The surgeon can visualize the structures inside the chest cavity on a video screen. Such instruments as a stapler or grasper may inserted through other small incisions. Although initially used as a diagnostic tool (to visualize the lungs or to remove a sample of lung tissue for further examination), VATS may be used to remove some lung tumors.

An alternative to emergency thoracotomy is a tube thoracostomy, a tube placed through chest wall to drain excess fluid. Over 80% of patients with a penetrating chest wound can be successfully managed with a thoracostomy.

See also ; Thoracoscopy .

Resources

books

Bartlett, Robert L. "Resuscitative Thoracotomy." (Chapter 17). In Clinical Procedures in Emergency Medicine. Philadelphia: W. B. Saunders Company, 1998.

Townsend, Courtney M., et al. "Thoracic Incisions." (Chapter 55). In Sabiston Textbook of Surgery. Philadelphia: W. B. Saunders Company, 2001.

periodicals

Blewett, C.J. et al. "Open Lung Biopsy as an Outpatient Procedure." Annals of Thoracic Surgery (April 2001): 1113-5.

Handy, John R., et al. "What Happens to Patients Undergoing Lung Cancer Surgery? Outcomes and Quality of Life Before and After Surgery." Chest 122, no.1 (August 14, 2002): 21-30.

Swanson, Scott J. and Hasan F. Batirel. "Video-Assisted Thoracic Surgery (VATS) Resection for Lung Cancer." Surgical Clinics of North America 82, no.3 (June 1, 2002): 541-9.

organizations

American Cancer Society. 1599 Clifton Rd. NE, Atlanta, GA 30329-4251. (800) 227-2345. http://www.cancer.org .

Society of Thoracic Surgeons. 663 N. Saint Clair St., Suite 2320, Chicago, IL 60611-3658. (312) 202-5800. http://www.sts.org .

other

"Detailed Guide: Lung Cancer." American Cancer Society. [cited April 28, 2003]. http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?dt=26 .

Diane M. Calabrese Stephanie Dionne Sherk

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?

Thoracotomy may be performed by a thoracic surgeon, a medical doctor who has completed surgical training in the areas of general surgery and surgery of the chest area, or an emergency room physician (in the case of emergency thoracotomy). The procedure is generally performed in a hospital operating room , although emergency thoracotomies may be performed in an emergency department or trauma center.

QUESTIONS TO ASK THE DOCTOR

Why is thoracotomy being recommended?
What diagnostic tests will be performed to determine if thoracotomy is necessary?
What type of incision will be used and where will it be located?
What type of procedure will be performed?
How long will is the recovery time and what is expected during this period?
If a biopsy is the only reason for the procedure, is a thoracoscopy or a guided needle biopsy an option (instead of thoracotomy)?

Also read article about Thoracotomy from Wikipedia

User Contributions:

mwaka liswani

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this is a very beneficial topic if you could kindly add approaches to thoracotomy

nere jhun m. florentino

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kindly sent me some others data of thoracotomy and procedures.

fran

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This is great information. What I can't find anywhere is length of time for recovery at home - for instance - how long to have pain in general? How long to have pain after activities? How long before I do more demanding activities? Thanks.

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Fran, from some of the recent research I did for my dad, most articles say 6 to 8 weeks recovery at home. Also most of them say to wait after 8 weeks before anything strenuous and that is of course after consulting your doctor.

Very good article. Thanks.

Linda

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What is a "Limited" Thoracotomy?
Thank you. Excellent article!

kathryn plyler

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I had my thorocotomy with biopsy on 5/8/09. I 'm still very sore, still taking pain medicine. I'm walking 20 minutes per day, but very slow moving. I have 3 insicions. One on my back where the video camera was put in, one under my right breast, one on my right side where the chest tube was. I am very surprized how painful this has been. One of my doctors mentioned a 6 months period to recover. Is that true??

moi

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FYI.this a good information regarding trachotomy surgaery

Rabia

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Hi everyone. Love truth, and pardon error. Help me! Please help find sites for: Opalescence pf directions. I found only this - to use opalescence teeth. This infinite comes no hexagonal character. More still a rate has to be called to a light popular scattering. THX :cool:, Rabia from Marino.

Marie

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I am due to have this procedure and this was great info my doctor explained very little of the entire procedure i had no idea it was intense - i am not a canadite for needle biopsy or thorascpy being i have multiable enlarged lymphnodes located in the space betwen my heart and my lung on the left of my aorta - i didnt know thye had to cut the breast bone - im really scared ! the women who said she has been in pain since having her surgery how long were you in the hosiptal and did they give you enough pain meds to kill your pain that is my biggest fear ive suffered long term chronic pain for years and was on pain meds so i have i very high tolerance what would one persons pain takes triple on me- when you woke up from the surgery where you in pain as soon as you opened your eyes and did you have any trouble breathing afterward shortness of breath ?

Sean

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I just had this surgery 7 days ago. I spent 5 days in the ICU and was discharged right from there. There was not VSAT, I had a 33 staple incision, my ribs peels apart and someone's hands in there to remove a fist-sized tumor. I am not on any pain meds now, and have not had anything int he last 24 hrs, Stanley cup playoffs are helping with the pain!! I did not get a very good discharge, so I do not know how long this is going to hurt, admittedly I am a fit 40 YO who has been exercising everyday for the last 20 years, and I do not quit! Staples out in 5 days and I think I will be back at work in the next 4 weeks or so, but I am still wondering how long before I can get back to hockey and running and all the other activities I do?

Dave

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I'm having this surgery on 7-28-10. The surgeon hasn't said anything about pain afterward, but did order an epidural, I'm assuming for pain. He said I'd be in ICU for 2 days & a regular room for 3. Then, remove the stitches a week after I come home & resume normal activities immediately after the stitches are out. Hopefully, he'll be right.

Richard

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I am now 8 years beyond 3 thoracotamy surgeries and still remain lung-cancer free, making me lucky.
I had these when I was 58, and it took me awhile to fully recover. Even though I lost 40% of my lungs, I have hiked and worked out and learned to breath a little differently. (Breath in through nose and then out through pursed lips - this maximizes exchange of O2 to take place).

About healing--it took me more than a year to get where I began to feel comfortable. But right from the start, I began walking and slowly increased my distances. I found that using a pedometer to keep track was helpful and after two years was logging about 600 miles a year. This also presented a challenge to me and gave me focus to push on.

I have recently had some heart issues and am now wondering if the extra hard breathing I have had to do while hiking/climbing has caused some of these issues. Docs are looking into it. So, wishing luck to each of you!

apple

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please add detailed interventions for post thoracotomy patients. i would like to know more on how to position these patients and if they will have bathroom priveleges. Will they be put in a ventilator? suctioned? or any other simple yet very important and often neglected actions to care for these patients..thank you very much for sharing your knowledge to me..

Steve

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I am 59 yo male,(Lung Cancer, right upper lobe Mass) I had my right upper portion lung and 4 (front and back) ribs removed. It has been 4 weeks now in recovery. My right side stays in discomfort, I noticed, if I exercise my right arm, my right side is in pain. I am on pain meds. I'm not sure how long this is going to be. I am in the Security field of work, and Doctor told me I won't be able to do push ups after a year. Next week I see a Rehab clinic and see how I do on the treadmill. Today I see the Chemo Dr. and find out the next procedure. Feel free to email me.

LeonardBloom

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My 67-year-old wife has been diagnosed with what appears to be a thymoma according to her CT and PET scans. We have seen doctors at Moffitt in FL, where we live and a thoracic surgeon at Sloan-Kettering and M.D. Anderson. At the latter institution, the thoracic surgeon said that they do not remove thymomas, or other mediastinal tumors, etc., without first performing a needle biposy to determine first what the tumor exactly is. The other two surgeons claimed that it is not necessary to do a fine needle biopsy since they have to go into the cavity in order to remove it- one procedure. It's location is lower in the chest cavity than normally seen by surgeons close to the periocardium of the heart just above the pulmonary artery. We may see a fourth and final thoracic surgeon at Mass General Hospital to weigh all the different opinions we have received to make a final decision. One personal question that nags us: age. One surgeon is 63, the second is 51, the third is 37 and the fourth (if seen) is 41. Should a surgeon's age, therefore, be a factor? We need HELP before the decision is made. Lastly, the tumor was accidentally found while my wife was having a stress test at her cardiologist's office during an anuual appointment. She is in fine health otherwise. Many thanks.

Steve

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I was recommeded by other Doctors in the area to see the Doctor that removed the Cancer in my Lung. I wouldn't think age is the factor, I would think reputation and success rate in his profession is the key. Hope this helps. God Bless~

Marge

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Assuming there no complications and general recovery is complete, what is the eventual breathing capacity after one chamber is removed? Will the patient forever experience shortness of breath? Will it be continuously strenuous to climb one flight of stairs?
Marge

Nina

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I had a thorascopy done on January 12 (11 days ago) as a biopsy to identify a large mass in my anterior mediastinum.
They made 3 incisions: 1 for the scope - 1 for the chest tube -and one in the crease under my right breast. I was originally told I would be in the hospital for 5 days - they made me leave less than 24 hours later even though I said I wasn't comfortable going home yet.
Anyways, I found that all of the pain I was experiencing was where the chest tube had run under my breast. 11 days later I'm still highly dependant on my painkillers and even they don't take the pain away half the time! I can't wear my bra so I've been walking around basically holding my boob up so the weight isn't on the area where it hurts. It's unbearable.
Has anyone else had this much pain from the chest tube??

Nick

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Good day everyone. Just wanna share my story. I was diagnosed having mediastinal mass during pre-employment medical exam last may 2010. I didnt kn0w before that i do have tumor on my left lung c0z i d0nt have any S/Sx at all. I seek 2nd, 3rd opinion with other DR. To seek clarification and advice what to do. I undergo chest x-ray in different angles, chest biopsy guided ct-scan, Ct scan with contrast and MRI. Fortunate enough it was not CA type, about golf ball in diameter and doesnt reach my spine which is very delicate part. I undergo surgery last jan.3 2011 after they found out that im good candidate for surgery. You can search info. On the net and never be afraid or hesitate to ask questi0n on whats on your mind c0z they are m0re knowlegeabe enough on that condition. My surgery goes smoothly as what is plan. Almost a m0nth of recovery, i have intense pain which is n0rmal but with pain meds. Prescribe with Drs. It lessen a bit and kinda tolerable. Practice deep breathing exercise, avoid lifting heavy objects on operative site, avoid bending, valsalva maneauver, proper positi0ning and eat nutritious food. I hope i share g0od info. Guys. By the way im a male registered nurse here in the philippines.

KRISTINE

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NURSING CARE TO THE PATIENTS AFTER THE THORACOTOMY

ch??ristine iannuzzelli

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If a physcian recommends that a patient have a lobectomy for lung cancer, how many lobes could be excised from each of the luns while still leaving at least one lobe?

pat seraj

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I AM TWO WEEKS POST OP FROM RT UPPER LOBE TUMOR REMOVAL BY THORACOTOMY.
AFTER THE OP I WAS MANAGED WITH AN EPIDURAL.GREAT RELIEF OF PAIN.
WHEN THE EPIDURAL WAS REMOVED THERE WAS A GREAT DEAL OF PAIN BUT WAS MANAGED WITH PAIN MEDS.
FOUND I WAS VERY WEAK WHEN DISCHARGED HOME.DOING BREATHING EXERCISES AND MOVING MORE EVERYDAY.FIND I HAVE STRANGE SHARP PAINS NOW AND AGAIN.CANNOT DO ALL I WANT TO DO,VERY FRUSTRATING.
I LIVE IN SAUDI ARABIA AND I AM FLYING TO LONDON TO DO THE( WALK FOR LIFE )ON THE 7TH OF MAY FOR MY FRIENDS WHO ARE SUFFERING THE SAME DISEASE.
WISH ME LUCK

wendy

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I had a thortoacotomy on april 15th 2011. my main problem is that i now have very limited function of the arm that was stretched ov ermy head during surgery. I had some previous nerve damage with prior surgery for a tumour over the bracial plexus o fht e same arm, but was wondering if anyine else has had problems with arm pain post op. Is this a standard resposne or just oarticular to me because of previous surgery? Appreciate any feedback. I am, or was an active sportperson prior to the op (49yo female) and its heartening to hear that some have been able to resume an active lifestyle. best wishes to all those recovering from this difficult op.

Steve

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I had my back, right side opened up (see 17 Nov post). I am still in pain, stiff on the right side. Stretching the right shoulder helps some. I was told it will take some time to feel normal again.

Josie

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How long after having the tube in your body to drain before it is removed? And does anyone know what causes all the fluid build up in the lung? I am asking because my sister has been in the hositpal for over 3 weeks and still over 200cc being drained each day. Thank you

J

Steve

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@Josie, The tubes were in me for approx 3 weeks. I had an Lobectomy done, with 4 ribs removed. It took awhile the chest cavity area to dry out. It was painfull when the tubes were in me, and it hurt when the Doc took it out, about 12 inches. Once it stops draining, you'll see, because you have to log the results. It takes time, just rest, pray, and try to get some sleep.

elena

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My surgeon told me recovery to get back to full activities[going to the gym] was 3 months. I am now at 2 months post op and certainly not ready for the gym. I am walking at a stroll right now for exercise. My endurance is limited. I tire after 2-3 hours. My dr. did not tell me about recovery time prior to surgery. I realize we all heal at different rates, but I also think they don't want us to hold a number in our heads, but to do as our bodies direct us. The surgery itself for me was very painful as I also had a lung wedge resection, so that has slowed my recovery along with a persistent cough caused by an irritated trachea after surgery. The first three and a half weeks were very rough. I needed a caregiver during that time, as well as 5 days hospital stay after surgery. My dr. did not give me any strong pain meds upon discharge,and it was excruciating.

janice braddock

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I WAS DIAGNOSED WITH LUNG CARCINOMA IN August of 2010 and athoractomy was performed on my right
lung in January of 2011. I HAVE HEALED WELL EVEN THOUGH I turned 73 years of age yesterday. I did not really go back and talk to my surgeon after the surgery healed as it was a trip I did not feel able to make on my own and I did not want to ask my brother to drive me. I am still finding it necessary to take some prescription pain med, and in fact went to the grocery store last evening and bought two 20 lb bags of ice as well as a rather large water melon. When I got out of bed this morning I noticed fairly substantial pain under right arm, and under my right breast where I understand that this is where the incision was made (scars bear that out)and possibly ribs were spread in the area under the right breast. I assume what I am experiencing is pain as a result of heavy lifting. Should I feel concern that I could have damaged other surgery tissue, etc

Steve

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@Janice, I had an Lobectomy (Oct 2010), I was told not to lift anything over 10 lbs until next year (Jul 12). You should have it checked out. Take Care, God Bless

sooty

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Hi i had two thoracotamies last year to remove 8 tumours i left hosp after 4 days and returned home deep breathing and slow walks for first few weeks got me through the pains meds i stopped taking about 5 -6 weeks after surgery. I do get nerve pain which comes on suddenly and goes just as quick but also found that certain things aggrevate the nerves ie sitting wrong or driving for too long etc i also have weakness in arms which is very frustrating however i was told it can take two years to heal prop after major surgery so i guess i will c also the tumours havent been back and the scans are looking all good..the hosp i was at were fantastic every aspect of care was sorted from the min u walked in the door a private patient wouldnt have got any better..take care all

Steve

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I was told it will take some time to feel normal again. (surgery area) I'm trying to ween myself off the pain meds. It's been a struggle. Take Care, God Bless

Henry

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My friend was told she wouldn't be able to lift her arms for 2 mths & would take 12 mths to recover. Funny, it took her 2 mths to raise her arms & 12 mths to recover. Was also told harder for young person (38) than old because nerve endings more active. By the way, no cancer found no COPD present. Also can't skydive as she promised 2 yrs later because of the thoracotomy. Is she milking it?

Steve

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She is not milking it, it will take some time to heal. Alot of stretching, and range of motion exercises will help. Every day stretching and every chance you get is a must to get better. Take Care, God Bless !!

Nancy

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I had this procedure done on April the 8th 2011. Ihad to have this done to figure out what was causing my air sacs and lympnodes in my lungs to swell and become inflamed. I wasn't able to walk very far without being out of breath. I have never smoked and I was prefectly healthy until
38 years of age. I am now 41 and have been dealing with this for over 3 years. The DRS still have no idea what has caused this issue. My samples were sent and tested at the Mayo Clinic. I am
now taking a Chemo medication that seems to be helping. I wasn't aware that this procedure would be so invassive. I still have movement issues and sometimes it hurts to take a breath. Anyone that is having this done--make sure to stretch and use the tube to measure the pressure in your breaths it will help eventually. May God Bless you all and speedy recovers.

Lynn Bell

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My daughter had a thoracotomy as her third biopsy for lymphoma. She had to have a blood transfusion during surgery, but now has nerve damage, lung is only working 40 % and her thoriac diaphram is out of place. Does any one know what can be done. She is undergoing chemo at the present time.

elle

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I had both a thoroscopy,thorocotomy,and lobectomy. I was in the hospital for five days, really needed to stay longer but was sent home to avoid any possibility of infection from the hospital. I was in severe pain for four weeks. By week six, I was feeling better and by week eight, I was back to more normal activity. Five months later, I continue to have shooting pain from the healing of the nerve endings.

Erika Stevens

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I just had a lobectomy Oct 3, 2011 with removal of lower left lobe due to copd. After waking from surgery, was in excruciating pain as my pain meds were not ordered and it took 1 1/2hrs to resolve. I was sent home in 3 days. Should have realistically stayed 5 days. When my epideral was removed - my pain shot to an 8. It's now 10 days and making remarkable progress. Only taking tylenol to control pain. Sleeping is more comfortable and now able to walk 20 minutes. I am a 60 female living in high altitude. It helps tremendously if you have a good hard outlook. I would do this surgery again as I am now 100% (minus the lobe) for recovery.

Good luck to everyone.

Renee Carr

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In the end of October 2004 I found out I had lung cancer in my upper right lobe and it needed to be removed.I was 41. By the end of November 2004 I was having surgery I still can't believe it,it happened so fast I couldn't process it all. Anyway, the next day i started bleeding very bad and they had to go back in and fix the bleed. I was put in a coma because of the trauma to my body,my kidneys shut down,I almost died so many times. God kept me going and still keeps me goin.I didn't need to have chemo or any other treatments. I am comin on 7yrs. of survival of lung cancer. I still hurt very bad, I think it's because of the fact they had to go back in. Make sure that before this surgery you have ALL the facts!And understand them, if not ask!! God be with you and yours.

John Ferrando

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Are the stapples that are left in after upper right lung removel ever cause problems

donna

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I had thoratic surgery done four months ago.I have three small scars.one under my arm which as bad nerve damage.my drain, and one in my back.I have started getting realy bad pains in my chest.When i tiuch my chest bones or try to pick things up it is so painful.It is getting so bad now that i cannot even sleep on my side as the painis so bad.lucky for me it turned out to be TB.CAN ANY ONE HELP.GOOD LUCK TO YOU ALL

Steve

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It's been a year and 1 month since my surgery. It will take time for everything to heal, continue to take your meds, and rest. I'm sure they told you to do some range of movement exercises, do them, and it will help. At first, seems like your body is ripping apart. Just do little at a time. House and NCIS series works well :) Take care, God Bless !!

Kathy

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It's been 11 months since my thoracotomy with wedge resection of my lower right lobe. I had a small mass removed. Thank God, no cancer. I also had a collapsed lung from a biopsy. The procedure was very invasive, 9 inch scar from underneath breast bone around to my spine. I still have constant discomfort from nerve pain, some days are quite painful. I was told recovery is usually 6-12 months. I say I am about 75% back to normal but have been stuck there for several months. Hoping to be back to myself soon!

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is it possible to take a piece of wire out of a lung?

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Have been diagnosed with 1 mm typical carcinoid in central bronchia. Surgeon wants to perform surgical resection. I am active 62 year old (climb, hike) in very good health (never smoked, ideal weight, in 99% of wellness exames) employed in job requiring international travel and have no family or dependents for support. What is the risk trade for having surgery for a non-malignant slow growing carcinoid which if surgically removed (and based on the comments above) will significantly impact my quality of life, and could cost me my employment, vs probability of carcinoid bcoming malignant? Can I wait at least a year until I can arrange a support base and finances to make this work? The down side of having the surgery now is that I could lose both my job and my insurance, and then run through my retirement savings. Anyone else with a similar situation?

joshua

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I had a thoracotomy done in Oct 2008 in Germany while I was stationed there. I have a 10 in scar on my left side splitting my wing muscle and another 2 in scar under where the lung tube was. I had a tumor on my esophagus. I was in icu for 4 days and a total of 14 days in the hospital. To this day I'm in severe pain.I can't lift, run, or do any impact activities with out it feeling like my ribs are going to crack.sneezing is still painful. I have tried to deal with the pain and suck it up as a solider is supposed to but it is worse as years go by. I now have to end my military career due to the psycical demanding nature of my job. I just want to say be careful and only get this procedure if life depends on it.

David

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Bj i was also just recently diagnosed with the same illness typical carcinoid lung tumor mine is located in the right bronchus. from what they are telling me they would like to take care of it as soon as possible to avoid further complication as mine was found after being admitted for coughing up large amounts of blood and pneumonia. I'm a 23 year old medical student and it sucks to be told information like this but i think at the end of the day you have to ask are you willing to take that chance with your life. I was supposed to graduate next spring but instead i would rather take care of this thing while they can spare lung tissue than to wait until they might have to think about lobectomies or further spread of this disease. Also to be considered is though pathology shows that it is typical carcinoid tumor the important note is that there could be other types of cells that may pose a greater risk to you so once the tumor is resected it is checked again (this time the whole mass) to ensure no other type of cells are discovered. Wish the best for you I will be having my surgery within the next 2 weeks!

David

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Boyer

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Hi,
I'm happy all of you got your operations I'm sorry it's been a tuff road ahead for some of you but I thank G-d you made it and your still here!

Not so.. For my husband who suffered horribly with a intercostal muscle hemmorage and wasn't propererly given the right medical advice and everything went wrong.. I stumbled upon your discussion and this looks like this would have been the operation he needed.. To get better.. He walked around with that excurting pain for 2 yrs and died of narcotic od in sept.. Such a loss so sad..

Happy Holidays.. Your going to be ok:)

Steve

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Hello,
Sorry for your loss~ I know, I will never feel normal again, I will be in constant discomfort, maybe it's better to be dead than alive, and suffer your whole life !!

God Bless, Happy Holidays !!

camille

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To those people who are considering not getting surgery for a carcinoid, that is a big mistake. It is a cancer, and although it is slow growing, the bigger it gets the more likely it is to spread to other parts of the body, AND the more lung you will have to lose when you can no longer avoid the surgery. Mine took a long time to diagnose, but if it had been found earlier I would have saved a lobe of my lung. But I ended up losing two lobes of my right lung because it grew to block one om my main bronchial tubes completely. I cannot stress how important it is to get the surgery done as quickly as possible. Also, if you wait too long for surgery you will keep getting lung infections and your lung will probably collapse. Also, they do not know the pathology of the tumour for sure until it is completely removed, so you could have an atypical one and then your prognosis is even worse. I'm not meaning to be negative, but it is a cancer, it is not benign, and it needs to be taken care of ASAP. Do the surgery now and you will lose less of your lung.

survivor

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Having had 2 thoracotomies over a 5 yr period i have been left with awful pain that comes and goes,when i get the pain it is very gripping and severe and very incapacitating...problem being i dont think people realise just how disabling post thoracotomy pain can be.I take morphine daily and have never missed taking it for many years,before having decent pain meds i was living in total misery and had great roublein getting it across to the docs just how bad it was..i got sick of them saying it was in the mind!!! my ass it was..having had your chest opened up through trauma how can you not be in pain? so to all out there going through the same thing i implore you to make sure you get strong pain meds top ease you along the road to partial recovery...anti inflammatories worked for few days then i found they shrunk my adhesions so much that they were causing me pain through their being shrunk...truth bing it is a god awful operation with [ain on a level very seldom experienced through any other operation...good luck yo you all if going through this operation and stay strong and dont do to much after it,i tried staying active and ended up back in theatre having another one...

Ellen

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I have been reading all messages. I was in the hospital for Mono in Nov. 2011 for 6 days. Needed VATS done and was not released until Dec. 2. On Dec. 7, 2011 I had my surgery. Was in ICU for 3 days and then moved to a regular room. On the 5th day both drain tubes were removed. Went home late afternoon on the 6th day. Two weeks to the day I went back for another surgery. I had the mediastincopy done and a port placed. Stayed 2 days in the hopsital with this. Now it has been 4 weeks sinc my VATS and 3 days ago I started coughing really bad to the point I start sneezing and it hurts! I do this usually first thing in the morning when I get up and it last 3-4 hours, then I seem to be ok and not cough as much. I find that I am out of breath a lot. Is this normal? Should I call my onc or the surgeon? I am new to the Lung Cancer thing, but did have breast cancer 3 years ago. The pain is slowly getting better and I have appointents next week with onc to get ready and start chemo. I also go see surgeon next week as well. Any advice would be appreaciated.

Dot

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Ellen, I hope you have told all of your doctors about the coughing. Any irregularity or change should be discussed immediately with your health professionals. I had the horrid thorocotomy on Nov.28,2011,and experienced complications 5days later. I was hospitalized for an additional 2 weeks. I'm still recovering at home. Each day gets better, but this is the worst surgery I've ever had--and I've had some doozies, including severed ulnar nerve and reattachment surgery. Being short of breath seems to be par for the course. I expected to be back to "normal" by now, but my best day so far has been 7hours out of bed. My surgeon did an excellent job, but he lied about the recovery time and grossly underestimated the pain one goes through for weeks afterward. If my primary GP hadn't come to my rescue, I would not have received the morphine I needed in the hospital. Be sure to connect with your network of doctors, including your GP. This operation is extremely difficult and serious, so the more professionals on your side, the better. Best of luck to you in your recovery. Stay strong and positive, as difficult as it seems at times. Your situation will get better.

Amelia K

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@Dot. I am a 16 year old girl and had my thoracotomy on nov 24th 2011 and also expect to be back to normal by now, especially with being considerably younger than most patients who have this extremely invasive surgery. Had this surgery to remove a fist sized cyst, thank-fully not cancerous. But I am still short of breath and have had 2 chest infections since the surgery so have been in pain quite a lot.
I feel as if my surgeon did not really tell me the recovery time as I was taken in the day after my appointment in clinic. Always ask questions!! That I must stress!
Good luck to all having this surgery!

Jake Braden

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Hi everyone I had a thoracotomy on 23rd November 2011! Luckily I have kept my lungs intact! I am 42 years old and was a regular gym goer / weight trainer! I am wanting to know if anyone knows about going back to the gym and upping my weights and how long it takes for the area where the do the incision to heal and knit back together.

I am quite keen to get back at the gym properly I started back second week of January doing light weights! I started doing my chest again this week! I am way down on weights from doing 30kg in each arm to 16kgs! Of course I want to be mindful of the healing process! Thanks in advance! Jake

Judy

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I had a thoracotomy with a wedge resection one year ago (March 3 2011). I had a 7 cm. x 5 cm mediastinal mass (adenocarcinoma) a metastases of unknown origin (probably lung cancer, though a non-smoker) as well as a small bronchoaveolar mass right lung and a carcinoid tumor. Three cancers. Due to the massive size of the metastases (which was about to seal off my airway and was affecting my heart (palpitations) they were simply going to get a better biopsy to use the appropriate chemo, and, though it was considered inoperable, the surgeon was able to remove them. I had had colon cancer eight years previous. (Four cancers total). Nothing prepared me for the horrendous pain (previous cancer surgery, hysterectomy, child birth ... nothing). I've tried for a year to return to normal. I was very active and slowly returned to weight lifting (light weights for quite a while, slowly getting back to where I was, not sure I'll make it) and golf. I continue to live in pain ... on pain medications. Just can't seem to get beyond it. I completed 33 rounds of radiation and 12 chemo treatments (which we had to discontinue due to pneumonia and MRSA from hospital germs). I try to live a normal life, but I'm beginning to feel that it will never be normal again. I've regained the 20 lbs. I lost and muscle mass, but the pain controls my life. I still have the chest tube pain and the rib and incision pain, as well as a deep dull pain, and the stabbing pain that occurs from nerve regeneration. I think we just have to put a value on the life that we have now, keep trying to live as normally as possible and not have it affect our loved ones. I had asked God for more time and he gave it to me. Last CT scan still showed no new masses ... I'm 70 now and counting. All the best to all of you.

Jesse Allen

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Ive had like 9 spontaneous pneumothorax's/lung operations on both lungs and still going strong. The doc's took lung out to see why it was happening so much but couldnt find anything...Reasons being I gues its because im tall and skinny. They cemented my lung to the chest wall and used staples from when they cut out a great deal of lung. Im glad and very greatful that im still here to this day thanks to wonderful doctors etc...!

private

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My mother just had this type of lung surgery and the doctor accidentally hit a main artery with a stapler and she dies because of this.

Sylvia marland

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I had a thoracotomy in jan 2010 following traumatic pneumothorax, 1 was 51 at the time, my ribs were broken and punctured the lung, the paramedic who came said I had winded myself , take two paracetamol and go to bed, this was half three in morning, I went to work next day looking and feeling terrible, I gave in and went to hospital at 11.00 thenext morning, the only thing I remember was giving my name in a & e and then chest drains being inserted, I awoke 4 weeks later after pneumonia, mrsa, sepsis, empyema, kidney failure and probable everything else !!

I had been given a thoracotomy after two weeks as I had gone into total respiratory failure and was on a ventilator, I haven't worked since but am just feeling I may be able to do light work now, I get very exhausted and still have a lot of pain in Lung, have had ultrasound on wound which did help and do physio every day, parts of breast and back are still numb and I think will always be, movement in arm limited and if I lift a heavy object know about it day after!! Still alive though !!

jeff

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Hi everyone, I had my thoracotomy performed in Dec. At The Brigham and Woman's in Boston. They performed what is known as a sleeve resection of my carcinoid tumor in the right middle bronchus. I did not have to lose any of my lung function and could not say enough about the team of surgeons and nurses who cared for me. I am 41 now and developed severe breathing problems after running a marathon in the fall of 2010. Could not get any of the doctors in my area to take it seriously for nearly a year until Nov. 2011 when I began coughing up blood. When I read my Med chart later I discovered that they believed I was making it all up. None of them would order a CT scan because my pulm. function tests came back as normal, I tried to explain that a marathoner would have better than average function even when suffering, but it fell on deaf ears for months. Anyway I am now back to work as a pipefitter/ seviceman in the natural gas field. I resumed full duties as of march and while not yet able to run, I am able to perform my job with manageable levels of pain ( no meds) and feel as though the physical nature of my job is helping me get stronger and heal. I believe that my lifelong pursuit of running, cycling, and other endurance sports prepared me to tolerate a level of discomfort that most are unfamiliar with and therefore shocked by when they encounter ( surgery ) .

jeff

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jeff

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Robin

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My husband had a Thoracotomy 5 weeks ago with Right upper lobe and 3 ribs partial removed.
We recently got him on Morphine after Vicodine after surgery. He is still having bad pain especially at night and not able to sleep. I really hate to hear this might take a year to get some comfort, he is getting in the sucidal mood. Doc just keep saying you will hurt for a while but no indication of how long.

Robin

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Can someone tell me what pain meds work for Thorocotomy wiht parts of ribs taken. My husband is on or has been on Hydrocodone, then added morphine ER adn 4 hr. Neither work very well going to Pain mgmt tomorrow. It has been 5 weeks since sugery, can not sleep in bed. We think the Morphine is giving him insomnia. He was also taking Neuronton, think it did the same.

Cynthia

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I am 41 years old and had an emergency thoroctomy and labectomy on May 23rd, not due to suspicion of cancer(though I was a smoker)rather due to VERY heavy bleeding from my lungs which prompted the last ER physicians to order a test wherein they put a little camera on the end of a tube and run it through the nose and into the artieries of the lung to try and find the bleed. Don't know what the name of this test is. Outside of this bleeding, all other tests, xrays, etc came back as normal. In fact, in the past 6 weeks, I had gone to 2 different ER's and was sent home because "everything is normal""I need to find a regular physician". I had left the 2nd ER just that afternoon for the same reason(s) only to find myself bleeding more and more profusely and going to the 3rd Hospital. The previous tests and xrays were performed as well as a CT scan and the tube test was ordered. The following afternoon, the last thing I remember was being put under for that test---Things went terribly wrong during this "routine" test hence the emergency "ectomy's".

I woke up 3 days later in ICU and under quarantine for TB (which turned out to be negative) tubes in my side and huge incision and plenty of pain to go around. The pain meds that were introduced then did help to a large degree, making it tolerable so long as I remained on schedule with them. Lot's of nutrition and fluids through the IV, daily blood thinner shots in the belly, breathing treatments and daily xrays rounded out the routine. After a week total in ICU, they ruled out the TB and moved me to a regular room where I continued to improve daily. The tubes were removed this past Thursday and I was discharged on Friday June 01 never knowing what procedures were performed on me (by their proper name) and asked on Monday.

I came across this article looking up the technical terms and wow am I shocked. I had no idea that this was so serious (though I did know it is/was painful). The lady who said that this is the worse pain she has ever known including childbirth is right on the money! Without the morphine and fentnyl, the pain would be unbareable! I feel so bad (and even guilty)for a lot of you guys who seem to be stagnant (or worse) in recovery as I seem to be getting to feeling better everyday. I hope that I will be better soon but, after reading all of your stories, I will take my time with it. Best wishes to each of you and yours and God Bless us all.

Trish

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Hi - I'm 60 years old, and was diagnosed with adenocarcinoma in my upper right lobe on my birthday...what a b'day present! It was small and early and I qualified for VATS surgery. I had an upper right lobectomy and lymph node removal on April 19, 2012. I had "narcotic necessary" type pain for about 10 days then weaned off of them. I did not need chemotherapy and the surgeon considers me "cured". I know I am very lucky. Pain has not been my issue at all. Shortness of breath has. I cannot take a deep breath and I get winded just putting on my clothes. The pulmonologist said it would be 3 to 6 months to heal entirely. Strangely enough, I am able to climb hills and stairs and I swim a mile 3 mornings a week, but very slowly because of shortness of breath. Also bothered by pressure and GERD that I never had before but I guess your entire system is pretty much in a state of shock after being invaded like that. Is anyone else bothered so by shortness of breath? Will it get better? The doctors tell me the best thing is to exercise to build up the undamaged portions of the lungs so they can take over for what was removed. How long before I can expect to feel "normal"?

Cynthia

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I second Trish's question as, though pain is still a noteable problem, the most troubling for me is the shortness of breath and how easily worn out I become. Just walking to the kitchen or taking a bath, I feel like I have run marathon. I am using the little blow toy that measures the volume of breath and exercises the lungs twice a day. Should I be doing more and are there other exercises that I can utilize?

Keith Shepard

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I'm 61 years old. Up until Thanksgiving of 2011, I worked out 3 to 4 times a week. I could go 50 minutes on an eliptical trainer at medium effort with no problem!
I was diagnosed with pneumonia at Thanksgiving of 2011.
In January 2012, I was admitted to the hospital. I had a Posterolateral Thoracotomy on February 14, 2102 to remove material from my right lung to be able to run tests on the material to try and diagnos my condition. I was in the hospital for 25 days and was released 3 days after the Thoracotomy on 17 February. I have been on every kind of antibiotic known to man with no improvement. I returned to the hospital in May 2012 for another 16 days or so because I could not breathe. My Pulmonologist finally diagnosed me with Cryptogenic Organizing Pneumonia (COP). I then went to Duke University Medical Clinic to verify the diagnosis and to see if they could figure out what to do for me.
It seems that my immune system attacked itself and caused my right lung to fill with white cells. Breathing has been very difficult. I am now off of the antibiotics cause the doctors say it's not viral or bacterial. I am now on steroids which seems to be allowing my body to return to a semblance of normality. I hope and pray that in 30 days or so, the doc will reduce the amount of steroids and then in another 30 days reduce the amount even more and sometime after that to be off of them all together.

The recovery from the Posterolateral Thoracotomy has been a bear! It's been about 85 days since the surgery. My right side (rib cage) is still numb and tender and swollen. I have an 8.5 inch scar on my back and a scar on my right rib cage where the drain tube was located. Range of motion seems ok, but after mild activity, the area under the scar on my back sems to sweel. I get a swollen feeling and tenderness about the size of half a racketball. I am off of the pain meds except for some moltrin which seems to take care of most of my pain and some inflamation.

My doctor did not tell me that I would have over 4 months of recovery. I found this out a month after my surgery. My family doctor, my pumonologist and my infectious disease doctor thought I would have 3 small incisions near my rib cage and not the major incision that I did have. I also found out from the doctor at Duke that the surgeon did not take enough material from the right places in the lung.

Make sure your doctor/surgeon explains everything to you before you give permission to him/her to cut on you!

Garv

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A chest x-ray cannot tell you if you have lung cnecar, it can only tell you if there is a shadow on the lung which could mean several things, an MRI scan is needed. If the breathing and back and chest pain are because lung cnecar is present it would be in its final stage and nothing could be done. If his family wont do anything to help him they must think he is either exaggerating the symptoms or they have heard it all before?? My dad had lung cnecar and only symptom was a slight cough he had a lung removed and survived but died 3 years later of stomach cnecar I live in the UK and it doesn't cost us anything for medical treatment or xrays etc but is there not some kind of free clinic in your area your friend could go to?

Joyce

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I am a 61 year old female. I have had mulitple surgeries for reflux, last one 4 years ago that resulted in my stomach being removed and my esophagus being connected to my small bowel. Now there is a major problem at that connection. I am scheduled for a left sided thoracotomy to re-do a esophagojejunostomy. I ended up on this site because I was looking at thoracotomy. I am also concerned about post op pain. I have severe asthma, but thankfully no lung cancer or tumors. Is their anyone that has this surgery for espophagus problems?

Shane

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Hello everyone. I thought I would share some of my experience with a posterolateral thoracotomy and recovery due to valley fever infection (Coccidioides.) Reading some of the other experiences has been very helpful in knowing how others are dealing with it, and managing my expectations in recovery. I hope my experience can do the same.

I'm a 38 year old male with good fitness. The surgery was the result of a two month process of too many collapsed lungs, chest tubes, ER and hospital visits and a video assisted thoracotomy that did not resolve the lung leaking air. Once the posterolateral thoracotomy happened, and Valley Fever was found to be the culprit, it was the start of resolution.

The hospital stay should have been a week, but I spent 3 weeks with the complication of kidney failure due to blood loss during surgery. The pain was definitely there, I couldn't have the standard epidural with the then unknown infection because of the possibility of developing meningitis. So, morphine, dilaudid and then percocets were the routine for the ensuing 2 weeks after surgery. I was up and pacing around the halls of the hospital within days. Slow progress continued from walks around the block to where I was taking 7-10 mile bicycle rides in a month and a half after surgery. The bike is great due the lack of impact, any exercise or any thing at all bumpy or remotely resembling an impact will bring pain. The percocets continue as needed, I have taken 24 since leaving the hospital six months ago.

The healing of the access points is the long term annoyance. The back scar and the under the skin scarring where the surgeon went into the chest cavity from the front are still not normal - tenderness and numbness there. I have been told it could take a year or more to feel normal. There is so much healing to be done with this surgery. Consider all of the muscle, nerves and bone that has to be cut through. I am six months on from surgery and have some tightness in the muscles on the side of surgery, and occasionally a little pain with prolonged sitting in certain positions or too much exercise. I measure the progress in months. Day to day it feels the same, but month to month there is notable improvement in range of motion, strength and pain. Patience is the key.

The best bit of advice I heard was from a nurse, be involved with the process. Ask questions and be informed about what is going on - it reduces the chance of mistakes by hospital staff, plus it keeps you from feeling helpless and in the dark.

Ron

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I had emer. thoro. done due to infection 2yrs. ago.Physician retired about a month after surgery.I thank him for saving my life!Problem is,I have been in wicked pain since,when my wife touches my right chest it's like a shock,and Ifeel it on my back,instead of the front.I have been trying to find out what is wrong for two years,and have been called crazy,a drug seeker,my memory is hosed,and my life has been put on hold.I used to do all kinds of activities,ham radio,play guitar,shoot practical pistol,etc.,but all that is gone!After chasing this around with two different health plans, I finally found out last week after having new digital x-rays,that a2" piece of my seventh rib was left out,and my fifth rib is still broken!! Imagine that,I'm not crazy.Do your homework,ask the doc exactly what he is going to do before surgery.They say it's possible to go back in and put a piece of stainless bar in to fill the gap on the missing rib,and fix the broken one, but I don't know if I want to go thru the cutting again.This is only the tip of the iceberg of all the errors that happened during my stay in the icu! I finally have been given some fentanyl patches,but they are not helping like I hoped,so I guess I'll just keep on plugging away until I get this figured out! Good luck to everyone else out there!!

Paul

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Very informative. I wish I had read it before the surgery; however, if I had not had the right upper lobectomy with the melanoma it would have been a death sentence.
In all honesty it hurts a lot. I talking about excruciating pain one they take the pump out and switch you to morphine shots and hydrocodone. I found that it takes at least 10 mg every 5 hours for pain and that means if you wait six hours you wake up very painful, This is the reason someone should wake you up to take at least one pain pill. They will not normally send you home with morphine in tablet form and suspect you want the drugs to get high; however, once I took all the ones I had and was released from the surgeon my oncologist said she would up the dosage to 10 mg and take two if I need them as often as I need them and gave me two months worth. after a couple days of taking regular dosages of pain pills, you get to sleep a little more unless you role over to the effective side which wakes you up. A cough of any magnitude will wake you from the dead for about 1.5 months. You find that a sneeze is more painful, and keep in mind that you will probably get constipated. I thought nothing could get worse until I started this new drug Zelboraf for Melanoma. Just finished 1 nd 1/2 weeks and rash broke out all over and I itch like a wild man the dived naked into a bush of poison ivory. Just got told to cut the dosage in half and rubs lots of any medication that works externally and take lots of benadryl. Since it took a week to flare up it may take longer to dissipate. I hope it works, it is the only medication specifically for my condition with the least side effects. Anything has to be better than cutting another lung or part of it out. I hope this helps some of you.

Myan

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All of the comments regarding length of time it takes to heal the ribs, nerve endings, range of motion, pain management, exercises, etc. are extremely helpful and does differ slightly from person to person. As they say: take 12 people, 6 of whom are 5' tall and 6 of whom are 6' tall and the average therefore is 5'6". Hah! No one understands the pain except fellow sufferers, not even the physicians, and it is akin to kidney stone pain that comes in waves! Had the thoractomy and lobectomy for a silver dollar sized tumor in the upper right lung on August 15, 2012; with removal of the lobe and several lymph nodes, broken ribs, etc. Cancer did not spread and was encapsulated. Still working on improving my breathing and tend to get lung infections quicker than you can say "jack rabbit". The suggestion of breathing through the nose and blowing out through the mouth with lips pursed in to an "o" shape works as I am now back to doing stairs at home, shovelling a bit of snow outside, etc. Still experiencing nerve pain, albeit significantly reduced, and find that sleeping slightly elevated definately helps.

Ted lewis

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Hi Had rt lower lobectomy on Nov 29th and removal of mediastinal nodes, recovering well , it is now 6 weeks post op. Is it safe for me to fly? 2/1/2 hour flight

Suzanne

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Hi Everyone, I had a thoracotomy on July 26, 2012. I had pneumonia, pleurisy and eventually ended up with an empyema. Docs tried everything to drain the infection but ended up having surgery.I have numbness under my left breast, but the biggest problem I have now is with my ribs. It feels like they are dislocated and its driving me nuts. I was never told of the long, extensive recovery either. I have not been taking any pain meds for months . I just want to know if this is normal. The last thing I want to do is have another surgery to repair the ribs. I cannot wear a bra, cannot bend over very far and cannot lift..the pain radiates into other places in my back and sometimes when it is really acting up, into my chest. When I sleep I put a pillow under my ribs to prop them up. I feel like I can push on my ribs and move them for more comfort.. This is the first surgery I have ever had . I am 58 years old. The more I research thoracotomy the more I am shocked as to the possibiity of never fully recovering. I also have had fibromyalgia for many years. Now I have surgery pain on top of this. So far I have found nothing that helps with the fibro pain.I've tried it all. Sue

Suzanne

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Phyllis Porter

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Wow, I wish I had found this site before having my thorocotomy resection! After reading these comments I might have let the cancer eventually take me before having the surgery. The pain is the worst I have EVER had and if the cancer comes back, I'm sure I will leave it alone to do it's thing! My doctor was very good and the hospital and staff wonderful, however I was only informed about the imediate pain, not this long lasting, maybe forever pain I have. My incision was on my back, from the top of my shoulder blade in a half moon shape, 12 inches long. I have numbness from the site all the way around to center front of my chest, with pins and needles and pain I can only compare to shingles in that area, not to mention all the other places with different kinds of pain, encluding muscle pain in the oppisite shoulder and back. I was not given any physical muscle exercises, but always thought I should have been. Any suggestions other then the breathing, nebulizers and inhalers? I am thankful to be cancer free and alive but I now have doubts that I will be able to ever be able to get back to my life as it was, or even close to being a normal person without pain. One can only hope and pray for the best and let God do the rest!

Henry

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I had a thoracotomy on 2/20/13 and I'm still having severe pain at times. I'm also coughing up blood several times per day. My surgeon says this is normal after this type of surgery especially since my lung has not fully re-inflated and there is still "stuff" in the lower part of it. The surgery was performed due to a fall with ruptured multiple areas in my left lung. I am also in remission from angiosarcoma and all tests so far have been negative for cancer and will have my 3 month check up next week. My main question is: Is coughing up blood one month after surgery normal? Thanks for any information anyone can give me.

robert

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Thoracotomy oct 19, 2012. Carcinoid removed triple sleeve resection left lung. Have had physical therapy to regain range of motion and break up scar tissue. Just now starting to lift small weights. 69 years old. But still taking one oxycodone and one 600 mg ibuprofen at night. Going to start therapy three times a week next week. Very little info readily found onpainand recovery. I also still have numbness. One therapist worked on nerve muscle response to get left rib cage open so left lung would work fully. Better now but I think even with therapy and exercise I hope for somewhat near a full recovery in a year or maybe a liile more. All of the best to all of you. I think it is better to take some pain me s to get a good nights sleep. Rest along with exercise sworks best for me so far and if I don't rest well I can exercise and the i get discouraged. However I do not take pain me s during the day since I am concerned about withdrawal. I stopped them at night for awhile but didn,t progress as fast, which by the way is at a snails pace.

Bruce Kermgard

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They give you pain med in the Hospital. And not bad. My question is is sneezing or coughing out of your chest tube normal

Bella

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I had this operation in June 2012 and I was 16 when I had it, I am now 17.
I was in hospital for 7 nights due to my lung collapsing due to the chest drain being taken out to early
I wasn't expecting how much the pain would be but planning a pain medication plan would be benifical.
After the hospital stay I stayed at home for a week and then after that week started to feel better and went to see friends
But I was on mrophine and OxyContin painkillers for around 2 months after the operation.
I didn't play sport until the September but I did start ridimg my horse again 1 month after the operation.
I did think whilst I was in hospital that the operation wasn't worth how much
Pain I was in, but as I looks back on it now I am so happy I did it now !!!
I hope this helps anyone who is due to or thinking of having this surgery

joanne

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Hi everyone. My situation seems to be different from anyone else's that I've read. I had a thoracotomy in February, 2013 for a severely ruptured disc on my thoracic spine at T9-10, that my surgeon had been watching for many years, but did not want to put me through such a horrific surgery..After 9 years, it calcified,(turned to bone) and was twisting my spinal cord ,causing bowel symptoms. He had no choice. I had previously gone through 12 spine surgeries, so I had been through a lot of extremely painful procedures , but nothing could have prepared me for this.Thankfully, I was given an epidural and it helped with the pain, along with the pain pump at my bed side. The most pain was from the chest tube, which needed to stay in for 6 days.I then got a UTI, AND Thrush, to make me more miserable.I was in the special care unit at Geisinger Medical Center in Danville,Pa for 9 days and then went to a rehab hospital for 12 day. I walked and walked and was doing great.The night of my release, I was having trouble breathing, but just went back to bed. In the morning it was worse. Thank God my sister is a nurse. She said go back to the ER now. I had a Pulmonary Embolism. They said most people don't make it to the hospital, so never ignor the symptoms. I'm doing great now,but I have increased nerve pain that feels like pieces of broken glass all along the area where the rib was removed. Good luck everyone. I wish you all a quick recovery. God bless you.

Tanya Cavner

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Did anyone lose their breast during this surgery? had mine done in 2011. My dquestion

Mary

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I had a thoracotomy done a year ago in June. I had heart surgery one year prior with major complications and 8 days in ICU, a drug induced come for 4 days and a 14 day stay.. I am a 43 year old who had both these major surgeries within a year of each other. I am not sure what caused the blood to pool around the outside of my lung on the right side,maybe from a fall I incurred at work, but it collapsed my lung. One thing I have to say, is please talk to your Doctor about pain management. I was in the worse pain ever when I woke up in ICU.No amount of medication makes it even bearly tolerable. I had two chest tubes in for 3 days, and released to go home after 5 days. My tube sites got infected with staff and that was aweful. I had t go back in the hospital for 3 days to have them cleaned out. AWAKE with locals, which did not numb the pain. All in all, my doctor did not explain to me the amount of pain I would have after.I will NEVER have it done again willingly.3 broken ribs that still cause me pain on top of my breathing, there isn't a MAJOR difference. Please get a second opinion before doing this. I am not sugar coating this, because you need to be educated, because I was not.

Gadget

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I have a 6cm esophageal leiomyoma (tumor of smooth muscle, assumed to be benign) that must be removed. Due to the size of it, my thoracic surgeon is proposing right thoracotomy. All these posts have been very helpful to me to compose my list of questions for my surgeon. The post-op pain is my biggest worry and how long recovery might be. It seems to vary but sounds about 2-6 months, but also as long as a year of residual pain. I had a bilateral mastectomy in 2012 which was also a long recovery period for pain and muscle spasms and and infection 5 months post-op. I think that experience will have prepared me for my thoracotomy. Question: Has anyone used accupuncture for relief of post-op pain?

Selina Rojo

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Hi everyone I had a thoracotomy recently on Feb. Due to having 3 lung collapses. I am 20 years old and I get pain underneath my breast and my lower back. I want to get better and I am really scared to get another lung collapse. Please wish me luck and God bless you all. You guys will be in my prayers and I'm glad I'm not alone.

Johnny

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Fibroid tumor right upper lobe. Thoracotomy 11/1/14. CAME THRU surgery well, but pain and discomfort still bad 2 months later. Trying to stay away from pain meds as much as possible. Do stretch and breathing exercises and just hang in. There is always someone much worse off than you.

rudy

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im going to have the same top right lobe removed they think . any inf. would be appreciated. the surgeon wants to open up to take the test of the tumour right away. i see you had this done in 2011. wondering how this went for recovery.

Gianna

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One month ago the VATS procedure was used for a lower left lobectomy to remove a non-small cell adenocarcinoma. My operation was successful and the pain control in the hospital was perfect. Once home I spent two days on narcotics but didn't like the side effects so relied on Tylenol and Aleve thereafter. I did not expect exhorbitant pain from the incision under my left breast and the area surrounding it in my diaphragm. It's a burning sensation as well as "pins and needles" and tightness. It is also extremely lung. This was the incision where the camera was inserted and where the lung is pulled out of which apparently is a struggle extracting. Can anyone attest to this intense pain and when I can expect it to subside? I know it will take time to heal but will this area come back to life?

Kelly

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My 71 mom has been diagnosed with stage 2 - 3.5m adencaconoma that is in her right lung that has eaten into part of 1 rib.,, she has done 25 rounds of radiation and 6 rounds of 1/2 dose chemo... The surgeon wants to do thoracotomy. The treatment has reduced the size and density has been reduced. She also has copd but is not in oxygen or any symptoms of copd other than the occasional shirt of breath. My question is ... Has anyone with copd and about 45% lung capacity and had surgery? Is is possible to kill it and not do surgery? And can vats be used to remove the tumor and 1 rib section? Are there any other options for copd patients? My mom is really nervous that the lung capacity will make it impossible to maintain some semblance of normalcy.. Any help or comments would be great information

J Clarke

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I had rt upper lobectomy and sleeve resection for carcinoid tumor 16 years ago. I was in hospital for 2 weeks and was told to stay home from work for 2 months. Also, I was told not to lift more than 10lbs the first month and 20lbs the second month. The pain was bad at first and I couldn't lie down for 2 months. I started out walking daily while home, starting with a walk to end of drive way and building up to a couple of miles over time.

As far as lasting side effects, I have trouble with shortness of breath when climbing and running. I use the breath in through nose, out through mouth technique. I still have pain on my side and still can't sleep on my back. Early on, I had the weird nerve issue where I would scratch my chest and feel it in my arm, but that subsided in about a year. I did some research on the web and found that about 33% have chronic pain afterward. After a while you learn to live with it.

After a year, I resumed all normal activity and worked out at the gym without issues except for the shortness of breath. Follow-up CT scans show extensive scaring in that area of the chest.

Rebecca

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September 2014 I found out that I had a cavitory lung lesion with an aspergilloma fungal ball. I had to have a lobectomy on my lower right lung to save my life. Yep! Being exposed to mold for about 4 years almost killed me. The surgeon made an incision on my upper right back of 5 inches and the drainage tubes under my right breast. Recovery had me begging to be induced into a comma. It was more painful than giving natural birth with no anesthesia. I know. I gave birth to my 1st born with no anesthesia. I was released just 4 days after surgery. I was sent home with pain patches and pills on September 17th. The surgeon explained to me that lobectomy is worse than open heart surgery due to the fact of cutting through more muscle and nerves. I suffered immensely before trying these few things along with my pain meds. Sleeping with Icy Hot patches along with a heating pad on medium and a postrepedic pillow that is a bit weighted and heavier than a normal pillow. It worked! After about 2 1/2 weeks of doing this I no longer laid in bed praying to just die. After that I was also able to take my kids trick or treating and get back to a routine which didn't involve me laying in bed crying in pain. I'm a 41 yr old female. I still have shortness of breath. Still have my scars. On occasion I have a random sharp pain. But within seconds it goes away. Im still somewhat numb under my right arm. Also, when I was having bad pain it was in the front. Not my back where the surgeon made his incision. So if your a caretaker of someone having this procedure, please be patient and understanding. It is a tough recovery. I never felt so weak in my life. But this humbled me. Hope my home remedy helps someone else! God bless!

Micha

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Hi all. I had a thorocotomy for severe ruptured disc at T6-T7 5 weeks ago that was causing bladder and bowel problems also left leg numbness. Like a lot of people on here, if I had known what pain I was going to endure beforehand I would be thinking twice about signing the consent form and accepting the inevitable wheelchair. I have pain under my left breast (even though my breast is numb to the touch) and feel as if when I lay down that my ribcage is actually moving about. Numbness in my left armpit and down to my elbow. I can't raise my arm past breast height without intense pain. I have muscle spasms right accross my whole back.My lungs have fluid in the bottom caused by the op so I get short of breath on the stairs and you can hear it bubble when I lay down. No one can tell you how painful things are as we all feel differently. All I can say is I'm not a softy. I had a full hysterectomy a few years ago and after 3 days was home and hoovering and coping. After the thorocotomy I just can't cope. 20mg Morphine 2 hourly doesn't dull the pain enough to feel comfortable. I have found a few tips though that I would like to share. First few days after your op if your comfortable in a chair just stay there with something to put your feet up on. Once the nurses understood that getting into a bed and laying down wasn't working for me they got me a large reclining chair. Hot water bottles are really good too. They seem to help with general pain and ease the spasms somewhat. Lots of fluffy pillows. Get someone to help you place the pillows. I can lay on my right side (thorocotomy was left) and my son tucks the pillows where I feel I need support from rolling fully onto my back (which hurts like hell).
Make sure your pain is under control BEFORE you leave the hospital ( which is where I went wrong I think. Pain is more frightening when your home and no one to tell it's unbearable or know if it's normal) Good luck to all heading down this path.

Chris

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Hello, I was just wanted to get my story out that im 29yrs old and I was actually born with only one lung. I have my right lung and not my left but its interesting because my right lung over grew to take the place of my left lung which means my right lung is as big as two lungs.it actually pushed my heart more to the left. Doctors get very very excited and very interested when they see my exrays. I try and not let it bother me but I do have major breathing problems and whats bad is that I cant get any kind of job that I want because of safety reasons but I think of myself no different than anyone else because I even smoke cigarettes. If anyone could help me with disability or know a very good job where they wont discriminationte please let me know I will check my email.

dorothy

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Would ice help relieve the pain. Surgery 5 days ago in addition to the pain pills.

Pete

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Had 1.5 cm nsclc diagnosed last October and VATS at Mission Hospital in Asheville, NC on right upper lobe a week and a half later. State 1 A so no chemo or radiation. Did not require narcotics in hospital or at home and released on the afternoon of the third day. Did have an epidural, which worked great, and although I was told the pain might be bad when it was removed, there was none. My pain never exceeded 2 out of 10, and that was when I had to blow into that damned spiromoter . The biggest problem for me, frankly, was waiting for the chest tube to stop draining. We had to chop up numerous maxi pads to cover this, and the draining stopped after 2 or 3 weeks. I began walking very soon after the surgery because I have been very active. Oh, yeah, I turned 70 a couple of days before the final diagnosis. I also have mild emphysema. I live in the mountains of Western NC, at about 2,000 feet and continue to hike up to about 5,000 feet, though I huffing and puffing at lot even when walking up a flight of stairs. My question is: I go to Santa Fe ever summer for a workshop (7,500 feet) and have hiked up to about 8100 or 8200...does anyone have have experience with this sort of activity at that elevation after such an operation? By the way, the Dr. (Binns) is excellent and the lung program here is very good. I have to go back for surveillance every three months for the first year, then every six months for the second. After that, providing there's no recurrence, I don't know what happens.

Marie

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Had thoracotomy due to Mrsa pneumonia. Surgeon had to scrape MRSA infection from left lower lobe as it would not all drain from chest tube. Very painful. In ICU for 21 days, then coded but alive. Thank God! Home with pain meds but after 12 weeks I still have intermittent sharp stabbing pains. Shortness of breath. Still off work. Trying to build energy level and stamina. This pain is definitely worse than childbirth. Can,t sleep on left side for more than 20 minutes without severe pain. I had to have the procedure to get the MRSA out and that saved my life. I coded (per doc) cause my heart was tired and done. Now I'm also on heart strengthened. I have heard each person is different but my surgeon says I may feel these pains the rest of my life? I'm only 53. I sure hope not. Trying to wean myself off pain meds but when I need them I REALLY need them! I had no idea I was so sick or would have to deal with something like this. People tell me to be patient and allow myself more time to heal.

Tammy

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No. 66, Trisha and 67, Cynthia---My final diagnosis after surgery is Adenocarcinoma, Stage 1A. Cynthia, my surgeon has me using the spirometer 10 times per hour. If you are only using it twice a day, that doesn't sound like it is enough to stretch those lung lobes open. I was told this is critical to do 10 times per hour during the first 2 to 4 weeks after the surgery to ensure obtaining the full capacity of lung lobe function. In other words, if you are expanding those lung lobes nice and large (even though painful,) within the first four weeks, then they will heal with a nice and large capacity. If you don't expand them nice and large within the first 2 to 4 weeks after surgery, while the majority of the healing is taking place, they will never expand nice and large, because they will heal to whatever size you have expanded them. This breathing exercise also helps with preventing pneumonia. The surgeon also gave me a green breathing tube, in which I blow air through. He prefers I use it 30 times an hour to vibrate the ???(forget the technical term) lobes to help loosen mucus in order to also prevent pneumonia. I had a wedge resection and lobectomy of the lower right lobe and removal of those lymph nodes. I must say this has been the most painful surgery and recovery of any surgery I have ever had!! Even though my pain has been excruciating, I have followed my surgeon's orders almost exactly. I really believe that doing the walking exercises and the breathing exercises have really helped me improve my shortness of breath! I was terribly short of breath, and in excruciating pain, but here on day 11 after my surgery, I'm breathing a whole lot better and only have shortness of breath after climbing a long flight of steps. For the first time three nights ago while asleep in bed, I developed extremely sharp shooting pains that are debilitating worse pain I've ever experienced!! From reading peoples comments, it sounds like this might be nerve regeneration. Does anyone know of something different, or why this might happen while reclined or lying completely flat. It's happening while I'm trying to get sleep. Of course, it prevents me from getting any sleep. I REALLY need advise on this for I really need sleep for good healing and good health!

100

amy

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My mom had a lobectomy with the left lower lobe removed along with 3 pieces of 3 ribs removed and lympnoids. We have been home for 4 days. They sent her home with Norco. The pain has been so bad that she can not even talk. The area around her mouth down to her neck gets so tensed up from the pain. We called the doc and they prescribed her gabpentine to help. Wich did not. She got no rest the first two nights not comfort during the day. Our 3rd day we went back to hospital bc the pain is unbearable and meds don't work. After going to hospital last night she was perscribed 8 15mg morphine tablets. The med seem to work for a while although it says to take 1 every 12 he but before 12hr comes she is back to unbearable pain. What do I do? She is in so much pain she said she would rather b dead. So I request stronger pain meds from her PCP? What helps? I feel so terrible to see my momma 54yr old I'm so much pain

101

Carmel

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Oct 8 2015 pare of lung removed from lung cancer 10month later I still having pain and very score at times I just touch my upper breast and numbness from the elbow up .my insurance put me in physico and it is helping plus I walk 2-3 times a day plus I have copd and ashmas I trying to get back to work I seeing my surgery on sept 6 for test and see him praying I cancer free. Will this ever go away .once I lift over 20 lbs I can't breath and the pain what is your comment my insurance company think I could be back to work month ago please need your help can I go back my job is heavy lifting and go go for 8 hour what your opinion plus lung collaspe and phenomenon

102

David Corder

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My wife had her right lung removed on April 8, 2016. Following that there were four chemo sessions just to be sure. Pet Scan looks clear with the exception of some slight infection in the bottom of the left lung. She has been slow to recover and has problems with eating/nausea/etc. Newest problem-her esophagus has shifted slightly at the upper end making food swallowing much more difficult and has a feeling of food stuck in throat. A procedure showed that this week. This is probably causing a stricture, some abdominal pain, continued nausea, continued fatigue. More tests coming up. What can they do.

Thanks

103

Amelia Mussanda

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Hi guys, interesting topics indeed, I have just had recently a thoracotomy incision, the opened my chest wall, I was removed a Thymoma, almost the size of my fist. I was operated in May and till now I still feel pain and if I sleep on my sides it still hurts, so I am only sleeping on my back and its tiring, after operation I didn't have blood transfusion, didn't go to ICU, and after a week was discharged, after a month I went through Radiotherapy for 5 weeks and now I am better, just want to know when i can start sleeping on my sides and I am concerned of going back to work, I am 29 years old.

104

Shanee

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I am doing a report on an open Thoracotomy (Lobectomy). It has to be in depth, with great detail and I am having trouble finding articles on it that have all this information on it besides this. It is due Dec. 1st. Can you recommend any? Must describe incisions, instruments, anesthesia, reasons for getting the surgery and so on...This is an awesome article but I can't seem to find any others!ï»¿

105

Tonien

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Hi everyone . I had this operation when I was ten years old. But now I have a problem with my thoracic case . There was a tumor in my right lung 3. Lobe from the bottom, so scare is under my right scapula. My question is why this operation makes Deformation on case ? My right side is become crooked also the abdomen part of my case warped thorough forward.

106

Anne

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This is a truly amazing article and it really helped me to get a better view on the procedure,
but to read this was kinda shocking to me. My boyfriend has cancer which has spread to his lungs, he has had this surgery three times now, the third time being today. I'm going to visit him in three days and I'm kind of nervous for that, I'm afraid he'll be in a lot of pain and I don't really know how to deal with that. His father messaged me that everything went as it should and that he is breathing on his own, but I still don't really know what to expect.

107

Anne

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108

Elizabeth Duncan

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I am post vats wedge resection for cancer that spread to my lungs. I had the procedure last February in my right lung and hardly had any pain, even in hospital. This time however the pain was almost unbearable when i came out of the
anaesthetic . I am now 14 days after my surgery and still have pain , even though it is not as bad. Just to let people know that you can have the same operation but the pain is different for every procedure. It does not go that because you had pain once that this will be the case every time.

109

Shelly

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I had a thoracotomy on 8-30-17 for 1.3x 1.0 nodule which was stage 1. Started out as VATS but needed to be opened up fo finish. I have a 7" scar. I had an epidural for 5 days and was not in much pain at all. I spent one day in ICC and 8 days on the floor. It took awhile for the air leaks to stop. I took pains meds for less than a week after I was discharged. I did everything they told me to do and did not do anything I was told not to do. I do have nerve pain that started after the numbness wore off. I was doing very well and 6 weeks post op something popped and I had a huge "bump" about the size of a softball at the incision area. I immediately went to the surgeons office and an emergency CT scan was done. I had a huge hematoma. While the blood settled all down my right side, across my pelvic, and my lower back I had so much bruising and was in excruciating pain. Pain was far worse than any pain I have ever had. I have seen a pain management doctor who gave me meds for the hematoma pain and different meds for the nerve pain. The "bump" has gone done but will take awhile for it to absorb. I had one rib cut during surgery. The think either the rib caught on something or a stitch came out that caused bleeding in my chest wall which caused the hematoma. I am am now 8 1/2 weeks post op. Still have the nerve pain. The nerve pain meds help, but not 100%. Other than that I feel real well.

110

Gus Tamayo

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