Severe pain post op

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9/14/2018 1:46am
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Replies: 13

I had my WLE and SLNB on the 5th. All went well - I have a probably 3 inch incision in my right shoulder and a 1 inch incision in my right armpit where they took one lymph node. My initial biopsy showed at least a T2B as it was at least 1.1 mm thick with 2 mitotic rate, nodular mm. The biopsies now came back with the lymph node was clean and the excision showed no more melanoma cells (which was bizarre as the first biopsy the margins were not clean so there should have been some cancer cells I would think). So I guess I am cancer free, though I don't feel it. Still dealing with pain from surgery and other malaises. 

The first couple days post-op were ok, I was in pain but I could take the edge off with pain meds. Then the pain increased exponentially. The incisions look fine - no sign of infection. The shoulder incision feels tight but it is a divit in my arm, deep enough. I am still fairly swollen in some places and I am very bruised. My entire upper arm (over/under) is covered in bruising. I have a very high pain tollerance and I never take pain medicine unless I have had a major surgery. The pain over the last 5 days has been agonising. Pain medicine has no effect, ice is not helping anymore, I am in pain whether I rest it in one spot or move it around. No narcotics are working so I don't see the point to taking them. I am thinking now it may be neuropathic pain and I may have to try to get my surgeon to recognise that so I can get a med that will help with that, but I also feel deep bone pain. I am not sure what the issue is. I know think a seroma has formed under the armpit incision. 

Anyone experience severe pain? What worked for you?


Joycem - (9/14/2018 - 11:27am)

Hi Finn,  Sorry for your troubles. Your diagnosis and surgery sounds similar to mine, (long time deep nodular lesion from shoulder/ back of upper arm, snb negative) but I did not experience any sudden increase in pain after surgery, (took 1 Percocet then a few tramadol the first couple days then just occasional ibuprofen or Tylenol for a few more. Back to work in 3 days (surgery Friday worked Monday)  I don’t recall large areas of bruising, although there was some I think.

So this sounds unusual to me. I would definitely reach out to your surgeon. Neuropathic pain is better to be treated quickly, but  not with opioids. 

lkb - (9/14/2018 - 2:15pm)

Sounds like a rough go! I can only add to other advice here to tell your doctors. I've certainly had a situation in which I named a symptom several times (to the doc, to the nurse, to the man on the moon) and then got relief. Wishing you the best.


October 2017 primary scalp WLE; SLNB; partial neck dissection (PND). July 2018 recurrence in neck. August 2018 second PND. September 2018 started Nivo. December 2018 SRS for brain met.


MelanomaMike - (9/14/2018 - 2:44pm)

Ouch! Wish i could help with yer pain but, pain meds like Vicodins, Norcos etc never realy worked for my surgeries, not that i needed them, most my surgery areas stayed numb even till this day (nerves are gone i guess)
The way i look at it, if yer feeling pain thats a good thing, it confirms yer still alive!.. Can i ask, are taking any Immunol therapy? Ipi, nivo, pembro etc? If so, that may have something to do with it, nerve pain runs rampid anyways surgery or not! well, youll heal, godspeed..Mike

Im Melanoma and my host is Mike..

Threefitty - (9/14/2018 - 4:04pm)

It sounds like your margins were better than they thought (?).

Clean SNLB, that's the real headline isn't it?

I can't relate on the pain (had mid back lesion) but I would definitely report back to the surgeon immediately about your pain, b/c shoulders are very complex places and there are certain things that can go badly wrong. I try to keep my self diagnosis to myself b/c doctors ignore it anyway and see self-diagnosers somewhat hypochondriac-ish. (My impression, ymmv)

Finn - (9/14/2018 - 4:59pm)

Yes clean SLNB is the true headline for sure. Just frustrated with the continued horrible pain which does not seem right. I am happy to not have to have any further treatment for the melanoma and just regular dermatology follow ups to keep on top of spots.

I saw my surgeon for follow up 2 days ago and he thought everything looked good. He did not expect the amount of pain I was having, but did not think it was odd either. He just prescribed a stronger opioid which sadly has not helped at all. I called to relay my concerns over the pain not decreasing and was told to just take more pills. Not sure how to proceed here since more pills are not the solution.

MelanomaMike - (9/14/2018 - 5:35pm)

Hi, like someone said here already, maybe try Tremodol or better ask for Ultram, Ultram is basicly the same (i think) but has a higher milligram content, like 100mg, 200mg and 300mg works great and yer not so blah, duh and feeling Zombie"ish"..those kinds of narcotics just "dull" the pain "if" that...hope you start feeling better, pain is no fun..Mike

Im Melanoma and my host is Mike..

bjeans - (9/15/2018 - 8:39am)

I’m so sorry, Finn. Your concerns were relayed through a nurse? Did you speak to a doc? If not, time to step up the self advocacy, aka push firmly to get someone to get that this is not normal. Things do go wrong, and nurses/docs can be so used to hearing about pain they don’t always catch a real problem. And if it turns out to be normal, fine, but you should be taken seriously, checked out and be helped. 


jennunicorn - (9/14/2018 - 9:27pm)

Nerve damage is common and I definitely had nerve pain after having some lymph nodes removed from my left armpit. I was prescribed gabapentin for the nerve pain and it helped. Nerves take forever to heal but the pain didn't last too long for me, the numbness was what lingered, and still does a little bit. (that surgery was november 2017). Definitely let your surgeon know about your increase in pain. 

Jenn - stage IV NED - Completed Ipi/Nivo (Yervoy/Opdivo) + surgery

Finn - (9/16/2018 - 4:24pm)

I sent an email describing my severe pain and that I was not looking for another narcotic to be prescribed, so that it would be taken seriously. The surgeon is not sure why I am in so much pain. He prescribed gabapentin and a stronger nsaid on friday. I am titrating up the gabapentin to 3/day. So far no improvement at all, but I do know gabapentin can take awhile to work. I do wonder if there is something else going on though for me to still be in such severe unrelenting pain. I see the surgeon tomorrow morning.

Glad they are seeing you tomorrow.  I hope the increased meds work quickly and you see some relief soon.

cancersnewnormal - (9/17/2018 - 9:41am)

Hopefully they can find the reason behind this. I hate to even bring up the thought, and I probably read too many "it can't happen to me" stories.. buuuuuuuut... might they have accidentally left some gauze in the surgical area? **yikes**

This sounds absolutely unbearable.  It sounds like you need to go back in to see the surgeon.  They need to check that all is healing properly and that the pain isn't a sign that something isn't right.  Don't try to bear this alone.  Please go back in.  I tried to grin and bear it when I had some complications and that ended me in the hospital.  I learned my lesson.  Be a complainer - tell them everything.  Don't hold back.  Don't tell them the pain is an 8 when it is really a 10.  If you are experiencing a 15 on their scale of 0-10 then tell them that.

Good wishes to you.  I hope they can help you find some relief.


Finn - (9/17/2018 - 2:55pm)

Saw the surgeon today and he is at a loss. The incisions are healing well and there are no signs of infection. He does not think the area under the incision could contain a haematoma. He's not sure what to do. We discussed imaging and he decided to refer me for a CT to see if we could find the cause. He is also referring me to a pain management specialist as maybe they would have an idea or could do a nerve block. So I guess it's a waiting game for the insurance to approve the referrals so I can figure this out. I can't understand why there is no improvement in my pain status. My right arm is essentially unusable for the most part due to the pain.