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Sunday, March 9, 2014
I had a thymectomy in October 2007 and my incision is still sore and so is my chest. Is that normal? I have MG (Myasthenia Gravis).
After the classic thoracotomy, patients can have pain from the incision and from the manipulation of the chest wall. Imagine it: your chest was opened with the equivalent of a large vice. There can be rib fractures or incompletely healed rib fractures. There can be irritation of the lining of the chest wall and the lungs. There is also the possibility of some nerve pain in the area of the incisions where the intercostal nerves run. The nerve pain may be amenable to medication, and musculoskeletal pain may be amenable to medications like acetaminophen and ibuprofen.
An image of the chest wall (chest CT) and a good physical exam can exclude large structural lesions, such as abscess , hematoma, etc.
Talk to your physician again and be ready to qualify the exact pain location (e.g. between two ribs on the right side, at the bottom of the rib cage on the left, et cetera); how long does the pain last; does it radiate; what makes it worse or better. Hopefully he/she can help you. I have asked my own patients and some of them have had pain for years afterwards, but it lessens in intensity.
Robert W Neel, IV, MD
Assistant Professor of Neurology
College of Medicine
University of Cincinnati