› Forums › General Melanoma Community › Rib cage pain
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Wally.
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- September 18, 2011 at 11:18 am
Hi all, I have posted on previous occasions and am now totally confused and possibly paranoid but I really do not know what to make of these developments so I need to rant and rave.
Hi all, I have posted on previous occasions and am now totally confused and possibly paranoid but I really do not know what to make of these developments so I need to rant and rave.
About a month after the malenoma tumor was removed from my right lung in April 2011, I started developing pain in my ribs, initially on the right side close to where the tumor was. In July I felt that the pain was no worse but consistant and very eratic and would move accross my ribs at times. Although initially the bones felt sore when I pressed my fingers on them, this is no longer the case. The pain is pretty severe at times and seems to stem from somewhere behind my ribs. It is like a severe stitch and other times like a stabbing pain and again at other times it feels as if it is on fire.
A Tc99 m MDP Three Phase whole body bone scan was done that indicated possible osteoblastic skeletal metastases with a proviso that recent surgery could also have been responsible. However, the pain continues. I was given a nerve block as the doctor who removed the tumor again indicated that the rib may have been damaged during surgery. Also apparent uptake left occipital need further evaluation to exclude metastasis in view of rib lesions
I went to my Oncologist on 7 September and a blood count was taken. This was clear / normal. Just to make sure a further scan was ordered. I only had a pre-scan to identify possible lesions. Nothing came up so no further scan done. The verdict being that the scan indicated a possible clean break of the rib during surgery.
I will now be have the ribs strapped (like rugby players have done when they injure their ribs) tomorrow (Monday)
My question is – can it take so long (some 5 months later still in pain) for a rib fracture to heal? Are the pains I am experiencing in line with a rib fracture. Surely any unusual movement, a cough or heavy breathing should induce pain. Surely pressing against the ribs should be a painful experience? I have none of this, just a constant pain that comes and goes as it pleases and is not isolated to one spot. This makes no sence to me. I do not want to sound like I am wishing that there is someting there but I just do not feel comfortable that they have done all they could to determine without any doubt whether or not I am disease free (NED) for now.
I just need to have closure on this topic and any feedback will be most welcome. I have had no treatment at all up to now, which is a blessing, but I am so afraid that there may be something lurking inside me that has not been picked up as yet and that any procrastination could be to my detriment. Is there anything else that can be done or is there anybody on this form that has had a rib tumor following a lung tumor. How was it identified – pain or any other way? Please help me.
I thank you all for your support. God bless. Wally.
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- September 18, 2011 at 12:41 pm
Wally,
The only thing I can help you with is the broken rib pain. I know it can be very painful and take a long time to heal especially if it hadn't been diagnosed right away. I know a coupld different people who had broken ribs for a while before diagnosis and it took a very long time for them to heal and for the pain to go away.
Hang in there.
Amy S. in Michigan
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- September 18, 2011 at 12:41 pm
Wally,
The only thing I can help you with is the broken rib pain. I know it can be very painful and take a long time to heal especially if it hadn't been diagnosed right away. I know a coupld different people who had broken ribs for a while before diagnosis and it took a very long time for them to heal and for the pain to go away.
Hang in there.
Amy S. in Michigan
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- September 18, 2011 at 1:29 pm
Wally, I have had a look at your profile and feel that it would be an idea to have another CT and/or PET scan. When one has metastatic melanoma it is always wise to make sure that the cause of any pain is not due to new tumours that may have formed.
As your have had recent surgery, pain might be caused by things such a fracture that hasn't healed properly, nerve damage, or maybe an infection in the area. If it is on the lower right side of the ribcage, I wonder if it could be due to an inflamed liver?
I have had fractured ribs in the past due to a sports injury, and the pain wasn't too severe. However, how people feel pain can vary quiet a bit and depends a lot on circumstances.
Hope this helps.
Frank from Australia
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- September 18, 2011 at 7:06 pm
Hi Frank
Thank you for your response. I was also rather surprised that they did not first take an X-ray as the bone scan done in July did reflect a possible fracture. My first check-up was supposed to have been in August at which stage a Pet Scan was to have been done. This was overlooked, it seems, by my rib pain complaint and all attention focussed in that direction. I see a Physiotherapist tomorrow to have the rib strapped and if that does not provide a solution, I will see my GP to arrange for a sonar scan to see if anything else is the cause of the pain. I have never had rib damage before – is the pain I am describing typical of a rib fracture. If so, how come it hurts so badly in the centre of my ribs and at time on the left rib area while the op was on the right side, or is that normal?
Once again thanks for the trouble taken to respond. Dian also provided some good input and I am grateful to both of you.
Regards Wally
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- September 20, 2011 at 4:53 am
Wally, I think that it would be very wise to have the PET scan done. It may have been overlooked inadvertently, as doctors and hospitals are usually very busy and things get forgotten. A sonar scan or ultrasound is not good at detecting anything that may be melanoma.
I don't feel that the pain that you are describing is typical, so it will need further investigation to make sure that it isn't due to melanoma. Pain can be caused by many things, and therefore the cause should be found without delay.
Best wishes
Frank from Australia
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- September 20, 2011 at 7:03 am
Thanks Frank. As always, I value your input. I have learned more from this forum about this scurge of Melanoma than any of the so called specialists have offered to tell me. Your comments are noted and I will follow through. The physiotherapist yesterday was also baffelled by this omission. I do have consequenses following the surgery due to skin trauma in the area of the wound, for which she gave me some painful treatment, but she could not explain the breastbone pain and she was also convinced that the rib, which the scan shows as having been fractured, has already healed and is not the sole cause of the pain I have been having, so yes, I will pursue.
Thanks again for your advice. Regards
Wally RSA
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- September 20, 2011 at 7:03 am
Thanks Frank. As always, I value your input. I have learned more from this forum about this scurge of Melanoma than any of the so called specialists have offered to tell me. Your comments are noted and I will follow through. The physiotherapist yesterday was also baffelled by this omission. I do have consequenses following the surgery due to skin trauma in the area of the wound, for which she gave me some painful treatment, but she could not explain the breastbone pain and she was also convinced that the rib, which the scan shows as having been fractured, has already healed and is not the sole cause of the pain I have been having, so yes, I will pursue.
Thanks again for your advice. Regards
Wally RSA
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- September 20, 2011 at 4:53 am
Wally, I think that it would be very wise to have the PET scan done. It may have been overlooked inadvertently, as doctors and hospitals are usually very busy and things get forgotten. A sonar scan or ultrasound is not good at detecting anything that may be melanoma.
I don't feel that the pain that you are describing is typical, so it will need further investigation to make sure that it isn't due to melanoma. Pain can be caused by many things, and therefore the cause should be found without delay.
Best wishes
Frank from Australia
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- September 18, 2011 at 7:06 pm
Hi Frank
Thank you for your response. I was also rather surprised that they did not first take an X-ray as the bone scan done in July did reflect a possible fracture. My first check-up was supposed to have been in August at which stage a Pet Scan was to have been done. This was overlooked, it seems, by my rib pain complaint and all attention focussed in that direction. I see a Physiotherapist tomorrow to have the rib strapped and if that does not provide a solution, I will see my GP to arrange for a sonar scan to see if anything else is the cause of the pain. I have never had rib damage before – is the pain I am describing typical of a rib fracture. If so, how come it hurts so badly in the centre of my ribs and at time on the left rib area while the op was on the right side, or is that normal?
Once again thanks for the trouble taken to respond. Dian also provided some good input and I am grateful to both of you.
Regards Wally
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- September 18, 2011 at 1:29 pm
Wally, I have had a look at your profile and feel that it would be an idea to have another CT and/or PET scan. When one has metastatic melanoma it is always wise to make sure that the cause of any pain is not due to new tumours that may have formed.
As your have had recent surgery, pain might be caused by things such a fracture that hasn't healed properly, nerve damage, or maybe an infection in the area. If it is on the lower right side of the ribcage, I wonder if it could be due to an inflamed liver?
I have had fractured ribs in the past due to a sports injury, and the pain wasn't too severe. However, how people feel pain can vary quiet a bit and depends a lot on circumstances.
Hope this helps.
Frank from Australia
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- September 18, 2011 at 4:18 pm
This paragraph confuses me:
"I went to my Oncologist on 7 September and a blood count was taken. This was clear / normal. Just to make sure a further scan was ordered. I only had a pre-scan to identify possible lesions. Nothing came up so no further scan done. The verdict being that the scan indicated a possible clean break of the rib during surgery"
What is a 'pre-scan'? I've never heard of such a thing. Did they do any kind of scan? PET/CT, Xray? Ultraound? I should think a simple xray would verify a broken rib.
And..if you had lung surgery in april, aren't you due for something like a PET/CT soon..october at least?
As to the broken rib, YES it can take a long time for such a thing to heal, especially if they are just now determining that you have a broken rib. I've known folks who've had so much pain they couldn't breathe, and another who told me he was taken by surprise that he he had a broken rib, because it only hurt occasionally and irregularly.
If they've confirmed that you have a break, then that's the most likely source of your pain, but I don't blame you for worrying that it's melanoma.
I think you'd find that most of us out here with stage III or IV melanoma worry that every ache or pain is related to this nasty disease.
good luck, wally!
dian
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- September 18, 2011 at 6:52 pm
Hi Dian, yes that is what is confusing me. With this rib pain they have focussed so much on a possible fracture and have only on the bones. I did not see the latest pre-scan as they called it. I had to phone 3 days later to find out what the outcome was and was told this telephonically. Apparently before injecting someting into your blood to highlight possible melanoma, the do a pre-scan to see if lesions are present. If there is something suspicious, they book you in gor the next day when the injection is done into a vein and this will highlight possible tumors. As they were certain that this was merely a possible bone fracture, they decided not to go further. Upon enquiory, the oncologist told be to come back in 4 months time as she has no further reason to worry about me. The blood count and scan they did apparently served as my 4 monthly check-up so now I only go back in January 2012 unless I have reason to go back before that. I also thought that they should perhaps first have opted for a normal X-ray instead of a scan as that surely would have been the simplist way to determine a fracture. I just find it strange that the surgeon did not mention to me immediately after the operation that my ribs were damaged as surely he would have been aware of that? He could then have told me to have the rib strapped to facilitate healing.
Thank you for taking the trouble to respond. I really appreciate it. I have no-one I can talk to or exchange ideas – this forum is my only resort.
Regards
Wally
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- September 18, 2011 at 6:52 pm
Hi Dian, yes that is what is confusing me. With this rib pain they have focussed so much on a possible fracture and have only on the bones. I did not see the latest pre-scan as they called it. I had to phone 3 days later to find out what the outcome was and was told this telephonically. Apparently before injecting someting into your blood to highlight possible melanoma, the do a pre-scan to see if lesions are present. If there is something suspicious, they book you in gor the next day when the injection is done into a vein and this will highlight possible tumors. As they were certain that this was merely a possible bone fracture, they decided not to go further. Upon enquiory, the oncologist told be to come back in 4 months time as she has no further reason to worry about me. The blood count and scan they did apparently served as my 4 monthly check-up so now I only go back in January 2012 unless I have reason to go back before that. I also thought that they should perhaps first have opted for a normal X-ray instead of a scan as that surely would have been the simplist way to determine a fracture. I just find it strange that the surgeon did not mention to me immediately after the operation that my ribs were damaged as surely he would have been aware of that? He could then have told me to have the rib strapped to facilitate healing.
Thank you for taking the trouble to respond. I really appreciate it. I have no-one I can talk to or exchange ideas – this forum is my only resort.
Regards
Wally
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- September 18, 2011 at 4:18 pm
This paragraph confuses me:
"I went to my Oncologist on 7 September and a blood count was taken. This was clear / normal. Just to make sure a further scan was ordered. I only had a pre-scan to identify possible lesions. Nothing came up so no further scan done. The verdict being that the scan indicated a possible clean break of the rib during surgery"
What is a 'pre-scan'? I've never heard of such a thing. Did they do any kind of scan? PET/CT, Xray? Ultraound? I should think a simple xray would verify a broken rib.
And..if you had lung surgery in april, aren't you due for something like a PET/CT soon..october at least?
As to the broken rib, YES it can take a long time for such a thing to heal, especially if they are just now determining that you have a broken rib. I've known folks who've had so much pain they couldn't breathe, and another who told me he was taken by surprise that he he had a broken rib, because it only hurt occasionally and irregularly.
If they've confirmed that you have a break, then that's the most likely source of your pain, but I don't blame you for worrying that it's melanoma.
I think you'd find that most of us out here with stage III or IV melanoma worry that every ache or pain is related to this nasty disease.
good luck, wally!
dian
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- September 18, 2011 at 6:51 pm
Wally,
I can sure understand your concern. The scans should show a break clearly. I broke 4 ribs (another horse back riding accident!) probably 8 years ago and the scans still show the damaged ribs. As far as your pain goes, if you had a broken rib you should have had noticed pain fairly soon after the break. I had 2 other broken bones and the ER missed the ribs when I went into the Specialist 2 days later and he asked how I was feeling I said not to bad except I feel like a mule kick me in the side. You may have not noticed it because I would have assumed you were under pretty heavy pain meds after your surgery. I don't remember how long I had discomfort, but it was many months. Here in the U.S. they don't wrap ribs any more, I don't know why. I really wished they had.
In the beginning my pain was pretty constant and as I described felt like I'd been kicked by a mule. I couldn't move very well and any reaching or anything like that brought shooting pain. Again this may have been masked for you by the surgery. After the ribs began to knit, which is where you should be, the pain was was a dull ache except for occasional "punches" sometimes for no reason at all or sometimes when I did something stupid. But the pain was always located near the break.
I don't know if this helped or not.
Good Luck,
Mary
Stage 3
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- September 18, 2011 at 8:17 pm
Thanks Mary. Much obliged and does give me some reassurance. The only thing that bothers me is that the pain is mostly nowhere near to where the supposed fracture is. Its dead centre (is that the breastbone?) where the two sets of ribs meet. Also, when I press against that spot, there is a sort of a clicking as if a bone or something is loose and moves around.
I appreciate your input
Regards
Wally
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- September 18, 2011 at 8:17 pm
Thanks Mary. Much obliged and does give me some reassurance. The only thing that bothers me is that the pain is mostly nowhere near to where the supposed fracture is. Its dead centre (is that the breastbone?) where the two sets of ribs meet. Also, when I press against that spot, there is a sort of a clicking as if a bone or something is loose and moves around.
I appreciate your input
Regards
Wally
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- September 18, 2011 at 6:51 pm
Wally,
I can sure understand your concern. The scans should show a break clearly. I broke 4 ribs (another horse back riding accident!) probably 8 years ago and the scans still show the damaged ribs. As far as your pain goes, if you had a broken rib you should have had noticed pain fairly soon after the break. I had 2 other broken bones and the ER missed the ribs when I went into the Specialist 2 days later and he asked how I was feeling I said not to bad except I feel like a mule kick me in the side. You may have not noticed it because I would have assumed you were under pretty heavy pain meds after your surgery. I don't remember how long I had discomfort, but it was many months. Here in the U.S. they don't wrap ribs any more, I don't know why. I really wished they had.
In the beginning my pain was pretty constant and as I described felt like I'd been kicked by a mule. I couldn't move very well and any reaching or anything like that brought shooting pain. Again this may have been masked for you by the surgery. After the ribs began to knit, which is where you should be, the pain was was a dull ache except for occasional "punches" sometimes for no reason at all or sometimes when I did something stupid. But the pain was always located near the break.
I don't know if this helped or not.
Good Luck,
Mary
Stage 3
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