Question about pancreatic surgery - post op effects
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I had an insulinoma tumor on my pancreas. It was removed by enucleation 6 weeks ago, it was an open surgical procedure. The insulinoma was on the head of the pancreas, it's the most difficult location to access. My surgeon said the surgery was difficult. My abdomen was cut open from one side to the other, horizontal, in the shape of a mountain, slanted on each side with a rounded top.
Since the surgery, i've had pain which comes and goes, at the bottom of the left rib cage, in the front of the abdomen on the left side. It hasn't improved too much but is becoming less frequent. It's not too bad of a pain, it feels like that area of the rib cage is bruised. It's tender, it comes and goes, and it sometimes seems related to the posture i'm sitting in.
Then yesterday, i got a new pain, on the left side of my rib cage, not the front but on the far side of my abdomen. It's something where different movements cause sharp pain. The other pain i've been having isn't sharp. The new pain, which is much worse today than yesterday, to a point where it's hard to walk around, will completely go away if i lay still. If i move around, it hurts. If i do something that triggers it, by straining an abdominal muscle, (like opening a sliding glass door, or getting up from a sitting position) then it hurts a lot, the pain is sharp, and if i trigger it by doing something like that, then it continues to hurt as long as i keep moving around, and if i take a deep breath inward, that causes the sharp pain. If i lay still, all the pain stops.
I called my surgeon's office. i spoke to a doctor on call. He first reviewed my chart. He said what it sounded like was some kind of injury to a nerve that is caused by retractors that are used during surgery, he said it's not uncommon, and it should go away pretty soon.
I am wondering if anyone else who's had pancreatic surgery has had localized rib cage pain post operatively, and if it did ever go away. I have been slowly recovering over the past 6 weeks, still pretty limited in what i can do, though definitely healing and improving, and now i have this new thing that is worse than any other pain i've had with the surgery and has me basically unable to do much of anything. It's only been two days, but i want to know more about it. i can't find anything about it by googling, i don't know what it's called--just post operative rib cage pain from abdominal surgery.
0 likes, 8 replies
genna07944 jaw444
Posted
stuart13 jaw444
Posted
jaw444 stuart13
Posted
Abdominal lesions is what it feels like. I am going to write another post on this thread just summing up what happened after i wrote the above post. I will put it at the bottom.
In sum, i have discovered on closer inspection that one of my left ribs is out of place and it sticks out on the left side, a large bulge in my chest, and next to it, there is a rubbery lump that i wonder about, whether it's scar tissue or maybe cartilege from the rib that's moved out of place.
I'm going to see my surgeon tomorrow about this. It's been 10 weeks since the surgery now.
jamesh78 jaw444
Posted
lelia80932 jaw444
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jaw444 lelia80932
Posted
Before my surgery, he was pretty confident that it would be laparoscopic and that he could enucleate the tumor. Enucleate means remove the tumor (only 1cm) without taking any pacreas tissue. i had to sign a consent saying that one of the things i was consenting to was a pancreatic head resection, which means they might remove the head of the pancreas in order to get the tumor off if they couldn't enucleate it. Did you have a head resection? While i was really hoping not to have one, it's a lot better than a whole whipple.
What happened in the surgery was that, first, they used the laparscope to find the tumor but the surgeon said that it was very hard to find the tumor, they had the intraoperative ultrasound in there, but they did not find it and he said for a while, he thought he might have to do a head resection. But then he said finally they found it "in a hidden place," and the IOUS stuck a needle in it, and the surgeon was able to use the needle to guide him to where the tumor was and he was able to enucleate it.
So, it sounds like there was a lot of poking around in there, and what you said, moving those parts around that don't move, the pancreas is in the back, behind the stomach and liver and intestines--and the ribs!!
That pain i was having when i posted here was almost gone by the next day. I took two ibuprofens during the night with a sleeping pill and when i woke up, the pain was almost all gone, very minimal. The doctor i talked to had said to take ibuprofen, and it worked i guess. By the second day, no more pain at all and it never came back. I do still get the other pain where the bottom of a rib on the left feels kind of bruised and tender but that oddly comes and goes, and over time, becomes more and more uncommon. It's weird because it hurts for a few seconds and then completely goes away. I also get a pain on the left when i get up out of bed, using my abdominal muscles to help me get up.
After that sharp pain episode i started looking more closely at my incision which seemed to be swollen, but then it never went down, so then i thought it was scar tissue on the muscles under the skin, or something. But i felt of it, there is a place on the left side of the incsion that really bulges out from my lower chest under my breast, it's very conspicuous, a huge bulge, while on the right side, it just looks normal, no bulge. When i felt of it, i was surprised that it was hard, not like scar tissue but like bone--my rib. My rib is sticking out. It's out of place. i saw my GP doctor and he said "you have a displaced rib." He referred me for physical therapy, but i want to talk to my surgeon first and let him see what it looks like and hope he can tell me why it is sticking out like that and whether it will go back on its own, or if there is any treatment to get it to go back.
I have an appointment to see my surgeon tomorrow about the rib.
Other than that, the rest of me is not having any pain and is feeling pretty normal, except for one thing---i notice i'm really tired most of the time, i have no motivation to do stuff. I just don't want to do anything that takes energy. When you say you were down for 6 months to a year, do you mean you felt tired or lacking energy? i would like to know if that can happen.
The insulinoma i had secretes insulin constantly, so my glucose was depleted all the time, and i had very little energy because the tumor was keeping my glucose down and i didn't have any to burn for energy. So, i thought after the surgery i was going to feel much better, i would not have severe hypoglycemia anymore and so i would have energy and i would recover in 6 to 8 weeks like the surgeon said, but instead, i feel about the same as i felt with the insulinoma. On the positive side, i do not have low glucose anymore. It's a little on the high side now, but not a lot (90s-low 100s). And so, i no longer have to force my self to eat every couple of hours, so i'm happy about that. And i no longer have to worry about waking up in the morning laying on the floor with no memory of how i got there. Progress!
But the idea that the surgery itself was traumatic to a point where my body isn't up to normal functioning yet and may not be for a long time gives me hope and gives me a reason to be accepting and patient instead of depressed and feeling pressure to get things done that i don't feel like doing and feeling guilty for not doing stuff.
jaw444
Posted
He also said, when i talked about other sensations i was having that were not normal, that it would take 6 months to a year for all those things to feel norma. When i talked to him previously, before the surgery and 2 weeks after, he said it would take 6 to 8 weeks to feel normal. Hearing that it can take 6 to 12 months makes me feel so much better, that what's wrong with me isn't something i have to act on and go to doctors and try to find out what it is, it's just to be expected. That's a relief. Something so simple as hearing those words has been very hard to come by, because i don't know people who have had major abdominal surgery and i am just on my own, googling and guessing about it.
However next to the rib that's sticking out, closer to the center of my left chest, there is a rubbery lump that also sticks out. It's not rigid and hard like the rib. It moves around and it's rubbery. i asked if that was scar tissue or if it was the cartilage of the rib. He said not cartilage, he said he thought it was fat. ??? It's not soft lke fat, it's a rubbery lump. Then, at one point, he said it could be a hernia. Great. He wasn't sure but he said to check back in three months from now about it.
I read up on incisional hernias. There is no nonsurgical treatment for them. They don't go back like they were on their own. If it's a hernia, eventually i will have to have another abdominal surgery. i read about it yesterday afternoon. Not as serious as pancreatic surgery, but not good. So, now i have to wait to find out. The way i am, i would rather know than not know. So i will be visiting my other doctors to see if they think it's a hernia. The stuff i was reading yesterday said that the sooner it's repaired the better because otherwise it gets larger over time. The larger it gets, the more difficult the surgery. If it's small, they can probably do it laparoscopically, which would definitely be better. But maybe it's too soon for another surgery.
The problem is, i need to sell my house and buy a new house and relocate to where my daughter and her family live, she just had her first baby at the end of June, she needs my help, she begs me to move up there, and i want to, i'm sorry to be missing out on the baby. But relocating will be a huge job with lots of lifting and packing and carrying boxes, and i can't do that with a hernia or with a healing hernia repair.
I was just waiting and waiting for my hypoglycemia to be cured so i would have the energy to move, and then the recovery from the surgery, waiting to feel better from that, and also, i had read about incisional hernias shortly after the surgery and knew i souldn't be doing any heavy lifting for a few months. I didn't think i had one. I just knew i wanted to avoid having one.
But now, it's all so hard to see any light at the end of this tunnel. i will just be grateful for the good parts, and there are some big ones. But that isn't going to take away my anxiety and my need to search for answers to unknown things that are knowable, like, do i have a hernia? It's definitely very sore in that area when i use my abdominal muscles to get out of bed and if i twist a certain way to reach for something.
I think what caused the hernia, if i have one, is that after the surgery, i was told firmly by the nurse not to use my abdominal muscles to get out of bed and things like that, but a week or so before the surgery, i had badly sprained my wrist (falling three times in about 15 minutes, landing on the left hand each time, because of the morning hypoglycemia), it got really swollen and black and blue and was hot like there was a fever in my left wrist for several days, it was so painful, not broken but i didn't have the use of that hand until about 5 weeks after the surgery. I had to use my abdominal muscles to get up. I also had to use my teeth to open child proof lid pill bottles, which after doing that for a few weeks, ended up breaking part of one of my molars off and i am scheduled now to go to the dentist to have a crown put on it. I do hope this will all get better some day, and thinking that it can take 6 months to a year gives a better perspective on what expectations should realistically be.
NHL2014 jaw444
Posted
Hello
After reading some forums that I once searched I have decided to give some info, since I had not 1 but 2 Insulinoma Tumors.
First I like to say that readings of 3.3 and lower should be concern and if it goes down to 2.8 and lower its danger point as I had that feeling and had almost passed out cause your pancreas is over working creating too much insulin thats what your body needs thus your sugar levels drop and that's no good cause it causes you to feel dis oriented or like being drunk and your brain don't function good thus you can pass out and go into even coma...
I may had it for 4 years with out propper detection by my family doctor cause he did not want to further investigate why I was having low sugar levels back in 2010 cause i was not eating 3-5 times a day so he thought thats why level is slightly low numbers. From 2010 i did have some lapses where i felt tired or dehydred and once again my doc saying cause im not eating propperly.
I fast forward to June 2013 and 4 days before jetting off for vacation to europe I end in hospital and they tell me not to fly cause there is a serious problem with my Pancreas and need tests to be done to find out what exactly the problem is.
After a few tests in the same hospital I was sent to a major hospital here in my home city to do more intense x-ray images and they discovered 1 tumor and upon doing more test and making plans for opertaion they find a second tumor one was almost large size of golf ball the other size of a nickel.
Now the bad part one is found in the front of pancreas called the head the other in the back called the tail.
One was active tumor causing me the problems and it was in the front the other was non active.
So even the doctors ther had me messed up on what to do, remove both--remove 1 and leave the other--but may have to remove the other later cause it may become active.
With having found 2 tumors they wanted to remove my entire pancreas, and in doing so I would become insulin dependent and would have to take pills for enzymes to be able to digest any food I would eat for the rest of my life.
Once the doctors told me this I thought I was at the end of my life and thers no way I could go with it.
I started searching the net for info but thers is not much out ther cause this type of tumor is very rarer.
I was told mostly found in woman compare to man
1-3 people in a 1million population per year, and so in finding a surgeon that has done a lot of operations is also hard, reason why is that the pancreas is so brittle material that it can take long time to heal so some doctors want to remove your entire pancreas or half of it depending where the tumor is . in such called a whipple removing half pancreas and hope fully the remaining gives you enough insulin other wise you become diabetic.
Some doctors have to open you up from chest rib cage down to belly button other do it by a few holes in the stomach area like they do gall stones, it depends how often a doctor has performed this type of surgery.
In my case I even consider going to the united states and paying out of own pocket cause they have more options including injections to kill the tumor instead of operating but the cost is too much and have to pay out of pocket
More doctors have done these operations in USA compare here in my home city.
So for short time I was taking meds to help with my problem but they did not last much.
I went to a second Hospital for a second opinion cause ther was no way i get rid of my entire pancreas.
I was lucky to find a doctor that listened to my concerns unlike they did in the first hospital.
I had an operation this past summer June 2014 and the doctor/surgeons were successful in removing both tumors with out having to remove any part of my Pancreas.
I spent 2 weeks in hospital i was on iv fluids for 8-9 days and then tried to eat and drink but i had hard time getting use it to get my appetite back as it was before surgery.
I had 4 drain bags from my stomach to drain fluid produced by the pancreas while it healed and it took 3 months for me to have all drain bags removed and to get the all clear that my pancreas is healed from the operation and functioning normal and I don't need any meds.
I had minor pain after surgery but once i left hospital had minor aches when moving abouts on the couch. The hard part was not able to sleep on my sides do to pressure on the stomach with the drain bags so i lost lots of sleep.
I even lost a good amount of weight i was 240lbs before surgery and by end of July i was as low 192 lbs but now Jan 2015 iv put some weight back on at 210 lbs.
The only small sad part I have scar but I consider it a tattoo from my rib cage down to 2 inches below belly button thats how the operation was done and i had 46 staples for 2 weeks, but I think that's a small sacrifice instead of not having a pancreas and be depended on meds that are not cheap.