Managing Post-Surgery Discomfort: Rib Stent Complications and Solutions

Rib support issues?

Hello, doctor.
I underwent rib cage stent surgery on June 30th last year.
After the surgery, I informed the doctor in the ward that I was experiencing severe foreign body sensation and back pain.
At that time, the doctor only mentioned it was PDST (Post-Discharge Syndrome).
I was taking one painkiller daily for 4 to 6 hours, thinking that the pain was normal after surgery.
However, even after the stitches were removed, I still experienced chest tightness, pain, and disturbances in taste and sensation.
Due to my mental and physical condition, I consulted a psychiatrist and was prescribed medication.
In mid-February of this year, I received the second dose of the BNT vaccine, after which my arm was extremely painful.
I thought it was caused by the vaccine, but the pain became so severe that I couldn't even fasten my bra.
By May, I consulted a rehabilitation specialist, who took X-rays and diagnosed me with frozen shoulder.
Since May, I have been taking painkillers and doing self-rehabilitation.
However, the chest tightness, foreign body sensation, and back pain have not changed at all.
Currently, I also feel a blockage in my throat and nasal cavity, with a foreign body sensation in my throat and tightness from my chest to my back.
I can raise my arm to about 160 degrees, but it still hurts when I try to move it backward.
I can fasten my bra, but it causes pain and weakness.
I would like to ask the doctor if removing the stent would improve my condition.
Is there any other treatment for the foreign body sensation and pain? Currently, I also feel discomfort in my breathing, and the area near the surgical site feels hard to the touch.
Pressing on the scar causes pain, and there is tightness from my chest to my back.
Since the surgery was performed by both thoracic and orthopedic surgeons, I had my stitches removed by the orthopedic department and did not follow up with the thoracic department.
If I want to improve my current condition, which specialty should I consult? The foreign body sensation has been very severe since the surgery, and I am even having issues with my diet and poor sleep quality at night.
I hope to return to my pre-surgery state.
What methods should I consider for rehabilitation? Thank you for your response.

Ning Ning, 40~49 year old female. Ask Date: 2022/06/25

Dr. Wang Shouji reply Orthopedics

Hello, if the rib surgery was performed by a thoracic surgeon, it is recommended to have a follow-up appointment with the thoracic specialist to assess the healing status of the fractures and determine if they can be removed.
If the tissue at the injury site is constricted, it may indeed cause such symptoms.
Most rehabilitation should alleviate the discomfort, but the process may be uncomfortable.
Applying heat and using medication should help improve the situation.
Changhua Hospital cares about your health.
Sincerely, Wang Shou-ji.

Reply Date: 2022/06/25

More Info

Managing post-surgery discomfort, particularly after rib stent surgery, can be quite challenging, especially when complications arise. Your symptoms, including a persistent foreign body sensation, back pain, chest tightness, and altered taste and sensation, are concerning and warrant a thorough evaluation.

Firstly, it’s important to understand that the discomfort you’re experiencing may be multifactorial. The sensation of a foreign body can often be attributed to the presence of the stent itself, as well as the healing process of the surrounding tissues. The pain in your back and chest could be related to muscle strain, nerve irritation, or even the positioning during and after surgery. Additionally, the development of "frozen shoulder" (or adhesive capsulitis) can occur post-operatively, especially if mobility is limited during recovery.

Given your ongoing symptoms, it is advisable to consult with a multidisciplinary team. Here are some steps you can take:
1. Consult a Thoracic Surgeon: Since your surgery involved both thoracic and orthopedic components, a follow-up with the thoracic surgeon who performed the rib stent placement is crucial. They can assess whether the stent is positioned correctly and if it is contributing to your discomfort. They may also evaluate the possibility of removing the stent if it is deemed necessary.

2. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can help you with exercises to improve your range of motion, strengthen the shoulder, and alleviate tightness in the chest and back. They can also provide modalities such as ultrasound or electrical stimulation to help manage pain.

3. Pain Management Specialist: If your pain is not adequately controlled with over-the-counter medications, a pain management specialist may offer additional options, including nerve blocks or other interventional procedures that can provide relief.

4. Psychological Support: Given that you have seen a psychiatrist, it may be helpful to continue this support, especially if your symptoms are affecting your mental well-being. Chronic pain can lead to anxiety and depression, which can further exacerbate the perception of pain.

5. Nutritional Consultation: If you are experiencing issues with eating due to discomfort, consulting a nutritionist may help you find ways to maintain a balanced diet while managing your symptoms.

6. Regular Follow-ups: Ensure that you have regular follow-ups with your healthcare providers to monitor your recovery and adjust your treatment plan as necessary.

In terms of whether removing the stent would alleviate your symptoms, this is a decision that should be made collaboratively with your surgical team. They will consider the risks and benefits of removal, as well as the potential for improvement in your quality of life.

Lastly, it’s essential to communicate openly with your healthcare providers about the severity of your symptoms and how they impact your daily life. This will help them tailor a management plan that addresses your specific needs and concerns.

In summary, managing post-surgery discomfort requires a comprehensive approach involving multiple specialties. By seeking appropriate consultations and engaging in rehabilitation, you can work towards improving your symptoms and overall quality of life.

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