Re: Pain relief for sentinel node injections?

December 5, 2006

Hi ,

I did not have any pre-medication for the injections before my SNB, and,

yes, I found it very painful. I was told there was nothing they could

give me. Other women in this group got EMLA cream and other medication.

I have found that various women have experienced little to

teeth-gritting pain in this procedure. I would ask for whatever can be

given. I don't understand why they can't start the anesthesia and then

do it.

-

Cantrell wrote on 12/5/2006, 10:05 AM:

> Hi, I'm new. My name is . I have a BRCA1 mutation and am

> planning prophlylactic bilateral mastectomy and reconstruction for

> late January.

>

> After mammo, MRI, and clinical exams, I have no evidence of cancer,

> for which I am very grateful. BUT my surgeon is a big proponent of

> sentinel node biopsy, even for prophylactic patients. The surgeon

> says that for a small percentage of women in my circumstance, they

> find cancer in the breast tissue anyway, and that's where the benefit

> of the sentinel biopsy comes in.

>

> The surgeon tells me they will give me valium (orally) and some

> numbing cream, but based on what I've read, THAT'S NOT ENOUGH! I

> want IV sedation. She (the surgeon) is adamant that they're " not set

> up " for any further sedation, and I am just as adamant that nobody is

> coming at my boobs multiple times with needles full of horribly

> painful stuff unless I am in la-la land.

>

> I have talked with two women who have had the same surgery and

> reconstruction that I am planning, and both of them mentioned how

> awful this was. One of them told me that throughout the whole ordeal

> of surgery and recovery and everything, the only time she thought her

> husband was going to " lose it " was seeing her in that awful pain in

> nuclear medicine.

>

> My goodness -- when a woman is about to face surgery to have her

> breasts cut off, it seems ... I dunno ... " cruel " is not a strong

> enough word ... to subject a woman to this kind of excruciating pain.

>

> Here's my question: Have any of you had any success in DEMANDING

> more sedation for this procedure or some other painful thing that you

> had to endure? You are the veterans with strength and bravery that I

> can only imagine.

>

> I want to put my foot down and be assertive, but I'm not sure how to

> go about it.

>

> Thank you for your replies.

>

December 5, 2006

,

I had my surgery 16 1/2 yrs ago. They took 23 nodes when they did my mastectomy

so I can't help with your question but I am sure some of the other ladies can. I

will keep you in my prayers.

Hugs

nne

Breast Cancer Patients Soul Mates for Life

http://www.geocities.com/chucky5741/breastcancerpatients.html

BreastCancerStories.com

http://www.breastcancerstories.com/content/view/433/161/

Angel Feather Loomer

www.angelfeatherloomer.blogspot.com

Check out my other ornaments at

www.geocities.com/chucky5741/bcornament.html

Lots of info and gifts at:

www.cancerclub.com

Pain relief for sentinel node injections?

Hi, I'm new. My name is . I have a BRCA1 mutation and am

planning prophlylactic bilateral mastectomy and reconstruction for

late January.

After mammo, MRI, and clinical exams, I have no evidence of cancer,

for which I am very grateful. BUT my surgeon is a big proponent of

sentinel node biopsy, even for prophylactic patients. The surgeon

says that for a small percentage of women in my circumstance, they

find cancer in the breast tissue anyway, and that's where the benefit

of the sentinel biopsy comes in.

The surgeon tells me they will give me valium (orally) and some

numbing cream, but based on what I've read, THAT'S NOT ENOUGH! I

want IV sedation. She (the surgeon) is adamant that they're " not set

up " for any further sedation, and I am just as adamant that nobody is

coming at my boobs multiple times with needles full of horribly

painful stuff unless I am in la-la land.

I have talked with two women who have had the same surgery and

reconstruction that I am planning, and both of them mentioned how

awful this was. One of them told me that throughout the whole ordeal

of surgery and recovery and everything, the only time she thought her

husband was going to " lose it " was seeing her in that awful pain in

nuclear medicine.

My goodness -- when a woman is about to face surgery to have her

breasts cut off, it seems ... I dunno ... " cruel " is not a strong

enough word ... to subject a woman to this kind of excruciating pain.

Here's my question: Have any of you had any success in DEMANDING

more sedation for this procedure or some other painful thing that you

had to endure? You are the veterans with strength and bravery that I

can only imagine.

I want to put my foot down and be assertive, but I'm not sure how to

go about it.

Thank you for your replies.

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December 5, 2006

I just had the SNB done on 11/27. The shots are not fun but they are

not that bad. They are over very very quickly (30 seconds total for

all four shots) and the stinging is intense for just a few seconds.

The issue on sedation is the time involved (you should be under

anesthesia no longer than absolutely necessary) and the issue for a

local is that is slows down the movement of the fluid and it needs to

get to your lymph nodes as soon as possible so they can find the

sentinel node asap after surgery begins.

Honestly, it was not as bad as all that.

>

> Hi, I'm new. My name is . I have a BRCA1 mutation and am

> planning prophlylactic bilateral mastectomy and reconstruction for

> late January.

>

> After mammo, MRI, and clinical exams, I have no evidence of cancer,

> for which I am very grateful. BUT my surgeon is a big proponent of

> sentinel node biopsy, even for prophylactic patients. The surgeon

> says that for a small percentage of women in my circumstance, they

> find cancer in the breast tissue anyway, and that's where the

benefit

> of the sentinel biopsy comes in.

>

> The surgeon tells me they will give me valium (orally) and some

> numbing cream, but based on what I've read, THAT'S NOT ENOUGH! I

> want IV sedation. She (the surgeon) is adamant that they're " not

set

> up " for any further sedation, and I am just as adamant that nobody

is

> coming at my boobs multiple times with needles full of horribly

> painful stuff unless I am in la-la land.

>

> I have talked with two women who have had the same surgery and

> reconstruction that I am planning, and both of them mentioned how

> awful this was. One of them told me that throughout the whole

ordeal

> of surgery and recovery and everything, the only time she thought

her

> husband was going to " lose it " was seeing her in that awful pain in

> nuclear medicine.

>

> My goodness -- when a woman is about to face surgery to have her

> breasts cut off, it seems ... I dunno ... " cruel " is not a strong

> enough word ... to subject a woman to this kind of excruciating

pain.

>

> Here's my question: Have any of you had any success in DEMANDING

> more sedation for this procedure or some other painful thing that

you

> had to endure? You are the veterans with strength and bravery that

I

> can only imagine.

>

> I want to put my foot down and be assertive, but I'm not sure how

to

> go about it.

>

> Thank you for your replies.

>

December 5, 2006

>

> Hi, I'm new. My name is . I have a BRCA1 mutation and am

> planning prophlylactic bilateral mastectomy and reconstruction for

> late January.

>

> After mammo, MRI, and clinical exams, I have no evidence of

cancer,

> for which I am very grateful. BUT my surgeon is a big proponent of

> sentinel node biopsy, even for prophylactic patients. The surgeon

> says that for a small percentage of women in my circumstance, they

> find cancer in the breast tissue anyway, and that's where the

benefit

> of the sentinel biopsy comes in.

>

> The surgeon tells me they will give me valium (orally) and some

> numbing cream, but based on what I've read, THAT'S NOT ENOUGH! I

> want IV sedation. She (the surgeon) is adamant that they're " not

set

> up " for any further sedation, and I am just as adamant that nobody

is

> coming at my boobs multiple times with needles full of horribly

> painful stuff unless I am in la-la land.

>

> I have talked with two women who have had the same surgery and

> reconstruction that I am planning, and both of them mentioned how

> awful this was. One of them told me that throughout the whole

ordeal

> of surgery and recovery and everything, the only time she thought

her

> husband was going to " lose it " was seeing her in that awful pain

in

> nuclear medicine.

>

> My goodness -- when a woman is about to face surgery to have her

> breasts cut off, it seems ... I dunno ... " cruel " is not a strong

> enough word ... to subject a woman to this kind of excruciating

pain.

>

> Here's my question: Have any of you had any success in DEMANDING

> more sedation for this procedure or some other painful thing that

you

> had to endure? You are the veterans with strength and bravery

that I

> can only imagine.

>

> I want to put my foot down and be assertive, but I'm not sure how

to

> go about it.

>

> Thank you for your replies.

>

Hi there,

I'm an RN and as patients we have rights and that is the law. If

this surgeon is unwilling to make you as comfortable as possible,

then I would seek a second opinion. I would be very open about your

concerns and fears, and he should respect that. This is your body,

and don't do anything that you are not 100% sure about, be strong

and hold strong to what you want. Keep us posted! Best of luck, and

go get em girl!!!!!!!!

Deena

>

December 5, 2006

>

> I'm an RN and as patients we have rights and that is the law. If

> this surgeon is unwilling to make you as comfortable as possible,

> then I would seek a second opinion. I would be very open about your

> concerns and fears, and he should respect that. This is your body,

> and don't do anything that you are not 100% sure about, be strong

> and hold strong to what you want. Keep us posted! Best of luck, and

> go get em girl!!!!!!!!

> Deena

> >

>

Here's the deal as I understand it. It's not so much a matter of what

the physician is or is not willing to give me. It's how the " system "

works. The system is that you go to Nuclear Medicine and get the

injections, then you go to surgery. They don't do radioactive

injections in surgery, and they don't do sedation in nuclear medicine.

I'm not expecting general anesthesia, just enough IV valium or whatever

to make me loopy and hopefully amnesiac.

I am having immediate reconstruction, meaning that I have to coordinate

the mastectomy surgeon and the plastic surgeon, and I have to have the

surgery done at a facility where they can both practice. So even if I

find that XYZ hospital across town is set up to sedate patients for SNB

injections, that won't do me any good.

Deena, I appreciate your comments. What can we, as patients, do about

this kind of situation? People have different pain tolerance levels.

I know mine is about zilch. I don't pluck my eyebrows because it hurts

so bad.

December 5, 2006

>

> I'm an RN and as patients we have rights and that is the law. If

> this surgeon is unwilling to make you as comfortable as possible,

> then I would seek a second opinion. I would be very open about your

> concerns and fears, and he should respect that. This is your body,

> and don't do anything that you are not 100% sure about, be strong

> and hold strong to what you want. Keep us posted! Best of luck, and

> go get em girl!!!!!!!!

> Deena

> >

>

Here's the deal as I understand it. It's not so much a matter of what

the physician is or is not willing to give me. It's how the " system "

works. The system is that you go to Nuclear Medicine and get the

injections, then you go to surgery. They don't do radioactive

injections in surgery, and they don't do sedation in nuclear medicine.

I'm not expecting general anesthesia, just enough IV valium or whatever

to make me loopy and hopefully amnesiac.

I am having immediate reconstruction, meaning that I have to coordinate

the mastectomy surgeon and the plastic surgeon, and I have to have the

surgery done at a facility where they can both practice. So even if I

find that XYZ hospital across town is set up to sedate patients for SNB

injections, that won't do me any good.

Deena, I appreciate your comments. What can we, as patients, do about

this kind of situation? People have different pain tolerance levels.

I know mine is about zilch. I don't pluck my eyebrows because it hurts

so bad.

December 5, 2006

>

> I'm an RN and as patients we have rights and that is the law. If

> this surgeon is unwilling to make you as comfortable as possible,

> then I would seek a second opinion. I would be very open about your

> concerns and fears, and he should respect that. This is your body,

> and don't do anything that you are not 100% sure about, be strong

> and hold strong to what you want. Keep us posted! Best of luck, and

> go get em girl!!!!!!!!

> Deena

> >

>

Here's the deal as I understand it. It's not so much a matter of what

the physician is or is not willing to give me. It's how the " system "

works. The system is that you go to Nuclear Medicine and get the

injections, then you go to surgery. They don't do radioactive

injections in surgery, and they don't do sedation in nuclear medicine.

I'm not expecting general anesthesia, just enough IV valium or whatever

to make me loopy and hopefully amnesiac.

I am having immediate reconstruction, meaning that I have to coordinate

the mastectomy surgeon and the plastic surgeon, and I have to have the

surgery done at a facility where they can both practice. So even if I

find that XYZ hospital across town is set up to sedate patients for SNB

injections, that won't do me any good.

Deena, I appreciate your comments. What can we, as patients, do about

this kind of situation? People have different pain tolerance levels.

I know mine is about zilch. I don't pluck my eyebrows because it hurts

so bad.

December 6, 2006

After he gave you the Novacain, did the other injections hurt -- the

ones with the radioactive stuff?

>

> The Radiaoligist at the hospital where I had the SNB numbed the

area with Novacain. This was the first time he had tried it but when

he first started talking to me about it, he said " you can scream,

yell or call me names, just don't hit or try to push my hands away "

after that statement I asked what can we do to make this bearable and

he said if I was willing to try the Novacain he would. There were 4

small skin pokes from the Novacaine but nothing like the pain that I

have heard about elsewhere. Speak up, Ask for it!!

>

> B

> Tulsa

> Re: Pain relief for sentinel node

injections?

>

December 6, 2006

After he gave you the Novacain, did the other injections hurt -- the

ones with the radioactive stuff?

>

> The Radiaoligist at the hospital where I had the SNB numbed the

area with Novacain. This was the first time he had tried it but when

he first started talking to me about it, he said " you can scream,

yell or call me names, just don't hit or try to push my hands away "

after that statement I asked what can we do to make this bearable and

he said if I was willing to try the Novacain he would. There were 4

small skin pokes from the Novacaine but nothing like the pain that I

have heard about elsewhere. Speak up, Ask for it!!

>

> B

> Tulsa

> Re: Pain relief for sentinel node

injections?

>

December 6, 2006

After he gave you the Novacain, did the other injections hurt -- the

ones with the radioactive stuff?

>

> The Radiaoligist at the hospital where I had the SNB numbed the

area with Novacain. This was the first time he had tried it but when

he first started talking to me about it, he said " you can scream,

yell or call me names, just don't hit or try to push my hands away "

after that statement I asked what can we do to make this bearable and

he said if I was willing to try the Novacain he would. There were 4

small skin pokes from the Novacaine but nothing like the pain that I

have heard about elsewhere. Speak up, Ask for it!!

>

> B

> Tulsa

> Re: Pain relief for sentinel node

injections?

>

December 6, 2006

I'm new to this list and want to say that I'm so pleased to have found a group

of such supportive women. I'm a quarter way through a A/C - T chemotherapy

treatments and found the second(done yesterday) to be much better than the first

- YEAH!!!

I recently had a second mascetomy and sentenal node bio. When I visited with

the neucleor med folks, he explained to me that they were unable to do any more

than a topical numbing cream because any subdermal sedation could interfer with

getting the dye to the right nodes, timing, etc. I had four injections around

the site of the lump and they really weren't too bad, but each of us feels pain

differently.

Maybe it would help if you could talk to the neucleor medicine folks before the

procedure. It might help to understand the process of the actual dye

infections.

Good luck.

Carolyn

The surgeon tells me they will give me valium (orally) and some

numbing cream, but based on what I've read, THAT'S NOT ENOUGH! I

want IV sedation. She (the surgeon) is adamant that they're " not set

Here's my question: Have any of you had any success in DEMANDING

more sedation for this procedure or some other painful thing that you

had to endure? You are the veterans with strength and bravery that I

can only imagine.

I want to put my foot down and be assertive, but I'm not sure how to

go about it.

Thank you for your replies.

.

December 6, 2006

I'm new to this list and want to say that I'm so pleased to have found a group

of such supportive women. I'm a quarter way through a A/C - T chemotherapy

treatments and found the second(done yesterday) to be much better than the first

- YEAH!!!

I recently had a second mascetomy and sentenal node bio. When I visited with

the neucleor med folks, he explained to me that they were unable to do any more

than a topical numbing cream because any subdermal sedation could interfer with

getting the dye to the right nodes, timing, etc. I had four injections around

the site of the lump and they really weren't too bad, but each of us feels pain

differently.

Maybe it would help if you could talk to the neucleor medicine folks before the

procedure. It might help to understand the process of the actual dye

infections.

Good luck.

Carolyn

The surgeon tells me they will give me valium (orally) and some

numbing cream, but based on what I've read, THAT'S NOT ENOUGH! I

want IV sedation. She (the surgeon) is adamant that they're " not set

Here's my question: Have any of you had any success in DEMANDING

more sedation for this procedure or some other painful thing that you

had to endure? You are the veterans with strength and bravery that I

can only imagine.

I want to put my foot down and be assertive, but I'm not sure how to

go about it.

Thank you for your replies.

.

December 6, 2006

This afternoon I talked with the surgeon's NP -- nurse practitioner.

I have talked with her several times in the last few weeks and always

found her very empathetic and supportive. Now I have mixed feelings.

I told her that I had discussed this with the doctor only once, and

that the doctor's response was that they are not set up to offer

anesthesia for the injections. The NP said that this may have been a

misunderstanding, and maybe the doctor thought I was asking to have

the injections after I'm already in the OR, under general

anesthesia. I was thinking more along the lines of the stuff they

give you for a colonoscopy, where you're out of it but still able to

breathe on your own and be somewhat responsive.

Anyway, the NP is going to talk with the doctor and clarify that and

call me back tomorrow, and maybe I'll get some encouraging news out

of that.

There were a couple of things that bothered me, though. At one

point, when I was talking about how scared I am of the pain, she said

that sometimes in life, things just have to hurt. I find that rather

patronizing. She also made a couple of statements suggesting that

there are people much worse off than I am, who have to bear more pain

than this will cause. I know all of that is true, but it strikes me

as not playing fair on her part. Know what I mean? When I read the

experiences here, women saying they would do everything they could to

avoid going through that again, I don't think I'm being unreasonable

to ask for substantial pain control.

I know that medical professionals are kind and caring people, and if

they could prevent all pain, they would do so. I also realize that

in order to do their jobs, they have to develop a certain sense of

detachment from their patients' pain, or they couldn't do things that

they have to do. I think sometimes patients get caught in the middle

of those two extremes. Doctors see this all the time and they know it

will be over quickly. For the patient, it is a horrible nightmare

she can't ever forget.

Another thing ... mercifully, most women will go through this only

once. Several of you have said that if you had to go through it

again, you would be much more insistent about having something for

the pain. I think it's going to take that kind of insistence before

they DO realize that stronger pain relief needs to be offered.

I guess I'm just venting. Thanks for listening. Please offer any

suggestions that you can. I'm not giving up yet.

December 6, 2006