Question about sternum pain

[ajc1991]

Hi everyone, I have a surgery scheduled for October 30th to get my mitral valve replaced with a St. Jude mechanical one. My surgeon plans on doing a minimally invasive surgery, which makes the incision smaller as opposed to making a large incision down your chest.

I do know my surgeon will have to divide my sternum in order to be able to access my heart. I have a question for the people on here who have had this surgery already, and that question is regarding the sternum. How bad is the sternum pain? What does it feel like? Is it like a bruised rib feeling? I appreciate your responses.

EDIT: I just realized this belongs in the "Post Surgery" forum. Sorry :/

 

[clay_from_nj]

There really is a whole range of possibilities that goes across the entire pain spectrum. That is, some people suffer pretty bad pain and may require meds. Others suffer very little or no pain. The only sternum-related pain I had was a short, sharp pain when sneezing or coughing, and some very mild costochodritis (inflammation of the cartilage connecting the sternum to the ribs), all in the first few days after surgery.

 

[river-wear]

test to see if this posts - will edit if it does

 

[Dan Zulu]

I had a full sternectomy (sp?) and have had little pain. In the hospital my sternum bone ached for a few days afterwards but with small doses of Percocet never exceeded 2 on the pain scale. My 4th day after surgery I decided to avoid the Percocet and the sternum woke me up hurting at 4:00 am. After that the nurses told me to take a Percocet before bed to prevent the nightly wake ups. Day 7 and afterwards I didn't need any pain meds of any kind. It hasn't been bad at all.

 

[ajc1991]

Very glad to hear, at least pain meds will be involved. I know I just need to be careful with the sternum. Not lifting anything over 10 lbs, avoid pushing or pulling etc.

 

[Odie]

I also had a full sternotomy. I used prescription pain meds for the first 5 days and then switched to Advil at night for two or three more days. I've bruised and slipped ribs before and I can the you the sternum pain was mild compared to the rib pain.

During a pre-surgery consult with my surgeon I confessed I was not one to take prescription drugs unless suffering greatly. He took that opportunity to deliver a lecture about how needlessly suffering would not benefit the healing process and would likely add stress to my already stressed body. His point was that it is smarter to take the pain meds than to try to "tough it out". His advice was to stay ahead of the pain through medication. I took his advice very seriously and experienced only mild soreness during recovery.

With that said, I want to share the one episode of intense pain for me. When I awoke in ICU the nurses were confused about how to manage my pain, so there was a delay in giving me anything. I once had an allergic reaction to a class of pain meds, so the delay resulted while the nursing staff consulted with others to verify my pain management options. The pain was a combination of stinging and burning, which I characterized as being an 8 on a scale of 1 to 10; however my wife says based on the number of F-bombs I dropped in the company of attractive young nurses, and the look on my face, a 12 might have been more accurate! Even the "bad" pain quickly seemed trivial. When I woke up I was still extremely groggy from anesthesia. Additionally, realizing you are alive and having feelings is really nice... even if the feeling is pain.

The reality is everyone has a unique experience. I've heard others talk about pain during tube removal, stinging sharp pain during nerve healing, and back pain. I experienced none of that.

 

[epstns]

I think I had more pain from the constant needle-sticks for blood tests than the sternum -- until I coughed, that is. I had a nasty cough for weeks after surgery, and believe me, I learned how to hold a folded up blanket against my sternum to avoid the pain. First sneeze was a real "eye-opener."

That said, I don't really remember the pain being much to worry about. I think a lot may have to do with how tightly they fasten your sternum when they close you up. I've seen the X-rays of my sternal wires, and they really tied it tightly. I never felt any movement or pain as the bone healed. I was even able to use my arms fairly normally right after surgery, as long as I didn't reach far out or up. That helped me a lot in moving around in bed and getting up and out.

It probably helped that I'm a wiry little gym rat - about 5'8" tall and right around 160 lbs., so I had a pretty decent "power-to-weight" ratio and could easily move around without using sore muscles too much. Within a short couple of weeks, I was moving so well that people were surprised to learn that I had recently had open-heart surgery.

 

[ajc1991]

Thanks you for all of your responses. It's put my mind at ease. Frankly, that's the only thing I was worried about lol. Tubes I'm not looking forward to but I know they're there for my own good and are taken out within the first two days. Thank you.

 

[Blake777]

Hello just wanted to say my first open heart sternum pain was very painful, I still remember it it was so bad. But the second open heart surgery I had no pain at all in my sternum. Two different surgeons though. So I guess it depends on the surgeon. I think my surgeon gave me some type of block that helped tremendously, I hardly remember any pain at all. Had other problems but no pain.

 

[PGARG]

Hi ajc,
I'm not 4 weeks Post-Op. I'm 41 and everything has gone pretty smoothly. I had the Aortic valve replaced with a mini sternotomy. There were a few times i felt sharp pain, and that was when they tried to turn me side to side in the bed. Mostly the pain was encountered getting in and out of bed. Otherwise the pain is not bad at all. Be very very diligent about pain medication. Remember that without pain medication, you will have bad pain....ofcourse, your bone has been sawed. So when folks say their pain wasn't bad, that really means that it was well managed. Take your pain meds on time, and make sure u take works for you. For me the certain meds were not working, and i quickly got them replaced. Hospitals are good about this stuff anyway, but you have to tell them about pain before it hits you or gets worse. Dont try to be a hero.
BTW, another interesting thing i found during this ordeal. Younger folks (and even i'm young as per doc), feel more pain as compared to older folks. That is mainly due to nerves get degraded in older folks and thus they lose sensation and hence they lose pain sensation too. For younger folks, they feel every bit of everything

Overall, with pain medication on time, you won't have major issues. I still can't believe i have had heart surgery .....

Good Luck!

 

[big_L]

In general, the older you are the less pain you'll feel. I can't explain. My pain was not bad and I wasn't taking pain meds at all after 2-3 days. Maybe I'd ask for one at night, but that was more to try and get through the LONG lights. Over

I'm still dealing with sternum itching and a weird feeling occasionally.

 

[R1Phrankey]

Hello,

I have had my aortic valve replaced via a mini-AVR. I have a 3 inch scar at the sternum.
I have had some pain, but it never was very high on the pain scale. I have used pain killers in the hospital and for the first week at home.
However, it was not a very nice feeling and it feels like my complete upper chest is painful, especially the muscles in my breast, shoulders and even the upper arm.
I think that via the mini sternotomy they really have to force the chest open, which is causing the muscles to hurt. I have spoken to people who had a full sternotomy and they had much less problems than I had.
Please note that the pain is not very high, but rather annoying, even lifting a jar from the table hurts. It took about 3 weeks to heal.
The pain on the sternum was never very painful, but now, 4 months after surgery I sometimes still feel some pain. It depends from day to day and depends on how I slept. But some stretching will remove this pain very quickly.

 

[ajc1991]

Ah ok. So is it a soreness or a kind of sharp pain?

 

[R1Phrankey]

Yes, it was more a soreness than pain. I have been thinking about the reason for this and in my opinion it is caused by the fact that with a full sternotomy the 2 complete chest halves are opened, where with the mini sternotomy only a part is opened. The ribs are sort of bonded together, and when opening the chest, only a part will be opened, causing some stress between the opened part of the ribs and the not-opened part. It sort of feels like muscle pain, but then for few weeks instead of a couple of days.
However, the advantage is that you are able to pick up things earlier, since most of the sternum is still okay.
It is all depending on the surgeon which technique he uses. I have only a 3" scar, but I have read about 5" scars also.

 

[ajc1991]

Oh ok. Thank you so much for your input.

 

[bw00]

I didn't think the pain was that bad. Only when I had to cough, and at night when I was trying to find a position to sleep in. But it's not something you should worry about, it's very doable

 

[ajc1991]

I have yet another question regarding sternum pain. My surgeon will be doing a minimally invasive procedure to replace my mitral valve. Does minimally invasive mean less pain?

 

[Paleowoman]

Not necessarily. Though in theory it's supposed to. It depends on where the incision is done, the length of incision, the ease or not with wich the surgeon can reach the area of the heart where he/she will be working - lot of manipulation going on. There are so many variables, but they say it's supposed to be less painful than a full sternotomy. Whatever, the hospital will be aware of the pain and should give you good pain relief. It's not something anyone should have to worry about prior to surgery.

I had 'minimally invasive surgery' - though it wasn't so minimal as the incision was almost the full length of my sternum. You might want to ask your surgeon where he/she is doing the incision and the usual length of it. Have a look at a thread I have going about that: http://www.valvereplacement.org/forums/forum/heart-talk/848447-minimally-invasive-surgery There's a couple of links in there.

 

[ajc1991]

Thanks for your reply Paleogirl. My surgeon said my scar will be about 2 inches.

 

[Paleowoman]

You should be fine with such a short incision ajc ! Let us know how it goes ! And all the best for a speedy recovery !