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hi, my husband had CABG 5 years ago, he has developed pain behind the sternum, it is so severe that he had all the tests done like, CT angio, stress test etc. But thankfully everything was alright. Pain is persistent & only responds to codeine & muscle relaxants. He is in real distress when in pain. The joints of ribs are extremely painful. I would be grateful if you can guide us to any research about the diagnosis & treatment. Both of us are anaesthetist & we live in Pakistan. My email is 

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There are many studies out there relating to Post-sternotomy pain. Here's one link.

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You may have to become a member to access the information. As a medical professional, you should have no problem. I will also forward this to your e-mail address. I also advise you to read the other post on this thread to see what others have done in mitigating the pain.

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hi all its me jeff still here after my sternal fixation.chest still a bit tight but no sternal pain the only thing i get now is wierd when its cold i get very bad nipple ache its enough to bring tears to my eyes so have to wrap up warm and stay out of the cold . heres hoping you all get the pain relief i got after my second lot of surgery all the best jeff
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So glad to hear from you, Jeff, and to know things worked out for you; except for that little glitch. Cold does seem to have an impact on this whole syndrome. Perhaps, someday, someone will figure out why. As for me, I discovered that my pain was a mixture of post-sternotomy pain and an actual need for additional stents. So, I had three inserted in the same blood vessel, which I had original been told was closed. Go figure. I have radically changed my diet to really low fat, low cholesterol and have lost 17 pounds.

So far, so good. Take care,

Lillian
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glad they sorted it out for you keep up the good work just been summond back to hospital something wrong with last weeks blood test will let you know the outcome fingers crossed .
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Its been over 6 years since Open Heart Surgery. As part of the operation I had my Sternum rewired. It wasnt long after that when the pain started. It spreads into my ribs and under my breasts. I also have a lump nearer the right side of my breast. At first the consultants thought it was nerve damage. Xrays showed nothing. The heart surgeon tried removing some wires but it just came back. I tried various pain meds: Tramadol, Gaphebentin, Pregablin but they made me feel like a zombie virtually unable to speak. I also tried Capsican cream but it just burned alot. I wear Versatis patches at night to try and get some sleep. It feels like a sharp stabbing pain and when I lean over it almost feels like a bra wire is sticking out if my chest. I was eventually referred to the Throrasic Team who did a 3D CT scan of my chest. It shows a step in my bones. They are not sure why this has happened but have offered Trigger Point Steroid Injections to give some relief. They have said further surgery is likely but very risky and would involve the heart team.

I too see no end to this chronic pain and also feel it would have been better had I passed away during the initial operation
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I am SO sorry to hear about the pain you are experiencing. When I read your history, I realize how fortunate I am, despite the intermittent discomfort I feel from time to time. Since I do not know what State you live in, it's difficult to determine whether the weather affects you. I know, because I've tracked it over the years, and my symptoms are most acute and ongoing during the winter months. I absolutely do not tolerated temperatures below 70 degrees. I also avoid whenever possible bending over for anything.

I recently purchased a file cabinet that needed to be assembled. This required bending. For several days, my chest pain was in full bloom...breast discomfort, "sticking" feeling and all the rest. I could even feel it when I walked. So, bending is a trigger point. I also refrain from reaching high. I find that at night a heating pad helps. And for some reason, whenever I get the pain and discomfort 600 mgm of Vitamin C seems to work. If there are no medical reasons why you should not take Vitamin C, I suggest you try it.

Most cardiologists do not adequately explain the side-effects of open heart surgery, especially the invasive kind (they're doing less of it today). Anterior intercostal nerve damage is one side-effect that can be the cause of chronic pain. If the mammary artery was used then breast discomfort usually occurs. Please do not get discouraged. There are Pain Management Centers available for support. If at all possible, I would consider going to John Hopkins for a consultation. My prayers are with you.

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Thanks for your reply, it was of some comfort to share someone else's experience and therefore feel not alone. I never knew of Vitamin C as an option but am willing to try anything if it may be of some benefit. I too find that bending and stretching is very painful and rely on my partner to put things within easy reach. I have used hot water bottles on the really bad days and cushions under my arms to take some of the weight off my chest. I also wear front fastening bras wireless as others just dig in and further aggrevate the pain. I agree with what you said about the cardiologists. They explain everything in medical terminology not simple terms which causes further problems when trying to understand the condition. It doesn't help when I go for my ICD checkups and they all gather round me and talk above me.

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I had a Ross procedure 3 years ago. I went back to full time work 4 months later. I felt pretty good figured everything was on the mend and now 3 years later my sternum is so sore. I do tons of lifting at my job and today it actually felt like I was being kicked in my sternum I am very frustrated. Hope I can get some answers. I am almost afraid to lift now. The bones are even sore to touch still.
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I'm not a doctor, so I would never try to diagnose your case. However, I am a nurse, and I had by-pass surgery 16 years ago. When I first had my surgery, it took quite a while for me not to feel as if my sternum was not moving whenever I raked the lawn, etc. Over time, that feeling disappeared, but chronic, intermittent pain with soreness in near the area surrounding the sternum occurs whenever pressure is put on the area, when I bend, when I reach for something higher than the second shelf in my kitchen, do any heavy lifting, and when I am exposed to cold or damp weather. I've done a little research on this, because my doctor does not advise that I have additional surgery to determine if the wires are creating the problem. A Dr. Nicolina van Leersum has conducted studies on patients that have had sternotomy operations due to cardiac problems and other medical problems that require opening the chest wall. In her study 33% of patients who had median sternotomy complained of pain post-operatively. In her opinion, aside from the obvious intercostal nerve damage that can cause chronic pain, she suggests other things. She calls our pain Chronic Poststernotomy Pain and find it to include muscles and skeletal tissue in the area. To me, although SHE doesn't come right out and says it, this suggests arthritis, sensitive scar tissue, and an inflammatory process. In her studies she also noted that the pain often includes the neck, shoulder, arm and back. You might want to google her name since I can't give any web addresses.

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You are alive, quick complaining!

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My dad had quadruple bypass 4 years ago and had severe complications.   He developed a deep sternal wound immediately after the surgery.  They tried the VAC route to clean out the infection but it didn't work so they had to go in and remove part of his sternum, then do reconstructive surgery for a flap.  He's been complaining of pain for a few weeks (the pain never has completely subsided, actually) and went to urgent care last night.  They took him to the ER by ambulance because they were nervous about a heart attack.  All tests are coming back normal so far with the exception of a CT scan that showed he has an infection in his sternum.  So he's on an IV now with heavy antibiotics and blood thinners...and they're running a few more tests today.  Has anyone heard of this?  An infection years after the bypass?  What causes it and what do they do for it?  I do wonder if the weather and a cold could be a factor, too, as I've read many of you have pain in the sternum with both (we live in Michigan so it's cold right now -- and my dad is just getting over a nasty cold).  Any input is much appreciated...I'm worried.

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I don't know your dad's particular case, but based on my own experience and what I hear from others, you really never get past the pain from any kind of sternotomy surgery (sternum), once you have it. Some people are fortunate,and never experience it.

There is so much that triggers the pain, and it could vary from patient to patient. Something simple like pressure after a physical examination with a stethescope could trigger it. Cold weather and viral infections also play a role. I would run to the emergency room or the doctor's office on numerous occasions thinkiing I was have a cardiac problem. Now, I recognize the difference. The topic of poststernotomy pain can be looked up on the internet. There's a host of information about it.
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Good to know - thank you
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Similar problem - 

        I had a bypass 3 years ago and have severe, constant rib pain mostly in one area on the left side.  After doing a CAT scan today, I was told there is nothing showing in the Cat scan.  Go see a pain specialist.   My heart doctor said, well they could open you up and see.  I do not think so. 

         My rib pain affects every move I make.   If it goes out of place, it stabs me on the outside and sometimes turns to stab me on the inside.  

         I will go to the pain specialist but am not too hopeful since the CAT scan was negative and I have no real diagnosis of the pain.  

         I sympathize with your problem.  Personally I am beginning to think this is " IT " and I will have to totally adjust my lifestyle to avoid the pain of my rib slipping out of place.  I exercise only as able, to avoid the pain and intend to just live doing only what I can manage.   Reading that you have had this problem for 5 years will help me to decide on any/no treatment. 

         Sharing on a site like this helps.    

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