Esophagectomy post-op pain

case1102
case1102 Member Posts: 1
in Esophageal Cancer #1

My Dad is POD2 from his esophagectomy.  They did a minimally invasive procedure with laproscopic approach through abdomen and thoarcic cavity.  Stage 3, 2 lymph nodes, no spread, they found no mets, and got clear margins, but had to attach stomach to esophagus at last section before entering the neck.  He still has NG tube as his stomach wasn't emptying today when they completed the upper gi series.  Chest tube is still in. oxygen levels stable at 91% on 4 liters with productive cough. He is on a PCA of Dilaudid at current time and oxycodone 5 mg through J-tube. My concern is the doctors are talking about discontinuing his Dilaudid PCA in the morning and I do not feel that 5 mg of Oxycodone is enough to control his pain.  Is it standard to d/c a PCA on POD3 for these surgeries? I am just curious about others experiences.  Prior to his operation he was on oxycontin extended release 10mg every 12 hours and Oxycontin 10 mg every 6 hours.  

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  • LorettaMarshall
    LorettaMarshall Member Posts: 662 Member
    edited October 2016 #2
    Case1102~Please be a bit more specific~thanks

    https://csn.cancer.org/node/305932

    Esophagectomy post-op pain

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    Hello Case1102 

    Pardon me, but I need to know a lot more than you have written here.  Please educate me, I have no idea of what POD2 means.  I put in a search with JohnsHopkins, and asked “What is Pod2?”  This is the answer I got.  “Sorry, no search results were found for "what is pod2".

     Have no experience with  what U R talking about with a NG which I do know is a NasoGASTRIC TUBE.  You say dad’s chest tube is still in.  My husband had both the NGtube and chest tube removed well before discharge from the hospital.  This is the normal procedure.  Is your father still hospitalized?  When did he have his surgery?  There are several different types of Esophagectomies.  Exactly what type of Esophagectomy did he have?

     http://www.hopkinsmedicine.org/healthlibrary/test_procedures/gastroenterology/upper_gastrointestinal_series_92,p07701/

    Upper GI series explained and why it is done.

    Furthermore, did he have a mediport?  Why is pain killer being put in a feeding tube???

    You write:  “He is on a PCA of Dilaudid at current time and oxycodone 5 mg through J-tube. My concern is the doctors are talking about discontinuing his Dilaudid PCA in the morning and I do not feel that 5 mg of Oxycodone is enough to control his pain.”

    First you say he is POD2 from his Esophagectomy.  Then you ask about PCA on POD3. You ask, “ Is it standard to d/c a PCA on POD3 for these surgeries?”  I’m sorry but I can’t even begin to understand the question much less the answer.  And I do have some idea of what esophagectomies are all about, and how patients fare before, during and after surgery. 

    Also, you say, “Prior to his operation he was on oxycontin extended release 10mg every 12 hours and Oxycontin 10 mg every 6 hours.”  I ask how on earth was an Esophagectomy performed on a patient with such a high pain level that he needed to be on these pain meds? 

    I’ve never heard of this in the 13 years I’ve been reading different stories from different patients.  My husband is now in his 14th year of survival from Esophageal Cancer and so we’ve been observing this type of cancer and the patients who have been diagnosed.  Some survived, and sadly many did not.  And so it seems that would have been difficult for the surgeons to have proceeded with a surgical procedure given the level of intense pain your dad was having, and according to your writing, is still having, all during the surgery!

    Did your father have pre-op chemo and radiation?  If so what were the meds and the schedule on which he received them?  Moreover, how many lymph nodes were tested for residual cancer during the surgery?   

    Furthermore, we always like to know where the patient has been treated, and what was his original diagnosis, and what type of Esophagectomy he had performed, and who were or are his surgeons?

    What is the reason for pain that requires strong pain meds both before, evidently during and after the “Esophagectomy.”   

    Moreover, there are two different types of Esophageal Cancer.  You say, Stage 3, so Stage 3 what? 

    I wish I could help, but am completely unable to understand what you reference.  Furthermore, I see that 71 others have read your letter as of 10-18-16 and so far I’m assuming others are not completely understanding your posting either.

     So perhaps if you could provide a bit more clarity, someone might be able to answer your questions, but I’m not able to do so.  I have absolutely no experience that would qualify me to be able to help.  Sorry

     Loretta (Wife of William, EC survivor now entering his 14th year, thank God.)

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