Post breast operation - thumb pain???

[Chasingsquirrels]

Edit: too long!

• Why would I have had a needle in the base of my thumb (causing bruising and nerve pain) when having a breast & armpit operation?

(Catheter in back of hand).

=================

Had a lumpectomy & sentinel node removal for breast cancer on Thursday, day surgery and all uneventful. Was home by early evening. Barely any pain or discomfort in my surgery sites.

I had a catheter in the back of my opposite hand, it was removed just before I was discharged and covered with a small dressing that I have since removed. I can see the needle track and a small bruise around it, all fine.

However there is also a needle track, scratch and a large bruise at the base on my thumb in that same hand, and I have numbness in my thumb and twinging nerve pain along my thumb when I use it - to the extent that I am using my surgery side arm in preference to avoid using my thumb.

Now, I'm sure it will pass as the bruise goes down and it is already less numb than it was initially (so it hopefully won't be an ongoing problem.

But I dont understand WHY I'd have had a needle in that specific area?

I recall they were having some issues getting the catheter into the back of my hand, and I was asked to fist my hand and squeeze. This was whilst on the operating bed in the surgery, so I was lying down, lots of other things were going on and I couldn't really see what was happening with my hand.

It isn’t a big issue, but I would like to know - could anyone with expertise throw any light?

I also feel ridiculous, I've been in for surgery, all this post op advice etc, yet when anyone asks how I am my main comment is that my thumb hurts!

Had the same surgery recently op.
Maybe the did put a canula there if its not referred pain.

Or did you consent to give blood for biobank? I did and they took blood from back of elbow.

Haven't heard of referred pain, but having googled I don't think so.

But, I have agreed to a trial which involved bloods being taken. I assumed they'd take through the canula but it could explain things. Wish they'd taken from my arm, my thumb is bloody painful and as it it my right hand (dominant) it is making things much more difficult.

Thanks for replying.

Maybe ring your nurse tomorrow if you have one. You don't want something affecting your movements as it can cause other problems

I mentioned it before I was discharged as it was numb, and on the phone to the breast nurse when she called on Friday morning post-op.
I'll see how it is in the morning and probably give them a call.
It isn't stopping me doing the exercises etc as it is the opposite arm. Just trying to eat left handed, avoid certain movement etc.

Other than the thumb issue, I'm much better than I thought I would be (never had an operation before) which is a relief.

It sounds as though you may have had an arterial blood gas taken or had an arterial line insitu in your radial artery. This is a more painful area to have blood taken and there is a risk of the needle interacting with the nerves in your wrist.

Difficult to say whether the bloods you had consented to from the trial would have been taken from an artery or why they would use an arterial line for day surgery unless you have past medical history that makes you higher risk. They are used for more accurate blood pressure monitoring and if frequent blood sampling is required.

If it persists then I would ask your breast care nurse if she could find out whether you had an arterial line and whether you need follow up.

If you have bruising etc on the base of your thumb maybe take some detailed photos of it so you can show them when you ask (to avoid being fobbed off)..

depends a bit on what you mean by 'base of the thumb'. There's often a pretty juicy vein on the side of the wrist on the thumb side that we commonly use to cannulate. There's an artery on the palmar side of the wrist near the thumb base that we use occasionally to put a line in for BP monitoring or for doing a specific type of blood test. The sensory nerves to the thumb pass close to both. If the cannula was tricky it's not beyond the realms of possibility they put a small one in to get off to sleep with a plan to change it to a decent size one once asleep. Very occasionally using an arterial line to monitor BP might be sensible - usually if there's significant cardiac problems, instability intraoperatively or a BP cuff wasn't working well (most likely reason for that would be significant obesity). If they knew they were doing blood tests then they'd usually have done those from the cannula...unless it was a small one that didn't bleed. If the surgeons hadn't told them they were supposed to be doing blood tests then a second needle'd be necessary once asleep. You have limited options for IV access/bloods/bp monitoring in breast surgery (either non-operative side or the legs) so occasionally a bit of improv is needed.

The people you've mentioned it to should have spoken to the anaesthetist about it it a) to see if it was something that happened in theatre (rather than recovery/early time back on the ward) and b) because it needs an eye keeping to make sure it gets better, especially if it's dominant hand. HTH.

Hope it improves soon.
I'm difficult to cannulate and they did use where thumb meets wrist area for mri.

My anaesthetist said cannula gave up no blood for sample. I said to take to when im sleep as it always takes some fair few goes.

Intrigued how you put a catheter in the back of a hand!

Google might help.

Thank you all. I will give them a call in the morning.

As far as I'm aware I haven't got any unusual medical history and am not obese.