Plural Effusion

Hi all, this is my first post. 

Besides the side effects of Afatinib (7th Cycle 40mg - all very positive) I was wondering if anyone has the additional problem of fluid in the plural cavity (plural effusion)?  Pain management has never been my best subject and I’ve never really jumped immediately for pain relief in the past.  However, the pain associated with Plural Effusion can only described as like having several broken ribs and I think I’m ready. I’ve been told off for not taking anything by the nurses, but my philosophy is that if I mask the pain I might over do it. 

Any thoughts guys? Thanks in advance. 

  • Hi Dashtu

    Sorry that you are in discomfort.

    I have mild pleural effusion but touch wood doesn't cause much discomfort. My oncologist said if it get's worse, they would look to drain some off. Have you spoken to your team about the discomfort? They may have more ideas than just painkillers up their sleeves. Hope you feel better soon.

    Gina

    "There are no perfect people, only perfect intentions" - Robin Hood Prince Of Thieves

    “I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” - Maya Angelou

    "Once more into the fray. Into the last good fight I'll ever know. Live and die on this day. Live and die on this day" - The Grey

    ♬I should've been more than this, I was gonna be something big, But I never did anything at all ♬ Dan Owen - Icarus
  • Thanks Gina, It was the pain of the plural effusion (initially thought to be a collapsed lung) that resulted in an X-ray back in April this year. Plural effusion was diagnosed at the same time that a mass was identified in the top of my right lung.  I’ve never been without pain since late April and it seems my Oncologist isn’t that concerned or has there been any mention of it being drained. 

    It’s the pain management that is new to me. I’ve never really taken anything for pain so the idea of keeping up a level of suppression is difficult.  Although I’ve been told by my support nurses what and how to take basic pain relief; I was wondering if there was anyone in the group or maybe the wider community who have been advised otherwise or has any comforting information. 

    Thanks again for responding Gina and for your advice. Enjoy your Christmas Christmas tree 

    Rgds J
    Per Ardua 
  • Sorry, I wrote you a long reply and it didn't post Rolling eyes I will try again.

    I wonder when you say the top of the right lung, if you mean the very top as in the apex of the lung aka a pancoast tumour? That's where mine was and what sent me to the Doctor. 

    Because of this I had a lot of nerve pain so was prescribed pregablin which helps to sooth nerve pain.

    I found rotating paracetamol and ibuprofen was useful for me. Keeping of course within the maximum dosages of them per day. That way, I felt like I was not left without anything or them varying off too long.

    For more general pain, please speak to the nurses or GP. There will be lots they can prescribe. They may offer something like codeine or co-codomal to start. If this doesn't agree with you, or manage the pain, there is Oramorph, or morphine or Oxycodine. There is so much they can try and tweak to get your pain more manageable, so don't worry about asking. 

    Hoping that someone who has direct pain from pleural effusion will give you a better answer, though your team will be the best ones as they will need to perscribe anything stronger than over the counter and let you know if anything can't be taken with other drugs. Also bare in mind to protect your stomach too. I take omeprazole as on a few drugs a day.

    I hope this helps a little.

    Gina

    "There are no perfect people, only perfect intentions" - Robin Hood Prince Of Thieves

    “I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” - Maya Angelou

    "Once more into the fray. Into the last good fight I'll ever know. Live and die on this day. Live and die on this day" - The Grey

    ♬I should've been more than this, I was gonna be something big, But I never did anything at all ♬ Dan Owen - Icarus
  • Huge help thanks, I do think some of the pain that isn’t related to the Plural Effusion is nerve related. I have my monthly appointment on Monday so I’ll push the Oncologist again for an explanation regarding pain management. 

    Thanks again. 

    Rgds J
    Per Ardua 
  • Hi Dashtu, I would definitely take the pain relief, and if possible get it drained. It was the pain from pleural effusion that first alerted me to the fact that I had cancer. I'm taking morphine twice a day, along with paracetamol, to make the pain bearable. A couple of months ago, I had 2 litres of fluid drained from my chest which relieved things for a while, but the pain level has risen again recently, so I suspect it has filled up again, and I may need to increase the amount of morphine I'm taking. In short, to answer your question, pain relief is in my opinion the best way to deal with pleural effusion...there's no point in suffering that level of pain unnecessarily. 

  • Many thanks Enjay, I’m becoming convinced that pain relief is important purely just to get through the day. 

    thanks again

    Rgds J
    Per Ardua 
  • What turned it around for me was getting to see my local Palliative care Nurse, who really knows her subject. I'd been suffering regular pain, and a lot of nausea too, which was really affecting my quality of life. After an hour's session with the Palliative care Nurse, we had tweaked the meds that I was taking, and my situation improved tremendously. And the team checks in with me on a regular basis to ensure that everything continues to work smoothly. A really good service that I would recommend trying. 

  • Hi there.  

    My DH is on 10th cycle of Afatinib 40mg (so far so good).  He had plural effusion in right lung (also where his main tumour is).  I would recommend getting it drained or asking them about it.  DH is a serious hospital-phobic and it took A LOT of persuading but he went for it - 2.5 litres remove,  but he said the relief after was dramatic.

    Whatever else though please don't be in pain.  DH was referred to pain clinic - and that was game changer too.  As he was so under weight (5stone at diagnosis) he was vomitting a lot (again they said it could've been the fluid on lung causing it) but couldn't keep meds/oromorph etc down so he's now on Fentanyl patches - lowest dose - and can take codeine or para's if any breakthrough (touch wood not needed so far and vomitting has stopped since the drain).

    He's stubborn as they come and tried to go without any pain control but the relief he's had since the drain and patches have really improved the horribleness of all of this. 

    Hope that helps with your decision a bit xx

    One day at a time.
  • Hi Dashtu

    I had a massive pleural infusion and when it was investigated, I was told I had a broken rib!  Some of my ribs have lost calcium and become weak.  I thought I had pulled a muscle. I had several chest drains but they never lasted more than a few days.  Eventually, it almost disappeared on its own and now I seem to be left with a permanent, small amount which is not really a problem. 
    I am at Christie's who recommend not using Ibuprofen. Try paracetamols and if they aren't enough, ask your specialist. Your hospital might have a pain management clinic that you can be referred to.

    I avoid painkillers too.  I find I feel more inclined to take them when I know exactly what the problem is and why it hurts.  Good luck

  • Many thanks Meera, things seem to be improving since I was put on antibiotics. I had a chest infection which wasn’t helping and added to the complications. I have to say, I feel much better and taking a full breath without pain is such a relief. 

    Many thanks again for the information and guidance. Hope all continues to go well with you. 

    Rgds J
    Per Ardua