Painkillers / Conflicting advice

Yesterday I met one of the BCNs who went through with me what I can expect with the WLE surgery on 1st August and possible scenarios plus treatment thereafter.


Among many other things, the BCN talked about pain management after the surgery.  She said I would be written up for ibuprofen and Co-codamol and said I can stagger with ibuprofen 3 x day and co-codamol 3 x day.  She said that new research has recommended taking that combination for at least 7 days (regardless of pain levels) as they are finding that people who stop taking pain killers too early tend to not do their exercises to prevent lymphedema as adequately so if they are hesitant because if it is painful then they may not do them properly.  She also said we need to be able to get a good range of movement back in time for the radiotherapy so doing the exercises will help with that too.  


However I went for my pre op assessment today with a nurse from the ward I will be on for surgery and she just said take painkillers according to my need, which can be paracetemol or ibuprofen.  So I mentioned the advice I’d received yesterday and she said she didn’t know about this and that she just recommended taking painkillers according to need.  However, she also promised she would follow this up with the BCN team as I was concerned about which advice is correct!  It concerns me that two different parts of the team are saying different things.  I am in the hands of the medics but do need to know if I am being given the right advice.


I am up and down like a yo-yo (depending how much sleep I have had) but feel better when I talk it all through.  Thanks for listening.  

Hi Anne,

It might be an idea to post in the ‘ask our nurses’ board, but probably both can be right depending on the surgery you have, but I would probably pay more attention to what the bcn says, as they deal with it all the time. 

I had a WLE, with 2 nodes removed through the same incision, so I did not have issues with arm pit pain & pain for me was not to bad & arm exercises were not a problem - so I got off lightly, really. 

I was prescribed co-codamol which I took more or less regularly for the first few days. As ever, it is best not to let pain get too bad before taking it & in the early days, taking it more regularly can help prevent this happening & it’s perfectly safe to do so. 

Exercises are important, so it’s good to be as comfortable as possible.

do take care

ann x


Hi Anne (Lady),


As a nurse myself, I would advise you to listen to the BCN.  The pre op nurse deals with people having dozens of different operations so the advice she has given you is generic, whereas the BCN deals only with BC ops so is specialised and knows the best way forward for you.  The pre op nurse isn’t wrong per se but as I said, it’s generic advice.  I would always listen to the advice of the specialist nurse … boobs are her bread and butter, lol.


Michele xxx

I was told to take both for the first few days, which I did   I had forgotten though how constipated Co-codamol makes me, so if it has that effect on you get some stool softeners in house before your operation x

Hi, just concurring with advice here re BC nurse. Boobs are indeed her bread and butter! My prevop was also with my BC nurse so no conflicting advice, fortunately.  I had a WLE in March - full LN removal . It can be quite painful as it really isn’t a dainty op under the arm, more a rummage and remove job. I was given Ibroprufin and co- codamol, and my op nurse checked I had paracetamol. I followed advice re keeping on top of the pain as I was very worried about Lymphodema. I started my arm exercises on third day - religiously! Going in for rads next week and my consultant is very pleased that I have full arm movement. If I had needed physiotherapy it would have held my treatment up.

As someone mentioned, and from my experience, co codamol does tend to constipate, and I bought a stool softener plus bags and bags of liquorice. The Pontefract cakes worked for me! Wishing you well. X

BCN all the way. Everything my pre-op nurse told me was incorrect. And I stocked up with tinned grapefruit etc so could have plenty of fruit and little hassle for my husband in prepping it.

Lactulose worked for me x