Air Travel

cowgal

I read that you need to wear your compression garments during air travel and then it went on to say that if you travel by bus you should follow the same procedures as for air travel.  It got me wondering are there any precautions that are needed with air travel whether it is commercial or in a small private plane that needs to be taken into account other than what you would for just sitting for a prolonged period of time?

cocojo

I'm glad that someone has brought this subject up. I'm going to Italy in April and was wondering about compression garments. I show no symptoms of arm lymphedema, but I do have breast lymphedema. There seems to be alot of contradiction in the literature. Some people saying you should wear comression garments and other studies that have shown that it makes no difference! I'm at a lost to decide whether to wear some or not!! Also, should I wear only a compression bra or do I need a sleeve even though I have no arm lymphedema??? Any suggestions or thoughts?

lorrhaw

I also have no signs of lymphedema but I wear a compression sleeve and glove every time I fly.  My husband works out of state so I am on a plane almost every other week and I don't want to take a chance.  The sleeves are relatively inexpensive and other than being a little warm, which triggers some hot flashes, are pretty comfortable.  My docs at MD Anderson wrote me the script to get the sleeve and glove and did suggest that I wear it since I am on a plane so much.  I figure better safe than sorry.

Lorraine

kira66715

The official National Lymphedema Network position is that women with lymphedema should wear compression, and those at risk should consider it: They just updated the air travel position paper:

http://www.lymphnet.org/lymphedemaFAQs/positionPapers.htm

Some therapists recommend the "subtherapeutic" compression for the arm if you're just "at risk" of 15-20mm (Jobst makes this in a sleeve). It is recommended that you don't wear a sleeve without a gauntlet or glove, as the sleeve can push fluid up into your hand.

http://lymphedivas.com/lymphedema/gauntletandsleeve/

Cowgal, they do comment on different types of planes in the NLN guidelines and where to sit.

So, if you have LE--even breast LE--likely best to get a sleeve and glove/gauntlet and wear it before the trip to make sure it agrees with you and wear it before and for an hour after travel. If you're at risk, you need to decide what to do--a low compression sleeve is likely harmless and could be helpful, and get a gauntlet too.

Kira

cowgal

Thanks Kira for the link.  I was curious about the cabin pressure and the link had the information about that in it.  I already have a sleeve and hope to meet with a LE therapist soon.  I have my last reconstruction surgery next week so it will be after that. 

DeeBee

I am very new to this and would appreciate advice.  I had a lumpectomy and sentinal node biopsy (3 nodes removed) 9 days ago.  I am a little stiff and sore and minimally swollen but I think I am doing very well and better each day.  I saw the surgeon a week after the procedures and he was pleased with everything - he noted a little swelling at the site of the SNB but said it was not of concern.  He said it was ok for me to travel to Panama in 2 weeks and I didn't know I should have asked about risk of lymphedema.  I don't have another appointment for a couple of months with him and the first appointment with the medical oncologist isn't for 10 days.  Do I need to get a prescription from him right away - or are there things I can do to reduce the risk of developing this when flying without a prescription sleeve, etc.  I'd appreciate any advice. 

kira66715

DeeBee, sorry your post got over-looked, there is a lot of controversy about needing compression when flying, and if you do get a sleeve, you also need hand protection--a gauntlet, so the fluid doesn't get pushed up. Some therapists suggest a low compression sleeve--15-20mm--Jobst makes them.

Here is the National Lymphedema Network position paper on flying:

http://www.lymphnet.org/pdfDocs/nlnairtravel.pdf

Here is the one on risk reduction:

http://www.lymphnet.org/pdfDocs/nlnriskreduction.pdf

Let me know if that answers your questions, it's wise to be concerned with such a long trip so soon after surgery. The other thing we've been hearing is to restrict the overhead stretching for the first 10-14 days so as not to put stretch on the delicate lymphatics.

If you decide not to get a sleeve: drink a lot of water, move around, lift your arm up and squeeze your fist periodically.

Good luck and let us know if you have more questions.

Kira

DeeBee

Thanks, Kira.  I am not so sure I should even be considering going on this trip but I really want to so especially since the timing seems to be ok as far as further treatments go but I am realizing I may have to give it up.  Dr's response was 'go for it.'  I have been religiously doing the 'fingers waling up the wall' stretch which he told me about - not overdoing it but have been doing it since the surgery - Dr told me he would rather I did the exercises and took pain meds than didn't do them because of pain.  I never needed pain meds - and it just feels like pulling a muscle.  This morning though I do have a hard lump in my armpit (between the size of a grape and a walnut) which I don't think has been there before although at first I was wimpy about looking.  So I guess I'll be calling Dr. in the AM and possibly going in and so I can quiz him more about flying.  Thanks for your advice and the links.

Dee

kira66715

Dee, that hard lump could be a seroma--have him ultrasound it and consider aspirating it if it's there.

I personally found my surgeon didn't have a realistic idea of my limitations: as I developed lymphedema three weeks post op, with a large axillary seroma and axillary web syndrome (can you see why I harp on it?), she said "Back to playing tennis??" Uh, no.

You don't want to limit your life, but seriously--first--no need to stretch that axillary area and get shoulder range of motion back right now--let that sensitive area heal, and second, if you go--just be prepared and have help with bags.

Kira

DeeBee

I really thought I was doing so well until this thing showed up last night!  I only had 3 nodes removed.  I guess anything can happen. 
Thanks, Kira - I am going to call in the AM and not minimize it which I tend to do with pain/uncomfortable things.   I definitely know I have to pack lightly and have help with the bag.  And whatever I have to do has to be done with the other arm for sure. 
Dee

gillyone

yes

I do not have LE but wear a compression sleeve when flying as a precautionary measure.

tweetybird

I do the same thing as gilly. I don't have LE, but had 5 nodes removed, I would rather be safe than sorry. I find when I fly, my arm isn't that bad while I'm up in the air, but when the plane is taking off and landing, I get a weird feeling in my arm. I can really feel the blood pumping/moving. I just make sure I do some arm exercises during that time, and put the sleeve on just before I leave the house, and take it off about an hour after the plane lands.

Binney4

Nancy, have you learned to wrap your arm? If so, it's always best to wrap when flying once you have any amount of LE in your arm. (If you haven't learned, be sure to insist on it before your therapy ends, as it's an important "tool" to have for self care.)

The breast LE is another matter. Do you have a bra or cami you use for compression? If so you'll want to wear it for sure. Here's a page about breast/chest LE, and at the bottom are some ideas for compression garments:
http://www.stepup-speakout.org/breast_chest_trunckal_lymphedema.htm

Another option for breast/chest compression is an UnderArmor-type sports shirt a size smaller than you'd normally wear, and turned inside out so the seams don't irritate your skin. Be sure it's a comfortable fit before you fly. 

Odd that the PT didn't make sure you had well-fitting protection if s/he knew you were traveling. By all means call and ask specifically about it. Did s/he give you other travel tips -- like staying well hydrated, exercise for your arms and hands in-flight, deep breathing, luggage handling? Here's the National Lymphedema Network air travel guidelines:
http://www.lymphnet.org/pdfDocs/nlnairtravel.pdf

Hope some of that helps. Be well!
Binney

kcshreve

I just flew back from vacation and found the mens Underarmour short sleeve shirt to be a good addition to my flight arsenal.  Sleeves, gauntlets, men's underarmour short sleeve shirt covers body and chest, going down to the top edge of the compression sleeves.  I usually wear women's UnderArmour, but for this flight, the men's design was more compressing for my back and shoulders.  This is very individualized, so trying on ahead of time is needed in order to compare fit.

kira66715

Nancy, I didn't see your post: be sure and hydrate and frequently raise your hands over your head and fist pump.

Here's link for health care providers on LE: perhaps they could use some education: I do agree, a flea with a sinus infection WOULD get better care--ignorance and denial of LE is rampant

http://www.stepup-speakout.org/essential%20informat%20for%20healthcare%20providers.htm

Tell us how you're doing

Kira 

DesignerMom

Hi everyone.  I am flying for the first time since diagnosis and treatment.  I was evaluated by a PT, who said both arms appear equal.  To my eye they look different and certainly feel different (like a tightening pulling).  She measured me for a sleeve and hand glove and recommended  Juzo Soft brand.  I will be fitted and buy it this week.  Anyone know of good places in NYC?  Any other tips about fitting, buying and traveling? 

tweetybird

Designer,

I'm on Long Island, and got my sleeve at Hanger Prosthestics in Hempstead. I just checked out their web site, and it looks like they have a location in Manhattan, and a couple of locations in Queens. When I got mine, it was about a week between when I got fitted, and when the sleeve came in.

DesignerMom

tweety-  Thanks for the input.  I'll check it out.

tweetybird

No problem Designer! Good luck with everything.

Randi64

I know I will wear my sleeve and gauntlet on LE side when I fly next month. What about other side where no nodes were removed at BMX? Currently have low compression on LEside of 15-20mm/hg. Should I increase compression on LE side during flight and wear lower if any compression on right? Thanks for any advice!

upcreek

I am flying 8 hours and will wear the silver wave sleeve from lympedema sleeve company with fingerless gloves.  This is prophylactic.  Will let you know how things go.

Binney4

Randi, sometimes more is less, so if that's why you're using a 15-20mm/hg on your LE side, then increasing the pressure might be a bad idea. Usually when we already have LE wrapping is a good idea, if you know how to do that.

As for the other side, a well-fitting sleeve and glove or gauntlet is certainly a consideration, especially since you already have LE on the other side -- which, as my therapist says, just goes to prove your lymph system isn't immune to breakdown. Just make sure the fit is good:
http://www.stepup-speakout.org/proper_fitting_of_lymphedema_garments.htm

Bon voyage, all you lucky travelers! Hope you're all going someplace wonderful, and none of you has a "swell" time of it!
Binney

Randi64

Thanks for the feedback! I hope to have a great time and wish happy travel for everyone!