what's the difference between cellulitis and lymphedema?

comingtoterms

I had 27 nodes removed in 2009. Have been very physically active - exercise every day. This week I thought I had the flu (weird time of the year, I know!) had a low-grade fever and extreme muscle, bone and body aches that reminded me of the Taxol part of chemo. A day later, my mastectemy arm is red, swollen, blotchy, painful. Nothing is cutting the pain. Long story short: I end up with three IVs of antibiotics, a ten-day course of oral antibiotics and a diagnosis of cellulitis. I don't understand what the difference between cellulitis and lymphedema is, and whether one tends to be a precurser to the other. My doc says just because you get cellulitis once doesn't mean you will ever get it again. Any words of wisdom would be greatly appreciated! Thanks! Tammy

Binney4

Hi, Tammy,

Cellulitis is a kind of infection. It's nasty and it can spread fast, so it's great that you've got all those antibiotics on board. WHEW!

Lymphedema is caused by our surgery and/or rads, because those procedures damage lymph nodes and vessels, and create blockages to lymph flow. When the lymph can't flow properly out of the tissues of our arms, breasts or chests, that's lymphedema. It causes swelling as the tissue builds up in those places, but before we see any swelling there can be as much as 30% more fluid in the tissues than is normal (which is a condition called "pre-clinical lymphedema" or "Stage 0 lymphedema). Less than half of all women treated for breast cancer ever develop measurable lymphedema, so that's the good news.

The link between cellulitis and lymphedema is complicated. In an area of the body already at risk for lymphedema, cellulitis can create more scar tissue (blocking the lymph flow further) and in that way may trigger lymphedema (or make it worse). Or it very well might not -- and hopefully that what you'll experience.

The relationship goes the other way, too. Women with lymphedema are more likely to develop cellulitis, because the stagnant lymph fluid in their tissues is warm and protein rich, which is just what bacteria need to thrive and multiply. A woman with undiagnosed Stage 0 lymphedema is at risk for cellulitis for the same reason, even though she doesn't know it.

So when someone who is at risk for lymphedema develops cellulitis, it's a good idea to get a referral to a well-trained lymphedema therapist for evaluation once the infection is cleared up. The therapist can help you understand if your cellulitis is related to undiagnosed lymphedema, and if so, can begin therapy to move the stagnant fluid out of there -- which reduces your chance of ever having to deal with the stupid cellulitis again.

Here's how to find a well-trained lymphedema therapist near you:
http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm

For now, though, rest up, elevate your arm as much as possible, and stay really well hydrated. Get well soon!

Gentle hugs,
Binney

comingtoterms

Thank you so much for your highly detailed, knowledgeable response, Binney. I knew they were related somehow and also knew I needed to report this incident to my Onc., but you offered another aspect that I hadn't thought of: seeing a lymphedema therapist. I am treated at a major cancer center in my area, so I am certain they have someone on staff. I wonder if it is a coincidence that this started right after I started working with a trainer to get some more strength back in my upper body. I have a feeling this may have triggered something - then perhaps the sweat (yuck) from other people's bodies and hands found a nice little opening. Wow, what a lot there is to learn! Thank you, Binney!

mc1973

Hello Tammy,

 I was diagnosed in 2005 and had a mastectomy in 2006 and the removal of 17 lymph nodes. My lymphedema started around 2007 and the cellulitis in 2008. The first time it occured I also had no idea what was happening. I had the same symptoms as you and was finally rushed to the ER for my course if IV anti-biotics. In my case it was Ancef followed for about a week then 10 days of Oral.

I have had 10 bouts with cellulitis since march 2008. It has been and is very difficult because it is hard to prevent. The root cause is bacterial but we are more prone because of our compromised lymphatic system. Having had Radiation also creates scar tissue in the shoulder area and such.

I manage lymphedema and cellulitis via my compression glove and sleeve, MLD, manual lymphatic drainage and having my arm and hand wrapped. I am also very careful with regards to my right arm and cuts, bruises, sunburns and such. I wear gloves for many chores and gardening also.

All the best,

MC

Please feel free to take a look at my website at:

www.mariecarolegallien.piczo.com

I also have a facebook group called:

Young women, Breast cancer, Mastectomies and Lymphedema

comingtoterms

Hi MC, thank you for sharing your story - 10 bouts with this!!?? Oh, my! It sounds like you do everything in your power to prevent it and yet, it still occurs. This must be very frustrating. Do you see a lymphedema therapist, as Binney suggested? I agree with Binney, who said these two situations are entwined in some way. My arm looks normal now, but for months, my elbow had been hurting and I just ignored it, assuming it was exercise related. But I am second-guessing that, based on what I have learned. Thank you so much for sharing with me. Tammy