which arm Rt Or Left?

shortlady

I had a bi-mx with 2 nodes removed on the left side and 4 on the right.  They were all negative.  I had radiation only on the left side.  I have a very light case of lymphedema on the left arm. No problems on the right so far.  I make sure they do my BP on my leg.  I do have to have a blood draw now at least 3 times a year and I am to receive a zometa infusion twice a year.  So which arm should I have the blood drawn and the zometa?  I am right handed so I am wondering if I should just have everything done on the left arm because I already have lymphedema on that side?  I am thinking that if I do not do anything on my right side I can keep from getting lymphedema on that side.  Please let me know what you think? I have talked to an Ot with lymphedema experience and several doctors and they do not have an answeer for me. 

Binney4

Shortlady, what a crummy dilemma!

In answer to your question, you need to know that this is your call, even though some health professionals may try to make you feel silly for protecting yourself. We can give you some suggestions, and hopefully that'll help you make your own decision.

If you already have some lymphedema in your left arm, it is at very high risk for infection, so you definitely want to avoid aggravating it with either blood pressure or any skin breaks at all, no matter how small or "sterile." In terms of IVs, there is also the problem of your adding fluid to the mix with the IV, which your nodes are no longer able to handle, plus the fact that since the lymph circulation is sluggish there it will be hard to predict how you body will handle whatever is being infused. So, left arm's a bad idea.

Lymphedema is a distressing condition anywhere, but in your dominant arm and hand it's even worse. How much you want to risk that is up to you, but I can tell you that you sure don't want it in your right hand.

Alternatives are a bit of a bother, but not as much of a bother as bilateral lymphedema. You can get blood draws done in your feet and IVs in your feet or neck. It requires that your doctor write "Draw from foot only" on the order sheet. (The contraindication to that would be if you have blood clotting problems.)

Shortlady, if you already have some lymphedema in the left arm, what you need is not an OT "with lymphedema experience," but a fully-trained lymphedema therapist. Here's how to find one near you:

http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm

Just like breast cancer, lymphedema is staged, and it will progress without treatment. Even if the swelling is still minor, the accumulation of lymph fluid causes tissue changes inside that can lead to hardening (fibrosis) and serious infection (cellulitis). With prompt and proper therapy, though, you can keep your arm in good shape and lower your risk of permanent tissue distortion.

Keep us posted on what you decide to do, and tell us how we can help!
Binney

shortlady

Thank you for the information.  My OT has had training in Lymphedema and works at a cancer center. From my understanding she is the closest one in our area, but I will check and see.  She has shown me how to do the message and I do it daily.  I also got sleeves and gloves to wear on my plane trip on my vacation.  

 I have heard that doing blood draws and ivs in the feet hurt a lot.  I loved my port, but did not want to keep it for 5 years just to have an infusion twice a year.  (they never drew blood from it)   I have not heard about doing it in the neck.  I wonder if that would hurt less than the foot.  Where on the foot would they do it?

BoobsinaBox

They use whatever they can use on the foot.  That is the only place I let them use (neither arm), though one place used the leg for an IV.  The foot doesn't necessarily hurt more than other places.  It depends on the skill and care of the person doing it.  I've tried using Lanacaine cream before going in, and that may help.  I'm not sure.  Go in well-hydrated and keep your foot warm.

Dawn 

shortlady

 foot IV & Blood Draw Question?

Do you have blood drawn also from your foot?  Do you use the cream for blood draws?   

 Do you put the lanacaine cream all along the veins on the top of your foot?

 I am thinking of going into my oncologist office before the procedure and ask the nurse about where she would put the iv in my foot if I had it done there.  I will probably also go into the blood draw location I go to and ask them about foot blood draws and their experience.  

Binney4

SL, I always have blood draws from my foot. I drink a LOT the day before and with my doctor's approval take an aspirin the night before. Then I wrap it in a microwavable heating pad for the trip to the lab (NOT too hot!) I keep my feet moving while I wait, bouncing my leg up and down, tapping my foot (the other people in the waiting room keep stealing glances at the crazy lady with her weird gloves who can't seem to sit still -- I smile back! I don't use Emla or anything for pain, because for me it doesn't seem to hurt any more than any other blood draw. You can tell them you want to lie down for it if you want -- easier for them and you both.

If you call the lab they'll most likely tell you they can't do it in your foot, so instead just take the lab sheet (where your doctor has written "draw from foot only") and go to the lab, smile calmly, and they'll find a tech who can do it. My favorite tech often has others come in when she does mine so they can learn. She tells them it's easier in the foot, because the veins are bigger.

There are veins on the top of your foot and above the ankles. Not really a problem to find them.

Keep us posted!
Binney

shortlady

I went into the place that usually does my blood draws today and asked if they will do a blood draw in the foot and they told me that they will not do it.  It is their policy.  I will check with my Dr and see if it would be a problem to go somewhere else.  Each lab may produce different results and it is better to compare lab results over time from the same lab.  I may just go ahead and get the blood draw from my arm since it will only be twice a year.  My Oncologist said taking the blood out is not as bad as when they put something in.  So, I may just do the Zometa in the foot.  I will go by and talk to the nurse at the oncologist office and see if she has done one in the foot before.  My oncologist may have to do it as he use to do his patients before he had a nurse.  They usually have him come and do it when the nurse can not find a good vein. 

kcshreve

Shortlady, I called around to several labs for a foot draw and found that a hospital's lab will do it.  They do not have to comply with a bigger chain's policies (Quest, CPL).  While the techs were not excited about it in the least, they did do it and it went fine.  I've done this twice now and need to do it again.  One time I had on warm tennis shoes and socks - that was the easiest.  The next time I had on flip flops and my feet were cold - rough go.  I recommend keeping those tootsies nice and warm for an easier draw.

Leah_S

Shortlady, if you find  different place that does from the foot then you could go there each time. Changing once shouldn't be a problem if they're comparing results; changing every time could present a challenge.

Best of luck.

Leah