Cords 8 months after surgery?

kate2011

About 2 weeks ago, I started having a shooting pain from my arm pit, down my arm, crosses into the front of my arm after the elbow, goes into my fingers.  Pretty much hurts all the time now, but especially when I move my arm, elbow, wrist.

I had really mild swelling & fluid build up after surgery at my lymph node site, but it went away.  I can't see a cord yet, but I think I can feel one.  Physical Therapist hasn't called me back yet.

Is this common?  Can it go away with physical therapy?

kira66715

Kate, it could be cording, here's a link to information on cording/Axillary Web Syndrome

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

cording could definitely show up at any time. 

Does your Physical therapist know how to deal with cording--although many people have cording, and most don't get lymphedema, it is a risk for lymphedema, so ideally your PT should know how to treat lymphedema--is she/he a lymphedema therapist?

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

It is common and PT can definitely help. Let us know how you're doing

Kira

kate2011

Kira:  Thank you!  I'm waiting for an appointment with the PT.  I will keep you posted.  Thank you so much!

kate2011

I like my PT.  She is a lymphedema expert.  Very nice lady.

She said it's cording.  You can feel it all the way down from my armpit to my wrist.  The nerve is swollen.  And I have mild swelling (possibly lymphedema) in my forearm.  Oh well.  PT starts tomorrow!

kate2011

No more yoga until it's better.

Does ice help with the pain?  I forgot to ask her about that. 

kira66715

Kate, some yoga poses are great for cording: child's pose with arms overhead, a spinal twist where you lay on your back, with arms overhead and bend your knees to the good side first.

You're going to want to avoid downward dog and cobra, and just modify your yoga so you don't put all your weigh on your hands/arms for now.

If there's any question of LE, you want to avoid extremes of hot or cold--they can cause swelling. 

When I had a lot of cords, it felt better to stretch after a shower.

Glad you saw the PT: cords hurt!

Kira

kate2011

Kira:  Thank you!  Yes, she said downward dog is a bad idea right now, too.  Thanks for the info on the poses I can still do and on the hot/cold situation.  Bummer.  I was hoping to get a little relief tonight, and I'm really going to miss yoga.  Kind of weird how this just popped up on me after almost 8 months.  The other day, my BF touched my arm (softly) and it hurt so bad.  And now it pretty much hurts all the time.  The only difference is how much it hurts...a little or a lot.  The PT is pretty confident though, so that's good news.

When did you start having problems with cords?  How much PT did you get?  Has it gone away?  Thanks 

kira66715

Kate, mine came on a couple of weeks after surgery, along with an axillary seroma, and my cording guru--Jodi Winicour PT from Klose Training-- at her amazing lecture at the NLN conference last year, gave an example of the typical woman with early cording--someone who isn't overweight, who has been aggresively stretching overhead and has an axillary seroma--described me perfectly. I got no post op instructions, so I was wall walking and stretching constantly overhead and had an egg of seroma in my arm pit.

I had almost a dozen cords and first felt the pain in my hand. Then I saw them in the mirror, and googled "cord in axilla after breast surgery" and figured out what it was.

I did see a PT, but she,unfortunately, had me do more stretches and repetetive motions--and then on a hot day, I got bug bites on that arm--three weeks post op, and my hand swelled, and it has never fully resolved. This was all prior to radiation.

There was an article in the British Medical Journal, and about early PT to avoid lymphedema, and they found that women who got a ton of cords early on, were at much higher risk for LE:

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

Axillary Web Syndrome is a risk factor for lymphedema:

In a study of early PT to minimize lymphedema, a subset of patients who developed axillary web syndrome at 3-4 weeks post-op had an almost universal development of lymphedema, despite intervention http://www.ncbi.nlm.nih.gov/pubmed/20068255
BMJ. 2010; 340: b5396. Published online 2010 January 12. "We also found that 12 of the 18 women who developed secondary lymphoedema had axillary web syndrome during the second and third week after surgery. The axillary web syndrome is a known but poorly studied complication of surgery. No study has shown any link between the axillary web syndrome and the onset of secondary lymphoedema. We and others suggest that the axillary web syndrome may be a sign of injury to the lymphatic system and it could produce a lymphatic overload as a result of failure of the lymphatic system. This overload, together with other factors, could be responsible for the onset of secondary lymphoedema"
 

So, I think early extensive cording, and if there's also a seroma, is a big risk factor for LE, as it's a time of risk and inflammation.

I got PT for it--my LE therapist is an LMT and doesn't feel comfortable manipulating cords--and the initial painful stuff got much better on it's own in about 8 weeks, but some cords lingered. And still, one will pop up in the area of my elbow at times. And even a few weeks ago, a cord reappeared in my axilla/upper arm--maybe due to lifting boxes--and went away with stretching.

Sorry about the long post.

Kate, yoga is good, you just have to modify it.

Love your avatar.

Kira