Possible hand surgery on arm that had 17 nodes removed

Anonymous

I have severe arthritis and my thumb joint has been very painful.  My orthopedic doc wants to do hand surgery on the same side in which I had 17 lymph nodes removed 11/10.  I have had several rounds of cortizone shots in my thumb joint.  I was always concerned about the possibility of infection with the shots but now surgery?  Has anyone had surgery on their bad side?  Any suggestions?  Warnings?  Things I should know or ask my doc?  

I have had some bouts with lymphedema, always wear a sleeve when I exercise, and drain my arm daily through massage taught to me by a lymphedema therapist. 

Leah_S

Pasofino, I don't have any suggestions since I've never faced this, but you might want to call your LE therapist and ask her what she suggests.

Best ofl uck with the surgery.

Leah

Binney4

Pasofino, some of the women here have had similar surgeries and recovered very well. It takes some preparation and follow-up, but with care it should not add to the stress you're already facing. Here's a page about medical care with LE from StepUp-SpeakOut that has surgery guidelines at the very bottom of the page:

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

Looking forward with you to smooth sailing and a great outcome. Please keep us posted!
Gentle hugs,
Binney

crystalphm

This is something I am interested in because I have a very painful shoulder.

As far as your situation goes, I think you would have so much more success if you had a lymphedema specialist on your "team" who you meet with before surgery and then right away after surgery for prevention.

I do know a woman who was in a car accident and broke her "node affected" arm, and she has terrible lymphedema, but she says 10 years ago, no one was looking at possible lymphedema issues, so she had no prevention.

I think a lymphedema specialist could give you a pretty good idea of the risks after a consultation.

kira66715

I broke my LE hand in October 2010, and was in a cast for 6 weeks: my LE therapist came over on the day I broke it, and afterward, I saw her about about every 2 weeks for MLD of the fingers and above and when I came out of the cast, my hand was not in good shape--and she worked with me weekly..

In the cast, I wrapped my fingers at night, but no other compression. I did have to work with the cast techs to make the cast not too snug. One cast was misery, but I had it replaced and figured out the good cast techs.

Post cast, it improved fairly rapidly, but there were  LE and weakness and pain issues. I'm never quite sure if it's exactly as well controlled as it was before the break, but I think it's very close to where I was pre-break.

I tend to use minimal daytime compression, and wrap at night to control things. Weird, but it "works" for me.

My LE therapist was invaluable for help during and after the break: and the wise advice of Binney and the women on the thread, because work was giving me a hard time about being out, and the hand surgeon said no writing, and it's my left, dominant, hand, and Binney said "Give it time now, or expect to be dealing with it for a long time." Gave me the fortitude to stay out and elevate, and take care of myself.

I needed OT for rehab after the break, and used a Norton trained OT for rehab: she still pushed my limits with the weights (no I can't start out with 20 reps four times a day...), but she adjusted to my needs quickly, and I didn't have to explain LE to her.

Kira

aussieched

Hi Pasofino 222,

I would be hesitant about the surgery if you have lymphedema, I ended up in hospital  with extensive cellulitis and have also had 2 more bouts of cellulitis just from a needle biopsy in my breast recently.

 I had 30 nodes removed and it has certainly caused some problems.  Are you taking Tamoxifen or and Aromatase inhibitor.  I am and it has caused extensive arthritis.  I had to wear a hand/arm support for over 6 months for the terrible pain I was expeiencing.  After about 6 months, the pain went as quick as it arrived, and I am sure the Femara is the cause of it.  It seems to then move on and attack another part of the body.  At the moment I am having extreme lower back problems, before that it was my neck, and before that it was my leg.

If you are on Tam or and AI, I would be waiting to finish the treatment to see if the arthritis improves, before jumping into surgery which could cause lymphedema problems.

Ched

Anonymous

I'm still not sure what I'm going to do.  I broke my right thumb joint a year before I was diagnosed with breast cancer and was receiving cortizone shots in my hands then.  So I know the arthritis wasn't caused by the Aromatase inhibitor but, may be making it worse.  I recently got cortizone shots in both hands and am feeling a little relief.  I saw a hand surgeon last week.  He thinks I should do my right hand and pooh-poohed my fear of surgery on my bad side.  I need to wait at least to the end of July as I'm riding the RAGBRAI (Register's Annual Great Bicycle Ride Across Iowa)  and need to hang on to my bike.  I padded my handlebars with pipe insulation.  The ride is a great place for reflection!   I will contact my lymphedema therapist and see what she suggests.  Thanks for all of your help!  Sara

melba

I wish I could provide more a helpful response, but wanted to let you know I am facing some of the same challenges.

I was diagnosed last year , had 6 lymph nodes removed, all negative, treated proactively and for the most part did not have many issues with the LE, wore compression sleeve and gauntlet during the day, massaged and exercised the arm.  It has been about two months and now my thumb is always swollen, diagnosed with carpal tunnel , both hands .  Swelling is only on the Lymphedema side. I have now worked with three qualified LE therapists.  I am considering changing from Arimidex to Femera, my onc gave me the script.  I am told much of the flare ups are probably due to the medicine but it is extremely limiting and painful.  I will try everything before surgery but may have to face it if it doesn't resolve.  I even contacted the National Lymphedema Network.  It seems no one has any clear cut answers.  I also met with the hand surgeon who was not terrribly well versed on Lymphedema,  He even suggested it may be the carpal tunnel causing the swelling, not the Lymphedema.  If I seriously consider surgery I may ask the hand surgeon to consult with the Lymphedema specialist, not sure how that will go.

Anonymous

Just thought I should write a follow-up...  I did have basal joint hand surgeries on both hands.  It took about a year for full recovery to be pain-free but besides a little stiffness, I am very pleased with the results.  I never had any problems with lymphedema after the surgeries.  I was very careful about infection and keeping the surgical sites as clean as possible.  I'm so glad I had the hand surgeries.

Binney4

Pasofino, good for you! Thanks for letting us know about your experience. I just love good news!

Hugs,
Binney

Rockym

pasofino22, thank you soooooo much for the follow-up!  I am having hand surgery in 2 weeks to release three trigger fingers and I am very nervous.  I've posted in one thread, but didn't get much info.  They are going to use a tourniquet on my arm and it is the left side where I've had nodes removed and breast and trunk LE.

I am sorry it took so long to recover, but glad you're doing well and that you are happy you did it.  I can't wait to NOT be thinking about my hand any more.