arm that is affected after lymph node dissection surgery

dksindistress

why is it that we are suppossed to be so careful with our arm on the surgery side.  I had a fall a few days ago and mainly got the worst of it in my shoulder area and upper arm.  It is quite bruised .  What can happen and wht should I be looking for?

Binney4

Dks, hello!

I love your avatar--what a proud and happy moment!

Good question! We're supposed to be careful of our arms on the surgery side because of an elevated risk of both lymphedema and infection (cellulitis). For now, you can help reduce your risks of problems resulting from your fall by staying really well hydrated (because that dilutes the lymph fluid and helps keep it flowing), stopping every so often to take a few deep abdominal breaths (because that stimulates the largest lymph vessel in your body), and by elevating your arm as often as you can (because that allows gravity to help your lymph system keep moving). Support your arm on the back of the couch while you read or watch TV, and on pillows at night.

When we injure ourselves our bodies send in extra lymph fluid to the injured area, because it's the lymph system that gathers and carries off any cell garbage (dead cells, bacteria and other "junk"). Because our lymph systems have been compromised in that quadrant of our bodies by surgery, rads and/or chemo, the extra lymph fluid can overwhelm the system and trigger the swelling of lymphedema.

Here's information on risk reduction--how and why we need to think smart about our affected side from now on:
http://www.stepup-speakout.org/riskreduction_for_lymphedema.htm

That said, we sure don't need to stop using our affected arm. Exercise that builds up gradually and slowly to strengthen our arms and shoulders actually helps manage our risk.

Any infection in an at-risk arm is an emergency, because it can spread and become systemic quickly. So if you see sudden swelling or increase of pain, new redness, heat to the touch or a fever, do go for help at once--don't "wait and see."

You might want to get any doctor on your team to write a referral for an evaluation by a well-trained lymphedema therapist, so you can discuss with her/him personalized risk reduction strategies, learn how to do a gentle lymph self-massage, and get baseline arm measurements for future reference. Here's how to find one near you:
http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm

Heal quick, and do let us know how you're doing!
Binney