PT questions need help please!

alrz1980

some of you may remember me posting a while back. I had an excisional lymph node biopsy (1 node) benign. No BC surgery. My biopsy was 9 weeks ago. I saw a PT today because of some ongoing arm discomfort (some of which was present before biopsy). She says she can see a small "pocket" that is on the upper outside of my surgery arm. I can kind of see it if I really try. Very minimal difference. The problem is that we don't know of this is just a difference in my arms being that my surgery side is my dominant side (possibly bigger muscle making the fat under seem larger). She basically said it could be fluid and blew me off after that. Says to call back and get a new referral if I swell more. Suggested a get a sleeve for exercise and flying. How am I ever supposed to know if this is normal difference between my arms? The entire upper arm isn't swollen for sure. U can see muscle definition. Just a slightly saggy area compared to the other side. Any advice? Btw... I love u ladies:)

Lenn13ka

arlz- see if you can get a referral to a certified lymphadema therapist for an evaluation. I was in PT right after surgery and rads and even though they said they treated BC patients they really didn't have the knowledge that my LE therapist has. I have a physical job and really needed to keep lymphodema under control. She had been awesome. It is so much more than just a sleeve.!

carol57

I second Lenn's advice. PTs have little to go on, unless they've had serious supplemental training to become a certified LE therapist. A CLT will have a lot more to offer you in the investigation of what might be brewing.

It can take a while to get a referral and then an appointment, so meanwhile, focus on sensations to see you have have an mild LE symptoms you can (eventually) discuss with the CLT. Do you have any feeling of heaviness in that upper arm; tingly feeling; general ache; maybe a slight burning sensation? These can be signs of lymphedema. Might you have some barely perceptible swelling elsewhere on that arm...jewelry tighter than it used to be, and you haven't gained weight?

Another tactic would be to see if what you're feeling responds to compression, and you can get a sense of that with a compression shirt--long sleeve or short sleeve, depending on where on your arm you have the issue you're noticing. UnderArmour is one brand to try, compression fit in a size smaller than you would normally wear. Most of us find that the men's short-sleeve shirts work better than the women's versions, because the women's short sleeves are cap sleeves. They don't reach the tops of our compression sleeves, and they cut into the armpit. The men's models are no fashion statement, but they provide good compression.

Regrettably, LE discovery and treatment planning has a good dose of DIY to it. The more perceptive you are about noting symptoms before you meet with a CLT for the first time, the more productive that discussion will be, in my experience anyway.

Keep us posted on what you figure out, and go to stepup-speakout.org for some information of finding a qualified therapist.

--Carol

Kicks

It is not unusual for some PT's to claim that they 'know all about LE' when they have no real clue. Get to a CERTIFIED LE Therapist. Those who pretend that they know 'everything' can actually do you harm.

My CLET is also an OT. The facility I go to will not let the PTs work on/with me, even on totally non LE related issues without first checking with my LE guy. There is also a lot of different issues that can be involved with the right compression/fit IF you need them. (I'm weird nothing off the shelf fits me so have to have custom made garmemts and low compression works for me - high compression makesmit much worse.) All that said, there is a good possibility/probability that you are jist like you lways have been but just now noticing the differemces in the 2 sidesmof your body. We are each so unique jist as both sides of our bodies are also. The 2 sides are not exactly the same.

Please see a CLET to get a base line, information and an evaluation who does have a 'clue'.

Marple

Here is the link that Carol mentioned above. Nope, apparently the new updated sight won't post the link for me. Sorry.

Marple

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

Marple

And apparently it did. Weird. Anyway, there is the link.............I hope it stays.

sushanna1

The site is acting weird or maybe it's my computer. Just lost my response so here goes again.

Airz1980--The stepup-speakout site listed above is a wealth of information about lymphedema. It was developed by some of the women who frequent this board and with luck, one of them will drop in to give you some advice. My advice: Beware of any PT who suggests a sleeve, but does not mention that you should wear the sleeve with a gauntlet or glove. Otherwise, if you do have lymphedema, you run the risk of pushing fluid into your hand.

Good luck.

Sue

cinnamonsmiles

Carol--- Can you tell me what CLT stands for? Ooops...I see....Certified Lymphdema Therapist.