Can someone explain the link between LE and cellulitis?

Tr4c3y

I'll try to make this short.  In Spring of 2013 I developed mild LE in my left arm, and we all thought it was from radiation I had in 2010 for DCIS.  Turns out it was being caused by lots of tumor activity and I had Stage IV IBC in my left breast, the same one that had the DCIS earlier.

Six months later, I was all clear and had a left mastectomy with no reconstruction.  Also, no nodes were removed.  So theoretically, there should be no LE.

This last Saturday (June 21) I flew from Tennessee to D.C. By Monday my left arm was achy and swollen, and I had chills.  By Tuesday it was unusable (but no fever, at least).  My left arm and my chest where my breast had been were also very red, like they'd been sunburned.

Wednesday I was diagnosed with cellulitis and have knocked it back with two rounds of IV vancomycin and oral Bactrim.  I hope there won't be any more drama (ha ha, right?).

Can anyone offer any insight into why LE makes one more susceptible to cellulitis?  Is it the tissue damage?

carol57

Tr4, With LE, the lymph (fluid) is thicker than normal. It's protein rich and moves slowly through the lymphatic system, and the result has been described as a petri dish effect--a perfect medium for bacteria to take root and flourish. Combine that with loss of nodes, and/or scar tissue from rads or surgery that reduces or prevents lymph flow through the nodes, and our body's filtration system is compromised, again giving the bacteria extra time to multiply.  Unfortunately, cellulitis is not only an enhanced risk if we already have LE, it can also be a trigger event for LE onset, for those at risk.

You've had a nasty time of it!  Rads is a risk factor for LE, and even with just a mastectomy, we lose lymph nodes in breast tissue, so there may have been some contributing factors at work.  It's possible to have 20-30% additional lymph in a limb with no visible swelling. Did you ever have any sense of heaviness, or a mild burning sensation, or achiness in your arm before the current problem?

There's so much to learn about LE. If you haven't discovered it already, one of the best sites for rock-solid, accurate and practical information is stepup-speakout.org.  

I hope there won't be any more drama!

Carol

Tr4c3y

Thanks, Carol57.  The bulk of the LE trouble I had with that arm took place way back in spring of 2013, before we had the latest diagnosis.  It was actually treated at a LE therapy clinic for a while, but the therapist grew concerned when it wouldn't respond to treatment.  (And about that time I discovered the enlarged node in my collarbone, leading to the new diagnosis.)

Since chemo and surgery, I would describe my LE as practically asymptomatic to the point that I'm not sure I still have it.

Kicks

Nodes do not have to be removed for LE to develope.  LE can develope after ANY surgery or traumatic injury.  I have a friend who deals with much worse LE issues after non invasive, minor knee surgery than I do though I had 19 positive nodes removed.  Anything that potentially causes damage to the lymphatic system can result in lymph edema.  Once the flow of lymphatic fluid is compromised, it can accumulate.  It is not an infection.  Because the fluid does not get removed normally, infections/cellulitis is much easier to develope because the body is not 'flushing' it away as usual  That is why aggressive treatment is required to control the infection to keep from becoming systemic (whole body).  LE - lymphatic fluid building up because the removal system is compromised but not an infection.  Cellulitis - infection.  That's quite simplistic.

Tr4c3y

Is it plausible that the air travel somehow triggered the cellulitis?  If so, would a compression sleeve have helped?  I flew to MN and back in December with zero issues.

carol57

I'm not a healthcare professional, but that sounds unlikely to me.  Hopefully, someone with more insight will weigh in.