shoulder replacement surgery on lymphedema arm

surfdreams

i was in an accident several days ago and broke the ball in my shoulder in 4 places. Of course, it was my lymphedema side. surgery is scheduled next week for a reverse right total shoulder orthroplasty. If i opt to let it heal on its own, I'm told I could have horrific arthritis and necrosis of the bone. Of course, with the surgery, with the lymphedema, the risk of complications is huge. My lymphedema has already increased significantly since the accident because I can't wear my sleeves and am in an immobilizing sling. Does anyone have any words of wisdom or suggestions?

rainnyc

Surfdreams, no wisdom, only sympathy. Are you having the surgery in the same hospital where you are being treated for your BC? Have you discussed the lymphedema with the orthopedic surgeon, and gotten a consult from whomever is treating your lymphedema? So sorry you are in this position.

carol57

surfdreams,
Ouch, that's horrible, and you are really in a lymphedema pickle. I am currently recovering from shoulder repair surgery on my non-LE side, and even that is giving me LE challenges, so I can certainly imagine the issues you are facing.

You can do ball squeezes with your hand, which might help a tiny bit, at least to minimize migration of fluid to your hand. I'm finding that the immobilizing sling given to me does a poor job of supporting the wrist, and I was getting hand swelling from having the hand dangle too much, too often. So I put a cardboard extender inside the sling to better support my hand, and I wear one of my gauntlets sometimes. You should be able to wear your gauntlet or glove, right? Even if you cannot wear the sleeve.

We have a lot of lymphatic vessels that run in the area of the shoulder, and I am experiencing swelling in my (diep reconstructed) breast, which 'til now had not shown any trace of LE. The breast drains in the direction of the shoulder, so I'm not surprised that swelliing and inflammation from my surgery continues to reduce that drainage. I'm six weeks out, and I get the breast/truncal swelling on my non-LE side after PT and within an hour of doing my at-home range of motion exercises. If that is also your experience--swelling migrating to the trunk--you might benefit from a compression tee shirt, which will help under the axilla that you are not currently able to move around for drainage benefits. No way to don a compression shirt over your head, of course, and my solution was to ask GO Travelwear to make me a custom compression shirt with a zipper down the front. It has a velcro strip at the very bottom to make it easier to hold the sides together and then feed the zipper, and the compression has made a huge difference for me. If that idea appeals to you, PM me and I'll give you some additional thoughts on the shirt design and changes you can request if you ask GO to make one or more of them for you.

As for not wearing a sleeve, that's a problem with no obvious solution. If you are removing your arm from the sling for bathing, to do pendulum exercises, or if allowed to let it be free but stationery when sitting quietly, is there a way you could position it on pillows that would permit you to use your good hand to perform MLD on your LE arm? The deep belly breathing is certainly possible, and your node stimulation, and moving fluid across to the other side.

I really, really feel for you because shoulder injury and the repair surgery bring long and hard recovery, and it's painful too. So stay on top of your pain meds --pain draws lymph--and do keep us posted on how you are doing.

Giant hugs coming from me!

Carol

surfdreams

the orthopedic surgeon said that the lymphedema shouldn't pose a problem. I think we all know better. I did contact my lymphedema specialist whom I'm not crazy about. She said she would want to see me about 4 weeks after the surgery and would then recommend wrapping again. what about these compression pumps? Does anyone think this might be helpful at this point?

carol57

The compression pump has a sleeve, I THINK not tight and glued to your arm like our normal sleeve, but a sleeve nonetheless. I've never used a pump nor seen the sleeve up close, so hopefully someone using one will think about whether you could get your arm in it. Do you have help at home? I'm wondering if, when you're allowed to lay the arm straight, a helper could get the pump sleeve on you. You do have to do some manual clearance of the trunk before using the pump, and that implies using your surgery arm forr some of that.

Binney4 has bilateral LE and she uses a pump (and she's a marvel of knowledge of LE), so perhaps PM her to ask what she thinks.

carol57

surf, you will be in rehab after surgery. Any chance that your rehab facility has a certified LE therapist? He/she would also be a PT or OT and maybe you could request that person to take you through the shoulder rehab? And if not at your most convenient facility, you surgeon's prescription should let you go anywhere (as insurance permits), so maybe you can find a rehab facility where the PT/CLT combo exists.

surfdreams

thanks carol. i wish i had a sleeve that was open and was secured with velcro. i've seen some online like that.

carol57

The ones I've seen like that are stiff, heavy duty affairs. I was at the World Lymphology meeting last month, and there was an exhibit hall with all the vendors showing their garments. I was looking for just that type of sleeve, because my right shoulder restrictions prevent me from reaching all the way over to bring my sleeve up to my left armpit. I didn't see anything that I thought would be flexible enough for you to wear comfortably with your arm bent in that infernal immobilizer. Have you been told you'll be in the darn thing while sleeping? (Probably). Once you're allowed to remove it for sleep, one of the velcro-adjusted night garments might work for you. I think they're easier to don than the daytime sleeves using velcro. Why don't you post a new topic,, something like 'is anyone using a LE garment that adjusts with velcro' to see if it catches anyone's eye who has experience with something like that?

Is your surgery side your dominant side, by the way?

voraciousreader

sending hugs and prayers your way! I've had shoulder surgeries both before and after my diagnosis. Never had a problem with respect to lymphedema. I was extremely concerned that I might develop it, but my physician assured me that I would do well and I did. I feel your pain! I couldn't sleep at all before my surgery. I shook all day and night from the pain.....I wish you well with surgery and I wish you even more wellness afterwards! 💞

glennie19

surfdreams: I have no answers, but sending gentle hugs. My one and only suggestion for truncal LE, is the EAB Medical breast binders, which use Velcro to fasten in the front, and would not bother your shoulder at all. Would be helpful if your LE is across your chest or under your arm.

crystalphm

Sending hugs...I am coping with a shoulder injury too, from an accident. 4 months of PT have not helped at all, and I am so nervous to see a surgeon. I sure will keep goor thoughts for you...please let us know what is going on and what answers you find. Denise

surfdreams

thanks for all your kind words and suggestions everyone! i'll keep you posted.

carol57

surfdreams, I was at PT yesterday for my own post-surgery shoulder issues, and I described your dilemma (my CLT is in the same rehab practice where I'm doing PT). Universal opinion (we had quite a group chat about this) is that it would be best if you could schedule your post-surgical therapy with a PT who is also a CLT or works closely with one. They also were mortified that your LE therapist wants you to wait four weeks for a return to therapy. But the best part of the conversation was that they wanted me to pass along to you that the particular shoulder replacement you're getting typically brings with it a relatively easy recovery, meaning not a walk in the park, but usually much easier, faster, and much less painful than patients expect. Let's hope that you have exactly that experience.