Two Questions
I neglected to ask these two questions and was wondering if any of you know the answers:
1. Why can't you shave during radiation?
2. Is it true that after sentinel node biopsy you cannot have blood taken from that arm or have your blood pressure checked? If so, why?
Comments
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You shouldn't shave under the arm you are having radiation on- shaving scrapes away a layer of skin along with the hair- and you need all the layers of skin you can get during rads. It also irritates the skin- something you don't need during rads either. I didn't shave and in about 2 weeks into rads all the hair fell out any way- one benefit of rads!
You cannot have trauma to the arm you have a sentinal node biopsy on because it could cause lymphedema (swelling of the arm)- it is painful and never goes away. You also have to be careful not to get cuts or bug bites etc. any trauma can set lymphedema off. There is a thread on here just for that- check it out if you want to. Hope you have smooth sailing through everything. Tami
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:-) About 5 days after my lumpectomy + SNB, I met with my medical oncologist for the first time & when she went to take my blood pressure on the affected side, I said, "oh, am I not supposed to have that arm used ever again for blood pressure?" and she said, "nah that's just being over-cautious." She said, "your surgeon didn't tell you that after the surgery, did she?" And I realized that she had not, it was just general information that I had received pre-surgery, so before there was certainty as to how many nodes would be removed.
On the other hand, my medical oncologist was over-cautious herself in other areas. So I wasn't quite sure why she had chosen a low risk of lymphedema as being the thing to be less cautious about.
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Janey and Donnamarie, I don't know how protecting yourself from a lifetime of lymphedema -- which is distressing, often disabling, and can actually become life-threatening in the case of infection related to lymphedema -- could ever be considered "over-cautious." Unfortunately, our doctors are not taught much about the lymph system in their medical education, so a lot of us have been unpleasantly surprised to find their advice on that issue unreliable.
I had one node removed from my bc side, and a prophylactic mastectomy on the other side, and I have lymphedema on both sides. There are many of us on the "Lymphedema After Surgery" board with the same story. The risk following SNB is lower than after AND -- it's about 7%. (If you have radiation, of couse, that raises the risk, as do a number of other factors.) But you really don't want to be in that 7%, so tell them all kindly but firmly that your affected arm is off limits from here on out.
Here's a page you might want to copy to take to your docs:
http://www.stepup-speakout.org/what_we_need_healthcare_providers_to_know_about_lymphedema.htm
Or send them to the National Lymphedema Network here:
The medical professionals who know about and treat lymphedema are not doctors, but well-qualified lymphedema therapists. A referral by any doctor on your team can get you an appointment with one for evaluation, personalized tips for risk reduction, baseline arm measurements for future reference, and fitting for a sleeve and glove to wear prophylactically for exercise and travel. Here's a page for finding a fully-trained lymphedima therapist near you:
http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm
Hope that helps, and that you never have to join us "sisters of swell!"
Be well!
Binney -
Thanks, for the info Binney. I will need to read the articles. I was only told not to lift anything for 3 weeks, but being the person that I am, I prefer to do things myself and not wait around for someone else to do it. I have been lifting any and everything! I will definitely be more careful.
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Lymphadema is certainly distressing and is definitely cause for concern. However, as someone who just finished chemo, and had SNB on BOTH sides, not using an arm wasn't an option. I was advised to use the non-cancerous side for blood draws and chemo. Thankfully, the arm seems to be OK.
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Different doctors give different advice & it can be frustrating. I had a single node biopsy on my mastectomy side and I do not allow blood pressure or needle sticks on that side. Before any type of surgery I make sure everyone knows not to take blood pressure or do needle sticks in my left arm. I make sure it is written on my chart. In an emergency situation I would let them do it but not routinely. I even had a Medical Allert braclet made. I'd rather be safe than sorry!
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Stacy, if you so choose you can protect both arms. Blood pressures can be done on the leg, IVs and blood tests in the foot (sounds worse than it actually is), and injections in the hip or thigh. It's your call, though you're likely to get some eye-rolling from nurses or docs who don't understand the risk. In fact, if you develop lymphedema in your arms you won't be able to use them and will have to use alternative sites (and you'll still get eye-rolling from those medical folks who know little about lymphedema and find our alternatives inconvenient
).
Just a thought,
Binney -
I woke up yesterday morning with my hand feeling a little swollen. I began to think "what did I eat that was salty yesterday?". As the day progressed, my hand began to feel numb and by the evening it was up to my elbow. Do you think it could be a sign of lympedema? Do I need to see a professional? My breast surgeon? Family practioner? I begin radiation Tuesday. Should I just wait and speak to the radiation oncologist? God, I hate this crap!
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Donnamarie, Tuesday (day after tomorrow) will be good. You'll need a referral (from any one of your doctors) to a well-trained lymphedema therapist. I posted a link above to help you find one in your area and know what questions to ask, but I'll put it here as well to make it easier:
http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm
Numbness and swelling are signs of lymphedama. Also you might have tingling, aching, or heaviness, or just plain "a weird feeling." Getting help promptly, as you are, will mean quicker response to treatment and an easier time controlling it. It will also help prevent spread of the swelling and reduce your infection risk.
Infection is another cause of sudden swelling, though. So if you notice redness or rash, warmth to the touch, fever or other flu-like symptoms, or itching, do get help at once, even after hours at the ER. Infection in an arm at risk for lyphedema can spread quickly, so antibiotics are needed quickly.
I'm really sorry about all the worries and "side trips" that come with this breast cancer diagnosis! Hang in there, you'll soon be back in control of your life!
Gentle (((hugs!)))
Binney
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