VISIBLE SIGNS OF LYMPHEDEMA - A PICTORIAL
Comments
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As time goes on I have stopped asking for help lifting things. I guess I better start again. My wrist started hurting after walking the dog one day. She walks wonderfully so it was from any pulling. I see my pcp on Tuesday.
I have a set of sleeves for when I take airplanes but I got them a few years back when I weighed less. I am not sure if it help or hurt me to where one.
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Laura, thank you for posting the picture of cording -- it's hard to recognize if you haven't seen it. It's also sometimes impossible to see if you're a bit overweight, but the "cords" can usually be felt if you know how to find them. Here are more cording pictures and information:
http://www.stepup-speakout.org/Cording_and_Axillary_Web_Syndrome.htmBMD, weight changes do make a re-measure and new garments necessary. Wearing garments that don't fit properly can have the same effect as a blood pressure cuff. Check the fit with a lymphedema therapist or an experienced fitter before wearing them.
Be well!
Binney -
Thanks, Binney. I don't remember seeing those pics on SUSO when I was there before. I really appreciate your post and the SUSO info so much!
Dawn
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this is so helpful for so many of us who aren't sure. This is great!!!
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I just found out yesterday I have lymphedema after 2 years of being diagnosed with breast cancer. I'm being fitted for a sleeve and glove Tuesday. I was just wondering hopw flexable the sleeve is? Will I be able to bend my wrist and elbow or is it more like frankenstein?
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Sherry, I'm so sorry!
Kind of a lot to get your head around, isn't it? Please know it gets easier.
Here's a page about lymphedema garments that will show you what they look like and explain a bit about how they should fit and feel:
http://www.stepup-speakout.org/proper_fitting_of_lymphedema_garments.htm
The garments are flexible, and you will be able to bend at all your joints. But they're tight and frankly they feel weird, especially at first. We just aren't used to being squeezed all up and down our arm and hand.
You don't mention therapy, so I'm wondering if you've been seeing a therapist daily or several times a week for the past weeks? Have you learned self-Manual Lymph Drainage massage and self-wrapping with layered short-stretch bandages? The garments cannot reduce swelling, they can only help maintain the reduction that comes from intensive lymphedema therapy. If that hasn't happened for you, do ask why not before getting fitted for garments. The following information page has sections to click on about Manual Lymph Drainage and Wrapping/Bandaging that can help explain the process.
http://www.stepup-speakout.org/treatments_for_lymphedema.htm
Sorry you had to join us "swell" Sisters, but glad you found us.
Please keep us posted!
Be well!
Binney -
Some also are a bit more flexible than others. i had an elvarex brand that was like " COMPRESSION OF STEEL"!!!! I didn;t work for me but a lot of others love 'em. I always liked my off the shelf MEDI, and I love my new Gottfried custom...
Moogie
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I had pain last Sunday so I called the oncologist and they said I could come in and see the PA. She was the one who wrote the script for the sleeve, she said some times we do the therapy but we're going to leave that up to the oncologist when you come back on June 11th for you regular appointment. So I'm supposed to wear this for the next 2 weeks and see what the dr. says.
Thanks binney and moogie.
I also woke this morning with itching on the same arm, is that a symptom of lymphedema?
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Sherry, the itching could be serious, as it can be an early symptom of infection. Do please keep a very close watch for any signs of infection: warmth to the touch, redness, increased pain or swelling, or a temp. (If there's redness, circle the area with a permanent marker so any progression can be followed.) If any of those symptoms start, go right away to critical care or the ER and be sure to tell them about the lymphedema, and that you suspect cellulitis.
Sherry, I'm sure your onc's office and his PA are excellent at what the do, but most onc's don't "do" lymphedema. The suggestion that you be fitted for a sleeve and see what happens is completely backwards. Especially if there may be infection brewing, a sleeve is not a good thing. Also, I can see where the doc might want to rule out other causes for your symptoms, but those other causes (blood clot, for instance) should NOT wait two weeks to be investigated.
On a strictly practical level, if you need lymphedema therapy, then the sleeve you order on Tuesday will no longer fit once any swelling is reversed.
But even more to the point, if what you're dealing with is, in fact, lymphedema, then the quicker you get help with it the better your outcome, the lower your risk for serious systemic infection, and the easier it is to control over time. My suggestion would be first, that you go directly for emergency help at any further sign of infection. DON'T WAIT!!! And second, if your arm is stable, on Tuesday skip the fitting and find a doctor on your team who will move forward with helping you get the proper treatment.
But that's JMHO.
Here's a page with information about cellulitis:
http://www.stepup-speakout.org/Emergencies_and_Medical_Care_lymphedema.htmPlease keep us posted, Sherry.
Gentle hugs,
Binney -
I haven't had any more itching since Sunday morning but I keep watching for other stuff.
I was also told to stop being on the computer unless I could learn left handed, is that true?
I was told stop crocheting and doing anything that makes the arm just keep moving, like washing dishes, folding clothes, mopping, anything I HAVE to do I now have to stop.I have nobody to take over all my stuff plus they have to do their stuff and jobs too.
I'm going to call the dr. office tomorrow morning and see what they have to say about me not going for my fitting appointment. The PA did say get it asap.
Is a sleeve and glove covered under insurances?
This whole thing is so confusing to me.
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Sherry, I'm so glad to hear you're doing okay!
Most insurance will cover sleeves and gloves to some extent (not Medicare, though). Mine considers it Durable Medical Equipment and covers it the same as crutches and such. But here's the problem: they will only cover so many a year (commonly, since they need to be replaced every six months at least, they'll cover one or two changes every six months). If you go out and get a sleeve and glove now, then go into lymphedema therapy, the garments won't fit after the swelling has been reduced, and your insurance won't necessarily pay for more until the six months are up.
The medical professionals who evaluate and treat lymphedema are well-trained lymphedema therapists. It's their specialty. Here's information about how to find one near you:
http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htmThe process of lymphedema treatment is to reduce the swelling first through an intensive phase of therapy that includes Manual Lymph Drainage massage, wrapping with layered short-stretch bandages, specific exercises, and careful skin care. When the swelling is reduced to normal or plateaus, then you're fitted for garments to maintain the reduction (garments will not reduce the swelling, only maintain the loss, so wearing them now will not solve the underlying problem). Most of us need to continue to wrap our arms at night or wear special night garments that are designed to maintain reduction or even help reduce it while you're not moving around or exercising.
This whole thing is very confusing to all of us, Sherry. It's a very steep learning curve that is not helped by the fact that doctors and nurses are not generally well-informed about diagnosis or treatment. I am not a medical professional and certainly wouldn't urge you to ignore your doctors and PA, but you sure might try a dialogue with them about getting a prompt evaluation from a lymphedema therapist.
Let us know how it goes!
Be well,
Binney -
Sherry, I woke up in the middle of the night thinking about you and realized I hadn't answered your question about typing and crocheting.
The fact is I use a left-hand-only keypad (had to relearn how to type!) and I've taken up the Knifty-Knitter in lieu of the crocheting I loved. But THAT'S NOT USUAL. What happened to me should not happen to any woman who develops lymphedema. I had some truncal lymphedema to start with. My doctors took a "wait-and-see" approach instead of sending me for prompt treatment. When I finally got a referral, it was to an inept therapist who had only a three-day training in lymphedema therapy (I didn't know any better). Far from reducing my truncal lymphedema, she was responsible for it's spreading to my right arm and hand. Still without adequate help, it eventually developed in my left hand and arm as well.
Recent research shows that prompt treatment can prevent progression (not to mention reducing the risk of serious infection). I wish I had known that, because if it had not progressed I would not have lost the ability to type and crochet with my right hand. Yours does NOT need to get to that point. Get GOOD help SOON.
And by the way, I can stil do dishes, fold clothes, and mop
. Too bad!
While you wait for help with your lymphedema, keep your arm elevated as much as possible (even on pillows at night), drink PLENTY of water, and do some gentle deep abdominal breathing from time to time.
Anxious to hear how it went today,
Binney -
Emme I recommend you see the surgeon that did the operation, they recognize LE. My surgeon knew immediately upon seeing and feeling it along with my input on my symptoms. You will be sent to physical therapist for confirmation and treatment. Don't wait if it is acting up. Good luck, Sherry
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hi binney, thanks for getting back to me. I do elevate and stupidly got on a massage machine forgetting duh that I have truncal and before I knew it my Le was back in myforearm and hand. It was mainly upper arm and baggy elbow with truncal too. I am so mad at myself, I know better. I was trying to feel better and I wrecked myself for a week. I had to resort to my night sleeve during day, Feels like a wing and if I take off I will only go in circles...lol
love ya
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LindaLou, this is awesome and well done. I agree that pictures of the baggy elbows and puffy anterior of LE armpit region. The last was my first visable sign, pain, heavy, aching was felt signs. Your a great asset and so professional, you could create a book based on your style of presentation. I would volunteer photos, sure others would too. Just a thought,
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Thanks so much for the photos - it is always a big help to find out that we are not alone in all of this. And you are so right that we all are a bit different. My hand is my signal for how the lymphedema is doing. If I can see the tendons then the swelling is down all up my arm. At one point I got annoyed about having to look after this for the rest of my life. Then I noticed that the things that caused this, the surgery and radiation, are the things that have given me the rest of my life. It's not that bad a trade off.
Since I had a single mastectomy and am not, umm, tiny, it is as a public service that I wear a bra and false boob. One thing I did recently was change to a sports bra which I wear with a light weight knit foob. I think that has made a positive difference to my lymphedema.
Thanks again for your successful efforts to help us all.
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Please ladies, share your pictures of what your stage of lymphedema looks like!!
We are in the midst of preparing the following page: http://www.stepup-speakout.org/What_does_lymphedema_look_like.htm
Any and all help and pictures are welcome--please send them to jane@stepup-speakout.org and we will get them on the page, and get the page up and running soon!!
Thanks for sharing, and helping those who come behind us!!
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This is sort of on this subject and again not...Lymphedema after breast surgery is a diagnosis for long term disability. My oncologist filled out all the papers and got me on long term disability. Was wondering how i was going to work with decreased ability to use my right arm and hand...Mine is very visable. and getting worse as time progresses...i wear the sleeve and glove daily.
angela colvin
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Totally in agreement. I am a board certified lymphedema therapist.
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A sleeve and glove does not reduce the limb, it only contains swelling for a short time. You need to apply short stretch bandages to reduce the size. After reduction, they you can wear the sleeve and glove, but you should wrap for reduction.
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I have a quick question. I am two and half weeks out from BMX w/ immed recon. (TEs) Is it possible to have lymphedema under your arm? It's like just above my ribs, but directly on my side. I can't even put my arm down. I think I have a pretty high pain tolerance. I was down to taking a pain pill just before bed. I went to the PS Friday to get my last two drains out. The first two he took out were a breeze, but this time I am miserable. I am soooo swollen. I went from finally being able to do things around the house to barely being able to get out of bed. My husband is back to helping me up. I look like a body builder on my left side. I wish I had a way to show you, but my camera isn't working. Maybe, my mom can come take a picture. I can't seem to find any pictures of where my pain and swelling are. I am now back to taking pain meds every 4 hours too. I hate this! Please tell me what I should do. I have my first appt with my BS tomorrow, but is it safe to wait? Thanks in advance and any help would be greatly appreciated. Allison
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Hi Hopeful,
Sorry I just now saw your post and see you have had no responses. I know you are probably at the BS office now so hopefully you will get some answers and relief. Based on what your recent history is with only 2 weeks out from BMX, Recon and having had drains removed on Friday, I would suspect the extra swelling you are having may be related to post-surgical drainage.
Sometimes drains are removed a little too early or our body keeps producing more fluid after the drains are removed and this can cause swelling and discomfort. If you have a seroma which is a pocket of fluid that can often develop, you can have that drained by your BS. This whole period of normal inflammation immediately following surgery can definitely put an extra burden on our lymphatic systems. For some women that extra burden is just enough to push them into early onset LE. Yes it is possible to have LE under the arm and in the chest/truncal/breast area also in addtion to the arm and hand.
Let us know what your BS told you today. I would hope that what you are feeling is normal since you are still early in the post-op process, but I would still suggest that when convenient you locate a trained LE therapist who can also evaluate the status of both your arms and truncal area now.
http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm
As you progress through your healing, if you have persistent areas of swelling that may be more than normal post-op inflammation you definitely should be formally evaluated for LE.
If what you are experiencing now is acutely painful and disabling, you need to seek urgent attention from your BS, PS or an ER. Please be aware that any areas of your body that feel hot to touch, painful, red in color and spreading in size, are to be considered a medical emergency.
We will be looking for an update from you. Best wishes.
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Emme, please don't be afraid. Be informed. Get every bit of information you can. You will feel better knowing as much as possible. If you get a therapist or doc you don't like, get another one, you deserve the best tlc there is
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Hi Ladies, I have a question for you all. Have any of you ever had a steroid injection? If so how long did it help keep the LE down. I know I cant keep getting them. It was a one time deal for a bad infection? I thought I had heard it will help for about 6 weeks.
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Buddy, I've only heard of or used steroid injections for joint/tendon inflammation--when it's injected into the joint.
But, some people use a shot of steroid to treat allergy symptoms, and it's not given in the location of the joint or tendon.
To my knowledge, there is no place for steroids injections in the treatment of lymphedema.
When used for a joint, you only give them three times in a year. Steroids suppress the adrenal glands, and can actually cause fluid retention.
Who gave you the steroid injection for lymphedema?
Kira
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Kira the shot was for excema that was out of controll i was told that it may help reduce some swelling from the le also but somewone else said it woulde only last 6 weeks
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spicekitty5 I sent you a PM
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Buddy, makes sense for the eczema--which you don't' want out of control with LE--did it help?
Kira
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Have any of you checked out this site? I have found it very informative and helpful.
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Hello:
I've learned a lot by reading all of the posts. The pictures are amazing! Thanks so much for going to all of that trouble!!
I am wondering if I have a problem with lymphedema. I had a BMX with immediate recon (SGAP tissue flap) with 4 nodes removed on my right side, about 6 weeks ago. My right arm has always been a little sore and stiff. Initially, I thought it was from the surgery, and it may well be, mostly because there are no visible signs of swelling. Now, I'm wondering if there isn't some small amount of swelling going on and it should be checked out by a LE therapist?
I'm not back to exercising just yet. I was thinking that the soreness/stiffness would disappear once I start running again and get the blood flowing more through my right arm. Does that seem to help - exercise? Should I wait to see a therapist until I'm back running again to see if it makes a difference?
Thanks!
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