Truncal Lymphedema Episode
I've dealt with mild truncal LE with occasional flares (like after exercising in the excessive summer heat), but nothing worth complaining about. But this week, DH & I were in Las Vegas, and my LE started really acting up, to the point of being quite painful. What bothers me is, I'm not sure what I did to exaccerbate it. We drove, so it wasn't flying. Some of the things that have crossed my mind are (1) hot baths (but no excessive heat directly on that area)? (2) saltier food? (3) smoky casinos? (4) slightly higher altitude than I'm used to? (5) 16th floor hotel room? Or maybe just a combination of them all? I just want to know what could have caused it so that I can avoid it in the future.
Comments
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dlb823- Sorry to hear about your flare up, I think everyone has slightly different triggers. Mine happen to be stress and salt. I hot tub (very limited time) and think that it sometimes also has an negative impact but figure the stress reduction qualities out-weight the negatives. I always do MLD after the hot tub and avoid it when I'm inflamed.
A salty diet, eating out, always seems to be problematic for me. The best thing I have found is watching my diet, exercise, MLD and deep breathing. If I start flaring up, I use the compression garments 24/7.
Good luck.
Betsy
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dlb, a long car ride can cause problems too. Don't know how far you drove, or how many mountains you crossed to get there. What helps with the long drives is stopping and stretching frequently, some arm stretches, side bends, walking or jogging. Also, maybe better compression for the trip, depending on what you're using for chest compression.
As for the hot baths, it's raising your core temperature as much as heat directly on the area that causes problems. (Which is why women who leave their arms out of the hot water still can have problems with LE.)
Sure hope it's back in control in a hurry and you get on top of causes for next time!
How was the trip otherwise? Hope you had some fun and relaxation!
Be well!
Binney -
Betsy & Binney, thanks for the input. Although our drive to LV is only about 4 hrs., I had no idea a long car trip could be a problem. And, Betsy, I had no idea that stress could be a factor, and this trip, which is an annual one for us, as fun as it is, is always stressful for me b'cuz it cuts a week of Christmas lead up time out of my schedule, and I feel totally overwhelmed when I get back.
Aside from the LE, we had a great time, Binney. My DH's family uses the NFR (rodeo) as an annual reunion get-together. Two years ago, I'd just finished chemo and could barely walk up a flight of stairs, I was so weak. Last year my mantra was, "What a difference a year makes," and this year -- aside from the LE -- I found myself so grateful to have enough energy to keep up the pace and rarely think about bc. So, along with the joy of seeing distant family, it's become a bit of a bc progress marker for me. Deanna
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dlb, I'm sorry you had such a painful flare. I have truncal LE, and my husband and I used to drive from PA to Fla. Every time I'd have a huge flare. For me, it was being sedentary for so long combined with the difficulty in finding low-salt food while on the road. I even found that with the a/c blasting, the sun coming in on me through the car window made me too warm and caused me to swell. I used to get a claustrophobic, crazy feeling and want to get out of the car!! The usual stops to walk and stretch just weren't enough for me.
My other thought about being in Las Vegas, is that it's in the middle of the desert, so maybe you weren't drinking enough water? It's easy to forget the fluids when you're in low-humidity places.
Very interesting about the stress factor, Betsy. I always forget that one, but I think you are right about that. I've noticed that whenever my husband and I have an argument or I'm upset about something, I will feel myself swelling more. Another reason to remember to breathe during those times. And, actually, our trips to Fla. can be stressful as well because they often involve a lot of responsibility on my part to care for my mother and handle her legal and financial stuff.
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My triggers are stress, long car rides. I haven't attempted a hot tub, yet. One thing I've noticed is that I swell up every day starting at @ 3:00 pm. I associate this with the change in barometric pressure. It may sound ludicrous but I believe it's the cause of my swelling. When the weather changes I know it before the weatherman LOL I'm in agony. Think about this;many women wear compression garments. When the barometric pressure drops there is less pressure-compression. It makes sense to me. Of course my surgeon tells me that I don't have lymphedema because she did a test on me with an LDex machine. The machine said I didn't have it. If machines could feel ...
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Makingway--the L-Dex brochure states that the machine is not intended to diagnose LE
http://www.impedimed.com/products/l-dex-u400/ldextrade-u4007714.htm
Note: This device is not intended to diagnose or predict lymphedema of an extremity.
Note: L-Dex® values that lie outside the normal range may indicate the early signs of lymphedema and values that have changed +10 L-Dex units from baseline may also indicate early lymphedema. The L-Dex scale is a tool to assist in the clinical assessment of lymphedema by a medical provider. The L-Dex scale is not intended to diagnose or predict lymphedema of an extremity.
The best use of bioimpedance is to measure over time--and it only works on extremities, and one researcher, at NYU--Mei Fu PhD--found it very insensitive.
I also have a "biorithym": I swell in the evenings.
And the barometer makes sense--as we swell at high altitudes.
Tell your surgeon to put down the toy, and examine and listen to the patient--just a suggestion.
Kira
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Tina, dehydration's a good point, and would seem like a logical factor the other times I've had some flares -- like when I jog/walk on really hot summer days. And that could also be a factor re. flying, don't you think? But I definitely noticed how dry my face was there, so I probably was dehydrated.
The other thing I thought of is that I wore "real" bras while I was there, instead of the sports type ones I live in at home. So not only missing the compression factor that Binney mentioned, but probably the underwires weren't a good idea.
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I think the bras alone could have caused it- I know wearing a bra is sure a trigger for my truncal LE. And car rides too for sure. I can't stand to wear a bra- anything with a tight band including sports bras feel constricting. Most of the time I wear stretchy camisoles that provide some light compression, but no constriction. I'm a smallish C cup I think- I know not every one feels like they could do this. I do still wear a bra sometimes, but never underwires as I just find them really uncomfortable. My favorite bra is sort of a neoprene sort of material with a seamless molded cup
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Hi To All. I mentioned a few days ago, that last week, went to breast surgeon and she drained like 2 syringe full of blood, and put a bandaid on, and that was it. I noticed that it seems like the area (trunk), filled up again. Called today, and have to go in on Wed. to get a drain put it. OMG!!!!
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Aw, Sharalou, I'm sorry! You sure didn't need any new snarls!
Deep breaths -- the drain will be a help, and before long you'll be healed and back on track.
Keep us posted!
Gentle hugs,
Binney -
Dlb, sadly enough, underwires are a killer for truncal LE -- they block the downward lymph flow, so even gravity can't help you.
How crummy is that?!!!
Are you back in camis? Are you doing any better?
Did I mention that LE rots?
Binney -
Binney & others... one more question... Can deoderants make a difference? The one in my travel bag is a natural brand, but not the Trader Joe's brand I use at home, so just wondered if any of you have noticed more problems with certain deoderants.
My swelling is much better today, and I have to say from the "aaahhhh" reaction I have just putting on a sports bra, I kind of think the underwire bras may have been the biggest instigator -- plus the salt-ladden restaurant food. Deanna
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Deanna, the deodorant theory is new to me, but stranger things have happened with LE.
Sometime when you're at home and everything's under control, you might try the travel brand again for a few days and see if it causes a problem. Do let us know what you discover!
I'd say it's a good bet the bra would be enough to give you grief all by itself. Bummer!
Still, it helps to know your triggers, and you've worked hard to consider all the possibilities. LE may be rotten, but it sure isn't boring!
Be well!
Binney -
Kira-Thanks for the validation
I'm about ready to read my surgeon the riot act. I asked for copies of all my records. And upon reviewing them saw no mention of the pain I've complained about since my operation 1 1/2 years ago. My surgeon told me that I'm her only patient with such issues, which is a lie, because my friend also had her as her surgeon and suffers from some of the same pain. The pain doesn't exist if she refuses to acknowledge it... I'm at a loss because I need a doctor to validate my conditon(s) in order to receive Disability. The attorney I saw told me it was up to me to find a doctor to validate this. Being on county funded insurance doesn't help matters. The doctors are the worst in the business.
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Makingway, so often the surgeons will deny that there are any problems--who knows why--shame, inability to admit that things don't always go well, inability to treat the problems?
Truncal lymphedema is painful.
Binney, who posted above, her surgeon still says that none of his patients ever got lymphedema....
If you could find a sympathetic physician--a primary care doctor, an oncologist perhaps--the doctors who know about lymphedema and treat it are few and far between--but are usualy rehabilitation doctors=physiatrists.
Here's a list from Lymphedema People: there have to be more--Stanley Rockson at Stanford may know of someone in your area--he's a top researcher and can be very helpful
http://www.lymphedemapeople.com/phpBB3/viewtopic.php?t=5
CALIFORNIA
Dr. Jonathan Levin
165 Rowland Avenue
Novato, Ca. 94945
(415) 898-6190Emily Iker, M.D.
Physical Medicine and Rehabilitation
2001 Santa Monica Blvd.
Ste. 470W
Santa Monica, CA. 90404310 829 7472
email: LYMPHEDEMA@JUNO.COM
..........
Stanley G. Rockson MD
Associate Professor of Medicine
Chief of Consultative Cardiology
Director, Stanford Program for Atherosclerosis and Cardiovascular
Therapies
Director, Stanford Center for Lymphatic and Venous Disorders
Falk Cardiovascular Research Center
Stanford University School of Medicine
Stanford, California 94305Telephone 650-725-7571 FAX 650-725-1599
srockson@cvmed.stanford.edu
http://med.stanford.edu/profiles/Stanley_Rockson/
http://cardiology.stanford.edu/Programs ... aurora.htm
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Let us know how you make out.
Kira
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Hi, Deanna:
I am so sorry you are having issues, but glad they're getting better. I'm like some of the other ladies - big triggers for me are long car rides and dehydration. Those two things alone will make me swell. For the truncal LE, the biggest help I have found is the MLD. If you can get in with an LE therapist (you may have already done this) and learn MLD, it will probably make a world of difference...that and lots of water!
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