Nordy, that's the best explanation I've heard! Keeps with my thinking, but I really, really had to push the walk-in clinic doctor to drain mine. My surgeon wouldn't.

Nordy, pseudo bursa makes so much sense--mine persisted for 5 months in my axilla, and it sure felt encapsulated. Finally it was drained--big syringe of clear, yellow fluid, and it did re-collect a little, but I massaged it, and it FINALLY went away.

I did send this information to my (former) breast surgeon--now she has no excuse to say "Oh my goodness, you have a seroma! What should we do about it!?" to anyone else...

She thanked me "for the update". (Nah, I'm not still mad.....)

Kira

Lets hope our surgeons are keeping as up to date on information about seromas as we are.  Mine said, "well, we can drain it or wait for your body to absorb the fluid".  Since it was uncomfortable I asked him to drain it.  Sigh, I still got LE though.

Erica, I was doing Tai Chi weekly until a few months ago--the deep breathing and the slow movements are definitely helpful. And the balance work is good as well. I just got tired of the class, took a break for the summer, and then broke my hand. I found a great instructor, and will likely re-join them soon.

I just figured out yesterday, while doing Pilates on the reformer, with a PT, that I have a touch of frozen shoulder after the cast--and while I borrowed my husband's exercises and will be in touch with the PT, I plan to do Lebed to stretch it. It's only "internal rotation, abduction"--the movement to touch your back--like to undo a bra. All other movements are great--but my deltoid had been really hurting while I was in the cast and splint.

If it's not one thing, it's another.

I think the seroma article shows that seroma can perpetuate inflammation and the pseudo-bursa, as Nordy described--can delay healing. Since the axillary lymphatics are delicate and have a limited time to re-join each other, I think it's the early seromas that we need to consider treating aggressively, and to limit axillary stretch so we minimze seromas and webbing--in the first 10-14 days post op.

Yes, I have a touch of frozen shoulder--but I was in a cast for 6 weeks and a splint for 4 weeks, not moving your shoulder for 10 days is not a huge issue. Ironically, I dug out my shoulder range of motion exercises that I'd gotten from PT in anticipation of surgery and did vigourously post-op, and Jodi Winicour says she sees that all the time: women who overdo the shoulder stretches post op,early, and come in with tons of webs and whopping axillary seromas--that was me, and I did it because I was told to--I sent Jodi's slides and this abstract to my breast surgeon, in the hopes she'll read them and understand the need to treat the axilla gently.

So, time to reconsider Tai Chi--I had done it weekly for almost 2 years and just needed a break, but we did Qi gong and stretching and the form. Good stuff.

Kira

My drains were taken out waaaay too early by the f***ing homecare nurse; day three!  That led to seromas on both sides which were drained twice.  I also had cording.  Did chemo first, 3 FEC and 3 Taxotere & Herceptin followed by surgery, then rads.

I developed LE six months after surgery, mainly a puffy hand.  Went to the lymph clinic, learned MLD which I do daily and have always worn the sleeve and glove for exercise and flying only.  Recently flew and had to take glove off because my fingers were numb (Dec 6).  Since then I have had various degrees of swelling in the left arm and hand.  Wearing both sleeve and glove seem to make it worse!  I'm at the end of my rope and really pissed that an incompetent nurse caused this.

Thanks Kira.  You're right about everything, especially the anger.  I was at the massage therapist the other day and she measured me for another sleeve and wrapped my hand; maybe I should try wrapping my hand.

I have an appointment at the Lymph Clinic on Feb 8th; I'll call them Monday to see if I can get in earlier if they have a cancellation.  It's all so confusing not knowing what to do.  I think the sleeve is pushing fluid into the hand (I was wearing an older sleeve yesterday).

Erica, she did--she came out with an inexpensive DVD--I haven't seen it. I've looked at her YouTube videos, but they're too short and poorly produced for me--I did write her and ask why she doesn't wear garments on YouTube (her DVD was sponsored by Juzo) and she said it's because they're so short.

Here's the link to it--she calls it a private class and it's $12. 

https://www.lebedmethod.com/store/?productID=60

Maybe you could preview it for us?

Kira

Kira,

Thanks for including the URL to order the new Lebed DVD. I have been trying to convince myself to get one for a couple of years, and this finally did the trick for me.  I have placed my order, and I am looking forward to getting it some time next week!  Perhaps between that and my rebounder, which I don't use enough, I will get myself in better shape for doing other things.  I'm still looking for a good Tai Chi class.  That's next on my agenda.

Dawn 

I had my first drain for 3 wks.  When I finally got it out and went back 3 days later, fluid was building up, and my BS aspirated it a couple of times.  When the radiologist put my port in, fluid went all over the place, and he thought he might have cut an implant at first.

To make a long story short, I went back to the intervention radiologist and had another drain put in and it finally worked.  My surgery was 10/12, and I got the drain out 12/20 for Christmas.

Reading this thread makes me really glad that my BS did not let the seroma just stay there - though I was getting really tired on the drain and wanted answers.  She did not restrict my movement in any way after surgery, and the seroma did not go away until I took it really easy for a week b/c I had another surgery to get a mass on my neck taken out.

I don't think it is a very common problem.  My BS has been practicing 20 years, and my case stumped her.  Thanks for all the info on this thread!

Dawn, I have both the original VHS tape and the DVD she put out: I really like the DVD and you can do specific chapters of it--I orignally took it out from our library to make sure I liked it. I believe I ordered it on Amazon--not reduced in price, but free shipping (if you need something else--to make it over 25$)...

http://www.amazon.com/Healing-Through-Therapeutic-Exercise-Movement/dp/B000HWY60G/ref=pd_rhf_p_t_1

On healthy steps it's the same price, ? shipping

https://www.lebedmethod.com/store/?productID=3

The new "private class" was done to be less expensive, and none of us have seen it, and I don't know if it's broken into chapters like the other DVD. Personally, I do the first chapter--lymphatic openning and then focus on arms and torso and skip the leg stuff.

Marcia: although seromas are common, it sounds like yours was lncredibly persistent and very unusual, I hope you're feeling better now.

Kira

I'm late in reading this topic, but I want to return to the question of arm raising in the first week or so after surgery. I know the thread concerns seroma, but there was commentary on the first page about exercises for range of motion also being part of the LE risk.

Here's a study (I'm excerpting here; this was sent to me as a Word doc, and I do not know that the link embeded in the title works, as I think a subscription is required):

A randomised controlled trial of two programmes of shoulder exercise following axillary node dissection for invasive breast cancer  Original Research Article
Physiotherapy, Volume 94, Issue 4, December 2008, Pages 265-273
Jacquelyne Todd, Andy Scally, David Dodwell, Kieran Horgan, Annie Topping

Here was the study objective;

To compare the incidence of treatment-related complications, including lymphoedema, after two programmes of shoulder mobilisation in women with invasive breast cancer when surgical treatment included axillary lymph node dissection.

Here's what was compared in the study and control groups:

Arm exercises and shoulder movement restricted to below shoulder level for the first 7 days after surgery. Controls commenced an exercise programme that incorporated exercises above shoulder level within 48 hours.

Results:  Of 109 women who completed the study 22 developed LE in their first postoperative year.  Sixteen were in the early-exercise group and 6 in the delayed exercise group. There were no statistically significant differences in shoulder movement, grip strength, or self-evaluated outcome between the two groups at one year.

My PS needed me to keep arms low after diep, to protect the flap's blood supply. I had zero instructions from my BS on the matter (bmx with immediate recon).  So PS's instructions along the way saved me from any inappropriate arm lifting.  Got LE anyway, so clearly there are no guarantees here. My LE is mild, so certainly it's possible that not arm lifting prevented worse. That's just a guess, of course.

Carol

I don't know how I missed this thread last year but I'm glad it was bumped. My surgeon instructed me to stretch my arms above my head to prevent frozen shoulder immediately after my AND and lumpectomy. That time is a blur. I do remember that my drain wasn't pulled until postop day #8. I definitely did overhead stretches after that. I developed cording 1 week post op and started PT with a poorly trained LE therapist 2 1/2 weels post op. I often wonder if some of the repetitive motion exercises with weights that she had me do contributed to my LE. Sigh. It wasn't until I found information on this site that I realized she/I could be making things worse.

I didn't have a axillary seroma but I did have donor site seromas after my S-Gap, One developed inspite of keeping the drain in for 8 1/2 weeks. I guess some of us are genetically predisposed to LE. It would be nice if our surgeons could give us advice to minimize the risks though!

Kira - "Shame and Humiliation in the Medical Enconter" I'd love to read that!

Thanks for bumping this Kira.  I am hoping with all the info you and everyone else has shared that I can make the best decisions that allow me to avoid LE.  I will have much to talk about with my radiologist who aspirates me, my LE therapist and my PT.

I wasn't sure about aspirating (the PS's nurse seems to leave it up to me) but this is info is leaning me toward aspirating vs leaving it be.  It is distressing but the info helps me face it instead of avoid dealing with it.