SWOLLEN UNDER ARM

Polyana,

Is this OT an LE specialist?  If not, I'd try to find someone who is.  Hopefully, someone can come along here and tell you about wearing a sleeve while you are still getting rads.  Honestly, I would be a little concerned about a lot of air travel right now.  You're just finishing radiation and you already have some swelling.  Will there be people who can adequately treat you if you have any problems once you get to your destination?  Those are some things to consider.  I'm sorry I'm not helping here.

Bobbie

Polyana,

For some reason 2 cm has been adopted as the "gold standard" but there's no scientifc proof that it's a meaninful number--it was created by 2 PT's for one study and because it's easy, has become "significant"

Radiation is an "at risk" time: the quadrant is irritated and there's more blood flow, and the lymph nodes, even if not intentionally in the field, are getting some radiation.

In my opinion, any swelling is a sign that you have Stage 0 or Stage 1 lymphedma--and should be treated seriously.

I agree that you should follow up with a qualified LE therapist when you are done with radiation, and all too often the qualitiy, even of well trained therapists varies

http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm

The issue of whether to wear a sleeve and gauntlet on a long flight is controversial for "at risk" women, but you have some mild lymphedema, so it would seem to be a good idea. Always wear hand protection with a sleeve--you don't want to force fluid up into the hand. Some therapists will advise a very low compression garment: 15-20mm, not the standard 20-30mm sleeve--to my knowledge only Jobst makes that lighter compression. The hand compession should be 20-30mm

The swelling in the axilla is likely reactive to the radiation right now, and as the radiation ends, you'll need your therapist to evaluate it further.

Here are links to the NLN position papers on treatment and flying:

http://www.lymphnet.org/lymphedemaFAQs/positionPapers.htm

And the Andrea Cheville paper on why you need to protect your hand with a sleeve:

http://lymphedivas.com/lymphedema/gauntletandsleeve/

Hopefully the swelling will resolve or greatly improve as you heal from the acute radiation reaction, but remember that radiation causes long term tissue changes, even as the skin heals.

I'd err on the side of caution--get a sleeve and gauntlet for the trip, push your therapist to acknowledge that lymphedema is like pregnancy--you can't be a "a little bit" swollen--any swelling is meaningful. This is an article I really appreciate by AW Stanton, that says that LE is present without 2 cm of swelling

Http://britishjournaloflymphoedema.com/journal/0101_arm.pdf

And, finally, due to widespread lack of knowledge about LE, we put a page for providers on the site:

http://www.stepup-speakout.org/essential%20informat%20for%20healthcare%20providers.htm

I know, WAY TOO much information: but I hope it helps. Hang in there through the end of rads, and please don't let your well meaning providers deny your reality--you swelled, you have lymphedema, I don't care how mild it is, it deserves treatment.

Kira