What are negative effects of taking BP on lymphedema arm?
Comments
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Kira, thanks for the information. It is scary, but I am not surprised, that they are trying to diminish and debunk possible lymphedema triggers. It is not considered a disability, though it has been the most disabling aspect of my having had cancer. I can understand WHY having BP on an arm would trigger lymphedema. But I sometims just get agitated that there are soo many restrictions on this arm. I was also very worried about flying, but had no issues. I did wear my sleeve. For me, the triggers seems to be just not wearing the sleeve, and lifting things (which I do all the time). I am now considering giving up gardening...tooo much lifting of buckets of weeds and rocks and more worries about dirt and cellulitis. Before I had my surgery, when I was a stage I cancer, I really didn't understand how disabling lyphedema could be. My surgeon told me it was something I did not want to have, that I was still young, that I had young children and that this could be a very disabling condition if I were to get it. It just didn't register. Now I get it.
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Kathleen, my surgeon told me not to worry, I had a 3% chance of LE--although in my notes, it was the first thing I asked her about--some sense that I had inherent risk.
It is very, very disabiling and stigmatizing, and yet we can work to make the disability less: I found that the first year or so was the worst, both in terms of control and adjustment.
There are women who post that it is just a chronic condition, and we should all adjust to it easily, yet Binney and I write each other back and forth all the time about the stigma and the fact that it's tied up in cancer diagnosis and the fact that it is embarrassing--yet having other issues--like carpal tunnel syndrome and splints--don't carry the same baggage.
Pat O'Connor, who has primary LE, wrote about emotional issues with LE:
http://www.stepup-speakout.org/patoconnorcopng.htm
I just HATE when LE causes us to substitute activities or give up things we love.
I see you're from Pittsburgh: I spent time a Magee when I was a graduate student, and I know that they have done studies there on LE--there is a doctor, Atilla Soran, who initially published about the laser--not impressive study. They also have the "Strength and Courage" DVD that Katie Schmitz likes--I like the stretches, I would just be careful with the weight lifting.
My DH grew up in Pittsburgh, and we were there for 5 years during grad school--living in Squirrel Hill.
So, I think we need to acknowledge the limitations, and I personally tend to overdo the restrictions--essentially out of fear--I am terrified of flairs and cellulitis, etc. It was so liberating to get back on a plane, and I think that if we gently and consistently push our boundaries, we'll feel better about dealing with this on a daily basis.
Kira
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Kira,'
Yes I did see Dr. Rockson ( very nice MD) and will continue to share information as I get more. One small item, re preventing blood draws and BP being done in limb that is at risk, I plan to get a medic alert band to wear which hopefully first responders would see. Also plan to order an armband (saw it in TLC cancer magazine) or make one when I go into hospital saying no blood draw since the techs and nurses ignored or did not see the little wrist band saying limb risk and proceeded to try and draw blood from limb at risk. They said did not see it cause it was the middle of the night. This happened 3 times post surgery. . I plan to take it up with quality assurance at the hospital. It is a matter of education and their ignorance about risks of lymphadema. I also plan to order a sleeve to wear on planes, they measured me at appt with Dr. Rockson. Although some people may have no problems flying and getting lymphadema, why take the risk?
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I would like to add a happy note to this discussion.
Yesterday I had my stage 2 revision surgery (feel pretty good today!), at Northwestern Memorial in Chicago. The very first nurse I saw during surgery prep asked me if I had any arm restrictions, before she even glanced at my surgical record. When I responded that my left arm should not be touched, after losing 5 nodes in my original surgery, she immediately ran a length of paper tape on that arm from wrist to shoulder, and wrote NO BP-- NO Needles--NO IVs in huge red letters on the tape.
I asked her what she would have done were I at bilateral risk, and without skipping a beat, she said she would mark the other arm and do the necessary BP/ IV using my leg/foot. I was fully prepared to push the issue if I needed to, but wow...the nurse was full on board with arm precautions.
From what I read on this forum, my experience may be unusual, and indeed when I had my bmx/recon at the same hospital last July, I did have to argue to leave that arm alone. Apparently I had one perfect experience in a most imperfect LE world.
Carol
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Carol, you sound good! Glad that surgery is now in your rear-view mirror, and really awed at the nurse who knows her stuff. Hope you got her name so you can let the hospital know about your experience. Never hurts to encourage the good-guys.
Rest up, heal quick,
Binney -
Hey Carol, glad to hear it went well. Binney, thanks for the tip. I had a great experience when I had my colonoscopy/endoscopy last month with no hassles on BP, wearing sleeve. In fact they were quite knowledgeable about LE. I am going to get a letter off today thanking them. Becky
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Binney, you are so right about reinforcing when they know their their stuff.
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I do know the terrific nurse's name and will definitely send an admiring letter to the hospital; what a great idea! I am feeling pretty good, glad it is behind me, and fully focused on a strong and speedy recovery. Need to be able to bake tons of holiday stollen!
Carol -
The OPs post sounds suspiciously like a nursing school assignment. He is making you guys do his homework for him.
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Jane, that's somewhat humorous, and if it's true, well....at least one more nurse knows to ask about and respond appropriately to LE.
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Breast cancer on both breasts however just small spot on right. Had 1st mammogram on July 1 and it was horrible sqeezed my right side much too tight. About a week later went to ER and told them something wasnt right. They looked and couldnt find a thing wrong so just throught I was nuts. About 1 1/2 later went back, breast was red and hurt and swollen. This time they had about a million doctors running in and out which upset me and while I was leaning over the trash can they did the blood pressure on my left which is my bad side. Well after a week stay in hospital and emergency surgery to remove the port (evidently infection can jump in that) I came home and got well however shortly after my left arm started swelling, hurt, breast felt like rocks were in them, my neck and shoulder hurt. Went to therapy and she was great, took off 11 inches of swelling, had them order a machine for my home and sleeve. While everything is ok now this just was a couple of months of horror. By the way they tried to draw blood in left arm too at same time and that dont work out either. I will never again go to a doctor or hospital without a sleeve on.
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Jennifer, how horrible!
I've seen some really nasty port infections, and also breast cellulitis, which it sounds like you may have had.
There is this movement to "debunk" risk reduction practices, and then you hear about something like what happened to you.
I'm so glad you got the help you needed and are doing better.
Good point about having a sleeve on as a strong visual reminder to leave it alone. The last time I went back to the rad onc, her nurse gave me such a hard time when I told her to leave my left arm alone! Come on--just take it on the right!
Recently heard from a surgeon who wrote the order to avoid the at risk arm, and walked in to find an IV in it......
The hospital that my office works with, has an electronic medical record, and at risk arm is on it, and virtually never filled out.
Kira
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The infection doctor called me in afterwards and told me that I would survive bc however infection kills and I believe her. Wasnt nearly informed as I should have been but am now.
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I work with kidney dialysis patients. They have a fistula in their arm for dialysis. They also cannot have bp's, needle sticks or anything that restricts blood flow to the affected arm. I teach them to just hold out the correct arm when they see a bp cuff heading their way. I second Kira's comment on the electronic medical record, Often a MD order can be entered into the record (often by the nurse). Depending on the electronic medical record, that order may appear on lab requisitions so the tech may know not to use a certain arm. It might be worth asking if an order can me entered into the computer. Just another possiblilty. I suppose I am more likely to ask a patient which arm to use.
When i had surgery I put kinseotape on my LE arm as an added barrier and wrote in surgical marker "no ivs or bps' -
Preventing lymphadema- good ideas! Thank you haltsaluteatex.. I plan to ask to put it in chart but I think the big tape around your upper arm is best since they may not look in the chart or forget.
By the way I learned the hard way about being very careful with insect bites . Last Thursday night, I got a tick bite near where the axillary node dissection was done, My upper arm swelled up hugely within 2 hours after the tick was removed. Got very red, hot, bullseye, looked like classic lyme disease. When I saw the internist day after the tick bit me, he asked me where my surgery was. Reaction was so bad he said I would have to get admitted to hospital if I got any worse. Happily the antibiotics are working and it has now been been 6 days and arm is slowly returning to normal. I am sure this is because of the axillary nodes being removed. We think of lymphadema being caused by blood draws, blood pressure, etc but injuries including insect bites can do it too.
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