Hi
So my BS said it is okay to get bp monitored because I just had the sentinel nodes (one on each side taken out) but I see from some of the postings here that that is not the case...even just sentinel nodes can cause problems when having bp monitored. My question is how do they take your bp with just sentinel nodes removed and also what about drawing blood for testing? Can that we done on either arm? Confused especially when you can't trust the BS?? Thanks.
Comments
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Barbie I had 10 nodes one one side and 4 sentinel on the other. During chemo my onc insisted I get BP on my arm since they nurses never did get a good reading on my leg. When they did it on my leg the machine made all kinds of noises because it was reading to high. I did not have high BP.
What I did demand is they use the manual BP and not the machine. The machine tends to constrict much higher than the manual. After chemo was over I then made them take it in my leg. I find that my ankle is the best place. Still runs high but still in normal range.
The issue with blood draws is, A. the have to constrict your arm and B. the actual stick could cause infection.
With 2 nodes your risk is greatly reduced but it's still there.
In my case since I do have LE in my 10 node are (much to my BSs surprise since I'm thin, etc.) I don't want to risk my other arm, which is my dominant arm. Right now I still have a port so I have them do blood draws from there. All IVs I've had done in my foot. I'm not sure what I'm going to do in the future because most places don't like to draw blood from the foot. There is a higher risk of infection from your foot than your arm.
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Barbie, the experts here, Binney and Kira will likely chime in but I would self-advocate and not have BP or blood draws in my sentinel side. I had a SNB and only one node and I developed LE within 3 months. There is a thread on here about those of us who developed LE with "only a SNB" and while it is certainly not the norm, it is a risk and you have to decide what risk you are willing to take. There are some things you can do to reduce risk - like not using the arm for BP or blood/injections and if it were me, I would not take the risk. Just my 2 cents.
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So what about treatment (chemo, etc cocktail) - don't they do that in your veins on your arms? If nodes are out in both sides, what do they do?
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My mother had bilateral breast cancer 12 years ago. Her doctor said that if after 1 year she did not have any problems then she can have the BP monitored and blood draws from the arm. She does and doesn't have any problems.
Sometimes what you read here on the boards are the unusual situations. Studies do sugesst that with SNB and 1 year of no problems it is safe. I have lymphedema in my right arm, but had all of my nodes removed there.
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Barbie, unfortunately the risk for LE is for life, yet most women will develop it in the first 5 years. The risk is relatively low with SNB, but as someone who got it with 3 nodes out, there are inherent risks that some of us have--genetic predisposition, heavy handed surgeons, axillary web, etc.
Some women will decide to take the risk--and a woman who posts here has LE on one side, and allows blood draws on her SNB side.
When women are bilateral, sometimes they decide to take the risk on their non-dominant side, and they are super cautious and don't allow multiple blood sticks, insist on manual blood pressures and just "baby" the arm.
Kira
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Barbie, in answer to your question about chemo, many women have a port placed. Even if you have a totally normal arm in which to infuse chemo and the chemo is infused properly, there's still a risk of sclerosing the veins. Ports provide a vascular access that is more reliable (although not perfect) and gets around that risk. So they are not used just for people with BMX, or even just for folks with breast cancer.
Lest you think I am working for Bard (they make the Power Port), let me add that ports also increase the risk of deep veinous thrombosis and abnormal heart rhythms. They can erode through the skin. They really hurt if something like a child's head bonks them. I'm probably missing something.
I had one. Very thankful to have had it, but got it out as soon as I could.
I want to add something unrelated:
While I agree that the posts in a forum like this are going to be biased in terms of being mostly from people who have had problems, I think there is another psychological factor to consider. Everybody wants their choices validated. They want to think they have chosen correctly. I think putting that in writing is a way of doing that. If I say, "I had 12 nodes removed and I've allowed blood draws in that arm and not had a problem," I am putting my experience out there for others to see, but posting it may also be giving me some validation to support my choice. I see this all the time. People want to refute statistics with their personal experience. Personal experience is personal experience. Unless the person is lying, it's 100% correct, but one person's experience doesn't change the group risk or prognosis.
An individual making choices and having a good or bad outcome doesn't change the observed risk for a group as a whole.
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Outfield, well written.
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Outfield: great post!
There is selection bias, as women who don't have LE, won't want to come and post here, and I tell my patients to consider some of the posts about adjuvant therapy in context again of who is having issues and are more likely to post.
But, as you astutely pointed out, our personal experience is "an n of one" and we can't extrapolate it to the general population, and we all do seek validation.
We're dealing with a condition that doesn't even have a diagnostic criteria--so it's really hard to study incidence/prevelance/risks etc.
I used to work for this brilliant, but maybe socially challenged researcher, and he would ask all the time--"why do people's personal experiences trump the evidence?" Because we experienced them, and they're vivid.
Thanks for posting something I've struggled to say for so long, and saying it so well.
Kira
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Does anyone know if it is OK to have boold labs done on the WRIST veins of the SN arm?
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