Procedure on at-risk arm

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jacksnana
jacksnana Member Posts: 168
edited June 2014 in Lymphedema

I have a sebaceous cyst on the back of my shoulder on the same side that I had eight lymph nodes removed during my BMX almost three years ago.  I'm pretty sure it is infected, it is big (at least an inch in diameter) and red and painful.  I have an appointment with the dermatologist tomorrow.  I've always been so careful to avoid any of the behaviors associated with LE risk but now this! 

Of course I'll let the doctor know, but I don't know what choice I have. There is no break in the skin, but I feel pretty sure it will have to be drained or lanced.  Will taking antibiotics help prevent LE?  Any adivce you have will be greatly appreciated.

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  • Binney4
    Binney4 Member Posts: 8,609
    edited August 2012

    Well, phooey, jacksnana!Yell And very ouchy too.Tongue out

    Yes, taking antibiotics will help prevent an infection of the skin called cellulitis, that can trigger LE, so if the cyst is infected the antibiotics you take for it will be doing double-duty.Smile

    Ways to help prevent LE in this situation also include staying really well hydrated (helps dilute the lymph and keep it flowing), doing some deep abdominal breathing several times throughout the day until healing is complete (stimulates the largest lymph vessel in our bodies), and elevating your arm after the procedure.

    Pain draws lymph fluid to the area, and that can overload a compromised lymph system, so insist on good pain control. If you use ice for that purpose, limit the time and avoid direct exposure (use a towel between your skin and the ice pack), because temperature extremes are also LE triggers.

    Do let us know what the dematologist has to say tomorrow. Good for you for being so pro-active--may you never join our Sisterhood of Swell!

    Gentle hugs,
    Binney

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  • jacksnana
    jacksnana Member Posts: 168
    edited August 2012

    Thanks,  Binney - I so appreciate your sweet words!  I knew all this water I drink is good for me, but  never knew it could help prevent LE!  Never thought I'd be so anxious to see a doctor, but I can't wait to get this behind me!  You're so knowledgeable - thanks for sharing some of that with me! 

    Veda 

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited August 2012

    Thanks Binney4 for your suggestions.  I am having hand surgery on my affected side where I had 17 nodes removed.  During the pre-physical for this surgery the nurse told me to remind the anesthesiologist of my condition...  Not looking forward to this procedure but living without pain sounds good.  When told of my cancer history, the doctor discussed my concerns about lymphedema, also saying many patients with similar histories undergo this surgery without complications. 

     Jacksnana - Last week I went in to see my family doctor for an infected bug bite on my good arm that had swelled up like a volcano.  He placed me on antibiotics which did nothing for me for 5 days, my infection got worse.  My whole arm was swollen.  I returned to the doctor where he lanced the infection and biopsied the core.  Turns out it was MRSA and placed me on levofloxacin.

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  • jacksnana
    jacksnana Member Posts: 168
    edited August 2012

    My visit to the dermatologist went just fine, he lanced and removed the (icky!) stuff from the cyst, it was a relief to have that done.  We talked about my LE concerns and he felt since this was on the back of my shoulder it shouldn't be a problem - he said he couldn't make any promises.  But so far so good... so appreciative for Binney's suggestions, I followed them to a tee.  I didn't know about drinking extra water and deep breathing and feel like that really helped.  How long after a procedure like this would you expect to see signs of LE if that was going to happen?

    Pasofino, that is so scary, how is your arm doing today?  Do they re-check you to make sure the the levofloxacin was effective against the MRSA? 

    Veda

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  • Binney4
    Binney4 Member Posts: 8,609
    edited August 2012

    Veda (what a beautiful name!), so glad that went so well! The initial concern in an area at risk for lymphedema after any procedure would be cellulitis (because latent LE is a hotbed of bacteria growth), so you want to watch for new redness or swelling, increased pain, fever, warmth to the touch of the skin around it, or flu-like symptoms. Use a mirror to help you keep track, and report any of those symptoms right away.

    LE can happen at any time post-breast cancer surgery, but in response to this procedure it would be likely to happen within a week or two. Keep up with the water and deep breathing, and elevate your arm as much as possible. Arm LE might not be much of an issue with this being on the back of your shoulder, but truncal LE could be. It's harder to see and often doctors aren't even aware of it as a possibility so they're not looking for it. Indications of truncal LE would be feelings of heaviness, achiness, fullness, and any indentations on that side of your trunk when you remove your bra. Here's information about it:
    http://www.stepup-speakout.org/breast_chest_trunckal_lymphedema.htm

    Awareness is good, worry not necessary! Heal quick!
    Binney

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  • Binney4
    Binney4 Member Posts: 8,609
    edited August 2012

    Pasofino, keep us posted--we'll be rooting for you! And do tell us how we can help!

    Gentle hugs,
    Binney

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  • jacksnana
    jacksnana Member Posts: 168
    edited August 2012

    Thanks so much, Binney!  Everything seems to be doing fine, it's pretty tender back there but he told me it would be and would continue to drain for a few days.  I have a great nurse (DH) so we're just keeping it clean and covered, not much else to do.  I am keeping up with your suggestions for water, breathing and elevation!  Honestly, you know so much more than the dermatologist did.  He told me to contact my breast surgeon if I have any LE symptoms.  It's okay that he didn't know much about LE, just so he knows a lot about what he does!!  It seems that medicine is so specialized these days and a lot of docs only know about what they do.  My PCP is ok, but I find myself just going to so many different specialists, which is ok.  I guess it eliminates the need to go to PCP and then just end up with a referral anyway.

    So thanks again, Binney.  Your experience and insight is so appreciated!      Veda 

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