Pre-Surgery LE Therapy and Compression Garments?

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chrissera
chrissera Member Posts: 79
edited June 2014 in Lymphedema
Pre-Surgery LE Therapy and Compression Garments?

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  • chrissera
    chrissera Member Posts: 79
    edited September 2012

    Hello All.  I will be having lumpectomy with SNB and ALND on October 5.  I will also have radiation.  I already went through 18 weeks of neoadjuvant chemo.  My BS recommended pre-surgery session with lymphedema therapist.  Went today and am very concerned and confused.  He showed me some of the exercises and the therapy that he will do when I visit him two weeks after the surgery.

     He metioned  something about being fitted for a compression sleeve/garment.  when will I need that?  right away after surgery or only if I get signs of LE? I understand the risk factors, and the precautionary measures that I will need to take forever on that side, but the compresson garment confused me, and I can't find anything about that?

    Any suggestions are welcome! 

    HUGS out to all :)

  • chrissera
    chrissera Member Posts: 79
    edited September 2012

    Hello All. I will be having lumpectomy with SNB and ANLD on October 5.  I will then have radiation .  I have already finished 18 weeks of neoadjuvant chemo.  My BS recommended pre-surgery session with the lymphedema therapist, who I met today.  I am very concerned about my risk of LE and confused.  He showed me some of the exercises (MLD) that he will want me to do, and explained some of the therapy he will do when I see him beginning two weeks after surgery.  I am glad that I went to get the information beforehand, as I understand there are many who are not made aware of this possibility.

    Can anyone help me understand the compression sleeve and garment?  he mentioned that I will need to be measured for that after surgery.  Is that something that I will need to use even if no sign of LE or only if I do develop LE?  He did initial measurements of both arms, etc. and it appears that my left arm is already a slight bit larger than my right. (BC is on left side). 

    Any suggestions for this?  I have info on the precautions I need to take FOREVER on that side after surgery, and information about looking for signs of LE and taking care of the arm, etc.  

     Thanks and HUGS to all! 

  • kira66715
    kira66715 Member Posts: 4,681
    edited September 2012

    Chrissera, it appears that he is concerned you might have early stage LE, and then compression can be helpful if you are swelling or have symptoms or are vigourously exercising or flying. The role for compression in high risk women without LE is more debatable. There does appear to be some benefit from wearing compression if you have "latency" LE and you are in a high risk situation--like flying or stenuous exercise. But that compression has to fit well. 

    If you already have some swelling--and do you have any symptoms? like aching or heaviness?--then you're either a stage zero or ? possibly stage one LE or at the very least someone at risk, who is going through a period of high risk--with surgery and rads.

    Piece of advice after your surgery: do NOT elevate your arm above shoulder height for 7-10 days. The lymphatics are delicate, and it's best to avoid stretching them in the immediate post op period.

    If you got care in RI: was it at WIH? There are two male therapists there, one is an LMT and one a PT, and the LMT is sometimes hard to understand--you can pm me.

    Here is a link to well fitting garments:

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

    The diagnosis of LE is clinical--you look and measure for swelling, and what is significant is not yet perfectly defined, and you check for changes in the skin consistency and any symptoms--heaviness, discomfort, aching, warmth, skin changes.

    It's great that you're being proactive--it sure is a steep learning curve.

    Kira

  • Connie07
    Connie07 Member Posts: 636
    edited September 2012

    Chrissera,

    First, welcome! Many before me have said, Welcome to the club nobody wants to join.



    Sounds to me as if you are in a FANTASTIC facility with a genuine caring Doctor. Congratulations! You will be a leader in here. Maybe bigger than that!!! The patient of a brand new generation of breast care specialists who care about the continuing quality of life for BC patients. At least you are the first one l have found in my search for answers.



    You are quite correct that MANY (most of us) were not informed, worse, now our dr.s deny that their treatments are the cause and blow us off, bye-bye, Next. I have been

    on a rampage after learning I have truncal LE. Meaning theres swelling in that breast, chest, back, arm, etc. I'm realizing that its been going on entirely too long, well over a year with no
    answers, no treatment, as if I were imagining that it was really swollen. Thats so demeaning being told its no biggie. Nothing til now, 5 years too late.

    Once developed, it is irreversable, no cure. Oh, and... It hurts.



    Please add this thread to your favorites, and tell us what happens with you. I hope and pray that your experience is far more favorable and less stressful than mine has been.

    Not trying to frighten you, this whole trip is scary enough. I WANTED to be informed and feel like they treated me like a child. ALL of them.



    And we went to high school together, me & my BS. I keep wondering if I pissed her off in 12th grade English? Should say my former BS. Im not going back to her or that radiation Onc. Never. Ever.



    So, lm still a newbie to LE and just went for a measurement session and learned that even lumpectomy/radiation patients are at risk just by the difference in volume.

    The sleeve and bra or cami that creates compression keeps the at risk tissues from getting backed up with the lymph fluid that is the main means of disposal of the debris we create inside
    by virtue of living. You wouldnt want your -for instance- your treated breast to swell up with lymph fluid, that sounds just gross, but thats what can happen.

    Since they are treating your cancer with multiple therapies (surgery, chemo, radiation,) then there will be damage to the vessels that carry lymph fluid. They ride just below the skin. And because so many of those are located in the upper chest, neck and armpit . . cutting some out and treating a breast is practically inviting a traffic jam in the lymph vessels.



    Its not hard to learn & do some preventative self-massage, add a couple of new exercises
    to your routine or wear a garment that can prevent the potential LE assault on an already medically treated breast.



    Wow. Just knowing you will get the information before surgery amazes me. Just go with it. That LE therapist knows a LOT more than you might think. Do all the exercises religiously, prevent, prevent, prevent.

  • chrissera
    chrissera Member Posts: 79
    edited September 2012

    Thanks for all of the information!  It is my way to gather as much data as possible and then process it all, so any advice is appreciated! 

    and after browsing some of the posts here I am extremely glad that my BS is proactive with suggesting I meet with the therapist prior to the surgery!  

    I will keep you updated on my status.  For now, I am just freaking out about the surgery and am really scared of it.  It scares me more than Chemo did, and I am not sure why... they say chemo is the hard part and I made it through that! 

  • Connie07
    Connie07 Member Posts: 636
    edited September 2012

    Hi, surgery is always scary. That fear is so valid. Are you scared of the anesthesia? Or of the recovery? Possibly the results? I have had several surgical events and each was very different.

    Having a surgeon cut on your breast is very scary. Talk to your BS. Ask questions. Be as prepared as possible. Knowledge is power and you are in the right place, Here, to learn some of the real potential outcomes. For my lumpectomy they took me to imaging and a long wire was placed to help guide the surgeon, that was weird but it made sense.



    Of course, dr.s say everyone is different, but the procedures aren't. Ask how you can contact them after, say, on a sunday when their office is closed. If i had a do-over, l would have asked for her private number. She should have given it to me.

    Plan to have someone with you for the first few days after, that seems to be the most uncomfortable time -in general.

    Stock some comfort foods... Soup, freezer meals, easy to fix healthy choices.



    Plan to pamper yourself, you deserve it.

    Take a pillow in the car for the ride home. Every little bump in the road caused a little bounce, a pillow clutched to your chest will at least solve most bumps.



    I have read where people will write on the "good side" something like DONT CUT HERE. or WRONG SIDE. It gives the team a chuckle and prevents accidents.

    Do something special just for you. Extra pillows for your bed, favorite sheets. Whatever makes you feel safe and comfortable. If you have a pet, they will be concerned too, so get some dry treats for them too.



    I'll be watching for you to post. Best wishes for a safe, caring experience.

    Connie

  • chrissera
    chrissera Member Posts: 79
    edited October 2012

    Connie, thank you for the kind words. Surgery scares me in general, but also because it makes this whole thing all the more real. Because I had chemo first, that was like taking medicine to make it all better, but surgery leaves permanent scars and reminders.. sounds stuipd I know...



    I took your advice and bought a new comforter set I have bee n looking at for a year... my bed looks so cozy I won't want to get up tomorrow for surgery

    thanks again... HUGS ALL AROUND!!

  • carol57
    carol57 Member Posts: 3,567
    edited October 2012

    Chrissera, best wishes for an uneventful surgery today and a speedy return to feeling strong. My experience with surgery is that the worry and anticipation are worse than the actual event. You will do fine, and you have a huge been-there cheering squad here, sending lots of good thoughts your way. Be sure to report back in when you are able!



    Carol

  • Connie07
    Connie07 Member Posts: 636
    edited October 2012

    Hey Chrissera,

    Hope you are hangjng in there and that things went fine.

    Connie

  • chrissera
    chrissera Member Posts: 79
    edited October 2012

    Hi Connie. sorry didn't post. things went ok. feeling sore. Only had SNB no axillary. Get path results Monday. Surgeon told my hubby things looked good. I am really nervous and think I made the wrong decision to go with lx rather than mx. my husband doesn't understand why I feel that way... Not sure what to do.next. Thanks for your support!

  • carol57
    carol57 Member Posts: 3,567
    edited October 2012

    Chrissera, it's good to hear from you!  Feeling sore and second guessing a decision are certainly natural after surgery that comes with the busload of questions that any BC surgery can raise.  Hang in there, focus on physical healing, give yourself time to sort out how you feel about all of this.  Hurrah that things look good, and we'll hold a good thought that they stay that way!

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