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NickyJ
NickyJ Member Posts: 722
edited June 2014 in Lymphedema

Ok - I really need some advice here. I was dx in July 2012. No surgery, no nodes affected. Had weekly taxol and herceptin until last month, now in tamoxifen and herceptin every 3 weeks. My problem is I developed LE in early November, the arm and trunk of the effected (left) side. My onco says its unusual (!) and can't offer any explanation It's really getting me down, particularly as the weather is getting warmer which isn't helping. I'd just like to hear from anyone else in the same situation? All I read is based on women who've been operated on and with affected nodes. It's a bit lonely here! Thanks for any information you can give me

Nicky

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  • hugz4u
    hugz4u Member Posts: 2,781
    edited April 2013

    Rats... I somehow lost my reply to you. It may show up somewhere else on the threads, not sure.

    I will start over. You can get LE from radiation so this is my guess is what happened. It is not uncommon. Your doctors are uninformed as many other mecical staff are to.Frown 

    Don't despair we are here to help you lift your spirits and have a better life with this condition.WinkYou won't have the "only lonely one" feelings here, if you stick with us.Smile

    Google:  stepup-speakout.org  where some girls here created a great site to educate people on lymphedema (LE) You will learn just about everything there and then ask us questions on the threads here too. You are very welcome here.Laughing

    Once you become a educated in LE yourself you will no doubt be telling us what they do in Europe for LE as I think the LE treatment was developed over there first. You have some excellent clinics over there.Cool

    You need care of your Lymphedema as soon as possible by going to a Lymphedema specialist to have your lymph system drained in your whole effected quadrant. That would be breast, chest, trunk, arm and hand. I am not sure what they call that kind of a therapist in France. They must be certified and not just a person that took a weekend course on lymphatic drainage. Some clinics have staff that is not well trained so ask for creditials. Ask if they will be measuring your arm. That way you can see if it is progressing or regressing with treatment. If caught early you can reverse it or make it so much better.Smile

    Still if you are having symptoms your LE specialist may recommend sleeves and a glove or gauntlet. You should wear a glove or gauntlet so you don't push Lymph into your hand. A good therapist will guide you and judge your situation. Depending how swollen your arm is will determine if your LE therapist will wrap your arm in special bandages and hand for about three weeks daily to get the swellling down. If you feel you distrustUndecided your therapist let us know what she is doing and saying and we will qualify what she is doing.

    Hopefully our experts will come on soon here and maybe let you know who does this in France. It's the weekend so the threads slow down a bit.

    You should get rid of the bra and see if your trunk feels better.It probably feels better in the morn than at night when the fluid has collected for the day.  Usually a bra cuts off your lymph circulation and causes swelling. Order a UNDERAMOUR compression mens tee shirt in a size smaller than you are and wear it under your clothes with no bra. I think they ship worldwide. Google: Underarmour . It will hold you in and my pain goes when I do this. You can wear a tight shaper in the day or sleeping also instead but if you have a full feeling in the back of your arm then a mens compression tee will take care of thatSmile.

    We are here for you. Ask anything. You haven't given us much info on weather you have had treatment for LE or not so I have given you a mini lesson on general LE eduation.  Let us know more about your condition, feelings, soreness, swelling etc so we know what stage you are at. Well help you keep on top of it.Wink

    With the warm weather, drink tons of water for your lymph system to flush and do not get a sunburn or overheated.  Elevate you arm above your head and fist pump 25 times... maybe 3 times a day. Don't lift heavy stuff that you are not use to lifting. Rest your arm on the back of a couch when it gets tired or when sleeping elevate it with a pillow. take deep belly breaths throughout the day. Search for my thread called tai chi breather exercises, Only takes a total of 5 mins a day.

    For now and the future, If you have any redness, flulike symptoms on your effected side and the redness is spreading fast then go to the hospital and mention that you may have cellulitis. It is dangerous but ok if you catch it right away. Not to scare you but just to educate you. That website I gave you will give you more info.

    You are in good hands here.Wink Of course I always reserve a hugz4u and a kiss of compassion to our new folks here.Kiss Your education is the first step to recovery.Smile

  • Marple
    Marple Member Posts: 19,143
    edited April 2013

    Lymphedema can be and is a lonely place sometimes but there are many of us affected despite our Drs. denial of our reality. And Hugz is right, many doctors haven't a clue about lymphedema.  (Haven't a clue are my words, not Hugz.) Here is a great place to start looking at information.  http://www.stepup-speakout.org/ 

  • hugz4u
    hugz4u Member Posts: 2,781
    edited April 2013

    Thanks for posting the link Marple. You saved me again!

  • carol57
    carol57 Member Posts: 3,567
    edited April 2013

    Nicky, Dr. Vignes at the Cognacq-Jay hospital in Paris is well known as director of the lymphedema clinic there. He also has led some interesting research. It is my understanding that his is the leading LE clinic in France, so perhaps a little trip to Paris might open some doors of understanding. Chemotherapy has been associated with LE, but to my knowledge it is not considered a high risk in and of itself, but suspected to exacerbate other risks such as surgery and positive nodes and high body mass index at the time of surgery.  So it may not be so surprising that the oncologist does not understand your LE.  Regardless of the cause, it's important to get treatment, and Hugz and Marple gave you a path to some wonderful resources. 

    Carol

  • NickyJ
    NickyJ Member Posts: 722
    edited April 2013

    Hugz, Marple, Carol,



    Wow, I'm overwhelmed by the support!!! Thank you all so much. Even without readings your replies I felt better - a lot less alone!

    Just to give a bit more information

    Hugz, I read that radiation therapy can bring on LE. Unfortunately I can't use that as an excuse. I developed LE early November but didn't have radiation until January.

    I have had treatment. Firstly, I take water tablets every day. I also see a physiotherapist who has been trained (properly!) in lymphatic drainage. However, other than on this site I've never heard of or seen wrapped arms, gauntlets or sleeves. I can see exactly how they could help but I need to ask about them here.

    With regard to how I'm affected, I have noticeable swelling in my thumb and first finger and the palm of my hand, the wrist tends to be less swollen but the top of my arm is constantly 35% larger than my right arm. My arm always feels heavy and is quite often painful.

    My torso is always slightly swollen, but up until now not painful

    My leg is always swollen and lately my foot as well. It can be difficult to walk sometimes. I also notice that now the weather is getting warmer its going to have an impact also...

    I am definitely going to google the information you have given me and I look forward to any other information you have to share!

    Thanks again for taking the time to reply. It helps a lot

    Nicky

  • carol57
    carol57 Member Posts: 3,567
    edited April 2013

    Nicky, I worry a bit when I read that you are taking 'water tablets.'  Diuretic drugs are not used for lymphedema treatment, because they remove water content from the lymph, but leave thick protein behind. The lymph thickens and becomes even more difficult to travel through the lymphatic vessels.  

    If you look at the Cognacq-Jay website, you will read about complete decongestive therapy, which includes not only lymphatic drainage, but also wrapping and compression garments. Take a look here: http://www.hopital.cognacq-jay.fr/presentation/la-mission-medicale/l-approche-medicale-03.php . The description of the stages of treatment is exactly what we would find from a well qualified lymphedema therapy center here in the US.

    So, LE treatment in France is available that includes a comprehensive approach.  It sounds from your recent post that you have swelling in many places, so it is important that you receive an evaluation from experts who are familiar with primary lymphedema, which is not caused by injury or trauma, but rather is from being born with missing elements of the lymphatic system, and/or a genetic problem that causes LE to appear at some point in life--and it can be quite young, or quite old, or in between that the condition shows as swelling.

    Wow, you have a lot going on!  Wishing you the very best as you take steps to get some more comprehensive treatment.

    Carol

  • Binney4
    Binney4 Member Posts: 8,609
    edited April 2013

    Nicky, hello!

    I too was surprised to see the diuretic use and I wondered, if your therapist has not used bandaging or compression garments, what his/her treatment consists of? Therapists are rare in many areas, and sometimes they're so overwhelmed with a heavy patient load that they can't do all the treatment that's needed. I hope you'll be able to find someone thorough and really helpful!Smile I know Bordeaux is a long way from Paris, but perhaps if you called the clinic there they'd be able to steer you to resources closer to home for you.

    One possible cause of LE that hasn't been mentioned here is that lymph blockage can be caused by mets. It's not uncommon, and several women who post on the Stage IV board have dealt with it. In some cases the swelling can't be readily reduced, but even then some support from wrapping or compression garments helps to ease any pain or discomfort. Many women use foam-filled night garments for that purpose because the softer form of compression is even more comfortable, in spite of being bulky. Leg swelling and discomfort may also be made worse when you've been treated with Taxol, which can cause both swelling and painful neuropathy. It's important for a LE therapist to take the time to assess the causes so she/he can treat it in the most appropriate way.

    So glad you've found us here, and hope you'll find the companionship of our "swell" sorority a boost!Cool Do let us know what you discover!
    Gentle hugs,
    Binney

  • Marple
    Marple Member Posts: 19,143
    edited April 2013

    I also noticed the 'water pill' comment and wondered if they were prescribed for another reason, namely high blood pressure which is the case for me.  Diuretics are not recommended for lymphedema but they are for high blood pressure.  I'll assume high BP trumps LE.  And lately I've been able to cut my diuretic in half and BP is still ok.  Nicky, it's daunting to have LE but you've come to the right spot for information. 

  • carol57
    carol57 Member Posts: 3,567
    edited April 2013

    Oh, and Marple, it's daunting to have LE with any other condition, including having to manage high BP.  What a balancing act. 

    Binney, you are of course correct that the Cognacq-Jay hospital networks with other LE clinics in France, so hopefully Nicky will find some resources easily enough.

  • NickyJ
    NickyJ Member Posts: 722
    edited April 2013

    Ok! The diuretics were the first thing perscribed to me when the LE became noticible. At first it was for 2 weeks. Then I was told to stop them for a few days to see what happened. I immediately swelled up even more so was put back in them and have been perscribed them ever since. I don't have high blood pressure so they're not for that. I'm also have a low BMI so any swelling is very noticeable. I saw my onco just last week and he told me to keep taking them, so I'll definitely be looking into that! The physio I have is lymphatic massage. It does help to a certain extent, it gets things moving to the point that after a good session I have often vomited! I notice afterwards that the heavy sensation is lessened and sometimes the swelling slightly too. She's limited in how much she can do however because with bone mets there are areas of my back neck and shoulder she can't touch 😞

    Your responses are really helping. I'm definitely going to get more pro active about my LE treatment. Up until now I've quite frankly had enough on my plate dealing with all the rest that goes with my dx that I've just gone along with what the onco has said. Time to get it sorted out!

    Nicky

  • purple32
    purple32 Member Posts: 3,188
    edited April 2013

     I was dx in July 2012. No surgery, no nodes affected. Had weekly taxol and herceptin until last month, now in tamoxifen and herceptin every


    Nicky

    You might want to try to p.m ( private message )  Victoria38.  Actually, if I recall, I believe hers has been attributed to chemo.

    I know that she did not have surgery, and has LE.  Your situations are sure to be different, as we all are, but perhaps the two of you could chat. It might be of some comfort to both of you- I'm not sure.

    I can't offer anything beyond what these wonderful ladies have except to wish you well.

    Take Care!

    *EDITED TO ADD:
    I recently spoke with a woman locally whose tx consists of Ace bandaging and water pills (NOT good/ neither)  NOTHING I could say could make her believe me.Frown  We do need to be 'careful' of some of the medical personell and educate ourselves.  It's the last insult LE slaps on us , unfortunately. (you came to the right place)

  • carol57
    carol57 Member Posts: 3,567
    edited April 2013

    Ace bandages + water pills for LE?  That is simply mortifying.  You'd think medicine was still in the dark ages. 

  • NickyJ
    NickyJ Member Posts: 722
    edited April 2013

    Thanks purple32. Going to send that pm now

    Nicky

  • NickyJ
    NickyJ Member Posts: 722
    edited April 2013

    Wow. I just want to say thank you to all who've posted here. I've just spent most of today following up on the information and links that were shared. So much I needed to know!

    When I got my dx, I made a conscious decision not to start googling or researching of any sort. To get through to treatment, I decided to concentrate on listening to my onco and taking things day by day. Despite numerous se's and incidents along the way, this way of thinking got me to NED in late February. Since then, I've started to be more pro active and to ask more questions about my treatment. My lymphodema has never been treated very seriously by either my onco or my GP; as a result I stupidly didn't consider it to be serious. Little did I know. I started this thread because I wanted to try and get some more information to help me understand what LE is. I am shocked to find out how mis-informed I've been. Everyone needs to be educated about LE. I'm very grateful to the ladies here for pointing me in the right direction. I'll be back regularly to pick your brains!

    Nicky

  • Denise-G
    Denise-G Member Posts: 1,777
    edited April 2013

    NickiJ - there are so many women here on these boards who know so much about LE.

    My Lymphedema Specialist is amazing.  She said she has seen many women who have gotten LE frombreast surgery alone - no nodes involved, not even a node biopsy.  She has seen them get it from chemo.  She has seen them get it from Radiation.  She has been doing this for over 20 years way before it became popular.   She has treated ALOT of patients and is so well informed. 

    I have a BC Blog.  I hear from women all over the world.  So many of them get totally wrong information about Lymphedema.  Their medical professionals do not have a clue.  It is very sad.  Many times they totally go untreated.  

  • purple32
    purple32 Member Posts: 3,188
    edited April 2013

     I'm very grateful to the ladies here for pointing me in the right direction. I'll be back regularly to pick your brains!

    Most of us are/were in the same exact boat!

    Carol

    It was SOOOOO discouraging to speak to this local lady.  (She had primary  LE btw ) I had another gal nearby <also with primary> all lined up  to invite her to  a workshop on proper LE care, a support group and a referral to nearby decent tx.  She believes her Drs ' know best". ( IMHO , they have essentially disabled her over the years- or at least ' helped to "  )  UGH

  • NickyJ
    NickyJ Member Posts: 722
    edited April 2013

    I'm back for an update. I don't see my onco for another 2 weeks, so I decided to make an appointment to see my GP in the meantime. I armed myself with the facts gleaned from all you wonderful ladies, along with the information from the web links. All nicely translated into French for convenience! ( at this point I should say I do actually like my GP and I find her easy to talk to and receptive to new ideas)

    The outcome was, she agreed that my lymphodema needs to be taken more seriously, she sent an email to my onco stating this. She then gave me information on a 3 week programme in a thermal spa lymphodema treatment centre in the Pyrenees that she can sign me up for - all paid for on my health insurance!

    No one ever mentioned this before! It just shows what happens when you arm yourself with a bit of information. Thanks ladies!

    Nicky

  • Binney4
    Binney4 Member Posts: 8,609
    edited April 2013

    Wait, wait! I want to go to a spa in the Pyrenees too!SurprisedCool

    Somehow, I don't think my insurance is going to cover that.Laughing So please do keep us posted. If you go we'll all want to hear all about it too!

    So glad you're getting some attention on this. Chocolate all around!
    Binney

  • NickyJ
    NickyJ Member Posts: 722
    edited April 2013

    I know, it's amazing! But it's all down to this thread. I hadn't a clue what questions to ask or how serious LE actually is.

    Will definitely fill you all in on what happens. Won't be going for a few weeks yet cos I need to organize the rest of my treatments, ie herceptin, xgeva etc.

    for anyone who want to check out the spa, the web address is

    thermes@luz.org. Can't wait!

  • Marple
    Marple Member Posts: 19,143
    edited April 2013

    Nicky~I'm so pleased for you.  You should be very proud of yourself for looking for and finding good information.  And bless your GP who is so receptive to what you found out.  Three cheers. 

    And you are right, the women here who have championed the LE cause deserve so much credit too.

  • hugz4u
    hugz4u Member Posts: 2,781
    edited April 2013

    Horray for Dr. Google and your sense of adventure to looking in to LEWink. Good thing you bumped into us.Cool

    I can't wait to hear from you of what treatment they do overseas. I know that Dr Vodder method was created in Europe and that is the method that is used on me.  Google the Wittlinger clinic. I bet I am spelling that wrong, they do Vodder method if you want to know some of the similar techniques that may be used on you. Make sure they are certified and have the required training.

    I am just so excited that you didn't give up making things worse in the end. Good for you for stickin with us.NOW YOU GO GIRL! Yeah!

  • Binney4
    Binney4 Member Posts: 8,609
    edited April 2013

    http://thermes.luz.org/web/FR_Luzea/156-lymphoedeme-traitement.php

    Nicky, your insurance PAYS for this? (And we can't even get ours to buy us a couple of lousy bandages!) Man, every woman with bc in France must be hoping she develops LE!!Laughing

    Be well!
    Binney

  • carol57
    carol57 Member Posts: 3,567
    edited April 2013

    That is kind of amazing. I do wonder about this: Cures bras et jambes produisant un drainage par jets d’eau thermale de toute la chaine ganglionnaire. My translation (which could be less than perfect): Arm and leg treatments that drain lymph using thermal water jets all along the lymphatic pathway. 

    Aren't we reluctant to hop into hot tubs?  Perhaps the water temperature at the spa is not so hot.  (Too bad I cannot go there myself to check the temperature...)

  • Marple
    Marple Member Posts: 19,143
    edited April 2013

    Hmmm, I didn't check the web site but I'd be kind of wondering about that too Carol.  Is this where Nicky is going?

  • Marple
    Marple Member Posts: 19,143
    edited April 2013

    I will try to wade through the French.  Even though I am Canadian I am far from bilingual.  Geez, I want this place to be wonderful!

  • Binney4
    Binney4 Member Posts: 8,609
    edited April 2013

    This all depends on the water temperature, and since the treatment includes all the standard protocols (MLD, wrapping, exercise) I assumed it must be a decent temperature, but worth checking. The idea of using moving water jets (if the temp is right) is wonderful.

    Aaaaaaah!
    Binney

  • NickyJ
    NickyJ Member Posts: 722
    edited April 2013

    Eau thermale can also mean just the water from the spring/source. It's not necessarily hot and usually has a high mineral content. Just hope it's not too cold either! 😉

  • hugz4u
    hugz4u Member Posts: 2,781
    edited April 2013

    OK just the mention of jets moving lymph makes me think....What about those high power hand dryers. When I slide my hand down into them the air pressure is so great that my skin on my hand blows in all different directions. Could it be pushing the Lymph fluid around and if you went in the correct direction could you push lymph fluid up out of your hand. Maybe there is an invention here? A controlled high powered air force that moves the skin in the right lymphatic direction mimicking a mld massage. My imagination is running wild here.

  • NickyJ
    NickyJ Member Posts: 722
    edited April 2013

    Hugz4u,

    You could be right! It opens up a whole new area of possibilities....I'm very excited about it. Can't wait to see my pt later today to ask her about it. I'll keep posting as I get more information

    Nicky

  • carol57
    carol57 Member Posts: 3,567
    edited April 2013

    Hugz, I have wondered that very same thing! We need an inventor!

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