Doctor says 'Lymphedema is not painful' - Is it?
I had 5 nodes removed in right axilla in 2008 during BMX; bad cording in right arm thereafter, quite painful, but problems subsided with PT over the course of 6 months. What remained was the feeling of having a softball or sometimes (after physical strain / high temperatures) a grapefruit underneath my arm: painful pressure that made all clothing feel too tight even if it isnt.
Then, 6 months ago, my right arm gets skin cancer in the most unusal spot: the inner elbow, which is one of the most protected areas. I have never been a sun worshipper and the whole thing made little sense. I had a tiny scratch on that spot a month earlier and dermatologist speculated that the trauma from the scratch in combination with the impaired lymphsystem may have triggered the cancer growth. Anybody ever hear of that?
Anyway, since the surgical removal of the skin cancer, my right arm has not been the same: right after the surgery I had again bad cording and mild swelling. It is as if the damaged lymphsystem in that arm is highly vulnerable to any insult. By now the cording has subsided and the swelling is only noticable when measuring differences between arms BUT I have bad pain in the inner elbow when I keep my arm bent for more than 3 minutes (as while typing this note). No muscles were damaged during the surgery; the Moh's surgery targeted only the skin cancer and the upper layers of the skin. No doctor knows what to do with the pain that I have now. I am being told that lymphedema does not cause pain; just swelling. That is not true, right?
Has anyone had a similar experience? Or does anyone have any advice for me? Dermatologist sent me to vascular surgeon who had no interest in the situation and tells me I should see an orthopod or a rheumatologist or a shrink. I don't feel in the least that this is an orthopedic issue or other but that the pain originated after the cording and has since not subsided. Help please.
I am in Southern California - in case anyone knows a physician who actually understands lymphedema.
Comments
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Im sorry for your troubles and skin cancer. Im not sure how to answer but others may be able to help some. However this much I do know....
I am being told that lymphedema does not cause pain; just swelling. That is not true, right?
Right. And doctors can be woefully ignorant about LE, nevermind being open to be "educated by his/her patent.Even though with your other factors, LE most certainly can and does cause pain. These are typically described as "fullness" burning, aching, all to varying degrees. The fullness would probabaly be the least painful.
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Allenroc, A couple of years ago, Binney and I were interviewed for the Washington Post, by a physician, and she mentioned that LE is painful.
Well, there was a letter to the editor by Nicole Stout, who is a PT researcher of LE, stating it's not.
And, we wrote a letter to the editor, that is IS!! And the NLN had to publish an apology and a retraction, and confirm that LE IS PAINFUL: one the important symptoms to follow is aching and pain.
When tissues are swollen or inflammed, they hurt. LE is painful.
I went to the NLN conference a few years ago, and one of the best lectures I heard, a two hour lecture, was from Andrea Cheville MD from Mayo in MN on how to manage the pain of LE....
All too often you'll read that LE is painless swelling. Not true.
Lymphology is a self-described and created field, and Lymphadema People has tried to keep a list of physicians who treat/understand LE
It's outdated, but they list an MD in Santa Monica
http://www.lymphedemapeople.com/phpBB3/viewtopic.php?f=25&t=5&sid=4dfddc3eb5f1695fcb8acde512a5dde5
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All I can add to this discussion is that my lymphedema HURTS and it rarely, rarely swells! I want these people who say it does not hurt to live in my sleeve (my version of 'walk in my shoes') for just one day. Yeesh.
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I have very mild LE but on not so good days, aching, tightness and fullness are clearly there.
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allenroc,
I can only give you my own personal experience, but pain was the very first inkling of a problem for me. It wasn't aching or heavy. The sensation was similar in quality to a pulled muscle, except that it was very superficial. It felt like something that should get better with stretching, but it didn't, and it didn't get better with time. Maybe a few weeks after it started I could actually see puffiness as the veins in my forearm started disappearing (I was very skinny at the time). Treating the lymphadema got rid of the pain. The few times I have had flares since my diagnosis, the pain has recurred.
I wish you luck in your struggles.
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I'm sorry I can't answer your other questions, but I can absolutely confirm that LE is most definitely painful!!
I have constant aching in my arm and my thumb is so painful I generally can't use it (typing this with one hand!). I find that these are the worst areas, but are also the areas that stay swollen all the time. My leg and truncal area also get painful, but luckily this is only when I have a flare up in these areas.
To say LE isn't painful is to dismiss it as a condition that's not serious; and yes, compared to other issues we have its true that its not number one on the list. But it's certainly life changing.
Nicky -
Thank you so much for your responses ladies!
One of the most unpleasant parts of the cancer and LE journey has been that one needs to defend oneselve: "No, it really hurts!" Even if you can't see any visible wound or swelling. "No I am not malingering!" But I am struggling most days with the consequences of the damage to my lymphsystem although it may not be as bad as other people's LE or post cancer problems. I feel very discouraged about talking to 'health care providers' about my health; so tired of hearing suggestions that it's all psychological 'maybe because of what you've been through' that I find it a chore and waste of my time to talk to my health care 'non-providers' at all.
Do you have difficulty convincing your docs that you have pain and need help? And how do you deal with that effectively? How do you convince them of what they can't see?
Kira: it's been suggested that the odd pain I have in my right arm, especially when I put it in a bent position is a neuropathy. Have you heard of neuropathy as a consequence of LE? Or of similar pain with LE? To me it makes sense in terms of LE, if I bend the arm, circulation is somewhat obstructed and the arm starts hurting and it gets better when I straigthen and move the arm lightly. Does anyone else have such symptoms?
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Allenroc, a pain when you bend the arm is usually an ulnar neuropathy--it's the "funny bone" area and it goes down to the pinkie and ring finger, and if you have swelling it would tend to compress the nerve more. Makes perfect sense that any swelling will physically compress a nerve that is already damaged from chemo.
I get those symptoms if I talk on the phone with my elbow bent.
Add neuropathy to the mix and all bets are off.
My daughter coined a phrase when she had migraine that presented as vertigo and was told she needed a psych consult (at 16): "Denying my reality" and we've used it a lot on this site.
Recently, the same daughter had a question about her optic nerve, and we're at the same hospital: Mass Eye and Ear where their head of otology confirmed the MAV (migraine associated vertigo) and the f##$king neuro-opthalmologist fellow starts to give us grief about how migraine can't present as vertigo, and I said "The head of your otology department at THIS institution diagnosed her: Look it up!!" She was busy trying not to puke as they dilated her eyes, and it turned out to be a false alarm. There was documentation, and yet, once again, some uninformed moron wanted to deny her reality.
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The pain near my elbow was one of the first signs that I had lymphedema. The fluid tended to pool in that area, especially when driving... and yes it was painful. Kinesio tape helped a lot. The taping along with swimming and manual lymph drainage, has kept me relatively pain free.
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I have been suffering with arm pain for the past 6 months. I went to my breast surgeon who gave me a whole 5 minutes of her time to tell me I did NOT have lymphedema. She didn't feel my arm, she didn't do any measurements, she did nothing. She told me I probably had fibromyalgia. So after being extremely upset to the point of having a nervous breakdown, my husband insisted I see my family doc. My family doc sent me to PT and they told me I DID have lymphedema and I've now been in PT for a month. My arm has fibrous tissue all through it and does not swell very much but it is a constant pain. I have no use of the arm right now and waiting for disability paperwork to be complete because I can no longer work. It's sad when my own breast surgeon won't take an extra minute to listen to me and I have to be diagnosed by my family doc.
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From my experience Lymphedema is painful and can just feel wierd. It can feel completely different from aything else that I have ever felt. When I told my husband after one of my cancer surgeries that I thought I had lymphedema he discounted it. Mind you he is an infectious disease doctor and will see the worst case scenario. Was he right of coure not!! I called my breast surgeon and got a consult for Physical Therapy. My case isn't bad. It is pretty much not noticible but I feel it and can see my finger and hand swell a little. I can see a difference between minoe swelling in my upper arm on the lymphedema arm and the good one. Aqua areobics helps, as does Tai chi and Yoga. I also do specific exercises every day and also MLD. About once a month I go for a lymphatic drainage massage that I pay for out of pocket for. Listen to yourself you know best. Doctors are just people. Best of Luck!
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