Cellulitis or lymphedema?

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RosieRose
RosieRose Member Posts: 15
edited June 2014 in Lymphedema

I had a lumpectomy and SNB in July 2013, with 35 radiation sessions in the fall.  None of the doctors (BS, MO, RO) have seemed concerned about lymphedema since I "just" had six nodes removed, but I've attended a class on it anyway, am very careful about that arm, have seen a PT several times, and as far as I know, have not developed lymphedema.

At least, not until two days ago.  Monday evening I got a slight pain in the arm on the LX side, just below the elbow.  Within an hour, it was red and swollen, very painful, and hot to the touch.  I didn't know if it was shingles or a blood clot or bursitis or cellulitis or what, especially since there had been no injury.  It was so painful that sleeping was difficult.  I was supposed to see the BS anyway Tuesday morning, so just kept the appointment with her.  She didn't seem to be alarmed by the problem, but she identified it as cellulitis and prescribed Cipro for 10 days.  I'm terrified of the possibility of C.Diff with Cipro since that has happened in our family, but I know that cellulitis is nothing to mess with and am taking the Cipro, along with lots of probiotics and Greek yogurt.  I don't know if they will help, but surely they won't hurt.

After two doses of Cipro, the pain has subsided somewhat and it doesn't seem to have spread any further.  My question is--do I possibly have lymphedema after all?  If I don't, will this episode of cellulitis be likely to bring it on?  I've stopped the stretching exercises from the PT, and I am avoiding using that arm in oncology rehab for now.  How long should I wait before restarting all of that?

Thanks for your help.  I keep thinking that I should be "done" with this whole BC thing since the hospital has declared me to be NED, but it seems like there is always something new around the corner. 

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  • Marple
    Marple Member Posts: 19,143
    edited January 2014

    Rosie, I can't answer most of your questions but gosh, you sure seem to be on the right path in taking the antibiotic.  I just finished an antibiotic (for a tooth) that c-diff could be a SE.  I've finished them and am ok and hopefully/likely you will be too.  I don't know if you have LE (lymphedema) or if you don't, or if this may bring it on.  Yes, absolutely, stop all exercising (upper body).  Drink lots of water.  Elevate that arm when you can.  BTW, Drs. generally are not concerned about LE.  Often because they know so little about it.  Taking the probiotics and the yogurt won't hurt either.  I've been doing both too.  I think at this point, you are doing all you can.  Thankfully your BS prescribed what seems to be working.  Hugs and good luck.  I know it's scary.

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  • Kicks
    Kicks Member Posts: 4,131
    edited January 2014

    See a CERTIFIED Lymphedema Therapist!   Some PTs are also Certified LE Therapists (as are some OTs) but most aren't.;

    Cellulitis can developed so easy from the smallest 'thing' - a paper cut or pin prick you didn't even notice at the time. 

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  • carol57
    carol57 Member Posts: 3,567
    edited January 2014

    Rosie, here's an excellent, accurate resource about cellulitis: http://stepup-speakout.org/Emergencies_and_Medica...

    Cellulitis is indeed sometimes a trigger of lymphedema, so you'll want to be watching and feeling for early LE symptoms as your infection heals and beyond:  feeling of heaviness, general achiness, slight burning feeling, and of course any swelling in your limb, including your hand. Here's the stepup-speakout resource on diagnosing LE, which gives more information about symptoms: http://stepup-speakout.org/diagnosing_lymphedema.... With six nodes removed, your risk is small, but not trivial.

    As kicks said, a certified lymphedema therapist is the best resource for knowing what to do to minimize your risk of getting LE.  If you're lucky enough to have a lymphedema clinic that puts on educational classes, perhaps they would be available for a quick phone call to ask for advice on when it's safe to re-start your stretching and rehab work.

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  • vlnrph
    vlnrph Member Posts: 1,632
    edited January 2014

    Be sure to separate the Cipro from your probiotics/yogurt by sufficient time otherwise it may kill the "good" bacteria you are trying to establish! Should not be too difficult to work out a schedule if the quinolone is twice a day (every 12 hours)...

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  • RosieRose
    RosieRose Member Posts: 15
    edited January 2014

    Thanks to everyone for the good advice.  I'm three days through the Cipro and so far, the tummy issues haven't been too bad.  Juggling that med with all the others that don't play well together has been a challenge.  The step-up/speak-out resource has been great!

    The swelling in the arm has gone down a little and the redness is mostly gone, but the elbow and an area below it look bruised and it is still very sore, though not as much as before.  Now of course it is the weekend and the big dilemma of what to do if it starts to go south again.  I still don't know if it is just cellulitis or if lymphedema is involved too.  I've put a call in to the lymphedema specialist but haven't been able to get them to return my calls yet.  Aargh!

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