Lymphedema Newbie!
Hello, not a BCO newbie but one to this thread. I had neoadj chemo, lumpectomy, rads completed a year ago. Had residual breast swelling after rads that only slightly resolved. Recently my breast is swollen, underarm, upper chest, and shoulder stiff. PT evaluation said fibrosis and need for 6 weeks massage and rom treatments. Tell me what i need to know!
Comments
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I am a relative newbie too, so I don't know a lot, but OT has helped me tremendously (in my third full week now), and the massage has made a big difference. I will say that wrapping is awful at first, but stay with it--now I love it. It feels so good, but the first few days I couldn't stand it, and I threw several tantrums (and all my wrapping LOL).
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Hi Paula, did you have pain after treatments?
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The OT treatments themselves haven't been painful at all; they actually feel really good to me. My OT uses a machine that produces light electrical stimulation with massage (called a Hivamat), and this may sound strange, but I love it. It has made a big difference in my swelling too. I can also tell a difference with the massage I do at home, and as much as I thought I would never say this, the wrapping has helped a lot. I am just about to the point where I can be fitted for my sleeves and my glove, and I am looking forward to that--the wrapping is pretty bulky.
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I am new to lymphedema. I have had 4 weeks of wrapping. Today I noticed my hand is starting to swell. I am getting so discouraged. My original swelling has stabilized and I am waiting for my sleeve to arrive.
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I don't have lymphedema yet, but I have read where some ladies wear some kind of sleeve apparatus when they are flying.
My RO knew I was flying across the country this week (2weeks post rads) but never mentioned the need for a sleeve.
Should I wrap something around my arm (maybe a tensor bandage)?
I won't have time to buy a sleeve before we fly.
Thank you for any help,
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One of first things my PT person said was to wear a sleeve always now flying.
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andrea do not wrap yourself without proper instruction. special non stretch bandages are used. do not use a regular ace bandage under any circumstance. you could cause morre damage than good.
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I will not try and do it myself; I don't want to cause any problems!!!
I only had 2 nodes removed, so maybe that is why no one suggested it. I told the nurse, techs and doctors I was flying and no one said anything.
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Definitely find someone (preferably a certified LE therapist) to teach you how to wrap. I had three nodes removed on the right side, none on the left, and the left is where I've developed LE. Go figure!
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AndreaJ - Any surgery, rather or not noodes are removed, can result in LE. I have a friend who had minor, non-invasive knee surger. She deals with worse LE than I do and I had 19 pos. nodes removed.
See a CERTIFIED LymphEdema Therapist - Not some pt that claims to "know all about LE". A CLT will be either a PT or an OT but will have additional education. My CLT guy is an OT.
Do not try to wrap based on UTube - you can do more harm. There is a lot involved with handling LE and it is not exactly the same for all.
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I had 3 nodes removed. It is the surgery and rads that cause my problems. I am seeing a CLT.
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Andrea, here are a few things you can do to protect yourself when flying, even without using a compression sleeve and glove.
Be careful both when packing and when traveling not to jerk luggage around with an at-risk arm. Use wheeled luggage and ask for help lifting it on and off of carousels and overhead bins.
Gently exercise your arm throughout the flight. Arm overhead, slowly open and close your fist several times. Or claw the air like a cat, reaching as far as you can. Pump your arm up and down.
At intervals, do some deep abdominal breathing, letting your tummy expand and inhaling and exhaling slowly and completely. (This stimulates the largest lymph vessel in your body, which runs past the diaphragm).
Drink A WHOLE LOT of water. (Yes, I know that means more inconvenient visits to that impossibly cramped little ladies room, but it also really helps to keep the lymph system flowing.)
As for no one on your medical team mentioning your lymphedema risk when flying, did you know that a recent survey out of Stanford University of all U.S. medical schools found that the average amount of time spent learning about the lymph system in a doctor's entire educational career is 15 minutes? So, no surprise there. The medical professionals trained to diagnose and treat lymphedema are fully-trained lymphedema therapists (at least 135 hours of specifically LE training beyond their PT or OT certification--asking a potential therapist about their training is OUR job, since nobody else is going to do it for us).
Happy travels!
Binney -
I only had 2 nodes removed, so maybe that is why no one suggested it. I told the nurse, techs and doctors I was flying and no one said anything.
ANDREA
That's not why! UNfortunately lots of the ' medical folks' don;'t warn us about LE. I had only SNB,. 2 nodes and NO RADS.
Read Binney's post carefully and follow her directions and try not to worry. She's our resident expert here.Hope you have a wonderful trip!
If planning to travel more, you might want to get fitted and get 1 inexpensive sleeve with Hand protection ( A MUST)
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Delayed swelling of the breast and trunk (truncal lymphedema, breast lymphedema, delayed breast cellulitis, etc.) is an all too common result of breast and axillary surgery and irradiation, not recognized widely by the medical community, but being seen more and more by therapists. This occurs with and without the more commonly recognized swelling of the arm and hand. It is harder to treat because the torso cannot be compressed as easily as the arm. Manual lymph drainage by a trained lymphedema specialist followed by mild compression (compression bra or vest) is the accepted treatment.
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thank you ladies for the great advice. I seem to be ok. My flights were each 5 1/2 hours and unfortunately there was much turbulence so the drink service was not as frequent.
I have another long flight planned next month. Who do I ask about getting a sleeve? And how ling does it take to get one? Are they usually covered by insurance?
Thank you Binney for the great tips!!
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Andrea
So happy your trip/flight went well!
Ask your DR for a RX for a compression sleeve and go to a DME supplier that is covered under your plan ( Call your ins. co. first) Be sure you are fitted and measured, and never wear a sleeve without hand protection ( eg a gauntlet) or you may cause more issues than you help. All INS. differ so we can't say what yours will cover. many cover 80% - some require deductibles first and sadly, some do not cover at all - which is why many people support THE LYMPHEDEMA TREATMENT ACT. (but that's for another thread :>)Sometimes sleeves *can* take a considerable amt. of time so be sure to tell your DR and supplier your flight date and impress upon the idea of expediting. This may make your supplier consider choosing one place over another in order to get your sleeve to you in time.
I hope this info help you, and I commend you for being proactive!
Laurie
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Andrea, thanks for letting us know how it went--really glad it was a success! Next time, as you board, tell the flight attendant that you have a medical condition that requires that you stay really well hydrated, and ask if she might give you water bottles to take to your seat. Works for me, and then I don't have to worry about the beverage cart being functional.
Or, once you're through security, buy a few bottles of water from the concessions.
Or, take your own empty bottles through security and fill them at a drinking fountain on the concourse.
The real trouble with the threat of LE is that you have to think about it all the time.
Bon voyage!
Binney -
Just one more aspect of this disease to deal with.
The only time lymphadema was mentioned was the day I was diagnosed and the nurse measured my arms.
Which doctor should I see about the sleeve? I have an appt with my RO next (in two weeks) and my BS in a month. Or should I just see my primary car doctor earlier?
Thank you.
Andrea
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Andrea, any doctor on your team is fine. You can even call them without going in and see if they're willing to write the prescription from just the call. Not every doctor will write it, since some have little knowledge of LE (that was a polite understatement…)
Keep us posted!
Binney -
Great! Thanks Binney, I will start the ball rolling tomorrow!
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Hello Ladies. Not new to BCO but new to the LE forums. First found mild truncal about a year or so ago. Got that treated effectively and thought I'd kissed it all goodbye. Then late last year woke up one morning to a swollen wrist and inner arm just above it. Got great treatment and advice from the LE therapist at my local cancer center. Went through a full course of txt with her and have now been doing all my stretches, weight excercises and MLD religiously on a daily basis. As I've found if I don't keep up with it I get achey and tingly in my arm and hand. The swelling has for sure subsided. Per my therapists instructions I've been slowly weaning off the sleeve/gauntlet so I can see if I can get by without wearing it all day every day. Has been seeming ok - but this morning my arm was noticeably achier and felt hot. Still don't see any swelling though thankfully. What I'm noticing more though is increased tenderness in my ribcage, implant area and shoulder blade on my affected/radiated side. I don't feel or see any signs of swelling but am starting to think I must have some fluid buildup. Anyone have good recommendations for compression garments to cover that part of the body? Awhile back I had gone to a local shop that is supposed to specialize in this stuff but the only items they had were intended to incorporate a prosthesis. There was nothing there for a woman with implants. So I left feeling kind of dejected... Would appreciate any suggestions you all have. Thanks for being here.
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Ramols I have the same, ribcage, breast and shoulder. I am in treatment now and it is going well but i don't have a clue if there are any garments to help afterwards.
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LOTS of choices, thankfully! Check out the bottom of this page for links to suggestions for binders, camis, shapewear and bras.
http://www.stepup-speakout.org/breast_chest_trunck...
Many women here use compression sports shirts such as Underarmour. For nighttime wear you can also order special night vests such as those made by Solaris or JoviPak--they're bulky but usually very effective at reducing swelling, pain and infection risk.
Speaking of infection, Ramols, you're going to want to be VERY WATCHFUL about that achiness and warmth. We're all at high risk for cellulitis, and IT IS AN EMERGENCY, because it can spread very rapidly and become systemic. Might be best to get your doctor to check it out today before the weekend. Here's more information:
http://www.stepup-speakout.org/Emergencies_and_Med...
Be well!
Binney -
jojo...I'm having the same symptoms. Swollen upper arm & armpit. A bit of swelling in the mx area. I have mild shoulder stiffness, but work through it. I have a PT appt on Monday.
Another Paula
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Soteria205 - i see we have the same dx date, guess that makes us related? lol. Thanks Binney for all that info, that really helps!
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Binney, Yes! Thank you for the great info. I don't have any symptoms, but I'm making an appointment for a lymphedema education just in case.
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Thanks all for the info. Binney - yes, my LE therapist drilled the cellulitis fear into me. No signs of fever and my arm was more heavy than hot. Used my night sleeve (absolutely LOVE my Solaris nightsleeve) the past few nights consistently and feel like that helped with whatever was going on in my arm. Also called my LE therapist about the shoulder blade and ribcage area and she referred me to an OT/LE specialist who she raved about. Set for my evaluation with her on Thursday. So hopefully i'll get this sorted out soon. Thanks again all. Feel good!
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New here. Lumpectomy in December with one node removed. But this week noticed swollen hand. BS made an appointment with PT. not sure what to expect or even if this will now be a chronic problem. Thoughts?
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Aw, Mimi, I'm so sorry for this new frustration! The good news is that you're on top of it so quickly, and that will make it easier to get under control and to deal with on-going.
Here's information about lymphedema treatment:
http://www.stepup-speakout.org/treatments_for_lymp...Be sure the therapist you see is fully trained in lymphedema management. Here are some questions to ask:
http://www.stepup-speakout.org/Finding_a_Qualified...Learning to live with lymphedema can be a steep learning curve, but we're all here to cheer you on. Please tell us how we can help, and keep us posted on your progress!
Gentle hugs,
Binney -
Does the swelling stay permanently like it is or can it come and go?
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