No needles, blood pressure readings after single node biopsy?
I had a single node biopsy. Over the years I have gotten conflicting answers when I ask docs if I should avoid needle pricks & blood pressure readings affected arm. What have you been told?
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I had three nodes removed on one side and none on the other. I developed LE on the left side first, then on the right after needle sticks for a colonoscopy (I think it was kind of brewing before that, but that seemed to put it over the edge). I thought I was at such low risk it was pretty silly to follow those precautions, but I definitely don't think so now. (I didn't have BP readings on either arm after my BMX, just to be safe, but I felt like I was being overly cautious.)
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I'd like to know, too. I'm set for a prophylactic BMX and two surgeons have each suggested SNB, though the final choice is mine. One said it would be a good idea to do it at least on the side where I had ALH earlier this year, and perhaps just take one from the other side. I'm worried about doing even that one, though.
aunt paula (hi!), how did you get LE on the side where no nodes were taken?! And if do have both sides done, how do get BP readings? -
You can have BP readings done on the ankle. Any breast surgery, even prophylactic without nodes, carries risk of lymphedema due to the disturbance of the breast tissue. You can develop lymphedema in the trunk, arm, neck, face, etc., although it is not common without the removal of axillary nodes. SNB with one node removal I believe carries about a 5% chance of LE, more nodes means more risk.
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Keep in mind that sentinel node biopsy often ends up taking more than one node. If the tracer dye touches several nodes at once, instead of just one, they take all that 'light up.' I lost 5 nodes that way--mine were apparently arranged more like a wagon wheel than in a string. The BS told me that is not uncommon (but of course, when proposing the SNB as an abundance of caution, she mentioned only the 3-5% LE risk associated with taking just one node).
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Drs. often downplay the risk of LE but their opinion isn't usually based on sound, current knowledge. It's a good idea to be safe rather than sorry and take as many precautions as you can. I think Drs. downplaying of the risk make us feel overly cautious but you are the one who'll have to live with any consequences. I suspect human nature being as it is, the longer one goes without symptoms of LE, the more risk one is inclined to take. Many never develop it despite not taking any or few precautions and some develop it despite taking most precautions. A lot depends on whether or not you are willing to take that risk.
Despite no nodes being taken on the prophylactic side there has still been trauma done to the chest, there is risk on that side too.
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My doctor told me to avoid it (I had 3 nodes taken as a SNB) if I am awake and conscious, but that if (for example) I have been in an accident and am unconscious, not to worry about it as I would have bigger problems at that point. Essentially, he meant that he didn't think there was a need for an emergency alert bracelet or the like, but that routine stuff should be avoided whenever possible.
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as a nurse I was always taught to avoid doing blood draws/bps/injections on affected side unless emergency. Some surgeons have told me it's okay to do it as long as lymphedema not present at time ..others say it's fine unless patient has had radical mastectomy with all axillary nodes out. My take away avoid it unless emergency not worth the risk... now as a patient I hold firm to keeping away from right side... even when they say it's okay. I think the consensus is they don't know so rather be safe than sorry
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Like Carol said, the SNB often takes more than one node. My surgeon took 6, cuz they were all right next to each other. The fewer nodes taken, the lower the risk,, but there are plenty of us who have developed it with only losing a few. (Me = 6) My surgeon considered me to be low risk and never gave me any warnings. At the oncologist's office, they are careful to ask which side I had SNB on. Try to keep your BP's and needlesticks to the non-SNB side if you can. Honestly, I have learned 99% of my knowledge about LE from this site and StepUpSpeakOut. Very little advice from my MD's. -
Hi, Lilith!
I have BP taken in leg now. I have LE in both arms, and on left side (no nodes taken) I also have neck, truncal, and breast LE. The right side LE is milder than the left, which is ironic, since the right side is the node-affected side. Go figure!
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Any surgery (or traumatic injury) can result in LE issues anywhere. Nodes do not have to be removed for it to develope. It is not limited to breast surgeries/node removal. I have a friend who had minor, non-invasive knee surgery - she deals with more LE issues than I do with 19 pos. nodes removed. We are all unique.
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Met with oncology nurse today. This was originally scheduled to follow up on Evista treatment, but I'm taking the PBMX route instead--I decided to keep the appointment so that I could ask a few questions, such as SNB. She said it's standard procedure, even for prophylactic MX, but that I have the option of refusing it. She says that as practitioners, doctors want to know they've done what they can to find any hidden cancer, and that's why they do it. In my case, even though my diagnosis is "only" ALH (atypical lobular hyperplasia), because I've had such a long history and am high risk, suggesting SNB seems like a good precaution. I will have to just make a decision and trust that it's the right one, I guess!
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Lilith, you need to look at your overall health first and foremost. Good luck with your decision.
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Something to consider is to have the dye/tracer injection prior to the PBMX, then depending on how quickly the pathology is done on the breast tissue, if nothing is found they don't need to do the SNB. If you have a finding of malignancy they can go in and remove the node(s) as the dye/tracer remains for a period of time. Your surgeon would have to be on board with this though, and pathology would have to be PDQ. Here is a synopsis of the procedure:
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specialk, that would have been perfect for my circumstances and I wish I had had that option. Thanks for sharing. Hope the info saves other women from LE grief!
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SpecialK, I've read about that, but the only place I've seen it is with that Pink Lotus Center. I didn't ask either surgeon yet, but the oncology nurse practitioner hadn't heard of anyone doing it. It seems to make so much sense, though! Why cause trouble if you don't have to, you know? Maybe I'll be brave and ask about it.
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Lilith - since you are in Orlando, have you checked with Moffitt? They are the only NCI center in FL. Also possibly Mayo in Jacksonville, to see if they do it? I have also not seen it outside of the Pink Lotus, but I think it is really something that could make a difference for PBMX patients, and even possibly pure DCIS patients doing MX.
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Hmm...no, had not considered looking outside of Orlando. I doubt that my insurance would allow me to go out of town for something like that. That's based on how resistant they were to a coworker with major heart problems that really needed to be dealt with out of state.
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If it is any consolation, it is pretty unlikely that either location offers PBDI, but hopefully it is something that has initiated interest and motivation to determine if it is a viable alternative for the appropriate patients.
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I just wanted to offer my 2 cents on the lymph node/lymphedema question. I've been a reader for 18 months now and have learned so much from all of you.
Per my surgeon, once you remove a breast you can no longer do a SLNB so I had one node removed from what turned out to be my non-cancerous side (there was an area of concern after an additional biopsy). I had the ALND on the cancer side (31 nodes removed). I was worried about never being able to have an IV or BP on either side but my surgeon said that it was highly unlikely that having one node removed would cause lyphedema because there are many, many lymph nodes left. So, I always use my right arm for vaccinations, BP, IVs, etc. I have been very fortunate to be lymphema-free on both sides. I've read to be really careful about cuts, hangnails, bug bites, etc. Always keep infection away by using triple antibiotic ointment and always monitor your fingers and wrists as swelling will likely show there first. Best of luck to all of you!
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Being overweight raises the risk of lymphedema. We are drilled about BP and needle sticks but how often do they mention maintaining a healthy weight. Just another thing to consider.
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Hi, Jbug--thanks for the input. I'm glad to hear you've not had any issues on the good side. I see my BS once more on Wednesday, so will have to make decisions after talking about it again.
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even though I had a lumpectomy and radiation only! with no snb, I have avoided needles and bp cuff on bc side. when I began allergy shots! 9 in one arm every week! yikes - but worth doing whatever I can to avoid lymphedema.
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I had a Sentinel Node Biopsy on my left side during my BMX, and three nodes "lit up" so they were removed.
Funny, at the time, several medical professionals told me I had no risk of Lymphedema, since I only had three nodes removed. But luckily, by then, I was a member of BCO and knew better.
Since 2011, I have always had BPs and needle sticks on my right side. But a few weeks ago, at Kaiser, I asked for my BP on the right side, and several of the nurses told me that the protocol on this was changing, and that I didn't NEED to avoid my left side.
I told them "Good luck convincing ladies with Lymphedema. And for the record? I'll stick to the right side anyway."
There are very educated women on the Lymphedema threads here.
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oh my gosh, Blessings,,, I can't believe the ignorance in the medical community on this!! Well, yeah, I can, but I can still be surprised. Good grief.I had 6 nodes removed and was also told I was very low risk.
I trust the people on this forum much more than the medical community. We all have actual experience with this bugger of a problem.
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Thanks, glennie.... better safe than sorry, right? I appreciate this forum SO much!!!
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Blessings, brava for you! Smart is so much better than "swell!"
Hugs,
Binney -
I'm in the middle of a freak-out, so I haven't gone back to figure out where I read something--but now I'm thinking this might be the right spot, and that glennie might be the one I'm looking for. Taking blood pressure on the ankle/calf--is there a particular type of BP monitor I should try to buy? Am using my mother's digital monitor, which I think is from Omron, but have no idea how accurate it is.
A visiting nurse was here about an hour ago. I had no idea that my BP was so high--160/90! She took the reading from my calf/pulse from my ankle and did it a couple of times to be sure she was right Said it was quite easy to hear, too. Have now taken a couple of Benadryl in case I'm having a reaction to my antibiotics (and thus the freaking out).
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Lilith, I am pretty sure I recall hearing that BP readings tend to be higher when taken on the leg. That isn't so terribly high. A reaction to antibiotics would likely be something more along the lines of hives or nausea, I would think. Try to relax. Do you have any Valium or somesuch? Just to take the edge off the (understandable) anxiety?
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Jennie93, thanks--I did take some Klonopin (anti-anxiety), plus the Benadryl. Doctor just called and said to stop the antibiotic for a day and we'll see what happens. Says she doesn't always even prescribe those. She'll check on me tomorrow.
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I'm not sure about the calf readings,,, I've never had that done. Agree with Jennie,, do you have something to take the edge off the anxiety? Take some calming deep breaths.
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