Just diagnosed 3 years after bmx/SNB
Hi all - I've been reading the LE forum for last few years thinking I might have LE but was told by my MO/BS/PS during follow up appts that my nerves were "regenerating" or it's "just scar tissue". Background dx DCIS/LCIS/ALH nsbmx July 2012 (had 4 recon surgeries, have implants and lots of scar tissue) 2 SNB taken out each side. Cancer side was the right and ever since the bmx the right under arm and armpit have been consistently bothersome (pins & needles) and my rt. breast always itches in the same spot, it really itches, not a phantom itch, plus my chest has been horribly tight all this time. Fast forward March this year, woke up in the middle of a Sat. night w/ painful left breast, it swelled, got hot. The right breast had it tooalong incision line. Thought I had IBC or infection all weekend, saw BS Mon first thing, dx as cellulitis, BS stated I don't have enough breast tissue left for IBC (not sure I agree). Oral antibiotic resolved it although the breasts are still pink and some spots hardened. Ever since the cellulitis + the summer heat my symptoms got worse, tingling down right arm to fingers, random stings in arms, feel fullness under right arm. At BS appt a few weeks ago I asked 3 times if it was possibly LE, was hoping to get a referral to a LE therapist & he insisted it could not be LE since I only had SNB; he blamed my implants. Days later saw PS, he said the problem was from lymph node removal & he referred me to a wonderfully qualified LE therapist at a big local hospital with 3 LE therapists on staff without me even asking. Had my first appt yesterday and I absolutely love my therapist, she explained the lymphatic system, lymphedema & she laid out my treatment plan. She dx me with preclinical LE because left & righthands/arms measured the same; but when she did MLD she felt lymph fluid and tissue build up under my armpit and upper arm and she felt how my skin there is thickened compared to the lower right arm. As she did breast MLD she noted that both have orange peel. Got fitted for a sleeve and gauntlet and we ordered them from lymphedemaproducts.com right there. Got a Swell Spot pad to wear under my camilsole (haven't been able to wear a bra for over a month now), it provides some comfort. I will get MLD twice a week for the next 5 weeks; then I have a vacation with flying, so treatment just in time! So here I am....3 yrs 3 months later with a dx and a plan to keep this condition from getting worse and hopefully get me feeling much better. Thank you all for this active forum, it really helped me. Jill
Comments
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sorry you had to join us, but physical therapy can work wonders!!
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Jill, your relief at finally getting a proper diagnosis really shines through your post. How frustrating that the breast surgeon did not want to refer you to the LE clinic. Cellulitis is well known to be an added risk when we have LE, but it is also well known to be a trigger of LE, and so any episode of cellulitis in someone who had BC treatment and is not yet diagnosed with LE should always raise the question--was there subclinical LE that opened the door for cellulitis? Only a well trained LE therapist is going to identify LE at that stage. If he/she finds no LE, then that episode of cellulitis means that the patient should receive education to be able to identify signs and signals of LE, which is now more likely to develop. I'm so glad your PS recognized the LE symptoms, but your clueless BS needs some wake-up education!
Any chance that you can recruit your wonderful LE therapist and clinic to reach out to the BS to provide that education? -
Carol - actually I inherited my BS, his DD a top notch BS relocated 6 months after my surgery...she would of gotten it. Afraid in his case can't teach an old dog new tricks. My PS on the other hand is top doc, much younger and on top of things. Never felt the need to change BS b/c mx done, only a recurrence or new bc would necessitate surgery. But he gives a very thorough br exam & I only have 2 more years under his care. My PS on the other hand wants to see me annually for as long as I have implants ( - : he's that good. Thank you for pointing out that my LE therapist is good b/c she was able to identify subclinical. She said so many doctors find it hard to admit or accept that actually one of their patients developed this horrible condition from their surgery and care and it has nothing to do with the type of surgeons they are! Some women get it, some don't. She's seen women with 30+ nodes removed and no LE and a woman with none removed but with surgery developed it. As to how I got the cellulitis is still a mystery but LE therapist thinks a bacteria got in and the LE jammed it up in my chest and the white blood cells couldn't get to it; she spoke in metaphors (traffic, car crash, ambulances can't get to the scene) to illustrate how LE develops and makes it hard if not possible to fight infections.
I'm sure there is a thread here for this topic but I need to figure out how to deal with people at work when and if they ask about the sleeve/gauntlet. This is a new job and no one knows of my bc history and I want to keep it that that way.
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I was reading your posts about cellulitis, and I know my LE got worse after a bee sting and cellulitis. I went to urgent care and told them about my history, and the doctor said you could have gotten cellulitis without having breast cancer in your history. The funny thing is I got into a nest of yellow jackets a month or so later. Thank the Lord they didn't sting me on that arm, but they got me everywhere else. They actually got down in my shoes and my feet looked bad for days, but I never got cellulitis. One bee sting to the affected arm, and it blew up with infection, 14 bee stings to other limbs and my body got over it. Up until this past year I did a lot of yard work. Now 14 years after breast cancer diagnosis, I don't do much outside. Scared to pieces of getting stung again.
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jill, your LE therapist sounds like a real keeper! And I sure do agree that there's such mystery about who gets LE, and who does not. I had snb, five axillary nodes from that, plus another went with the breast tissue, and I developed LE, fortunately for me a pretty mild and manageable case of it. My mother had a radical mx at age 38 and today she is 85. They removed every single axillary node and in all these decades, she never developed LE. Go figure.
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Hi Jill, sorry you have had to join us "swell sisters", but welcome! You are in the right place for advice.
I bumped up two threads that address what to say when people ask about sleeves. *I was attacked by a gator* remains my personal favorite.
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Thank you Glennie for bumping up the threads! And Carol that is incredible about your Mom surviving BC and such a brutal surgery and making it without LE. My therapist described that lymph nodes are in 3 layers, close to the surface (SNBs) and those in/on the muscle and back in the day the lowest surface nodes came out with the muscle. She must have been a real special woman.
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Jill, my mother is indeed a special person, still going strong, and feisty.
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I was wearing my purple sleeve the other day, under a black blouse,, and someone said to me: You're missing your other sleeve,, in a real smart-ass tone. I replied "No I'm not" and walked away.
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I know several others, including myself, that have LE with only SNB. Your history sounds similar to mine.
Try again with the doctor, it is important to learn drainage and get some LE garments
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