Sleeves/Gloves As Prevention If Flying?

Agree on getting someone else to lift your bags--or use your non-surgical arm. Better yet, ditch the regular or two-wheeled suitcases and get 4-or-8-wheel spinners instead. They practically propel themselves, whereas the 2-wheelers have to be pulled and set off arm swelling from the exertion.

I will tell you that at my pre-op “teaching session," the BS' nurse measured me for and gave me an Rx for a sleeve and gauntlet. She said that even if I didn't have symptoms I must wear them for all long flights (>4hr), don them an hour before takeoff and remove them an hour after landing (unless the destination was over 1 mi. high, in which case to keep them on a bit longer and check to see if the elevation caused any swelling). I too had 4 nodes out via SNB, and got some mild non-visible cording symptoms starting a week post-rads. Made an appt. to see an LE specialist a month away. I took a Mediterranean cruise a couple of weeks after that. The first flight leg to Europe was 8 hr, so I put on the compression stuff an hour before boarding. Second leg was only an hour--and had I known we'd have a 2-hr layover in Amsterdam I'd have taken them off before boarding the next flight. When we checked into our hotel in Rome, I took them off. I noticed a little tightness in my bicep after a couple of hrs. on a shore excursion in Sicily to a town 1.5 mi. high near Mt. Etna, but it eased immediately as our bus began to descend back towards the port. On the return, from Barcelona to Amsterdam I didn't wear the compression but put it on as soon as we landed for the 8+ transatlantic leg. Took it off an hour after landing in Detroit and kept it off for the last short hop to Chicago. On the Amsterdam-Detroit flight, I noticed my rings were tight--but it could have been due to very high-sodium airplane meals & snacks.

When I saw the LE specialist (a nationally-recognized pioneer in the disease and co-founder of LANA), my cording had resolved and he hit the ceiling when I showed him my sleeve and gauntlet. “I never prescribe compression for patients who had only 4 nodes removed." But when I told him about the finger swelling in flight, he changed his tune and told me to get a glove for flight instead of a gauntlet. He measured me and found no difference from my pre-op measurements, but staged me as 0 because I had claimed symptoms, and that was the only way Medicare would pay for LE therapy. Good thing, because I eventually did get visible axillary cording and am now definitely at stage 1 LE. I wear compression during exercise (including guitar playing and long sessions of housework or cooking) and if there's a front coming through. For short periods, such as workouts and guitar, I can use the gauntlet. But if my rings get tight and self-drainage massage doesn't help, I put on the glove as well until my rings get loose. And for my next trip this month (London, Lausanne, Paris) I will wear sleeve and glove on the transatlantic legs, and while in Switzerland if I’m spending much time at Alpine level (Lausanne has a wide variation in altitude). I will wear sleeve and gauntlet. I won’t wear it on the 2.5-hr London-Geneva flight, and probably won’t need it on the Lausanne-Paris TGV train because the entire run will be at lower elevations.

Most boutiques that sell compression have at least the Jobst or Juzo in stock, in standard sizes. If your measurements indicate you'll need a custom set (and the fitter confirms that), better get the order in ASAP. Be prepared to pay several times as much as for an off-the-shelf sleeve. Wearing a sleeve that is too loose is flushing your money down the toilet; too tight is much worse than no compression at all. Well-fitting compression can't hurt you or trigger LE.

Confirm that you can fit into a plain off-the-shelf Juzo or Jobst before you mail-order from LympheDivas. Don't forget to consider your arm length and upper arm circumference, since Juzo does have an extra-wide-band option, and LympheDivas have Short and Long --no “regular"--sizes. Too short and too long can cause constrictions--the latter by rolling down--which are harmful. And if you need a glove, call LympheDivas with your finger length measurements, because their gloves run long in the fingers. Normally, that wouldn't be a problem, but my fingers are so short relative to my palms (alas, I have Donald Trump hands) that my fingertips are completely covered (up to the nail tips) in their gloves so I can't work a touchpad and the fabric mutes my guitar strings. Their gauntlets are fine, though. And whatever brand you buy, make sure it has a silicone gripper band to keep it from rolling down and cutting off circulation in your upper arm.

I wore my Lympadiva sleeve and gauntletwhen flying, mine is the magnolia pattern and weirdly I got compliments on it! At the lymphedema seminar I went to we were advised to wear for all flights and to put on just before boarding and keep on after the flight preferably for 24hours, but she said to at least try for 12 hours. I managed 14 hoursafter my outbound flight and barely 12 after the return flight. I don't have lymphedema, thank goodness, and I don't want it.

I had 20 nodes removed and have flown several times without a sleeve. Nothing happened; I still don't have lymphedema. In fact, some ladies on the triple positive board have pointed out that this issue is controversial. Some LE specialists say that if you don't have lymphadema, it's a mistake to wear a sleeve; others see it as a preventive measure. Good luck!

My LANA-certified PT does not recommend one if you don't have LE and said she thinks it may cause problems instead of avoiding them. The issue hasn't been widely studied, unfortunately. I will be flying in June and have no intention of wearing a sleeve or glove.

Balthus, if you do not have LE and wear poorly-fitting garments they could be trouble. Well-fitted garments with a low compression (15-20 mm/Hg for instance) would be a reasonable choice, though. If you don't wear garments on the way to your destination and run into trouble, say, having such garments along would be a practical way to make the rest of the trip manageable. My right arm/hand LE first appeared on a flight to Alaska, which pretty well wrecked up the entire excursion, as finding a LE therapist in Sitka proved impossible. If you use a sleeve, do wear at least a gauntlet. Here's why:

https://www.lymphedivas.com/en/hand-protection

Aside from that, yes, the suggestions you've listed are certainly wise. Also pausing from time to time to take a few deep abdominal breaths, as that stimulates the largest lymph vessel in your body.

Bon voyage!
Binney

I think level 1 compression (20-30) is what most therapists recommend--Level 2 (30-40) is difficult to don without damaging it and 15-20 might not be much help (unless you don't have LE--many athlete non-patients wear that level on both arms for working out, especially in the cold). Not all insurance will cover even therapeutic level compression--and some vendors won't take your insurance. Alas, neither Medicare nor supplement policies do, which is one of the reasons why the Lymphedema Treatment Act has such broad bipartisan support in both houses of Congress. (Unfortunately, the majority's leadership is holding it hostage as a pawn for repealing the ACA or de-funding Planned Parenthood....end of political rant).

As long as you are wearing compression that is properly fitted to your measurements, and wear hand protection (proper size gauntlet or glove), it won't cause LE...it might or might not prevent it, though. And my LE therapist says compression or no, you should still move your arms a lot (fist pumps, hand waving--apologize to the flight attendants in advance), drink water and go to the loo a lot, and move about the plane as much as they’ll let you. If any adjacent passengers complain about your hand gestures, there’s a one-fingered one that if done repeatedly can get that fluid moving......

My question:

I was fitted with a sleeve and gauntlet by the LE specialist, tried it on in her office, said it fit. Was told to wear it for flying, put it on an hour or so beforehand and leave it on for a couple hours after landing. Also wear it if doing anything much more strenuous than normal everyday work. Not guaranteed to prevent it, but can't hurt, might help. Have not flown yet, but wore the sleeve twice (briefly) for some heavy lifting.

However. I cannot wear the gauntlet. There is a seam that goes right over the thumb knuckle and is very painful. If I fold it back the thumb turns blue pretty fast.

Insurance is different this year and none of this is covered so don't tell me to go back to the fitter because we simply cannot afford it right now. Anyway she thought it was fine.

Question is, I now have to go on a fairly long flight and there will be no access to any kind of medical advice where I'm going. Is it better to use the sleeve only, no gauntlet, while flying, or do without entirely? Or should I try getting a glove from someplace like lymphedivas? Better to experiment or no? Are they returnable if it doesn't fit?

And if my arm does blow up, presume it is not wise to try to squeeze it into the sleeve at that point, correct?

I think it's been too long, and frankly I would rather just look for one on my own, if that's do-able. Insurance doesn't cover any of this. So there's no reason to get a prescription, right?

What I'm really hoping is that if wearing it for precautionary reasons only, it's ok to use the sleeve only and no gauntlet.

Thank you so much! The isotoner glove looks good, and the price is right. I will definitely try one.

Yes, this is purely prevention. I have truncal LE but never any swelling in the arm (knock on wood).

Thank you for starting this thread. I am flying to Mexico in April and had the same concerns and questions. I had my mastectomy 3/9, with 19 lymph nodes removed. So far no signs of LE