Blood draw

tsoebbin · August 2016

hi there! I've had lymph nodes removed on both sides 3 on one side 4 on the other. I had a double mastectomy about eight weeks ago and my MO wants to do a blood draw to figure out my hormone levels for tamoxifen. She states with that few nodes removed it's okay to take a blood draw on my arm. She's adamant that it's okay.

Now my lymphedema PT specialist suggest I have it taken from my ankle my blood pressure also.

The cancer center that I go to only takes it from the arm.

I'm really not sure what to do next. She wanted to take it last Thursday and I put it off for a week to do a bit of research and to talk to my lymphedema specialist again this week.

Has anyone else had left nodes taken from both sides?

Any advice?

dtad · August 2016

I don't understand why there is a general lack of information about lymphedema amongst medical personnel? Why is it only lymphedema therapists who are aware of the preventative measures? Lymphedema is one of the worst if not the worst SE of treatment and yet no one seems to care about it. I had nodes removed on both sides and I'm constantly arguing about BPs, blood draws, etc. I just don't get it. Even my breast surgeon poo poos it!

tsoebbin · August 2016

dtad... Where do they draw your blood from?

SusanSnowFlake · August 2016

Recently a study was concluded that has led professionals to believe that blood draws for BC patients on the affected side will not contribute to the risk of LE or infection. It did not include information about those that have LE. My experience was this: My veins are bad on my good side so the tech wanted to use the other arm which has no swelling at this time, she cited the study I'm referring to, I asked her if the study included patients that already have LE, she didn't know. So we used my hand on my good side.

It's always a good idea to listen to the professionals advise but remember that they will give you the most conservative advise and take care not to do anything that could cause legal problems. There are woman that have posted on this board that have had to use an affected arm for IV's and blood draws. I'm hoping that one of them will respond to your question.

If your still in doubt as to what to do, you should contact your LE specialist and find out the risk. I believe the risk is infection, taking special care of the puncture site can avoid that complication. Ask about the compression that used to get a vein and the possibility that could be a problem. Also ask about using your hand, no compression is used to find a vein.

Sometimes asking the right question takes care of the problem, but, for me, the biggest problem is figuring out the right question.

Hope you get the answers you need.

BarredOwl · August 2016

Hi Tsoebbin:

Here is a relatively recent thread which may be of interest. If that links you to the middle, start at the first post:

https://community.breastcancer.org/forum/64/topics/845231?page=1#post_4738459

BarredOwl

Mom4four · August 2016

I also have this issue. Every Dr. I ask has a different opinion, when I was in the ICU the Dr and the blood draw people even had an argument about how to get an IV. I have my blood pressure taken on my leg, I usually have to tell the nurse how to do it. I had one blood draw after my BMX but before I was diagnosed with LE, I am dreading the next blood draw decision.

tsoebbin · August 2016

Thank you for your help and links to articles and recent posts. Still not super clear, but it helps!

PoppyJQ · August 2016

Since I had nodes removed from my right they did all of my chemo on the left so those veins are still hard to use. My oncologist said the risk for blood draws is slight since it should all be sterile and told me if ever needed to have them use my right arm. Last month they were on their 5th attempt (two different people tried) at getting a vein before a procedure so I had them use the right side. I was very careful afterwards to keep it sterile and babied it the rest of the day. When I think about it there are so many times I've accidentally done something to that arm, once the cat even bit me badly there so infection is always a risk for us.

woodstock99 · August 2016

I had my first blood draw today for labs after my BMX with SNB (4 nodes removed both sides) that was done in Hanuary. My surgery and post-op car is at an NCI facility and they would not do blood draw in foot. I spoke to BS, MO and head of Oncology all who says there was no reason not to do in my arms and that risk of LE is negligible. They also said risk of blood clot to have foot draw. You just get tired of arguing. I already feel like I have a flag on my file as a trouble maker. They were not doing any special markers just standard labs so I waited until now so I could get my internist to give me order as I have my annual checkup later this s month. I also have a colonoscopy in 2 weeks and will have to have IV for sedation. That is done in right hand so had today's draw done on left at Labcorp. I told the tech who was gentle and quick. I do feel like 12 hours later that my arm and chest feels worse than usual but hopefully my imagination. I put neosporin on it and looks fine. Trying to do some MLD tonight and it could be more from going to gym last night but I will say this really is a terrible and anxiety inducing experience to live with for the rest of my life. Is doing blood draw in the hand painful or less threatening? Hopefully will not have to do again for awhile. I feel everyone's fear and frustration. Will be seeing my PT (private) if I still feel concerned this week.

Seedsally · August 2016

Hello everyone I have a question. When my regular dr checks my BP in my leg it is very much higher than it was in my arm. She told me she won't touch my cancer side for anything but wants me to ask my Oncology dr if she can draw blood from my other arm. I had a prophylactic on my left side but also a lumpectomy type biopsy prior on that side. My BS took a couple of lymph nodes from the prophy side that had atypical precancer cells in them. Where do you get your BP measured and is it normal for the reading to be a lot higher in the legs? My dr was really concerned and added generic Norvasc to my meds. I was already taking a small dose of lisinipril because I am type 2 diabetic. It's supposed to help my kidneys but my BP is not usually high. I am supposed to have EX surgery in a month and am worried about the IV and BP cuff. Any advice from you guys?

I forgot to mention I have not been diagnosed with LE yet but I do swell sometimes under my right arm and get a heavy feeling with achiness in that same arm. It is the cancer side and had an incision at the edge of the armpit with sentinel node dissection. Thankfully no mets that we know of yet.

BarredOwl · August 2016

Hi Seedsally:

For routine blood pressure readings, I now have them taken on my thigh.

In the first or two year after surgery, I had blood pressure readings with the cuff on my calf a few times, and the readings were a lot higher than those taken on my arms in the recent past. Essentially useless in my case.

I asked my PCP about it, and she recommended a "thigh cuff" (ordinarily used for people whose arms are too large for the standard arm cuff). She placed the stethoscope behind the knee and obtained a reading from the popliteal artery. I have had this done three times now, twice by my PCP and once by a nurse, and all three readings were in the normal range.

BarredOwl

woodstock99 · August 2016

good to know about thigh vs cuff as NCI center did Bp on calf and it was very high and nurse also tried to tell me it's the same. I told her my Bp has never been even close to those numbers. Maybe I should by my own thigh cuff and take with me. Thanks

Seedsally · August 2016

Thanks BarredOwl for your reply. I am wondering if the cuff needs to be different for me. I also wonder if I should invest in a thigh cuff Balthus. But will they use it in the clinics I wonder?

BarredOwl · August 2016

Hi Seedsally and Balthus:

Before investing in one, I would first ask your local providers if they have a large or thigh cuff in-house, and see if they will / can take an accurate pressure on you with it.

Seedsally:

What is "EX surgery"?

BarredOwl

BarredOwl · August 2016

Hi Balthus:

One more thing about blood draws in light of the information you received about risks associated with blood draws from the foot (which gives me pause). Please see Ksusan's post and SpecialK's (immediately following) regarding their personal approach to routine blood draws:

https://community.breastcancer.org/forum/64/topics/845231?page=1#post_4738407

Insisting on precautions makes me feel like a butthead, but then I am the person who would have to live with the substantial impact of LE. I wrote a big note to myself in Sharpie pen in my visit notebook, to help me stand my ground (when feasible).

For post-BMX colonoscopy, I informed the team of my at risk status due to bilateral SNB (with number of nodes per side) in the pre-procedure phone call, discussed their policy, and reminded the nurses again on the day of the procedure. At my facility, internal procedural hurdles and policies applicable to sentinel node biopsy (versus axillary dissection) meant an IV in the hand or arm. I do not know if one is preferred over the other, so you may wish to inquire about that. In my case, my arm is hard to deal with, so both times, I had an IV in my hand (on the non-dominant arm, which also happens to be the side with the lowest number of nodes taken).

There is a need to monitor BP throughout the procedure, which was done automatically (also on my non-dominant, fewer nodes taken side).

BarredOwl

woodstock99 · September 2016

hello all - just wanted to update that I had my blood draw for my labs 2 weeks ago in my left arm and got a great tech so got 5 tubes for every needed test done in one draw and had my colonoscopy this morning.

They did my IV in right hand and BP cuff on right leg. That went well too except went to new GI and he does conscious sedation so I was more awake during the procedure than I recall being the last 2 times I have had this procedure. I didn't feel anything and maybe better to get out if your system quicker. Just had one polyp this time versus 3-4 in past so I believe eating more healthy since BC has made a difference. Like the 3 pound loss in one day but I am sure it will come back tomorrow .

Labs came back perfect except glucose was 102 so still need to work on sugar. I have my annual checkup with internist on Thursday. So far no issues from blood draw or IV. I did get a touch of anxiety and surgery flashback going into procedure this morning but didn't last long. Thanks

Blood draw

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