Swelling just not going down
Hi friends--
My mom's lymphedema just isn't improving. She's had so many ups and downs since she was diagnosed about 6 months ago. At first, we were doing well with massage and compression. She was fitted for a sleeve, but the compression wasn't enough, and she had a flare up. While that flare was happening, she was wrapped constantly waiting for a higher compression sleeve--about 6 weeks.
Since then, we've been up and down and up and down. Sometimes she gets massaged and wrapped and it works. Other times, not so much. She's had wrappings on for the last five days, and we aren't seeing any kind of reduction in the swelling.
In the meantime, she's also had a lot of shoulder pain. The doctors were worried about mets to the bone, but after a CT scan and a follow up MRI, she was given the all clear from cancer; but she has been diagnosed with arthritis, brucitis and tendinitis, along with two small rips in the muscle.
We met with an orthopedidic surgeon who wants to treat with physical therapy and perhaps cortisone, but would rather avoid the cortisone.
All that said, my actual question: has anyone else had lengths of times when they just can't get the swelling under control? Can the inflammation from her shoulder be causing more blocks in her lymph system? The therapist keeps thinking that the cancer is back, but nothing is pointing toward that--except for a slightly elevated tumor marker number.
She's in the process of trying to get s lymphedema pump approved, and I'm hopeful that will help, but in the meantime, my mom is entirely miserable and I don't know what to do to help. I just keep trying to keep her hydrated, keep massaging as often as I can, and try to keep her eating well. But it is terrible to have her arm so wrapped so constantly.
I'm willing to try just about anything. Tips or recommendations would be so, so welcomed.
Thanks, everybody!
Comments
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just wanted to say hi and hugs and this scenario sounds somewhat familiar to me
. I had a lot of trouble the first summer, and ended up with a very damaged (almost completely frozen) shoulder from that period and (I think) the lack of use and extra weight on my arm from the associated wrapping. I don't have any magical solutions (I wish I did!) but I know my swelling didn't get better until I started being able to move that arm more normally again through some gentle pt / lifting and having my muscles help push some of the fluid out. Right now water pt is super helpful for me. It's easy to move my arm and helps swelling at the same time.
Is your mom still getting chemo? I know my arm hurt / swelled / flared with every infusion.
I hope she (and you) get some relief soon.
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thank you so much for the kind response, floaton! I've been reading a lot about water therapy and it is good to hear that it has worked for you. We were on our way toward controlling it and it is just so frustrating to figure out how to get this right. I am hoping that once she starts doing the extra PT we may actually be on our way again. I just feel so bad for her!
She is on oral chemo right now (nothing detectable, but after a recurrence to her belly fat, potential lymph involvement on the second side and a cancerous pleural effusion, we are being proactive. So at least we don't have infusions to deal with...but the constant tick of taking a pill each day wears her down just as much
We both really appreciate you taking a moment to share your experience. That is what has been getting us through optimistically... Because not much else seems to. ❤️
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Emily, I'm so sorry this struggle seems to just go on and on! Summer is a real bear for a lot of us with lymphedema. I'm doing battle with it now too, wrapping off and on and also using a DVD exercise program called The Lebed Method:
http://www.gohealthysteps.com/Store
I use the first two sections (opening exercises and leg stretches) daily, and it really helps. There are also youtube videos of the exercises that are free and easy to access if she'd like to give it a try.
I agree with floaton that water therapy might be helpful as well. If you have access to a pool you know is scrupulously clean she can enjoy just cooling off and moving gently through the water. A regular water aerobics class would probably be too strenuous to start with, but standing shoulder-deep in the water and moving her arms about, or doing a few laps of a gentle stroke might really improve both the swelling and the pain. Something to check out with the PT, for sure.
Finally, I've had problems with "rebound swelling," which happens when I've been wrapped too tightly. For some of us lower compression is less aggravating than higher compression, which can cause the lymph system to react by introducing more fluid into the area. Worth experimenting with, perhaps--just try wrapping less tightly and see if her arm responds better. Doesn't work for everyone, but when it does it indicates we're "compression sensitive."
As for whether the shoulder inflammation is causing more blockages, it's more likely that the inflammation is triggering her body to send in more lymph fluid. Any pain or injury causes our bodies to rush lymph fluid to the site so that any "bad actors" can be carried away to the lymph nodes and destroyed. So, yes, the inflammation could be causing the lymphedema to be harder to manage, but not because of new blockages.
Give your mom a hug for me. Hugs and prayers for both you amazing women!
Binney -
Emilylaughed, just echoing some of what the others have said. If the wrapping doesn't seem to be doing any good, and especially given how miserable she is, I'd give her a break from it.
I was told: hydration is important, light exercise is great, even just walking if she can manage it.
Your mom's story sounds a bit like mine in that I was in the midst of wrapping last winter while undergoing radiation, and finally the skin in the radiated area under my arm was so irritated that I had to stop wrapping; it was just too painful. I spoke to the head of the LE service, and she told me that it was more important to finish the radiation and let the area heal at that point, that we could always play catchup with the LE therapy. So it might be worth trying to get your mom's pain under control; the LE won't get much worse if you discontinue therapy for a while. After I'd healed from rads, it turned out that the lymphedema hadn't gotten worse in the intervening time when I wasn't wrapping (maybe 6 weeks?). So at that point I went directly to a sleeve and glove.
Good luck; I hope your mom feels better soon!
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Really and truly, bless you all. Each story that I read her that echoes some truth from someone else's experience is this flicker of light in what is continuing to be just a really dark place. The cancer never got her down this much. But the pain in her arm is enough that I just want to find her some kind of relief.
She's been trying to walk around, but it's so incredibly humid in the area that she can't handle going outside (and I don't blame her. I don't want her out there either). She's trying to do things in the kitchen and around the house, but everything is so hard when she's wrapped down to her individual fingers. Even feeding the dog is a terrible struggle and she winds up frustrated and annoyed and near tears because she just can't seem to do anything. She wants to exercise her arm, but the most that I can get her to do is flex her fingers without her going into bouts of talking about how much it's hurting.
I've been big on hydration with her. It's the one thing I seem to be winning that battle. I'm glad that was a good choice.
(That's been one thing I've done all along. Even when any part of this journey has seemed like it was spiraling out of control, I could always fill her water glass and tell her to drink.)
Tomorrow I'm going to the LE therapist to talk to them now that we have a diagnosis on her shoulder and to understand the preferred course of treatment and the level of priority on taking care of the different parts of this process. I'll talk to them about water therapy, too. I don't know how my mom's going to feel about it, but I would imagine that the water could be one place that she actually feels like herself again. Plus, she used to love swimming when she was young, so maybe just having that sensation for however brief of a time could be a good influence.
Binney, thanks for your explanation about the lymph fluid/inflammation. At least there is a reason that one is causing the other. It's so discouraging to go through these cycles, and even worse when nothing you're doing seems to get her any kind of relief.
She's taking her pain pill and looks like she's about to start resting comfortably enough for the night. I'll take it. At some point something is going to have to give.
All of this stinks. I'm sorry you've all experienced it, and wish you all the very, very best.
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I couldn't cope with the finger wrapping and ended up getting a custom glove that I could wear when my arm was wrapped. It made an enormous difference, and I wore the glove during the time when I couldn't wrap my arm. So that's something to consider, too. It was about $100 and worth every penny, if that's an option.
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If it's something that works, I think it could be $100 well spent. With the exception when it comes to thousands for a pump, I'm more than happy to toss money into solutions.
She has two sleeves and two fingerless gloves right now, and we're working on getting a night sleeve, too. But the more options on the table (insurance-covered or not) the better...
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One more question: We just noticed two tiny bumps right around the area that everyone's been working. This is the area under her mastectomy, where she's got a lot of swelling right now. I think they are likely caused by irritation from all of the lotion and massage and general disrupt to the area, but cellulitis doesn't start like that, right—That's something that's more of a red rash? I don't think they're cancer concerns, but we'll clearly be keeping an eye on them. They weren't there yesterday. She fell asleep, and now I'm working on not consulting google...so I figured I'd pose the question here.
It's quite honestly always something.
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Emily, here's information about cellulitis so you can be vigilant about it:
http://www.stepup-speakout.org/Emergencies_and_Med...
Good idea to stay away from Google with this! Hang in there, and please keep us posted.
Gentle hugs,
Binney -
I can understand your frustration. I did every single thing my PT told me to, with no luck. I have the automatic pump thing, too. I don't think there's a magic formula, or one that works consistently. I did read some new ideas in this thread - not wrapping high. I think that it takes a long while when LE acts up during treatment for it to calm down, or to react to things more typically. It's my last guess based on my arm, which is just sort of stable, not normal.
One thing I'm not sure I saw, is to see if she can sleep with her arm elevated - wrapped or no
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So. It's been a bit of time, but we got the news last week that her swelling is actually due to cancer, not just lymphedema. She started getting small red bumps that were finally biopsied, resulting in a positive screen for cancer. Her disease is slow and degenerative, but at the moment it is feeling fast. She has swelling all through her body—her trunk, around her organs and lungs, and it started today in one of her legs. (The leg isn't too bad yet.)
I'm sitting beside her as she finally sleeps, listening to her breathe and wheeze and wishing that things were somehow different than they are. At least we have our answer as to why the swelling wouldn't go down; it turns out it was cancer and not just lymph fluid that keep multiplying.
I thought that cancer tended to make people thinner, but with my mom it is plumping her back up. All of the swelling is causing stress on her organs, and it's all gotten very, very complicated.
She's working on being enrolled in a clinical trial for an oral chemo and new hormone that should work together to give her some more time. Beyond that, we might try a few rounds of taxol (she was on taxotere already, so that might not work as effectively as they would like). The doctors insist that she still has life left in her. But not knowing what to do to make her more comfortable or to make this easier or to fix her is infuriating and heartbreaking.
Anyhow. Just logging in to update with sad news. Thank you all for your continued support. I'm going to allow her to sleep, but continue pondering if I should wake her to get her to a hospital. I just can't stand considering waking her when she's finally sleeping after an uncomfortable few days of her not sleeping.
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I saw this in the "active threads" and just wanted to say I'm so sorry about these developments.
Why do you think you should wake her to take her to the hospital? Has her breathing changed, or...?
Do you have some support as well? Brothers, sisters, husband, children? I know how hard it is to take care of an ailing parent, and how helpless you can feel...
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Emily, I'm so sorry to hear how hard this is all becoming (but really glad the doctors are feeling there are some options still). Also really glad she's finally sleeping. I hope she'll have a really good rest. There is nothing quite like sleep!
Are you getting any yourself? Wish I were close enough to stop by, share a cup of tea and some tears and hugs--and maybe a laugh or two. Please do take care of YOU.
Gentle hugs,
Binney -
Thanks, ladies.
I've got my dad, her husband, trying to help, but he's doing a fine job of trying to ignore what's actually going on. My younger brother is the same. They are both wonderful people, but not the best support. That said, I am enrolled in a yoga teacher training right now, and that's been really useful. We've spent a lot of time on philosophy and it is helping me put all of these new feelings into place. It's also given me a family of gorgeous women who are the most supportive friends I have ever had.
Since my first post she woke up, ate some dinner, we re-wrapped her arm, and she has a bit more color. She's starting to snooze again, and we're watching the gymnastics competition, so I'm just taking in each moment as they come. Eating is rough because she's got such a full feeling all the time.
Her breathing is changing all the time. Right now, she has one lung that's been radiated twice that we also did a pleuradesis on about a year ago. The other lung has the start of what is probably a cancer-filled pleural effusion. Together with the trunk swelling, it's causing extra compression on her lungs. She can breathe, she just gets short of breath, wheezes from time to time, and does abdominal breath when she's sleeping. There was some rattling this afternoon—first time I heard that—but it slowly faded away. So it could have just been the way she was positioned.
Just so anxious for the treatment to start. It might be a week and a half or two weeks, but I'm hoping it happens faster than that. She might be getting a drain for her breathing issues in the meantime; that's why i was wondering if we should go to the hospital. She saw her PCP on Friday who recommended the drain but through a doctor, not a tech. I agree. But I think the drain is necessary pretty soon, and we just don't have an appointment yet. I don't think there's going to be a tech who can install it on a Sunday night, either, but at least she would be somewhere they are monitoring her. Now that she woke up, I feel less like I might need to make that happen right now. We're getting all of the previous treatments out of her system, so nothing is fighting anything in the meantime--which just feels so wrong.
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I should also mention: she got the flexitouch pump and it was working WONDERS on her arm. But then we had to stop using it because she was diagnosed with chronic cancer--and the depth of that massage can push cancer cells into other organs at a faster rate, so it's off the table. But had this only been lymphedema, that would have worked wonders!
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How are things going Emily....?
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Things have been rough through August.
My mom was diagnosed with a recurrence a few weeks ago. It's not a large tumor, it's lots of small metastasis popping up all over her skin and in the pleural lining of her lung. She's had a pleurex installed and she's breathing a lot better than she was before. She got home from her hospital stay and her arm, which had been wrapped for the 6 nights she was in the hospital, opened up, so we had to deal with healing that. But now we are waiting for chemo to start next week.
The doctor had originally wanted to get her enrolled in a clinical trial for a new oral chemo, but she is unable to go through the testing necessary to be enrolled—And the cancer seems to be a bit more aggressive than we'd hoped.
Right now, she's really tired, sleeping a lot, and feeling uncomfortable. Nothing is really going to help until we can start fighting the disease. The oncologist was encouraging about the treatment, but we're increasingly anxious about it... Mostly because without doing anything, the cancer is visible on the skin and just keeps growing. It's gone from about 15 bumps along her scar to more than I can count wrapping the whole way around her body.
She doesn't have any tumors in any other organs, so no radiation, no surgery on the table; just a systemic approach to fending off the beast a bit longer. Maybe (hopefully, I pray) a lot longer).
I didn't think that lymphedema would lead to this.
Thank you all for your support through this. We're coming up on 4 years since the first diagnosis. I'd always hoped for 5. Not my will, though. Thy will. And it will be done. I just hope she doesn't suffer.
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Emilylaughed, joining my prayers to yours for a great response to treatment and a backing off on the suffering. God is good.
Gentle hugs,
Binney -
Thinking of you Emily and your mom tonight.
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Thanks, Ispy, for bringing Emilylaughed to the top again. I too am thinking of both you and your mom. Hoping the diabetes is stable and the halavan kicking out the bad guys.
Hugs, prayers,
Binney -
hi there,
I had my mastectomy only a month ago, Sept 9, and I now have a lump under my arm, not in pit area, but in surgical site of Lymph node removal. I'm trying massage and turmeric for swelling and seems to work very well. Turmeric is also a natural pain reliever. I haven't asked Dr. yet what it is, but did research on several cancer sites. Chemo starts next week, so I'll ask then, but turmeric seems to be helping. I use capsule from GNC, but it is a spice you can get in grocery store. Your mom can try this, and see if it helps.Its all natural, so can't hurt.
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Kooltchr-
Thanks for sharing your tip! Hopefully it's helpful for others as well.
The Mods
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When swelling provrrsses after staring with compression garments, it does not mean (for ALL) that higher le el of compression. Some of us are very sensitive to compression levels and need lower compression while the same or higher levels will cause swelling. I happen to be one of those - I have to havs low level compression to prevent major swelling.
I am fortunate to have my LET guy that has been 'challenged' by me. Not only do I have compressing level issues but also syndactly (somewhat webbed fingers) which makes it impossible for OTS gloves to be wworn without the webbing being cut causing open/painful sores. He did finally get my custom gloves measurements figured out. My point is only - swelling at one level does not automatically mean that a higher level is the way to go - lighter may be the answer.
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Kicks and kootlchr it turned out that Emilylaughed's mom's cancer had returned, sadly (read through the whole thread). So the swelling was due to the cancer returning, not just lymphedema. I don't think the tips on swelling reduction are going to be helpful to her.
Emily I am still thinking of you and your mom and sending loving and healing thoughts.
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Emily, does your mom have night garments (JoviPak or Solaris)? They support swollen tissue comfortably, and many women with Stage IV cancer-caused swelling find real relief from them. That isn't to say the swelling is necessarily reduced, but the support eases the discomfort and may help prevent further swelling. A fitter can call Solaris and request a rush order when pain is disabling.
Keeping you in my thoughts and prayers,
Binney -
Hi everyone—
Thank you so much for checking in.
My mom is actually beginning to turn the bend and has been getting better. It's a slow process, but I the warrior who's fought for the last 4 years is coming back.
The chemo seems to be working; She's had some odd reactions (her sugar will drop, her blood pressure will rise), but for the most part, she's stable. Her tumor markers are falling, and the swelling is slowly reducing. The upper part of her arm is now supple, and the the fingers, hand and lower arm have all reduced; they aren't better yet, but it's slow steps in the right direction.
She goes for her third chemo infusion on Wednesday and if all goes well, we're expecting the Oncologist to sign off on use of the flexitouch. Once cancer begins to be controlled, they say that it's safe to move the lymph around, and we may be able to reduce some of the swelling by resuming some massage. We want to make sure that's something her doctor's agree with, but for the most part, it seems like the jury is out as to if it's dangerous or not.
We've had her wrapped pretty much constantly for the last 2 months and she's tolerating it so much better than she had been. I don't think it was lymphedema, I think it was lymphedema with cancer cells that made the past 2 months so miserable.
We're hopeful right now that the chemo will continue to work and maybe she can regain at least a little bit of motion in her affected side.
She does have a number of sleeves; light compression, tight compression, night garments, velcro garments—We really did try everything—but the gold standard—4 ace bandage wraps, beginning with fingers and going the whole way up the arm—are the only thing that are doing the trick right now.
After a very trying August and September, October is proving to be a better month by far.
Love to you all!
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Good news is such a treat--thanks so much, Emilylaughed, for the update. Give your mom a big hug for all of us. Can she hear all the cheers coming from here?
Gentle hugs,
Binney
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