Study suggests some precautions in mastecomy arm are "myths"?

tessu · January 2017

Lymphedema Precautions: Time to Abandon Old Practices?

HEY --- Everybody please just scroll down to KIRA's comment below. She is an LE expert and says this "study" is NOT VALID. I'm very sorry if I misled anybody by posting this. The title includes the question mark because the linked article spoke against what I've read before about LE. So SCROLL DOWN AND READ WHAT KIRA WROTE!!

This overview suggests that there is no clear evidence that blood pressure measurements or blood draws on the mastectomy side arm increases the risk of developing lymphedema, or that wearing compression sleeves during flights might prevent LE from developing. Only obesity and mastectomy-side arm infections have been clearly shown to increase the risk of developing LE.

I already have (luckily now mild) lymphedema in my surgery-side arm. I have learned to live with it, but if I could have prevented it, I would have. (In my case, it just happened --- I did not have blood draws or blood pressures on that side.) So I'm not sure that even with the info in this study, would I recommend to a new post-op bc sister to "go ahead and allow blood draws and blood pressure measures", if the other arm is healthy and can be used for things like that.

hugz4u · January 2017

Tessu. Haven't looked at the link you gave but I wonder if it's the one we talked about here before. If it is then we figured it was a faulty study. Meanwhile noooooobody is coming near my arm with a bp cuff or needle.

We were asking in the grrr thread if you knew anything about a special type of "cupping" machine for Le in Finland. Maybe you saw the post and replied.

Nice to hear from our far away sister.

kira66715 · January 2017

ARGHH: this is making the rounds and has no evidence to support it--and it's based on an editorial that took a narrow conclusion from an observational study and made a sweeping, and unsupported conclusion, but now women will have to fight against the "evidence" that it's safe to intentionally traumatize their at risk arms without regard to triggering lymphedema

That editorial took a modest conclusion where the mass general group measured just the arms--not hands/breasts/axilla of breast cancer patients and asked it they had at risk exposures, and very few had, and in the minority that remembered they had an IV or blood pressure taken on the at risk arm, didn't find >10% swelling. They concluded that "the jury is still out"--but more study is needed. (the quote is from their article in Pathways a Canadian Lymphedema publication.)

The editorial used lousy data and old articles and made a sweeping conclusion that blood pressure should always be taken without regard to the at risk arm, and IV's were likely not an issue.

This letter to the editor expands on the fallacies in their logic: Do No Harm: Lymphedema Risk Reduction Behaviors

I've asked the major lymphedema groups to respond to this dangerous conclusion as a blood pressure can be a single careful measurement, or an automatic high pressure cuff, and a blood draw is very different from an IV that can cause an infection and inflammation.

In the next few days, LE&RN and the NLN should be coming out with rebuttals and there will be more letters to the editors.

I queried the members of LANA about it and one wise member responded: "why the rush to injure at risk limbs?"

Why indeed.

The article was summarized in the NEJM highlights as debunking risk reduction behaviors.

Here is a link to the Lymphedemablog about it as well:

http://www.lymphedemablog.com/2016/04/06/debunking...

Kicks · January 2017

Well - I don't 'buy' that so called 'research/study' as absolute.

I was not obese (well within normal weight for my height and age), never been obese, no infections in arm, no BPs or blood draws. No flying, nothing supposedly associated with LE developing that I know of in the 9 weeks post UMX (6 weeks into 12 weekly Taxol) when my LE decided to 'show up'.

I am not about to allow anyone to use my LE arm for BPs or draws just because they 'want to' instead of using other arm. Not worth taking a chance of aggravating my LE for no reason. Not worth taking even a 1 in a thousand chance of allowing activities to be done on my LE arm and possibly increasing issues - definately even more not worth allowing if LE is not already present. It's just so simple - just always use other arm and no possible problem. In other words, "If it ain't broke - don't take a chance on breaking it".

I have only run into on RN that tried to insist on using my LE arm for a BP. He was the Intake RN for an Ortho appt I had and issisted the he had his office set up so that only right arm (my LE arm) had to be used for BP. 'Words' were exchanged and as I was opening the door to leave his office, his Supervisor was coming in. He did do my left arm and as I walked out - she stayed to 'talk'. When I went to the next Ortho appt , I said I would not see that RN and was told "He's no longer employed here."

tessu · February 2017

Kira THANK YOU for the clarification! I'm sorry if my posting the link misled anybody, but very happy that you saw it and responded, or I might have given in the next time the "vampires" wanted to stick me on my LE side. THANK YOU

cliff · February 2017

I warn everyone off my LE arm, my surgeon said if I let anyone even take a blood pressure on that one, she would sew the old boob back on.

pupmom · February 2017

Call me old fashioned, but I choose to listen to and follow my doctor's advice.

Study suggests some precautions in mastecomy arm are "myths"?

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