A little extensive medical lesson for you:
Lymphedema is a potential side effect of breast cancer surgery and radiation therapy that can appear in some people during the months or even years after treatment ends.
LYMPH is a thin, clear fluid that circulates throughout the body to remove wastes, bacteria, and other substances from tissues. EDEMA is the buildup of excess fluid. So lymphedema occurs when too much lymph collects in any area of the body. If lymphedema develops in people who’ve been treated for breast cancer, it usually occurs in the arm and hand, but sometimes it affects the breast, underarm, chest, trunk, and/or back.
Why does lymphedema happen? As part of surgery, many people with breast cancer have at least two or three lymph nodes removed from under the arm (sentinel lymph node biopsy), [This is what I had done and according to the National Cancer Institute, anywhere from 5-17% of women who have SLNB develop lymphedema.] and sometimes many more nodes (axillary lymph node dissection). If the cancer has spread, it has most likely moved into to those underarm lymph nodes first because they drain lymph from the breast. Many people also need radiation therapy to the chest area and/or underarm. [Luckily I did NOT] Surgery and radiation can cut off or damage some of the nodes and vessels through which lymph moves. Over time, the flow of lymph can overwhelm the remaining pathways, resulting in a backup of fluid into the body’s tissues.
So what does that mean for me? I guess it means that I have a 5-17% chance that I could develop lymphedema sometime in the future (although most every site I researched emphasized the risk from SLND is very low) What are percentages for anyways? And what am I supposed to do about my 5-17% risk? It's almost comical how many percentages have been thrown at me the last couple weeks. Like I could ever keep them all straight and IF I develop any of the side effects of my treatments then isn't my personal percentage 100%. LOL Whatever, I guess!
However, back to lymphedema... I did find this quote. It is actually about a person who has more nodes removed than I did but in all my research, it doesn't ever come straight out and say anything about the sentinel lymph node dissection so this will have to do.
"Anybody who has had axillary lymph node dissection is at risk for life, so follow preventive methods closely at all times. No blood pressure measurement, no injections, and no blood drawn from the affected limb—ever." -Saskia Thiadens, R.N. is a nurse and the founder and executive director of the National Lymphedema Network (NLN), a non-profit organization providing education and guidance to health care professionals and women affected by lymphedema.
I'm not sure now whether it was the doctor or my reading that made me aware of that fact. I do remember having to ask several times to get a NO LIMB bracelet in the hospital after my surgery before anyone got it for me. So, I guess I will have to double check that fact that I should be avoiding those things with Panwalker. Knowing him though he'll tell me "you're young" and only had a little bit of cancer and "you"ll be fine". LOL.
But since I thought avoiding things in my right arm was my responsibility to ultimately avoid Lymphedema , I went on a search for a medical alert bracelet to wear. My searching brought me to this fun website called Fiddledee IDs. They supply medical alert tags and many options for wearing it. I just bought a very basic band to start with but I have big plans to make some fun bracelets to wear with it. I'm so excited! {I even added a touch of Spanish just in case we do make it to Colombia. So fun!}
Check them out at: Fiddledee IDs
OTHER Lymphedema Information:
Here's an article about the reason behind not having anything done to the affected arm:
No Blood Tests, Blood Pressure, I.V., or Injections in this Arm!
By Pat O'Connor, Lymphedema People Nov 1, 2004
Needles
Perhaps the foremost rationale for NOT allowing the use of needles in an arm with lymphedema is the threat of infection. Every break of the skin creates potential entry foci for bacteria. Because of the immunocompromised state of the arm any infection can and often does escalate quickly into cellulitis. These infections cause further damage to the lymphatics, thereby increasing the severity of the lymphedema.
Lymphorrhea (which is the fluid in the arm) is a protein-rich substance that provides excellent nutrition to any bacteria that might gain a foot hold in the arm. Once an infection has begun the excess fluid and any fibrosis of the arm tissue makes it tremendously more difficult to eradicate the bacteria.
Injection of Medicines
The doseage strength of any medicine injected into the arm will be diminished for two reasons. First, because of the fluid accumulation in the arm it is going to be immediately diluted. Following that, because of the impaired fluid outflow of the arm, the medicine will have a more difficult time reaching the remainder of the body system.
IV's
The first reason for not allowing an IV is simply the break in the skin - which would be a continous opening until the removal of the IV. Beyond that and even more important is the simple fact that lymphedema is caused by the inability of the arm to remove even the normal excess fluids of body dynamics. When you add the fluids that are present in the administration of an IV, you catastrophically overload the arm. It simply is totally unable to rid itself of that extra fluid thereby causing a substantial increase inswelling.
Blood Pressure Tests
The danger of having a blood pressure test on an at-risk arm or an arm affected by lymphedema is that the squeeezing involved can cause possible further damage to already fragile lymphatics and blood vessels. If this occurs, it would cause worsening of the lymphedema.
These are common sense approaches that any physician should be immediately aware of.
Here's a few of the early signs to look for:
Swelling in the arm or hand
Feeling of tightness, heaviness or fullness in the arm or hand
Feeling of tightness in the skin or a thickening of the skin
Pain or redness in the arm or hand
Tight fit of rings, watches or bracelets
Sleep problems
Here's other things to help reduce the chance as well:
1. Protect your skin.
2. Protect the arm and hand from extremes such as overuse, excessive pressure, or extremely hot or cold temperatures.
3. Work with a lymphedema specialist to develop a gentle exercise plan for strengthening the arm and upper body over time.
4. Lose weight if necessary.
5. Know the signs and symptoms of lymphedema and get help for them right away.
And some helpful links:
This site is really extensive:
This is an actual fact worksheet that is very helpful:
One last one just because I am an options girl. LOL
No comments:
Post a Comment