Monday, September 20, 2010

If your arm swells after mastectomy


It’s called lymphedema…where the big lymph circulatory system that hydrates and clears waste from cells gets damaged or infected and spews out lymph fluid. This can happen if the lymph nodes are removed or disturbed in breast cancer surgery.

Some figures put it at up to 70% of cases. Usually if it develops, you will notice a weird feeling of fullness or pins and needles in your arm within two years, but it can appear decades later.

A study in Spain showed that early physical therapy (scar management and lymph drainage massage) can cut that to as low as 7% of cases. Just educating women on when to seek help can cut lasting problems to 25% of cases, in this study, anyhow.

Gwen White, PT, and Jeannie Burt wrote a good book on this called Lymphedema: A Breast Cancer’s Patient’s Guide to Prevention and Healing.

Often lymphedema is identified with tight compression sleeves or cumbersome bandaging systems, but White says at Kaiser Permanente, Portland OR, where she works, this is only needed by 10% of women.

Breast surgery patients are urged to avoid tight clothes or jewelry and infection in the area, say from a nick shaving.

Physical therapy can be a big preventive and help if it does develop. And it’s pleasant. Manual lymph drainage is light massage of the skin above the muscle to encourage the lymph to flow.

“We never massage harder than you would on a newborn baby’s head,” White says.

Often it’s so soothing patients fall asleep.

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