Going through cancer treatment – surgery, chemotherapy and radiation – is a challenge in and of itself. What is often not known upfront are some of the side effects that accompany these treatments. Preparing ahead of time can help you create coping strategies and reduce the stress.
1. Lymphedema – this can happen after node dissection – either upper body or lower body. Once lymph nodes are removed, the lymph transit system is impaired causing a backlog of fluid which creates uncomfortable swelling. Taking precautions to reduce your risk of getting lymphedema are critical as there is no cure – only management.
2. Early Menopause – this can be triggered by chemotherapy. For some, regular periods come back, but for most, they do not. Since hormone replacement therapy is not advised for breast cancer patients, finding suitable herbal solutions can help. Also, look for wicking clothing – wicking nightwear and daywear – to alleviate some of the discomfort of sweating with the accompanying chill afterwards.
3. Fatigue – exercise is the antidote. As strange as it may sound, exercising will help you increase oxygen uptake, increase blood flow, reduce your risk of lymphedema and elevate self-esteem. Something as simple as a brisk walk. Or, join an exercise class with a group that understands your cancer needs – Healthy-Steps. Find a buddy to join you, especially for the days you don’t feel like getting out there.
You will get through this time much easier with some thought to coping with cancer ahead of time.
The issue of lymphedema as a risk resulting from cancer surgery is still not always discussed. Since my cancer diagnosis in 1990, you would think this would have improved. It has to a small degree, but still there is much that is not shared.
One of these concerns is the risk of lymphedema due to the pressurization of the plane cabin when flying. Since winter heralds flocks of snowbirds and those of us tired of snow and sleet to warmer climates, I wanted to make sure you were aware and knew what to do.
Please invest in a lower compression (preventive) lymphedema sleeve. Wear it on the flight and make sure you also get a gauntlet (glove) with it. Some lymphedema sleeves have the gauntlet as part of the garment. Not only will the sleeve moderate the pressure on your arm, but will also remind you to be mindful when lifting your luggage as heavy lifting is also a risk factor.
Prevention is key. Once you are diagnosed with lymphedema, it will be a lifelong commitment of maintenance. Better to prevent if at all possible – at least reduce the risk by being aware.
These two words are not always associated together when wearing a lymphedema sleeve as they are normally flesh toned to blend in rather than stand out.
Some manufacturers have come to realize that some women want to make a fashion statement – or just a statement. Now you can see lymphedema sleeves in solid colors and even fancier ones with patterns to suit your outfit, mood or occasion.
One manufacturer has designed sleeves that are lighter weight but still have the same compression, are made of wicking fabric for summer or hot weather wear, and come in many fabulous patterns.
If you already have lymphedema, you will know what I am speaking about. You might as well make the best of a now lifelong management plan and have some fun. Enjoy exploring new options.
Having just returned from Hawaii, I want to share the issues surrounding the care needed to reduce the risk of lymphedema when travelling by air.
If you have had breast cancer, whether recent or a long time ago, you may not be aware that it is wise to wear a prevention compression sleeve when travelling by air. Here is an excerpt from a position paper ‘Air Travel and Lymphedema’ distributed by The National Lymphedema Network.
‘The cabin pressure that is experienced during air flight is less than the atmospheric pressure on the ground. During flight, cabin pressure decreases from sea level to the low air pressure found at between 6,000 and 8,000 feet above sea level. The decreased pressure within the plane’s cabin may give rise to increased swelling in a lymphedematous limb as tissue pressures are physiologically altered. (1; 2) Changes in fluid production in the tissues occur when the external pressures exerted on the limb are changed. (3) Diminished pressure in the airplane cabin will result in a decrease in the fluid moved in to the lymphatic system. The fluid will remain in the extracellular spaces and an exacerbation of lymphedema may result. (4) The use of the compression garments will provide external pressure on the extremity to adequately support favorable resorption and decrease the potential for fluid accumulation in the tissue. (5) The use of compression may prevent worsening of pre-existing lymphedema and is recommended for those with lymphedema during air travel. (6) Compression bandages will potentially increase the interstitial tissue pressure and enhance the muscle pump in the lymphedematous extremity. The beneficial outcomes are two-fold. First, resorption of fluid at the capillary level is enhanced due to the compression. Second, the garment or bandages stimulate the lymphatic system, via the muscle pump, and uptake of extracellular fluid increases, helping to prevent an exacerbation of lymphedema.’
Wearing the compression sleeve not only supports your arm while in the air, it serves as a physical reminder to take care when lifting and handling luggage. The compression sleeve also alerts others to your situation and many offer help with the heavy lifting.
It pays to be careful and take precautions to reduce the risk of getting lymphedema. Once you have lymphedema, it is a chronic issue which you will need to manage for life.
Lymphedema being a lifetime side effect of cancer treatment means wearing a compression sleeve daily and also nightly for some depending on the severity of the condition.
The usual compression sleeve comes in fleshtones to make the sleeve less obvious or a sophisticated black. More recently, a fashion compression sleeve has been designed to add a lighthearted feel to a serious condition. These sleeves add a chic option to everyday wear or special occasions. Or they are just fun!
The LympheDiva sleeves are lighter in weight without losing compression, have a smooth surface so sleeves on tops don’t ride up, and are more comfortable in the elbow area as they don’t bind. Matching gauntlets round out the look.
Once diagnosed with lymphedema a patient must deal with the condition for life. As a chronic ailment it requires constant care and maintenance to ensure a comfortable and healthy lifestyle. The condition is caused by radiation therapy and cancer treatments which affect the lymph nodes in our body. It is most common in breast cancer survivors but also has a high degree of incidence with other forms of cancer. In forms of cancer other than breast cancer the lymphedema may be confined to the lower extremities.
Arm lymphedema is prevalent among breast cancer survivors because of the localized damage done to the lymph nodes during breast cancer treatments and surgery. When the lymphatic system is damaged in this way fluid flow in the body is restricted or blocked. Once this occurs it is irreversible and must be managed for life. The best way to avoid the problem of lymphedema is to learn how to reduce the risk beforehand (see earlier posts for tips). Early diagnosis can also help in preventing the condition from becoming serious enough to affect daily life.
I keep hearing this and it makes me upset. The issue of not knowing that moving your arm and shoulder – doing the exercises – as soon as the drain is out reduces the risk of getting lymphedema as well as frozen shoulder. Most hospitals will advise you of exercise for lymphedema but some do not or the message is not heard when you are still in shock.
Here are a few exercises you can do:
Walking up the wall – standing facing the wall, walk your fingers up the wall and extend the arm as far as you can without pain.
Arm circles – you can do these both standing and leaning over. These arm circles help the flow of lymph fluid and keep the shoulder flexible.
Head tilts – a) chin to chest and up to upright; b) tilt ear to shoulder, and c) head roll – make a smile on your chest with your chin making sure not to take the head back. These movements open up the lymph system to drain the lymph fluid.
These are just a few of the exercises, but they are so important to do daily. Look for exercise classes in your area that understand lymphedema and the issues around breast cancer. The Healthy-Steps™ program (formerly known as The Lebed Method) is excellent if there is one in your area.
Since I’m due to travel shortly, the thought of lymphedema prevention and protection has crossed my mind. This is an area that people often overlook – feel they are safe and don’t need to worry. Wrong. The air pressure in the aircraft cabin can affect the lymph drainage in your arm, especially if you have had node dissection for breast cancer.
Wearing a lower compression lymphedema sleeve reduces your risk of getting lymphedema during travel. I found the one with a gauntlet (or glove) attached easier to manage rather than having two pieces. It is easy to slip the glove part off when washing your hands.
Also, having the lymphedema sleeve on is a great reminder to be careful when lifting your luggage, especially lifting heavy luggage. The recommended weight for lifting is 15 pounds. Get help if you need it. Most people are willing to be of assistance.
Lymphedema is a swelling of the arm and/or leg after surgery. Breast cancer and prostate cancer are the two most likely causes. Once you have lymphedema, it is a matter of managing the symptoms as there is no cure. I have talked about ways to reduce your risk, but once you have lymphedema, it is a matter of adapting it into your lifestyle.
One area will be the wearing of a lymphedema sleeve for arm lymphedema or a compression bra and/or camisole for torso lymphedema. You will need to be fitted properly by a trained lymphedema specialist who will diagnose your condition, provide initial manual lymphatic massage and bandaging to bring the arm or torso to a stable condition. They will then prescibe the proper tension and sizing for the compression garment. For some, you will be able to claim this garment on your health insurance.
There are also options for special arm lymphedema sleeves for nighttime use to eliminate the need for bandaging.
As you get familiar with your options, life will move on and you will incorporate these garments into your lifestyle.