In Feb.2007 I had a lumpectomy for invasive ductal cancer and then a week later they removed all my lymphnodes on my right side. Now I have lymphodema. I am getting physical therapy. Will this ever go away?? My insurance only pays for 25 treatments per year. I am at 21. What will my options be when I can't get anymore treatments. I have not had a day without real pain for over a year now. Do I have more optionsSheil
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Q: What causes lymphodema after invasive ductal cancer
Answers (3)
8/ 7/08 6:29am
Shelia, lymph nodes help circulate the lymph fluid in your body. Removal of nodes or damage to them (for example if you had radiation following your lumpectomy) may lead to a build-up of lymph fluid in the body near where the nodes were. For breast cancer patients, this is most frequently in the arm on the cancer side. Be sure to tell your therapist that your benefits are running out. She should be able to teach you some self-massage and bandaging techniques you can do at home. You might also be able to space out your remaining sessions. Your tendency to lymphedema won't ever go away now that you have had it, but you may be able to get the swelling down enough that it doesn't hurt. At a year out from surgery, some of your pain might also be nerve and scar tissue damage, which will probably get better. Let your surgeon know what is going on. He or she may have some additional ideas about pain management or therapy.
8/ 7/08 7:26am
Sheila, the 1998 Federal Breast Reconstruction Law requires group insurors to cover all the costs of lymphedema if the patient has had a mastectomy. I know you had a lumpectomy, but it would be worth a try, bringing it up with both hospital personnel and your insurance company, to see if it could apply. I'm sorry for your troubles; insurance companies don't understand that lympnedema shouldn't be a physical therapy issue, like a sprained ankle; it should be part and parcel of cancer treatment. I ran into this same issue myself, and luckily my hospital was able to bill in a certain way that turned it from PT into something else, so insurance covered it. I'd press your hospital billing dept. and PT dept. to see if they could do something similar. Good luck - PJH
8/ 7/08 7:39pm
Sheila,
I understand your problem. I've battled lymphedema for the last 3 years. Here is a link to some FAQ to help you better understand what is is and what you can do to help prevent it. What I suggest is inquiring for a PT who specializes in lymphedema that can teach you the techniques of massaging the area to help the fluid flow out of your arm. It's a light "feathering" technique. You can also request a fitted compression sleeve - and if that does not help you canask your doctor to rx a pneumatic compression pump that will do the job. They are available through a durable medical supply company and your insurance should cover most if not all of the cost for it.
In addition to learning how to do it yourself you can also take a nerf football, put it under your arm, and squeeze or pump for 3 reps of 10 each. Yoga bands are also an excellent tool to help exercise your arm. As PJ mentioned, lymphedema is covered under the federal act if you had a mastectomy - but since you didn't I would talk with both your insurance and doctor to see about negotiating a discount rate. Many are willing to do that for women without insurance or ones who's insurance is limited such as yours. You may also qualify for health insurance under your state's Medicaid program or other health-coverage programs for low- and moderate-income individuals - so you might also want to try that.
I hope you can get some help and get the lymphedema under control! Good luck!
Angi
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