Q. I definitely want to avoid lymphedema. Is there anything I can do to ward it off, or is lymphedema totally random?
A. The very best thing you can do to help prevent lymphedema is to make sure you get full range of motion back in your arm, whether after surgery or radiation. Favoring the arm on your affected side, hunching your shoulder protectively, being too stiff to stretch your arm up over your head and around towards your back–these are all things that will make it easier for lymphedema to gain a foothold.
I have a friend who’s a physical therapist specializing in lymphedema treatment. In fact, we became close as she gave me daily massages to relieve my own swollen arm. (Just as getting a tummy tuck is the silver lining of a tram flap reconstruction, a daily massage is the big plus of having lymphedema!)
This friend says that women who’ve had surgery, particularly a mastectomy with lymph node removal (even if just a single node) need physical therapy. It shouldn’t be one of those “Well, it might be nice” kind of treatments; it’s critical in preventing lymphedema and a host of other issues, including a painful condition known as frozen shoulder. So step #1, if you feel your treatment makes you a lymphedema candidate, is to schedule physical therapy as soon as possible after your surgery. Ask for someone who specializes in breast surgery patients; that person will no doubt understand lymphedema, and will gear your therapy towards its prevention.
Q. I’ve heard all kinds of other advice, like don’t lift anything, don’t get your blood pressure or bloodwork done in the arm on your affected side… even don’t garden without gloves! Is this all true?
A. Lymphedema has been a “forgotten” side effect of breast cancer, not getting nearly the attention that, say, hair loss or the fatigue of radiation has gotten. Therefore, as it gradually gets more attention, some of the classic advice about its prevention is being questioned. For instance, studies on women with double mastectomies show that having blood pressure taken, or blood drawn doesn’t seem to increase the risk of lymphedema, even though for years we’ve been told to use our non-affected arm for these procedures. So, what’s the story? The jury’s still out. In which case, why not play it safe? It’s easy enough to hold out the “right” arm when the nurse gets out the blood pressure cuff.