Mastectomy and compression arm-sleeve

[Krolik]

Hi,
It's been 2 weeks since mastectomy and removal of 9
lymph nodes. The adjacent hand is by 1/4 inches bigger than the
other one. I am getting contradictory advice about
wearing a compression arm-sleeve. Do I have to wear
it? If yes, then do I need to wear it at night? Is it
advised to start exercising the hand at this point? For the previous
2 weeks I was advised to minimize  moving the hand.
Could you please give me some direction?" Thank you.

[CCF-RN,MSN-rf]

Dear krolik:  Lymphedema is a relatively uncommon condition that can occur as a result of lymph node damage or removal (which often is done with a mastectomy).  Lymphedema used to be more common when the numbers of lymph nodes that were removed were in the 20's and 30's, rather than the 6-12 range that they usually are today.  While we cannot evaluate whether there is evidence of lymphedema without seeing you, it may be important to note that our hands are rarely the same size.  Usually one is larger than the other.  You might benefit from your surgeon or an oncologist to evaluate whether the hand is swollen from the procedure or whether it is really lymphedema.  If the concern is lymphedema, occupational therapists who specialize in lymphedema can make good recommendations in terms of what interventions (including compression sleeves) may be helpful.

[rkmsim]

I have lymphedema in my arm and hand following surgery for breast cancer in 1998.  I've found that exercise helps keep the swelling down.  I use weight machines at a local healthclub.  Also, swimming or just walking back and forth in a swimming pool while letting the water press against your arm is very good for reducing the swelling. I was told at the lymphedema clinic NOT to wear the compression sleeve at night.  However, they did recommend a REID sleeve which I got.  Fortunately, after about a year of vigorous therapy - manual lymphatic drainge (MLD) massage, swimming pool, weight lifting and the REID sleeve at night, I no longer need to wear a compression sleeve or the REID sleeve.  I do, however, wear the compression sleeve when flying.  I can't emphasize enough how much the exercise helps with lymphedema.  It helps prevent further development of scar tissue as well as increase the efficiency of the lymphatic system.  Hope this helps.

[japdip]

To put all your doubts and questions in the proper place ....... make an appointment as soon as possible with a Physical Therapist trained in the treatment of Lymphedema. You will be evaluated and the proper treatment will be started. This may be a combination of several things. You will be taught the proper massage tecnique and more than likely ordered some sort of compression garment .... sleeve, glove, etc. The longer you delay, the more difficult to treat. I went thru this and had excellent results. It's a bit of work on your part but then nothing comes without effort. Best of Luck .....

[Krolik]

I am very grateful to you for your detailed answer.

[rkmsim]

Glad I was of some help.  Lymphedema can be so frustrating and depressing because you feel like after everything you have gone through, you shouldn't have to deal with that too.  It takes time and constant management, but if caught early, you can keep it under control.