what feels like a tightened violin string...

[katarina777]

I have been asking for the purpose of advising women not to have their bloods drawn, and/or blood pressure taken on the side where they had a mastectomy.
Every response so far has been a guess. Since I only have one good vein in my right arm, and this is where I had the mastectomy, lab technicians have a hard time getting a vein on the left side. Sometimes I get stuck three times and then they end up on the other side anyway. So, this last time I withheld the information about not using my right arm, and the lab technician made the tourniquet so very tight that I immediately regretted my decision. sure enough, I developed this cord-like, tight string which goes starts under my arm and goes one third down my upper arm. (I had many lymph nodes removed.)
My question is twofold. What really is the purpose of advising about the blood drawing and BP? And my second question is what may have happened. Is this lymphadema, or a vein or a tendon or what else could it be. The skin is sore and this string like thing is very thin and very hard, but there is no infection or discoloration present, really, and very little swelling. much of the tissue under my arm feels otherwise like scar tissue. Should I be concerned? I asked my family doctor about this since I had to see her for something else, but she did not know what it was and also she did not know the reason for avoiding needles and BP cuffs on arm where you had the mastectomy. She felt maybe this advice was outdated? Nobody else I asked did anything but make wild guesses as well. i thought this may be of interest to others here as well. thank you in advance for reading my question.

[Rowena Santos, MD]

How are you? When the lymph nodes under the arm have been removed, a woman is at higher risk of lymphedema. Poor drainage of the lymphatic system may cause the affected arm to be more susceptible to infection and to be less sensitive to extreme temperatures.  In addition to swelling of the affected arm, the following are the most common symptoms of lymphedema: feeling of fullness or tightness in the affected arm, aching or pain in the affected arm, swelling in the hand, or weakness in the affected arm. Protection of the affected arm is very important after breast surgery. Persons with lymphedema should avoid injury and infection and should be aware of those activities that put too much pressure on the affected arm such as injections and blood tests.

Treatment for lymphedema depends on the severity and extent of the condition. If the condition persists, a visit to your specialist may be of help. I hope this helps. Take care and keep us posted.

[japdip]

The answer to your question is very simple and well known; I'm suprised that you had difficulty in getting it. When a mastectomy is done there is also removal of some # of lymph nodes to be tested for cancer invasion. Once the lymphatic flow is disturbed or comprimised there is the possibility of developing lymphedema. The no needle stick theory is that this might cause some inflammation although that is pretty far fetched with blood draws under sterile conditions. One should be cautious of cuts, scratches, etc. like when gardening an such. Cellulitis can develop under these conditions. The B/P thing is that the circulation is cut off to that arm and so is the flow of lymphatic fluid. There are more who don't believe in these theories than those who do but it's wise to take some precautions if you have had lymph nodes removed. I recently had hand surgery on the operative side and the surgeon didn't believe in either theory .. needed a tourniquet on the arm for the duration of the procedure. He did agree to put it below my elbow but still maintained that the theory has never been proven.

[katarina777]

Thank you very much for your responses. The people I asked guessed and I can do that as well, but I wanted a real answer. I am also concerned about this rope like thing which begins under my arm and goes half way, or more down to my elbow. I had all the lymph nodes removed because so many were affected, and not only the ones in the axilla. I had IBC. And that tourniquet really hurt, nothing like that little needle stick.

[Rowena Santos, MD]

How are you? Do you still feel the rope like tightening in your arm? I do hope it has improved since your last post. Take care and please do update us.

[katarina777]

Thank you for asking. No, it has not changed and is still the exact same.  It does not really hurt but it feels very weird and not normal and unfamiliar and you can see it externally how as well. It feels strange when you use a bar of soap while showering. Uncomfortable, not painful.

[Rowena Santos, MD]

Hi,
Better recovery occurs when lymphedema is discovered early, in your case, the feeling of tightness in the arm should be mentioned to your doctor. Lymphedema can be treated by physical methods and with medication. Physical methods include supporting the arm in a raised position, manual lymphatic drainage and cleaning the skin carefully to prevent infection. Here is a link that could be helpful: http://www.cancer.gov/cancertopics/pdq/supportivecare/lymphedema/Patient/page3
Take care and regards.

[harwood]

I had a left breast resection 4 weeks ago, and also have the stringy thing in my armpit working its way down to my elbow, in fact I now have 3 of them, with no answers from my doc's. I find it quite painful, and was hoping to find answers here. Keep us informed, and good luck.

[katarina777]

You too keep me posted. Then, it seems that Dr. Rowenta Santos thinks this is lymphedema. I had my surgery last December.

[harwood]

I've seen 3 docs and none of them have even suggested lymphedema, the symptoms dont even match those of lymphedema,  it almost feels like people arent listening to us!!

[katarina777]

My radiation oncologist called me today about something totally unrelated and then I asked her after that was taken care of, if I could ask her a question. I told her I had this tight string like cord in my arm originating  under my arm..... She responded by saying: "OH, I just had a patient who presented with the same problem and I sent her to physical therapy. Would you like me to write you a prescription for physical therapy?"

I told her yes, if this was what she thought was best, but also that I didn't know what this was and if I should be worried about this, and if this was Lymphedema. She did not answer my question and told me the physical therapist could tell me more about what it was.
So, I  told her that I just didn't know if this was a tendon, or a vein, or a muscle and if she thought it may be a tendon.

She said she thinks so, but that was all she offered. She said they would most likely call me on Monday and then bill my insurance.

So, i will keep you posted. yes, weird that nobody is answering to this, isn't it? Actally, one doctor on another forum said it was lymphedema related/ Specifically, he said it was the latter, when I suggested two options and in this case my second option was Lymphedema.

The website the doctor included her did not say anything about our symptoms.