Increased since surgery

[japdip]

In June I had a scar revision from Mod.Rad.Mastectomy Oct.2002. Since that time I have had an increase in edema in the shoulder and back area. My incision was extended about 10 cm further with this surgery. This seems to have interferred with the previous lymphatic drainage ----- is this truly a possibility ??? I have had to eliminate the wearing of several mastectomy bra styles and have also had to change breast forms which has helped to some degree. Any other advice to improve this new situation ??? I'm certainly not sorry that I had the scar revision as there was an area of redundant skin and tissue that was becoming quite irritated to the point of discomfort when I put my arm down at my side. Any comments will be welcomed.

[CCF-RN,MSN-JS]

Dear japdip, I would think that it is possible for the latest surgery to have some interference with the lymph drainage, but without details of the extent of surgery, location of the extension of incision it's difficult to say for sure.  It is likewise difficult with the limited information to directly advise. I am assuming that your surgeon is aware of the swelling and there is no clinical problem (other than those noted above) that needs medical intervention?  Is this edema causing other symptoms such as pain or shortness of breath? If so re-evaluation should occur.  If the problem is strictly the edema, evaluation by a physical or occupational therapist or lymphedema specialist might help to give you additional suggestions.  For example, making sure to optimize the mobility of your upper body on the effected side without overdoing (which could lead to more edema).

For more comprehensive information about lymphedema prevention and treatment we have information on our Cleveland Clinic Website. Which is www.clevelandclinic.org once there, click on Health Information Center, then type in lymphedema.

[japdip]

The extension mentioned is posterior to the axillary region. Unfortunately my surgeon is not much of a believer in lymphedema (like many other physicians I have encountered) so we don't discuss it much. I feel fortunate to have a primary care doc who does believe. I have been through the MLD program offered by the Physical Therapy Dept. and routinely follow the massage and exercise program prescribed for me as well as wearing my compression sleeve as needed.I think I am doing all the "right" things but thanks for your comments and ideas. This is a wonderful forum and has been of great benefit to me on previous occasions. Thanks to all........