Posts Tagged ‘lymphedema

15
May
10

Rash Actions

A day or so after my last chemo treatment (May 4 or 5), I developed a rash on the back of both hands. This happened once before, I thought with the adriamyacin treatment, but since abraxane is essentially the same as the taxol, it probably was with the taxol.

Exactly the same as the previous time, it starts at the base of the thumb, and runs towards the wrist for up to an inch-and-a-half; follows the web of the thumb to the base of the ring finger, where it covers the knuckle; and spreads a little bit up the ring finger, a little towards the knuckle of the middle finger, and maybe even up the middle finger a little bit. It starts out bright red, with extremely shallow bumps that taper out as they get further away from the web towards the center of the back of the hand. It is not itchy, and only mildly painful topically; but it is extremely sensitive to water temperature, more than lukewarm being very painful.

This week it was clearing up after using Aveeno hand lotion regularly, and periodically soaking it in a paste made of Aveeno oatmeal bath soak.

Tuesday and Wednesday were beautiful days, sunny and warm, so I went out into the back yard and lay in my lounge chair in the spotty shade provided by the elm. It was a little cool in the shade, but you’re not supposed to have sustained sun exposure while on abraxane, so I snuggled under the quilt that Evelyn made for me (really, I’m going to post pictures, just having some minor logistic difficulties). I’m pretty sure that my hands were mostly under the quilt both days.

I noticed on Tuesday evening that my hands were swelling a little bit – I didn’t think too much of it, as minor fluid retention is one of the expected side-effects.

Wednesday morning, not only was my left hand quite swollen, but my ring finger was extremely swollen. Before going to my support group meeting, I showed Brian what was going on, and we decided the ring had to come off. We tried soap, lotion, oil, and icing to reduce the swelling, but that puppy was going nowhere. While I was at the meeting, he called our PCP to ask if they knew of any special techniques. When I returned home we tried her suggestion, which involves running a piece of string under the ring, then winding it around the finger. By pulling on the string as you try to pull the ring off, it should get the ring past the swollen spot. In my case, the finger was just too swollen, and although we could see some progress, it was incredibly painful.

At that point, I was getting seriously concerned about triggering lymphedema in the arm (swelling due to the lymph fluid not being able to get out of the arm – typically, when only the sentinel nodes for the breast have been removed (such as mine were), it’s not a high-risk concern, but the additional surgeries and the radiation increased my risk somewhat). I also started having a minor panic reaction at the feeling of claustrophobia of having something so tight on my finger.

So I made the painful decision that the ring needed to be cut off. We called a local jeweler who told us over the phone “Sure, we can do that”, but when we got there, fobbed us off with the excuse that their cutter was out for repair (actually, one person said it *needed* to be sent out for repair, another said it was, and we think they were both full of it). When I asked if they could help us find a jeweler who could cut it off they didn’t even bother to say “sorry” before they said “NO”. So we drove over to the mall and at the first store we found, they were very nice and concerned, and cut it off in less than a minute.

I asked to have it soldered together on a temporary basis, so that I can wear it on a chain – since the rash is a known side-effect of the abraxane, I don’t want to take any chances on having it re-sized and then discover that I have to have it cut off again.

The swelling is mostly gone now, although it took a couple days to show much result.

We pick up the ring tonight, and I’ll be very glad to have it back – until now, the only time I haven’t worn it since we were married was when I was having surgeries, and then it’s been on a chain around Brian’s neck.

29
Oct
08

October 29, 2008

I’ve been dilatory in posting – my apologies.

Radiation is just over a third done. I’ve had 12 treatments out of 33, and up until yesterday evening, I haven’t really had any side-effects. I started feeling a little bit itchy, and when I got ready for bed, I saw that I’d developed a mild “sunburn”. I told Brian that I had a modified trucker’s tan.

The radiation oncologist had me start using aloe vera gel right from the start, but I’d only been using it once a day, and now she wants me to use it twice a day. Based on the itch factor, I think I’m going to use it three times a day.

One of the potential side effects of having lymph nodes removed so near the arm is that you can develop lymphedema – the lymph fluid collects in your arm because it doesn’t have as clear a path to get back out. Lymph fluid carries proteins, foreign materials, and cell detritus through the lymph system and the lymph nodes filter out the detritus – the fluid then passes back into the blood (this is a very simplified layman’s description – please don’t sic the Accuracy Police on me!).

When just the sentinel nodes are removed (i.e., the first three lymph nodes that carry fluid out of the breast), the risk of developing lymphedema is very small. Radiation increases the chances of it occuring, so the radiation oncologist sends all her patients to consult with a physical therapist to learn how to prevent it, how to recognize the symptoms, and if necessary, to treat it. I checked with my favorite physical therapist, and sadly no-one in his office does lymphedema-related work, but he referred me to one of his colleagues who does. I met with her last week, and she was impressed at how well I’ve healed after all the surgeries, and at the range of motion I have. After teaching me some stretches to help with muscles that have tightened from the surgeries and thus potentially could raise my chances of getting lymphedema, she measured me for a compression sleeve. I asked why I needed a compression sleeve now, since I had no sign of lymphedema, and she said it needed to be fitted when I was a normal size, so that if I *do* get it, they don’t have to guess by measuring the unaffected arm. OK, so I’ll have a compression sleeve that I hope never to need.

Let’s see – I don’t really think there’s anything else to mention, since mostly I have very long days going to radiation, commuting to work, working, commuting home, and not much else. Tomorrow night I am going to my beading group, and we’re making earrings to donate as Christmas gifts for soldiers in Iraq – there’s a group we’re donating through, but I don’t have the details yet. BTW, as far as I know, the intent is earrings for *female* soldiers, although I suppose they could really be for whoever wants some.

Oh yeah – we’re having our annual Games Party on November 8 – 26th Annual! I’m looking forward to it, although I suspect I’ll want a nap that afternoon to make sure I’m up for Midnight Party ;-}




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