New News on Lymphedema

Lymphedema has long been known as a life long complication from breast cancer surgery.

I am not a doctor but here is my understanding of lymphedema: the lymph system is a second system in your body connecting hundreds of lymph nodes which help clean out your body and heal injuries or diseases. When you have surgery the lymph system is often impaired because it does not heal and reconnect after. If the lymph system is unconnected to the rest, you can end up with swollen body parts, or lymphedema.

After breast cancer if a bunch of nodes are removed under your arm as with an axillary node dissection, you can end up with problems. In previous decades when a radical mastectomy was routine treatment for breast cancer, lymphedema occurred regularly for patients. Now they skip start with the sentinel nodes which are assumed where breast cancer starts to spread and then only if they are positive, do you get an axillary node dissection.

What they told me is that if you have an axillary node dissection the chances were high of getting lymphedema. I was told that do not strain your arm, no shots or needle pricks, or blood pressure cuffs, no purse straps over your arm, no, no, no, no, no.... Basically baby that arm for the rest of your life. I do regular exercises at the gym but I do them at lower weights than my right so I don't strain it. Blah, blah, blah, blah....

So with me, I had one tiny positive node in the sentinel node so I had an axillary node dissection after my lumpectomy. Then I had chemo and radiation. Then I followed all directions and was fine, until I fell the following winter and used my left arm to break my fall. And voila, lymphedema (and no its never goes away).

But now there is new information on lymphedema. I got this from Barbara over at Let Life Happen where she wrote about "Debunking the Lymphedema Risk". There was a recent new study done on causes of lymphedema.

"The study found that chemotherapy, more advanced disease and greater than normal body weight significantly increased the risk of lymphedema for patients who had surgery of lymph nodes under their arms to assess the spread of cancer. Radiation therapy also strongly correlated with lymphedema for patients undergoing axillary node dissection (ALND), the more invasive form of axillary surgery.

"“Lymphedema rate was significantly lower among patients undergoing axillary surgery without these additional risk factors,” says study co-author Judy Boughey, M.D., FACS, professor of surgery and research chair, department of surgery at Mayo Clinic. “We must recognize that today, breast cancer is no longer a disease treated primarily through surgery, and many therapies impact the risk of this chronic condition. Risk factors appeared to be cumulative, affecting women in a step-like fashion.”

So this was my chronology with my stage II breast cancer: lumpectomy (June), axillary node dissection (July), chemotherapy (August through December, lumpectomy (December), radiation (late January through early March). I was normal body weight before breast cancer. After breast cancer about the same. My weight gain came later.... So I did not have advanced disease nor overweight but I did have chemotherapy and radiation.

Nevermind me, I just find it very interesting that the sole cause was not the surgery but the combination of surgery, radiation, and chemotherapy. 

An App for Lymphedema Self Care

I am on the fence on this one. At NYU, a bunch of really smart people have developed a prototype of an app for self-care for lymphedema. They have tried it on about 20 people. They realize that they used their app on patients who are highly educated and tech savvy. A great idea. Right?

Not. They realize their audience is skewed in one direction. But I think I could be put in that group myself of well educated and tech savvy but I am not going to jump on my phone or laptop at every twinge. Not happening.

I think I blogged about the idea of 'cool' apps for anyone over 30. Not so great. I like the idea of helping with self-care for patients but not necessarily an app. I think we need a new idea for this. The internet and technology do not solve everything.

Lymphedema and the lymph system

So as an extra gift with breast cancer, I have lymphedema in my left arm. I am very coordinated and fell on our icy front walk and landed on my hand. My arm swelled up and voila, I have lymphedema. I have a 'lovely', 'skin tone' sleeve that I get to wear sometimes. It even provides some sun protection so I get a tan line on my wrist.

So what is the lymph system? I had no idea until I fell that day. I sometimes try to find more information on the lymph system.

First of all what is lymph? That clear fluid that seeps out of blisters and cuts sometimes. Its the other system in your body like your blood system but it has white blood cells and cleans out the dirty cells.

The smart people at Dana Farber provided this nice picture and a more detailed description on their blog here.

So if you look at the picture in detail, you will see how it flows around your body. And its pretty much divided in four quadrants of the body: top right, top left, bottom right, bottom left. Lymph nodes are lymphatic coolers. But if some get taken out, a 'traffic jam' occurs and all that lymph fluid gets backed up in whatever part of your body is beyond the incisions.

In my case, they took a big scoop under my left arm that grabbed a whole bunch of nodes. So the little lymphs get stuck in my arm which swells and is permanently larger than my right, dominant hand.

A former co-worker of mine had a bad leg from something traumatic and walked with a lymph. He ended up in the hospital for six months with lymphedema in his leg. I have a friend who had lymphedema in her arm and also on her side and in her abdomen. With treatment, she is now a smaller size in her torso.

So this is a nice little education class for the day. Class dismissed.

One heck of a week

I haven't been blogging because I've been a little busy, to say the least. Yes I still have a cold. It keeps lingering which doesn't help anything. And it means I can't go to the gym and work off the stress.

During this week we have had all kinds of fun:

• The buyer of our old house's lender wanted documentation that doesn't exist. We had to jump through hoops to get a letter from the town on something that no one has ever asked for, ever. Our broker came through on this. But it cause a lot of stress, starting New Year's Eve.
• The buyer of our old house's broker is an idiot. They didn't understand there was any reason to do anything helpful, or have someone keep on top of things while they went out of the country for the holidays.
• The seller of our new house's broker is also an idiot. Although the seller was legally required to ensure that the house was maintained and snow removal was taken care of after they moved out a month ago, nothing was done. The broker blamed the seller for not making plans and then dumped it all on the seller's attorney to get it taken care of. I met her and I could tell she was more concerned with how she looked than actually touching anything. She never even tried to call a plow service, she made the attorney make the calls. And the attorney bitched about it at the closing.
  Because we had a storm last week which snowed and switched to rain and sat on the driveway untouched, it turned into a glacier that my husband spent hours salting, sanding, and chopping yesterday until a plow finally showed up. I told them we would go to the closing but not sign anything until we had proof the driveway was clear (so the movers could get into the driveway today). We were late to the closing because we needed to go see the plowed driveway ourselves.
• Finally, we took our cats to a cat sitter for the duration of the transition. One of our cats, Boots, got out some how. We found out yesterday morning that he has been missing since Wednesday afternoon. While my husband was shoveling snow yesterday, I was walking around near the cat sitter looking for him. I am going to head out this morning to go look for him in another neighborhood near by where there might have been a sighting. 

But finally we own a new house and are moving in today. The POD will be dropped off this morning by 10. The movers are coming between 8-830. Verizon is coming between 11-2 and the hutch we purchased will be delivered between 330-4. But I need to go find the cat.

Oh, my lymphedema arm is not happy with all this moving business. I might have actually carried things and am feeling it in my arm. And all my sleeves are packed so I have to wait until I can unpack to find one. but I have been doing my exercises which helps.

And my cold is still hanging in there. Yes I will go to the doctor if I am still sick on Monday.

Good things come to those who wait

Back in 2010, I blogged about wishful thinking for a cure for lymphedema and other things, like cancer. And now, (insert drum roll here), a study is going on in the UK on 'replumbing' lymph nodes after breast cancer surgery. Barbara Jacoby over at  Let Life Happen blogged about this.

So five years after first hearing about this surgery to reattach lymph nodes now there is a trial going on. This doesn't mean I can talk to my doctor about having this surgery any time soon, but I can see the progress.

The world of a patient is filled with hope and waiting. It is nice to see that progress is happening once in a while. We hear about all these breakthroughs but then it is rare to see them start to actually be rolled out. That is when good things come to those who wait.

We just sometimes get sick of waiting so long.

And I would like to point out that there is no way that I will undergo a five hour surgery under local and use my other arm to read a book or use an ipod during it. I will be fast asleep so I don't freak out. Yuck.

Lymphedema sleeve and all

Yesterday I had a (not so fun) back procedure. As my arm has been acting up, I wore my lymphedema sleeve on my left arm. I am going to the lymphedema clinic in another week or so and will keep wearing my sleeve.

But I digress. I got there and got checked in and changed into a lovely hospital gown and robe - they make them ugly so people don't steal them. The nurse took my vitals after getting me settled in a big comfy chair. Even though I was wearing my sleeve she asked if she could use my left arm for blood pressure. Really? But she did put the IV into my right arm without questions

Then when I got positioned on the table with my back (and the bright red underwear I wore on purpose) exposed for the procedure, they needed to hook up heart electrodes on my chest as well as oxygen in my nose, and blood pressure, O2 sensor, and start the IV on my left arm. A student nurse asked if all three could be done on one arm and the other nurse said yes.

The procedure went well. It should help with my back issues. It was painful to have but it should really be beneficial once it heals up. Before it, I could barely stand for ten minutes before my back started to hurt. This morning, I slept late and it didn't hurt at all until I walked downstairs to feed the cat.

I have a love-hate relationship with my sleeves. I really dislike wearing them all the time. It will start to annoy me when either the little silicone disks cause a rash on my arm or I start to get a tan line on my wrist. (Both have happened in the past.) In addition, its a reminder about cancer - sort of like wearing your heart on your sleeve, you wear a sleeve for your cancer.

Issue #937.2a that they never tell you about having breast cancer.

There are so many things they don't tell you about having breast cancer. Here's is another one. You may not be able to wear your wedding ring. Really. My cancer was on my left, I had a bad node that lead to a axillary node dissection, which lead to lymphedema issues.

I woke up in the middle of the night last night and noticed my left arm was puffy. This morning I spent some time and got my wedding and engagement rings off. Now the puffiness is subsiding. I have done some of the stupid lymphedema exercises. I will wear my sleeve today.

But my rings are on the pinky finger of my right hand. They feel like they might fall off. Damn. I want to wear them on the ring finger of my left hand and can't.

Cancer sneaks into your life in little ways. I wish they told us about all the issues before hand.

Poked and prodded

Yesterday I had a dermatology annual skin check. This is a real conversation:

"How long has this mole been two colored?"

"I have no idea, its on my butt and I can't see it."

We did get a snicker out of that one and she laughed at herself. But the mole is no longer as it has been scraped off. And its a little sore and its on my butt. So this will be a fun day.

I also was a little daring. I had a wart appear on my left arm. My left lymphedema arm. My left lymphedema arm which cannot have needles or pressure or cutting or anything. I thought I was going to be stuck with the damn thing for life.

But the dermatology NP thought that since burning it off wouldn't be a problem because its  surface thing. I thought another second or two and said fine, go for it.

Right now my arm feels fine. I may wear a sleeve for a day or two just in case. I usually do not wear a compression sleeve except when working out or flying.

Then for more fun and games, I am going back to the doctor this morning for another look at my toe to see if I need more antibiotics or not. The first thing they do is squish the part that hurts. Ow.

A very unsettling conversation

Yesterday, as part of my day to myself, I dragged my sorry a$$ to the gym. As part of my getting ready ritual, I pulled on my lymphedema sleeve. An older woman entered the previously empty locker room and asked me if it was a lymphedema sleeve. Often I just say it is a compression sleeve so as not to enter the 'what is lymphedema' conversation and get into my medical history with a virtual stranger.

She looked somewhat on edge. I told her it was a lymphedema sleeve. She said she had been diagnosed with breast cancer 28 years ago when she had a lumpectomy and radiation. Then she had a recurrence 7 years ago (I am pretty sure it was 7, it might have been 4) when she had a mastectomy and more treatment.

Three weeks ago she started to get swelling around her implant and around to her back. She had had an MRI and a CT scan to make sure it was not more cancer. It was lymphedema. I believe she said her doctor called it 'sectional lymphedema'.

She wondered how she could have gotten lymphedema at such a late date for no reason. I did remind her you can get it from a little cut or injury. She replied but it wasn't on her arm and just her torso on that side. I did suggest she call and get some treatment asap as it is important to get lymphedema under control as soon as possible. She said she was going to call her doctor back later in the day.

Then we both went our separate ways.

Later I started thinking.

First of all a recurrence over 20 years after the first diagnosis. Crap.

Second of all, lymphedema 28 years after the first diagnosis and 7 years after the second surgery. Double crap.

You start to get comfortable with a cancer diagnosis. And then whammy. You find out about late recurrences and it all becomes a little too close to home. Triple Crap.

That brief conversation gave me a lot of food for thought and was very unsettling.

Can we undo my surgery please?

When I had my breast cancer surgery the sentinel node was tested and came back with microscopic traces of cancer. It was then deemed necessary to have an Axillary Node Dissection where they take out a lot of lymph nodes in your arm pit to see the possibilities that the cancer has spread further in your body. Mine came back negative. But the damage was done.

When that many lymph nodes (20 in my case) are taken, the lymph system in your arm in permanently compromised and the risk of lymphedema is greatly increased. That would be my problem.

Now there is a new study (because the researchers needed to keep working), that says that if the sentinel node is positive, the better outcome for a patient is to have axillary node radiation instead of an axillary node dissection. There appears to be the same or lower risk of recurrence and the risk of lymphedema is substantially reduced.

This is clearly in the category of now they tell me. Damn. I have lymphedema which complicates my life - and has no cure.

I guess this is what research is all about - figuring out how to improve treatment so that they can prevent complications and reduce risks from previous treatment standards.

Well they scared the crap out of us

When women are diagnosed with breast cancer, they are brainwashed scared into thinking that they will get lymphedema and  end up with an arm the size of an elephants. If they have an axillary node dissection where a dozen or more lymph nodes are removed in the hunt for evil cancer cooties, they are given a list of rules for the rest of their life:

• do these stupid wall climbing exercises to make sure your arm doesn't swell up
• never allow anyone to take your blood pressure or stick any needles in that arm 
• never carry a shoulder bag or any bag on that arm that might compromise your circulation
• never lift anything heavy
• never injure your arm or fall on it.
• at any signs of swelling, contact your doctor.

And these are for the rest of your life.

Now they come out with a study which says "Breast Cancer Patients’ Fear of Developing Lymphedema Far Exceeds Risk". Well they scared the crap out of this with the 'rules' they gave us.  I even had a special session with a nurse to review everything about lymphedema. 

I was fine for about a year and a half and fell on my arm. Now I wear a stupid sleeve when I work out. I can't have needles or blood pressure taken on my left side. If I wear a watch on my left wrist, no matter how loosely, my arm feels heavy and swollen for days after.
 
So maybe they scared me, but they were right. Crap.

A cure for lymphedema

I  had heard about this a few years ago and was told that it was only in experimental stages and not yet ready for use regularly. However it seems enough time has passed so that it is now becoming a reality.

This is nice progress to see that something was too far off into the future to be a reality to end up being put into use.

Every patient is different

Every patient is different. Every patient is different. Every patient is different. Every patient is different. Every patient is different. Every patient is different. Every patient is different. Every patient is different. Every patient is different. Every patient is different. Every patient is different. Every patient is different. Every patient is different.

As you may know from reading my blog that one of the biggest thing that irks me is when someone tells you that their neighbor's cousin's dog walker's sister's friend had the same ailment as you 20 year ago and their treatment protocol was different and they just don't understand why you are getting something different. Its rude. It makes you doubt your own treatment protocol and doctor. And its none of their damn business.

So now this study (because we needed another study) says that 'Individualized Care is Best for Lymphedema Patients'. I didn't go to medical school and I could have told you that.

Living with lymphedema is no fun. I can't wear a watch or bracelet on my left arm - no matter how loose it is. If I do I have to wear a compression sleeve for a week to make my arm feels better. This surprises my doctors. I also have to wear a compression sleeve when I work out or when my arm feels like its acting up - like maybe today I will. I have to do the stupid little lymphedema exercises to help my arm. They are just annoying.

I have a friend who had lymphedema and then lost a lot of weight and it went away. I have another friend who is very thin and has to wear a custom sleeve every day - and has for 17 years. I have a lot of friends who had the same surgery and never got lymphedema. See we are all different. 

Medical (mis)adventures

Yesterday I had such a wonderful day I needed chocolate ice cream at the end of it. Why was it such a wonderful day you ask? Well I am signed up for more medical (mis)adventures. I am so (un)excited.

I had an appointment with my back pain doctor, also known as the doctor who prescribes the good drugs. He told me that I looked in good shape, and didn't comment on my high blood pressure reading that concerned the nurses. He told me that I have pain from my facet joints (the little joints along the side of your spine), my right sacroiliac joint (the long joint along the side of your tail bone next to your hip bone), and from greater tronchanteric bursitis in my left hip. All the previous treatments/injections have worn off and I need to start over again.

He insisted on squeezing me in on Wednesday (as in tomorrow) to give me an injection under fluoroscope into my left hip. I am not sure why he didn't want me to wait but I'm happy to have some pain relief coming. But then they gave me the instructions for the procedure which say: "The doctor will numb your skin with a small needle, which will sting a bit. It is important to hold still and let us know if we are causing you discomfort. Next the doctor using an x-ray machine (fluoroscopy) to guide the needle into the correct spot. Local anesthetic and steroid are then injected through the needle and the needle is removed." The parts that I am so (not) looking forward to are the sting a bit and causing discomfort, and the big needle in my hip.Or all of the above.

Next after that we will schedule a repeat of the radiofrequency denervation in my right SI joint. That is in the top three of the all time most painful medical adventures I have had. I asked if it is likely to be as bad as last time and he said most likely. But it is the only way to relieve the pain (which is similar to that of an ice pick into your back). I can't wait.

Finally, we will repeat the facet block injections. These are no fun. They give you three injections on each side of your spine - twice. The first with anesthetic and the second with steroid. Oh, and even though you are sedated they hurt - each one. I really can't wait. But that will probably not be for a couple of months.

I just have to get through today first. I finally broke down and called my primary care doctor yesterday about my shoulder. I bruised it in late July and it got better for a while. This weekend I ended up icing it several times. My concern is that it is my lymphedema shoulder. If it wasn't, I would probably suck it up and give it until October when I have an appointment to see my PCP. I am not entirely sure what they can do because I have range of motion and don't think anything is really damaged - only bruised. But the lymphedema aspect is more concerning.

Three days, three doctor appointments/medical adventures. What a way to start a week.

One of those days

This is one of those days. I can tell already. I woke up at 335am and couldn't get back to sleep. My husband did. The cat did. I didn't. I finally got up around 5 and am tired but can't sleep. But I did run the dishwasher and clean the kitchen.

I am not blogging about the impending visit by Irene. It is being over-hyped by the media and there are plenty of other people talking about death and destruction as a result.

I am not blogging about the fact that my tennis elbow seems to have returned and is very aggravating as a result. I will see how it goes but may need to go back to PT. Grrr...

I am not blogging about the fact that I have yet another skin rash - something I never got before chemo and now get frequently. I have a dermatologist appointment in two weeks and will suck it up until then.

I am not blogging about lymphedema related issues since I injured my shoulder and my arm has been living in a puffy state since. There is nothing they can do at the lymphedema clinic anyway. I could do their stupid exercises again - if I could remember then.

I am definitely not blogging about the 2012 presidential election because it is too far in the future and frankly I am sick of all the candidates and their stupid posturing already.

I am blogging about being in a crappy mood because I am tired, itchy, and achy already. Maybe I'll take a nap.

Yesterday I was on to something

Yesterday morning I wrote about learning how many other cancer survivors are out there with second and third cancers. Then after going to the grocery store and gardening I needed to rest my back, I decided to read my latest issue of Cure Magazine. (A note about Cure, if you have/had cancer and don't read it you should. It explains new advances and information about cancer in easily understood language that doesn't talk down to you and covers real issues.)

Its latest issue covers three topics which are near and dear to my heart.

- Use of radioactive iodine in treating thyroid cancer particularly when treating those under 18. I was 19 so I think I can be included in this article considering my medical history. The article states: "Radioactive iodine should generally be prescribed for those at very high risk for recurrence or known to have microscopic residual disease and those with iodine-avid distant metastases,” the researchers wrote in The Journal of the National Comprehensive Cancer Network. However, “RAI should be considered in other patients only after carefully weighing the relative risks and benefits and the aggressiveness of the clinical presentation, because RAI may be associated with an increased risk for second malignancies and an increase in overall morbidity and mortality.”" Yoo hoo!! Are you talking about me?

- Thoughts on avoiding over treatment in cancer treatment - There is such a thing as too much of a good thing. "...a growing number of people—from patients and caregivers to doctors and researchers—concerned about the balance between the risks posed by cancer itself and the risks of treatment. Several recent studies have documented “overdiagnosis” or “overtreatment” of people with certain types of early, slow-growing or low-risk cancers or even precancerous lesions—many of them picked up with increasingly sensitive tests.". I think they are hinting at a theme here...

- Another article referring to over treatment and node removal in breast cancer treatment. "Now researchers have found that a select group of early-stage breast cancer patients may not need ALND (Axillary Lymph Node Dissection) even if one or two sentinel nodes contain tumor cells. Skipping ALND eliminates common side effects of the procedure, including painful and chronic swelling of the arm, known as lymphedema, and infection. Yet again, less is best." I hate this. I am in this category so maybe I was over treated and now have lymphedema and shoulder issues as a result. But I will stop thinking that because there is no sense in regretting the past.

To summarize, I had thyroid cancer and was treated with Radioactive Iodine which is now shown to cause other cancers when used on young patients. I had breast cancer and had on small metastasis in one lymph node and had the surgery that has caused more problems. I have to just think that I was treated according to the standards at the time and it can't be undone. Isn't the cancer roller coaster fun when these fun little emotional side trips are added in?

Lymphedema land

I am speaking to my left arm here: Time to get skinny! I am not prepared for puffiness. Stop it now please!

Basically I am having a lifetime lymphedema discussion. I was fine until I fell on it a few years back. I went and got a sleeve (which is like a girdle - after you wear it for a few days you won't notice it (NOT) and it gave me a tan line on my wrist) which I wore for a while and stopped because my arm was behaving. Then I started going to the gym and using the machines. I was told to wear my sleeve and gauntlet while working out - I remember it about 50% of the time and my arm seems to be behaving.

But not in the past few days. Back to sleeve wearing - which I hate and as the weather grows warmer it becomes even less fun. %&*$^%&*^q+ Grrr! But I will suck it up for a while until I get a tan line on my wrist.

Snow and winter and cancer

It snowing out. It snowed all night. It snowed since yesterday afternoon. It is supposed to keep snowing for a few more hours. Our street was just plowed. We couldn't tell where the yard ended and the street began. I now have to wait until my husband starts shoveling and using the snow blower. I can't shovel. I can't use the snow blower. Bummer.

No its not a bummer. I will stay inside where its warm and get some work done. Its pretty to look at but I'll just stay here and hang out with the cat.

Between my tennis elbow, lymphedema arm, and bad back, I'm not going anywhere until the snow removal process is complete. I had actually planned a work at home day today so this fits in just fine. My husband's office (USAF) said non essential civilian employees did not need to report so he is happy to stay here with me and the cat.

Part 3 of my VERY long day

Yesterday, I was supposed to be smart and stay home and work quietly and recover from my VERY long day. I was STUPID (worthy of capitals - and that was after I was a MORON because I forgot to pay the mortgage which I immediately rectified) because I didn't do what I was supposed to do.

In the morning, I decided that since I had finished stamping the latest newsletter from my nonprofit job, I could put all 1700 of them in their 3 boxes on a two wheeled cart and get them into the car to drive them to the post office and then out of the car and into the post office. That wasn't so bad as I lightened the boxes by taking some newsletters out when I had to lift them in and out of the car and was not above dragging them.

Next I decided that with my abundance of healthy feelings I was in good shape to go to Costco for one last time before the holidays (so I wouldn't be forced to go to the grocery store to buy things at retail prices). I made a point not to get anything heavy. I meant to put on my wrist brace before leaving.

However, there was the wrestling match with the toilet paper. (Yes, in public.) I needed to buy TP and this means at Costco or other warehouses you get the giant 24 rolls in a big plastic wrapped bundle. First round, I tried to fit it on the rack under the carriage and it only sort of fit, even when assisted by my foot. Second round, I had to pull the stupid TP bundle back out to put in the giant bundle of paper towels behind it. Again, I had to assist with my foot and it still didn't really fit but seemed wedge. Third round, the damn TP bundle fell out in the middle of the cheese department. I gave up and threw it into the main part of the cart. Fourth round, I decided not to purchase the gift basket I had in my cart, under the *()&^^%% TP bundle so I pulled it out and got the gift basket out and then threw the DAMN bundle back in. Fifth round, I had to wrestle the (*&^%%^ bundle onto the counter at the checkout. Sixth round, into the back seat of the car where the *)&*(&*^^% thing stayed until my husband got home from work. (I should have gone to the grocery store and purchased individual rolls but no I am cheap.)

As a result, my back hurt, my left lymphedema arm hurt, and my right tennis elbow hurt. My husband cooked dinner - including making brownies. Today, I can't pick up my coffee with my right hand again.

On Tuesday I shall have to admit to my physical therapist that I lost the battle of the toilet paper.

Yesterday I also talked to the lymphedema people yesterday to find out that my rash from the compression sleeve should be treated with hydrocortisone (which it is) and if it does not get better soon I should call my primary care or go to the walk in clinic or even the ER if needed. That was not the message I wanted to hear. (I will not go to the ER unless there is dripping blood in significant quantities.) In the meantime, I will try wearing my lymphedema sleeve inside out so I don't continue to irritate the (DAMN) rash.

Today, I am meeting friends for a walk and will not carry anything heavier than my water bottle.

Rats!

(Feel free to replace the title with the appropriate word of your choice which equals frustration).

Yesterday I went to my exercise class and talked to the instructor about my elbow. She said she wanted me to talk to the physical therapist this morning about what I should and shouldn't do. Then I went to the monthly breast cancer support group I never get to because the lymphedema specialist specialist was there. She said I need to wear my (damn) sleeve again until my right arm is back to normal AND I need to be extra careful not to stress my left lymphedema arm until my right tennis elbow is under control.

My husband is gloating because he was telling me I should wear my damn sleeve and he has been proven right. That's not the frustrating part (even though he didn't remember to notice my hair cut yesterday even while prompted). The frustrating part is by day I wear my (f)ugly lymphedema sleeve and by night I get to wear my stupid wrist brace for my tennis elbow. Now I am accessorized 24/7.

Then yesterday I was exhausted. I don't know why but I ended up taking a nap and then even going to bed early. Grrr!

Today I am off to work and will attempt to make it through a whole day. I need to talk to the PT people (after I scrape them off the floor when I give them my medical history and the list of don'ts from doctors) about how the pain kicks in and I can't do much of anything.

Just another post cancer day. Grr, grr, grr.