The following article by Michael Woods appeared in the Toledo Blade on June 15. It is most informative. Mr. Woods is the science editor for The Blade and writes a column about health and medicine on Mondays and a column for computer novices on Saturdays. The article is on The Blade's web site at http://www.toledoblade.com/editorial/woods/8f15wood.htm, and will be there until about October 18. We thought it important enough to reproduce here for anyone who might miss The Blade's time-frame. The article is reproduced in its entirety. Mr. Woods can be reached by e-mail at michaelwoods@mindspring.com.
June 15, 1998
The petite stainless steel medical alert bracelet, intended for women after breast cancer surgery, carries a message that may furrow the brows of the most medically sophisticated consumers:
"LYMPHEDEMA ALERT: No Blood Pressure - No Needles into this Arm"
Lymphedema is a potentially serious health threat for breast cancer survivors and millions of other individuals. Yet few people are aware of lymphedema and the simple precautions that can prevent it or reduce its severity.
Patients and support groups, including the National Lymphedema Network, which supplies the bracelet, insist that many physicians, nurses, and other health care professions are ill-informed about this long-neglected disease.
The term "lymphedema" (pronounced limf-a-dee-ma) comes from two words. One is lymph, the clear fluid consisting of water, salts, protein, white blood cells, and other material that circulates through a system of channels in the body. The lymphatic system, which includes the lymph nodes, plays a key role in protecting the body from disease. Lymphatic vessels also return excess fluid and protein from body tissues to the blood circulation. The other word is edema, which means swelling. Lymphedema means "swelling caused by the lymph."
Don't confuse it with ordinary edema. The more familiar kind of swelling can occur in legs and ankles of patients with heart failure, blocked veins, and related conditions. Ordinary edema can be treated with diuretics, or "water pills" that make the kidneys excrete excess fluid.
Lymphedema involves accumulation of lymphatic fluid in a limb or other part of the body. Symptoms include swelling that can make an arm or leg balloon to several times normal size; pain; numbness; loss of motion, and hardening of the skin.
The backed-up lymph is rich in protein and other nutrients, and makes a good breeding ground for bacteria. Scratches, pin-pricks, and other minor injuries can lead to infections, skin ulcers, and other problems.
About one in 6,000 Americans have hereditary lymphedema due to abnormal formation of the lymphatic system. Most cases, however, result from surgery, illness, or injury that damages lymphatic vessels, blocking the normal flow of lymph.
Breast cancer surgery is among the most common causes. Each year about 163,000 breast cancer patients undergo surgery that involves removal of underarm lymph nodes. The nodes may harbor cancer cells.
Experts estimate that ne of every three such women develop some degree of lymphedema in the adjacent are. The risk often increases with the number of lymph nodes removed. Radiation treatment after surgery to destroy any remaining cancer cells may damage lymph vessels and increase the risk of lymphedema.
Women preparing for breast cancer surgery that involves sampling or removal of lymph nodes should raise the topic with their physician.
Simple measures can minimize the risk during hospitalization. The doctor, for instance, can order that no needles be used for blood tests or other purposes in the adjacent arm. Blood pressure readings should be taken on the opposite arm to avoid potentially harmful compression of tissue when the blood pressure cuff inflates.
Some hospitals issue a special lymphedema alert wrist band to remind nurses about these measures. since the risk may continue for years after surgery, consider the lymphedema medical alert bracelet. It is available from the National Lymphedema Network (1-800-541-3259).
For more information consider a new book, Coping with Lymphedema, by Joan Swirsky and Diane Sackett Nannery (Avery Publishing Group, $13.95) that deals with lymphedema in cancer and other patients.
Back to the Lymphedema information page.
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