Topic: Swelling in palm

Rosered,  In you hand your lymph nodes are located in the palm.  When my mother has hand swelling the palm is alway swollen.  I would question your therapist...is she certified? I also recommend having a LE therapist teach you to do a massage yourself..this is a great way to help. There are gloves available, and if your fingers are not too swollen I would recommend a gauntlet by Farrow Wrap.  They have added a pocket on the inside that you can insert a cushion and that seems to help with the palm swelling.  Your LE Therapist should be able to measure you and advise. I would guess that when your hand is swollen the Raynouds flares up too.  Stress can be a trigger for the lymphedema.  What type of Raynouds do you have?  Primary, or secondary? Do you know the cause?  My Mother does not have Raynouds, but she does have Radiation Induced Brachial Plexopathy and her Lymphema arm is totally paralyzed.  We have fashiponed some fleece mittens for her to put over her hand to help keep it warm...The cold makes her hand hurt  These extra-ordinary things certainly do make life a challenge...I will keep you in my prayers, and hope that you can get relief.

Terri

Rosered, hello,

I have palm swelling, but no problem on the top of my hand. My therapist says it's unusual (she told me jokingly that my lymph system must have been installed upside down!), but it's certainly not unheard of. I do find the Solaris Palmar Spots really helpful, inside my wraps or inside my gloves. The worst thing for making my palms swell is leaning on my arms -- as in riding a bike or just standing next to a table and leaning on it with my arm straight, or kneeling on the floor and supporting myself on one arm while I clean up a spill. Even resting my elbow on my desk and then resting my head in my hand. Boom! Practically instant palm swelling -- <sigh!>

The MLD massage for palm swelling adds another step. Because the top of the palm drains to the back of the hand, take the fingers of your opposite hand and gently run them up your palm and between the fingers of your affected hand. Do that several times before clearing the back of your hand and hopefully you'll see some reduction.

Another idea besides the Palmar Spot is, when you are ready to order gloves, it helps if the person fitting you adds a bit of "give" to the measurement around the palm. Otherwise, the way our hands are made, too tight compression pulls the sides of your hand inward and the fabric doesn't even touch your palm when your hand is at rest. If the measurement there is a bit looser it results in greater compression in the palm area. Hope that makes sense -- works for me so I usually don't have to use Palmar Spots, which make my hands sweat in the summer.

The Palmer Spot is used for back-of-the-hand swelling too, by the way, because it tightens the fabric across the back of the hand as well.

Hope I didn't just make this more confusing!

Be well!
Binney

Rosered,

  I hope we didn't make you doubt your therapist--my LE therapist was kind of horrified about the palm swelling because she treated a pediatric dentist whose hand swelling was so hard to control, she had to retire. So, I think it upset her.

My palm swelling is mostly at the base of my index finger, and it seems like gloves trap it, and then it goes down.

RE: Solaris night garment--they are chipped foam, which, again, my LE therapist considers a bit aggressive, and apply about a 20-30 mm compression. I have one, and use it intermittantly (mostly I wrap--although recently I needed a remedial wrap session, because I was wrapping too tightly and causing problems)--your therapist is correct in her concern that over-compression can cause rebound swelling. I wonder if there's some way you could try one for a couple of hours and see how it impacted you.

As JoAnn Rovig--maker of competing night garments JoviPak, says on her blog: You only need night garments if 1) you swell at night and/or 2) you have fibrosis.

Have you ever wrapped at night? Do you need to? 

If your fingers swell, the gauntlet is not a good choice, you need a glove with fingers.

Watch out for the super tight glove--gloves can trap fluid, and too much compression can cause swelling.

I have a custom glove, but I also use medi 95 off the shelf gloves, and I'm between a size 2 or 3 (they have 7 sizes) and I was able to try both, and the 2 was just too tight.

To massage the palm, I massage up on the upper part, through the fingers to the top of the hand, and down on the lower part to the wrist and forearm, and since the middle finger is weird, I bring that area down as well. 

I have a good diagram of the palm, I'll have figure out how to upload it.

Kira 

Here's the JoAnn Rovig blog--she's a character, and if you read more, you'll find out she refused chemo despite positive nodes and just detoxed... But she makes these products and puts out good self care videos, so take it with a grain of salt

http://www.joannrovig.com/?m=200908JoViPak or no JoViPak?
Thursday, August 27th, 2009
Good communication is essential to any successful transaction and today we had a good reminder of that.

A DME had ordered two JoViPak arm sleeves for a patient who had had a lumpectomy many years ago and a recent mastectomy on the other side. We received a call at JoViPak saying the patient can't wear her new JoViPaks. Because - when she lays down at night her hands and wrists begin to throb. After several conversations with JoViPak Customer Service and the DME, the patient was turned over to me. . . . . . and that is what I am here for! I love talking to patients, and as you may have guessed, we always end up talking about nutrition- particularly if they are a cancer survivor. The most important question I had for her, however, was how well did she tolerate bandaging. Well, she didn't! and that is a question that should have been asked before the order was ever sent in. The next most important question for her was "Do you swell at night?" and she didn't think so! (For her own peace of mind, she needs to know that.)

It's not unusual for a patient to find a product on the internet and decide it has to be "the magic bullet." What I want to make perfectly clear to anyone considering a night-time garment is this: A foam-filled padded night-time garment serves two functions: 1) contains night swelling and 2) softens fibrosis. If a lymphedema patient has neither, a JoViPak serves no purpose.

Terri, no kidding, you're a water aerobics instructor?! What a great thing that is! Did you ever have other women with LE in your classes (or men, for that matter)? It really is such a help to almost everyone with LE (well, except if you try to do too much all at once.) I hope Connie still gets to go with you sometimes -- it can be so relaxing. Sure wish I had a warm pool handy, along with an understanding instructor like you!

Hugs, and hi to Connie,
Binney

Rose, I can't use Kinesio tape because I'm allergic to adhesive, but therapists who have been trained in its use can get good results. She can teach you to apply it yourself, too. Here's a page about it:

http://www.stepup-speakout.org/kinsiotaping_for_lymphedema.htm

Hope it works well for you -- do let us know how it goes.

Be well,
Binney

Hooray on routing the lesions so quickly! And really glad the cellulitis is already under control as well. Ouchy! I do hope you're not in pain now, Carol!

Terri, I sure hope you do it! You'd be wonderful as a LE therapist, and we need ya'.

Lots to look forward to, both of you, and I'm looking forward with you!

Hugs, prayers,
Binney