Subclinical lymphedema testing
I am 6 years out from my treatment. I had mastectomy with direct to implant and then needed radiation due to positive nodes. I developed cording 3 years out from treatment. Went to PT and broke the cording lose but then began to develop numbness in my fingers and parasthesia in my arm. I went to PT a second round due to persistent pain where cording was and the numbness, also have a lot of pain in my axilla and my muscle on my side. My arm also feels like it weighs 100 pounds and it is weak. My question is if there is a specific test I could ask for to check for subclinical lymphedema. I have also seen a hand to shoulder doctor that diagnosed me with cubital tunnel syndrome, then radial tunnel, then suspected thoracic outlet syndrome. She suggested a nerve release surgery for the lower arm parasthesia. I am currently at my wits end with this chronic pain/ discomfort and before committing to surgery I want to make sure it’s not lymphedema. The radial tunnel diagnosis makes sense for the forearm but my whole arm is weak, and in discomfort and pain especially where I had the cording. I also have a painful knot in the bend of my arm where the cording seemed to end. I feel desperate for an answer or solution but feel defeated that maybe there isn’t one. Any insight for testing would be helpful.
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Hi @dani444, I am in a somewhat similar situation with hand numbness, arm weakness and muscle wasting which is not due to lymphedema. They were able to check for subclinical lymphedema since I’m in a clinical trial where my arms were measured by both perometer and bioimpedence spectroscope before surgery. If you don’t have a baseline measurement there is imaging called lymphoscintography where a radioactive dye is injected and the arm is scanned to show how lymph fluid is flowing and draining. Since cording involves the lymphatic channels consulting a plastic surgeon who does LVA bypass might help you find a solution or get a referral to the appropriate doctor.
I have been dealing with my arm for eight months now. I finally got an appointment and EMG testing with a neuromuscular neurologist which has changed the direction of the search for a diagnosis. I’m glad I did not have the recommended surgery for foraminal stenosis even though something similar might be done eventually.
Your history of surgery and radiation means the source of the problem could be the brachial plexus (thoracic outlet syndrome involves the brachial plexus.) If you need more info on imaging for that or the cervical spine where the roots of the brachial plexus originate PM me. I’m sorry that you are also in this despondent state.
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