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Topic: question about flying

Forum: Lymphedema — Risks, tips for prevention, and info about products that can address the symptoms of lymphedema.

Posted on: Sep 3, 2006 02:16PM

mcdds wrote:

My husband and I are taking a trip to Hawaii in December for our 25th anniversary. It will be about an 8 or 9 hour flight. I haven't had any problems with lymphedema so far but I don't want to either. Surgery was in Feb 05 and I had 5 lymph nodes removed.

When I asked my oncologist about it, he said he didn't think it would be necessary but I could wrap my arm in an ace bandage if I wanted too. I plan to ask my surgeon when I see him next month to see what he says.

Guess my question is - what do you girls think? Should I insist on a sleeve or just ace bandage it? How do you wrap it?

MCDDS Dx 2/3/2005, IDC, <1cm, Stage IB, Grade 3, 0/5 nodes, ER+/PR+, HER2-
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Sep 3, 2006 03:51PM BJAlexandria wrote:

Mahalo, Carol! I've had 3 on the left side removed (2000) and 4 on the right side (2005). And I fly often, never had a problem. If you haven't experienced any LE so far, I doubt getting on a plane will make any difference. Go with your surgeon's advice.

And have a great trip! ALOHA!
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Sep 3, 2006 04:01PM Binney4 wrote:

Hi, mcdds,

Good for you for thinking of this before your trip -- not eveyone does.

To put this gently, our oncs and surgeons often don't have the straight story on lymphedema (LE), because they don't treat it (no drugs or surgery for LE -- it's all in the hands of LE therapists). So you've got at least one serious piece of misinformation here. That is, the bandages used for LE wrapping look a lot like ACE bandages, but they're something else altogether. They're called "short-stretch" and have a competely different action on your arm. When we wrap for LE it's only after thorough training by a well-qualified LE therapist, and it includes layers of gauze, stockinette, foam or other soft surface, and then graduated layers of short-stretch in a specific direction and with graduating tension. Definitely not something you want to get into. An ACE bandage could have the same effect as a blood pressure cuff, congesting the lymph flow from your arm and actually CAUSING lymphedema.

On the other hand, a well fitted sleeve and glove could spare you considerable grief. There's a list of prevention guidelines and air travel guidelines at the National Lymphedema Network site (click on "Position Papers):

There's some controvesy over whether to be fitted for a compression sleeve and glove before flying, but if you do, be sure it's fitted by someone who has a lot of experience with lymphedema and fitting LE garments. (To be fair, most of us who have already developed LE don't find this controversial at all -- we recommend that you do everything in your power to prevent it.) Always wear a glove if you're wearing a sleeve, to prevent lymph fluid from getting "stuck" in your hand and making it swell. Some women who don't yet have LE choose to be fitted and just take the garments along, not wear them. That way if they develop problems, they're prepared and don't have to fret the trip home. If you get them, try them out before your trip. They can irritate the elbow crease and between the fingers when new -- cornstarch in those areas before putting them on may help. Wear them for an hour or so after landing before removeing them, giving your body time to acclimate.

Even light luggage can cause you problems if you jerk it around -- out of overhead bins, say, or off the luggage carousel. So be gentle to yourself and give crowds plenty of leeway to avoid bumbs and bruises. Avoiding insect bites makes a lot of sense, but some are probably inevitable. If you're bit, bruised, burned, nicked, or your skin is otherwise compromised, use a topical antibiotic cream to avoid infection, and keep a careful eye on it to make sure no swelling, undue pain, redness, or warmth to the touch develops. Any sign of infection should be treated promptly -- don't wait til you get home! Do avoid sunburn as well (and if you did rads remember the entire radiated area needs to be protected from the sun).

The trick is to tuck all this information away in your mind in such a way that it protects you but doesn't interfere with the fun and delight of your trip.

Bon voyage!
P.S. - You might want to print out the Lymphnet info, for your onc and surgeon
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Sep 3, 2006 04:16PM Binney4 wrote:

Hi, bj,

Just a word of caution here. Unfortunately, the fact that you have not had any trouble with LE yet doesn't offer you any protection. Some of us have developed LE years after surgery, many of us while flying. Because our lymph system has been compromised by our bc treatment (any breast or chest surgery with or without nodes being removed, rads) the problem accumulates over time and we can never be sure that the next time we stress it we won't tip the balance. Our LE risk is for life. Of course we each make our own compromises with this risk, and that's as it should be. A wise decision depends on getting all the facts first, and unfortunately those facts can be hard to get.

If your insurance will cooperate (or even if they won't), you may want to see a well-qualified LE therapist for baseline arm measurements, a lesson in prophylactic LE massage, and prevention tips.

Be well!
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Sep 4, 2006 03:49AM BJAlexandria wrote:

Thanks for the tips, Binney - will check it out. I had no idea.

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Sep 4, 2006 01:16PM mcdds wrote:

Binney, Thank you for sharing all your information. I knew from past posts that you know alot. I really appreciate you taking the time to share with all of us. I will be sure to talk with my surgeon and oncologist again before I go in December.

Am I correct in thinking that the longer the flight is, the more at risk you are? Just wondering.
MCDDS Dx 2/3/2005, IDC, <1cm, Stage IB, Grade 3, 0/5 nodes, ER+/PR+, HER2-
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Sep 4, 2006 01:27PM Binney4 wrote:

Carol, hello,

That's one way to think of it, though my pilot sons tell me it has more to do with altitude, which is generally higher for longer flights (and cabin pressure is apparently adjusted accordingly). Staying hydrated and keeping arms and body exercised is especially important for a longer flight. I think if I were going to fly that far I'd alert the airline beforehand that I needed extra fluids because of a medical condition, since you can't bring your own water on board. Then just remind the flight attendant as you board.

Have a wonderful trip and let us know how it goes!

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