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Topic: leeve When Flying if you Don't Have Lymphedema?

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

Posted on: Sep 9, 2019 05:47PM - edited Sep 9, 2019 05:49PM by OCDAmy

OCDAmy wrote:

I had 13 nodes removed over 2 years ago and have no signs of lymphedema. I am careful with the blood pressure cuff and needle sticks but I have never had a sleeve. I have flown several times without one and had no problems. I am going to be taking a long overseas trip in November and asked my PS if he thought I shoudl get a sleeve and he said if I don't have lymphedema I don't need to wear one. I worry a little about the long trip and wondered what everyone else is doing. (*that is supposed to say sleeve in the post topic but I can't figure out how to edit it!)

Dx 2/2017, IDC, Left, 4cm, Stage IIB, Grade 2, 2/13 nodes, ER+/PR+, HER2- Surgery 11/15/2018 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting, Silicone implant Hormonal Therapy Arimidex (anastrozole) Surgery Reconstruction (left): DIEP flap Radiation Therapy Whole-breast Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery Lymph node removal; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Sep 9, 2019 06:38PM LeesaD wrote:

I had 18 nodes removed two and a half years ago. Have not had lymphedema but I do wear a sleeve flying just as a precaution. Don’t know if it helps or not or even if needed.
Oncotype Score 3, 2/4 Sentinal Nodes micromestasis so pushed for ALND for 'peace of Mind' and surprise found 2/14 positive axillary nodes Dx 2/3/2017, IDC, Right, 3cm, Stage IIB, Grade 2, 4/18 nodes, ER+/PR+, HER2- Surgery 3/27/2017 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 4/17/2017 Lymph node removal: Underarm/Axillary Chemotherapy 5/9/2017 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 8/2/2017 Hormonal Therapy 9/7/2017 Arimidex (anastrozole), Zoladex (goserelin) Surgery 11/17/2017 Prophylactic ovary removal Surgery 1/30/2018 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Oct 21, 2019 01:00PM saltier wrote:

I have breast LE but with 8 nodes removed plus radiation, my arm is obviously at high risk for future development. What I was told by both my LE therapist and my oncological naturopath was that flying for about 4 hours is okay so long as I am mindful of drainage/exercise while flying and do my breast drainage upon arrival (well, as soon as I'm someplace where I can undress).

Longer than that, though, and they said that I could likely reduce risks with a sleeve even though it's impossible to weigh what my risk is and how much reduction a sleeve would actually provide. So, insurance. In any case, loose clothing and elevating the risk arm plus some mild, clothed stroking are things I was encouraged to do every couple hours inflight.

There's a cost, of course, involved in a sleeve, but in that there's no going back from LE, I tend to choose on the side of caution and prevention. I'm thinking about picking up one of the yellow hospital caution sleeves to use both when flying and during any procedures, and thus maximize my use of that investment.
tnbc tx 2016 w/ partial mastectomy, chemo, rads => LE breast, extensive & worsening CIPN
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Oct 21, 2019 01:51PM letsgogolf wrote:

I don't have lymphedema but have worn my sleeve each time I fly. I also try to move around frequently and do stretches over my head while seated during flights. I have no idea if it helps but I figure it can't hurt either. I had 8 nodes removed and radiation to the remaining nodes. Best wishes.

Oncotype DX = 3. IDC with Lobular Features. Sentinel Node had Micrometastases - Estrogen 100%, Progesterone 99.89%, Ki67= 3.3% Dx 2/14/2017, IDC, Left, 1cm, Stage IB, Grade 1, 0/8 nodes, ER+/PR+, HER2- Surgery 2/26/2017 Lumpectomy: Left Radiation Therapy 4/5/2017 Whole-breast: Lymph nodes Hormonal Therapy 5/31/2017 Arimidex (anastrozole) Targeted Therapy
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Oct 21, 2019 08:33PM MinusTwo wrote:

OCD - as you know, lymphadema can present any time - up to 25 years later. I have mild breast & truncal LE. I do NOT want it to progress to my arms. I wear sleeves for every flight. Be sure you also have gauntlets or gloves so fluid can't end up in your hands.

Take a look at this informative web site created with much input from BCO people.

https://stepup-speakout.org/


2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Oct 21, 2019 08:56PM OCDAmy wrote:

I’m just trying see if there is any research that shows that flying CAUSES lymphedema if you don’t already have it.

Dx 2/2017, IDC, Left, 4cm, Stage IIB, Grade 2, 2/13 nodes, ER+/PR+, HER2- Surgery 11/15/2018 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting, Silicone implant Hormonal Therapy Arimidex (anastrozole) Surgery Reconstruction (left): DIEP flap Radiation Therapy Whole-breast Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery Lymph node removal; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Oct 21, 2019 10:22PM rlmessy wrote:

OCD...my mom had lymph nodes removed in 2006 and developed lymphedema in 2012.

After surgery and prior to LE I had her fitted for a sleeve as a precaution. She did not wear it everyday but when we travelled by car she wore it and when she flew she wore it.

I would wear one flying for sure. My hubby, a frequent international flyer flew to China and his feet were so swollen by the time he got there he could barely walk. Never happened before that and has not happened since.

I would take no chances after lymph node removal. LE can pop up quick and infections even quicker with no rhyme or reason sometimes.

My DX appears below but I am also a caregiver to my awesome Mom, a 13 year (2006) BC Survivor, IIIa IDC, ER/PR+, HER2+, R MX, Lymphedema R Arm Dx 10/10/2019, IDC: Papillary, Right, 2cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2+ (FISH) Surgery 12/18/2019 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left Targeted Therapy Herceptin (trastuzumab) Chemotherapy Taxol (paclitaxel)
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Oct 21, 2019 10:30PM - edited Oct 21, 2019 10:31PM by MinusTwo

OCD - there's lots of research about ambient pressure changes. Not only flying, but sometimes going from sea level to hiking in Colorado. And studies in hyperbaric chambers. There are several LE threads on BCO that describe the process & the research. Everyone has a different risk tolerance. I just wanted to do every possible thing I could to prevent the LE from going down my arms.

Getting pricked by a rose thorn can bring on LE. Tons of other things to avoid.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Oct 22, 2019 12:33AM star2017 wrote:

I didn’t have lymphadema. Flew about 1.5 years after surgery. Developed mild lymphadema. Now I make sure to wear the glove and sleeve.

Dx@37, pregnant, BRCA2+ Dx 9/2017, DCIS/IDC, Right, 6cm+, Stage IIIA, Grade 3, 4/8 nodes, ER+/PR+, HER2- Surgery 10/16/2017 Mastectomy: Right; Reconstruction (right): Tissue expander placement Chemotherapy 11/28/2017 AC + T (Taxol) Surgery 4/17/2018 Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Silicone implant Radiation Therapy 5/21/2018 Whole-breast: Breast, Lymph nodes Surgery 10/24/2018 Prophylactic ovary removal; Reconstruction (left): Silicone implant Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Oct 22, 2019 09:32AM - edited Oct 22, 2019 09:43AM by SummerAngel

I have never seen a study that shows that flying causes lymphedema in breast cancer patients.

My LANA-Certified PT advised against wearing a sleeve while flying for those who don't have lymphedema.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652571/

"Patients with a history of lymph node dissection are often told to avoid air travel or wear compressive garments (even if they do not have lymphedema) when flying. Unfortunately, as with many other recommended preventative measures, this guideline appears to have little scientific evidence supporting it. Ward and colleagues presented case reports (level 5) of lymphedema development after air travel and cited anecdotal rates of lymphedema development in 5–30% of at risk patients by The National Breast Cancer Centre of Australia 32. Casley-Smith (1996) reported a questionnaire based retrospective study (level 4) in an effort to determine the triggers that led to lymphedema development (infection/insect bite/plane flight/burn/other/unknown) 33. 531 patients responded (1020 surveys were sent) and of these 27 reported that their symptoms started after an aircraft flight. In addition, 67 patients reported worsening of existing lymphedema after flying. These findings led the authors to conclude that lymphedema can be triggered by travelling on aircraft and may be due to reduced activity or lower cabin pressure for long periods of time resulting in pooling of blood in the limbs. However, the authors acknowledge that this is merely a speculation with no direct evidence.

Other retrospective studies have suggested that air travel has little effect on the development of lymphedema. For example, Graham and colleagues surveyed 293 breast cancer survivors about changes in arm circumference and airplane travel (level 3) and found no cases of permanent new onset lymphedema in this cohort 34. In fact, patients who had taken precautions when flying, such as using compression garments, were actually more likely to develop lymphedema or have progression of their existing lymphedema than those who had not. Similarly, Kilbreath et al prospectively assessed the impact of flying on at risk limbs in breast cancer patients (level 2) by evaluating patients who had flown from Canada to Australia to attend a dragon boat regatta. They found no adverse changes in impedance ratios comparing the normal limb to the at risk limb in 95% of patients when comparing pre and post flight measurements. The authors acknowledged that the subjects in this study had trained for dragon racing and that this exercise may have had a protective effect 35."

Age at dx: 45. Oncotype, left-side tumor: 9. Right side had multifocal IDC and "extensive" LCIS. Isolated tumor cells in 1 right-side node. Dx 3/27/2015, IDC, Left, 2cm, Stage IIA, Grade 1, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 4/27/2015, IDC, Right, 1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 6/1/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right Surgery 6/1/2015 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/28/2015 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/4/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Oct 22, 2019 10:33AM - edited Oct 22, 2019 11:00AM by OCDAmy

Summer, that's what my research is showing and my PS and BS both told me it's unnecessary to wear a sleeve if you don't have LE.

Thanks for providing those studies. I plan to just keep my arm elevated and moving.

I also have been exercising and lifting weights which research shows helps to prevent LE.

Dx 2/2017, IDC, Left, 4cm, Stage IIB, Grade 2, 2/13 nodes, ER+/PR+, HER2- Surgery 11/15/2018 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting, Silicone implant Hormonal Therapy Arimidex (anastrozole) Surgery Reconstruction (left): DIEP flap Radiation Therapy Whole-breast Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery Lymph node removal; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Oct 22, 2019 06:13PM MinusTwo wrote:

This bothers me for two reasons.

1) It is a report from 2011/2013. Things change every day with cancer treatment, not to mention LE.

2) I didn't mention before, but there are plenty of studies that confirm most doctors have only 15 minutes education about Lymphadema in the entire 4 years of medical school - plus specialty training. The first of these studies came from a Stanford doc who specialized in LE. I'll look for the video.

You don't say where you are located OCD. If you have an National Cancer Hospital close by, it may be worth more research. Perhaps it's worth talking to a certified LTPT, or finding a doc who specialized in wound care & LE.

BTW - I never said flying causes LE. But it is & can be a risk. I've sat in waiting rooms with patients who's arms (or legs) are swollen to the size of elephant legs and are in extreme distress and I will take any precautions I can to avoid that.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Oct 22, 2019 06:29PM MinusTwo wrote:

OCD & Summer:

Below is a talk by Dr. Stanley Rockson from Stanford University. He points out that the average medical doc has between 15-30 minutes total of education on LE. Look at the chart at approximately 3:20 minutes into the video. There are several other links to research from Stanford and Dr. Rockson that are more current, but this is the one that first caught my attention several years ago.

I certainly am not a doc and don't want to tell anyone else what to do, but I do go overboard to protect myself. We all have to make our own decisions, but at least 3 doctors at major med center in Houston (including MD Anderson) have told me - yes, wear sleeves (and gauntlets) when you're flying - an hour before & an hour after as a precaution. And wear sleeves when you are doing repetitive activity - like digging in the garden all day.




2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Oct 22, 2019 07:35PM OCDAmy wrote:

My breast and plastic surgeon are both with an NCI Designated Cancer Center affiliated with a major university. I’m pretty sure my breast surgeon, who removes lymph nodes has had more than 15 min of training in LE. Thanks for your input.

Dx 2/2017, IDC, Left, 4cm, Stage IIB, Grade 2, 2/13 nodes, ER+/PR+, HER2- Surgery 11/15/2018 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting, Silicone implant Hormonal Therapy Arimidex (anastrozole) Surgery Reconstruction (left): DIEP flap Radiation Therapy Whole-breast Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery Lymph node removal; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Oct 23, 2019 09:10AM SummerAngel wrote:

MinusTwo, I would love to see studies that show that wearing compression sleeves during air travel prevents lymphedema.

My LANA-certified PT who advises against it has articles on StepUp-SpeakOut, so I trust her opinion and have followed it. I have flown numerous times since my surgery, including overseas, without issue.

Age at dx: 45. Oncotype, left-side tumor: 9. Right side had multifocal IDC and "extensive" LCIS. Isolated tumor cells in 1 right-side node. Dx 3/27/2015, IDC, Left, 2cm, Stage IIA, Grade 1, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 4/27/2015, IDC, Right, 1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 6/1/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right Surgery 6/1/2015 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/28/2015 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/4/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Oct 23, 2019 09:49AM MinusTwo wrote:

Summer: As I said above "BTW - I never said flying causes LE. But it is & can be a risk."

As I also said, we each have to make our own decisions. I'm glad both of you have had no issues.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Oct 28, 2019 06:28AM Oceanlove25 wrote:

Hi Amy,

I had my sentinel node removed and developed stage 1 lymphedema practically 3 weeks postop. I got in with a lymphedema physical therapist for treatment. She said that lymphedema can show up even years after surgery and she knew someone who was ten years out, flew somewhere and her arm really blew up in swelling. She said it also had to do with the pressure and altitude changes that happen when we fly. She recommended always wearing the sleeve when flying. I hope this helps.

Hugs,

Patty

Dx 1/17/2019, IDC, Left, 1cm, Stage IB, Grade 3, ER+/PR+, HER2- Surgery 2/3/2019 Lumpectomy: Left; Lymph node removal: Sentinel, Underarm/Axillary Radiation Therapy 3/11/2019 Whole-breast: Breast Hormonal Therapy 4/21/2019 Femara (letrozole) Dx 9/29/2019, Left, 1cm
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Oct 28, 2019 08:43AM SummerAngel wrote:

As discussed, there is disagreement on this topic, and many of those most trained in the subject of Lymphedema (LANA certification) do NOT recommend wearing a sleeve for those who don't already have it. There is no evidence at this time that flying causes Lymphedema, regardless of people attempting to frighten those on this board into wearing one "just in case".

Age at dx: 45. Oncotype, left-side tumor: 9. Right side had multifocal IDC and "extensive" LCIS. Isolated tumor cells in 1 right-side node. Dx 3/27/2015, IDC, Left, 2cm, Stage IIA, Grade 1, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 4/27/2015, IDC, Right, 1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 6/1/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right Surgery 6/1/2015 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/28/2015 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/4/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Oct 28, 2019 10:26AM ksusan wrote:

Nobody's "attempting to frighten" anyone. We receive different advice and have different experiences. My LANA-certified LE therapist wants sleeves on flights over 4 hours.

Mutant uprising quashed. Dx 1/2015, IDC, Right, Stage IIA, 1/1 nodes, ER+/PR+, HER2- Dx 1/2015, DCIS, Left, Stage 0, Grade 3, 0/2 nodes Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lymph node removal: Sentinel; Mastectomy: Left, Right Radiation Therapy Whole-breast Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel)

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