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Topic: Cortisone shot in lymphadema arm...is this a bad idea?

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

Posted on: Nov 18, 2020 07:13PM

amanda6 wrote:

i have a lymphadema flare going on, first in 10 years, & it has caused a compressed ulnar nerve in my elbow. Actually not sure which came first - the nerve thing or the lymphadema - anyway it has become very painful. I I saw an orthopedic surgeon today & he suggested a cortisone shot for relief - I'd love relief, but this seems scary to me. I'm currently being treated by a clt & the elbow swelling is lessening, but it's stubborn. I can't take nsaids because of heart meds I take.

Does anyone have experience with this or something similar? Any thoughts will be greatly appreciated!

Dx 2/2010, Left, 2cm, Stage IIIA, 4/10 nodes, ER+, HER2- Radiation Therapy 8/30/2010 Breast, Lymph nodes Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy Femara (letrozole) Surgery Lumpectomy; Lymph node removal
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Nov 18, 2020 09:36PM SpecialK wrote:

Can you speak to your therapist and ask their opinion? I did not need a cortisone shot in my LE arm but have had two skin cancer removals on the upper arm - one near the shoulder that was approx a two inch wide excision, and later had another similar size MOHS surgery for a recurrent infiltrating cancer on the part of the bicep area you would see in the mirror facing forward. Fairly deep tissue removal of about a square inch for both of those. I had a sensation of arm irritation for a day or two and could not use my pump or wear a sleeve, but no worsening of my decently well controlled lymphedema. I have also had a crushing injury - the hood of my SUV closed suddenly on my hand - and it did not cause me any long term problems either. I have had b-lateral lymphedema for almost ten years with several flares during that time.Of course, I am a study of one, and what holds true for me might not for you, but I sure hope you can get some pain relief without exacerbating your lymphedema. Good luck!

BMX w/ TE 11/1/10, ALND 12/6/10. 15 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 6/18/13-present. Dx 9/27/2010, DCIS, Stage 0, Grade 3 Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+ (IHC)
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Nov 18, 2020 10:04PM ShetlandPony wrote:

How much does this orthopedic surgeon understand about lymphedema? I hope he does not have tunnel vision in his own specialty. I agree with SpecialK that your lymphedema specialist needs to weigh in here. Can you get those two to discuss your case by phone?

2011 Stage I ILC 1.5cm grade1 ITCs sn Lumpectomy,radiation,tamoxifen. 2014 Stage IV ILC mets breast,liver. TaxolNEAD. Ibrance+letrozole 2yrs. Fas+afinitor nope. XelodaNEAD 2yrs. Eribulin,Doxil nope. SUMMIT FaslodexHerceptinNeratinib for Her2mut NEAD
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Nov 19, 2020 08:22AM amanda6 wrote:

thanks for your replies...I will see my therapist today & run it by her. The suggestion of having the 2 confer is a good one. My impression was that the doc had a decent knowledge of lymphedema & was a pretty open guy. I'll let you know where this goes, much appreciated :).

Dx 2/2010, Left, 2cm, Stage IIIA, 4/10 nodes, ER+, HER2- Radiation Therapy 8/30/2010 Breast, Lymph nodes Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy Femara (letrozole) Surgery Lumpectomy; Lymph node removal
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Nov 19, 2020 07:51PM LivinLife wrote:

I am just finishing P.T. for tennis elbow. Your condition may be different though I was told to avoid cortisone shots for this condition as much as possible and that wasn't about lymphedema. P.T. made the difference for me though it took a while. since you have some concern due to lymphedema maybe check with one of your docs about trying P.T. first and see if that helps. A cortisone shot could always be an option later. I suppose P.T. may be a risk factor too tho?

Dx 7/2020, DCIS, Left, 1cm, Stage 0, Grade 3, 0/1 nodes, ER+/PR+ Surgery 8/31/2020 Mastectomy: Left; Prophylactic mastectomy: Right
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Nov 19, 2020 08:19PM amanda6 wrote:

thanks Livin, that's helpful info. Saw my clt today ( she's also a physical therapist ) & she doesn't like the idea of a cortisone shot. She thinks my stiff shoulder is contributing to the pain & taught me some exercises - they do seem to help. I see the orthopedic guy on Mon & the clt again on Tue. I have a lot of confidence in my therapist, she's really good, so we'll see where this goes...thanks again for your input:).

Dx 2/2010, Left, 2cm, Stage IIIA, 4/10 nodes, ER+, HER2- Radiation Therapy 8/30/2010 Breast, Lymph nodes Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy Femara (letrozole) Surgery Lumpectomy; Lymph node removal
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Nov 20, 2020 05:36AM Rah2464 wrote:

I try to avoid needle sticks in my bad side as much as possible (for example flu shot etc). But I do have acupuncture on that arm routinely. So it is a toss up. Amanda6 I think you are wise to pursue all other avenues of assistance first and then go to the cortisone shot as a last resort. My MO explained to me that the main risk with a needle is infection from the puncture not a nerve response that leads to swelling. Is that anyone else's understanding?

Dx 5/23/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (IHC) Surgery 6/26/2018 Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 7/26/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Nov 20, 2020 09:47PM amanda6 wrote:

Thanks Ky, interesting, do you do the acupuncture for your lymphedema? I have a lot to learn about lymphedema, there seems to be a fair amount of conflicting info out there about it. I was assuming that the injection would "confuse" the lymph system rather than the stick being a possible entry for infection... I'm going to run that by my therapist.

Dx 2/2010, Left, 2cm, Stage IIIA, 4/10 nodes, ER+, HER2- Radiation Therapy 8/30/2010 Breast, Lymph nodes Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy Femara (letrozole) Surgery Lumpectomy; Lymph node removal
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Nov 21, 2020 05:11AM Rah2464 wrote:

Amanda I do the acupuncture for my hot flashes which are legion ha I go about every 3 weeks.

Dx 5/23/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (IHC) Surgery 6/26/2018 Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 7/26/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Nov 21, 2020 04:02PM MinusTwo wrote:

Amanda - conflicting is an understatement. Not to mention that most docs only have about 15 minutes education on LE during their entire medical school years (from Stanford). Doesn't look like anyone posted this very valuable link yet on this thread. Such good information.

Good luck with your decision

https://www.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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Nov 21, 2020 10:25PM amanda6 wrote:

Thanks for that link minus, it's a great resource!

Dx 2/2010, Left, 2cm, Stage IIIA, 4/10 nodes, ER+, HER2- Radiation Therapy 8/30/2010 Breast, Lymph nodes Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy Femara (letrozole) Surgery Lumpectomy; Lymph node removal

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