Flying and Lymphedema

I havent been here for a while. Janet has finished her year of Chemo &
Herceptin and, apart from a nurse practitioner finding a lump which turned out to be part of her breastbone, all seems to be going well.

She is flying to Egypt in March, (about 6 hours or so), and is worried that flying could cause lymphedema.

She also intends to go scuba diving, so I think I should also ask if the pressures involved in diving can cause lymphedema?

I looked up lymphedema on the Uptodate web site.

Some interesting facts:
it doesn't matter if you have lumpectomy or mastectomy both have equal risk
Sen. node reduces the risk but not eliminated the risk.
Most occurences happen 3 years after initial surgery.
The older the women the higher the risk.

The precautions - listed - limiting blood draws, BP, etc have never been researched but come from nursing literature.

Good response. You have special status here Tim; many people see you as the fount of wisdom and I certainly recognize your wide ranging knowledge on the subject as well as your generosity with your time. However all this means that you have a very special responsibility to take great care with what you say. Lymphedema is an area in which we are not well served by the medical profession and we are all groping for a certainty which doesn't exist.

Perhaps I misspoke; what I meant to say is that a pressure sleeve has uniform pressure throughout, whereas a wet suit may well not. A wet suit has tight seals at the neck, wrists and ankles but may be more or less snug over the remainder of the body.

My wife wears a pressure sleeve when flying and is okay so far. If you get one make sure the sleeve is fited by a professional. Dunno about scuba; in the US I'd suggest you try asking Divers Alert Network whose # for non-emergency diving questions is 1-919-684-2948 ET. They also have a web site www.diversalertnetwork.org where there's probably a way to ask.

lymphedema -- is quite poorly supported by research. I've read what I can find on the subject, and it seems that even the question of whether exercise is beneficial or risky is not yet answered definitively.

So true. I recently found an article that suggests that treatment of lymphedema is the same as it was--believe it or not--in the late 1800's--yep
1800's--which surprised me as I thought that in some post where I said it was at the primitive level wasn't that far off base.
And Anthony commented that a wet suit was unlike a compression sleeve in that pressure was uniform throughout. Well, some lymphedma sleeves are like that, too--the Reid sleeve which one generally wears at night-- comes with a pressure gauge and one is supposed to adjust it to 20 lbs of pressure evenly each time one uses it. Also lymphedema pump that is used is also gauged at 20 lbs of pressure throughout.

The older the women the higher the risk.>>

I seem to again be on the negative side of such events...I woke up from my bilateral mastectomy, which I had at age 50, with signs of lympohedema which in my case was discomfort in my elbow as well as upper forarm--same side as malignancy and lymph node removal.

I agree with all you say, but we have to do the best we can, which in this case seems to be to consult the professionals. If flying is thought to aggravate the chance of lymphedema, presumably because of the pressure changes, then scuba seems to me to me risky business indeed, involving as it does much more severe changes in pressure; even recreational divers routinely dive to depths where the pressure is 4 1/2 atmospheres, a much, much more significant change than experienced in a commercial airliner. The all-over nature of the pressure which you mention seems irrelevant; if it doesn't protect when flying why would it do so when diving? And the wetsuit argument strikes me as bullshit. But of course, what do I know?

You make an incorrect assumption here. Lymphedema is serious business and the OP needs specialist medical advice on the matter of scuba diving.

Two incorrect assumptions. First, a wet suit is not like a compression sleeve. A compression sleeve is, or should be, professionally fitted to provide firm and equal pressure along the limb. Very few divers have custom wet suits. Off the peg wet suits, if they are to do their job, will have tight seals at neck, wrists and ankles but may not fit closely over the whole body and will generally be chosen for their reasonable fit over the torso. Second, by no means all scuba diving is done in a wet suit; in warm water plenty of people dive with just a swim suit, and in cold water a dry suit, quite a different matter than a wet suit is necessary. I was annoyed by what seemed to me a flippant and ill-informed response on your part to a very serious question. And although you say no-one knows about this, starting, as I suggested, with DAN, an organisation dedicated to dive medecine and based at Duke Medical Center makes an awful lot more sense than relying on the guesswork provided by amateurs on the internet. This is not a matter of your or my ego, it's a matter of the best chance of the OP's wife to enjoy continuing health.

Cathy - it was me! <g>

Janet will be delighted to hear that you have faired well diving.

A poll of 1 is clearly not definitive, but it is better than a poll of
0, (in this instant).

Now where are all the others? <g>

<Snip>

That's interesting; thanks for posting it.

Thanks for the reference - here is my reply from DAN:

Thanks to all who have replied. I think she has a sleeve for the flight, and she is very aware of DVT. The wet suit thing seems to make sense - a bit like all over compression.

I wasnt looking for a medical opinion, just some experience and thoughts, which is what we get here.

i fly for an hour and a half without a sleeve since i forgot it one time - don't have no effect in a pressurised aircraft ... don't know what would happen if the pressure failed tho. ... got no lymph nodes for my left arm.