Ganglion possibly on my affected arm. Do I need any treatment?

[clown]

I got a new swelling on the inside of my wrist. (I have lymphedema on both arms following a double mastectomy) I have been to 2 doctors. One said it was a ganglion the other, part of my lymphedema. I was told I am wasting NHS money when I asked for a scan! It is quite painful. Any suggestions as to what I should do next?

[Lynora]

Ask your lymphoedema clinic therapist to check it out. It's generally advised to avoid any form of surgery on limbs affected by lymphoedema, but if you are experiencing pain because of this ganglion, then it may be appropriate to ask for a referral to a surgeon. Sometimes it is a fairly uncomplicated procedure, and can be done with a local anaesthetic. However, surgery is not 100% effective, and they can reoccur In some cases they can just disappear. Ask your team whether an orthopaedic surgeon could have a look.

[Lizziejane]

Sounds like it could be a ganglion & don't think connected to Lymphoedema !! I have developed Carpal Tunnel Syndrome in hand of affected arm which my GP agreed with but whether can have op to treat not yet sure? I am seeing a Consultant in Oxford early sept to discuss Supermicrosurgery which only available at the Nuffield Orthopaedic Centre so am hopeful can get some answers on that too!! As for wasting NHS funds I would be insulted&if you are in pain just what is it there for......go back to GP &tell him you want something done to help you and suffering Lymphoedema as it is is enough to deal with.......!!!

[Lynora in reply to Lizziejane]

I had carpel tunnel in both hands for about 2 years until the summer of 2002. I had breast cancer surgery and removal of all axillary lymph nodes on the left side in 2001 - when I went to see the carpel tunnel chap, he refused to treat my breast cancer affected side. I had the other wrist done and could completely understand why he didn't want to touch my bc arm - it wasn't so much the procedure (took a few minutes at most) it was the application and loosening of the tourniquet that was the toughest bit!!!! All done under local anaesthetic, so I was able to watch was going on. I did remark at one point that I felt sure they were cooking roast pork in the hospital kitchens near by, but the surgeon laughed and said 'That roast pork is me cauterizing your blood vessels!!' Should have offered me some apple sauce!!!

Whether it was coincidence or not, I never experienced carpel tunnel pain in the untreated side from that time.

I have since met women who have found a lot of help for CTS with therapies like Bowen Technique, osteopathy - and MLD can help too.

[LymphSuppNetwork Partner LSN]

Dear Clown

Thanks for the enquiry - sorry about the delay in replying - Having checked the information with our nurse advisor we are able to give the following advice. Lynora is right to say that historically one was advised to avoid all surgery but the latest thinking is that necessary surgery which will improve quality of life of the person of maintain the functionability of a limb should be judged on an individual basis. Weigh up the pros and cons for your individual situation but, in most cases, go for it bearing in mind the following - make sure your lymphoedema is as stable as possible pre op -this may mean talking to your therapist and having some pre op bandaging, ask your GP surgeon to prescribe you a course of antibiotics to being before surgery and to continue during your recovery - this will minimise the risk of infection. An increase in swelling is normal post op but should subside as healing takes place - follow advice about movement and exercises specific to the operation really pro actively - with support from your lymphoedema specialist get back into your prescribed compression as soon as it is possible to do this, be especially vigilant about your skin care both approaching your op and as you recover and finally take along with you a copy of the LSN fact sheet ' what is lymphoedema' you would be surprised how many health care professionals do not know about the condition.