QuestionMr. Cusumano,
First off, I'd like to thank you very much for the response.I got a better understanding of my wife's condition.
After reading your response i found a site and i learned that all the axilla lymph nodes sit in a fatty packet (that's how they described it). Said it would be easy enough to tell if one had a total axilla lymph node dissection by just feel. After looking and feeling my wife's armpits (just behind pectoral) i could feel that fatty packet on the left side (good arm). However, I could notice a indentation on her right axilla. After i touched this indentation it was hollow and just caved in (Mrs nearly belted me because of pain).
Could this be true as to tell that that easily? I can't believe after all the doctors she has seen, none has told her this...
Back to the MRI issue...If i may. Your last response you said MRI should show nodes and you felt reason none were showing is because they were gone. With that fatty packet gone, would that not stick out like a sore thumb on a MRI? I'm just not sure if fat tissue would show and maybe this could be the reason it has not been mention.
Last question, Besides from the lymphedema, nerve and muscle damage, Should we be concerned about any other problems down the road as i understand it's part of the immune system? Just concerned that she appears to have no nodes on that side...
Thank you once again for your time...
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Followup To
Question -
Mr. Cusumano,
Would a MRI show the lymph nodes in the axilla area?
My wife had a cyst removed in Aug. 02. After surgery she was told that he went up to armpit (tunneled) and removed a lymph node. in records said he removed Intrammary node (also in right breast i found)
She has been told by all doctors she has Lymphedema but they avoid the topic of lymph nodes and why her armpit is deformed. After surgery she had a vein that popped out from under her armpit, came down her side and crossed over her stomach. This lasted a few days. She has numbness on the upper inside and outside of her right arm. A burning pain on back of arm and limited shoulder movement, also has a problem with infections.
The first MRI said, "maybe cellulitis". From looking on the net this morning, i found that all the above symptoms are expected from a total axilla lymph node dissection.
My wife recently had a second MRI where they found the pectoral muscle has been cut and they want to repair that. Question on this too....Can this be repaired after a year and a half? would it not be scar tissue and just come back?
My wife has applied for disability and this cellulitis thing is clouding things up. She has been told the two MRI's do not show her lymph nodes. We're not sure if Dr. is avoiding the subject (malpractice) or if they really would not show up on MRI.
If not...is there any kind of test that would. She would really like to avoid another surgery in that area to find out just what is going on with her with lymph nodes...even leaving the pectoral muscle as is.
Any help would be greatly appreciated...Thanks
Answer -
Hi Mike,
I can understand your confusion about this. If she had a radical node removal from her axilla, she can expect all the symptoms she is now experiencing.. There would be disruption of lymph drainage system causing the swelling in the arm and surrounding axillary tissue; the burning is a result of nerve trauma during the surgery and should resolve in time even if nerves were transected. There is a possibility that she has developed a neuroma at the surgical site. This is scar tissue around the nerve endings that causes chronic pain. The torn Pectoralis can be repaired even this late but it would not guarantee return to full function. The repair should hold despite the time lapse. The other thing is that unless she has a dysfunction due to the Pectoralis injury, she might just decide not to do anything about it. The cellulitis is inflammation of the tissue around the surgical site. This can be caused by bacteria or constant trauma by the arm's movement at the shoulder. The lack of nodes found on MRI suggests to me that they were all removed.
AnswerHi Mike,
The indentation is the empty space left over from removal of the lymphnodes and fat. That will eventually shrink to conform to the arm's architecture. As for the fat and the MRI, the MRI can differentiate between fat and nodes. Fat is easily seen and identified. The loss of nodes in her axilla will not lend her to an immune deficit. She should not have IV's or blood pressures or blood sticks in this arm in the future.
PS: leave your poor wife's axilla alone. I'm not surprised that she tried to clock you :-).
