Blood tests from snb arm

Hi ladies

I’m hoping someone out there can help me. I am due in to have my ovaries out at the beginning of September and when I went for my pre op the nurses had a hard time getting blood out of me. They got an anaesthetist in to try and she gave up in the end and said I would have to go back, she also said that it is ok to take blood for testing from the side you had your sentinal node biopsy. I always thought that this couldn’t be done, I need to go back on August 1st for a second try and would like any advice on this.

Thank you

Jackie

no dont let them do it… ask for a phlebotomist to do your blood test, if you have had any glands removed under the arm it is not advisable to have bloods taken or blood pressure … there should be no restrictive pressure … i work for the nhs i am a phlebotomist, angie x

Angie is right absolutely don’t let anyone take blood, BP or put a cannula in the side where you’ve had nodes removed because of the risks of developing Lymphoedema. She may feel that the risk is low because you had SNB rather than having some or all nodes removed but I would err on the side of caution if I were you.

I have terrible veins and a phlebotomist has always been able to take blood from my good arm.

Nymeria x

Hi Jackie

I thought that as i had only had SNB and no nodes removed that I could let them use my operation side arm. I phoned the lymphodema society (their number was on the hospital web-site) and was told that the fact that you’ve had surgery puts you at risk from lymphodema and not to let anyone use that arm.

Like you, I have veins that hide and it always takes them several attempts to put in a cannula.

that’s something i hadn’t thought about, so do u mean u should never let them take it from the affected arm or just until it’s healed up? x

I was told never. I had my mx last October

I’ve been told never too.

oh right, thanks for the info, i learn something new everyday on this site! x

yeah, can’t imagine what people did before this site. It would have been a complete lottery as to whether the hospital staff told you what you needed to know.

NEVER EVER … there are plenty of other places they can get blood from the back of the hand for one. or even a thumb prick, that arm now should be protected by you for life… the only time we as phlebotomists use the affected arm…WITHOUT restriction is if glands are removed from both sides and only if no other suitable spot can be found

I agree with others - don’t let them stick you.

I had full node clearance and don’t even let them take blood pressure on that side now, let alone stick anything in there. Wear insect repellant too so don’t get stung whilst out in garden too…

Just as an illustration of how the removal of even a small number of nodes can affect you - I only had two removed in the SNB and therefore assumed that I wouldn’t be affected by it since there were so many nodes still left. I was wrong! I over-did things by gardening madly over a weekend 10 days ago and that resulted in cording in the armpit on that side and increased stiffness in my breast, and that’s a year after surgery.

My GP had warned me not to have blood pressure checks, injections, etc on that arm, now I understand why.

Sarah x

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Hi Jackie
I went in for an oophorectomy a couple of weeks ago and had the same worries as you.
At my pre-op I said I had difficult veins and could I go to the blood lab instead (as I know they are well-trained and don’t prick you endlessly without result). So that hurdle taken succesfully.
On the day of the operation, I vented my worries about needles in my right arm and was given a red band around my wrist indicating an allergy. The nurse said that these red wrist bands always set off alarm bells with the anaesthetist. So I mentioned it to the anaestethetist pre-op. She said, repeat this when you get to theatre (as if I had nothing else to worry about!). So I made sure they put the canulla in my left hand and was assured they would not touch my right.
My op was late afternoon so included an overnight stay, a very alert staff nurse had put a laminated note on the right hand side of my bed which said: no bloods, no blood pressure to be taken from right hand side. Mind you, I ended up on the breast surgery ward, instead of gynea ward, where they are very alert on these type of things.
Others have suggested to just write on your arm, no needles!
Good luck!

As others have said, nothing in that arm.

They can use your feet. I had a full axillary clearance and then on the arm on other side developed multiple blood clots. I therefore had a full general anaesthetic administered in my foot - on two occasions. I also had blood pressure checked on the leg.

I’d suggest taking something from the lymphodema society in with you so you can point out the risk. The problem is that many health care professionals simply don’t have any knowledge or very limited knowledge about the risks of lymphodema or lymphodema itself.

Hope it all goes well. Elinda x

My GP surgery is very good - when the phlebotomist was unable to get blood from my good arm a couple of weeks ago, I was seen by the duty doctor who took blood from my foot (which was fine, certainly not a problem after the six attempts in my arm!!), and they all took the risk of lymphodeoma very seriously.

Hi Elinda
That is very true about health care professionals being unaware. When I was walked to theatre by a member of the anaesthetic team I mentioned ‘no needles on right as I have had node clearance’, the guy asked me: are you right handed? To which I replied, no left handed. He then went on to ask whether I was sure to have the canulla on the left?? Seemed he was totally unaware of the lymphodema risk.
Nikki

My GP insists that it is perfectly o.k. to take my blood pressure on my affected side. I like a coward do not protest but in future i will. I’m due for a reconstruction soon so i’m going to make sure they don’t do anything to that side (other than give me a new boob :slight_smile:

Here is a list of dos and don’ts from Breast Cancer Org (USA):
breastcancer.org/tips/lymphedema/avoid.jsp

This is from the Lymphodema support Network UK - and is advice specifically for doctors:

lymphoedema.org/Menu4/3What%20can%20I%20do%20for%20my%20patient.asp

Beaniebaby - I would take that in next time you see your GP or ask if he/she has seen new research that contradicts all the current advice.
Whilst there doesn’t seem to be any strong evidence that I can see on things like blood pressure being done on the at risk arm, it logically makes sense to be careful.
All the advice I’ve seen from breast cancer organisations, specialists, lymphodema organisations etc is the same - No blood pressure readings on the at risk arm unless absolutely essential.
With blood pressure, you will be preventing the free flow of lymph fluid in that arm and causing a backlog of fluid.
With needles, the risk is of infection.

I don’t fully understand myself all of this and why getting an infection may cause lymphodema. Perhaps someone else does?
I will ask my lymphodema nurse next time I see her but that probably won’t be for ages now. elinda x

Hi Elinda,

That information was very useful, thank you. I will make sure in future that she takes my blood pressure in my other arm.