Sandra Lee Hospitalized with Post-mastectomy Complications

Food Network celebrity Sandra Lee has been hospitalized due to complications following breast cancer surgery.

According to Page Six, the 49-year-old Semi-Homemade Cooking host was rushed to the hospital when she experienced an ” an extremely painful fluid buildup” in the areas where she had undergone a bilateral mastectomy in May 2015. She had been diagnosed with cancer earlier in the month. A friend of Lee’s told Page Six:

“She’s going to be in for a couple of days.She started having pain. She knew something was wrong. It’s some sort of fluid buildup and pain. She was just feeling general ­fatigue and run down.”

Lee’s long-time partner, NY Governor Andrew Cuomo, was reportedly at a his friend Billy Joel’s farewell concert at the soon to be closed Nassau Coliseum , but rushed back to be at Sandra’s side.

Specifics about the Lee’s medical condition were not released, but this gives us the opportunity to talk about two potential post-mastectomy complications, both of which involve the abnormal collection of fluid: seroma, and lymphedema.

Seromas

Seroma

Seroma

A seroma is a collection of serous fluid in a place where tissue has been removed by surgery. Serous fluid is sterile, clear to pale yellow body fluid which lines the inside of body cavities. Fluid can build up under the skin typically close to an incision site. Seromas typically occur within 1-2 weeks after surgery.  If the fluid builds up too much, the area will look swollen and may be painful.

If the seroma is small, nothing may need to be done. The excess fluid will be reabsorbed by the body. Larger seromas are treated with removal of the excess fluid with a needle and syringe. This may need to be done more than once. Pain medication such as acetaminophen or ibuprofen may be suggested to aid with pain.

Although uncommon, seromas can become infected, so patients should look out for signs of infection, including redness or warmth at the site and fever over 101.4 F or drainage of cloudy or bloody fluid from the incision.

Lymphedema

Lymphedema is the build-up of fluid in soft body tissues when the lymph system is damaged or blocked.  It is a common problem that may be caused by cancer and cancer treatment. Lymphedema usually affects an arm or leg, but it can also affect other parts of the body.

A quick lesson about the lymphatic system:

LymphaticSystemThe lymph system is a network of lymph vessels, tissues, and organs that carry lymph throughout the body.

The parts of the lymph system that play a direct part in lymphedema include the following:

  • Lymph: A clear fluid that contains lymphocytes (white blood cells) that fight infection and the growth of tumors. Lymph also contains plasma, the watery part of the blood that carries the blood cells.
  • Lymph vessels: A network of thin tubes that helps lymph flow through the body and returns it to the bloodstream.
  • Lymph nodes: Small, bean-shaped structures that filter lymph and store white blood cells that help fight infection and disease. Lymph nodes are located along the network of lymph vessels found throughout the body. Clusters of lymph nodes are found in the underarm, pelvis, neck, abdomen, and groin.

When the lymph system is working as it should, lymph flows through the body and is returned to the bloodstream:

  • lymphatic ductsFluid and plasma leak out of the capillaries (smallest blood vessels) and flow around body tissues so the cells can take up nutrients and oxygen.
  • Some of this fluid goes back into the bloodstream.
  • The rest of the fluid enters the lymph system through tiny lymph vessels. These lymph vessels pick up the lymph and move it toward the heart. The lymph is slowly moved through larger and larger lymph vessels and passes through lymph nodes where waste is filtered from the lymph.
  • The lymph keeps moving through the lymph system and collects near the neck, then flows into one of two large ducts.
    • The right lymph duct collects lymph from the right arm and the right side of the head and chest.
    • The left lymph duct collects lymph from both legs, the left arm, and the left side of the head and chest.
  • These large ducts empty into veins under the collarbones, which carry the lymph to the heart, where it is returned to the bloodstream.

Lymphedema occurs when lymph is not able to flow through the body the way that it should.

Cancer and its treatment are risk factors for lymphedema. Lymphedema can occur after any cancer or treatment that affects the flow of lymph through the lymph nodes, such as removal of lymph nodes or radiation therapy. Lymphedema often occurs in breast cancer patients who had all or part of their breast removed and axillary (underarm) lymph nodes removed.

It may develop within days or many years after treatment. Most lymphedema develops within three years of surgery.

Possible signs of lymphedema include swelling of the arms or legs. Other symptoms can include:

  • outline-edemaSwelling of an arm or leg, which may include fingers and toes.
  • A full or heavy feeling in an arm or leg.
  • A tight feeling in the skin.
  • Trouble moving a joint in the arm or leg.
  • Thickening of the skin, with or without skin changes such as blisters or warts.
  • A feeling of tightness when wearing clothing, shoes, bracelets, watches, or rings.
  • Itching of the legs or toes.
  • A burning feeling in the legs.
  • Trouble sleeping.

How is lymphedema treated?

The goal of treatment is to control the swelling and other problems caused by lymphedema.

Damage to the lymph system cannot be repaired. Treatment is given to control the swelling caused by lymphedema and keep other problems from developing or getting worse. Physical (non-drug) therapies are the standard treatment. Treatment may be a combination of several of the physical methods. The goal of these treatments is to help patients continue with activities of daily living, to decrease pain, and to improve the ability to move and use the limb (arm or leg) with lymphedema. Drugs are not usually used for long-term treatment of lymphedema.

Treatment of lymphedema may include the following:

  • Pressure garments
  • Exercise
  • Bandages
  • Skin care
  • Compression device
  • Weight loss
  • Laser therapy
  • Massage therapy

Source: NCI

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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