[dlaxague]

Hello,

I know that many women swear by their sleeves but if you do not actually have lymphedema (but are at risk for it), there is no evidence that wearing a sleeve will prevent its development. The only evidence that exists (about domestic flights) actually trends toward a suggestion (not proof) that a sleeve may make things worse rather than better. The reason that this may be true is that the smallest lymph channels run right under the skin and are very fragile. If you do not already have swelling (which "cushions" things), the sleeve may impair drainage rather than enhance it.

I think that the bigger culprit when flying is immobility. Squeezed like a sardine into a seat for hours at a time - that is guaranteed to slow both blood and lymph circulation and is know to lead to swelling of lower extremities (and clots, etc). Also we are easily dehydrated when traveling, and we are more likely to be lifting and carrying more than we are accustomed to and not paying a lot of attention to our body's cues. I try to get my affected arm on the aisle and I move it a lot - up and down, scratch my back, "wring" my arm out by twisting at the wrist, clench and unclench fist, etc. Same thing with long car trips.

Also related to the immobility issue is the fact that sleeves are not intended for use when immobile (for example, no one would suggest that you sleep with a compression sleeve on). If you feel that you must wear a sleeve, please move that arm a LOT. (sleeves are different from bandaging/wrapping).

Lymphedema is an area that is lacking in good research, but that's getting better. Lots of the edicts that you'll hear bandied about for preventing or managing lymphedema are not evidence-based. You'll hear some of the misleading information (alas) from supposed lymphedema experts - even certified therapists. "We" (people in general) do like to think that we know all about a problem and have lots of solutions. "We" (people in general) just hate to admit, or to hear, that not enough is know to give a clear answer. But the hard news is that for many issues of lymphedema we do not have a clear answer.

Here is what we have, about domestic flying (I don't think the abstract is a very good summary. I have the full text in a PDF file and can send it to your private email if you'd like). Sorry about the bad formatting:

SUMMARY. This study aimed to assess exposure to flying in breast cancer survivors and assess the relationship of
flying to lymphoedema. A total of 293 relapse-free breast cancer survivors with known pathology and treatment
details and prospectively measured arm circumferences were surveyed for their flight exposure and precautions
history. Of these, 287 responded, with a mean follow-up of 31.6 (4±111) months. A total of 50.5% had flown, and of
these, 27% had travelled overseas. The mean number of flights was 5.3 (1±100); 24% had taken lymphoedema
precautions, 90% of which utilized compression techniques. There was no signifcant difference in lymphoedema rates
for fliers (11.2%) and non-fliers (8.3%). No woman reported permanent (new or increased) swelling after flying. Of
the nine reporting temporary swelling, six reported 1±3 concurrent potential risk factors. On regression modeling for
both measured and self-reported swelling endpoints the use of precautions (OR 5.6 for lymphoedema and 3.7 for
flight-related temporary swelling) were statistically signifcant. For patient-reported swelling, the number of positive
nodes (OR 1.2) and the number of overseas flights (OR 1.4) was also signifcant, whereas for clinical lymphoedema
age (OR 1.07) was signifcant. We conclude that domestic air travel (54.5 h) is low risk and that compression devices
are possibly counterproductive. # 2001 Harcourt Publishers Ltd