Edema

If necrosis was removed and there is still hardness, then it is most likely from either 1) additional / remaining fat necrosis, or 2) edema (can feel hard, especially likely in radiated tissue). In either case, resolution is likely without additional surgery if you wait long enough (may take 1-2 years), although breasts will be smaller in either case. If pain is present, and fat necrosis is still present, then surgery to remove the rest of the dead fat may be indicated.

Richard M. Kline Jr., M.D.

In addition to all of the above, ask your doctor about a broad spectrum probiotic. Depending on the type of cancer and medication you are taking, these can be either very helpful or not advisable if they interfere with the treatment protocol.

Hives, also known as urticaria, are flat topped bumps, called wheals or welts, that swell and are redder than the surrounding skin and itchy. The welts vary in size and may join together and form larger areas. Unique to hives is the fact that they change shape, go away, and then crop up later on different parts of the body. Hives may appear suddenly. Hives are caused by insect bites, medications, or foods and are the result of the release of histamine from cells in the skin. Hives usually last 24 hours.

Hives around the face, especially the lips and eyes, is called angiodema. Swelling from angioedema may also be seen in throat, hands, and feet.

Hives may be the first sign of an anaphylactic reaction, which is a severe allegic reaction that is life threatening. If any of the following symptoms appear after hives, seek emergency treatment immediately: shortness of breath, difficulty swallowing, your tongue swells, nausea, weakness, and confusion.

Here are a couple of other resources on hives:
http://www.nlm.nih.gov/medlineplus/ency/article/000845.htm#Definition
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001848/

Hives are patches of edema (swelling) that occur on the skin surface. Hives are swollen areas of the skin that are red and itch. Hives may change shape, go away, and reappear. Hives commonly appear in the upper arms, legs, neck, and sides of the body.

Treatment
- For mild symptoms treatment may not be needed
- Avoid the offending agent causing the hives
- Cool soaks

- Over the counter treatment includes
- Antihistamines topically or orally;
- Anti-inflammatory medicines (corticosteroids such as hydrocortisone cream topically or oral agents)

For moderate to severe symptoms which include breathing difficulty, emergency treatment should be initiated.
Epi-pen (Epinephrine) may be administered.

Edema is abnormal retention of fluid in your body.

Symptoms include:
- After walking or standing your feet and legs appear swollen and skin appears stretched and shiny (especially at the end of the day)
- Shoes feel unusually tight
- When you make a fist, your hand feels abnormally tight.
- The ring on your finger is too tight
- Stomach or abdomen is swollen
- When you remove your socks there is an indentation from the elastic that remains there longer than normal
- There is swelling or puffiness under your skin and when you press on your skin a dimple remains which is slow to disappear.

It is important to contact your physician if:
- Experience difficulty breathing, rapid breathing, or shortness of breath
- If you urinate a small amount or none at all
- Gained more than 5 pounds in a week or short period of time
- Chest pain
- When touching your hands and feet they feel cold

Excess fluid beneath the skin is called edema. It is most prevalent in the feet, ankles, hands and face, but edema or swelling may also appear in other parts of the body. The accumulation of fluid may be from chemotherapy treatment, cancer surgery, heart failure, or an allergic reaction.

Other causes might be:
-Too much salt in the patient's diet
-Blockage of lymph system, especially after a mastectomy or surgery
-Heart failure, kidney or liver problems
-Excessive standing, walking, exercising in warm weather and sun exposure (resulting in sunburn)

To reduce the swelling:
- limit the amount of salt you eat
- when sitting, raise your legs and hands
- wear support stockings
- your physician may prescribe a diuretic (water pill)

If you notice swelling in your throat, tongue, lips, eyelids or airway, this may be an allergic reaction which could result in suffocation. It is important to seek aid immediately.

Actions to manage edema include:
- Try to keep your feet elevated, do not stand for long periods of time, and do not cross your legs while sitting.
- Consider sleeping with a pillow under your feet and lower legs
- Wiggle and exercise your feet, toes, and lower extremities during times of sitting or extended times of standing
- Consider exercising 3-5 days a week
- Avoid tight clothing (shoes, girdles, etc).
- Avoid extreme temperatures such as hot baths
- Try to watch your salt intake and avoid salty foods such as ham, processed food, canned soups, chips, french fries, and consider reducing trans fatty acids such as margarine and use olive oil instead.
- Eat diuretic vegetables such as asparagus, parsley, beets, grapes, green beans, leafy greens, pineapple, pumpkin, onion, leeks, and garlic
- Avoid tobacco and alcohol
- With permission from your physician you might consider wearing support stockings or hose.
- Consider weighing yourself often and inform if your physician it you gain weight and have trouble breathing. (A significant amout is 5 pounds or more in a week.)

To treat edema, it is important to treat the underlying cause. But if the cause can not be treated, the physician might recommend a treatment plan including a diuretic.

Diuretics are known as "water pills" as they work by making you urinate excess fluid. Some examples of these medications are furosemide (Lasix), Torsemide, Butethamine, metolazone and Hydrochlorthiazide. You may receive this medication alone or in combination with other medications.