Symptoms after RPLND

[Watson]

I had a Post-Chemotheraphy RPLND 8 days ago, and have 3 symptoms I am concerned about. Has anyone had these symptoms?

1) Acidic taste in throat and mouth- I feel like I have gastric bile in my mouth. Has anyone else had this after RPLND? Is this normal or associated with any complications? I have no nausea, only a bad acidic taste coming from my throat.
2) One leg is very swollen- all the way from thigh through foot (they did an ultrasound at hospital and confirmed there was no blood clot)- the swelling went down before I was discharged, but the swelling came back in full force last night.
3) Scrotum swelling- I am told this is normal and will go down within a couple of weeks, but it is HUGE.

Thanks. I am especially concerned about the bile taste and the fat leg and foot....

[Kat]

Possible side effects from RPLND are lymphadema or chylous ascites. Your lymphatic system goes nuts, for lack of a better word, due to trauma in your lymph nodes. What happens is you end up with excessive lymphatic fluid that has no where to go, so it generally follows gravity---landing in your feet, legs, and scrotum. You should call your doctor immediately and let them know what is going on, or you could end up in a lot of pain. Your doctor may need to drain the excess fluid so that you don't swell up like a balloon. When Patrick had his RPLND, he had chylous ascites, which is essentially lymphadema (excess lymphatic fluid) that is full of fat, because his body could no longer process fat. However, he didn't swell up (then) because they left in a drain for quite some time after his surgery. This is not the normal course of action. They usually prefer to give your body time to absorb the excess fluid on its own, and if that doesn't work, they drain it. In order to get it to go away (sort of) Patrick had to go on a fat free diet (because of the fatty part of his complication). Presumably when you were discharged from the hospital they told you to stay on a low-fat diet for a few weeks---take them seriously.
So, the moral of the story is, call your doctor. No, you're not going to suddenly drop dead because of it, but it absolutely needs to be treated ASAP. In the meantime, elevate your feet and legs, and ALSO your scrotum. Yes, I'm serious. If you have a small hand towel or washcloth, wad it up and put it under your scrotum while you are sitting, so that the fluid drains back into your torso.
Also, even though they checked you for blood clots recently, they should KEEP checking as long as you are still swelling.
As for the weird acid/bile tasting thing?---how far out are you from chemo? Patrick had a horrible acidic taste during and after chemo for quite a while. It could just be that. But, I'd make sure you tell your doctor that, too. At least there's a pill for that! (As though you haven't taken enough pills by now, right?)
Best wishes!!! Call your doctor!!!

[Watson]

Kat- Thanks so much for your response. We did call the doctor yesterday (Dr. Sheinfeld- MSKCC) and he is not concerned and told me to wait it out for a bit, and call if it gets worse or does not go down within a day or two. I figured I'd post to see if anyone had the similar bile taste or one leg swollen as these seem to be symptoms that are a little on the strange side..... I did just finish up Chemo 4 weeks ago, but the change in taste I have had from that seems different.

This morning I woke up with a cough that produced some bright green-yellow vomit. My throat was itchy, like it had a piece of food lodged in there, and I coughed until the small amount of vomit came up. After that, the throat irriation was gone. I am hoping this was a one-time aspiration, as I have had no nausea or stomache issues...just this wierd bile taste and throat discomfort.

If the symptoms don't get better by the end of the day, I will call the doctor again...but if anyone has had similar symptoms that have resulted in side effects- please let me know so I can watch out!

[Scott]

Watson, I experienced both 2 and 3 after my L-RPLND five years ago. Fortunately, the swelling in the scrotum did not last long. The lymphadema in my ankles and legs took a while longer, at least a couple months. I wish now I'd kept a daily diary. I could push my thumb into my ankle and leave an impression as if it were Play-Doh. Weird.

It's very good to hear that you're communicating with your medical team about all symptoms, concerns, and questions. That's critical.

Hang in there. Things will get better soon.

[Watson]

Scott- were those symptoms related to your Chylous Ascites (I read your story- thank you for your continual posts!), or do you think those symptoms are norm and will go down post-surgery?

We'll definitely keep in touch with the doc- just wanted to see what you think.

[Scott]

The lymphadema may well have been related to the chylous ascites. I'm pretty certain the fluid in the scrotum would have happened regardless.

[Watson]

Thanks for your reply Scott. I am already feeling much better and my leg swelling is going down. This forum has really helped me gain a lot of information. Thanks to all of you!

[smithgerry]

Same to clinical stage I patients who are found to be pathologic stage II, clinical stage II patients may be present two accessary courses of BEP after RPLND. Again, this view virtually remove the prospect of repetition and therefore is reasonable in selected patients. However, there is no need for administering two courses of BEP after RPLND for stage II disease since, as noted above, 50% to 75% of patients are cured by surgical therapy alone.