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Wristband Used To Prevent 'Wrong-Arm Access'

Tribune photo by FRED BELLET

Barbara Costas models a wristband that her husband Bill created for his cousin, a breast cancer survivor.

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By LAURA KINSLER | The Tampa Tribune

Published: February 20, 2009

BROOKSVILLE - Bill Costas is a tinkerer. He likes to come up with solutions and inventions for all kinds of problems.

When his cousin, a breast cancer survivor, told him how difficult it was to keep nurses from poking and prodding her arms, he got to work.

Like many cancer patients, Costas' cousin had her lymph nodes surgically removed, which left her susceptible to lymphedema, a painful and often irreversible swelling of the arm.

"Lymphedema is one of my pet peeves in life," says Christine Laronga, who heads the breast cancer program at H. Lee Moffitt Cancer Center. "About 20 percent of breast cancer patients will get it. The people who get it are miserable."

When lymph nodes are removed or damaged by biopsy, surgery or radiation, lymph fluid can build up in the arm tissue. The condition is incurable, and any kind of trauma to the arm can trigger it — even something as simple as squeezing the arm to take a patient's blood pressure or start an IV. Infections can be another trigger, and Laronga says breast cancer patients should never have a needle inserted into an affected limb.

"Every time she goes to a doctor's office or a medical facility, she has to constantly remind them not to put a needle in her arm," Costas says of his cousin. "She's paranoid that something will happen when she's asleep."

To prevent what he calls "wrong-arm access," Costas developed a pink wristband specifically for breast cancer patients and survivors. The loose-fitting band is bright pink and displays the message "NO BP NO IV" in bold, bright letters.

"It tells the health care worker, 'Do not touch this arm.' It cannot be missed," he says.

Caregivers often overlook medical directives to avoid using a patient's arm. That's how breast cancer survivor June Bucy got lymphedema. The Tampa woman had a double mastectomy in 2000. Shortly after her surgery, Bucy developed lymphedema.

"I would go to the doctors' offices for follow-up visits, and they would take my blood pressure on my arms," she says. "I just figured they knew what they were doing."

Laronga says such cases are more common than she'd like to admit. "I think it happens frequently," she says. "We're a cancer center, so we're very attuned to it. But that doesn't mean every medical professional is. They don't see the patients, and they're not the ones who have to treat the lymphedema afterward."

Patients can develop lymphedema two days after surgery or 20 years later, Laronga says. They suffer varying degrees of swelling.

"It could be something as subtle as your wedding ring doesn't fit anymore, or it could be as severe as elephant arm, where it won't even bend at the elbow," she says. "The thing patients always say is their arm just feels heavy."

Bucy has to pump both arms for an hour each night and wrap them in bandages. During the day, she wears tight-fitting sleeves for support. She has managed to maintain, but not reverse, the swelling.

"If I skip one night, I'll wake up in the morning and my arm will feel achy and uncomfortable," she said.

Bucy says Costas' wristband might have prevented her case. He sells the wristbands for $7.95 a piece on his Web site, www.wrongarmaccess.com. A portion of the proceeds go to breast cancer research.

Reporter Laura Kinsler can be reached at (813) 779-4617.

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