About Your Lymphovenous Bypass (LVB) Surgery for Lymphedema

This guide will help you get ready for your lymphovenous bypass (LVB) surgery at Memorial Sloan Kettering (MSK). It will also help you understand what to expect during your recovery.

Read through this guide at least once before your surgery and use it as a reference in the days leading up to your surgery.

Bring this guide with you every time you come to MSK, including the day of your surgery. You and your healthcare team will refer to it throughout your care.

About Your Surgery

About lymphedema

Lymphedema is swelling caused by a buildup of lymph fluid. Your limb (arm or leg) with lymphedema is called your affected limb.

Sometimes, lymphedema happens when lymph nodes are removed during surgery or lymphatic vessels (thin tubes that carry lymph fluid) become blocked by scar tissue after surgery. LVB surgery can be done to help treat lymphedema caused by blocked lymphatic vessels.

About LVB surgery

LVB surgery is sometimes called lymphovenous anastomosis (LVA) surgery.

During your LVB surgery, your surgeon will use a microscope and small surgical tools to connect the part of your lymphatic vessel that’s not blocked to a nearby vein (see Figure 1). This lets your lymphatic fluid get past the blockage and flow away from your affected limb.

It’s very hard to know how much change you may have after your surgery. You may be able to see less swelling, your affected limb may feel different, or you may notice other small changes (such as your jewelry fitting differently). Different people will have different results. Your surgeon will talk with you about what to expect after surgery. Some people notice changes right away. Other people don’t notice any change for up to a year after their surgery.

Getting Ready for Your Surgery

This section will help you get ready for your surgery. Read it when your surgery is scheduled. Refer to it as your surgery gets closer. It has important information about what to do to get ready.

As you read through this section, write down questions to ask your healthcare provider.

Getting ready for surgery

You and your care team will work together to get ready for your surgery. Help us keep you safe by telling us if any of these things apply to you, even if you’re not sure.

• I take a anticoagulant (blood thinner), such as:
  These are examples of medications. There are others.
  
  Be sure your healthcare provider knows all the medications you’re taking.
  • Aspirin
  • Heparin
  • Warfarin (Jantoven®, Coumadin®)
  • Clopidogrel (Plavix®)
  • Enoxaparin (Lovenox®)
  • Dabigatran (Pradaxa®)
  • Apixaban (Eliquis®)
  • Rivaroxaban (Xarelto®)
• I take an SGLT2 inhibitor, such as:
  • Canagliflozin (Invokana®)
  • Dapagliflozin (Farxiga®)
  • Empagliflozin (Jardiance®)
  • Ertugliflozin (Steglatro®)
• I take prescription medications (medications my healthcare provider prescribes), including patches and creams.
• I take over-the-counter medications (medications I buy without a prescription), including patches and creams.
• I take dietary supplements, such as herbs, vitamins, minerals, or natural or home remedies.
• I have a pacemaker, automatic implantable cardioverter-defibrillator (AICD), or other heart device.
• I have sleep apnea.
• I have had a problem with anesthesia (medication to make me sleep during surgery) in the past.
• I’m allergic to certain medication(s) or materials, including latex.
• I’m not willing to receive a blood transfusion.
• I drink alcohol.
• I smoke or use an electronic smoking device, such as a vape pen or e-cigarette.
• I use recreational drugs, such as marijuana.

About drinking alcohol

It’s important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.

If you drink alcohol regularly, you may be at risk for problems during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.

If you drink alcohol regularly and stop suddenly, it can cause seizures, delirium, and death. If we know you’re at risk for these problems, we can prescribe medications to help prevent them.

Here are things you can do before your surgery to keep from having problems.

• Be honest with your healthcare providers about how much alcohol you drink.
• Try to stop drinking alcohol once your surgery is planned. Tell your healthcare provider right away if you:
  • Get a headache.
  • Feel nauseous (like you’re going to throw up).
  • Feel more anxious (nervous or worried) than usual.
  • Cannot sleep.
  These are early signs of alcohol withdrawal and can be treated.
• Tell your healthcare provider if you cannot stop drinking.
• Ask your healthcare provider questions about drinking and surgery. All your medical information will be kept private, as always.

About smoking

If you smoke, you can have breathing problems when you have surgery. Stopping for even a few days before your surgery can help.

Your healthcare provider will refer you to our Tobacco Treatment Program if you smoke. You can also reach the program by calling 212-610-0507.

About sleep apnea

Sleep apnea is a common breathing problem. If you have sleep apnea, you stop breathing for short lengths of time while you’re asleep. The most common type is obstructive sleep apnea (OSA). With OSA, your airway becomes fully blocked during sleep.

OSA can cause serious problems during and after surgery. Tell us if you have or think you might have sleep apnea. If you use a breathing device, such as a CPAP machine, bring it on the day of your surgery.

Within 30 days of your surgery

Presurgical Testing (PST)

You’ll have a PST appointment before your surgery. You’ll get a reminder from your surgeon’s office with the appointment date, time, and location.

You can eat and take your usual medications the day of your PST appointment.

It’s helpful to bring these things to your appointment:

• A list of all the medications you’re taking, including prescription and over-the-counter medications, patches, and creams.
• Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid doppler study.
• The names and telephone numbers of your healthcare providers.

You’ll meet with a nurse practitioner (NP) during your PST appointment. They work closely with anesthesiology staff (specialized healthcare providers who will give you anesthesia during your surgery). Your NP will review your medical and surgical history with you. You may have tests to plan your care, such as:

• An electrocardiogram (EKG) to check your heart rhythm.
• A chest X-ray.
• Blood tests.

Your NP may recommend you see other healthcare providers. They’ll also talk with you about which medications to take the morning of your surgery.

Identify your caregiver

Your caregiver plays an important role in your care. Before your surgery, you and your caregiver will learn about your surgery from your healthcare providers. After your surgery, your caregiver will take you home when you’re discharged. They’ll also help you care for yourself at home.

For caregivers

‌  Caring for a person going through cancer treatment comes with many responsibilities. We offer resources and support to help you manage them. Visit www.msk.org/caregivers or read A Guide for Caregivers to learn more.

If you don’t have someone to take you home after your surgery, call one of the agencies below. They’ll send someone to go home with you. There’s usually a charge for this service, and you’ll need to provide transportation. It’s okay to use a taxi or car service, but you must still have a responsible care partner with you.

Agencies in New York

Agencies in New Jersey

VNS Health: 888-735-8913

Caring People: 877-227-4649

Caring People: 877-227-4649

 

Fill out a Health Care Proxy form

If you have not already filled out a Health Care Proxy form, we recommend you do now. If you already filled one out or have any other advance directives, bring them to your next appointment.

A health care proxy is a legal document. It says who will speak for you if you cannot communicate for yourself. This person is called your health care agent.

• To learn about health care proxies and other advance directives, read Advance Care Planning.
• To learn about being a health care agent, read How to Be a Health Care Agent.

Talk with a member of your care team if you have questions about filling out a Health Care Proxy form.

7 days before your surgery

Follow your healthcare provider’s instructions for taking aspirin

Aspirin can cause bleeding. If you take aspirin or a medication that has aspirin, you may need to change your dose or stop taking it 7 days before your surgery. Follow your healthcare provider’s instructions. Do not stop taking aspirin unless they tell you to.

To learn more, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E.

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements

Vitamin E, multivitamins, herbal remedies, and other dietary supplements can cause bleeding. Stop taking them 7 days before your surgery. If your healthcare provider gives you other instructions, follow those instead.

To learn more, read Herbal Remedies and Cancer Treatment.

2 days before your surgery

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs, such as ibuprofen (Advil^® and Motrin^®) and naproxen (Aleve^®), can cause bleeding. Stop taking them 2 days before your surgery. If your healthcare provider gives you other instructions, follow those instead.

To learn more, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E.

1 day before your surgery

Note the time of your surgery

A staff member will call you after 2 p.m. the day before your surgery. If your surgery is scheduled for a Monday, they’ll call you the Friday before. If you do not get a call by 7 p.m., call 212-639-5014.

The staff member will tell you what time to get to the hospital for your surgery. They’ll also remind you where to go.

This will be the following location:

Josie Robertson Surgery Center (JRSC)
1133 York Avenue (between East 61^st and East 62^nd Streets)
New York, NY 10065

Sleep

Go to bed early and get a full night’s sleep.

Instructions for eating before your surgery

‌  
Do not eat anything after midnight (12 a.m.) the night before your surgery. This includes hard candy and gum.



 

The morning of your surgery

Instructions for drinking before your surgery

‌  You can drink a total of 12 ounces of water between midnight (12 a.m.) and 2 hours before your scheduled arrival time. Do not drink anything else.

Do not drink anything starting 2 hours before your scheduled arrival time. This includes water.

Take your medications as instructed

A member of your care team will tell you which medications to take the morning of your surgery. Take only those medications with a sip of water. Depending on what medications you take, this may be all, some, or none of your usual morning medications.

Things to remember

• Wear something comfortable and loose-fitting.
• If you wear contact lenses, wear your glasses instead. Wearing contact lenses during surgery can damage your eyes.
• Don’t wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your surgery can cause burns if it touches metal.
• Don’t put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
• Leave valuable items (such as credit cards, jewelry, and your checkbook) at home.
• If you’re menstruating (have your monthly period), use a sanitary pad, not a tampon. You’ll get disposable underwear, as well as a pad if needed.

What to bring

• Your breathing device for sleep apnea (such as your CPAP device), if you have one.
• Your Health Care Proxy form and other advance directives, if you have completed them.
• Your cell phone and charger.
• Only the money you may want for small purchases (such as a newspaper).
• A case for your personal items (such as eyeglasses, hearing aid(s), dentures, prosthetic device(s), wig, and religious articles), if you have one.
• This guide. Your healthcare team will use it to teach you how to care for yourself after surgery.

Where to park

You should park at the JRSC.

• If you’re arriving on Northbound FDR Drive, you’ll need to go around the block to pull into the driveway on southbound York Ave, between East 62nd and East 61st Streets.
• If you’re arriving on Southbound FDR Drive, take southbound York Avenue and pull into the driveway.

There are several options for parking at the JRSC. There’s a valet service at the JRSC entrance. If you choose to use this service, the valet will park your car next door in the City Parking garage. The valet service is free, but you’ll need to pay the parking garage fee when you leave the JRSC. For more information about parking, call 646-888-7100.

If you choose not to use our valet service, there are nearby garages. You’ll have to pay to park in these garages.

Once you’re in the hospital

Once you enter the JRSC, a concierge will greet you and direct you to the check-in area on the 3^rd floor. When you get to the 3^rd floor, a staff member will give you a badge to wear. This badge will help your healthcare team know where you are so they can give updates on your progress. A staff member will also ask you for the name and contact information of the person who will take you home after your surgery.

If you have any dietary restrictions (such as kosher, halal, gluten free, or vegetarian), tell us when you check in. We will make sure we give you the food and drink you need.

After you check in, a member of your healthcare team will bring you to the pre-surgical center on the 6^th floor.

Get dressed for surgery

When it’s time to change for surgery, you’ll get a hospital gown, robe, and nonskid socks to wear.

Meet with a nurse

You’ll meet with a nurse before surgery. Tell them the dose of any medications you took after midnight (12 a.m.) and the time you took them. Make sure to include prescription and over-the-counter medications, patches, and creams.

Your nurse may place an intravenous (IV) line in one of your veins, usually in your arm or hand. If your nurse does not place the IV, your anesthesiologist will do it in the operating room.

Meet with an anesthesiologist

You’ll also meet with an anesthesiologist before surgery. They will:

• Review your medical history with you.
• Ask you if you’ve had any problems with anesthesia in the past, such as nausea or pain.
• Talk with you about your comfort and safety during your surgery.
• Talk with you about the kind of anesthesia you’ll get.
• Answer your questions about your anesthesia.

Get ready for your surgery

You’ll either walk into the operating room or be taken in on a stretcher. A member of the operating room team will help you onto the operating bed. Compression boots may be placed on your lower legs. These gently inflate and deflate to help blood flow in your legs. If your surgery is on one of your legs, that leg won’t have a boot on it.

Once you’re comfortable, your anesthesiologist will give you anesthesia through your IV line and you’ll fall asleep. You’ll also get fluids through your IV line during and after your surgery.

During your surgery

After you’re fully asleep, a breathing tube will be placed through your mouth and into your windpipe to help you breathe.

First, your surgeon will inject (give you a shot of) green dye between the fingers or toes on your affected limb. The dye will travel through your lymphatic vessels so it’s easier for your surgeon to see them.

After your surgeon injects the dye, they’ll make about 1 to 5 small incisions (surgical cuts) on your affected limb. Each incision will be about 2 centimeters (¾ inch) long. They’ll use each incision to connect a lymphatic vessel to a nearby vein.

Once your surgery is finished, your surgeon will close your incisions with Steri-Strips^™ (surgical tape) or 2 to 3 sutures (stitches).

Your breathing tube is usually taken out while you’re still in the operating room.

Recovering after your surgery

This section will help you know what to expect after your surgery. You’ll learn how to safely recover from your surgery both in the hospital and at home.

As you read through this section, write down questions to ask your healthcare provider.

In your recovery room

When you wake up after your surgery, you’ll be in a recovery room. A nurse will be monitoring your body temperature, pulse, blood pressure, and oxygen levels. You may be getting oxygen through a thin tube that rests below your nose or a mask that covers your nose and mouth. You may also have compression boots on one or both of your lower legs.

You might have tiny green marks on your affected limb. These are from the dye used during your surgery. They’ll go away in about 1 week.

Managing your pain

Most people have very little pain after LVB surgery. If you have pain, tell your healthcare provider. They may give you pain medication to help manage it.

What to expect

The length of time you’re in the hospital after your surgery depends on your recovery. Most people are discharged from the hospital the same day as their surgery.

While you’re in your recovery room, your healthcare provider will help you get ready to go home. When you’re awake, your healthcare provider will:

• Encourage you to walk. If you had surgery on one of your legs, you can walk on your affected leg right away after your surgery.
• Give you something to eat and drink.
• Review your discharge instructions with you.
• Answer any questions you have.

Before you leave the hospital, look at your incisions with one of your healthcare providers. Knowing what your incisions look like will help you notice any changes later.

At home

Caring for your incisions

Don’t shower or get your incisions wet for 48 hours (2 days) after your procedure.

After 48 hours, you can shower as usual. Let the water run over your incisions when you shower. It’s okay to get your stitches or Steri-Strips wet.

If you go home with stitches in your incisions, your doctor will take them out about 2 weeks after your surgery. If you go home with Steri-Strips on your incisions, they’ll loosen and fall off by themselves. If they haven’t fallen off within 10 days, you can take them off.

Caring for your affected limb

It’s important to take good care of your affected limb to help it heal. The instructions below are general. If your surgeon gives you different instructions, follow those. If you have any questions, call your surgeon’s office.

Avoid putting pressure on or near your incisions until your surgeon tells you it’s okay. For example, avoid sleeping on your affected side and don’t wear tight clothing.

For the first 2 weeks after your surgery:

• Don’t visit your lymphedema therapist.
• Don’t wrap or massage your affected limb.
• Don’t lift, push, or pull anything heavier than 5 pounds (2.3 kilograms). A gallon of milk is about 8 pounds (3.3 kilograms). You’ll need help with things like doing laundry and carrying groceries.
• Keep your affected limb elevated as often as you can. It’s best to rest your limb on 2 pillows while you’re sitting or sleeping, if you can. This will help prevent swelling while you’re not wrapping your affected limb.
• Depending on where your incisions are, your surgeon may tell you to avoid raising your arm above your shoulder. Follow their instructions.

Starting 2 weeks after your Surgery:

• You can visit your lymphedema therapist.
• You can wrap your affected limb. It’s okay to wrap over your incisions.
• You can massage your affected limb, but don’t massage over your incisions.
• You can start using your compression garment again.
• Keep following the same lifting, pushing, and pulling restrictions. Don’t lift, push, or pull anything heavier than 5 pounds (2.3 kilograms).

Starting 4 Weeks After Your Surgery:

• You can wrap and massage over your incisions.
• You don’t need to follow any restrictions. You can go back to all your usual activities.

Going back to work

Talk with your healthcare provider about your job and when it may be safe for you to start working again. If your job involves lots of movement or heavy lifting, you may need to stay out a little longer than if you sit at a desk.

Using MyMSK

MyMSK (my.mskcc.org) is your MSK patient portal. You can use it to send and read messages from your care team, view your test results, see your appointment dates and times, and more. You can also invite your caregiver to make their own account so they can see information about your care.

If you do not have a MyMSK account, you can sign up at my.mskcc.org. You can get an enrollment ID by calling 646-227-2593 or your doctor’s office.

Watch How to Enroll in MyMSK: Memorial Sloan Kettering's Patient Portal to learn more. You can also contact the MyMSK Help Desk by emailing [email protected] or calling 800-248-0593.

When to Contact Your Healthcare Provider

Contact your healthcare provider if:

• You have a fever of 100.5 °F (38 °C) or higher.
• The skin around your incision is warmer than normal.
• The skin around your incision is getting more red.
• The area around your incision is starting to swell.
• Swelling around your incision is getting worse.
• There’s new drainage (liquid) coming from your incision.
• You have any questions or concerns.

Monday through Friday from 9:00 a.m. to 5:00 p.m., contact your doctor’s office.

After 5:00 p.m., during the weekend, and on holidays, call 212-639-2000 and ask to speak to the doctor on call for your doctor.

Support services

This section has a list of support services. They may help you as you get ready for your surgery and recover after your surgery.

As you read through this section, write down questions to ask your healthcare provider.

MSK support services

Visit the cancer types section of MSK’s website at www.msk.org/types for more information.

Admitting Office
212-639-7606
Call if you have questions about your hospital admission, such as asking for a private room.

Anesthesia
212-639-6840
Call if you have questions about anesthesia.

Blood Donor Room
212-639-7643
Call for information if you’re interested in donating blood or platelets.

Bobst International Center
888-675-7722
We welcome patients from around the world and offer many services to help. If you’re an international patient, call for help arranging your care.

Caregivers Clinic
www.msk.org/caregivers
646-888-0200
At MSK, the Caregivers Clinic provides support specifically for caregivers who are having difficulty coping with the demands of being a caregiver. For more information, call Dr. Allison Applebaum’s office at 646-888-0200.

Counseling Center
www.msk.org/counseling
646-888-0200
Many people find that counseling helps them. Our Counseling Center offers counseling for individuals, couples, families, and groups. We can also prescribe medications to help if you feel anxious or depressed. To make an appointment, ask your healthcare provider for a referral or call the number above.

Food Pantry Program
646-888-8055
We give food to people in need during their cancer treatment. For more information, talk with your healthcare provider or call the number above.

Integrative Medicine Service
www.msk.org/integrativemedicine
Our Integrative Medicine Service offers many services to complement (go along with) traditional medical care, including music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy. To schedule an appointment for these services, call 646-449-1010.

You can also schedule a consultation with a healthcare provider in the Integrative Medicine Service. They will work with you to come up with a plan for creating a healthy lifestyle and managing side effects. To make an appointment, call 646-608-8550.

MSK Library
library.mskcc.org
212-639-7439
You can visit our library website or call to talk with the library reference staff. They can help you find more information about a type of cancer. You can also visit the library’s Patient and Health Care Consumer Education Guide.

Nutrition Services
www.msk.org/nutrition
212-639-7312
Our Nutrition Service offers nutritional counseling with one of our clinical dietitian nutritionists. Your clinical dietitian nutritionist will talk with you about your eating habits. They can also give advice on what to eat during and after treatment. To make an appointment, ask a member of your care team for a referral or call the number above.

Patient and Caregiver Education
www.msk.org/pe
Visit our Patient and Caregiver Education website to search for educational resources, videos, and online programs.

Patient Billing
646-227-3378
Call if you have questions about preauthorization with your insurance company. This is also called preapproval.

Patient Representative Office
212-639-7202
Call if you have questions about the Health Care Proxy form or concerns about your care.

Perioperative Nurse Liaison
212-639-5935
Call if you have questions about MSK releasing any information while you’re having surgery.

Private Duty Nurses and Companions
917-862-6373
You can request private nurses or companions to care for you in the hospital and at home. Call for more information.

Rehabilitation Services
www.msk.org/rehabilitation
Cancers and cancer treatments can make your body feel weak, stiff, or tight. Some can cause lymphedema (swelling). Our physiatrists (rehabilitation medicine doctors), occupational therapists (OTs), and physical therapists (PTs) can help you get back to your usual activities.

• Rehabilitation medicine doctors diagnose and treat problems that affect how you move and do activities. They can design and help coordinate your rehabilitation therapy program, either at MSK or somewhere closer to home. To learn more, call Rehabilitation Medicine (Physiatry) at 646-888-1929.
• An OT can help if you’re having trouble doing usual daily activities. For example, they can recommend tools to help make daily tasks easier. A PT can teach you exercises to help build strength and flexibility. To learn more, call Rehabilitation Therapy at 646-888-1900.

Resources for Life After Cancer (RLAC) Program
646-888-8106
At MSK, care does not end after your treatment. The RLAC Program is for patients and their families who have finished treatment.

This program has many services. We offer seminars, workshops, support groups, and counseling on life after treatment. We can also help with insurance and employment issues.

Sexual Health Programs
Cancer and cancer treatments can affect your sexual health, fertility, or both. MSK’s sexual health programs can help you before, during, or after your treatment.

• Our Female Sexual Medicine and Women’s Health Program can help with sexual health problems, such as premature menopause or fertility issues. For more information or to make an appointment, call 646-888-5076.
• Our Male Sexual and Reproductive Medicine Program can help with sexual health problems, such as erectile dysfunction (ED). For more information or to make an appointment, call 646-888-6024.

Social Work
www.msk.org/socialwork
212-639-7020
Social workers help patients, families, and friends deal with common issues for people who have cancer. They provide individual counseling and support groups throughout your treatment. They can help you communicate with children and other family members.

Our social workers can also help refer you to community agencies and programs. They also have information about financial resources, if you’re having trouble paying your bills.

Spiritual Care
212-639-5982
Our chaplains (spiritual counselors) are available to listen, help support family members, and pray. They can contact community clergy or faith groups, or simply be a comforting companion and a spiritual presence. Anyone can ask for spiritual support. You do not have to have a religious affiliation (connection to a religion).

MSK’s interfaith chapel is located near Memorial Hospital’s main lobby. It’s open 24 hours a day. If you have an emergency, call 212-639-2000. Ask for the chaplain on call.

Tobacco Treatment Program
www.msk.org/tobacco
212-610-0507
MSK has specialists who can help you quit smoking. For more information about our Tobacco Treatment Program, call 212-610-0507. You can also ask your nurse about the program.

Virtual Programs
www.msk.org/vp
Our Virtual Programs offer online education and support for patients and caregivers. These are live sessions where you can talk or just listen. You can learn about your diagnosis, what to expect during treatment, and how to prepare for your cancer care.

Sessions are private, free, and led by experts. Visit our website for more information about Virtual Programs or to register.

External support services

Access-A-Ride
web.mta.info/nyct/paratran/guide.htm
877-337-2017
In New York City, the MTA offers a shared ride, door-to-door service for people with disabilities who can’t take the public bus or subway.

Air Charity Network
www.aircharitynetwork.org
877-621-7177
Provides travel to treatment centers.

American Cancer Society (ACS)
www.cancer.org
800-ACS-2345 (800-227-2345)
Offers a variety of information and services, including Hope Lodge, a free place for patients and caregivers to stay during cancer treatment.

Cancer and Careers
www.cancerandcareers.org
A resource for education, tools, and events for employees with cancer.

CancerCare
www.cancercare.org
800-813-4673
275 Seventh Avenue (Between West 25^th & 26^th Streets)
New York, NY 10001
Provides counseling, support groups, educational workshops, publications, and financial assistance.

Cancer Support Community
www.cancersupportcommunity.org
Provides support and education to people affected by cancer.

Caregiver Action Network
www.caregiveraction.org
800-896-3650
Provides education and support for people who care for loved ones with a chronic illness or disability.

Corporate Angel Network
www.corpangelnetwork.org
866-328-1313
Offers free travel to treatment across the country using empty seats on corporate jets.

Gilda’s Club
www.gildasclubnyc.org
212-647-9700
A place where men, women, and children living with cancer find social and emotional support through networking, workshops, lectures, and social activities.

Good Days
www.mygooddays.org
877-968-7233
Offers financial assistance to pay for copayments during treatment. Patients must have medical insurance, meet the income criteria, and be prescribed medication that’s part of the Good Days formulary.

Healthwell Foundation
www.healthwellfoundation.org
800-675-8416
Provides financial assistance to cover copayments, health care premiums, and deductibles for certain medications and therapies.

Joe’s House
www.joeshouse.org
877-563-7468
Provides a list of places to stay near treatment centers for people with cancer and their families.

LGBT Cancer Project
http://lgbtcancer.com/
Provides support and advocacy for the LGBT community, including online support groups and a database of LGBT-friendly clinical trials.

LIVESTRONG Fertility
www.livestrong.org/we-can-help/fertility-services
855-744-7777
Provides reproductive information and support to cancer patients and survivors whose medical treatments have risks associated with infertility.

Look Good Feel Better Program
lookgoodfeelbetter.org
800-395-LOOK (800-395-5665)
This program offers workshops to learn things you can do to help you feel better about your appearance. For more information or to sign up for a workshop, call the number above or visit the program’s website.

National Cancer Institute
www.cancer.gov
800-4-CANCER (800-422-6237)

National Cancer Legal Services Network
www.nclsn.org
Free cancer legal advocacy program.

National LGBT Cancer Network
www.cancer-network.org
Provides education, training, and advocacy for LGBT cancer survivors and those at risk.

Needy Meds
www.needymeds.org
Lists Patient Assistance Programs for brand and generic name medications.

NYRx
www.health.ny.gov/health_care/medicaid/program/pharmacy.htm
Provides prescription benefits to eligible employees and retirees of public sector employers in New York State.

Partnership for Prescription Assistance
www.pparx.org
888-477-2669
Helps qualifying patients without prescription drug coverage get free or low-cost medications.

Patient Access Network Foundation
www.panfoundation.org
866-316-7263
Provides assistance with copayments for patients with insurance.

Patient Advocate Foundation
www.patientadvocate.org
800-532-5274
Provides access to care, financial assistance, insurance assistance, job retention assistance, and access to the national underinsured resource directory.

RxHope
www.rxhope.com
877-267-0517
Provides assistance to help people get medications that they have trouble affording.

Educational resources

This section lists the educational resources mentioned in this guide. They will help you get ready for your surgery and recover after your surgery.

As you read through these resources, write down questions to ask your healthcare provider.

• Advance Care Planning
• Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E
• Herbal Remedies and Cancer Treatment
• How to Be a Health Care Agent

For more information about lymphedema, you can also read the New York State Department of Health’s resource Understanding Lymphedema.