Pycnogenol for the Treatment of Lymphedema of the Arm in Breast Cancer Survivors

Inclusion criteria:

* Unilateral (ipsilateral to breast cancer resection side) lymphedema of the upper extremity.
* Extravascular water ration of \> 1.07/1 between affected vs. normal arm using multiple frequency bioelectric impedence
* Patient is \> 2months from last surgical or radiation treatment to the affected axilla
* Renal and hepatic function:

Creatinine clearance \> 50ml/min, total bili \<2 mg/dl, transaminases \<1.5 x ULN

* Patient not pregnant or breastfeeding. Use of barrier contraception if sexually active.
* ECOG performance of 0-2
* Patient not allergic to pycnogenol

Exclusion criteria:

* Patients treated with their first course of chemotherapy or radiation
* Chemotherapy or radiation to axillary lymph node will exclude patients for 8 weeks following treatment
* Patients with more than one episode of arm cellulitis, venous clot, or woody fibrosis of the affected arm. Antibiotics used to treat cellulitis must be completed at least 4 weeks prior to initial screening
* Patients with a defibrillator Midazolam study only: Patients requiring or benefiting from supplemental oxygen, patients allergic to cherries