Sunday, March 27, 2011

The Adventures of Pancake and Waffle

I have new nicknames for Flopsy and Mopsy.  Mopsy is like a pancake now, flat and soft.  Flopsy is more like a waffle, thicker, and lots of folds for syrup to collect in.  They don't look like twin sisters anymore. 

I recently started a special kind of physical therapy with my lymphedema therapist, Doris, for scar mobilization.  The therapy helps to loosen scar tissue, not just where the incision is, but inside the radiated breast.  I have places inside Flopsy that are hard, knotty and immobile.  The idea is to gently massage these areas to loosen things up prior to reconstruction, and on an ongoing basis to help prevent lymphedema.

Click here for a good explanation on WebMD all about lymphedema, if you need a reminder.

Some of the initial changes to Flopsy have gradually faded in the two months since I completed radiation.  Most of the redness, skin soreness and some of the swelling is gone.  As a side note, the hair under my arms, both of them, has not started to grow back.  Supposedly under the radiated side it never will; not sure why Mopsy's side is hairless but I'm not complaining.

The changes in Flopsy that have remained are increased pore size due to swelling, lots of lumpiness, and my areola and nipple are not as rosy brown as Mopsy.  The color is pinkish with some areas of light gray.  Underneath Flopsy, some of the speckled skin has sloughed off, but I still have some freckling and spots.  I have gently used a washcloth with sugar scrub or salt scrub on the area and it has helped to remove crusty skin.

Doris showed me how to gently massage the areas that are tightest, and how to gently pull and stretch the surface of the skin which helps to loosen scarring, and move lymphatic fluid.  The areas that are lumpy are problem areas because they can block the flow of lymphatic fluid in the breast, and under the arm too.  Doris said it's common in these cases for lymphatic fluid to collect in the breast.  She showed me how to hold Flopsy up and gently squeeze her like an orange, while massaging the surface of my skin towards Mopsy and my right arm pit.  This technique manually helps move lymphatic fluid over to the side that is fully functioning and where no lymph nodes were removed.

I do feel better after the lymphatic massages, and she suggested I have Husband come with me to one of my appointments and she will show him how to do them.  Some of the massaging is not so easy to do on yourself, you need another set of hands.

Doris wants me to get a compression sleeve, but in the meantime, she made me an upper sleeve and lower sleeve out of some tube-like stretchable bandages.  She cut one large piece for my upper arm, and then another piece for my forearm down to my hand, with a small cutout for my thumb to pop through.  She suggested I trying wearing this makeshift sleeve a couple hours at a time to see if it helped.

I tried it and the gentle compression really does work to ease tightness and heaviness in my arm.  The whole idea behind compression is during swelling the skin is stretched so much that it is not a firm surface for the muscles to contract against.  Muscles working and contracting is how lymph is moved through the vessels. (Deep breathing too!)  The compression garment acts like a "new" firm skin surface, the muscles contract and the pressure gets things moving.

Did you know that swimming is also great for lymphedema?  The hydrostatic force of the water acts the same way as a compression sleeve.  I am returning to the pool this week, and I'm really excited about it!  I had no idea it is so helpful for lymphedema, but discovered it while reading about it online.

I continue to do the exercises I've described here before, and use the stretchy exercise band Dean made for me.  Although I sometimes get sore, the more I stretch and move the area, it really helps with the stiffness.

This is an easy to follow guide for exercises after lymph node removal, prepared by the good folks at Ohio State University.  Most of these were taught to me by my physical therapist, but I like having something to refer to and found this guide which is easy to follow.  These same exercises also really help after a BLM, and with upper neck, back and shoulder tension.  Try them!

Lymphedema will always be a concern and something I need to monitor.  As recommended, I plan on ordering a medical bracelet, so in case of an emergency no blood is drawn or blood pressure taken on my left side.  Here's a great link to shop for some attractive medical bracelets!  This is really important for any breast cancer survivor who has had lymph nodes removed.  If you plan on custom engraving the bracelet, just make sure you have the following wording on it "Lymphedema Alert, No blood pressure - No needles into this arm" and make sure the universal medical symbol is on there too.

So there you have it.
The adventures of Pancake and Waffle,
and everything you wanted to know about lymph,
from your favorite nymph.

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