The therapist was actually a lymphedema specialist. Lymphedema is an accumulation of lymphatic fluid in the interstitial tissue that causes swelling. It can develop when lymphatic vessels are missing or impaired (primary), or when lymph vessels are damaged or lymph nodes removed (secondary). In my case, it is secondary since all of the lymph nodes under my left arm were removed.
This condition, or the threat of it, is going to be something that I am on alert for throughout the rest of my life. A swelling of my left arm and hand can develop at any time.
She asked to see my scars, and offered to step out of the room so I could put on a gown. Don't bother! I'm not shy about my chest in front of medical types any more. I just stripped off my tank top and pulled my camisole down around my waist. Whatever. She said it looked "really good." Seriously? THAT is good? I told her it reminded me of Frankenstein. She suggested that I massage the scars to loosen up the tissue. That'll be easy since I'm rubbing Vitamin E oil on them twice a day anyway. She said that the looser the scars are, the better. Especially down the road when I am having radiation treatment.
The first thing she did was to measure my hands and arms at various places to find a baseline. No big deal, although it left little black sharpie marks on my arms. I had been concerned about a strange fibrous "band" under my left arm and showed her. No problem, she said. She had me lie down on my back and she pressed hard on each end of the band. It was a little uncomfortable. Then she had me move my arm up and down, like I was making a one-armed snow angel. She heard it go "pop, pop, pop" and then it was gone. I didn't hear the popping, but my head was on a pillow with a paper protective cover, so all I heard was the sound of the paper rustling. She said it was scar tissue in the lymph area, referred to as axillary "webbing." I found this interesting website about it. I think I'll bookmark it just in case it comes back. (It has pictures if you want to see what it looked like-I just don't have permission to repost them).
Because I have no lymph nodes under my arm, my lymph system is compromised. The lymph
system gets rid of "junk" in the body as well as filters out disease causing things. If you want a more scientific explanation, you can go here. The lymph fluid travels around the system in a particular order. You have lymph nodes in your neck, under arms and groin. The good news is that I can do some simple exercises every day to help move the fluid around. I also am going to go back and learn something called "lymphatic massage" that will also help the system work and thus avoid lymphedema.
I'm all about prevention, so I'll be faithful about the exercises and massage techniques.
We also talked about risk factors for lymphedema. Anything that would make me swell. It could be: hot weather; travel; changes in altitudes; cuts/scrapes or injuries on my left arm or hand; tight clothing; overheating; extreme temperature changes; my future radiation treatment; and more.
She suggested I get my doctor to prescribe a compression band and glove to wear. At first, she told me to wear it during my waking hours for 2 weeks. After that, just wear it during those high risk times, unless I actually do experience some swelling.
It's all about knowing my body and being aware of slight changes in it. That is where exercise comes in as well.
There is no "program" or list of exercises I can do. When I asked her that, she told me to stop thinking in that way. That is going to be tough. I'm used to printing out Jillian's workout and going down the list without exception. Give me a program, and I'll follow it to a "T" like a good girl.
There were some hand weights on the wall, so I asked her when I could start lifting weights again. She said I could now! Hallelujah! However, moderation is the key. Hmm. I've never been real good at that one. She said I could increase cardio workouts by 5 minutes every 3 workouts, and add 2 new upper body exercises every 3 workouts. Well, I told her I was already doing 60 minutes of cardio. Did I mess up? Nope! She said I just had that as a baseline. My baseline is going to be different from anyone else's, which is why there isn't a "program" out there. She said, (and I quote), "You are fit, Tonya." The key is going to be starting new things slowly, not overdoing it, and keeping an eagle eye on my left arm. If it starts to swell, I need to back off.
The other piece of good news is that she said I can pick up Jean-Marc. I'm a mom, she said, and you need to be able to pick up your child. But like the exercise, I need to keep an eye on my arm and make sure I don't swell. That is going to have to be a habit I develop for the rest of my life.
I made two of three follow up appointments so I can come back and learn the lymphatic massage technique. Fortunately, I'll be able to do those in San Marcos. (Today, I had to drive down to Kearny Mesa in rush hour traffic on the 15.)
My prayer requests:
- That I don't develop lymphedema!
- That I be able to ease back into some upper body exercises. Exercise is a sort of therapy for me, mentally as much as anything else. It has been hard to be restrained and unable to do as much. I still need to take it easy, and that is not easy for me.
- That I do not catch the cold that Olivier came down with. I've had a sore throat for a day or so. That is usually the first sign of a cold for me. I took my last Cipro this morning for this round. I'm hoping that, as well as a lot of fluids and frenetic hand washing will keep me from coming down with his cold.
- That the cancer cells are being disrupted and dying horrible little deaths inside my body. :-)
Thank you all for your continued support and prayers. I feel like Moses in Exodus 17 when he went up on the mountaintop to oversee the battle. As long as his arms were outstretched towards heaven the battle went well. But his arms got heavy, and it took Aaron and Hur to come alongside of him to help him hold up his arms so the battle could continue. Your prayers are like the aid of Aaron and Hur to me as I go through this. I thank God daily for all of my support system....YOU.
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