Without going into major detail about my finding an RMT with enhanced training in lymphedema management, over the next 2 years after my surgery, I saw a few. The first one I saw was shortly after my surgery and just before my first chemo treatment. She greatly relieved my fears as she herself was a breast cancer survivor. Even after five years post treatment, she had a full time massage practice and was not bothered by lymphedema herself.
I had a couple of sessions with her where she massaged the cording under my armpit, down my arm and the ones that were visibly peeking out from under my right rib cage. Yes, even there! It turns out that surgery to the underarm and chest area can traumatize the connective tissue that encases nearby bundles of blood vessels, lymph vessels, and nerves. This can lead to, scarring, and eventually hardening of the tissue. By the second massage treatment, my mobility was much better and fairly soon after, the cords had disappeared. However, to this day it is essential that I exercise and stretch my arm, otherwise, I will have tightness and mobility problems. Yoga has greatly helped my arm function and I will talk about that in future posts.
I did not have lymphedema yet. However, I had experienced some of the risk factors and felt fortunate that by being pro-active I was able to learn what some of them are:
– The extent of the surgery (whether or not one has a full axillary node section, multiple nodes, mastectomy, etc)
– High blood pressure
– Overweight. A BMI of over 29.5
– Lack of exercise
– Repetitive use of affected limb
– A past injury that resulted in fracture, frozen shoulder, dislocation, etc.
– Air travel
– Extreme temperatures (Heat from a hot tub or sauna for example)
So, for the time being I felt a little reassured although I knew I would always be at risk. I had read articles that suggest that the average onset of lymphedema can occur within 2-3 years of cancer treatment, however, it can also appear many years later. This happens because of the way the scar tissue forms. It can show itself gradually or even suddenly as I explained in the dripping tap scenario of a previous blog.
My RMT advised me to continue to do the gentle and graduated exercises given to me after my surgery. As well, she suggested that if I was to do any plane travel to buy and wear a compression sleeve. (I will talk more about the benefits of compression in another post)
As important as it is to know the risks, it is equally important to know the early signs and symptoms. If it is caught early, it can be reversed quite successfully through treatment and ongoing management but if it is not, treatment is much more difficult, expensive and less successful.
What should you look for?
-may look shiny, swollen, puffy on the same side as the surgery. Compared with the “good” limb there may not be “wrinkles” where the good limb has them…wrinkles in this case is a good thing! (who knew?) It may feel tight or have a full feeling. If the skin is pressed it may indent or clothing and jewelery may leave marks or feel snug.
-The hand or limb may look noticeable bigger than the other. ( The arm may feel heavy, achy, uncomfortable, tingly or numb. There may be a feeling of warmth and or redness in the limb. Pain may also be experienced.
So off I went. For the next 6 months I had chemotherapy, then radiation. My husband and I sold the house, sold most of our belongings, bought a truck and 5th wheel trailer (our new home) and headed south for our new life and adventure!
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