Sorry Gulch, Arizona, by Eric Talerico

Monday, August 3, 2009

Lymphedema, part 2

Lymphedema is a discouraging outcome of surgery for breast cancer, especially if that surgery includes lymphedectomy, or  lymph node removal, of more than a few lymph nodes plus radiation of the lymph area.  It's debilitating, and depressing.  In some ways, worse than breast cancer.  It can occur almost immediately after surgery, or many years later.  Here is a reliable website giving the best current knowledge and pictures: 
http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=927625   You really need to look at this to understand what this posting is about.  

The article mentions checking one's arm daily for size, softness, and any injuries.  I do that.  Size remains the same - my left arm is about about 50% larger than the left, and that's not bad.  It is pithy, in that my fingerprints remain from moderate touch.  When I awake each morning, my left arm has a weird tangle of deep lines sketched by pillow case and sheet wrinkles as I dreamed.  I'm always relieved to see that when I elevate my arm, the pithy lines disappear and my arm, though red and somewhat swollen, is soft, the tissue is loose and flexible.  

If the lines do not disappear with elevation, if the muscle and tissue are hard, I'll go immediately to my doctor.  The danger here is cellulitis, infection, abcess.  To avoid this, I'm very careful of my arm and hand.  No injury or strain.  I wear a compression sleeve all day, and receive manual lymph drainage once or twice a week.  The lymphedema is also in my left chest wall and breast.  Although that area is included in the massage therapy, there's no compression girdle for it.

Although I'm not prone to self-pity, I was a bit taken aback by this.  However, I have discovered several wonderfully helpful things.  Water is one of them.  If I drink at least 2 litres a day, and this is hard for me - somehow I'm not a water drinker - but 2 litres daily is good for lessening the swelling.  The other help is exercise.  Although strain on the arm is bad - I can walk daily for 6000 - 10,000 steps, and move my arms with the motion of my steps, and it's all good.  The third thing is attitude.  I've simply stopped worrying about it.

It's a thing that's incurable. OK - I'm no longer dismayed that people gawk at my gloved, medically sleeved left arm.  I compensate without thinking, do what I have to do.  And life goes on.  It's a small thing, really.  Still, I hope to wake up one morning and discover both arms are the same once again, and my operated breast smaller than the other, as it should be. 

Guess we'd all like to wake up and find things as they should be.