Physical Therapy (PT)

An illustration of the lymphatic system
from a National Lymphedema Network brochure.

In mid-November, Jill (plastic surgeon's office) deemed me ready for physical therapy. My referral was to OncologyRehab, a PT office that helps oncological patients. This particular group focuses on reducing lymphedema risk, minimizing pain and swelling, and maximizing function. 

Lymphedema: swelling of the arm, hand, trunk, or breast caused by a build-up of lymph fluid in those tissues after breast cancer surgery. Edema is the medical term for swelling. Lymphedema can develop at any time after surgery.

It's important that I do what I can to reduce my risk of lymphedema. Since all 16 of my level one lymph nodes were taken, the rest of my lymphatic system will have to compensate for that loss. Because of the lymph nodes taken, and because of the radiation I'm receiving, there is a higher risk of me developing lymphedema. Learning what to watch out for and how to not overtax my body is important!

There are 5 ways in which I can overtax my arm:
1. Activity
2. Injury
3. Air pressure changes
4. Systemic infection
5. Weight gain

Meet Brianna, my physical therapist.

The physical therapist/lymphatic expert I've been paired with is Brianna. She is a great match for me! She wants to stretch things (ar, ar, ar...) but also is on the conservative side of what activities I should/should not do. We both don't want me to hinder my progress by doing too much too quickly. Since I've recovered well from surgery, it's sometimes easy to forget that I have physical limitations.


Brianna gave me instructions to activate and "teach" my lymph system via massage techniques. I practice these massages twice daily - in the morning and evening in bed. Joshua helps some, which my left arm appreciates; it gets tired of doing it all. At the beginning of PT, I had two approved stretches that I could perform: the "bye-bye" exercise twice daily and the standing in a corner/in a door frame 3+ times daily. 

I inquired about lower abdominal toning exercises that I can do now to help not only tone my stomach, but also my lower back. I miss my sit-ups! (OMG - did I just say that?) The belly has gotten soft since surgery. Anything I can focus on and improve physically at this point is a good thing. Speaking of improvement... My right arm range of motion has increased drastically since I first began PT. Each saline fill would set me back some, but I would rebound nicely after a couple of PT appointments after those fills. Now that the fills are over on the right side, I believe I can continue improving even further.

Earlier in December, I was approved to do some more stretches, which makes me happy. It feels good to do more on my own to help with my range of motion and strength. I've also gotten approval for increasing my exercise routine - no longer do I have to just stroll! I can kick it up a notch at a time and increase my walking speed, add hills, and will eventually build up to jogging a little at a time. Gradually, I'll add strength training, weights, and yoga. Then hopefully Slim in 6 and P90. I know I've got a long way to go and, although I'm not sure of the timeline, I know when I meet P90X again in the future that I'll feel like Superwoman! Until that time in the distant future, though, it's baby steps.

Side note about Brianna: she wrote up an interesting guest blog post on a friend's site about PT being the "missing link" in breast cancer treatment post-surgery. I found it insightful, interesting, and TRUE. Please read her short article: The Missing Link (physical therapy).