One sultry morning in July 2010, I sat down to watch an episode of Dexter. I was about two-thirds of the way through my regimen of chemotherapy for Stage IIb breast cancer, and I found something soothing in the blood-drenched gore of early Dexter shows. Plus, if I took my pain meds during the opening credits, by the time Dexter had sliced, diced, and dumped someone in the Miami Bay, my pain would have abated and I would likely feel well enough to shower. Or walk to the mailbox, if I was really up for a challenge.
It Started with a Tingle
Anyway, on that particular day, as the glorious Michael C. Hall fried up his steak and eggs, I felt a funny tingling in my left arm. “Huh,” I thought. “That’s weird.” By the time I watched Dexter Saran-wrap some notorious villain to his table and commence dismemberment, I realized my left arm had swollen to gargantuan proportions. “Well,” I said to myself, “that was fast.”
I quickly scheduled an appointment with a physical therapist and lymphedema specialist after my arm ballooned up to four times its normal size. They took my measurements and said, “Yup. That’s lymphedema.”
Quick Lymphedema Tutorial
A quick tutorial for the uninitiated: Secondary lymphedema can affect anyone who has lymph nodes removed from nearly any part of their body. Women who have had mastectomies with lymph node removal are particularly high risk. When I had my double mastectomy in April 2010, the prevailing wisdom was that the surgeon would check your sentinel lymph node, the one closest to your breast ducts, and if there was evidence of disease they would remove the entire cluster from under your arm.
In my case that turned out to be 19 nodes, only the first one of which had microscopic disease. A few months later, the standards changed: Even if a positive sentinel node was found, surgeons would remove only those nodes that had evidence of cancer, leaving the rest in place. This less aggressive surgery significantly decreased the risk of lymphedema.
I’m not going to linger too long on the causes, risk factors, and percentages of lymphedema among breast cancer patients. You can read about those here (http://www.cancer.gov/cancertopics/pdq/supportivecare/lymphedema/patient), or here (http://www.lymphnet.org/), or here (http://www.mayoclinic.org/diseases-conditions/lymphedema/basics/definition/con-20025603). I’d like to focus instead on my own experience and my efforts to control my condition, rather than letting it control me.
Of Sleeves and Wraps and Machines
After a consultation with the lymphedema therapist, I was fitted for compression sleeves and taught how to wrap my arm in bandages. The initial treatment, an attempt to reduce my swollen arm to just two or three times its normal size, involved wearing “wraps” about 23 hours per day. These wraps made my arm look mummified and were a colossal hassle to put on, take off, wrap up, wrap off, etc. I was “fortunate” my first flare-up was over the summer. It is impossible to put a sweater on over these things. I also had to see the therapist every day for an hour, four or five days per week, for manual lymphatic drainage. And I had to learn how to self-massage my arm in order to move the collected fluid out of my arm and into the rest of my body.
When the lymphedema got really bad, I was fitted for a Compression Machine. (See photo.) This torture device involved lying perfectly still for an hour while a series of tubes and air pressure pumps massaged my entire left side. Creepy, weird, uncomfortable, and unsustainable. How many moms with kids under the age of five do you know who can lie still for an hour a night before bed? That’s right: none.
Chronic but Survivable: Time to Thrive!
Finally, after months of intensive therapy, daily maintenance, endless doctors’ appointments, and chronic pain, my lymphedema stabilized. I still wear a compression sleeve every day, but I’ve stopped wrapping at night and using the Machine. I have flare-ups when I fly long distances or when the weather turns hot and humid. The pain is chronic but manageable.
Now, three years later, my lymphedema is under control but by no means resolved. After that dark day in July, I commenced what would be a long, difficult, painful journey toward managing a chronic condition. A journey that, unfortunately, I am likely to be on for the rest of my life.
BUT! I am alive and intend to stay that way for many years to come. The lymphedema is a bitter reminder of what I went through to overcome breast cancer. But it’s also a reminder that I did come through. I did survive. And I will continue to thrive.
Next post! Next week I’ll share some lymphedema tips and tricks and offer some photos of my favorite compression sleeves.