(This is a long somewhat whiny post, now that I read it, so apologies upfront)
I went back to the Lymphadema Clinic at Princess Margaret Tuesday for a follow-up on the art of bandaging. Tessa and Luka accompanied me this time, Tessa to film and Luka to do some hands-on bandaging. One of the many frustrating things about this stage of lymphadema is that when the hospital therapists show you how to do the required bandaging, they do it with their two hands. Then you go home and have to bandage your arm with one hand. In my case, my dominant hand is the one with the lymphadema, so I am using my not-very-adept left hand, which makes it even slower and more frustrating. So, Luka agreed to come and be the RMT-in-training.
This is not new—Luka coming with me to appointments—when Tessa returned to Russia in March, Luka stepped in as my right-hand when it came to appointments. He had a break when Tessa returned at the end of May, but since she is back to Russia again first thing in September, Luka has been my partner in this new lymphadema bandaging debacle. He came and filmed the first bandaging appointment and demonstration at the hospital, then came and filmed a one-hour manual lymphatic drainage massage with an RMT and osteopath last Saturday. Michel Moya-Mora, at the Wellness Institute on Royal York Road, gave me an excellent two-handed massage, and talked all the way through, telling Luka how to angle the shots, and instructing me on what he was doing and why. Such a luxury!
At Princess Margaret I learned that my swelling wasn’t at 13% more than my left arm but at 23%. Ug. I thought my right arm and hand looked HUGE, but when I heard 13% I thought “Well, it looks really puffy to me but 13%, that’s not so bad.” Who knows what percentages look like when you’re looking at your own appendages? But hearing the value is 23% made me think “Holy crap, I knew this was serious.”
Pam, the lymphadema therapist I met with, was very sweet. I’d met her before in the clinic, but with all the women she must meet there I was surprised she remembered me. I told her I was freaked by the increase in the size of my arm and the hardness of the flesh now that I was bandaging. She made suggestions, changed me from soft cotton padding to the thick, firm, open cell foam I’m using now. I asked her for truths about my condition, not gentle platitudes, and she gave them to me.
Bandaging is a pain, but it is he only way to reduce the size of the affected arm. I can and must do self maunal lymphatic drain massage twice a day, for an hour. That involves stimulating lymph nodes in the head, neck, shoulder, chest, back, armpits, trunk and groin, in addition to massage to move the fluid in the fingers, hand, arm, shoulder, back, chest, breast and trunk.
Then, in this order:
1. cotton stockingette on full length of arm
2. bandaging of all fingers, thmb, hand and writst with two rolls of two-inch gauze
3. channelled foam padding between the fingers and on the back of the hand
4. cotton stockingette over the hand
5. strip of fine four-inch foam around the hand twice, above and below the thumb
6. wrap four-inch-wide, four-centimetre thick open-cell foam all the way up the arm
7. 6-cm short-stretch Compilon bandage over te hand at least eight or nine layers, then up the forearm until it runs out
8. the 8-cm wide bandage from wrist to armpit
9. then 10-cm wide bandage from wrist to armpit
10. then tape securely and go for a nap. Sometimes I do—it’s a tiring wrestling match.
This bandaging has yet to go smoothly on the first go. I do it too tight and can’t feel my fingers by the time on the second short-stretch bandage, or worse, the tingling starts 10 minutes after I’ve finished the whole thing, which means I have to unwrap EVERYTHING and start fresh. There’s no such thing as leaving the arm wrapped and finessing the hand—it starts with the hand. I drop rolls of bandage and gauze, and of course they unroll across the floor.
The lymph node and arm hand massage takes an hour. The bandaging, so far, takes at least an hour when you factor in the fact I must re-roll all the gauze and bandages before applying them.
That’s four hours a day!
I am elevating my arm above the level of my heart twice a day for an hour at a time, letting gravity do its part to lessen the swelling.
Through my work insurance I can get five hours of professional lymphatic drainage massage, so I’m planning to blow that in the next two to three months to try and get this arm down and into the sleeve and glove I hated so much before.
Now I think wistfully of my sleeve and glove. It’s like Joni Mitchell’s Big Yellow Taxi: you don’t know what you’ve got til it’s gone.
Onward and upward.
Filed under: cancer, health matters, lymphedema arm, lymphedema hand, lymphedema massage, lymphedema trunk, radiation side effects, surgery, triple negative breast cancer | Tagged: axilla lymph node dissection, axilla lymph node removal, bandaging, breast cancer, breast surgery, caregiving, hate that cancer, Luka, lymphedema, lymphedema arm, lymphedema hand, lymphedema trunk, manual lymphatic drainage massage, MLD, Princess Margaret Hospital, radiation late effects, Tessa, triple negative breast cancer | 2 Comments »