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Showing posts with label pain. Show all posts
Showing posts with label pain. Show all posts

Thursday, May 19, 2016

Cording

Cording refers to the development of palpable cords (tight bands) usually in the axillary region when it is called axillary web syndrome (AWS). Reported rates vary widely. There is little known when it occurs, or why it occurs, or how long it lasts.
Tight cords under the axilla limits range of motion, and sometimes aggressive stretches are used to improve shoulder mobility.
Not only is there little known about the origin (dilated thrombosed lymphatics, or thrombosed superficial veins, or both), risk factors are guesses, and it is unclear how to treat it.  Physical therapy (stretches), non steroidal anti-inflammatories, heat packs, lymphatic massage has been mentioned.
Some forums say there is little one can do to speed up the process.

In a literature review of 8 studies symptoms lasted between 1 week to 2 years, most resolved within 3 months. The prevalence can be high depending on the studies, there is no consensus on definition, treatment, or standardized screening.

References:
Piper M, Guajardo I, Denkler K, Sbitany H. Axillary web syndrome. Current understanding and new directions for treatment. Ann. Plastic Surg 2016; 76:S227-S231.

Moskovitz AH, Anderson BO, Yeung RS, et al. Axillary web syndrome after axillary dissection. Am J Surg. 2001;181:434–439.

O'Toole J, Miller CL, Specht M, Skolyny M, Jammallo L, Horick N, Elliott K, MNiemierko A, Taghian A. Cording following treatment for breast cancer. Breast Cancer Res Treat 2013; 140:105-111.

Even less is known about truncal cording "What is Cording?" National Lymphedema Network
This may be a case of underreporting, especially if the truncal cording does not limit daily activities or causes pain.

However I was not happy to have discovered this across my abdomen during the 5th week postop (see photo of left side during a lunge stretch).  Best guess: possibly due to overdoing the GHD sit-ups (3 sets of 10). To be continued ....





Monday, May 2, 2016

Evolution of pain post surgery

At first it feels as if there is a burning hot cable with spikes wound very tightly around your chest. Then it is a cable with spikes, but no longer hot, and then a cable or belt without spikes.
On the sides under the arms the stitches pull more and it feels as if the lower ribs are bruised. This is the part that makes being upright uncomfortable, and this is more uncomfortable than the pain across the chest. However all of this is still better than nausea from pain medication! I am a wimp when it comes to nausea.

The fluid retention underneath the arms is very uncomfortable. Sometimes it becomes more, especially when waking up in the morning. Light, passive stretches help alleviate the discomfort. It becomes very annoying, though, over time, even after it subsides a little. There is also the worry that it might develop into a seroma, if you do too much/too little/...(?) There are no clear rules to follow.

Garrison Keillor's writings come to mind referring to Midwestern mentality of "getting a grip."
http://www.garrisonkeillor.com/his-nerves-are-tired-and-he-needs-to-lie-down/

Thursday, April 28, 2016

Normal daily activities

You will have been told that you can return to normal daily activities 2 weeks post mastectomy.
Hopefully you will also have been told to abstain from carrying laundry baskets or vacuuming.

If you have help, use it!  Asking for help can be a great learning experience. It is not easy (for me)!

Normal daily activities can be more challenging than doing deadlifts in the gym (which you are told not to do so soon). However I found that exercises in the gym including strength training are carefully controlled movements while normal daily activities can be complex movements (cleaning) and may involve heavy weights (grocery bags) that are not necessarily appropriate.  Be realistic!



  • Showering did not happen for me until a week post surgery. Wash cloths and baby wipes work, and a hair wash in a salon feels great. 
  • Walking can be painful and wasn't comfortable until almost 4 weeks post surgery. Go easy.
  • Having cleaning help is a blessing.
  • Chopping carrots (or other hard vegetables) can be a strain. Directing your teenage son to chop various kinds of vegetables for a vegetable korma dish is a great learning experience for him.
  • Allowing others to help can make them feel good about themselves. Asking for help can be a great learning experience!
  • Sunday, April 17, 2016

    Walking


    Beautiful sunshine and unusual hot weather (80 degrees) invite for a walk around Cascade Lakes. That means 15 minutes walking away from the car with relative ease, and miserable, painful 15 minutes walking back.

    Who said I should walk after surgery as much as possible?

    Friday, April 15, 2016

    After discharge from the hospital

    Back in the hotel. It is so nice to have a husband who is super good helping to care of drains how he was taught to do in the hospital. Taking one tablet of a narcotic before going to an appointment makes me nauseous. I’ll be sticking to Tylenol after this. However the appointment was with a rehabilitation specialist, and we talk fun stuff like exercise and research studies of exercise after mastectomy.

    A wedge pillow is comfortable to have. Since getting there by car, I was able to take all sorts of stuff that I may or may not need. A foam roller and a yoga bolster was part of it. This, the yoga fish pose, and a long back scratcher bring relief from sleeping on the back.


    Thursday, April 14, 2016

    Post Surgery

    You can order room service meals J I am hungry. Half of a veggie omelette (no cheese) hits the spot, and a cup of blueberries, that the nurses eye enviously.

    After a good sleep despite the continuous leg muscle massage, I woke up, looked down my chest and thought: “I am going to like this!”  And I still think that after seeing myself in the bathroom mirror when I get up. Note that after watching the pre-op video “Preventing Falls in the Hospital”, you do call a nurse to watch you. I enjoyed talking research with the resident, a friend send some flowers, another friend visits for a chat, and I have my iPad to stay connected with others. It is all going brilliantly until it is time to get up, get dressed, get discharged. Then the pain hits, and opioids make me feel much worse (disoriented, hallucinations). So I need a little more rest, but we do leave at around 10pm.