Monday, May 21, 2012

Mastectomy Therapy: Physical Therapy using Lymphatic Therapy for Pre and Post Mastectomy Surgery


Many of our clients come to Healthy Being Wellness Center managing breast cancer.  We often provide pre and post surgical education and lymphatic therapy to assist their bodies in recovery and obtaining optimal health.  It is absolutely essential for the breast cancer patient to understand the process their body is undergoing as they recover from such an invasive surgery as a radical mastectomy and potential follow up radiation therapies.  The lymphatic system is a key and integral part of their recovery and must be attended to pre and post surgery to maximize the healing process from a mastectomy.


Many of our mastectomy patients experience:
  • Limited upper extremity mobility (range of motion)
  • Arm weakness and swelling
  • Fatigue
  • Shoulder dysfunction
  • Chest pain  
  • Severe scarring and slow wound healing

Many women may not immediately notice these difficulties, as they may have intentionally kept their arms immobile for fear of hurting the incision. It may be only when the individual tries to lift something, perform household chores, drive - or even zip up a zipper - that she realizes she cannot move her arm as she once could.

Several of the post-surgical problems are interrelated. The surgery itself and scarring from it can, for example, tighten the skin on the chest wall and form fibrous adhesions, which can cause shoulder joint dysfunction. This dysfunction can lead to improper joint use, in turn causing the joint to contract, or tendonitis to develop. The results are pain, muscle spasms, immobility and the loss of range of motion.

OTHER DIFFICULTIES

Additional difficulties may result from breast surgery may include:
  • One of the most significant complications of breast surgery is lymphedema, or swelling of the arm. In addition to causing discomfort, such swelling can produce other complications, including infection as well as changes in posture and musculoskeletal problems related to the increase in the arm's weight.
  • The scapula, or shoulder blade, is susceptible to problems after surgery. Trauma to the long thoracic nerve during surgery can cause temporary or permanent paralysis of the muscle that helps stabilize the scapula (the serratus anterior muscle). This may be first noticed when the patient tries to reach for something, or when headaches, low-back pain or interscapular pain occur.
  • Nerve entrapment by adhesions or cutaneous nerve regeneration may cause chest wall pain and numbness. These conditions are often worse for patients who have undergone reconstructive surgery.
  • Over-compensating for the loss of breast weight may cause prolonged spasms of the rhomboids or trapezius muscles.
  • Chemotherapy can intensify the effects of immobility, when treatment causes fatigue and corresponding inactivity.
  • Abdominal pain and upper abdominal swelling (just below breast bone) often occurs after reconstructive surgery.

The degree of difficulty patients encounter with any of these complications varies with the extent of the disease and the procedure, as well as age and prior orthopedic problems.

Recovery from breast surgery - which may take several years - is however, even more directly linked to the timing, intensity and quality of a rehabilitative post mastectomy surgery program.
 
LYMPHATIC THERAPY AND MASTECTOMY RECOVERY

With a preventative goal, our Lymphatic Therapist, Melissa Gallagher, will begin treatment before surgery to:
  • Establish a baseline for lymphatic functional ability and arm circumference.
  • Instruct patient on how to prevent severe scarring, swelling and edema.
  • Maximize healing process with a combination of at home exercises and lymphatic therapy.

Immediately following surgery - ideally while the patient is still hospitalized - a lymphatic therapist will re-evaluate the patient to determine the extent of dysfunction, set rehabilitation goals and begin assisted and self-managed exercise.

Visit our website for more information regarding lymphatic therapy.  For more information or to schedule a lymphatic therapy treatment call 727-502-3464
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