Step up for prevention
Recently, a dear friend of our family had another reoccurrence with a type of women's cancer where she had to have some more of her lymph nodes removed. We were in town visiting and I thought I would get her set up with some compression wraps, compression shorts and stockings. Little did I know how complicated it would be to do such a thing in a different area of the country.
Simplicity is key when it comes to complex health issues, especially with issues of tissue healing following surgery and edema/lymphedema management. Prevention is always the best management, but how do we prevent things that the patients don't even know about until after their first post-operative visit? I ended up calling pharmacies all over town and visiting some physical therapy offices trying to find what we needed. I was surprised that no one had what I needed and then a level of frustration for my patients quickly followed. I have always felt such compassion and empathy for people trying to be well, and I feel strongly that we in the medical community need to take strides to decrease these levels of frustration so people can heal and be well with less stress. But how do we do this? It is a tricky situation.
Currently, our medical communities are overworked and under staffed, and the insurance companies are not paying for things like they used to for our patients, like pre-operative visits to physical therapy. Many times too many assumptions are made, and patients don't understand their "plan of care." Often the first few weeks are critical and their drains aren't even removed yet following lymph node removal. Recently it became clear that adjusting to the next step of your life following a mastectomy or hysterectomy with ovary removal is difficult. So what should we do to make these things better?
Well it seems like the idea should be easy. Make access to health care and good information quick and simple, and utilize providers in efficient and cost-effective ways.
My friend did just that. She is a nurse and she used her network of friends and family to connect her to the best information available and her friends rallied to get her all situated. But what happens when our patients don't have a network of medical people they know and feel like they are at a loss?
Following surgery, think of the things you need to do to get you well in the first 2 weeks:
1) Rest, a good nights sleep, sunlight, good food and lots of water.
2) Decrease the swelling around the area, using ice packs in a pillow cover 10 minutes at a time.
3) Compression: two-way stretch wraps, not ace wraps, TED hose for venous issues.
4) Exercise: gentle movements at other joints surrounding the area. Begin walking daily, short pain free time frames multiple times a day.
5) Skin care: watch for infection, redness, and swelling that seem excessive.
6) Deep breathing exercises to activate the lymph system for healing and moving oxygen in and out of the system.
What you do in the first two weeks after surgery sets the tone for your healing progression. You can make at difference in this healing with how you care for yourself. So pay attention to your body and take the time to get well. Get a caregiver to help you if necessary. You are worth it.
Sheree DiBiase, PT, is the owner of Lake City Physical Therapy, and she and her awesome staff can be reached in Coeur d'Alene at (208) 667-1988 and in the Spokane Valley at (509) 891-2623.