When doctors told me last January I had breast cancer and needed surgery, I didn’t spend much time thinking about how the surgery might affect the mobility of my arm or shoulders. In fact, initially I didn’t think about it all.
I had cancer and I wanted it out.
But a program unique to Surrey Memorial Hospital made me realize I needed to look at the bigger picture.
Research shows that one of the risks of breast surgery is lymphedema, a swelling in the arm. Sometimes having lymph nodes removed (which I did) can make it harder for your body to get rid of extra fluid, leading to tightness and pain. It’s something that can occur immediately or might show up months, even years later.
So while my priority is of course to finish treatment cancer free ( my chemo is almost over!), I also want to come out of this with a healthy body. I want to be able to do all the things I did before.
After surgery, I was surprised not only by how weak the arm on my surgery side had become but how much movement I had lost in it. Simple stretches had become incredibly difficult.
Even now, my body is still healing and physiotherapy is helping it do that.
I’m one of about 355 patients this year who will go through the physio program at Surrey Memorial offered to breast surgery patients. Fraser Health says the program is the only one of its kind in the province.
Patients aren’t just taught stretching exercises in a pre-op class, but a physiotherapist also takes baseline measurements so they can later be compared for strength and stiffness post-surgery. Then patients are automatically booked for follow-up physiotherapy at the hospital.
“We see patients at one month, six months and one year after surgery basically to redo the measurements and progress exercises and activity. But if at any point during those check-ins someone has an issue, we can bring them in for more visits,” says Chiara Singh, clinical supervisor of the physiotherapy and surgical program.
“The hope is that we prevent that stiffness and that weakness from setting in.”
Singh says the program began because of the number of breast surgery patients who were developing lymphedema.
“We were getting a lot of referrals to the outpatient centre for people with arm swelling and our thought was there’s a lot that can be done to try and prevent these issues so we wanted to focus more on a prevention model rather than treating someone once they already have a problem.”
She says women are getting diagnosed with breast cancer much younger and it’s important to prevent side effects from treatment so they have a better chance of going back to the activities they did prior to treatment. Fraser Health is now considering expanding the program to Abbotsford.
“The literature is pretty clear…the prevention model is effective for decreasing the incidence of lymphedema and decreasing stiffness, weakness and pain after surgery.”
If you’re going through the same post-op physio, hang in there. It really can make a difference.
In the first two months after my surgery, a simple exercise like facing a wall and walking my fingers up it, was discouraging. The stretch in the arm on my surgery side stopped at least ten centimetres lower than the non-surgical side. Today, that gap has almost closed and I credit the physio program and the series of stretches and later light weights I was given to do at home. It takes about thirty minutes a day, six days a week, but it’s making a big difference. And that’s motivation enough to keep it up, even on the days I’d rather skip out.
I want to be strong again. And I’m getting there!
Michele Brunoro will be providing ongoing updates during her medical leave on her blog, The 3,800 Club.