Archives for the month of: August, 2013

This post was orginally going to be written by my very tolerant friend, A.  She’s been my test dummy since I originally started my massage study back in 2004 – she had a lumpectomy a few years before and had developed lymphoedema as a result.  She’d get on my table and let me practice all my lymphatic techniques on her (and her husband donated his body to my remedial massage practice – man they were great friends).

A. has been coming to see me over the years to help her keep her lymphoedema under control.  Sometimes regularly, sometimes not.  Life has this habit of jumping in the way of best intentions.  She was going to write this post, but again, life has jumped in and the time has slipped away, so I offered to write it from her feedback.

When I got my laser a few months ago, A. was one of the first on my table as guinea pig.  We were amazed at how well she responded, there was significant softening of the fibrosis at the top of her forarm and her skin felt soft for the first time in ages.

After the third week of my Vodder course I persuaded A. to let me again use her body in the pursuit of my studies and she duly rocked up on a Sunday afternoon and let me run wild with her.

I explained that the most significant difference in the treatment protocol was the treatment of fibrosis.  I would normally go in a bit firmer with her fibrosis but really kept in mind the idea that lymphatic drainage should always be gentle.  But with Vodder, “aggressive” is the word they use in relation to fibrosis.  Can you believe it?  I still have bruises on my leg from where the lecturer demonstrated the fibrosis treatment on me – on someone without an issue it’s really painful, for someone with an issue, it feels normal.  Ouch.

So, I watched with anticipation as I started giving her the “aggressive” treatment.  Her eyes widened and her jaw dropped.  Luckily she trusts me.  At the end of the session she had a feel of her forarm and couldn’t believe how much it had reduced and how great it felt.

Then, because she is so lovely, she let me bandage her.  She’s never had bandaging done before, nor does she want it again, so she’s going to be very regular with her treatments from now on to avoid the possibility of ever having to undergo it.   Here’s her beautiful arm …

Image

A’s beautifully bandaged arm

I spoke with A. on the following Wednesday.  She said that she actually felt sort of bruised on Monday and Tuesday but that on Wednesday it felt normal again, but that the arm was still soft and feeling great.  Normally she says that she’s ready to rip her compression sleeve off by about 8pm, but she was able to leave it on until bedtime.  And normally within a couple days she starts to feel congested again, but not this time.

She came in for a follow up after ten days.  Progress report – her eczema on her hand was playing up, she had a paper cut (man do those hurt!) and a torn “quick” on one of her nails, all on the affected side.  Normally that would mean big swelling and heaviness.  While the arm wasn’t as good as the week before, it really wasn’t that bad, considering all the things that had gone on during the week.

We did another treatment and towards the end my comment to her was “your arm’s squidgy”.  She looked at me like I was a little deranged.  Maybe I am?  She sat up at the end of the treatment and investigated her arm … “you’re right, it is squidgy, and I have wrinkles”.  Her sleeve just slid on.  She had the cheesiest grin on her face – love it.

UPDATE 28/8/13

So, had third treatment today and at the end she was so amazed she said we should have taken a video of the treatment.  Well, too late for that, but we could take a video of her enjoying her soft arm – her favourite spot is the indent that she now has in her elbow, she hasn’t seen that for a long, long time.  The video’s a bit dark, but that reflects the subdued ambience of my treatment room – it’s all about comfort!

This is new territory for me  – I’ve just created my first youtube video!  Here’s the very supple movement of her arm …

http://youtu.be/u3so183HeMs

I’ve been following Helen’s blog (http://lymphnodetransplant.wordpress.com) since before she had her amazing surgery back in March.  Before then, I had no idea that it was even possible to transplant lymph nodes and so I was very interested (and to be honest, excited) to see how she went.  Helen has been very open with sharing the ups and downs of her surgery and has continued to bring information on lymphoedema, manual lymphatic drainage, exercise, self massage, bandaging, compression – all the important things when dealing with lymphoedema.  I’m sure her blog has brought answers to many out in the real world who are looking at options to manage their lymphoedema, as there’s not much available written from a patient’s perspective, the info that is out there is all in doctor speak.

I received an email from Helen after my first week of Vodder training – she had calculated when I’d be back in the clinic after my training and wanted to come in to have some Vodder lymph drainage with me and to try my laser (http://www.riancorp.com/FAQ/frequently-asked-questions-ltu-904-laser-for-lymphoedema.html) to see if it helped with her scar.  So we scheduled an hour and a half appointment so we could discuss her case history and have enough time to do some laser as well.

Image

Riancorp Laser -http://www.riancorp.com/FAQ/frequently-asked-questions-ltu-904-laser-for-lymphoedema.html

Yesterday was the day.  I was very excited to meet her finally.  It’s always interesting to meet someone after only communicating in writing, you get to hear accents.  Helen is originally English and I’m originally from Trinidad.  There was so much to say.

Firstly we took some measurements of her transplant leg (I didn’t tell her what the measurements were – there were times early on when Helen was measuring every day and it got a little disheartening for her when things didn’t reduce as quickly as she imagined and the measurements were more for my information so we could monitor her progression).  I have to say, her leg actually looks great, as does the scar, she feels the knee isn’t working quite the way she’d like and she’s still getting swelling after exercise (it resolves after a good night’s sleep).

And away we went with treatment, creating pathways from the groin area up to her axillas (armpits) and constantly clearing fluid upwards towards them.  I used the laser around the scar and medial knee where Helen says most of her issues are, then turned her over and worked the back of her thigh.  Interestingly, the skin on her leg was soft throughout until I got half way down the back of her thigh where there was almost a line (not one that you could see, but one I could feel) where the texture changed to a slightly more “spongy” texture.  Interesting.  All the while I was clearing fluid up to her axilla.  All too quickly we were out of time.

As Helen left she asked “so, who’ll write the blog, you or me?”.  You guessed it – me.  We have another appointment booked for next week so I’ll find out then how she felt after the treatment, although I’m sure she’ll post a comment on here before too long.

Thank you Helen for the opportunity to work with you and to be able to blog about it afterwards.

Well, here it is, my certificate showing my certification as a Vodder therapist.

Image

My certificate

It has been an amazing four weeks.  I have learnt an incredible amount, met some amazing fellow students and without a doubt some amazing lecturers, whom I’ve named and given links to in previous blog posts.  I need to mention at this point the wonderful Sheryl who was in the background helping with organisation and giving us encouragement the whole way through – Sheryl has been a Vodder therapist for many years and her insight throughout the course was invaluable (and I have to mention also her calm and lovely touch, a beautiful addition to the team).  Thank you Sheryl.

Image

Vodder graduates, Sydney 2013

The last few days were pretty intense, with each of us having to perform some of the techniques on Koby, our lecturer (poor Koby, 16 people with nervous, clammy hands all trying to keep calm and do our best), a bandaging exam and a pathology exam.

We could have pulled anything out of the hat … for the bandaging it could have been a simple case of lymphoedema post surgery or it could have been a venous issue (or various other things of course), short stretch or long stretch.  My case scenario was someone with swelling in the lower leg because of a venous issue, so that called for a long stretch bandage to the knee.

For the pathology exam, well, the range of health issues we could have had to deal with was enormous – mastectomies with swelling or fibrosis and arm lymphoedema, or tight scars causing range of motion issues; secondary lymphoedema in the legs post hysterectomy, prostrate cancer, gynaecological cancers; primary lymphoedema in the legs; chronic sinusitis, detached retinas or traumatic eye injuries; tinnitus; Meniere’s Syndrome; facial nerve paralysis; whiplash; migraines; hip or knee replacements; shoulder pathologies; trauma to any joint; venous ulcers; treatment after cast removal after fractures … you name it.  Out of all that, I pulled out a mastectomy with nodes removed from the axilla and radiation with swelling in the arm.

We finished our exams by about 12.30 on Friday and we were given a long lunch until 3pm while Koby collated all our marks.  We trooped along to the food court and all had lunch together then made a dash to the park in Burwood to soak up some of the beautiful sunshine we’d been missing, it was the most perfect day to be outdoors.

Then it was back for photos and results.

This weekend I’ve been playing catch up with all the things I’ve neglected for the last four weeks … the kids, the cleaning, speaking to family and friends, walking around the farmer’s markets and enjoying a coffee outdoors.  It feels strange to be able to sit down and not have to study or practice something, but I’m certainly not complaining!

Really looking forward to putting it all into practice now.

Thanks to everyone for their support throughout, your words of encouragement have really spurred me on.

Three weeks in and I can’t quite understand where the time has gone.  Seriously, I feel like a day went missing this week.  Monday and Tuesday were spent listening to Professor Neil Piller, of Flinders University, talking about some of the conditions that can be treated with manual lymphatic drainage; some of the tests that can be run to see how the lymphatic system is working, which pathways the lymph is using; some of the equipment we can have in our clinics to help us tell what is going on with our clients’ bodies; some of the equipment we can use to help in our treatments; more anatomy and yet more physiology.  I think my brain is going to explode.

On Wednesday we had our first class with Koby Blanchfield, an accredited practical instructor with the Vodder School.  This week it’s all been about treating conditions and bandaging.  The only interruption to the practical work this week was another theory exam on Thursday morning on everything Prof Piller taught us.  Glad to be done with that one.

Here’s a photo of my poor daughter, bandaged up while watching TV on Thursday night.  My kids are very patient with me thank goodness.

Image

Bandaging my daughter for homework – please note the adorable pink bunny slippers in the background! How cute are they?

This weekend’s homework is more bandaging, studying all our basic treatments as well as all the “specials” in preparation for more scenarios next week.  

Maybe I can allow myself a sleep-in on Sunday!

I’ve managed to survive another week.  In no small way thanks to the amazing people I’ve spent the last two weeks with – the ones who have kept me laughing when we all felt like crying.  Day one we were advised by our lecturer, Jan Douglass (http://movinglymph.com), that for the next few weeks we had “no life” – which lead to two of us instantly sticking our hands in the air and singing … “no life, without wife”.  If you’re not into movies then you won’t get the reference – that’s from a movie called Bride and Prejudice, a fabulous adaptation of Pride and Prejudice, set in India (http://en.wikipedia.org/wiki/Bride_and_Prejudice).  After two weeks of singing that refrain I just couldn’t resist, I had to watch the movie tonight to celebrate being half way through the course.  And to celebrate passing my first lot of exams.

Image

Vodder Therapy 1 certificate

This week involved a lot of physiology study, a lot of talking about how the lymphatic system works, a lot of practices of sequences, “specials” – special tests and treatment for specific areas that are commonly problematic, like the shoulders, elbows, wrists, hips, knees, ankles, and a fair amount of panic.  On Thursday morning we had our theory exam and this morning we had to pick a slip of paper with two body parts on it and do the sequence for treating the areas – without any notes.  If only you knew the volume of new information we have been subjected to in the last two weeks then you might understand the panic of trying to memorise every sequence for the entire body on top of all the theory.  I had to perform the sequences for the bum and right arm on my “client” and she had to do the nape of the neck and the breast on me.  Let me point out here that all manual lymphatic drainage is done skin on skin, think about it.  I have had the breast sequence done on me three times in the last two weeks, twice by men!  I guess you lose all inhibitions after a few days.

On Monday and Tuesday next week it will be all theory with Prof Neil Pillar (http://www.flinders.edu.au/medicine/sites/surgical-diseases-and-sciences/staff/professor-neil-piller.cfm), followed by another exam.  The rest of the time will be spent with Koby Blanchfield (http://vodderschool.com/accredited_practical_instructors) who will teach us the practical component for treatment of people with impaired lymphatic systems and all our bandaging.

Another week with “no life” … but lots of learning!