Archives for posts with tag: cancer

Last Monday night, at our monthly support group meeting, Nicola Beverley came to talk to us about makeup post cancer treatment – she runs Make Me Me,  a voluntary, community based event created for women dealing with cancer or long term illness to spend an afternoon together being pampered.  Watch her introductory video here.  A number of the ladies had been on the Look Good Feel Better program but felt that perhaps they weren’t quite ready to take in all it had to offer as they were still in treatment and tired and feeling pretty wretched (though the information about scarves and wigs was universally appreciated!).

Nicola’s idea, while very similar, has a different time frame.  The perfect example was Bernadette, who volunteered to be made up on the night.  She’s about two years post diagnosis and is back at work full time, back to “business as usual”.

Nicola went through describing the products she uses, all as natural and chemical free as possible.  Natural fibre application brushes.  Natural cleansers. Then she applied makeup on Bernadette, explaining how to achieve the natural look easily.  The most exciting part was towards the end when she showed us how to do eyebrows – not using a pencil but using a brush.  The result was amazing and Bernadette was almost jumping up and down with excitement – “EYEBROWS, I HAVE EYEBROWS!!!”.  It’s the little things that can sometimes make the biggest difference.

Here are some before, during and after photos for you …

Nicola’s idea is to teach women how to do their make up post treatment in the relaxed environment of their own home – invite a few girlfriends round, open a bottle of wine, have some nibbles and learn about makeup.  Sounds a lovely idea to me.

http://lisahiggins.ntpages.com.au

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I’m just back from a week in Darwin in the Northern Territory of Australia having attended the 2016 Asia Pacific Lymphology Conference.  I’ve made a very short video giving a few highlights for you to view  here.  I’ll be working on a few blog posts over the coming weeks to talk about what I learnt at the Conference.  I’m still processing all the information – my brain hurts!

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The second day was always going to be full … I was to attend the Smith and Nephew hosted breakfast session – breakfast at 7.30 and a talk at 8, followed by the full schedule of talks from 9am to 5.15pm, followed by the Conference Dinner at the War Memorial from 7pm till 11pm.  But it started slightly differently – I woke up and thought, “wow, it’s much lighter than yesterday” then looked at the clock and saw it was 7.35am!  Not a good start.  I did manage to get to the start of the Smith and Nephew talk, well, it was 8.03 and I had only missed the introduction.  I thought that was a pretty heroic effort.

The talk was pretty much the launch of the JOBST Elvarex Plus, the latest innovation in compression.  The garments are made using 3D knitting techniques and are seamless and the edges have been improved so there is no unravelling.  We were shown some of the machinery that was designed specifically to test the hardiness of the material.  They look pretty impressive, the fingers and toes have no ridging or seams and they seem to be exceptionally well designed, click here for more information.  At the moment they are only available in custom-made garments.

There were a number of presentations on studies that morning, I’ll give the titles of the talks and the conclusions in brackets – The prevalence of LE following gynaecological cancer (one-third of women have swelling by 12 months post surgery, three-quarters by 24 months); incidence and risk factors for LE at 18 months following surgery for early breast cancer (at 18 months, 10% had swelling, mainly in women who had node dissection); generalised oedema post taxane-based chemo in women with early breast cancer (incidence of LE in the arm on affected side increased at 6 months after completion of taxane-based chemo); Improving the way we measure bilateral upper- and lower-limb lymphoedema (Bioimpedance spectroscopy (BIS) is an effective diagnostic tool for measuring lymphoedema).

I attended a Kinesio taping workshop that has inspired me to go off and do the course.  We used it on a muscular level, as we didn’t have guinea pigs with lymphoedema to experiment on, but we saw instant improvements in the range of motion in a number of people with shoulder issues, pretty amazing.  I’ve already sent off for details of the next course!

Kinesio tape

Kinesio tape

The afternoon session had talks on: the feasibility of night-time compression systems for breast cancer related lymphoedema (early results suggest use of night-time compression is not significantly better than standard care, however, they are preferred due to their comfort and convenience in application); Review of the evidence of lymphoedema treatment effect (reviews consistently concluded that complex physical  therapy is effective at reducing limb volume. Reductions were also recorded using compression garments, manual lymphatic drainage and compression pumps. Insufficient evidence to support these treatments as stand-alone strategies); low-level laser therapy (LLLT) for lymphoedema (this was a review of a number of studies, which concluded that there is an emerging and reliable evidence base for the positive effectiveness of LLLT for lymphoedema); LLLT for fibrosis, capsular contracture of post-mastectomy breast implants (this study was done on mice, placing silicone implants subcutaneously on mice then irradiating the site to induce fibrosis.  Results – no capsular contracture in either group, but the implants receiving LLLT had tissue that was better “organised” and had less inflammation.); Do women with breast cancer-related LE need to wear compression during resistance-exercise? (no change in L-Dex readings were observed for either compression or non-compression control groups, immediately post-exercise and 24 hours post-exercise); The acceptability and perceived effectiveness of treatments prescribed for the management of LE (this was a survey sent out to members of the LA Associations of Victoria and Queensland – outcome was – understanding patients’ perceived acceptability and effectiveness of treatments is necessary to determine whether treatment strategies proven clinically effective are feasible in the real-world settings); Imaging in LE in clinical practice (Dr Keely talked about Venous Duplex Scans, Ultrasound of soft tissue and Echocardiography).

A lot of the talks were very evidence-based and statistical which is why I chose to list them out with their conclusions.  The ones that made an impact on me were: the studies on using the Low Level Laser, these showed benefits to using LLLT and I felt justified in purchasing one last year; and the study on wearing compression during exercise – I would have expected there to be a difference, but I think the take away message was that it’s a personal choice, wearing the sleeve will not do harm (of course there’s always the odd person who’ll prove that wrong!) and for some there may be an improvement, but try it and see.

Then there was the conference dinner.  It was held at the beautiful War Memorial.

war memorial view We walked through parts of the Museum to get to the event but it wasn’t really long enough to have a proper look at the exhibits unfortunately.  There was an opening ceremony with Maori dancers performing a number of dances, culminating of course with the Hakka, always an awe-inspiring event.  Literally as we finished the main course a DJ started to crank up the music and in an instant the dance floor was filled with women – I’ve never seen so many women dancing in one spot in my life. I asked one of the guys the next day if he found it odd – he really did!  And we boogied until after 11 (I was dragged onto the dance floor by those who shall remain nameless … Kelly!!!!!).

All in all a very full day.

If you’d like info on any of the talks, please message me.

Day 3, coming up!

Sometimes I am totally surprised by someone’s will to live.  Not the will to fight or battle or any of those words that are thrown at cancer, but the will to live.  I think that’s the attitude of most of the ladies I see in my clinic, but every now and then, one person will stand out.

L is a tiny lady of 75 who has been through it all.  Breast cancer in 1988, colon cancer in 2001, breast cancer again in 2006 and of course all the various chemo/radio treatment that comes along with those.  She came to the clinic originally early in 2012 to see one of our osteopaths, who referred her to me as she was developing lymphoedema in her legs.  I started working with her in May 2012 – she was on chemo again and was very frail and had been told to take it easy, her response to that was “but it is so boring”.  She had always been fit, playing tennis, swimming, walking and doing yoga regularly.  Her goal was to be well enough to do her annual trip back home to Canada to see her family.  Her doctor tried to discourage her from going, because really, she was very frail.  We (the osteopath and I) worked with her up until the time of departure and said our good-byes not quite expecting to see her again, she was that weak.

Lo and behold, she came back in September 2012 having had an absolute blast on her holiday.  After some tests they found she had liver metastasis and it was inoperable.  More chemo, more swelling.  Then there was some surgery to remove a stent from her stomach and lots of antibiotics and more swelling.  Luckily she managed to get into Mt Wilga Hospital (http://www.mtwilgaprivate.com.au) for some intensive decongestive therapy so I didn’t see her for quite some time as they brought her swelling under control for her.

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photo courtesy google images

She started osteopathic treatment again in February and came for a lymphatic treatment last week as she had forgotten to tell a doctor about her lymphatic problem and she was given the wrong meds and her leg started to swell again.  Actually, she had to cancel her original appointment last week as she had severe abdominal pain and had to go to hospital but she made it in the next day (with an opium patch on to help with the pain) with apologies for inconveniencing me with a late cancellation!  In spite of her recent medical issues she’s started playing tennis again, once a week, “but only two games”.  One of my favourite conversations with her was about older people taking the same vacation every year, on the same cruise ship, eating humungous meals and getting fatter and fatter.  Not her ideal holiday – she needs to go and do and see things, otherwise it’s boring.

And her goal now?  To enjoy this year’s trip to Canada.  And that is what I call – the will to live!

 

Sunday 23rd June 2013 – Through another client I saw on Friday I found out that L passed away three weeks ago, with her children by her side.  They had come over from Canada to be with her at the end.  A beautiful ending to a story of courage and determination.  May she rest in peace.

I don’t often get to see people before their surgery which is a shame, because a couple sessions of manual lymphatic drainage beforehand makes a huge difference on a number of levels …

  • the immune system is given a tune up
  • any lingering toxins are cleared out of the body
  • new pathways away from the site of the surgery can be created helping to reduce swelling or oedema more quickly once the surgery has taken place

I see R on a monthly basis to work on some swelling she has in her lower legs and feet.  She and other females in her family all suffer from this condition and while in her case it is not severe, it is enough to make buying shoes difficult, not to mention it’s just plain uncomfortable.

R was diagnosed with a DCIS (ductal carcinoma in situ) in her right breast in December.  She’s been having annual screening for over twenty years as she was considered high risk and after a couple months of deliberation she has decided to have a double mastectomy and a tram flap reconstruction at the same time.  This is a huge decision on many levels.  A DCIS is not usually considered an aggressive cancer and the recommendation is a lumpectomy, sometimes followed by radiation and one of the hormone inhibiting drugs if deemed necessary.  But R’s reasoning is that she has been screened for 20 years and she’d like to stop worrying.

The surgery is major but one of the main benefits is that there is only one (usually, of course there may be complications but hopefully not).   Muscle, fat and skin are taken from your abdomen to create a new breast using your own tissue.  The transverse rectus abdominus muscle is used to create a breast and later on, if you choose, there is another surgery to create a nipple and areola.  Or you can use a prosthesis nipple – a client told me today she bought one and wore it to bed the other day and woke up with a new nipple on her arm!  Probably best to take it off before going to bed.)

The surgery is long, eight hours or so.  As with any procedure there is a risk  with anaesthetic.  And the recovery is long and quite painful (think about it, you’re moving your stomach muscle up to your chest, ouch). 

The following excerpt is from About.com Breast Cancer, http://breastcancer.about.com/od/reconstructivesurgery/tp/tram_flap.htm

Moving Muscle and Skin

TRAM Transverse Rectus Abdominus Breast ReconstructionIllustration © National Cancer Institute
On the skin markings, your plastic surgeon will make an incision, and raise the skin and muscle flap. A tunnel will be created under your skin so that the flap can be relocated. This tissue flap will go through the tunnel to your mastectomy incision. Notice that this illustration shows a free flap — the skin, fat, blood vessels, and muscle have been cut.

Creating Your New Breast

TRAM Transverse Rectus Abdominus Breast ReconstructionIllustration © National Cancer Institute
The abdominal skin flap (still attached to muscle) will be positioned so that it fills in the skin that was lost during your mastectomy. If you’re having a pedicle flap, your plastic surgeon will close the skin incision to create a new breast. And if you’re having a free flap, your surgeon will use microsurgery to reconnect blood vessels first, and then close the skin incisions.
 

Post surgery there is hourly monitoring to make sure that the tissue is still functioning (there is a small chance of necrosis) and numerous drips which are gradually taken out over the next few days.  There are bandages for the breast and braces for the tummy.  The stomach will likely be sore for about six weeks.  But at the end of all that, there are beautiful breasts made from your own tissue.

After the surgery, as soon as she feels able, R will come in for some post-op lymphatic drainge to help her

  • eliminate toxins from the surgery
  • build her immune system back up
  • reduce the swelling around the surgery site

Extra care is taken and only superficial work is done in the abdomen, that is, if she’s able to tolerate any work at all.  With R I have to be mindful that her lymphatic system is compromised already but luckily she will not have nodes removed in the surgery so the main collections under her armpit should not be traumatised and I can direct fluid towards them as well as the nodes in her neck.

Surgery is next week, good luck R.