Rehab
My palliative care doc (yes, I have one!) referred me to a local rehab center, Courage Kenney (it’s a well-known name around here). I hadn’t thought about rehab of any kind, to be honest. Didn’t know I would need it! But, taking that much tissue from my chest results in a tightening of the skin that can impact arm function. And this is beyond the lymphedema that you can get from the removal of lymph nodes.
I learned a lot of great things during the appointment and actually feel better prepared for surgery AND radiation.
The rehab doc said that I had been originally referred to rehab because I still have lingering fatigue. Yes, but also…it’s really not bad. I mentioned the lower leg swelling and very minimal neuropathy. I said I was still drinking lots of water and trying to move around as much as possible. She said that I’m doing way better than most folks she sees (my type-A personality loves to hear these things). She suggested I keep increasing my daily step count and that I should try to increase strength as much as possible before I start radiation.
Her recommendation is that I start physical therapy for arm range-of-motion about 2 weeks after surgery. I’ll use those exercises during radiation, as much as I’m able. I guess your range of motion gets worse during radiation, so it’ll be important that I maintain those exercises.
We spent a bit of time talking about lymphedema – the truths and myths. It’s true that the more lymph nodes they remove during surgery, the more likely you are to get lymphedema (swelling). What I know right now is that at least ONE lymph node fits that, but it’ll only be a sentinel node biopsy (they take a chunk of the lymph node). This is the node that they marked during the biopsy I had before chemo started. Before surgery, I’ll have that appointment where they inject me with some radiation so those lymph nodes will light up (somehow, not sure of the details on that). We won’t know how many nodes will need to be removed until they’re in surgery. At most, probably 4-6 lymph nodes…which isn’t a bad number considering there are upwards of 30-40 lymph nodes, and there are folks who have to take them ALL out. So I feel somewhat lucky in that respect.
The doc said that you can get lymphedema from just one sentinel node biopsy, to folks who get 10+ lymph nodes out who don’t get it. She said the key to treatment is catching it early. Luckily, Mayo has a center focused on lymphedema, so I’m in good hands to matter where I’m at. Once symptoms show up, they’ll prescribe a sleeve to wear. She said even if I had the worst case of lymphedema, I’d still be able to use my right hand to write and play volleyball. 🙂 That eased my mind.
The last thing she said was that she’s anticipating I do well through surgery and radiation. Always a good sign that the doc (or nurse!) thinks you’ll do well.
In other good news, Evelyn is back in school. We ended up taking her into the doctor since she had been home for 2 days. They retested her for COVID and then for strep and flu – all negative. She still doesn’t sound great, but I knew when she asked to go to Starbucks that she was feeling better. 😉
Surgery is feeling more real now that I had my “final” team meeting at work, and then the Mayo portal had check-in options for next week’s procedures. It also means that I’m DAYS away from seeing my bestie! Evelyn was asking about it and when we were going to stay in the hotel (for my surgery). I told her my surgery is Wednesday and then we’ll be back Thursday. And what does she want to know about? “Where is Auntie Lindsay sleeping?” ???? But that’s cool, I’d rather they be thinking about that.
One week to go!
