Lymphoedema and Kinesio Taping
A potential side effect of lymph node removal as part of surgery for breast cancer is lymphoedema. The removal of nodes from the armpit can impact the proper drainage of lymph from the affected arm, causing fluid to collect in parts of the arm, chest and back. This swelling is called lymphoedema.
The lymphatic system is our under-appreciated rubbish collection and disposal system! It collects toxins and other waste materials from throughout the body and also works to fight infection. The lymph vessels are located in the skin and have 'junction points' throughout the body where lymph nodes collect and filter fluid (e.g. in neck, armpits, groin). In surgery for breast cancer, lymph nodes may be removed and checked to see if they contain cancer cells that have drained from the breast. This information helps to determine the extent of the cancer and additional treatment that may be required (e.g. chemotherapy). For more information about the lymphatic system and lymphodema, visit the Lymphoedema Network NZ website.
As part of our ongoing health care post surgery (especially if that surgery involved lymph node removal) we need to look after the arm(s) affected and be mindful of any symptoms that could alert us to the onset of lymphoedema. Once diagnosed with lymphoedema, the condition is permanent, requiring degrees of ongoing treatment and management dependent upon the extent of swelling so it's better to be proactive rather than reactive in this case!
Symptoms may include swelling, a heavy feeling in the area affected, discomfort and a deep aching. Having a lymphatic massage can improve general well being and help to clear any fluid that may be collecting. Keeping the skin well moisturised is important and ensuring that we protect the arm from scratches, bruises, burns and needles (for blood tests or injections) to minimise risk of infection is also vital. When flying, a tight compression garment is advised. The artificial atmosphere of an airplane can place extra load on our bodies and a compression garment will help reduce any swelling and keep the lymph flowing.
I 
have not had even minor swelling but do from time to time experience the feeling of heaviness in my arm and aching in the forearm.I don't have a lymphatic massage as often as I'd like but recently I went along to see my therapist Michele Urlich (pictured) and had some treatment.
I was first referred to Michele by my Breast Nurse, Janice Wood, not long after surgery. Janice suggested a wide range of services and options, all of which would help to support me over the months to come and seeing Michele for a lymphatic massage was one of the best. I was so impressed with Michele that I wrote about her in my first book, Welcome to the Amazon Club.
I was quite fragile at the time, at an emotional low and still recovering from surgery with chemotherapy looming. Michele was very kind and gentle and gave me valuable information about how to care for my arm and also how to perform lymphatic massage techniques on myself.
Michele has a lovely treatment room upstairs at her home in Auckland's Mt Albert. It is small, light and warm with a window that looks out onto the tops of trees - like being in a treehouse. Sun, clouds, birds, sky, trees moving in the wind and some quiet music playing in the background make for a lovely hour and when the massage is over, the feeling of relaxation, warmth, delightful tiredness ...
Lymphatic massage is delivered with about the same pressure as stroking a cat. It is very gentle and there is no pain. Michele has been a therapist for twelve years and is now an internationally recognised authority on lymphatic massage and treatments for lymphoedema. On my recent visit, I asked her about Kinesio taping which is the latest therapy for treating minor swelling. Michele completed her training in this technique this year and is now qualified to teach the application throughout New Zealand. “Lymphatic taping and multi-layer bandaging along with lymphatic massage can often reduce pain and swelling,” says Michele. “I teach family members and caregivers a few simple drainage techniques too so they can help in a positive and useful way.”
The tape is the same as that used by atheletes to treat sports related injuries. It is the same thickness as skin, adheres to it and works by lifting up the skin to facilitate better drainage of fluid.It comes in four fashionable colours! Michele applied tape to my arm, demonstrating the technique so I could see how it worked. The different colours follow the lymph vessels in the skin.
The tape was not uncomfortable to wear. I kept it on for two days and then gently peeled it off under the hot shower, using warm baby oil to help with areas where it was stuck tighter. It certainly was not difficult or painful to remove and Michele has had alot of success with the taping of seroma (post operative swelling) and minor lymphoedema conditions. As a qualified instructor, Michele will travel throughout New Zealand to teach other medical professionals how to apply the medical tape.
The secret to managing lymphoedema is to catch it early. If left unattended, it can cause considerable discomfort as fluid presses on nerves. The good news is that qualified practitioners like Michele are using the latest techniques available and treatments are becoming more effective. Awareness of lymphoedema is also increasing as women learn more about the risks of developing it post surgery and how they can prevent it.
YWCA Encore
I've written about YWCA Encore before in my website Journal - it's a great gentle exercise programme for women who have experienced surgery for breast cancer. It's free, available to women of all ages and there are programmes running throughout New Zealand from Invercargill to Whangarei.
I've been an Encore Programme Facilitator for a few years now. I attended the first training course for Facilitators held in NZ (2006) and since then have conducted four programmes up here on the Hibiscus Coast. I've written extensively about Encore for various publications and talk about it every chance I get because it's wonderful and it works. Women in our programmes report real benefits, have lots of fun, regain confidence that can often be lost after a diagnosis of breast cancer and make new friends.
The exercises were first developed by a ballerina who experienced breast cancer and are designed to help restore 
flexibility and mobility that can be lost after surgery. Each programme consists of eight weekly sessions of two hours. Floor and pool based exercises are slow and gentle with an emphasis on diaphragmatic breathing. Women participate to the extent they feel able. Weekly 'homework' encourages participants to do exercises at home, encouraging longer-term practice and benefits.
The exercises are also very good for the lymphatic system. During breast cancer surgery, lymph nodes under the arm may be removed in some cases, inhibiting the flow of lymph in the affected arm. This can cause swelling (lymphoedema) which can be uncomfortable and requires ongoing care. Encore can relieve the effects of lymphoedema and help prevent the condition from occuring at all by improving circulation.
After breast surgery some women find it difficult to get back into a bathing suit and into the water. All Encore programmes are conducted in quiet, private venues where women can feel comfortable, be amongst others who 'know how it is' and enjoy a supportive and caring environment. Each weekly session also features a half hour over a cup of tea either with a guest speaker (presenting on a variety of topics from health and fitness to Laughter Yoga!) or a general 
group discussion about an agreed topic.
Last year we had the first In-Service Training programme for all Course Facilitators nationwide. Held in Auckland, the training brought us all up to date and provided wonderful opportunities for networking, exchanging ideas and listening to stories from all over New Zealand.
If you'd like to know more about the programme, visit the YWCA Encore page for information and programme dates and locations. It's free, lots of fun and offers real health and wellness benefits!
Georgea's Scrapbook
My local breast cancer support group is very fortunate to have Georgea (pictured) as a member because she always brings her camera to our lunches and events and takes great photos.
Georgea joined our Breast Friends about two years ago and she began a scrapbook, taking the best of our group photos and placing them into this wonderful book.
We've had some great times together as a group and one ot the things we do best is go out for lunch. We've frequented most of the local establishments and needless to say, we are quite well known about the place - and much welcomed, I must add, as a lovely, personable group of very fine ladies!
Georgea also makes cakes - divine, decorated delicacies to celebrate birthda
ys and other special times.
The scrapbook is a wonderful testament to the spirit of sharing, support and fellowship that our group enjoys.The book brings back memories of good times we've shared together and celebrates the contributions and lives of those women who are no longer with us.
Georgea's Scrapbook is beautifully done - a work of art and a real treasure!
Asking for help
When I was diagnosed with breast cancer, I knew right away that I wouldn't be able to do it alone. I'd need help. Overcoming my natural instinct to not ask for help was the first hurdle I had to get over.
Sometimes I think it's a 'woman-thing' not to raise our hand and say, "I need some help here!" We're always so busy helping everyone else! Aaargh!
When a life-threatening situation occurs, we gather together those resources and strategies we've used before to deal with a crisis. Adjusting those skills to cope with a big, new, scary thing can sometimes be too difficult for us to handle alone. We need help to sort ourselves out, discover strengths we never knew we had, pick ourselves up, dust ourselves off, make a game plan and keep traveling on down the road.
There can be nothing better than speaking with a woman who has 'been there too'. Recently diagnosed or some years down the track, it helps to talk to someone who shares a smiliar experience and can see and understand things from your place and perspective. We can be surrounded by excellent medical support, loving partners, family and friends - and yet still feel so alone. A chat with someone who 'gets it', who understands, can be of great value.
Please don't go through breast cancer alone. Ask for help when you need it. There's nothing wrong with saying to yourself, 'I just can't do this - I don't know how.'
If you live anywhere in New Zealand and would like to speak with another woman who has experienced breast cancer, please call Breast Cancer Support toll free on 0800 273 222 (0800 BreaCanSupport) or the Cancer Society of NZ toll free help and information line 0800 226 237 (0800 CANCER). If you have recieved a diagnosis of secondary breast cancer, please call Sweet Louise on 0800 112 277.
We're here, waiting to help, so please let us.You don't have to go through breast cancer alone.
Living in the moment ...
If there's one thing an experience with serious illness teaches us, it's to live in the moment and make the most of every day.
When we're ill and frightened, lIfe seems to draw in. We live minute by minute, hour by hour. Then, as we get better, life expands again and we take those little steps towards living day by day, week by week.
The one thing we all need when we're ill is hope - hope for a positive outcome; hope for a full recovery; hope that each day will bring something nice, something wonderful to be enjoyed, to look forward to. When we're very ill, we hope for less pain and the warm comfort of family and friends.
Hope can teach us about living in the moment. When I was having chemotherapy, I'd loo
k forward to things during the day, like sitting outside on the deck under the big umbrella, watching people at the beach, kids riding bikes in the street, birds flying high in the sky. I'd hope to receive a phone call from a friend or a card in the post. On a fabulous day, there might be some flowers that I would enjoy for hours, looking at the rich colours, the delicate shapes, smelling the scent. Then of course every morning I'd hope that Betsy the cat would play with Mom and I. She rarely disappointed. We'd make paper tunnels for her to run through, throw little balls and fuzzy mice around and she would chase them, hurling herself about the livingroom with the full and proud knowledge that she was the star of this show and her high-flying antics would brighten my day.
Friends and family want to help a woman experiencing breast cancer but they don't always know how. Helping her to make the most of every day can be a good place to start. Sometimes that's as easy as popping over to help with the laundry, or doing some grocery shopping, tidying the garden, cleaning the windows or waterblasting the front path! Being abl
e to look through a sparkling clean window out onto a tidy garden can bring hours of joy. Going out for morning tea on a good day, or quiet companionship on the not-so-good-days -little things that can mean so much.
Making the most of every day can also involve some major adventures and spending lots of money on something you've always wanted .Why not, I say! In my book, The Pink Party, Manon decides she will do something spectacular to celebrate her recovery from a second breast cancer diagnosis ... I hope you enjoy this excerpt from The Pink Party (view as a pdf) and can share in Manon's celebration of being spontaneous, joyous and living in the moment.
Breast Cancer Awareness Month
October is Breast Cancer Awareness Month here in New Zealand - and in many other countries - because breast cancer is a global disease. It affects women living in every country and in spite of all the research that's going on, we still cannot say with absolute certainty that we understand what causes it.
In New Zealand, over 2500 women are diagnosed every year. That's about one in every eight Kiwi women - and that's not too flash. Over 600 will die annually from breast cancer. The good news is that mortality rates are decreasing as treatments become more effective and targeted.
I've seen breast cancer from many angles now. I've had it myself. I was diagnosed on Saturday 13th October 2001 at around 3pm by Auckland breast surgeon Belinda Scott in her office with my best friend Katherine sitting next to me. The irony of being diagnosed during Breast Cancer Awareness Month was not lost on any of us!
The diagnosis came at a time when I'd finally taken back control of my own destiny - I'd left the corporate job, had 18 months off and was going to the USA on the 15 October 2001 (yes, two days later!) to write best-selling sex and violence potboilers. Thinking back now, I know that sometimes in spite of our plans, 'life' happens and within a minute, you're off in another direction that you never planned for or ever even imagined.
After I recovered from my treatments, I began volunteering in the support area to help other women newly diagnosed (Breast Cancer Support, BCS). I worked within the advocacy area too, alongside a group of very dedicated women who tackled our government and fought a long and tough battle with NZ's drug funding agency PHARMAC to gain funded access to Herceptin for our early stage HER2 positive girls (Breast Cancer Aotearoa Coalition). I now work for Sweet Louise, an organisation supporting women whose breast cancer has spread to other parts of the body (known as secondary or metastatic).
I've written two books about my cancer (Welcome to the Amazon Club and The Pink Party) , numerous articles and have given many talks about my own experience with breast cancer and yet I sit here this morning and say yes, we have accomplished so much, but I still feel so helpless because our beautiful women keep dying from this bloody thing.
This afternoon, I will walk up the hill to our local Baptist church to farewell another of our wonderful ladies, Mary. I've known Mary since about 1998. She and her husband ran the airport shuttle and Mary would drive me down for business trips. If there were no other passengers, I'd hop up into the front of the van to sit beside Mary and we'd have good chats and laughter about family, work, all the usual. We both loved driving - I shared my experiences as a courier driver with her and she would tell me of her adventures behind the wheel and the people she'd meet during the course of her busy days.
A month or so after my diagnosis I was invited to attend the local breast cancer support group and, fortuitously, just in time to enjoy their Christmas lunch. Who should pull up in her shuttle bus to take us to lunch but Mary. Imagine the mutual surprise when we saw each other and realised that we both belonged to the 'pink club.'
Mary had lived with secondary breast cancer for many, many years. Her life had been full, busy, blessed with close familiy and grand children too. Her contribution to our local support group was of immeasurable value. She was much loved and an inspiration to us so when her cancer began to progress, it was a shock to everyone and we rallied around her. She came to the group as often as she could but the treatments were hard and as the cancer developed, it became difficult for her to walk and her energy levels were low.
I visited Mary at home a few times. We'd sit and chat. I'd bring some bread for Rosie the part Kune Kune pig (Rosie lives in the back paddock at Mary's place) or Mary would have me go into the kitchen and fetch something to give her. I'd call Rosie and up she'd come, trundling through the paddock and the glorious mud for her treat.
I saw Mary about a week before she passed away. She was very ill but we still managed a laugh or two and she said, 'Go into the kitchen and get something for Rosie.'
A mutual friend called this week, on Wednesday morning, to say Mary had gone. My friend had been on her way to Hamilton when she received the call. 'I had to pull over and sit for a while,' she said. 'I just couldn't take it in.'
It still comes as a shock - a moment of disbelief when you hear the news, a response of no, this can't be right - I only saw her last week and I was planning to see her again tomorrow - in fact we'd actually talked about it and she'd said, yes, please do come by and see me.
I miss Mary. I miss her laugh and her smile. I miss her brightness, energy, her irrepressible sense of humour. She always asked about my Mum and she'd offer to host our support group ladies for a special morning tea each January. We'd sit in her garden pergola or out on the back deck, looking down over the fields to the river and of course feed Rosie delicious cakes and goodies.
I'll miss our lunches, shared over a glass of wine and good, strong coffee.
Mary made sure I arrived at my destination safely, on time and she was always there to pick me up again when I came home.