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Stand by Me

Good Sam Rehabilitation Therapists Help Ease the Recovery Journey for Cancer Survivors

Dr. Heck
Dr. Thomas Heck

Judi Biser was progressing through chemotherapy when her left arm, on her surgery side, started to hurt.

She assumed it was an old elbow injury, but when she mentioned the pain to her surgeon, Thomas Heck, MD, he immediately referred her to a certified lymphedema therapist.

For most breast cancer patients, that would mean scheduling appointments, shuttling records and driving to another medical facility. For Judi Biser, it meant just a walk downstairs to see Theresa Walchner, PT, CLT-LANA.

With the new Oncology Rehabilitation Program at Good Samaritan North Health Center, patients move easily among specialists as they journey toward recovery. Whenever aftercare problems arise, there is someone on staff to help.

After their last treatments, patients are welcomed into a continuum of physical therapy care that addresses post-treatment issues and helps them create new lives as empowered cancer survivors.

Uncommon Care for a Common Condition

Judi is one of thousands of patients who develop lymphedema each year from breast cancer treatment. Disruptions of the lymphatic system, from surgery, radiation or both, can lead to pooling of lymphatic fluid and swelling of the affected arm.
Untreated lymphedema can lead to serious health consequences.

Following the biopsy, Dr. Heck performed breast surgery and also removed 21 of Judi’s lymph nodes. Risk of lymphedema increases with the number of nodes removed.

After the diagnosis of lymphedema, Theresa and Judi began an intensive course of twice-weekly treatments for six weeks. Theresa taught Judi exercises and stretches to do at home as well as how to massage the scar tissue and to channel lymphatic fluid to her remaining lymph nodes. Judi’s husband of 24 years, Mike, also learned the massage techniques and uses them to assist in his wife’s care.

“Theresa has been unbelievable,” Judi says. She helped ease Judi’s sensitivity about the appearance of her swollen arm. “She makes you very comfortable.”

Theresa Walchner and fellow physical therapist Ellen Moler, PT, CLT-LANA, developed a lymphedema program as part of cancer aftercare. Both therapists became certified by the Lymphedema Association of North America and created the program at Good Sam North in 2006. The Oncology Rehabilitation Program grew around that anchor in 2009.

“We saw the need for our patients,” Theresa recalls. “Any cancer patient may be dealing with side effects, from fatigue to difficulty walking and problems with balance. Some have neuropathy, a numbness and tingling in their hands and feet. Some experience loss of strength. For all of our cancer patients, we work to reduce pain and discomfort and help them maintain functional independence. There’s so much we can do.”

Quick Response, Steady Support

Cancer PT and patient
Physical therapist Theresa Walchner helps Arlene Washington during a therapy session.

Lymphedema can be a tricky problem, sometimes showing up immediately and sometimes years after treatment. The smallest event can trigger its onset. “We see people who develop it after mosquito bites,” Theresa says.

“The key is to act at the first sign,”says Dr. Thomas Heck, breast cancer surgeon and co-medical director of Samaritan Breast Center. “Lymphedema often starts as a heavy feeling in the arm, decreased flexibility or suddenly tight clothes. We want to start treatment immediately, because if you allow lymphedema to persist untreated, scarring in the lymph channels makes it extremely difficult to reverse.”

Treatment involves manual lymphatic drainage, in which the therapist uses a light pressure massage to redirect the fluid from the affected arm to healthy lymph nodes in the torso. The arm may be bandaged to shrink severe swelling. Once the size is reduced, a woman wears a compression sleeve.

Because Good Sam North’s breast care specialists are in one location, sharing records and discussing progress, post-cancer rehabilitation becomes seamless for the patient.

“From the day of my mammogram to the day of my last chemo, the center has been amazing,” Judi says. “I had the same chemo nurse for all my treatments, and she talked me through what was going to happen next.

“In one facility I can get everything taken care of, and it gives me peace of mind to know all my doctors are under one roof, and if I have a question I can get the answers. I felt they were as passionate about my health and recovery as I was.”

Living with Lymphedema

Therapists at Good Samaritan’s Oncology Rehabilitation Services make sure each patient with lymphedema has a home program for long-term care. It includes massage, exercise, weight maintenance—and medical cautions because lymphatic fluid, as part of the body’s cleansing mechanism, is rich with proteins that are attractive to bacteria.

To protect an arm with lymphedema:

  • Avoid cuts and scrapes. These can lead to cellulitis, a potentially serious skin infection.
  • Wear gloves when gardening.
  • Avoid blood pressure readings or blood draws in the affected arm when possible.
  • Wear a compression garment when flying to guard against more swelling.

For more about lymphedema therapy, call (937) 734-5720.

<< Samaritan HealthTalk Fall 2010