Lymphedema

We had a lymphedema appointment today, followed by a physical therapy appointment.

The lymph system is the super highway that transports the waste away, and the lymph nodes are the "spaghetti bowl" interchanges. Wow. That sounded official. It's basically my own description of the system as I envision it.

Lymphedema is a condition caused when the body, or a specific area, cannot drain the waste fluid (proteins, fats, etc.) away properly due to blockage. As a result, the area build with the fluid, swells, and can harden. Blockage can be due to various reasons, but, in this case, we just removed 41 nodes and we also have a giant scar running across the highway.

Jennifer has lymphedema, so we met with the pathologist today to get an assessment, some therapy, training, and a really cool Epstein Facioplasty support mask......Ladieeessssssss and Gentlemennnnnnnnnn! In this corner, we have the welterweight wrestling champion, Jammin' Jenny.

Just kidding. It looks more like the part of a nun's habit that goes around the facial area. Now, if I can lay my hands on a neck brace.......

The pathologist is the same we've met with a couple of times before. He's pretty sharp. He started by asking what our concerns were. Although we haven't heard wheezing lately, Jennifer still experiences a feeling that her trach did not close properly, pronounced when she swallows and feels a pulling on her throat. He inspected the trach site and mentioned that the outer skin area may have healed/stuck to the inner trachea area, jwhich could give that sensation. So, he started stretching her skin around the trach hole to basically separate the two areas (tear them apart)...eeeewwww. The outer hole is healed, but it was hard to watch.

He examined Jennifer's swelling and made his assessment. Since the scar is blocking the highway, we have to train the body to reroute the drainage around the scar, down the neck, and into the collar/arm area, where it will drain as normal. Time to get off the freeway and take some Farm-to-Market roads. We're setting the cones. Luckily, the scar angles below the ear enough that we can redirect right over it, rather than going up and around the ear.

He next instructed Jennifer on massage techniques to open the downstream drains and work her way up the system to the swollen area....then, in reverse to push the fluid though the system. Awesome! I am totally amazed at what you can do with your body. Next thing you know, they'll be telling us that you can actually lose weight if you do physical activity -- probably by burning fictional units of energy -- lets call them calories. Hah. Just kidding again...that's purely science fiction.

He then took measurements around Jennifer's head and crafted the Facioplasty device right in front of us. Is basically a spandex and Velcro device that holds special pads made of foam. Two types of foam are used. The first type is a pad made of small, cubed foam pieces. These are placed in an cloth sleeve and shaped around the problem area of her neck. The resulting pad is shaped like an elongated pancake, but has an irregular surface area due to the cubes. The second pad is made from a smoother foam piece. He cut and shaped it on the spot so it would conform to her neck..he did an awesome job and we discussed his certifications in arts and crafts. He even joked he had a Masters in Arts and Crafts.

The first pad is worn for about thirty minutes. The irregular surface area actually breaks up the "hard" fluid, which preps the area for the next steps....the massage therapy mentioned above. We witnessed it. It was pretty cool. After Jennifer massages through the system and back, she then wears the smooth pad for at least 2-3 hours...this puts pressure on the area to help push fluid through the recently opened drain lines (FM Road 42). It also maintains an evenness in the area.

As you can tell from my long write up, we spent a lot of time on the lymphedema massage. It was very productive.

Next was the appointment with the physical therapist. Last week, Jennifer worked on stretch exercises for head, neck, arm, hand, face, tongue, lips.....
Today was strength exercises. Unfortunately, they did not hook her up to the circa 1840's gps device like last time. Today she took some strength measurements for her hands....squeezing a grip, pinching with her thumb (lateral), with her index finger and thumb, and with two fingers and a thumb. Naturally, there was clear evidence of atrophy in he left hand (where the skin graft is).

The therapist gave her a ball of putty (more like hard clay). She is to squeeze and pinch it like a stress ball to build strength and endurance in her hand and fingers. I'm more concerned that the therapist just gave my wife ammunition to throw at me or the kids.....but moreso at me.

She got to lay down and the therapist did some neck stretches and manipulation....I think Jennifer found Heaven for a moment. She may have even fallen asleep for a bit. I tried to get in on it to, but, as it turns out, the caregiver doesn't get the good treatment like the patient. What's
that about? Whoa is me.

Jennifer then worked with an elastic band to build strength in her arms and shoulder. She did great on the straight arm and bent arm stretches. The rotator cuff exercise was a bit tougher, but she did great.

The final test was that we got out at 5:00 and had to drive from the south side of Houston all the way to the north side during "holiday" traffic. We passed that too.

We also have started receiving the bills...how does this affordable healthcare act stuff work? Do I just send the bills to 1600 Pennsylvania avenue? It's free, right?

I took the kids to buy some fireworks...not a lot, but maybe a lot...remember Jennifer, sometimes it's better to ask for forgiveness than permission. Also remember that to forgive is the right thing to do.

I wish everybody a wonderful Fourth of July, the day, I believe, to have the most historic significance for our country, when the Declaration of Independence was finalized and signed by the 56 brave men. Remember why they took that action.

Stay safe and enjoy.