The joy of putting on your own T-shirt

Chris Cascio thought the worst was over. She had been diagnosed with breast cancer and made it through her mastectomy surgery. However, as she recovered from surgery at home in Milford, she realized she needed help to do even simple tasks such as putting on a T-shirt.

"I never realized the recovery after breast surgery and cancer would be so difficult," Chris said. "You think you are through the worst, but then you have ongoing pain and issues."

Chris sought help in the form of physical therapy with Beebe Physical Rehabilitation Services. Chris had several lymph nodes removed during her breast surgery and was at risk for developing lymphedema (a painful swelling caused by lymphatic system blockage) following her surgery. Chris was referred to Lymphedema Management's Breast Cancer Pathway program at the Beebe Health Campus – Rehoboth Beach.

"It has been a great experience. I think everyone who goes through surgery should make sure to do physical therapy afterward," Chris said. "They worked with me to talk about my goals, and we created a treatment plan that would help get me to where I wanted to be." Chris worked with certified lymphedema therapists Camilla T. Carter, physical therapist, and Cari Ossman, physical therapist assistant.

"One of the primary concerns Chris had upon starting her program was getting her range of motion of her shoulders back. She didn't want to have to depend on others for the rest of her life to do everyday tasks," Carter recalled. "This is something we hear often, and we work with our patients to help them."

Lymphedema management helps patients be properly informed about musculoskeletal anatomy, the lymphatic system and lymphedema management, the program process, and proper movement technique. The program also works with patients to create attainable functional goals and expectations, and return to performing their daily and work activities safely and without pain. After several weeks of physical therapy, Chris could definitely see results.

"It is very rewarding when patients like Chris meet their functional goals," Carter said.

"When I started, I could barely get a coat on or put my arms in a T-shirt over my head, but now I am greatly improved," Chris said. "I am so glad I reached out and decided to do physical therapy. I just know myself, and I knew I wouldn't do the exercises at home by myself. I need someone to help me see there is a light at the end of the tunnel."

During a recent session, Chris used resistance bands to continue to improve her strength. She also lifts light hand weights now, something she couldn't imagine doing when she first started. "As I get stronger, they add more resistance or increase the difficulty," Chris noted.

Throughout her treatment, the lymphedema specialists monitor her arms to determine if there is any swelling that could indicate lymphedema. "By measuring her arm regularly, we can keep track of any changes. The physical therapy sessions promote joint and muscle movement, as well as facilitating lymphatic flow. Research has shown that controlled movement reduces swelling," Carter said.

While seeking help after surgery is great, Carter also noted the importance of planning before surgery. "There are many benefits to pre-surgery consultations," she said. "When we see a patient before breast surgery, we are able provide them with information and resources, and form relationships with the patient's oncology care team. We are also able to get to know each patient and medical provider personally, identify their needs, and address any fears or concerns related to the recovery and rehabilitation process."

Often, with pre-surgical therapy intervention, patients are able to reduce post-surgical complications, she said. "I feel pre-surgical physical therapy improves the overall program and recovery for our patients. It takes time to regain function after surgery, but physical therapy definitely helps you get there," Carter said. "Speaking up and asking for help is the key, because then we can help you get you back to the quality of life you want."

In addition to the exercises, the physical therapists also show Chris ways to do her everyday tasks, like putting on a T-shirt. "They show me little tricks to get these things done, which is great," said Chris, who demonstrates how she can now put her hand behind her back, something she couldn't do just a month ago. "They really put me at ease and empower me to continue to improve. When I started, my range of shoulder motion was around 50 percent decreased, and now it is closer to normal," she said with a smile. "Some days are a challenge, but I know I will meet my goals because I have a whole team on my side. One day, I will put on a T-shirt without even thinking about it!"

For more information about Lymphedema Management and Beebe Physical Rehabilitation Services, go to www.beebehealthcare.org/lymphedema. As a community-based, not-for-profit healthcare system, Beebe Healthcare depends on the generous support of individuals, corporations, businesses, and private foundations. All gifts to Beebe Healthcare, large or small, are tax-deductible and are channeled through Beebe Medical Foundation. Please consider making a gift today and sharing your story with our community. To make your proud personal donation or to learn more about Celebrate Excellent Care, go online to www.beebemedicalfoundation.org/cec or contact the Beebe Medical Foundation at 302-644-2900 or foundation@beebehealthcare.org.