Tag: breast surgery

Breast Surgery: Post-Op Stretches

Breast Surgery: Post-Op Stretches

by bridewitt ♥ 0 Leave a Comment

Before beginning any exercise program, please check with your physician or physical therapist! Not all exercises or stretches are appropriate for everyone – please read my full medical disclaimer here before trying any of the exercises listed below.

After both breast-conserving surgeries and mastectomies, people often find they have difficulty reaching overhead or behind their back, washing or fixing their hair, or feeling tightness throughout the chest wall. The following stretches are helpful to improve range of motion and help you restore your ability to complete your usual daily tasks!

These stretches should be done after a sufficient amount of time has passed post-operatively so all incisions in the breast, chest, or axilla (armpit) have healed. Be sure that any incisions are well-healed before attempting these stretches without guidance from a healthcare professional. Normal soft tissue healing of the skin and underlying tissues takes about 4-6 weeks. Stretching might be uncomfortable as you push into tight areas, but you should not typically experience pain >5/10 while performing stretches.

Watch the video for a full demonstration:

*Note: video plays at 1.5x speed – take your time when you stretch!

Shoulder Stretches

In a kneeling, or seated position, slide the hands forward until you feel a stretch in the shoulder or axilla. Perform gentle repeated stretches (10-15 repetitions) or hold for longer durations (30-60 seconds) as tolerated.

Modifications: For greater stretch of the side body, walk the hands to the left or right.

Cat/Cow

Begin on hands and knees in a neutral spine position with hips stacked over knees and shoulders stacked over the wrists. Inhale and slowly drop the belly to arch the back, lifting the breast bone. The, exhale and round the back from the tailbone to the neck, broadening the space between the shoulder blades. Alternate moving into each position for 5-10 repetitions.

Modifications: Perform in a seated position, reaching forward as you round the back, and allowing the arms to reach behind you as you lift the chest.

Sidebend Stretch

In a seated or standing position, grasp your affected arm with the opposite hand and gently lean away to stretch the shoulder and side body. Breathe deeply into the ribs on the affected side. Hold 30-60 seconds as tolerated.

Modifications: Lie on the unaffected side over a pillow or foam roller and gently stretch the affected arm overhead, limit the range of motion as tolerated.

Pec Stretch

Lie on your back and allow one or both elbows to fall out to the side. For mastectomy patients, perform only one side at a time until cleared by your physician to perform both sides together. Do not allow the back to arch away from the floor or bed. Hold for 30-60 seconds as tolerated.

Modifications: place pillow/s or a yoga block under the elbow to allow tight shoulders/chest walls to relax during the stretch. This stretch can also be performed standing with forearms placed against a doorframe.

Open Book Stretch

Begin lying on the unaffected side with knees bent to 90 degrees to protect the low back. Place the affected arm behind the head and allow the body to rotate and open up the front of the affected shoulder/chest. Breathe in as you open and exhale to return to the starting position. Repeat 5-10 times.

Modifications: Straighten the affected arm for a greater stretch or circle the arm over the head to stretch in various angles.

All stretches are designed to be gentle, but can be progressed if they become too easy or maintained if full range of motion is achieved. Stretches can be performed 1-3 times per day as needed.

Happy stretching!

Aloha ❤

Birthday Week

Birthday Week

by bridewitt ♥ 1 Comment

Yesterday was my 31st birthday, and I’ve been feeling so grateful to have made it to this day. I can remember the night before my 30th birthday last year so vividly, and I just knew that this year would be big in so many ways. It has been one of the most challenging years for me personally, as well as physically, but I have learned so much about myself and Justin and I have grown deeply in our relationship. With that said, all the learning was great, but I’m ready to leave 30 in the dust. This year, I’ll celebrate my birthday, looking forward to the year ahead (cancer free!) and I’ll celebrate all that I’ve accomplished this year with the help of everyone I love.

We had a great time celebrating my birthday yesterday (my mom always knows how to make birthdays very special), but this morning, Justin & I dropped her off at the airport even though I tried really hard to convince her to move here (or at least stay through Christmas). It was so nice to have her here and we were able to have plenty of good dinner chats, walks, coffee dates and couch parties binging Schitt’s Creek. I’m looking forward to getting back to Montana next year sometime to see her and the rest of the fam again.

Mama ❤

I went to take my 3rd COVID test today. I needed to do a rapid test because – surprise! I am having my port removed tomorrow! I had really been hoping this would have been removed with my lumpectomy, but it was left just in case there was any residual cancer or other IV treatment required. So tomorrow that little guy is coming out, and I don’t think I’ll miss it!

I’ll have a consultation with my radiation oncologist on Monday next week and will decide on a plan for radiation. I will likely need several weeks of radiation to eliminate any rogue cancer cells (should they exist) in the breast tissue that was not removed during surgery. I’ll update as I know more.

Otherwise, I’m still recovering from surgery (today I’m 2 weeks post-op). Swelling has been less in my arm, but I am developing a “cord” which I can feel from my armpit to my wrist. Cording, also known as axillary web syndrome, is common after a lymph node removal procedure and is a sign of scarring along a lymphatic vessel. It is thankfully treatable, but right now it’s painful and limits my range of motion in my left arm. I’ve been working on some lymphatic drainage techniques including lymphatic massage and exercise, and I think that as my shoulder mobility improves and I can get in to see my PT, the cording should resolve.

Delicious birthday din at Istanbul!

With Christmas only a few weeks away, Justin & I are busy putting gifts together (I am always a last minute gift buyer) and preparing for the end of the year. I am hoping to be able to transition back to some light duty work until I can treat patients again so we’ll see what happens with that. I may update a little bit on the blog over the holidays, but will likely be a bit quiet, so I hope you all have a safe and wonderful holiday season with your families!

Aloha ❤

GratiTuesday

GratiTuesday

by bridewitt ♥ 1 Comment

It seems like time is moving so slowly some days during this pandemic, and yet here we are in Thanksgiving week already. Though 2020 has had it’s detours, I can honestly say there has been more to be grateful for this year than ever.

Yesterday, I went in for my pre-surgery blood work and COVID testing. In all honesty, my white count was still quite low and I was pretty sure we were going to have to bump my surgery, but my surgeon and oncologist agreed that it’s high enough to proceed on Friday so today, I’m most grateful not to have to delay. My COVID test was also negative – not surprising since I never go out without a mask on or practicing social distancing. That immunocompromised life, though…

Peep that 4-week post-chemo hair growth!

My mom has been here for a little over a week now and it’s been so nice having her here. Thankfully, she’s been up for trying all of our vegan cooking, walking almost daily, and watching plenty of The Crown and Holiday Baking Championship. We were lucky enough to be able to have a little stay-cation at Aulani Resort thanks to my mom’s colleague, and we had a really nice time relaxing by the beach and pools.

I know that it would be easy to look back on the last 9 months and say what a shit show this year has been between COVID restrictions and a cancer diagnosis, but what I’d rather remember from this year is the simple, day-to-day moments that are the true blessings in life.

I’m grateful for the way my husband has stepped up more than I ever could have expected he would after my diagnosis (I should have known better, though…he’s the best person I know).

I’m grateful for my my mom calling and FaceTiming with me on a daily basis and who patiently waited for a safe time to come visit. For my sister, who has sent care packages, shared my posts, and called often. For my dad, who’s been calling more often just to say hi and to check in on me. For my stepdad, who calls and texts me just to let me know he loves me, too.

I’m grateful for texts, calls, & vent sessions with my besties and zoom mocktail dates. For care packages and cards from my aunties. For frequent check-ins and notes from my co-workers.

I’m amazed by the empathy and integrative care I’ve received from my doctors and healthcare providers this year who are doing their jobs excellently while dealing with added considerations from a pandemic.

I’ve enjoyed trying new plant-based recipes and taking an extended break from alcohol and processed sugar. I was lucky to get to work with fun nurses and to be able to give people good news while working safely from home. I’ve been able to walk outside often and to improve my Pilates skills at home.

If I can sum it all up, I’d say that I’m most grateful for my people who make this life so beautiful. We all have a responsibility to each other, and with all that has gone on for me personally this year, I urge you to be kind to one another and take care of each other as best you can.

Happy Thanksgiving, friends! Take a moment to write down what you’re grateful for this year!

Aloha ❤

Surgery Update

Surgery Update

by bridewitt ♥ 2 Comments

Hey everyone- hope you’re all having a good week! I had a few people text me about the results of my MRI & surgery consult so I figured I better update you!

I did my MRI two weeks ago and they took images with and without contrast. The good news is that the mass that was present on the ultrasound did not “light up” on the MRI so we’re hopeful that small mass is just scar tissue rather than residual cancer cells. However, we will not know for sure until the mass is removed and sent to pathology after surgery.

I met with my surgeon on Monday, and we agreed to go forward with breast-conserving surgery (aka “lumpectomy”). She will also do a sentinel lymph node biopsy to be sure there is no cancer in the lymph nodes. We are planning for surgery on November 27 as long as my pesky white blood cell count comes back up – it was really low last week again. I better enjoy my Thanksgiving dinner because no eating after midnight!

From what I know now, I’ll check in early in the morning and will have a radioactive dye injected into my left breast. The dye traces the circulation from the tumor itself to the lymph nodes. The surgeon will then remove the first node to which the tumor drains as well as any other lymph nodes which may contain cancer cells.

Once the nodes are removed, they are sent to pathology to determine how many contain cancerous cells. If there are cancerous cells in a majority of the nodes, the surgeon may choose to remove additional nodes while I’m still under anesthesia. Otherwise, she will remove the mass and that will be that!

The recovery should be relatively “easy” as I should only have 2 small incisions and no precautions or drains like I would have if I opted for a mastectomy with reconstruction. I should mention that I’m not choosing a mastectomy for several reasons:

  • I do not have a BRCA gene mutation, therefore my risk of a local recurrence and my overall cancer survival rate is not affected by choosing a more conservative surgery.
  • As a rehab professional, I am well aware that a mastectomy is a MAJOR surgery, and the recovery is more difficult and the healing timeline can be longer.
  • Had I chosen mastectomy, I would have likely chosen to have reconstruction as well which would require multiple additional surgeries & I just don’t have the energy for all of that!

Breast-conserving surgery is my personal choice based on what I know about my cancer now. There are many reasons why someone else would choose a mastectomy. Everyone’s situation is very different so just because this seems to be the right option for me doesn’t mean it’s the right (or best) option for someone else.

I will need radiation after surgery as well and I’ll be referred to a radiation oncologist to determine the plan. I’m also going to see my PT colleague for pre-operative lymphedema measures so I have a baseline to compare to after surgery.

2 weeks Post-chemo Faux-Hawk!

My hair and eyebrows are growing in nicely! In fact, I can almost make a baby mohawk. For 3 weeks post-chemo, I’m pretty excited about that! With my eyelashes growing in, my eyes have become super irritated, but I will be SO thankful to have lashes again! I miss mascara!

If you have any questions for me about surgery, lymphedema risk, or anything related to breast cancer or physical therapy – leave a comment for me below!

Hop you all have a great weekend! My mom will be here in two days! How lucky am I?!

Aloha ❤

Frozen Shoulder & Capsulitis after Breast Cancer Surgery

Frozen Shoulder & Capsulitis after Breast Cancer Surgery

by bridewitt ♥ 4 Comments

Staying on topic with complications after breast cancer surgery. The two I’ll discuss today are common and can be disruptive to daily life. You’ve probably heard of frozen shoulder (adhesive capsulitis), but you may not have heard about breast capsulitis after breast reconstruction. Let’s dive in a little deeper.

What is capsulitis?

Capsulitis is inflammation of a joint capsule or the capsule around a breast implant that can lead to scar tissue adhesions and stiffening or immobilization of the joint or breast capsule. Uncomfortable – yes. Functionally limiting? Also, yes.

Frozen shoulder

While frozen shoulder (adhesive capsulitis) can occur after any shoulder injury, it can occasionally occur without any injury, and is more common in females and in people with diabetes mellitus or hypothyroidism. Frozen shoulder typically presents as a significant loss of motion in the shoulder with or without pain. To read a bit more about frozen shoulder, click here.

After breast cancer surgery, frozen shoulder is also common. For women aged 50-59, women who had mastectomy, or women who had breast reconstruction, the risk of developing frozen shoulder on the affected side is approximately 10%.1

Functionally, frozen shoulder leads to difficulty getting dressed, showering, combing your hair, lifting and carrying objects, driving, sleeping, and a whole lot of things we do on a daily basis.

Physical therapists treat frozen shoulder using manual therapy like joint mobilizations, teaching passive stretches and gradually strengthening around the joint as motion improves, and educating patients on healing timeline and ways to modify daily activities to improve use of the arm and reduce pain.

Rehab for frozen shoulder can sometimes take close to a year before a person feels “back to normal.” If caught early enough (i.e. during the “freezing phase” when motion loss begins to occur), a steroid injection can help to minimize the symptoms and restrictions. See your doctor right away if you notice a major loss in joint motion after breast cancer surgery.

Post-reconstruction capsulitis

Post-reconstruction capsulitis or capsular contracture can occur when fibrotic changes occur in the tissue capsule that forms around new breast impants. The breast around the new implant hardens, can become painful, and the breast shape can become distorted. To read a bit more about capsular contracture, click here.

Risk for developing capsular contracture is higher after radiation therapy or following infection, hematoma, or seroma that develops around a new implant. It is not clear whether smooth versus textured implants play a role in development of capsulitis.

Typically, if capsulitis occurs and is painful, distorts the breast shape or an underlying infection is present, revision surgery is needed. In Australia, approximately 39% of revision surgeries each year are due to capsular contracture.2 With early stage contracture, a physical therapist can use manual therapy to try to restore motion and prevent further fibrosis of the breast. A PT will also be sure to address shoulder, neck, and chest wall motion which could be compromised with post-implant capsulitis.

For both frozen shoulder and post-reconstruction capsulitis, getting into see a physical therapist early is important to prevent loss of motion and to reduce pain. Ideally, PT’s would love to see breast cancer patients within 4-6 weeks after breast surgery or reconstruction. Developing a relationship with a physical therapist during and after breast cancer can be a great asset to your health and wellness beyond cancer. Ask your surgeon for a referral or find a PT in your area here.

Aloha ❤