PT Grad

I am a master PT patient! But seriously, I was so good at laying there and letting that woman gently rub my arm that I only needed four sessions to graduate from the program.

Okay, so yeah, my insurance would only pay for four sessions but at the end of the fourth session, my physical therapist said she’s sure I’ll be able to manage my lymphedema on my own.

Wheee!!!

With her wise teachings and handy dandy exercise handouts, I’m on my way to a non-swollen left arm!

And hey, this is one more thing that Olivia and I have in common. You know, other than our regal good looks and our sparkling personalities. Now we’re both physical therapy graduates too.

Also, go me, I actually did my exercises this morning and I didn’t actually HAVE to do them because I don’t have to answer to the therapist at my next appointment, because, yes, that’s right, there is no next appointment.

She did tell me that if I feel like Leftie is getting large and trying to take charge, I can all my family doctor and he can write an order for another PT session, so it’s not like I can never see this therapist again.

No need for tears, is what I’m saying.

Only too bad for me, she still wants me to get a compression sleeve. Do you know what those things are like?

I don’t either, but Imma google the hell out of lymphedema compression sleeves and freak myself right out. Wanna go with me? Yeah, field trip!! Let’s go.

Okay, so yes, there are some cool colors out there. There are also the gross flesh-toned ones. Ick. And I kind of hate how they go about three quarters up the arm and stop at what is probably the grosses part of a fatty’s arm. Yeah, that ought to be SUPER fun and attractive. And, best news yet, if I have to wear the thing every day, it will last maybe six months before needing to be replaced. There’s an expense I didn’t see coming.

Cancer…the gift that keeps on punching you in the face, even after you thought treatment was over.

And what do you wanna bet that my insurance will NOT pay for this thing? Well, the first ones I came across are in the $20 range, so that’s not horrible. And my HSA will probably pay for it but still, what’s the freaking point of insurance if it doesn’t actually pay for anything? That’s what I want to know.

Where are all my premiums going if not toward my stupid healthcare? Huh?

So How's Physical Therapy Going?

Hey, thanks for asking! As I write this, I’ve had two actual therapy sessions. I have two more and then insurance is just sure I’ll be cured.

Ha. Whatever.

At the first PT session, my therapist, let’s call her Kim (because that’s her name…or is it?) gave me a handout that described the lymphatic system and included pictures. They were gross because the lymphatic system is under the skin, so the diagram showed a skinned dude. Ick.

She also gave me a handout that described the exercises she wants me to do. Then, because she thinks I’m an imbecile, she walked me through the exercises. We started with deep breathing. Gag.

Actually, though, the exercises aren’t that bad. They’re very gentle, so I don’t even get out of breath doing them. There’s stretching and breathing and moving of joints. Mostly, the exercises are meant to work with the gentle massage to keep the lymphatic fluid moving in the right direction. See, the muscles that are moving during the exercises are beneath the lymphatic vessels, the massage works the vessels from above, so…everyone is working at a team. Wheee!!

Kim also gave me a handout with directions for self-massage.

I, um, haven’t done any of that yet.

I don’t know why, don’t ask me questions. I just haven’t. To be honest, I haven’t even looked at the paper. Again, no clue why, just…haven’t.

But I have gone swimming several times since the first and second PT sessions. According to Kim, swimming is excellent for the lymphatic system. The gentle pressure from the weight of the water works like massage, so there.

The massages she’s given me during the sessions are quite nice, actually. I mean, once you get past the fact that a stranger is rubbing her hands along your arm in a semi-circular fashion, up and down, up and down and all around.

She tells me that once I start doing the massages myself (ha! Except, okay, I WILL do them…sometime) I’ll actually learn to feel the difference between my left and right arm and be able to tell when ol’ Leftie is retaining fluid. Right now, I couldn’t tell you if Leftie had gone on a bender and was holding in a pint or two of lymphatic fluid as compared to good old Rightie, which happens to have all her lymph nodes and so still works like a champ at draining all that fluid.

Kim did say that from session one to session two, the tissue in my left arm seemed to be moving better, so…that’s good, right? She seemed please when she said it, so we’re going with good.

She keeps talking about a sleeve and I’m all, let’s wait and see. Apparently, if I ever fly again, I’ll need to wear one but hey, a person can go a lifetime without flying if they want to be boring and never have fun again. So there’s that.

She’s asked me a couple of times if the radiation oncologist mentioned the sleeve. I just tell her that all he said was that he was referring me for physical therapy. I don’t actually like talking about him. His very name makes me cranky so the less we speak of him the better.

But seriously folks, it’s fine. Therapy is fine. I’m fine. The lymphedema is fine. Old Leftie here is still hanging out, writing words, typing even more words, feeding my face, not swelling (much) and just being a good old arm.

Oh, hey, I forgot to mention that Kim is glad I’m too precious for fingernail polish. She said that the swelling from lymphedema can inhibit healing and so I should be careful of nicks and scraps on my arm and hand. She also said that nail polish can hide potential fungal infections and so it’s a good that I can’t stand the feel of polish on my fingernails. Did I ever mention that? Yeah, nail polish feels ‘heavy’ on my fingernails. I know how weird that is, believe me, but there you have it. And people sometimes wonder where Liv gets some of her idiosyncrasies.

Insurance and Physical Therapy

My insurance very kindly (insert heavy sarcasm) approved me for four whole physical therapy sessions.

Isn’t that grand? (Yes, Alyssa, I STILL hate that word, I’m being snarky here and so…it fits.)

If you’ve done any sort of research on lymphedema (obviously, at this point, I HAVE done just a little research) you know that it’s not something that is cured. Once you have it, you’ll always have it.

Joy.

So, four whole PT sessions are probably not going to make a huge dent in my potentially gigantic left arm.

Okay. Yes, four sessions are better than none.

I will learn as much from these sessions as I can and try to control the lymphedema at home with exercise (Ha! Hahahahaha.) and gentle massage.

Please believe me when I say that I will be administering said gentle massage myself. I will not be asking my husband to massage my stupid arm. My arms are gross. I don’t want him to touch them.

It was bad enough when the poor fellow had to cram gauze into my boob incision. Imma pass on him massaging my flabby, fish-belly white arms.

I do realize how vain I sound. Whatever. I own it. I’m vain. I haven’t worn a tank top in public since 1995 because I hate my arms. Yes. That’s true, not even a little bit of exaggeration.

I may be the queen of hyperbole, but this time, it’s not needed. It has literally been 24 years since I wore a tank top in public. A swim suit at the pool or lake does not count because honestly, wearing a stupid T-shirt over your swimsuit just emphasizes your fatness. No offense to anyone who does wear a T=shirt, just sharing how I feel about it when it comes to MY body. So...yeah.

I just don’t want to be that woman at Walmart waltzing around with my giant blubbery arms hanging from my grody shoulders without some sort of sleeve covering the dimpled flesh.

So.

Four sessions of PT.

What the hell is wrong with our health care system?

I know. So many things, right?

Why do insurance companies get to decide what kind of and how much treatment a person gets? Shouldn’t that be up to the doctors, the patient, the therapists?

I’m preaching to the choir here, I get that. But it just makes me crazy to think that some bureaucrat out there is deciding that my arm (my stupid, stupid arm) needs four therapy sessions.

Yeah…we’ll see.

It's Official

Yay?

I mean, okay.

We caught it early, just like the cancer that led to the lymphedema.

When the nurse measured my arms, Leftie was three centimeters larger than Rightie.

When the PT measured them exactly a week later, either Leftie had shrunk or Rightie had grown because there was only a 1.5 centimeter difference.

So that’s good news.

Alas, once you’ve been diagnosed with lymphedema, you will always have lymphedema, even if your affected limb doesn’t balloon out to elephant proportions.

For what it’s worth, I REALLY like to avoid that.

Apparently, I’m lucky that my affected limb is my dominant arm. That means I’ve maintained better range of motion due to constant use of said arm. (Read: I wipe my butt with the hand on the end of that arm…holding toilet paper, let’s not be any grosser than I’ve already been in this sentence.)

Typing is also good for the hands that might be affected by lymphedema. So, go me for having a job at which I sit and type quite a bit each day. And yay for blogging, right?

Right.

My insurance company approved the consult with the PT but hasn’t approved the actual physical therapy yet. Huh.

The therapist said it’s usually approved so we’ll see how that goes. She’d like to see me twice a week for four weeks and by then, I’ll have hopefully learned how to do the massage portion of the therapy myself.

That ought to be fun…for no one.

I’m not really as pissy as this post comes across.

I’m more…resigned.

I mean, the cancer diagnosis was bad enough. The surgery and ensuing recovery was, well, it was exhausting.

Chemo was awful and radiation, while not as bad as chemo, was time-consuming and tiring.

And now we’re throwing lymphedema into the mix because why the hell not? I guess I haven’t paid my dues enough yet.

I know I’m lucky to be here. Damn it, I KNOW that. I don’t want to go all ‘why me’ about this. Why not me, right?

It just sucks.

Reason #7064 Why I Need to Chill

Last week I suffered a great deal of angst over the whole physical therapy thing. I was stressed over having to drive five thousand miles on a regular basis just to have my stupid arm massaged to make sure it doesn’t balloon into a cartoon version of itself.

This was on top of the fact that my doctor makes me feel like Fatty McObesity.

So I was kind of a bitch at home for a few nights.

I skipped a few dinners to punish myself for being…well, me.

I also walked and was miffed when Tom and Olivia wanted to walk with me because, hello, they don’t need to be punished!!

I took a few breaths, slept pretty well for a couple of nights and ended up calling the original physical therapy place back to schedule a consult.

I figured I could drive the million miles for a consult. Consulting with a PT didn’t mean I HAD to go back for any more therapy.

Basically, I started to get my shit together.

The very next day after I called the clinic that is on the other side of the sun and scheduled an appointment, I received call from the rehabilitation center at my local hospital telling me they’d received orders from my doctor referring me for physical therapy for lymphedema and did I want to schedule an appointment for the next week?

This would require a drive of two miles from my work to the hospital for this therapy.

Yes.

If I’d just chilled my stupid butt out, it all would have worked out without a lot of angst and tears and pissing my poor husband off.

Sigh. I might never learn but I am going to try.

See, wait. To give myself a little credit, the scheduler (Sandy) at the doctor’s office TOLD me to call the PT office that I originally called. At first, she wanted them to call me once she’d sent them the doctor’s referral. She had my cell # but I told her I didn’t receive calls while I was at work and that I didn’t have any voice mail set up.

Since I’m technologically challenged, she said she’d send the PT orders to IPT (the original clinic) and I could call them myself to schedule the appointment.

When I first called, the day I declared I was NOT driving to Pluto for therapy, the person answering the phone did not see any referrals for me.

What I think happened is that Sandy called IPT, they told her that their clinic is in the Delta Quadrant (REALLY FREAKING FAR AWAY) and so she decided to call the hospital’s physical therapy clinic, which is practically in my lap. Since they had openings, she sent THEM my referral and, hey, would you look at that, they called me a mere two days after my original doctor’s appointment.

Whew.

What a mess. But really, the mess is only in my head and that’s clearing, just as I knew it would. It always does. Those first couple of days after the appointment are always so awful and I know, logically, that things always get better. I need to remember to just keep to myself for a couple of days and my stupid mood will even out, I’ll calm down and everything will work out.