By Leanne Thomas, Tripler Army Medical Center Public AffairsApril 17, 2019
HONOLULU (April 17, 2019) - The first lymphedema therapy program was recently established at Tripler Army Medical Center by embedding a certified lymphedema therapist from occupational therapy into the Tripler Radiation Oncology Therapy Clinic.
This brand new capability at Tripler provides comprehensive rehabilitative care for patients suffering from lymphedema as a result of surgical oncology or radiation oncology procedures, and the feedback from staff and patients has been tremendously positive.
"My husband retired here from the Army at Fort Shafter, and I feel lucky enough to have continuous care here," said Heidi Kane, a military spouse receiving care at Tripler.
While undergoing a full left breast mastectomy, Kane, also a double cancer survivor - breast and lung cancer, had an axillary lymph node dissection where 32 lymph nodes were removed due to the breast cancer diagnosis. As a result, she developed lymphedema, a condition that causes extra lymphatic fluid to build up in tissues and causes painful swelling of limbs or other parts of the body, limiting mobility.
"No one realizes ahead of time ... I mean you know you're going to have to go through chemo, you know you are going to have to go through radiation, but having your movement taken away from you, after having your whole breast removed, and not knowing the complications that happen after surgery. It's the little things that you don't realize are affected," explained Kane.
Initially right after surgery, before Kane could complete lymph drainage, she experienced scar tissue issues that had to be dealt with to regain the mobility back in her arm. There was also cording that happened under the arm which was very painful because the fluids can't move, and the limb swelled.
"Everyone's path is different," Kane said. "Because of the different treatments, radiation, and chemo, my upper arm was first affected, and it wasn't until a year later or more that I went through radiation which caused the lower part of my arm to swell. Now I'm dealing with the whole arm. But it's gone down because the lymphedema specialist at Tripler has taught me how to manage the condition."
When a patient has swelling in their extremities, specialized lymphedema treatment and management reduces swelling through: manual lymphatic drainage, multi-layered compression bandaging, compression garments, lymphedema exercises, patient / caregiver education, and skin care.
"We provide the patients all of the tools and strategies necessary to ensure positive outcomes. Follow up visits are recommended to ensure the patient is managing their lymphedema, and ongoing support is provided," said Tripler Certified Lymphedema Therapist, Eileen Itamoto-Gaza. "The goal of therapy is for the patient to be independent in the long term management of lymphedema."
Kane said, "If I didn't have access to this program at Tripler, I wouldn't be able to move my arm. I was in so much pain because of the swelling in my elbow where I couldn't carry anything; I couldn't hold anything."
It wasn't until Kane started seeing a little progress, that she realized lymphedema is a condition that she is learning how to manage.
"I remember just the smallest thing initially where I cried ... where I could actually take my left hand and put my deodorant on under my right arm," Kane said. "Something as simple and little as that."
Initially, after surgery, Kane was told she wouldn't be able to put any weight on her shoulder because of the excess fluids, but she found through the program, and with the help of her therapist, she could actually live and enjoy her life again.
"So I've actually been scuba diving now, and I've been diving for over 30 years ... so to be back in the water again, it' an amazing experience - You're weightless; you're breathing ... you don't have to worry about anything else when you're under the water," Kane said with pride and joy.
"It's been a long journey ... but Eileen, and actually, the whole Tripler staff has been there for me," she added. "So I just feel blessed."