Was I being summoned to take care of an oozing wound?  Did I need to find a needle from the sewing basket in A Stitch-Popping Emergency?  Nope.  I had to reset the clock on the VCR.  And change the numbers on the speed dial of her phone.  And rub her sore…shoulders?  Not a chance.  It’s the FEET that need rubbing.  Those are pretty far from the shoulders, Gram, but any increase in circulation is a good thing, so we’ll let that slide…all three times.

And I did it all happily, as this woman had hand-made my clothes growing up,  cooked us weekly dinners, and best of all, let us one-at-a-time spend Friday nights at her house, get a DONUT, and go Garage Sale-ing Saturday morning.  I totally owed her.

The result of this weekend was a very happy lady, a glimpse of my inevitable role to come, and some tips for any of you who may be going through a similar surgery.  Shoulder surgery, especially rotator cuff repair, can be a fairly simple out-patient procedure.  The most difficult part is the recovery, or really, the one-armed living habits you must cultivate while your tissues are healing.  Only using one arm is DIFFICULT!  (Next time you are in the loo, try pulling your pants down and then back up with one hand.  It can’t be done, I tell you!!!)

If you or someone your care for is getting ready for shoulder, breast, or hand surgery, send them these tips:

1.  Shirts are pretty much out of the question just after shoulder surgery.  Going topless is also equally out of the question An excellent compromise:  Purchase one yard of fleece and make a poncho!  Just fold in half and cut a neck hole (you can also make a 6-8″ vertical cut down the front to prevent throat/neck aggravation) and viola!  You have full coverage and warmth with no buttons, zippers, or sleeves to deal with.

2.  Ask for any braces or slings ahead of time and practice putting them on beforehand.  My grandmother’s sling was very complicated, and even with my engineering background, I may have put it on backwards.  I suggest putting it on with the help of your Dr.’s office and have them label which Velcro straps go where (a Sharpie works great.)

3.  But a set of inexpensive underwear one size larger than you normally wear.  This makes bathroom-ing an easier task for the single-armed.

4.  Pain medication can wreak havoc on your stomach and upper intestine.  For most, medication is a necessary part of healing, but you need to make better dietary choices during this time.  Avoid “acidic foods” such as decaf and regular coffee (that’s a food, right?), sodas, chili and seasoning peppers, and limit tomatoes, citrus juices, and fried foods – especially if they upset your stomach or cause heartburn.  Focus on a whole-food (no processed foods), higher fiber diet during this time.  Your body is trying to heal a surgical wound – a wound you chose to inflict because of your overwhelming desire TO FEEL BETTER! Choose well.

Finally, find multiple people to tend to you.  Try not to depend solely on one person for the entire duration.  This will keep everyone fresh and reduce some of the inevitable irritation that comes with the slow healing process.  And find someone to rub your feet.  Especially one that, as they say, owes you big time.

LINDA G., A BREAST CANCER SURVIVOR, IS JOYFUL EVERY DAY — A FEAT THAT BECAME MORE DIFFICULT AS SHE DEVELOPED A FROZEN SHOULDER AND THEN A MILD CASE OF THORACIC OUTLET SYNDROME IN THE YEAR FOLLOWING HER SINGLE MASTECTOMY. “I KNOW THAT I SHOULD BE GRATEFUL THAT I KICKED CANCER, BUT IT WAS REALLY DIFFICULT TO BE HAPPY WHEN MY SHOULDER ACHED ON A DAILY BASIS,” LINDA SAID.

FOR MANY YEARS, women receiving breast surgery were told to “baby” their arm to prevent lymphedema (a swelling of the armpit, arms or hands). And while this advice seems appropriate when trying to prevent agitation of the surgery site, it has a drastic effect on the mechanics and health of the shoulder girdle. As we develop a better understanding of the role healthy muscles play in overall body health, research is starting to show that gentle use of the arm during the healing process can keep the tissues of the shoulder girdle mobile, help the scar tissue lie down in the correct direction and actually reduce swelling in the arms.

In addition to aiding in the healing process, working on skeletal alignment can actually create a healthier environment for the breast tissue before there is an issue. In fact, many asymptomatic women are slowly collecting lymph in the armpit area due to poor tone of the rotator cuff, pectoral and latissimus muscles. This excessive swelling around the bra area is often accumulated waste, even though it looks and feels like fatty tissue.

How does your lymph system work?
Circulating alongside your blood vessels, our lymph system drains the cellular waste products removed from the cells. But unlike the heart in the cardiovascular system, lymph has no pumping mechanism. It depends on the movement of the muscles in the area. And even if you work the large muscles in the gym, the smaller muscles often get neglected. Whether you are interested in preventing waste accumulation or reducing swelling due to stagnant lymph, exercises to slowly stretch and strengthen the area are greatly encouraged!

The “egg-hole” test
This is a simple way to evaluate the tone of the muscles that define your armpit. Muscles that are easy for you to innervate (which means to “supply with nerves” by contracting) indicate the lymph has a better chance at being removed from the area.

Stand in front of a mirror with a clear view of your armpit. The less clothing you have on, the easier it is to see. Bring your elbow out to the side and lift it until it is the same height as your shoulder. Gently pulling your shoulder blade downward should create a hole about the size and shape of an egg. If you have some lymph in the area, the wall of your armpit will be flat. If you have a lot of lymph in the area, your armpit will bulge.

If you have a generous amount of swelling in the armpit, it may be a good time to schedule a breast examination and have your nodes checked — and start these exercises right away!

What types of movement are safe?

When you first have surgery, most movement is uncomfortable and there is a lot of fear of re-injuring or damaging the surgical site. Your surgeon should let you know when the suture has healed and you are no longer at risk of opening the site. During that time, however, you can still move the surrounding areas without impeding the healing process.

Keep your hands active to keep neurological activity moving through the arms. Do “piano player” exercises with your fingers, touching each finger to the thumb, going up and down the scales working on speed and fine motor skill. Add gentle hand and finger stretching often, to keep the tissues from atrophying while you are healing. Also, add the “head hang,” (pictured below ) to stretch the back of your neck. Healing tissues tend to be stiff from disuse, so keep the neck supple by allowing the chin to drop until it touches the chest.

Put the swing back into your step!
Of all the exercises you could do with your shoulders, walking with natural arm swing is the most important to breast health! Many people have adopted the race-walking posture of bending the elbows when going for their daily exercise, but long-armed swings pushing behind you (imagine pushing ski poles behind you) is the more natural and calorie-burning way to walk. Remember, race walking is a sport, so these athletes are trying to conserve energy and expend less calories — why would we want to do that?

Stretching your chest with floor angels

Reclining on a bolster or stacked pillows, reach your arms out to the side, keeping the palms up. Try to get the backs of your hands to the floor, keeping your elbows slightly bent. Once your chest can handle that stretch, slowly raise your arms above your head, trying to keep them on the floor. Do this for five to 10 minutes per day, and be gentle with yourself!

You may not feel up to heavy bouts of exercise right after treatment or surgery, but as you begin to feel better, small movements can aid the body in healing and have an overall energy-increasing result.

These exercises from the Aligned and Well™ program can be used as both preventive health measures as well as part of a recovery program. They are designed to gently restore the circulation of electricity, blood and lymph mechanics, which all lead to better breast health!