Monday, 13 March 2017

Lymphoedema Awareness Week ~ Francoise

Read Francoise's fascinating account of the impact of pioneering super-micro-surgery for lymphoedema in this post which she wrote especially for our #ResilienceinLymphoedema series:

I was diagnosed with breast cancer in September 2013.

I finished treatment (Chemotherapy, Mastectomy and lymph node clearance, and then 5 ½ weeks of radiotherapy in May 2014).
In February 2016, my arm got painful and I realised it was getting bigger. My doctor referred me straight away to the lymphoedema clinic. However, there was over 3 months to wait before the first available appointment and my arm was very sore so I saw a MLD (manual lymphatic drainage) practitioner who relieved the symptoms. (I had to go once a week and it cost £40.00 so it was not sustainable in the long run.) She gave me a compression sleeve and I could see how I could manage the lymphoedema in the future. It definitely was do-able but I hated the sleeve, not just because it is so ugly or uncomfortable but because it reminded me constantly that I had had cancer and that it might come back. Also I was in constant discomfort – not terrible pains but permanent.

I had heard about a new type of surgery - “super-micro-surgery”. The surgeons describe it thus: “Through tiny incisions, often less than 2cm (1 inch) in length, we find lymphatic channels and small veins just beneath the skin. We then connect the lymphatic channels to the veins, using sutures that are less than a fifth the width of a human hair. This gives the lymphatic fluid an alternative route to escape from the affected area, effectively bypassing the area of damage to the lymphatics.”

The clinic is in Oxford and I live nearby so I thought I should at least consider it. I went to a consultation and found out I would be suitable for surgery. There was the small (not) question of money as this procedure is not available on the NHS in England but my husband and children (they are adults) were very supportive and we decided I should have a go.

We found the money (£15,000) and I had surgery in April 2016, before my first appointment at the lymphoedema clinic.

The surgery took 2 surgeons 5 hours: one hour for mapping my lymph vessels and veins (fluorescent green dye injected in my arm). Very high tech stuff but still they used red markers to know where to cut… I did not know veins and lymph vessels follow slightly different patterns in different people. Then two hours on the inside of my arm, one surgeon on the wrist another one at the elbow and two hours on the outside. I ended up with 4 small incisions with 4 connections in each. I was awake throughout, listening to podcasts on my phone. It was quite interesting. Two weeks off work then back to wearing my sleeve for 6 months. Straight away, the pain in my arm disappeared.

A year on I am still pain free. I only wear my sleeve when I go running or to my Zumba class. Very happy I had surgery. #ResilienceinLymphoedema

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