Once I began to move and groove my arms again after surgery, I noticed a tight band in my left armpit. I assumed it was some sort of tendon that was shortened in the axilla surgery (where 6 lymph nodes were removed). It restricted my movement and was incredibly painful ~ it felt like a tight piano string from my armpit down through my forearm and wrist. I showed my plastic surgeon and he encouraged me to keep stretching and massaging it with oil. Believing a gentle approach is always best, I was slow & mindful with it.
A week later, I met with my breast surgeon and she examined it with a concerned look on her face. She said it was a fibrous band and needs immediate attention. I later learned that it’s also called “Axillary Web Syndrome” or “Cording.” Isn’t it funny how when a medical name is put to something, it sounds so much scarier? It’s a rare complication after a Sentinel Lymph Node Biopsy or Axillary Lymph Node Dissection where scar tissue forms at the surgery site and then long, thick, painful cords form down the arm or chest. What’s weird is that they do not know for sure what the cords are made of ~ it could be hardening of the lymphatic channels (thus creating a greater risk of lymphedema), blood vessels, or nerves. It can last a couple of months or a lifetime. Although there isn’t much research yet, the therapy to address cording is still the same: #stretchandmovethisshit.com.
As the breast surgeon wrote the referral for physical therapy, she said that I could not begin radiation until I had full range of motion on the left side. You need to hold your arms above your head for 10-15 minutes during radiation. She said that she wants me doing handstands at our next appointment in 3 weeks. Gulp. I was also receiving weekly “boob fills” from my plastic surgeon which made the cording even tighter. It was a pretty intense process for me, yet also very cool to see my boobs grow every week! (more on this later)
After I left the office, I began to feel a tightening in my stomach and throat. Then Anger appeared for a visit. My internal dialogue went something like this…“Are you kidding me? Another damn thing to deal with on top of everything else? I’m just starting to feel “normal” again and now THIS! And why wasn’t this band thingy listed in the MASSIVE amount of paperwork I had to read before surgery?!!! I signed off on EVERY possible side effect/complication, including DEATH!!! They didn’t prepare me for this!” And then Despair started bargaining, “I just want a break…please. No more universal tests. Enough. White flag is up.” A little whisper from Curiosity snuck in: “Hey, what if this is a good thing? You never know what cool things this could lead to.” Anger + Despair + Depression ganged up on Curiosity: “SHUT-UP Ms. Try-to-look-on-the-bright-side-of-everything and just admit it, this SUCKS BUTT.”
So Anger’s gang won for a few hours.
On the car ride home, I vented to my mom and my brother on the phone. Then at home to my husband who extended an invitation to inquiry (The Work of Byron Katie). Exploring two thoughts in particular really began to shift my experience:
Cording is going to make my life more difficult.
The surgeon didn’t prepare me for this complication.
Through inquiry, I came to discover I had no proof that cording would make life more difficult. In fact ~ I had more proof it would make it easier. There was nothing “new” I needed to learn ~ I had an expert physical therapist for that. And even though my job as a Yoga Therapist is working with bodies and helping them heal, I felt a little nervous with my own body after this surgery. So, now that’s my physical therapist’s job! In fact, it’s quite easy for me ~ I just show up and do what she says, ask questions, learn, repeat. Hmmmm….maybe this cording thing is better than I thought.
Through questioning my thoughts about the surgeon, I saw how well she did prepare me for this situation ~ the moment she saw it, she recognized it, and sent me directly to physical therapy. She was also very encouraging about me moving my arms right after surgery ~ actually, while still IN the hospital ~ I may have babied my arms more than necessary. “I didn’t prepare me for this complication” is truer ~ and when I was believing my thoughts, I was full of blame, anger, and guilt. I saw images of the cords multiplying until I have zero use of my arm for the rest of my life. They felt so solid and permanent. Plus, where did the label “complication” come from? My mind.
Without these thoughts, I hear a sweet, calm, open-minded “follow the simple instructions” voice. Curiosity steps in (ie our true nature) and an openness to seeing the blessings unfolds. And that’s what I did.
Placing the blame or judgment on someone else leaves you powerless to change your experience; taking responsibility for your beliefs and judgments gives you the power to change them. ~ Byron Katie
Medical City has the STAR Program ~ a branch of Physical Therapy & Rehabilitation that specializes solely in working with cancer patients. After my first session, I was blown away by its awesomeness. It turns out physical therapy is super similar to yoga therapy and it’s paid for by insurance! Guess what cording led to? Free private yoga therapy with one of the coolest therapists ever, Tiffany. Her mother is a breast cancer survivor and she is a complete expert in this field. I freaking LOVE it! I’ve learned so much about my body, anatomy, alignment, stretching, and strengthening. I now even incorporate some of the new moves with my private yoga clients. Yep, it’s actually made me better at my job.
We started with a lot of slow, deep stretching, followed by her manually stretching and massaging the cords (oh yes, more cords appeared!) ~ it was extremely painful at first…but the hurts-so-good pain that you can tell is making a difference. She also gave me a daily home practice that I followed to a T and incorporated into my own yoga practice. I loved getting creative at how I could blend it all together.
She had warned me that the cords can make a crunchy noise and even snap as they break up ~ this is a good thing. I experienced a small snap at home during self massage and then during one PT session, there was an extremely loud POP in my armpit as she was stretching me. It was the oddest sensation…like a firework exploded in my armpit…it actually wasn’t very painful in the moment but then the remembering of the unfamiliar sound & sensation led to an unplanned outburst of, “holy shit, fuck, shitballz!” in a room full of strangers. 😉
Within a few weeks, I experienced a drastic shift in my body ~ I had gained full range of motion back along with the confidence to move and use my arms in all daily activities. The cording was still present, but I felt unattached to the outcome – I saw so clearly how I could live a full life with and without this cording. The cording just keeps me in my yoga practice. (See – The Work of Byron Katie keeps working its magic!) And then within two month, the cording left me.
I chose to continue physical therapy as long as I could, which included through most of radiation…we began to work on more strengthening and flexibility in my upper body and core. I honestly think I have even better posture and more strength than I ever have before. I am also convinced that Tiffany takes pleasure in torturing me…perhaps this is “payback” for all of the times I have dug my elbows into clients trap muscles and butt muscles in thai massage & yoga. Well, IT WORKS!
Now I have “graduated” from the Star Program and I HIGHLY recommend physical therapy for ANYONE recovering from surgery or experiencing side effects from treatment. There’s no need to wait for a complication to appear, most doctors can write a referral for you if you request it. And most forget to mention this option to you. I’ll be doing it after next year’s reconstruction surgery (ie – Build-Bethany’s-Beautiful-Boobies Surgery).
So here I am, a strong, flexible, and even more educated yogini…thanks to that sweet little “complication” which is really just a huge blessing. The next time I face a similar challenge, I now have more proof that the universe is kind. It all happens FOR me.
Life is simple. Everything happens for you, not to you. Everything happens at exactly the right moment, neither too soon nor too late. You don’t have to like it… it’s just easier if you do. ~ Byron Katie