Managing swelling without MLD

Two weeks since the cast came off, and all things considered, I think I should be fairly pleased with progress dealing with the lymphoedema swelling.

There was, and still is, some pain from time to time, exactly as Mr Marston in the fracture clinic warned. Nothing to worry about though, having been forewarned. - actually oddly reassuring. But its late, and I am tired, so let me get to the two points I really want to write about before I give up and go to bed.

My visit to Barts was productive. Sonia seems to be in charge of all the nursing services in the West Wing and knows her stuff when it comes to Lymphoedema. We had a good talk, and she completely understood that I'd just been really scared the day before when the cast came off. She was pleased with the state of the skin - the showers and the moisturising the last 24 hours had transformed its condition, it had recovered remarkably well.

But it was still a lot more swollen... after measuring, I needed a size III Mediven sleeve, rather than my usual size I, and I needed one with an integrated hand: partly because the hand was swollen but also because the remaining haematoma around the wrist where the break was proved awkward for straight sleeves (without hands). She also ordered me a separate glove with fingers, which proved useful, even though by the time it arrived my fingers had gone down.

Of course, what everyone except we patients forgets is that any glove appliance, whether it's an integrated one or separate, causes pain in that sensitive little area at the base of the thumb, and I have to be honest, it is driving me mad. I have - or had - a coping routine that meant I wore my sleeves in bed most nights, but with this level of swelling I needed to wear a glove as well or be damned by even more swelling than I went to bed with (in my hand, not my arm, obviously). However, by rotating my old sleeves and the new finger glove with the new integrated sleeve and several nights "off", I have managed to cope to the extent that I went back to see Sonia yesterday and persuaded her to let me have a size II sleeve (its' still integrated though).

Excercising has been a much more positive affair, and that brings me to my second point about the Physiotherapy appointment on Tuesday... Tim (my personal trainer) would be very pleased to know we are on the right track, and the physio was very impressed with the degree of strength and mobility I have already regained - a real positive for having kept up the training while the cast was on. However, there are three very important learnings at this point:

1. The use of a hand piece during exercise and other flashpoint times is crucial:
2. The muscles need to be gradually brought back to strength so they can once again be the proper drivers (actually I call them my "engines" or "pumps") for pushing the lymph out;
3. Proper exercise - including but not limited to compliance exercise - is what has helped me accelerate the healing process, without doubt. I just have work on following through with that so I can bring the weights back into my compliance exercises as soon as possible.

I shall keep you posted.

One piece of advice though... keep pushing the boundaries. There is a very strong school of thought that advocates avoiding physical stress. I understand the point, but its not the whole point, and if that's all you stick to, believe me you will be more prone to problems not less.

More on that some other time. Very tired now, time for Bedfordshire.