Post-Surgery

Persistent Genital Arousal Syndrome (PGAD)

Breast Surgery

Exercise helps to decrease any side effect after surgery and helps you to return to normal daily activities, also prevents shoulder stiffness after surgery.

Advised by your physiotherapist

You should do the exercises as often as possible. When resting the arm on the operated side supported the arm on a pillow and try not to let it hang down by your side.

1

Step 1

Open and close your fingers as if making a fist.

2

Step 2

Move your wrist up and down as if waving.

3

Step 3

Bend your elbow and straighten it out fully.

4

Step 4

Shrug your shoulders.

5

Step 5

Press your shoulder blades back together.

6

Step 6

Turn your head from side to side.

7

Step 7

Join your hands and keep your elbows straight. Lift your arms up to eye level. This exercise can be done either sitting or lying. If you have had an axillary node clearance do not stretch your arms over eye level for the first 7 days post -surgery.

8

Step 8

Sit up in a chair or lay on your back, with your hands behind your neck and your elbows pointing forward. Move your elbows apart back to the chair or bed. You will need to achieve good flexibility in this exercise if you will require radiotherapy treatment.

Once the drains have been removed you can include the following exercises:

Stand facing a wall. Walk your fingers up the wall as high as possible, reverse down in the same way.
Stand with your non-affected arm against the wall. Raise your arm up sideways toward your head with the thumb leading the way (like the arm of a clock).

You may have a burning, tingling, numbness or soreness on the back of the arm and or chest wall. The surgery can irritate the nerves. These feelings may increase a few weeks after surgery. Rubbing or stroking the area with your hand or a soft cloth can help make the area less sensitive.

Exercise to help improve aerobic (heart-lung) capacity is also important for women who have had breast cancer. There’s evidence that fitness and weight loss may even help lower the risk that some types of cancer recurring after treatment. Ask your doctor about fitness exercises during and after breast cancer treatment.

Other exercises are designed to help reduce your risk of lymphedema, or swelling in the arm on the side where you had surgery. The exercises shown here are mainly designed to help regain range of motion (flexibility) of the arm and shoulder. Ask your doctor about your lymphedema risk and if you should use exercises to help reduce that risk.

Lymphedema is a build-up of lymph fluid in the fatty tissues just under your skin. This build-up causes swelling (or edema), most often in the arms or legs. Lymphedema can be the result from surgery or radiation therapy to treat certain cancers. During surgery for cancer the doctor may take out lymph nodes near the tumor to see if the cancer has spread.

Our bodies have a network of lymph nodes and lymph vessels that collect and carry watery, clear lymph fluid, much like veins collect blood from distant parts of the body (like the hands and arms) and carry it back to the heart.

Lymph fluid contains proteins, salts, and water, as well as white blood cells, which help fight infection. In the lymph vessels, one-way valves work with body muscles to help move the fluid through the body and control the flow.

Lymph nodes are small collections of tissue along the lymph vessels that work as filters for harmful substances and help fight infection. Taking out lymph nodes and vessels makes it harder for the lymph fluid in the arms, legs, or other body parts to flow to the chest where it can get back into the bloodstream. If the remaining lymph vessels cannot remove enough of the fluid in the area, the fluid builds up and causes swelling, or lymphedema.

Lymphoedema

Common signs and symptoms you should watch for include:

- Swelling
- Part of your body (like your arm) feeling full or heavy
- Skin changing texture, feeling tight or hard, or looking red
- New aching, tingling, numbness, or other discomfort in the area
- Less movement or flexibility in nearby joints (like your hand, wrist)
- Trouble fitting into clothes in one area, such as a sleeve
- Collars, rings, watches, and/or bracelets feeling tight even though you haven’t gained weight

Treatment to contol the lymphedema:

Manual lymphatic drainage (MLD). MLD is a specialized technique that involves gentle skin massage. It helps blocked lymphatic fluid drain properly into the bloodstream and may reduce swelling.
Exercise. Exercising usually improves the flow of the lymphatic system and strengthens muscles. Ask your doctor or therapist when you can start exercising and which exercises are right for you.
Compression. Non-elastic bandages and compression garments, such as elastic sleeves, place gentle pressure on the affected area. This helps prevent fluid from refilling and swelling after decongestive therapy. There are several options, depending on the location of the lymphedema. All compression devices apply the most pressure farthest from the center of the body and less pressure closer to the center of the body. Compression garments must fit properly and should be replaced every 3 to 6 months.
Skin care. Lymphedema can increase the risk of infection. So it is important to keep the affected area clean, moisturized, and healthy. Apply moisturizer each day to prevent chapped skin. Avoid cuts, burns, needle sticks, or other injury to the affected area. If you shave, use an electric razor to reduce the chance of cutting the skin. When you are outside, wear a broad-spectrum sunscreen that protects against both UVA and UVB radiation and has a sun protection factor (SPF) of at least 30. If you do cut or burn yourself, wash the injured area with soap and water and use an antibiotic cream as directed by your health care team.
Elevation. Keeping your affected limb elevated helps to reduce swelling and encourage fluid drainage through the lymphatic system
Low-level laser treatments (LLLT). A small number of clinical trials have found that LLLT could provide some relief from lymphedema after removal of the breast, particularly in the arms.
Medications. Your doctor may prescribe antibiotics to treat infections or drugs to relieve pain when necessary.
Physical therapy. If you have trouble using your arm, fitting jewelry, or other issues resulting from lymphedema of the arm, you may need physical therapy.