breathing, moving fluid

kcshreve

I had a conversation with a non-LE treating masseuse yesterday, which I found interesting. He mentioned how most of his clients have compromised lymphatic movement, and the first thing he teaches them is therapeutic breathing.  So I asked him about breathing, specifically.  It is this technique I thought I'd share, as it makes sense and gave me a good focus, which I did not have before.  We know about breathing in through the nose, out through the mouth, getting a good tummy breath, right?  What he added was the importance of a full abdominal tightening/crunch which includes the butt and a kegel squeeze at the end of the exhale.  Then, the inhale is started by abdominal relaxation, then filling the lungs.  Does that make sense?  I've never seen it specified this way, and I found it to be helpful.  

Binney4

KC, I get this and it works really well -- thank you! Good kegel exercise too. I found it took a bit of coordination at first, but once I got into it I could see the difference. Nice!
Binney

kira66715

KC: Brilliant! I'm trying to do it in my chair at work--and it's really helpful.

Kira 

Racy

Sounds similar to pilates breathing. Pilates is great gentle exercise.

carol57

Today I met with my LE therapist, who is also a PT (and a fabulous person!). I asked her to spend a minute strategizing with me on some frustration I have coming back to full core strength after my diep recon, which technically was a muscle-sparing flap because I lost dime-sized bits of muscle on each side. I'm not limited in any sense of the word, just aware that I'm not as strong in the lower abs as I was pre-surgery. After poking a bit on my abs as I tightened and relaxed them, feeling shape, etc., she suggested I need to work on developing the transverse muscles. So of course I asked: How?  To my surprise -and a propos the topic here-- her answer was to tighten the butt and do kegels! 

What a multi-purpose maneuver, the kegel. 

Carol

Marple

We never stop learning.  I'm breathing................and tightening.

Anonymous

Have to try this! Thank you, KC!

Jennifer1295

Hope it's ok to jump right in and start posting again. I come and read periodically but don't post as often as I used to. Just wanted to thank you for the tip about the breathing. I tried it after I read it and it made sense. I messed up the first time of course but by the second time I was able to do it despite the allergies or cold I am getting. Who knew kegals added to breathing could be beneficial in more then one way. If they only told us it could help tighten the tummy (I also had DIEP a few years back) we would have been doing them all long.

kcshreve

I wanted to add one more thing to the above breathing description, since I saw this massage guy again today (for a hip complaint).  He worked on my lower abdomen, deeply massaging just inside my hipbones on up to just below my belly button.  He told me I could get similar results with a tennis ball (in a smooth sock to avoid skin irritation, if needed).  What a difference!  I really cannot believe it.  So, breathing and deeper abdominal massage seems to be improving the overall balance I thought I'd already achieved by my version of MLD.  I was not taught this before.  Hope it helps.

Galsal

Interesting.  LT has me do abdominal breathing where as you inhale you expand the belly.  In her words, get fat.  Half the time I have to stop and really focus on synching with that function.

mcm24

My PT also has me doing abdominal breathing. Stick tummy out when inhaling. It does take some practice. She said it stimulates the lymph nodes deep in the core of your body. I think the massage of the good nodes and moving the fluid to those areas has really helped me, too.

kira66715

KC--where do you put the tennis ball? Between you legs and squeeze?

There is a LE PT who recommends this move called the "Hulk" where you clear your neck and axillary nodes, and deep breath and then make fists and bring your hands to the midline in a Hulk move as you forcefully breath out and contract your arms and abdomen. She wants women to do it 8 times a day, and swears it can make huge improvements. You repeat it 5 times--any more and you'd get light headed.

Honestly, I've tried to do the move, but can never remember it 8 times a day.

Kira

carol57

Here's the science, from one of my LE books:  'Learning to breathe in a manner that moves the abdominal muscles is an easy way to create an ongoing gentle pumping action to the central lymphatic vessel in the chest cavity (the thoracic duct), and thus to stimulate the flow of lymph. When you inhale using your abdominal muscles the pressure in the chest cavity changes because the breath moves the diaphragm. Likewise, when you exhale using your abdominal muscles, the pressure changes once again. The alternating pressure acts like a pump on the thoracic duct, which runs upward through the chest cavity and drains into the venous system at the neck. If you learn to breathe this way all the time, not just during your lymphedema treatment sessions, you'll be gently pumping your lymphatic system throughout the day.'  

Breathing like this all the time...that would be unusual (most of don't prefer to be puffing out our tummies with every breath--when I do it, I think I look pregnant!). But worth doing often, at least!

The book I quoted from is wonderful:  Lymphedema, A Breast Cancer Patient's Guide to Prevention and Healing, by Jeannie Burt and Gwen White, PT.  I think I bought it on Amazon. 

Carol 

olearca

Kira, love picturing the HULK move!!! Seems not only good for breathing but a great way to sort of growl at LE when I'm pissed off! Put on a green under armor and wow, what a visual! Lol

kira66715

Olearca, I just did a series of 5: I do it after MLD--the PT who swears by it, says you can forgo full MLD, just do it 8 times a day

But, somehow that never works for me

I clench my fists, meet at the bellybutton, and pull them out to the sides with the inhale, and bring them back to the middle with a fist/arm contraction on the exhale. While tightening the abdominal muscles.

I keep thinking I'll do it 8 times a day--she recommends doing it in the bathroom at work--but I haven't gotten there.

Do love the visual, bursting out of compression garments and becoming the LE hulk!

carol57

Somehow, we need to modify this great move so we can call it 'the windshield.'

Anonymous

I am giggling here. I love the image of doing the hulk move in a green UA!




I think all of these breathing moves are similar - Lebed's hugging a tree/blowing out birthday candles, the hulk, the kegel breaths, but each has a subtle difference. Lebed tells you to curve your back like the letter "C", which has a way of further activating the abdominals, the hulk move sounds like a similar stance and contraction (I am curious and want to try the fist and arm movement), and the kegel breaths force your abs to work deeply when you contract your butt and pelvic floor muscles. It would seem to me they all help you fully exhale, so when you inhale again with your abs you are making the most of that pressure change.




In contrast to the powerful imagery of the hulk (which I definitely will try!), I have been using more sedate imagery for MLD. I know the importance of ab breathing when it comes to meditating and incorporate it with my drawing. However, when doing breathing as part of MLD, I usually just want this part to be over, so I don't do it slowly or deeply enough. Once I started doing the kegel breaths, it got me to slow down. Now I have incorporated some visualization with it, which really keeps the pace slow and the exhale and inhale are extended. For each breath, I will visualize moving water or air. So, as I start my breath, I say to myself, "this is the water flowing freely in the stream", or "this is the waterfall rolling off the edge"', and "this is the air swirling around the mountain". Rain, ocean, breeze on my face, whatever comes to me I will stay with that image for the inhale and exhale. They all represent my lymphatic fluid flowing freely through my body without disruption. My brain is stubborn, so I have to trick or entertain it so it buys into the process!

Chris13

Whoa, feeling a little lightheaded here... My chiropractor SIL mentioned he tells patients to think of moving the breath up from their abdomen through the body as they exhale. I do this with the kegel breath exercise, noted above.

1openheart

My myofascial PTs sell small yellow rubber balls that are a little larger than a softball.  I am instructed to lie on my tummy with the ball in various locations around my belly.  Hurts like hell, but it is used to break up scar tissue and fascial adhesions.  These adhesions pull on the fascia and can cause pain in other areas of the body such as the neck, shoulders, back, groin, pelvis etc....

I am also doing some deep breathing exercises that the Art of Living workshops teach.  It is basically a series of deep, abdominal breathing with the arms in 3 different positions.  One set with hands at waist, another with hands at arm pit level and elbows extended outward, and the last with elbows upward in the air next to ears with palms resting on back near the shoulder blades.  I think this is helping some with the Mondor's Cording in my trunk and abdomen.

BeckySharp

So many different techniques from therapists.  Mine would have me bend my knees and as I exhaled she would push down hard on my stomach.  I asked why I had to bend my legs and she said it made the muscle work more with abdominals or something like that.  I do that myself when doing MLD am and pm.  Now I will have to try the Hulk when I am standing.

kira66715

Becky, the Hulk works well sitting--and no risk of getting dizzy from the valsalva maneuver you create: she wants you to clear the neck and axilla and then do five of them, 8 times a day.

My LE therapist always has me do deep yoga breaths while she pushes on my stomach. After clearing the neck and before starting the MLD on the arm/trunk/back.

When I do MLD, I do a few of them as well.

kcshreve

Tennis ball goes just inside hip bones, pushing down into lower abdomen, rolling upward, sideways, lower, but always deep.  Then, you move over a couple inches and do it again....and again. For me, it adds deeper pressure than I can generate with my hands alone - that's probably the advantage.  And being a ball, it does the work rather than my hand, so I can do it a bit longer.  And it's kind of fun.  

1openheart

When I lay on the yellow rubber ball I am on my stomach with the ball between me and either the floor or the bed. Sometimes it is too painful to be on the floor and I need to be on the softer surface of the mattress.  It is for adhesions and fascial restrictions in my case.

kira66715

Jo--my therapist does it to move the chyla cisterna, the deep duct of the lymphatic system. 

Check out these images on Wikepedia

http://en.wikipedia.org/wiki/Cisterna_chyli 

Kira 

Leslie1962

JO-5 - I have the same sensation as you described for truncal pain. I was told that would most likely never go away. Some days I don't notice any pain but other days it becomes very sore.

~ Leslie

Binney4

Question is - Any of you with truncal still have those sharp jabs in that area, and a soreness?  This comes and goes down my back from the arm pit and down the side by my ribs. When I wear my vest bra it does pretty well but a regular bra (and I've been professionally fitted and it fits well) hurts. There is no noticeable swelling but "feels" swollen. Does that make sense?

YES! For me it has to do with weather changes, hot or humid days, and sometimes doing too much with that arm/side. I have to keep switching around to stay on top of it, either just my WearEase cami, or add a Swell Spot or a chocolate bar (the hard foam kind, not the candy sort -- although a few dark-chocolate covered cherries don't hurt either, just not in the cami.)

Bleeeeeeeah!
Binney

olearca

Jo, glad to hear the "pain" is better.  It's funny that you posted about the swelling and pain and does it ever go away?  I had this new spot for the last 2 days.  couldn't see anything but could feel spongier spot and it hurt.  It was the soreness that kept me thinking it was back /side LE.  So, yes, I do think the LE can manifest as spots of soreness or pain.  Mine was just this spot of burning and "itching" even while I was just sitting.  The TENS sounds like it might be a good trick for you. 

carol57

I get a similar spongy, sore feeling sometimes, and it's always in an area under my armpit that does from time to time swell noticeably. It's never a sharp pain, so different from what some of you feel, but it's constant, persistant, nagging and when it happens, it really wears down my batteries. Sort of like the saying 'death by a thousand paper cuts' --it just wears away at my spirit. Putting on an UA or another compression type shirt helps, especially if I sleep in it, but I don't want to think about that solution now that hot weather is coming.  Olearca, did yours finally go away, and if so, how did you help to make that happen?

Carol

Anonymous

I get exactly how you describe, Carol. It does just wear you down. There have been a couple of times when it was bad enough that I took leftover pain meds because I just couldn't deal any longer. Compression, water, MLD, didn't help, so I might as well sleep! The pain med did help with the nagging pain, but I hate feeling stupid.

olearca

Death by a milllion paper cuts!!!  YES, that is a great way to describe the torture - it just slowly, ever so slowly wears you down.  Heck, I haven't even been at this nearly a year and I'm already so defeated sometimes.  The sore area is in the similar spot you describe, Tina and Carol and my newest trick is the following.  I went to Home depot to look for a paint roller and I found these little ones.  The roller is a really soft material and its about the diameter of a quarter or half dollar and it's about 2-3 inches long.  I am not good yet at MLD - I go too fast and either too firm or too swipey (is that a word).....so I got this little roller and I use it to roll the spot - just like MLD but not using my own hand but the roller.  It is very light, I can adjust the pressure and it is actually soothing - I can also reach better under my arm and round my back.  (I know Binney mentioned the paint rollers before).  It may be that it's all in my head, but I do feel like it's helping.  I just gently roll the area, and make my way from inguinal to under arm to shoulder etc. - whatever the path you do MLD is.  I also did use my own fingers last night to palpate a small area under my arm - sort of where the bra strap is - and I could massage into the rib cage - the intercostal area.  Just gently pulsing my fingers into the area.  For me, the frustrating part is this is supposed to be my non_LE side but I think from sleeping on this side, I collect fluid at night there.  I just can't sleep on my back and I have broken the LE side sleeping habit.  I don't know if a little roller will help you or not, but it's my newest tool in the box.

I really think a compression suit is the way to go.  Just compression from neck to toes.  I am seriously going to try out for superhero next time there's an opening.

Catherine

Anonymous

Catherine, I really should try the paint roller. I remember hearing about this. I need all the tools I can get, and this one is affordable!




When I first started doing MLD and had my implants, the side area under my arm was hard for me to do because it felt so weird that it made me want to throw up. I can't explain it. When therapist did MLD, I could handle it, but touching it myself and the weird numb feeling felt dreadful. Fortunately, with the implants out, I no longer have that feeling. No numbness. Anyway, I also had trouble in the winter not being able to get a stretch to the skin because my hand would slide. I have these large orange foam inserts for the side of my trunk and I tested using a corner to do MLD, and it felt good. I told my therapist and she cut me a square piece the size of a large bar of soap, and it worked really well. Lightly gripped the skin, so no more sliding, and the size of it kept me from pressing too hard or being aggressive. It also took away the feeling that made me want to throw up. I still use it for my back because it helps me reach a little, but I mostly like it because it reminds me not to press too hard and sloooooow down. It's great in winter when there's limited tackiness to your hand and fingers. My therapist said it was a great idea. We should patent a Welcome to LEville basket with paint roller, small orange foam square, an exercise ball, green Hulk compression suit . . Let's see, what else?