OCCUPATIONAL THERAPY SERVICES FOR PATIENTS BEFORE AND AFTER BREAST SURGERY

BEFORE SURGERY
Patients should consult with an Occupational Therapist prior to surgery to prepare for potential post-operative complications including:

1. Possibility of a drain
2. Decreased sensation in the breast and arm
3. Decreased range of motion and/or pain in the arm

The therapist will explain the nature of each complication. The therapist will also demonstrate methods for minimizing the risk of Lymphedema, and exercises that will decrease pain and increase range of motion in the arm.

AFTER SURGERY
Patients experiencing post-operative complications may schedule an evaluation with the Occupational Therapist. The Therapist will evaluate:

1. Shoulder motion
2. Scar healing and movement
3. Pain and sensation
4. Skin condition
5. Risk of Lymphedema

Patients presenting with Lymphedema will receive Complete Decongestive Therapy (CDT). CDT treatment consists of:

1. Manual Lymphatic Drainage (special massage)
2. Compression Bandages and Sleeves
3. Infection Control and Skin Care
4. Personal Hygiene
5. Remedial Exercises

LYMPHEDEMA
Lymphedema may occur in patients who have had lymph nodes removed from their armpit (axillary dissection). Symptoms typically appear immediately after surgery, but may also surface years later.

Lymphedema is painless. Swelling in the arm may limit a patient's ability to move comfortably during functional activities.

Lymph nodes help fight infection. Once lymph nodes are removed, patients are at a higher risk for infection. It is important to take all precautions in avoiding cuts, burns, and injuries to the affected arm.

If you do encounter any of these be sure to clean the affected area with antiseptic and watch for further signs of infection. Signs of infection may include: redness, increase in temperature, pain, swelling, and/or flu-like symptoms. If you have any of these symptoms call your doctor immediately to receive an oral antibiotic, and avoid hospitalization.

Minimizing Risk of Lymphedema

1. Keep your arm moisturized to avoid dry cracked skin
2. Keep your arm and hands clean and avoid cuts, burns, or injuries when possible.
3. Avoid blood pressure cuffs, injections, and blood drawing from the affected arm.

To schedule an appointment, please contact the Rehabilitation Department at Beth Israel:

(212) 844-8750
(212) 844-8593

P.A.C.C. 10 Union Square East Suite 5N.

If you have any additional questions, please contact Stephanie Dessi. Ms. Dessi is an Occupational Therapist specializing in Lymphedema Therapy. Stephanie can be reached at: sdessi@chpnet.org