Hi everyone,

Glad to find a group that has been through the same stuff as me. We all need as much support as possible.

Had my right neck dissection two weeks ago and it's not too bad with the exception of pain in my right arm and shoulder. Doing some arm rotations and am told it is temporary.

The worst was having a 2x3cm mass taken off the base of my tongue. He went another layer deeper to make sure so I'm not really sure how much he took off. He did use the TORS so I feel lucky for that. It was the worst pain I've ever had in my life. Couldn't swallow for two weeks and thought I'd never be able to eat again. I still choke but it is improving.

I will start low dose RT in a few weeks so hopefully it won't return. The reason for low dose is that my tumors were clearly defined and low grade. Why it spread is a mystery.

Tom

Welcome to OCF, Tom! Glad you have found the best forum for oral cancer patients and caregivers. Im sure you will find support to help you thru the rest of your treatments.

As far as your arm and shoulder, do you see a physical therapist? That would be very helpful in getting your range of motion back. The sooner you start, the better your results will be.

You know Christine, I asked that very question to my surgeon a few days ago and didn't really get an answer. He did say my range of motion was good so he wasn't worried. And to tell the truth I can't afford another co-payment for treatment unless it is absolutely necessary. I do a series of exercises daily to keep it flexible and hope that is enough. I'll ask my RT Oncologist what he thinks next time I go in.

Tom

I wouldnt expect your surgeon or RO to be able to give you the best info about exercises. Seems like all doctors are specialists in their own field and know very little about anything else. In my opinion, it would be alot easier to see the therapist now while they are better able to help your situation. Ive learned this the hard way, putting things off doesnt help. Waiting only makes things harder to correct.

Check here on the forum, I think I listed a how to of physio for neck and shoulder. And welcome!!!

Hi, Tom.
I am an orthopedic physical therapist and also a patient/survivor that had/has neck issues. After a neck dissection, your soft tissue anatomy is never quite the same. When you have soft tissue changes (muscle, tendon, fascia, ligaments, etc.), the joints stiffen up as well. You can also have referred pain from your cervical spinal nerves as well as your spinal accessory nerve, which must be physically moved out of the way during your neck dissection. Nerves are highly sensitive and they tend to hold a grudge when mess with them, no matter how gently.

Personally, I went to PT when I was about 2 months out of surgery. It's important to allow time for healing of the tissues before you start PT. In that time, one can certainly develop secondary issues, though. The swelling in the area can also contribute to the radicular pain (radiating pain in neck and shoulder). Since the pain is originating from your neck, doing the arm rotations will not do much. Be easy on yourself because you are so early into your recover. It's good to keep moving and to gently stretch, but nothing even close to vigorous. You could cause complications with your neck dissection that will only prolong your recovery. I would suggest GENTLE neck range of motion exercises. I can send you a PM with some exercises if you'd like.

I hear ya about the copays. Since I worked at the PT clinic where I got my therapy, they didn't charge me a copay, so I was lucky. After you're about 8 weeks out and your doctor is okay with it, you may want to go for a PT consultation only and tell them when you book the appointment that you specifically want to learn a home exercise program and cannot commit to a full course of PT. It helps the PT to know this ahead of time. It may take 1-2 visits to get it right.

I hope this helps and that your pain subsides quickly.

Take care,
Kerri

Thanks Kerri,

I will take your advice and give it another 4 weeks until I seek out a PT. It's great someone here knows their stuff.

Ten years ago I had shoulder surgery called a Labral Decompression with Mumford. Back then it was crucial to keep your arm moving or it would atrophy. So now with this surgery it feels almost the same and that is why I am moving it a lot. I will slow it down and seek professional help before hurting myself.

Feel free to PM me with exercises if you think it will help.

And Thanks a lot for the information.

Tom

Sure thing, Tom. I am going to work tomorrow night and will get pics/instructions of the exercises to try. I can't email them directly from the exercise software program that we use at work, but I can print them out and scan them into my computer at home, then email them to you. I will send them to your private email if you don't mind because I I don't thing the PMs in this forum will support those kind of file attachments, but who knows.

Oh, and don't get me wrong...gentle shoulder ROM exercises are fine if you feel like your shoulder is stiffening up. I'm just not convinced it will do anything to ease your pain, but it will be good to keep the region loose, especially if it's on the same side as your previous shoulder surgery.

Take care and I'll be in touch in a couple of days. I won't get home from work until late tomorrow night, so I will do my best to get the exercises to you by Tues/Weds.

Thanks Kerri, you are going above and beyond. You rock!

Tom

Hi, Tom.

I'm sorry I'm getting back to you a couple of days later than I had promised. I thought of a better idea than to cut & paste pictures/captions of exercises. I did a youtube search and found these videos which are wonderful. In fact, I am going to make a handout with these links to give to my neck patients. He basically explains everything very well and uses all the techniques/educational components that I use every day.

I'm not sure of his credentials, but it sounds like he is a physical therapist. He is explaining The McKenzie Method, which is highly effective in treating spinal problems. It's especially helpful in that it teaches the patient how to treat themselves, which is exactly what we need to do to keep pain at bay for a lifetime. Even though he is talking about herniated disks/pinched nerves, etc., don't get hung up on the diagnoses. The techniques should work for you if you do them as prescribed. If they don't, please let me know ASAP. This works on the vast majority of patients, but remember that you had major surgery to the soft tissues around your spine and spinal nerves. You have to be VERY GENTLE! Your body needs to form scar tissue and let the tissues heal/sutures to hold, etc. Early mobilization/stretching is good, with caution. Discomfort (mild) with the stretching/range of motion is expected, but pain is a signal to stop. I would advise you to keep icing as well. Ten to fifteen minutes every couple of hours as needed. You have to let the blood flow back into the area for nutrition/oxygenation, so if you keep ice on it constantly, you will deprive the tissues of these things. Also, if the ice pack becomes room temp or warm, you are actually now heating the swollen area by keeping it on too long, which you don't want to do in the case of swelling.

Enough of my blabbing. Here are the youtube links. If they don't work for you for any reason, either technical or by your learning style, let me know and I will make adjustments. He has about 36 videos in his series. I tried to put them in an order that made sense. Let me know how it goes. Best of luck and I'd be more than happy to answer any questions!

Be well,
Kerri

http://www.youtube.com/watch?v=Z9lp...p;list=ULwQ8Rz5uHoA4&lf=mfu_in_order (Step 1)

http://www.youtube.com/watch?v=ZQes...p;list=ULZ9lpe4a0a3c&lf=mfu_in_order (Step 2)

http://www.youtube.com/watch?v=wQ8R...p;list=ULZQes2ijwcKY&lf=mfu_in_order (Step 3)

http://www.youtube.com/watch?v=CMuJ...p;list=ULwQ8Rz5uHoA4&lf=mfu_in_order (Step 4)

Thanks again Ms. Kerri,

I did some housework yesterday and am now paying for it. Just vacuuming and mopping the floors but now my arm hurts.

Called my GP and set an appt for next Monday. I will ask him for a script for PT and see how that goes.

Tom