Hey PeteyB

Ya my Dad's shaving is pretty scary too. He nicks his chin all the time. His neck and chin are all bumpy; they said it's the folds in his skin.

He said his ears burn from the middle to the bottom.

What massage technique tips are you referring to? send me the link. Want to know how everyone else is massaging to make sure we are doing it right.

Thanks
LisaB

Hi All,
Just to add my two cents, I think the sooner you start the neck massage and drainage exercises, apparently the better luck you may have with it. I am 5 years out, still have the stiff neck, my PT says my neck is not yet stabilized, we are working on it but like he said, you were given one perfect neck. I have also been seeing a new lymphedema specialist teaching me manual exercises for the puffiness and swelling in my face and neck....Good Luck to All! Carol
Hi Petey!!!!!!!!!!!!!!!!!!!!!!!

Petey......neck and ear numbness.....and lip function.......ALL of these got better for me slowly. My lip won't make a perfect "O" but otherwise, it has gradually come back to normal. My ear drove me crazy with the numbness....felt like an elephant's ear, and actually hurt is a most bizarre way if it was touched. Then it began to improve, and it developed an itch that was the nerves regenerating, I guess........bothersome but much better than numbness. Now I realize....18 mo. out....that that itchy feeling is mostly gone too, and my ear is 98% normal. My ear felt clogged at first, and we thought I might have to get tubes put in, but with the use of Sudafed regularly.....and time....that resolved too.

So....be hopeful. In time, I guarantee that most of those things will improve for you.

.but probably you will still have to shave by color just to be on the safe side!

XO

Hi August,

you said quote: "My surg. told me fairly early after surgery...don't recall...maybe 6 weeks or so....that I'd better "massage the heck out of" my neck. He meant breaking up the scar tissue. Scar tissue doesn't stretch, so this sort of massage needs to be done as soon as possible after surgery, to keep it broken up as it heals".

Can you explain how he told you to massage? I'm interested in massaging for exactly this; loosening the skin.

(We'll see a lymphatic massage therapist to learn how to do that type of massage). I wonder what the diff is between the 2 types of massaging. Anyone know?

Thanks
LisaB

I've had two kinds of massage.

Lymphatic drainage massage is very gentle. It is not deep tissue massage but apparently it does help over time if you still have lymphedema in your face or neck.

But I think the massage you need to do to break up fibrosis in your muscles requires deeper (and more painful in my experience) massage.

This is making me realize I need to go back for more PT--my neck is getting really stiff again.

Nelie

Hi again and thanks.

For swelling; we are waitng to get in with one of the MLD therapist I've researched (not many here in TO).

For the scar hardening; we are massagiang it in circular motion; sometimes I use my knuckles and press firmly. We do this for about 15 mins 3 times a day. Does this sound about right?

He's doing his stretches. Some of you say physio should hurt. Did you do yours with a therapist and what did they have you doing to make it hurt?

This tight feeling around the neck is driving him crazy.

Thanks
LisaB

I did not have much instruction in how--or why--to massage. But I figured it out on my own. I didn't know enough to worry about lymphatic massage. I still have occasional mild puffiness on that side, but otherwise it takes care of itself in time. The massage I did was focused on the scar itself and on the skin of the neck flap.

The scar tissue on the scar itself ....on the surface of the neck...and in several deeper layers.....doesn't stretch. No scar tissue does. So, when it has healed enough, you need to massage it in any way you can.....circular, and along the line of the scar itself...with some sort of lubricant...some nice cream or oil....to keep that scar-line from healing into a tight strip of tissue that will always cause a feeling of pulling if left to heal without massage.

Also....the flap itself must heal. It must re-attatch itself to the underlying layers. You do want your dr.'s go-ahead before you do this, since you don't want to interrupt the early healing. I think of the healing of this sort of flap as beginning with tiny fibers that begin to knit together. If you don't move that tissue around, they will grow short, creating constriction and the feeling of having something tight around your neck. I worked hard to move that skin around, thinking about gently affecting its connection to the underlying tissues. I was leery at first, but I soon found that it was a good thing to do. It increased circulation, and it kept that skin free to move. I worked it over my jawbone too......I had no set routine. I rubbed the scar, to stretch it linearly, and I rubbed the skin of my neck in a circular motion, to free it from the underlying layers. I also did neck stretches, by stretching and pointing my chin to the sky, and I did jaw stretches, by opening and closing my jaw with my neck stretched high.

I did not do any deep massage. There is very little tissue left inside the neck, it seems, and the structures that I feel are the carotid and jugular vessels and the big tendons inside there. Of course, your neck has been "dissected," just like poking around in a frog in biology lab, and there is healing going on that is deep also, I suppose. I did not do anything that caused pain. Before you do that, I think that you need your doctor's go-ahead and some professional guidance about how to do it.

The goal of the massage as I see it is to stretch the surface scar, and to free the surface skin from the underlying layers so that it heals in a pliable fashion.

Perhaps the lymphatic massage requires more deep massage, and perhaps it causes some pain in the tender surgical area, but I would NOT think that ANYthing that causes pain would be recommended. Just MHO. Ask the dr. or the cancer therapist about this. ....Be sure it is someone who knows about neck dissections, and not just a routine therapist.

So....get some nice cream, and rub firmly along the scar....and rub the skin in a circular motion, visualizing gently refusing to allow it to get stuck down to the underlying tissue, and extending that rubbing and stretching over the jaw and even into the cheek area..why stop?? and then do chin stretches and neck turns to both sides.....do it whenever you think about it.

Thanks. Ok so that is pretty much what we are doing for the tightness.

I watched a video online about lymphatic massage and it shows very soft pressing; anyhow we'll leave the MLD massage to the professional to do.

Question; what is the flap?

Thanks again,
LisaB

A flap is a layer of tissue that is separated from its underlying connections, and its circulation and nerve supply. It is raised so that work can be done underneath, and it is laid back down on the surface for healing. It is like laying sod in your yard. If you don't prepare the underlying bed properly...or if you lay it (ie.) in the driveway where it can't be nourished and encouraged to grow, then it will die.

In a neck dissection, the skin of the neck is lifted from the underlying tissue and folded back. Then the surgeon works at dissecting the underlying tissues, getting out all of the lymph nodes that he can see. Most of them are along predictable pathways, though some might be hidden. This requires some "digging around." It also requires very careful identification of structures, such as blood vessels and important nerves. He can't just dive in and start cutting. It is a pretty slow process. when he has gotten all of the nodes out that he can find, and is satisfied that he hasn't cut something important, he lays the skin flap back down (and of course I don't know the procedure or the preparation) and stitches, glues, or staples the edges shut. Usually there is a drain placed, since the tissues will "weep" inside...serous fluid...and if this fluid is allowed to collect inside the area, it will provide a perfect medium for infection, and it will also possibly keep the skin layer from making good contact with the underlying tissues, thus causing tissue death......ie. death of the flap. That would then require removal of that skin, and a skin graft to cover that area.

This is why you should not begin any sort of massage of your neck until your doctor gives you the go-ahead. But there is a lot of healing that needs to go on inside and outside your neck, and that makes for a lot of potential stiffness from scar tissue.

Is this more than you wanted to know? probably!

XO

Thank you Colleen. I appreciate all the info. I guess our dr's never referred to it as flap before. This all makes sense. And yes we did get the go ahead from the surgeon to do massaging; both for the hardness and MLD.

I don't know if I should start a new threat or post this here. 'Tightness during/after eating' Do any of you notice that after you eat or while eating your throat gets tight?

LisaB
Happy Canada Day!