Physiotherapy for Cancer patients is a relatively new thing here in Vietnam, and I was very fortunate to be introduced to Dr Huong, the doctor in charge of the Physio Department in K Hospital. Yesterday afternoon, we met to discuss ways in which we could work together to introduce massage into his patients’ care.
The majority of Dr Huong’s patients have had treatment for Breast Cancer, including surgery, Chemo, Radiation and Lymph Node Removal. As a result, many have developed Lymphoedema in the arm of the affected side, and this is what Dr Huong and his team are trying to address. The equipment in the department is very basic and it soon became clear over the course of our discussion that the knowledge of how to manage, reduce and treat the symptoms of this condition was also very limited.
Lympoedema is a difficult condition to manage, with treatment to reduce symptoms including specialised massage called Manual Lymphatic Drainage and use of compression garments. The patient must also be educated in managing their symptoms and avoid activities and conditions that aggravate them, such as extreme heat and cold, over-exercising the affected limb and being especially careful to avoid infection from things such as cuts, grazes and insect bites.
Manual Lymphatic Drainage Massage requires specialist training and is not something I have experience of, but it soon became clear to me that there is plenty I can do to help educate both staff and patients in the basics of self care and management. The affected area itself cannot be massaged, but there is so much that can be done massage-wise within the scope of my own experience and this is what I hope to pass on to the staff.
I spent this morning in the department with Dr Huong and one of the nurses, Luan. Dr Huong was keen that Luan learns some massage techiques and I can honestly say that she was a natural and a very easy student to teach! Our patients, My and Thu, had both had surgery, Chemo and Radiotherapy for Breast Cancer and had Lympoedema in the arm of their affected side. Using a basic self massage guide that I had from a Lymphoedema information booklet produced by Macmillan, Ha and I practised the techniques together and showed the patients how they can massage themselves to help relieve their symptoms. Initially shy and nervous, both Luan and the patients soon relaxed and we all had a good laugh when Dr Huong started to nod off as he watched us work!
Word soon spread and other members of the department’s staff kept popping in to take a look-it looks like we will have plenty of eager pupils over the next few days! As well as the self massage, Luan and I also practised some of the techniques from Touch, Caring and Cancer for the hands, neck, back, shoulders and feet. When Thu’s husband came to collect her, she told him to go away and come back later so she could have her feet massaged for longer!
I must admit that I had a moment of panic yesterday and felt completely overwhelmed by the task in hand. The conditions in K hospital are crowded, the facilities and equipment limited and the resources for furthering education lacking due to financial limitations. What we do have by the bucket-load though is enthusiasm and unwavering dedication from the staff. The change in atmosphere in the room during the two hours we spent working together was quite striking. Both patients and staff smiling, laughing and relaxed by the time we said goodbye.
Dr Huong has his patients best interests at heart and desperately wants to improve the care that he and his staff can deliver. What they lack in materiel resources they more than make up for in compassion, dedication, enthusiasm and a hunger to learn. This is what we need to harness over the next two weeks.
Bring it on!