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Cording that just wont go away: A new telehealth service may help

Only weeks after breast cancer surgery, a woman noticed tight bands extending into her arm which were so painful it made raising her arm impossible. She was directed to attend the local lymphoedema therapy service for assessment and treatment. The therapist realized the problem as cording, which is different to lymphoedema. Unfortunately the therapist was not trained in this area of care and could not offer treatment specifically for the cording. The client went to the internet and found another lymphoedema therapist in a town 27 kms away. After several treatment sessions of arm stretches and massage, the tightness in the arm and the pain was still not changing.

“Are they missing something?”

Cording may be difficult to see but it stops you from raising your arm and you wil lfeel pain into the arm.

After the next internet search for cording treatment, I was contacted by email. The breast cancer survivor explained her problem: she had already returned to her work as an accountant and she lived 5,000km away - so travel and time off was difficult to arrange. We decided that a telehealth appointment was worth trying, even though breast cancer cording required hands on treatment.

To assess the severity of the problems, I needed the woman to show me her mastectomy. Then to bring about changes in pain, I needed to show her how and where to apply a very specific massage treatment. The patient needed to do the treatment for herself, every day for several weeks.

Not only did I need to provide good clear and effective instructions- but we needed good internet speed, clear video and audio and the highest priority being to ensure online privacy. The importance of these technical features has been recognized: Becon Health, a new Australian business, now offers a telehealth platform for Australian health professionals and health consumers.

By the end of our first telehealth session the woman learnt to successfully touch and treat her mastectomy scar and cording- this was a nice achievement. A review date was set and a follow up email reminder of the home treatment program was sent.  

“This is very different treatment.  I could do it myself and I could tell it was working."

The added benefit of an in- home telehealth appointment was the husband was able to attend the first telehealth session. He did really well at touching his wife’s mastectomy scar for the very first time. However at one moment he did go very pale and looked like he was going to feint. So I sent him off  to go make his wife a cup of tea, while we finished off our telehealth session.

This is not an uncommon response for both survivors and their partners. Training to achieve safe, comfortable and even intimate touch is a great goal for telehealth appointments.  

“I am not frightened of touching my chest now- I especially love using the cupping device you posted to me”

Pain management for breast cancer survivors is complex and relies on the experience and skills of the health professional. Telehealth offers an economical and stress-less way of connecting breast cancer survivors to experienced practitioners. 

"I love providing telehealth services to people who want to take charge of their recovery after breast cancer. Providing personalized interventions and training in self- management is exciting and rewarding.

Seeing a happy face and hearing a positive voice is such a great sign that they have found solutions that work for them." ( Denise Stewart)

If you do not have access to a therapist in your town who has training in treatment of cording and you have a mindset positive to self -treatment , then consider a telehealth consult.

Connect with Denise Stewart at Becon Health to make your private and confidential telehealth appointment .

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