over the weekend, i noticed that the slight pain on the top of my hand was getting worse, and also that there appeared to be some swelling. by sunday, i could barely see my tendons at all when flexing my hand out. not a good sign for someone who has had lymph nodes removed -- lymphedema is a condition which can become irreversible if not monitored and treated when symptoms show up. basically, fluid (lymph) filled with infection-fighting white blood cells runs through your lymphatic system, and lymph nodes act as a filter to get rid of bacteria and waste before the fluid returns to your bloodstream. however, when lymph nodes are removed (six for me), the process can get screwed up in that area of the body, and the node-less section of the system can get overwhelmed. excess protein-rich fluid can start leaking out into nearby tissues and areas around the tissues, causing swelling (lymphedema). no bueno.

physical therapy was already scheduled for monday afternoon, so i was happy to be able to address all of this at the start of the week. first things first though: back to radiation on monday morning, then another hybrid ipad/in-person meeting with dr. d. she examines my skin and says that i was about where she expects me to be, regarding redness and tightness. "so i'm average, huh?" "yes! but average is good. we don't want unexpected things." she suggests getting some hydrocortisone, even though i wasn't experiencing any itching... but i assume she has seen this a million times before, so i heed her advice. from there, another quick lunch (this time, i order ahead and have a chopped brisket slider and mac and cheese from dickey's barbecue pit -- pretty good, and a welcome change to mcdonalds. still have to eat it in my car in the physical therapy parking lot, like a hungry squirrel). as i walk into the main room with the physical therapist, towards the arm bike, i hold out both of my hands to display my tendons and/or visual lack thereof. her eyes get wide. "ooooh, you're getting swelling? well... let's get you measured." we head right into the exam room, she measures little pen marks every 4cm from my hand to my shoulder, and she measures the circumference of my hand/wrist/arm at each mark, just as she did in late february to get the original baseline measurements. as it turns out, not just my hand, but on average my whole arm is at least 0.5cm larger than normal. the increase is enough for her to scrounge around in the cabinets to find a compression sleeve and glove for me to borrow and wear during the day. she shows me how to put them on (the process is slightly painful where the cording is), and how using a kitchen glove on the other hand provides juuust the right amount of friction to help get them into place. hopefully the swelling is just my body's response to radiation, but for now, physical therapy sessions will transition into lymphedema therapy sessions. i discuss my continual cording issues, and how i was showing andy the other day where the cords were. she mentions that because the radiation redness is now in my armpit area, i could no longer be pressing around in there to try and loosen the cords. "but whyyy?" "wellll... because the radiation." "fiiine." the rest of the appointment is spent helping me get my arm more stretched out (i couldn't fully extend my arm straight at the beginning of the appointment), and getting measurements for different brands of compression garments. so instead of having my usual chilling out on the couch monday evening, it is mostly spent researching and ordering a compression sleeve and gauntlet (like a glove, but without fingers). fun times in Cancer Land.

tuesday: radiation. cinco de mayo. fajitas!

being busy on wednesday is evidently the new tradition. radiation: check. panda express, scarfed down in my car, in a parking lot: check. pick up exemestane prescription and hydrocortisone: check. grocery errands: check. physical therapy: check. today is arm bike, pulley stretches, then into the exam room. compression garments off, then onto the table for some light lymphatic massage. excess lymph fluid is just under the skin, not very deep, so the pressure is very light. the lymph needs to be drained from my arm towards my trunk, so there were lots of repeated gentle strokes in different areas (neck, chest, back, belly, arm) and in a specific order, so as to clear the lymph vessels in other areas of the body, before encouraging the lymphatic fluid from my left arm to head on over that way. i am clearly not a therapist, but that's the general idea. i find it funny that i have a participatory role at one point, and what i have to do is... take deep breaths. guys, i am becoming an EXPERT at breathing during medical appointments. i am now on a schedule to meet with her every monday and wednesday, and i admit that i am, and actually have been for some time, quite thankful for the forced work from home situation we are in right now (though not thankful for the pandemic driving it). having to park (and pay) and re-park (and re-pay) in the work parking garage for all these appointments would have driven me into a rage by now.

thursday: radiation. also, my compression garments arrive in the mail:

on friday, i get to show off my new cyborg sleeve. honestly, i thought more people would have seen custom compression sleeves in the radiation oncology department? but apparently i am cutting edge. or they were feigning surprise. either way, i figure if i am going to have to wear one every day for awhile, it might as well be awesome. i find the gauntlet to be sort of fussy, and it kind of squishes my pinky finger, so i will likely order a glove and see if that fits better. it makes things a little tricky with typing, and with all the constant hand washing nowadays, but we will see.

today and yesterday has been a lot of puttering and doing little tasks. researching and ordering things online, clearing items off my laptop, laundry, replying to emails, etc. happy to stay inside with the beautiful-looking but quite cold weather. we ordered some chinese takeout on saturday and have been working on little projects and playing board games. Week 37 is over, and i am halfway done with radiation -- three more weeks to go with The Baconator. i am getting pretty red, so i'm interested to see how toasty i end up... not that i have much of a choice. let's do this.