Lymphedema Therapy in D.C.

May 11, 2010

Looking for a lymphedema therapist or physical therapist in Washington, D.C. or the surrounding area?  I’ve seen a BUNCH of them, and these are my absolute favorite physical therapists who I would recommend to any breast cancer survivor (or new mom, cough cough) in Maryland, Northern Virginia, or Washington, D.C.

Bretta FabianBretta Fabian. Bretta is my all-time favorite physical therapist.  Her years of training and experience have helped her get directly to the root of the problem and know exactly what to do to help get the body back working the way it should be.  Over the years, Bretta has eased the swelling in my arms, taught me manual lymph drainage techniques, stretched the cords of scar tissue running up and down my arms until they gently release (important both for lymph drainage and mobility), manipulated scar tissue on my chest (to relieve pain and unbind the muscles), put my back back in joint, and realigned my pelvis after childbirth (ooh, that was embarrasing to type. But if you’ve ever had that pain, you need to know there’s help out there, and it may only take one visit).  Bretta is affiliated with the George Washington University Medical Center and works closely with their surgeons.  The only drawback is that her practice does not take insurance or medicare, so you’re on your own.  Bretta is at the Center for Wellness Solutions, 202-862-0770.

Vicki and Janice at The Adventist Rehabilitation Hospital of Maryland.  Adventist Rehab has five lymphedema specialists.  I have been very happy with and can highly recommend Vicki, who trained under the founder of the Norton School of Lymphatic Therapy.  Vicki helped me understand how the lymph system works, both verbally and by referencing the instructive posters that surround the treatment area.  Vicki is a master at lymphedema wrapping, has instructed both my husband and me in manual lymph drainage techniques, and has a cheerful, supportive demeanor in all that she does.  Vicki is creative and helped me find lymphedema wrapping materials when I was allergic to everything she’d worked with before.  She also returns phone calls from current patients and aids in ordering lymphedema sleeves, gloves, and nightwear garments.  Adventist Rehab also has a half-dozen or more physical therapists at each site who are highly skilled in a number of different hands-on and rehabilitative therapy techniques.  Janice in particular is a real treasure for hands-on work including scar tissue manipulation, muscle-energy techniques, and rehab to restore everyday function.  (Both Vicki and Janice are referred to here by first name only, as they don’t have a web presence of their own.)  Adventist accepts many forms of insurance with a physician’s referral.  240-864-6200.

Katina Marinos, MPT, is the chief physical therapist at a small practice in Rockville called Manual and Sports Therapy.  Her specialties, as you may be able to tell from the name, are manual work and sports medicine, although she worked for years with an orthopedic medicine group and has an exhaustive knowledge of the interplay between the bones and muscles, making treatment comprehensive and effective.  Katina is a physical therapist who can take you from couch to marathon, as both she and her almost 70-year old father have run marathons in the past few years; she trains people of all ages and abilities to run well and without injury.  This family-run, woman-owned business is a comforting, encouraging place to heal, and Katina has been able to work wonders realigning my bones, neck to legs in the past few years.  If your bones or muscles hurt, she’s absolutely wonderful.  Katina accepts some insurance with a referral.  301-770-1613.

I’ve seen at least five other physical therapists around the area in the past three years, in a quest to find one to relieve the pain AND take my insurance, but these are my absolute favorites and it’s not fair to keep them to myself any longer.  If you live outside the D.C. area, to find a lymphedema therapist, check out the National Lymphedema Network.  If you need help affording lymphedema sleeves, gloves, and/or gauntlets, try the Marilyn Westbrook Garment Fund.  If you think that insurance should cover these garments that cost $100-$1000 each that are necessary for breast cancer survivors and other edema suffers, please let your Congresspersons know that you support H.R. 4662, the Lymphedema Diagnosis and Treatment Cost Saving Act of 2010, introduced February 23 by Congressman Larry Kissell (NC-8) and now cosponsored by Congressman Ron Paul (TX-14).

Two steps forward, one step back

November 15, 2008

Two steps forward, one step back.  Something happened last weekend to my back, and I couldn’t figure out why I was in such pain.  Bretta’s diagnosis helped, but when I went to the doctor and PT later in the week, they both blanched at the report that I had 3 ribs and 5 vertebrae out of place.  The PT refused to treat me, sending me to another PT, a specialist.  The doctor, well, let’s listen in on part of the conversation that she and I had when I went in on Thursday.

Me: I’ve just finished a year of treatment for Stage III cancer, and I seem to be having some side effects.

Dr.: Okay.  What kind of side effects?

Me: Well, the right side of my back hurts a lot.  My lymphedema therapist thinks that the muscle underneath my arm was fried a bit by the radiation, and it’s pulling across my back and pulling the ribs out from under my spine.  After months of trying to figure it out, we think that’s what’s happening.  I need a treatment plan.

Dr: A treatment plan?

Me: Yes.  I need a referral to a PT in my health insurance plan who can help me with the muscle, to my radiation oncologist for my 6 month checkup, and to a specialist who can help me with the pain.

Dr: We’ll see about that.  I’m not giving you anything until I examine you.

Me (meekly): Okay.

Dr: Take your shirt off.

Me (doing it): Okay.

The doctor brusquely makes a note in my chart and turns away to check something.  When she turns back around, I’m naked from the waist up, all scars and burns and lumps in strange places.

She blanches.

Without touching me, she looks for just a minute, and then says, “Okay.  Now let’s get you those referrals.”


I walked out of there 15 minutes later with 3 referrals and a promise to help me get the lymphedema treatment covered too.

I’ve never been so relieved to be so visibly damaged.

An answer to my back pain

November 12, 2008

Bretta is a genius.  Not only does she drain the lymph that clogs my right arm as a result of my mastectomy, but she finds answers to my other aches and pains.  Yesterday, she discovered what’s been causing the incredible pain under my right shoulder blade.  The PT out here didn’t.  He stretched the muscle for 8 sessions, but never found the cause.  She took about 5 minutes to figure it out.

Get this.

Last spring’s radiation damaged the muscle under my arm.  Which pulls on the muscle across my back under my shoulder blade.  And pulls my vertebrae out from under my spine.  Which hurts like hell.


An answer to the pulled-out vertebrae (which she put back in quickly and painlessly), the back pain, the neck stiffness, and the tenderness on that side under my arm that has lingered for months.

I go back tomorrow to have the muscle worked on — and hopefully the pain fixed.

Seriously.  I think this woman is a genius, and a great person too — she’s working on a program to bring lymphedema therapy to breast cancer patients in Egypt!

If you’re a breast cancer patient with a mastectomy and haven’t seen a lymphedema therapist yet — go.  It’s worth every penny and every second of your time.  And you never know what else she might be able to fix!

A wii bit of physical therapy

August 17, 2008

I’m all about technology.

You know that during my cancer battle, I blogged almost every day, to keep in touch with friends and family, and to keep my spirits up. You all were my daily compatriots during my cancer fight, and I couldn’t have done it without you.

With a borrowed blackberry (and a whole lot of pain medication), I twittered my mastectomy.

With the help of some new friends, I traveled to BlogHer 07 in Second Life, since in real life I was stuck in bed.

But get this. I’ve found a way to incorporate new technology into my physical rehab during my recovery as well.

As you may remember, I now have lymphedema in my right arm (thanks, mastectomy!). That means that the arm and hand swell up frequently, sometimes to the point where I can’t use my hand or bend my wrist or elbow easily. I have to do special exercises every day (wall crawl, anyone?), manually move my lymph around, and see my lymphedema physical therapist a couple times a month to get the scar tissue stretched out and the lymph moved through the scars and back into my torso.

I also wear a lymphedema sleeve, which makes it look like I have a disability. But I’m okay with that … now. Because, really? Sometimes I do. When my lymphedema flares up, I can’t carry my laptop or bag on that arm or hand — and really, I’m not supposed to at any time, to prevent flareups. I can’t carry too much weight in my left hand, either, then, since that throws my back off-kilter. Lovely, eh?

It also makes it hard to open heavy automatic doors sometimes, to pick up my kids, to carry the laundry basket downstairs, and to do some of the other things I really need to do every day.  Oh, and it hurts to shake hands if my hand is swollen.  (I’m the dork waving hi to you from two feet away, desperately hoping that we can hug or skip the handshake.)

But I’m adapting.

I’m learning to do most of the household chores and play left-handed. I’ve got most of them down by now, however rough and awkward they may be. (Note to self: only attempt to pitch wiffle balls to preschooler when baby is out of range.  Far out of range.)

This weekend, though, I discovered a new tool. I bought my husband a wii for his birthday (Happy Birthday, honey!), and, you know what? I use it now too. I play the games left-handed, to strengthen the muscles and hone the use of my left hand and arm. At first, it was more frustrating than not, but I’m getting better.

And that means I’m getting better at using my left arm offline as well.

All I needed was a wii bit of physical therapy.