Physio-therap-me!

You will be pleased to hear I'm going to stop writing miserable posts for a while. Post-Christmas has been hard for all the reasons I moaned about earlier but I've taken control and been feeling better for it. It all started last Friday with my Physiotherapy session.

I've really been looking forward to my Physiotherapy as I was hoping for acupuncture to help with my rash. Sadly this was not to be.

My immune system is too suppressed for that at the moment. I also couldn't have extensive massage or manipulation of my muscles as I am 'too fragile.' Me, fragile? Not a word I would have used for myself, (especially not with the extra weight gain, ha ha) so I was surprised to emerge with some simple exercises to help stretch my back, stretch my arm and improve my posture.

And that was it.

The thing about Physio is it's a little at a time. Considering I'm normally used to pounding the pavement, lying on my stomach and squeezing a cushion between my knees feels a bit pathetic. But, I am a trooper. So the last few days I've been squeezing away as though my life depends on it.

My life may not depend on it but my posture does! I was told my posture is 'poor.' This horrified me as I've always been proud of my deportment. I've gone from finishing school to slouching like a sulky teenager at school. It has to change if I am ever to sashay in my shoeboots again.

My Physio realigned my back as my pelvis was slightly tilted and demonstrated how to sit correctly. It feels nice to sit up straight but it feels very strange. I've really had to catch myself during the day and pull up my spine and relax my shoulder blades. It's been five days and what a difference! Already it is becoming more natural as I make a conscious effort in the car, in front of the TV (sometimes!) and when I'm walking along.

As for walking...I took the Physio's advice and have also started walking for half an hour a day. I am desperate to go back to running, (I envision running 5k, 10k, a half-marathon for the Katie Piper Foundation) but I have realised this is a pipe dream at the moment and as the old adage says...I need to walk before I can run.

The physio also recommended some holistic therapies such as Reflexology and Reiki to help relax me. I'm looking forward to those!

So well done me. Now I'm going to sit up straight, squeeze those knees....and have a glass of wine.

Massage - My experience on how to do it and what to use

Massage is really important to your recovery.

Massage helps rebuild the collagen in the skin, breaking down tough fibres. It also stimulates new tissue growth. Massage is important to decrease sensitivity in the tissue and stimulate damaged nerves. It also reduces pain and tightness in the scar. Scar massage will increase circulation in the area.

Dedicated scar massage will help the healing process in the scar and also help it to fade. There should be less redness and swelling. Massaging the scar reduces the chance of it contracting.

When I first had the bandages off my skin graft, I was horrified that I had to massage it. The procedure had only been done 7 days ago but the nurses pronounced it 'taken' and ready to massage. It looked like a shark bite and I felt a horrible sensation when it was touched. I was told that I needed to massage it four times a day. I was really nervous of doing this. I was told to use whatever cream I preferred as long as it was gentle or non-perfumed.

At first I cried every time I touched it. I really hated it. Mum and I took to calling it my 'pretty' skin graft and my 'clever' skin graft and tried to stroke it with love. After all, it had repaired painful and dangerous wounds on my arm.

I started off using E45 to massage my arm but I found it dried and left a white emulsion over my skin. I switched to Aqueous cream because of this, as it was little lighter it didn't leave the same residue. After about 4 weeks, once the skin had healed more and the stitches had come out, I switched to Bio-Oil.

My skin has changed colour rapidly. I don't know if this is because of the Bio-oil, the surgeon's skill or the dedication to massage early on. Some of the skin has already changed back to normal colour! Now I am in the compression vest flattening down the scars too, I am hoping it is going to look excellent in another 3 months.

I have lost the feeling in my arm in several large patches, due to nerve damage. All I have been able to feel is occasional stabbing, needling pains in my arm and mostly in my shoulder. However, recently, I have felt sensation in my grafts! I am hoping this is due to the massaging and that it means my nerves are growing back. My boyfriend is going to massage my grafts too shortly, to help me work out what I can feel and hopefully stimulate the nerves further. It might even be relaxing....we will see!

Obviously, everyone will be told how to massage their own injuries by their physio. Here are some things I have only recently discovered. Find somewhere warm if possible and keep as warm as possible overall. Your body has so much work to do healing you; you don't want to give it extra work, such as keeping you warm.

1. The massage must be firm. I didn't realise this to begin with and simply massaged the skin at top surface level. Your fingers should push very firmly on the skin and move in small circular movements. This will have the best results. Afterwards, you do feel better and more able to move!

2. Stretch! As my skin grafts are on my arm and shoulder, the physio had me lie on the bed with my arm stretched out whilst massaging. This helps keep the movement and helps keep the skin limber. It also meant the contracted tissue and scars were stretched out and then massaged at stretching point.

3. Don't rush it. This is a difficult one but I do try not to rush my massaging. I don't spend a really long time doing it, about 5-8 minutes a time but I do try to stretch it out at other times during the day. I would suggest that you do it as long as it feels ok. If it feels sensitive or sore then stop.

4. Blistering, spots and skin breakdown The physio said that I might experience blistering, spots or skin breakdown (i.e. small sores) If this happens, then I should just be gentle on that area. She said it might breakdown because of the firm massaging but that the massaging is more important.

It is so BORING massaging. I really find it a chore. Part of this is because the weather has turned cold and I hate taking off my clothes to do it. However, I know that it needs to be done if I want good results. If, like me, you are struggling with the commitment, think long term. I want to get as close to my pre-accident arm as possible with just a few scars for character.

Massage can also be used to treat pain and stress. It is worth looking into having a massage elsewhere on your body to help relax you and increase your well-being. When in hospital, my Mum gave me a foot massage twice a day and it was lovely to be touched and feel my body as a source of pleasure rather than the pain I was predominantly feeling. I am going to look into reflexology now I am home.

Further information can be read at this discussion forum http://www.katiepiperfoundation.org.uk/forum/#/discussion/44/creams-for-scars-and-burns

http://www.bio-oil.com/en-us/

Compression garments

The discovery

I had a couple of weeks where every time I went to the hospital, the nurse got out what I referred to as her list of doom. 'You need skin grafts now.' Boom! Number one on the list of doom. 'This will really hurt.' Boom! 'Afterwards we will measure you for your compression garment.'

I had no idea what this compression garment was, as no one had mentioned it yet. So I regarded the child-size one she brought out to show me with something akin to aloofness. What did this have to do with me?

As she began to explain the purpose of the compression vest, it began to sink in.

It's my exact measurements.
It's tight.
Really tight.
I have to wear it for 23 hours a day.
I have to wear it for up to 2 years. When I will be nearly 30 years old.

It has a little collar.

Did I mention...it's really, really tight?

The reality

Here is my compression vest.



It's taken me a long time to get around to wearing it as I've had a rash around my grafts for 2 months. Nothing has worked on it so I'm going to try acupuncture in the next few weeks. Eventually, the physio told me that not wearing the vest was going to be detrimental to my scarring, so I am wearing it and hoping it doesn't make the rash worse.

Actually, it's not that bad.

It's been 3 days so far and this is what I've decided.

It's not that visible under clothes really. In fact, it's more cosmetically acceptable than my red chest and neck.

My grafts feel quite 'safe' under it. Less vulnerable.

It is coming up to winter and I'm always cold anyway!

It is really tight once you put it back on but you do get used to it. It never gets comfortable but you adjust to tune it out.

I can take it off for special events or nights out if need be, as long as I put it back on to sleep in.

When I take it off to massage I can already feel the grafts and scarring flattening out. I am seriously pleased about this!

Everyone who I care about seems to accept it.

And the only true positive thing about it is....I can wear a proper bra over it!!!! I have had to wear strapless ones for three months as the straps seriously chafe my skin. All of a sudden I have a bust back in the place a bust should be and not halfway down my waist!

If you have to wear a compression vest, it is a horrible thing to be told. It is not sexy or glamourous and 2 years is a long time. But I promise you, if I can already feel the flattening in 3 days, it will be worth it in the long run.

I am aware that people reading this might have to wear facial compression masks or full body garments and might be thinking 'oh dear, this girl has no idea' but I can only face my own battle. I did see these type of compression garments when I was doing my research and I am aware of how lucky I am, lucky that mine is not visible under my clothes. I wish you all well. I think of Katie Piper, she was the model of patience and dignity when faced with her treatments. She looks amazing now thanks to her perseverance.