In March, 2010, I had a tongue resection for tongue cancer. Dr. Skorecki replaced the removed part with a flap from my upper thigh. My speech fluency deteriorates a little as the day goes on. Bart Smith, of speech therapy, suggested trying a massage regimen on the flap using rubber gloves.
Personally, I think this is useless, and can detect no improvement after doing it daily. I continue it, at my wife's insistence, just to keep peace in the family.
I think it is useless for two reasons: First, I detect no improvement. Second, as far as I know, there will be no lymph nodes in that piece of thigh flesh, or if there are a few, they have not been connected to any possible drain.
Kindly confirm that this is probably useless, or set me straight if I am wrong.
(Patient number on request)
Posted: 07 Jun 2012 02:38 PM Originally Posted: 07 Jun 2012 02:37 PM
Do you know why your speech fluency deteriorates? Does it happen every day? Sometimes? Any relationship to the amount of speaking? Does your speech fluency return to your baseline every morning? What happens if you delete your "massage regimen" for several weeks? Do you still return to your baseline speech fluency every morning?Do you deteriorate earlier?
If you regain your speech fluency every morning after a night's rest, is it because you do not speak or eat during your sleeping hours and therefore rest "relatively " your tongue?Can you rest your tongue during the day and regain some speech fluency? Is it a positional issue?Does lying with your head in one position or another make your speech fluency better or worse? ? Is there any maneuver that helps you regain speech fluency?
Does anything else besides speech fluency deteriorate? Such as swallowing? Have you only had surgery or also radiation? Chemotherapy?
Has anyone examined you early in the day when you are at baseline speech fluency then re-examined you later in the day when your fluency has deteriorated? Maybe even do comparison photographs of your tongue AM versus PM.
When you say you can "detect no improvement," are you expecting that daily massage will cure the process of deterioration? Can Brad do a session of "massage" and help recover some of your speech fluency? Is it a technique issue?
At this time, lymphedema is not curable. Treatment must be daily, if not more frequently. It is kind of like rolling a rock up a hill and not having a stable place to permanently secure the rock at the top. The rock will roll down and you must roll it back up. To expect the rock not to roll back down is unrealistic.
I cannot confirm that your massage regimen is "probably useless".Too many factors are in play and I do not have all the information. Brad is a speech and lymphedema therapist with extensive experience in treating head and neck cancers individuals. I would recommend setting up a time to go over your concerns with him.
Regarding the thigh flap lymphatics, just like blood vessels, lymphatics respond to growth factors and can form new vessels andconnections.
Posted: 22 Jun 2012 09:06 AM Originally Posted: 22 Jun 2012 09:08 AM