Haplos ng Pagmamahal: Dealing with Lymphedema by Doris Nuval

Febuary 1, 2009


December 20, 2008, Makati City. Five feisty breast cancer survivors got together at the residence of
Doris Nuval to attend their first ever massage class to ease the discomforts associated with
lymphedema. The session was conducted by a big-hearted couple, Carol and Ric Santos who started the
class with a lecture on physiology – specifically the human being’s lymphatic system and its drainage

The background lecture was conducted by Carol with a living, moving chart as a point of reference – Ric,
who assumed the role in good humor. Questions were entertained during the demo to clarify the
technical aspects of the subject matter; which Carol answered with authority, citing medical references.

In essence, the lymphatic vessels and nodes are found all over the body but are concentrated in certain
areas: the hands and breast, head and neck, armpits and groin (Coping with Lymphedema by Joan
Swirsley PN and Diane Sacket Nauverg). For most of us at ICanServe who have had either modified
radical mastectomies or lumpectomies, a number of axillary lymph nodes in either or both the armpit
and breast areas have been removed; affecting the circulation of fluid in that region. Some unlucky
survivors develop lymphedema or the accumulation fluids on the compromised side of their bodies;
resulting in a swelling of the area and correspondingly, to extreme discomfort and pain. Some lucky
ones, however, have gotten away with it.

Basically, Carol and Ric taught May Tanseco, Jidgette Velasco, Becky Fuentes, Marie Paynor, their
partners and this writer how to ease this discomfort by rerouting the accumulated fluid to the nearest
lymphatic vessels which have not been affected by surgical procedures. The hands-on training was
demonstrated by Ric to the partners present; who in turn practiced the techniques on their own
survivor-partners. Since the lymph nodes are located almost directly underneath the skin, we were all
told to massage very very gently; much like how we would massage/seduce a loved one; or as Ric put it:
“parang haplos ng pagmamahal”. The four-step procedure; though fairly simple definitely has to be
demonstrated to ensure proper application and effectiveness:

1. Activate the lymphatic vessels directly above the collarbone by gently pulsing it about 15 times;
2. Massage the swollen area in your arm where the fluid has accumulated away from your armpit
very, very lightly with your extended and flattened fingers ;
3. Reroute the fluid by massaging your arm toward the activated lymphatic vessels; again with
your flattened fingers; and
4. Repeat this procedure until you are comfortable; which may take from 10-20 minutes. Repeat
massage as necessary or for as long as your husband has the energy to do so.

As one of the complications associated with breast cancer, lymphedema may be prevented through
several ways; primarily by avoiding the following: infection and injury, pressure on the involved
extremity; constrictive clothing, heat and extra-vigorous activity, and extended use of diuretics. It would
also be good to exercise regularly, maintain one’s ideal weight and eat healthy food.

Though the sisters present were in different stages of treatment and remission, everyone admitted to
being at a certain discomfort level; prodding them to respond immediately to the query posted on our
site on lymphedema. According to Carol, therapy for this condition is not yet available in the country;
which is why she and Ric volunteered to conduct the lymphatic massage learning session. They learned
how to perform this in 2003 from a survivor, Jo Anne Rovig who learned how to do it while recovering
from her own breast cancer surgery and who later established her own clinic in Seattle, Washington –
the Northwest Lymphedema Center. Jo Anne became the first therapist in the US trained in
lymphedema treatment modalities pioneered in Europe and Australia. Carol remembers her as “warm
and compassionate, giving up her lunch break to teach us”. Upon parting ways, Carol recalls Jo Anne
saying “go back to your country and teach and help all our breast cancer survivors-sisters out there!".

And that is precisely what Carol and Ric did.

Hopefully, there will be a second session this first quarter of 2009, as there were a number of sisters
who signed up for the class but couldn’t make it because of the insanity that comes with the Christmas

ICanServe, a spirited sisterhood like no other, has again accomplished another first in the service of its
members. And Carol and Ric are the embodiment of that spirit; paying it forward; lending our special
sisterhood an international flavor in the process.