Spotlight on Breast Cancer Awareness Month: A New Dawn

By Alexandra Becker

In Nov. 2014, Dawn McDonald noticed a small lump on her skin, just below her collarbone. She had never seen it before and even asked her husband if, perhaps, she had just missed it. She’d always been one to stay on top of her health and maintain all recommended screenings, so anything out of the ordinary alarmed her—especially since she had a family history of lung and cervical cancer. But when her husband said that he, too, had never noticed it, she immediately scheduled an appointment with her OB-GYN.

“I wanted to get it checked out, just in case,” McDonald recalled. “My doctor reassured me and said it was likely a fluid-filled cyst, but ordered a diagnostic mammogram and ultrasound to be safe.”

Immediately after her imaging appointments were completed, McDonald was introduced to a nurse navigator, who told her she would need an additional biopsy.

“I knew then that something didn’t look quite right, but I was optimistic,” said McDonald, an occupational therapist who was working for a local school district at the time. “I was not prepared to hear the word ‘cancer.’”

But a few days later, her doctor called and confirmed her worst fears.

“I remember that I was getting ready to go into a meeting with a big group of staff members and my OB-GYN called me and said, ‘Dawn, you have cancer, and we need to schedule surgery immediately,’” McDonald recalled.

Her OB-GYN recommended a surgeon, who delivered some bright news: she had caught the cancer early. Nevertheless, it had already started to spread, and after discussing her options with the surgeon, McDonald decided on a bilateral mastectomy.

“Every year your chance of the cancer recurring goes up, and I didn’t want to have that weighing on me my whole life,” she said.

McDonald’s surgery took place on Jan. 8, 2015. After, she had to follow a very specific recovery regimen to help her body heal. Everything was going smoothly, but after some time, she still couldn’t use her shoulder properly and the swelling in her arm was not improving. She reached out to a physical therapist friend who told her she should look into a breast cancer rehabilitation program.

“I remember my friend saying, ‘I think you have lymphedema,’ and I kind of brushed it off and explained that it was just surgical swelling,” McDonald said. “But then she gave me an article to read and I realized there were so many things I should have been doing, and that I probably did need some kind of therapy.”

Lymphedema is characterized by swelling and is caused by a build-up of lymph fluid inside the body. This happens when lymph nodes fail to function properly, often due to a blockage within the lymph system, which is responsible for the flow of fluid and cells that help fight infection. Lymphedema typically affects the arms or legs, and is it usually caused by cancer or cancer treatment, including surgeries like McDonald’s. 

After her doctors confirmed that she did, in fact, have lymphedema, McDonald was referred to TIRR Memorial Hermann for rehabilitation.

“I attended therapy at TIRR Memorial Hermann – The Woodlands during the summer when school was out of session, and from my initial evaluation I was so impressed with everyone there,” McDonald said. “During one of my therapy sessions, I said, ‘So, what exactly does it take to do this job?’”

McDonald learned that because she was already a licensed occupational therapist, she would just need to complete a few weeks of training and pass the required coursework to specialize specifically in lymphedema rehabilitation. Coincidentally, TIRR Memorial Hermann – The Woodlands was looking for an occupational therapist to help lymphedema patients at the time.

McDonald loved her job at the school district, but the thought of working at TIRR tugged at her. Just to see, she decided to interview for the position. Not long after, she got a call with an offer.

“I got the job almost by accident,” McDonald said. “When I told my employer, they were so supportive. They said it was a great career move and they were happy for me.”

McDonald completed her coursework with exceptional scores and has never once looked back. 

“I’m so excited to be able to identify with other women like myself and help guide them in their rehabilitation,” McDonald said. “We have a high number of lymphedema patients, but there are not that many of us who are actually certified lymphedema therapists. Every time I meet new patients, they often tell me they didn’t know this kind of help was out there. I really want to spread the word that there are therapy options right here in Houston for anyone who has lymphedema.”

McDonald recalled feeling embarrassed that as an occupational therapist, she had never known about lymphedema—and had not even identified it in herself.

“My nurse navigator reassured me and told me that it was because I hadn’t been working in the world of cancer; conditions related to cancer and cancer surgery are in a field of their own,” McDonald said.

At TIRR Memorial Hermann, McDonald helps patients learn how to manage their lymphedema through bandaging, compressions, exercises and manual lymph drainage massages.

“The only way to help people reduce their swelling is by compressing their skin,” McDonald said. “We do all of this in therapy with our patients, but we also teach them techniques they can use at home so they have the education they need to manage this condition and aren’t just dependent on us.”

McDonald said that being able to now help patients who felt as helpless as she did gives her life a whole new purpose.

“This whole experience has been life-changing for me, and I want to help others learn what I know now, because I feel empowered,” McDonald said. “After everything I have been through I can still do anything, including this job. Even more, I can do this job really well because I know exactly what my patients are going through.”

McDonald added that she encourages everyone to stay on top of their health—whether they notice something out of the ordinary or experience unanticipated side effects after a surgery.

“Don’t dismiss your health, and seek out the advice of a medical professional you trust,” McDonald said. “I may have dismissed my lymphedema early on, but the reason I’m here today is because I went straight to the doctor as soon as I saw that little bump under my skin. We caught it early and now I’m able to help others like me.”

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