When Dr. Tamar Ference found out she had breast cancer, she spent a week in her home. She could not believe that after helping so many cancer patients as a doctor of physiatrics, she would be thrown such a curveball.
“I didn’t want to talk to any one. I disappeared. I was in shock. There was no way I could be there for my patients that week,” said Ference, also an assistant professor at the University of Miami Miller School of Medicine. “It’s tough to find out you have breast cancer – even for someone like me.”
While she was undergoing chemotherapy, Ference continued to help patients recover at UM’s Department of Rehabilitation Medicine.
“Some of my patients helped me,” she said. “Many of them were breast cancer survivors. They had already gone through what I was going through. They understood. … Some of them would tell me that I was going to make it. … Some of them would send me emails and cards.”
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It is no coincidence that so many of her patients are cancer survivors. As life expectancy grows for cancer patients, so does their demand for rehabilitation medicine.
Finding the Israeli-born Ference, who was diagnosed in 2009, was like finding a gold mine.
“This experience has made me more empathetic,” she says. “It’s like we are speaking the same language. Now when my patients tell me they are in constant pain, I understand exactly what they mean.”
Chemotherapy, surgery and radiation treatments can have debilitating side effects including chronic pain and loss of strength. Ference works with a team of physical therapists to help survivors return to their daily activities.
“Cancer treatment is somewhat inhumane,” she says. “It’s a very traumatic process, and some of us come out of it with many complications.”
The removal of underarm lymph nodes and radiation therapy increase the risk of lymph edema, the swelling of tissue due to the blockage of the system that drains lymph fluid.
I had 16 nodes removed, and I am scheduled to begin radiation therapy this week. As a preventive measure, Ference gave me a compression sleeve.
“It’s important to wear the compression garment because lymph edema develops slowly over time,” she said. “It can begin months or years later. … Early management is important.”
The tight, ugly sleeve, which puts pressure on the arm to stop the fluid from collecting, is going to become a part of my fashion statement.
But that’s not a source of anxiety for me; radiation therapy and its possible complications are. Ference knows how I feel.
“I would have panic attacks during treatment. And years later, I am still afraid. … Now I have to deal with the fear of recurrence,” she says. “Every now and then someone will say something and fear will come up out of nowhere, and I have to take a moment to calm myself down.”
Through chemo and surgery, I have learned that the key to dealing with fear is to recognize the difference between what I can and can’t control. My main concern at the moment should be dealing with my arm’s lack of mobility. And that, Ference says, is in my hands.
“Certain exercises can help to keep your arm and shoulder flexible. You have to work with a physical therapist and fight and fight and fight,” she says. “Every hour you have to stretch. The more time you wait, the least likely you are to recover your flexibility.”
Ference wrote “URGENT” on the referral form I took to Luis A. Feigenbaum, director of the sports physical therapy department at the University of Miami Hospital. His office was like a gym minus the muscle-obsessed men and scantily clad women.
After an assessment, he sat me down in front of an “arm bike” to “warm up the upper body.”
A line of fire was burning from my ribs to my hand with every guided exercise that followed.
“That’s your tendon. With persistence, you will be able to raise your arm in a few weeks,” Feigenbaum said.
Later, we walked past a man who was recovering from what appeared to be a knee surgery. The petite woman with him looked up at Feigenbaum and said, “You are an angel.”
“I don’t think there are angels in this place,” he modestly replied.
She smiled. “Yes, there are.”
I hoped she’s right. Feigenbaum and Ference are telling me to trust the same body that betrayed me. I feel like I’m in need of a miracle.