Rebecca “Becky” Benner has always been incredibly active. An avid gardener, she loves to dig, load up wheelbarrows and get her hands dirty. She enjoys cooking and baking too.
Her life was turned upside down when she was diagnosed with left tonsillar cancer in December 2021. The cancer had metastasized to her cervical lymph nodes.
Before starting treatment, Becky’s oncologist referred her to Debra Piccirillo, speech language pathologist (SLP) at Luminis Health Physical Therapy in Annapolis. Debra assessed her swallowing skills and began Becky’s swallowing therapy. Prior to and throughout her radiation treatments, Becky practiced exercises to help to improve her ability to swallow. This work also protected her airway throughout the radiation treatments. Radiation may have long-term effects on swallowing abilities, so these exercises became a necessary daily routine indefinitely.
Her care team performed a baseline modified barium swallow (MBS) study, an X-ray procedure performed that provides a look at the anatomic structures in the head and neck. This is essential to make sure these areas are working properly while chewing, drinking, and swallowing, and can help a care team make additional suggestions to keep swallowing safe. Debra quickly realized the need to refer her to physical therapy (PT) to address the impact of swelling on Becky’s health and swallowing skills.
Becky describes her chemotherapy and radiation treatments as her “Big Adventure.” When she began treatment, she saw a sharp decline in her energy, balance and general strength. She went from being an active walker to needing support while moving around her house.
Cancer-related fatigue and decline in strength and balance are real consequences of cancer treatment, especially in older adults who have a smaller reserve due to other medical diagnoses.
Becky was extremely motivated to get back to her prior level of physical function. With physical therapy, she started making gradual progress. Her family provided excellent support, taking turns bringing her to therapy and encouraging her to practice exercises and strategies at home. At the beginning of May 2022, she needed a walker to walk and was able to stand on one leg for just a second. Her physical therapist, Runzun Shetye, provided walking and standing exercises to help with her mobility, as well as introducing lymphedema-reducing strategies. By December 2022, she was able to walk in her garden without any assistance, push a wheelbarrow filled with garden and yard trimmings, and was able to stand on one leg for 60 seconds!
Becky also experienced significant pain and changes in her swallowing function, also known as dysphagia, requiring her to alter her diet to foods that were easier to manage. She found swallowing to require more effort, compared to pre-radiation where eating and drinking were automatic. She worked with an oncology dietician who assisted with optimal intake and food choices which helped her. Becky continues to have some difficulty with eating certain types of meats, pastas and breads and still does her numerous swallowing and jaw exercises.
Her doctors and therapists continue to collaborate to provide the best care for her. Becky is building her physical endurance every day and has returned to gardening at her home and in the community and to volunteer work in the community.
Becky recaps her “Big Adventure,” “I’ve really appreciated the exercises for my mouth and for balance and equilibrium. Debra and Runzun answered my questions, gently encouraged new exercises or resources to aid or speed recovery, accepted my occasional lack of progress, and, most importantly, allowed me to vent!”
