Top Tips for Air Travel With Lymphedema

With the holiday season in tow, an increase in travelers will invade airports all over the country.  we've put together a few tips for those with lymphedema and are planning to travel by air this season.

Cabin pressure during a flight in a plane is less than the atmospheric pressure while on the ground. The decreased pressure in the cabin can cause increased swelling of the limb. If you have had a mastectomy, lumpectomy or radiation therapy you should wear compression garments while traveling by air to reduce risk of swelling.

Air travel is sedentary in nature, normally causing blood and lymphatic circulation to slow.  When you have been properly fitted for a sleeve and glove/gauntlet, it should be tight at the wrist and sit one finger width from the arm pit.

A hand piece or glove should be worn with the sleeve in order NOT to push the fluid into your hand. It is recommended to wear your sleeve 2 hours prior to flight and 2 hours after you have landed. Wearing garments applies to other types of long distance travel such as a car, train, or bus.

Travelers Tips:

-Wear comfortable clothing
-Avoid lifting and carrying heavy baggage
-Take a short walk every 2 hours
-Raise your arm and turn in circles several times
-Wear compression garments while on the trip will help prevent symptoms and swelling
-Drink plenty of liquids, avoid dehydration
-Take sunscreen, insect repellent, and extra non-scented lotion such as Eucerin

If you are in need of compression garments, call our BOC/ABC certified fitter, Kristen Knowles at 713-623-4247.  She specializes in creating customized solutions to increase mobility and decrease lymphedema swelling.

Steps to Prevent Stress-Related Hair Loss

The holiday season is known to put extra stress on both men and women.  Worrying about trying to stretch your monthly budget to pay for extra presents for the kids and family, trying to put together a holiday feast like a professional chef and even working your way through that string of lights to figure out which one is broken, are all events that we've experienced.

We've put together a few easy tips to help you avoid hair loss during the hectic holiday season:

1.  Consult your doctor to find the cause of your hair loss.  There are many medical conditions that can contribute to your hair loss including: Iron or zinc deficiency, an excess of vitamin A, a thyroid imbalance and even prescription medications.

2.  Reduce stress in your mind.  Get a massage, start an exercise routine, or even avoid stressful situations are all good ways to reduce your stress load.

3.  Find "me" time.  Set aside 30 minutes a day to write in a journal, listen to your favorite music, or drink a cup of hot tea.  All of these things will help you relax and even increase endorphins.

If you are experiencing stress-related hair loss and need help with hair replacement techniques, please call our Ricky Knowles Hair & Wellness team at 713-623-4247 and set up a free consultation appointment.  We specialize in the hair duplication business and provide our clients with a supportive and discreet environment.

Preventative Mastectomy is an Option for Women Who are at a Very High Risk

From the Meadville Tribune

People around the world were shocked to learn that actress and activist Angelina Jolie opted to have a double mastectomy in 2013 to reduce her risk of breast cancer. Jolie, who was 37 years old at the time of the procedure, reportedly learned that she carries a mutation of the BRCA1 gene, which sharply increases her risk of developing breast cancer and ovarian cancer. In addition, the actress has a family history of cancer. Her mother, Marcheline Bertrand, died of ovarian cancer in 2007 at the age of 56.

By having a preventive mastectomy, Jolie reduced her breast cancer risk from 87 percent to 5 percent, according to an op-ed piece she authored in The New York Times. Jolie is not the only well-known actress to opt for a preventive mastectomy, as fellow thespian Christina Applegate had a similar procedure in 2008 after learning she had a mutation of the BRCA1 gene. These highly publicized cases have left many women wondering if a preventive mastectomy is something they should consider.

BRCA stands for "breast cancer susceptibility genes," a class of genes known as tumor suppressors, says the National Cancer Institute. Mutations in these genes have been linked to hereditary breast and ovarian cancer. A person's risk of developing breast and/or ovarian cancer is greatly increased if he or she inherits a harmful mutation in BRCA1 or BRCA2. Mutations in these genes could also put a person at increased risk for other cancers.

Genetic tests can check for mutations in BRCAgenes. During such a test, a blood sample is taken, and if a mutation is found, a person may get genetic counseling and work with a doctor to develop a plan of action. It is important to note that not all people with a genetic mutation will get breast cancer or ovarian cancer. The National Cancer Institute's "SEER Cancer Statistic Review" states a woman who has inherited a harmful mutation in BRCA1 or BRCA2 is about five times more likely to develop breast cancer than a woman who does not have such a mutation.

Although there is no surefire way to determine if a person with a mutated gene will develop breast cancer, many women who are considered high risk opt for a preventive mastectomy to reduce their risk. Women who have a family history of breast cancer, have received positive results from gene testing, have already had cancer in one breast, or have dense breasts that make testing difficult may want to get a preventive mastectomy.

The decision to get a preventive mastectomy is not one to take lightly. Many breast centers are staffed with breast-health specialists, genetic counselors, breast surgeons, and reconstructive surgeons who can help patients make the best decision. Second opinions are strongly recommended for women considering a preventive mastectomy.

Women should understand the options available to them if they have an extremely elevated risk of breast cancer or ovarian cancer.

Innovations Target Risk of Lymphedema After Cancer Treatment

By NARA SCHOENBERG | CHICAGO TRIBUNE 

In the past few years, surgeons have made strides in preventing lymphedema, a potential side effect of breast cancer surgery in which a blockage in the lymphatic system causes fluid buildup and swelling in the arm.

By preserving the underarm lymph nodes in patients with less-advanced cancer, surgeons have reduced the lymphedema risk for those patients.

But lymphedema still affects an estimated 10 to 40 percent of patients, depending on the extent of the cancer and the type of surgery and radiation required.

What can be done for patients whose underarm lymph nodes can't be preserved because of the spread of cancer? Or the ones who get lymphedema despite lymph node-saving surgery?

Approaches that may help are being tested and tried at major cancer treatment centers, among them the lymphatic microsurgical preventive healing approach (LYMPHA) surgical technique, which connects lymph vessels to a nearby vein, restoring drainage when underarm lymph nodes are removed. There's also axillary reverse mapping, which seeks to identify and preserve lymph nodes related to arm drainage (as opposed to breast drainage), and highly sensitive L-Dex bioimpedance spectroscopy, which is used to diagnose lymphedema at its earliest stages, when it is most responsive to treatment.

"There are a lot of people working on different things," said Dr. Sarah McLaughlin, a breast surgeon at the Mayo Clinic in Jacksonville, Fla.

But as much as researchers would like to see advances in this area, she said, it's important to wait until new approaches are backed up by reliable data.

"It just takes time," she said.

At NewYork-Presbyterian Hospital/Columbia University Medical Center, surgeons are seeking to replicate the results of a promising Italian study, in which researchers at the University of Genoa attempted to prevent blocked drainage after lymph node removal by allowing lymph vessels to drain into a nearby vein. In the Italian study, published in 2011 in the Annals of Surgical Oncology, 4 percent of the women in the LYMPHA group had lymphedema at six months after surgery, compared to 30 percent of the women in the control group.

The NewYork-Presbyterian pilot study started in January.

"We've performed this on about seven patients, and so far, it looks very, very good," said Dr. Sheldon Feldman, chief of breast surgery at NewYork-Presbyterian. The procedure takes less than an hour, and the technique is quite simple, he said: Lymphatic vessels are basically attached into a stump of a branch of a nearby vein.

Axillary reverse mapping, in which an injection of dye is used to identify the lymph nodes that drain the arm, as opposed to the breast, for the purpose of preserving the arm lymph nodes during surgery, is being used at some large cancer centers.

Early detection of lymphedema is the aim of L-Dex bioimpedance spectroscopy technology, which uses a small electronic current to detect volume change.

"The longer lymphedema is there, the tougher it is to treat, so the idea is to have a very sensitive tool which could be used to detect very subtle changes in volume in the arm - before it's apparent to the patient, before it's apparent to the doctor," Feldman said.

"That's what this bioimpedance spectroscopy can do."