Acupuncture and Lymphedema

Published by Memorial Sloan Kettering

A study from Memorial Sloan Kettering investigators has shown that acupuncture may help relieve lymphedema of the arm, a swelling that sometimes follows breast cancer treatment.

The research, led by Barrie R. Cassileth, Chief of Memorial Sloan Kettering’s Integrative Medicine Service, and Clifford A. Hudis, Chief of the Breast Cancer Medicine Service, was published April 10 in the journal Cancer.

“We have shown that acupuncture as a treatment for lymphedema is safe and well tolerated,” says Dr. Cassileth. “Furthermore, this study demonstrated reductions in lymphedema for the patients treated, providing strong impetus for the randomized controlled trial that is now under way to prove that the effect is real.”

A Need for New Treatments

Some breast cancer patients need to have lymph nodes surgically removed, either because cancer has spread to them or because the lymph nodes have been damaged by radiation therapy.

Normally, lymph nodes help filter and remove fluid from the body. When the lymph nodes are removed, the fluid can collect in the affected limb and cause painful swelling.

Lymphedema is most commonly seen in the arms of breast cancer patients who have had lymph nodes removed in their armpits, but can also occur in the legs of patients whose pelvic region lymph nodes were removed. The condition causes discomfort and restricts mobility and also can lead to infections requiring hospitalization.

Patients affected by lymphedema of the arm often receive regular and intensive physical therapy to reduce the volume of lymphatic fluid. They also may need to wear restrictive stockings on their arms to prevent the fluid from recollecting. The treatments can be time-consuming, expensive, and uncomfortable, and they do not reduce arm circumference in a sustained way.

“This is a condition for which there are currently no good treatment options,” Dr. Cassileth says. “There is a pressing need to develop more-effective means to treat this problem.”

Evaluating Acupuncture

In this early-stage study, Memorial Sloan Kettering researchers aimed to assess the safety and potential effectiveness of this approach as a treatment for lymphedema of the upper arm.

Study participants received acupuncture at Memorial Sloan Kettering twice weekly for four weeks, using a regimen developed by the Integrative Medicine Service. For each session, acupuncturists inserted 14 needles at sites on the affected and unaffected arms, legs, and torso.

The researchers measured the participants’ upper-arm circumference before and after the treatments. They found that among the 33 patients who received acupuncture, 11 had a significant reduction in swelling and another 18 had at least a small reduction. When contacted several weeks later for feedback, patients reported lasting improvement in swelling.

In addition, the study showed that acupuncture caused no serious side effects.

Although the researchers caution that it is difficult to draw firm conclusions from a small study, they are encouraged by the results. “I believe it is absolutely worth exploring for patients who are struggling with this difficult condition,” Dr. Cassileth says.

Next Steps

A larger study, a randomized clinical trial led by Dr. Cassileth and Memorial Sloan Kettering breast cancer specialists, is under way. This study compares patients receiving acupuncture with those undergoing only conventional treatments. Researchers hope that this more definitive trial will shed further light on the effectiveness of acupuncture as a treatment for upper arm lymphedema.

Dr. Cassileth cautions patients who might seek acupuncture for lymphedema on their own. “Because of the potential for complications,” she concludes, “it’s important that acupuncture treatment is received only from licensed practitioners who are also specifically trained to work with cancer patients.”

Tips for a Healthy Pregnancy

Compression stockings are often recommended during pregnancy to help energize tired, achy legs, help prevent and reduce swelling and promote better circulation. Great for those who are standing or sitting for long periods of time, gradient compression products help keep legs healthy.

Gradient compression hosiery during pregnancy helps keep your legs looking and feeling their best! Often recommended for those with tired, achy, fatigued legs and feet, swollen feet or ankles or mild to moderate swelling, gradient compression helps keeps your legs going strong!

By applying the tightest “squeeze” to the ankle and then gradually decreasing the pressure up the leg, gradient compression hosiery help promote better circulation and more leg energy.

If you are experiencing any of the following, you may benefit from wearing gradient compression:

• Tired, aching, fatigued legs

• Swollen feet, ankles, and legs

• Mild to moderate swelling

• Stand or sit for long periods

• Traveling

• Overweight

Even if you do not have any of the above conditions, you may still appreciate the benefits of wearing compression because of how great they make your legs look and feel.

Did you know?

• About 40% of all pregnant women suffer from varicose veins.

• Pregnancy increases the body blood volume.

• The increase level of the hormone progesterone cause blood vessel to relax. Therefore valves separate slightly and they don't work properly, letting the back-flow of blood in the veins.

• The uterus presses against the major veins in the pelvic region and increases the pressure in the leg veins are then subject to becoming varicose.

• The weight increase enhances the risk of venous insufficiency affecting the legs.

Graduated-compression stockings are designed to be tight at the ankle and get looser as they go up the leg, making it easier for blood to flow back up toward your heart. As a result, they help prevent swelling and may keep varicose veins from getting worse.

To prevent blood from pooling in your legs, put the stockings on before getting out of bed in the morning, while you're still lying down, and keep them on all day.

For more information about compression garments, contact our compression garment guru, Kristen at 713-623-4247.  She is a certified compression garment fitter and can help you choose a compression garment to fit your lifestyle!

March is Lymphedema Awareness Month

Lymphedema is the fluid that is retained in your body, but mostly appendages, after cancer surgery, radiation and/or chemotherapy. 

There is treatment, which includes compression garments and manual lymphnode drainage massage therapy, however, Medicare and many other insurance policies do not pay for these garments and treatments, often leaving patients to suffer infections and increased disability.

HR3877, is currently being debated in the House of Representatives and if passed into legislation, the bill will set a precedent for insurers to follow and cover the cost of medically necessary compression supplies.

Contact your congressmen and senators and stress the importance of standing behind this bill. 

To write your representative now, go here for an easy interactive form from the Lymphedema Treatment Act Organization.

Vibration Exercise Improves Your Lymphatic Health

With every beat of the heart, subtle vibrations are sent through the body, the movement stimulating a higher degree of circulation and a higher level of overall health. Because this movement is conducive to achieving a healthier circulatory system, among others, it has been recreated throughout the cultures and ages of history in an attempt to heal illnesses and improve the overall quality of life. A practice that has been utilized for thousands of years, vibration exercise is said to amplify the effects of the vibrations made each time the heart beats. These vibrations produce a level of blood flow that is uninterrupted, allowing oxygen and other important substances to circulate freely. By constantly pumping blood through the many systems of the body, the modern vibration exercise machine also promotes the drainage of the lymphatic system, which acts as a network of pipes that pushes toxins out of the body.

Moving the various fluids of the body requires power, which is only achieved through muscle contractions (such as the contraction of the heart when it pumps). The vibrations created by a vibration exercise machine create small muscular contractions. This forces the fluids through the body in a way that is efficient, constant, and gentle enough not to cause any harm while being forceful enough to discard toxins and other potentially dangerous buildup.

Individuals that cannot get rid of their toxins are more prone to illness and do not feel as healthy as those whose lymphatic systems are capable of draining regularly. Exercise is certainly one way to achieve a high level of lymphatic draining, but not everyone has the ability (either physically or practically) to indulge in a great deal of physical activity. For this reason, whole body vibration, facilitated by a machine, is able to help combat the effects of a sedentary lifestyle and rid the body of the toxins that it has stored. This being said, individuals that don't have time for extensive exercise can greatly benefit from whole body vibration.

In addition to acting as a catalyst for lymphatic drainage, a vibration exercise machine also sparks the activity of the lymph nodes, which are key components of the immune system. Therefore, the movement allows individuals to both rid their bodies of toxins that they already possess and prevent them from contracting illnesses from new ones.

Another benefit, which many individuals enjoy, is weight loss. Though the loss is not drastic, using a vibration exercise machine allows the lymphatic system to push stored fats out of the body, resulting in a healthier, leaner figure. This smaller figure can also be attributed to the decrease in cortisol, which is a known agent of belly fat, due to an increase in serotonin.

The benefits of vibration exercise, particularly to the lymphatic system, have been enjoyed by people from several cultures over thousands of years. Modern medicine will most likely continue to study this technique and analyze its many effects on the body, but as the research is conducted individuals will continue to utilize the therapy and take advantage of their healthier circulatory and lymphatic systems.

Have questions about Lymphedema or need to schedule a free consultation with our custom compression garment fitter?  Email Kristen at kristen@hairandwellness.com

What Treatments Are Available for Lymphedema?

Unfortunately, there is no cure for lymphedema. However, with early intervention and proper treatment, the condition can be controlled and minimized, allowing the individual to lead a full and normal life.

Treatment begins with a physicians referral to a lymphedema trained massage therapist. The therapist performs a thorough evaluation to determine a baseline of the individuals sensation, pain, range of motion, strength, skin integrity, and extent of swelling.

A treatment plan to decrease the swelling and improve the individuals ability to function may include:

• Lymphatic manual drainage, or MLD, is a specialized lymphatic "massage," to move the extra lymph fluid through intact lymphatics and create new pathways for the lymph fluid to flow.
  
• Compression bandaging to reduce swelling.
  
• Exercise to improve functioning of the lymphatic system, range of motion, and strength.
  
• Establishment of a good skin care program to decrease the chances of infection.
  
• Recommendation of a compression garment and instruction for wear and care.
  
• Thorough patient education regarding all of the above to promote independence with self-management of lymphedema.

Not all therapists have received special training to treat lymphedema, so it is important to select a therapist that is qualified to treat individuals suffering with the condition. At Ricky Knowles Hair & Wellness, we have several qualified therapists who have been trained and certified to treat lymphedema.  We have a BOC, ABC certified garment fitter, who is constantly troubleshooting to find clients the best solution in compression garments.  Our team would be happy to help you develop a customized plan to help you improve your mobility. Our insurance specialist will even submit your claims and serve as your patient advocate, ensuring that you receive your full insurance benefits.

For more information, or to schedule an appointment, please call 713-623-4247.

Is MLD massage right for me?

We are often asked this question from our lymphedema and edema patients. In most cases the answer is YES!  

MLD, or Manual Lymphatic Drainage helps your body's lymphatic system to drain and aids in removing wastes, toxins, bacteria and fluid build-up from your body's tissues.

The lymphatic system is a natural detoxification system. Your lymph nodes, in your armpits and groin, are responsible for filtering out waste, which plays an extremely important role in your immune system. The lymph system produces lymphocytes to kill bacteria, which helps you prevent and fight off infection. If MLD is applied correctly, it can have profound effects on your body. Having an MLD massage can help with the following:

• Lymphedema

• Muscoloskeletal problems

• Increase effectiveness of detox following a dietary detoxification (usually recommended by a Naturopathic doctor)

• Reduce pain signals sent to the brain

• Help post-surgical recovery

• Reduce scar formation

• Decrease general fatigue and "sluggishness"

If your lymphatic system has been compromised, due to a trauma or surgery, you may be at risk or have lymphedema. MLD is a proven primary tool in the treatment of this condition. Combined with compression therapy, MLD will help your lymphedema so you can achieve better mobility and a better quality of life.

Of course, there are exceptions to every rule. Manual lymphatic drainage is not an appropriate treatment if you have the following:

• Active cancer

• Inflammation (infection)

• Congestive Heart Failure

• Thrombosis

If you have additional questions about Manual Lymphatic Drainage, please call us at 713-623-4247 and book a consultation with one of our certified massage therapist. We will help you understand how MLD can improve your mobility and well-being.

Top 10 Lymphedema Tips for the Summer

1.  Increase fluid intake, mostly H2O
By increasing your daily water intake, you are telling your body that it has plenty of reserves and as a result it will release fluid out of your body.  If you are not a fan of drinking water, try flavored waters.  Crystal lite offers on-the-go packets, available in delicious flavors such as kiwi-strawberry, cherry pomegranate and raspberry peach.

2.  Try and stay as cool as possible
At times staying cool may seem impossible in 90+ degree weather.  Use fans to help circulate air conditioning while indoors.  Also store plastic bottles of water in the freezer for easy access to cold water when you travel outside.

3.  Avoid tight restrictive clothing
Opt for lightweight, loose-fitting cotton clothing.  Cotton clothing will keep you cooler than those made out of synthetic materials.

4.  Avoid severe sunburns

I like sunscreen products that good for sensitive skin, affordable, waterproof and offer UVA and UVB protection.  Banana Boat Baby Tear-Free Sunblock  SPF 50 is $10 for 8 ounces, Bull Frog Water Armor Sport 50+ is $9.99 for 6 ounces,  Beach Defense Water + Sun Barrier Lotion SPF 30 & 70 is $10.99 for 6.7, or Hydrosport Sunblock Spray SPF 30 by Aveeno is $8.99 for  5 ounces are all great options.

5.  Always use insect repellent
Protecting your skin from insect bites is another top priority during the warm summer months.  Avon carries a strong defense against mosquitos, gnats, ticks, sand flies and other biting insects.  Skin So Soft Bug Guard Plus Picaridin Aerosol Spray is $7.99 for 4 ounces of protection.  Another good option is Deep Woods Off! Deep Woods Insect Repellent V, 25% DEET, 6 oz for $7.49.  This insect repellant is a reduced DEET product that works well.  It sprays upside down too!   Be sure that you apply insect repellent over your garment.

6.  Try and avoid high sodium foods
Restrict your daily salt intake to between 1,500 – 2,300 mg per day.  Also avoid processed foods as they typically contain a lot of sodium and preservatives.

7.  Protect your handsWhen working in the yard or gardening try and wear glove to protect your hand with upper body edema.  Choose a work glove with a suede leather palm for heavy-duty protection.

8.  Exercise Smart
When exercising outdoors try and do this not in the middle of the day, instead opt for early morning or after sunsets.  Exercise for shorter periods of time, take breaks at regular intervals and always wear compression on the affected limb, unless you are swimming, as water resistance acts as natural compression.

9.  Protect Your Feet
With lower body edema it is a good idea while at the beach wear water shoes as to avoid cuts and scrapes.

10.  Travel Prepared
If possible, talk to your doctor and get a prescription for antibiotics in case of infections.  Also, remember if you are flying, drink plenty of water and make sure you wear your day time compression garments, as the decreased air pressure in the airplane’s cabin may increase your swelling.

For more tips, contact Kristen, our BOC, ABC Certified compression garment fitter at kristen@hairandwellness.com.

Manage Lymphedema and Edema During the HOT Houston Summer

Lymphedema and chronic swelling patients have it especially rough during the HOT Houston summer. That’s why we work with our patients to offer cooler compression alternatives and tips.  I’m realistic when it comes to edema management during the summer and understand that patients need relief, not only from their edema, but from the heat.  So, I advocate using less aggressive garments during the heat of the day, and then wearing a lightweight night-time garment in order to keep the swelling under control.

Cooler Custom Garment Alternatives

One option for upper body edema is LympheDIVAS arm sleeves.  These arm sleeves are made with moisture-wicking technology, which pulls sweat away from the body.  They are also infused with aloe vera so that the arm stays moisturized and cool.  LympheDIVAS arm sleeves come in a variety of fun patterns and colors too.

A good option for a night time garment during the summer heat is the Tribute garment.  This garment is ideal for any type of edema (upper body lymphedema or lower body lymphedema).   It also has a wicking material and the foam multi-directionally pushes into the skin to move the fluid while you sleep.

Exercise Alternatives

Another thing I really encourage all of our patients to do is get into a pool.  Why?  Well, first, you do not have to wear garments and second, the water acts as a natural compression to the limbs.  It is also the best exercise for anyone as it takes the strain off of your joints.

If you would like more information about our custom garments, please call me at 713-623-4247.  We want to work with you to stay cooler in the summer heat while managing your lymphedema!

Have a question?  Contact me at kristen@hairandwellness.com