Lymphedema Treatment Act Update

We have 3 new co-sponsors bringing our total to 68: Smith (R-NJ-4), Kirkpatrick (D-AZ-1) and Farr (D-CA-20).

If your Representative is not a co-sponsor yet, please use the advice in the Lymphedema Treatment Act Advocacy Handbook to make it happen.

http://lymphedematreatmentact.org/advocacy-handbook/

New breast cancer procedure helps prevent lymphedema

By Petrina J. Johnson

Axillary reverse mapping, a breast cancer procedure involving the removal of cancerous lymph nodes, is helping prevent lymphedema in patients.

Dr. Leonidas Miranda of North Houston Specialty Physicians, said the procedure is relatively new but very important. ARM was developed by Dr. V. Suzanne Klimberg, a breast surgeon. Miranda, a general surgeon, said he begin using the procedure about a year ago. Miranda said ARM is a major improvement because it decreased the risk of lymphedema down to 4 to 7 percent.

“In the old days we use to take the lymph nodes from the arms and breasts,” said Miranda. “This is why there was such a high rate of lymphedema, 20 to 25 percent.”

The previous procedure was a great experience but the high risk for patients developing lymphedema made it what Miranda described as a “sad situation.” It was something he said the patients should not have to endure.

“On top of the fact that they (the patients) had to go through all these treatments they had developed swollen of the arm,” said Miranda.

The new procedure, Miranda explained, helps to identify the lymph nodes coming from the arm. He said ARM involves injection of a special blue dye under the skin in the arm. The blue dye travels through the lymphatic (channels) in the arm. Miranda said the lymph nodes that are blue help the surgeons know which ones are coming from the arm.

“When you open the arm pit you see them (lymph nodes) and then you don’t take them, this is what axillary reverse mapping is,” said Miranda. “When you see those lymph nodes you only take the ones that are not blue.”

Miranda said because the surgeons do not have to remove the lymph nodes from the arm, it helps preserve the return circulation coming from the arm. This helps to prevent lymphedema.

“It does add a few more minutes to the procedure (the operating time) but it is well worth it,” said Miranda.

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.

Extensiveness of breast cancer surgery linked to risk of lymphedema

Breast cancer survivors who have extensive surgery are four times more likely to develop arm lymphedema. According to a new study, the extensiveness of surgery to treat breast cancer proportionately increases the risk of developing the debilitating disorder.

According to the lead author, Tracey DiSipio, PhD, from Queensland University of Technology in Brisbane, Australia, women who had undergone an axillary lymph node dissection, which is an invasive surgery to remove lymph nodes under the arm, were four times more likely to experience swollen or disfigured arms compared with women who had received a sentinel lymph node biopsy. The study was published in The Lancet Oncology.

"Arm lymphedema is typically characterized by swelling in one or both arms, causing pain, heaviness, tightness, and a decreased range of motion," DiSipio said. "The appearance of the swollen or disfigured arms provides an ever-present reminder of breast cancer and often contributes to anxiety, depression, and emotional distress in affected women."

DiSipio said the study, a systematic review of the incidence of arm lymphedema after breast cancer, also found that the condition is diagnosed in one in five women (21.4%). She explained, "This is a significant research finding and provides us with the most accurate incidence rate to date. Until now the incidence rate has been reported as anywhere from 0% to 94%. With this information we can explore whether lymphedema rates differ between breast cancer survivors."

The study also pinpointed a number of risk factors linked to arm lymphedema. Risk increased with a lack of regular physical activity and with a high body mass index. DiSipio said, "These factors are potential targets for future prevention strategies or for more effective management of the disorder."

DiSipio said the results of the study added weight to calls to integrate prospective surveillance of arm lymphedema into standard breast cancer care.

"Currently there are no standardized practices when it comes to detection and treatment of arm lymphedema," she said. "Given most patients present with the arm lymphedema within the first 2 years after breast cancer, more frequent surveillance throughout this time is recommended."

If you or a loved one is undergoing breast cancer treatment, call 713-623-4247 to schedule a free consultation with our ABC/BOC certified compression garment and mastectomy prosthesis fitter.  Kristen and our team will develop a customized approach to helping you maintain your mobility and comfort during and after your cancer treatment.

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 is the Difference Between Ready-Wear and Custom Compression Garments?

After a lymphedema diagnosis, it is imperative that you get measured by a certified compression garment fitter. Although there are compression garment shops who claim that they can fit you for a garment, be sure that the fitter has the specialized training necessary to fit you properly in the appropriate garment. Ill fitting garments can cause major setbacks in your progress towards maintaining the condition.

One major difference between ready-wear and custom compression garments is that ready-wear, or off the shelf garments, are made of lesser quality materials which include lycra or rubber. Custom compression garments use silicone and silk offering more comfort while wearing the garments.

Since ready-wear garments are available over the counter, they are tend to be less expensive, easier to replace and quicker to purchase. They are seamless and are available in a variety of lengths, compression classes and sizes, however, they may not provide enough support for your affected limbs and are not as precise in fit as a custom made garment. They also have a tendency to roll at the top of the garment.

With custom made compression garments, precise measurements are taken to ensure that your garment fits properly throughout your whole limb. They are generally made from thicker but more breathable materials. And offer better containment of the swelling than ready-wear garments. These garments can be made to accommodate any shape which is particularly helpful if a client has a disproportionate limb.

Custom made compression garments are are available in all four compression classes and can be combined with a custom toe cap if necessary. With custom compression garments, pads for extra support can be stitched into the garment as well.

The heavier knit materials provide greater stiffness resulting in greater resistance and better containment of the swelling than ready-made garments (so-called stiffness factor).

To schedule your free consultation with our BOC/ABC certified garment fitter, call 713-623-4247. Kristen can answer any questions you have about compression garments and assist you in maintaining your lymphedema.

Is it OK to exercise with lymphedema?

Yes, exercise is safe and beneficial for individuals with lymphedema, as long as a few standard guidelines are followed.

1. Always wear your compression bandages or garments when exercising – Compression garments help to move your lymph fluid from your limbs, trunk or face.  Without the garments, lymph fluid will collect in the affected area and increase swelling.
   
2. Get clearance from your doctor – As always, it’s a good idea to discuss your exercise goals with your physician and to make sure that you are in good overall health before starting an exercise program.
   
3. Start slowly – Your exercise program should include stretching, strengthening and endurance.  Some good examples of exercise programs are: Yoga, walking, swimming or cycling.  It is NOT advised to engage in high-speed activities like tennis, water skiing or football.
   
4. Hydrate – Hydration is super important to maintaining a healthy body, and even more important for people with lymphedema, as it aids in your body’s ability to expel lymph fluid.
   
5. Pay attention to your body – It is important that you feel good after exercising!  If you notice increased swelling, then you will want to choose a different activity for that day (i.e. swim instead of walk).

We want to assist you in reaching your exercise goals.  With our dedicated staff on your team, we can ensure that your custom compression garments will support you in your exercise program.

Let us know if you have any questions or concerns about your treatment options.  Our certified lymphedema specialists will be happy to answer your questions about how we can help you or someone you know who have lymphedema.  Call today at 713-623-4247, or email us at Kristen@hairandwellness.com

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.

Breast Friends Support Group Meet Up

The University of Texas MD Anderson Regional Care Center in the Bay Area is sponsoring the Breast Friends Support Group and Educational Program for surrounding communities. The next meeting is set for Wednesday, June 12 from 6-8 p.m at the CHRISTUS St. John West Building.

This month’s meeting will feature two guest speakers—Vicky Moore, OTR, CLT-LANA, lymphedema therapist at UTMB Victoria Lakes and Kristen Anderson-Knowles of Ricky Knowles Hair and Wellness. Vicky will lead a discussion on managing lymphedema, and Kristen will talk about lymphedema sleeves and other related garments for cancer patients.

The purpose of these meetings is to support, uplift and empower patients as they go through this challenging time. Meetings are open to all breast cancer patients, survivors and caregivers, regardless of where treatment is received, and snacks and refreshments will be provided.

Meetings take place in the West Building of St. John Hospital, located at 2035 Space Park Drive. No pre-registration is required. For more information contact meeting facilitator Diana Vasquez at (713) 745-2396.

The MD Anderson Regional Care Center in the Bay Area is located on the campus of CHRISTUS St. John Hospital at 18100 St. John Drive. As MD Anderson’s first comprehensive clinical cancer center to open outside of the Texas Medical Center, the Regional Care Center in the Bay Area provides medical and radiation oncology, APBI, chemotherapy infusion, laboratory and pharmacy services and nutritional counseling

For directions or to learn more about the MD Anderson Regional Care Center in the Bay Area visit www.MDAnderson.org/BayArea. For up to date news and information about the Center join the conversation on Facebook at www.Facebook.com/MDAndersonBayArea.

From the Bay Area Citizen