Exercise Class for Female Cancer Patients Offers More than Fitness

When Newark resident Violet Williams was diagnosed with breast cancer in 2006, all of her immediate family who might provide support lived out of state, leaving her to face her treatment alone.
Throughout her treatment and recovery at The Frederick B. Cohen Cancer Center for Blood Disorders at Newark Beth Israel Medical Center, Williams took advantage of several support programs, including Recovery Fitness, a free, all-female exercise class for cancer patients.
"Those groups really carried me through the whole thing," Williams said. "Both the support group and the exercise class helped me mentally and physically to recover and get my strength back."
Recovery Fitness, offered at NBIMC on Mondays and Wednesdays at the new Beth Fitness Center, helps female cancer patients to have fun, get strong and reduce stress. It is one of only a few such programs in the state to specifically offer exercise classes tailored to the needs of female cancer patients. Recovery Fitness is made possible by grants from The Jewish Women’s Foundation of New Jersey and Eisai Co., Ltd., which were made through the Newark Beth Israel/Children’s Hospital of New Jersey Foundation.
"I like everything about it," said Williams. "Just being there and mingling with the other cancer patients is helpful, especially for the newly diagnosed women who can get a bit of hope from the ones who have been through it already."
Williams, who also suffers from Lymphedema, a condition of fluid retention and tissue swelling caused by a compromised lymphatic system, says that she has seen improvement in her arms with much better range of motion and less joint pain.
The class' instructor, Carol Michaels is a Certified Cancer Exercise Specialist who meets with each participant individually to learn about problem areas and to find ways to benefit each person. Goals of the class include increasing muscle mass, decreasing body fat, increasing flexibility, strength, posture and balance, strengthening the heart and bones, reducing stress and increasing self-confidence.
Many cancer patients experience secondary complications as a result of their cancer, such as frozen shoulder after a mastectomy and stiffness and discomfort as a result of lymph node dissection, Michaels said.
"Some female cancer patients experience the added aggravation of chronic conditions after treatment, and through this exercise program they can increase their range of motion and feel stronger again," said Dr. Alice Cohen, director of the Frederick B. Cohen Comprehensive Cancer and Blood Disorders Center. "Exercise improves function and also helps with overall stress reduction."
Studies have shown that exercise can aid in the recovery process during cancer treatment as well as to possibly decrease the likelihood of cancer recurrence, said Cohen.
Most importantly, Recovery Fitness offers a warm environment for patients who are at all different levels of recovery.
"This isn’t boot camp," said Michaels. "The exercises are safe and gentle and we have an appreciation for every fitness level. Someone might be able to work out with weights while another person sits in a chair to lift hers. It is very individualized."
Michaels said the group becomes, in effect, a support group with each person learning from one other and offering words of encouragement.
"Many people do not feel comfortable returning to their gyms right after surgery or treatment," she said. "Gym classes can be large and impersonal. At our class, the participants can even remove wigs and head wraps without feeling self-conscious. Gaining confidence through support is part of the whole recovery process."
After a year of participation, Williams plans to continue with the program.
"I even lost a few pounds," she said. "I’m going to keep going."
– Staff reports

http://newarknj.patch.com/articles/exercise-class-for-female-cancer-patients-offers-more-than-fitness

Manual Lymph Drainage and it’s Role in the Treatment of Lymphedema

By Joachim Zuther, on December 21st, 2011

Manual lymph drainage (MLD) is one of the main components of complete decongestive therapy (CDT).  In combination with compression therapy, skin and nail care and decongestive exercises, MLD performs the crucial role of re-routing stagnated lymphatic fluid, which is essential in the treatment and management of primary and secondary lymphedema. This gentle manual treatment technique is based on four basic strokes, which were first described by Dr. Emil Vodder (1896-1986), PhD.
The goal of MLD is to stimulate healthy lymph vessels and lymph nodes, which generally are located adjacent to the area of non-functioning or blocked lymphatic drainage, and to re-route the lymph flow around these blocked areas into more centrally located healthy lymph vessels and nodes. This is achieved with specific stretches and manipulations – a common denominator in all MLD strokes – to the skin and those structures located directly beneath the skin, the subcutaneous tissues.
The resulting increase in lymphatic activity in the healthy areas creates a “suction effect”, which stimulates the accumulated fluid present in lymphedema to move into an area with normal lymphatic drainage.

What is the difference between MLD and traditional massage?
It is unfortunate that the term massage is often wrongly used to describe MLD. The origin of the word massage is derived from the Greek massain (to knead) and is used to describe such techniques as effleurage, petrissage, vibration, etc. Massage techniques traditionally are applied to treat ailments in muscle tissues, tendons and ligaments, and in order to achieve the desired effect, these techniques are generally applied with considerable pressure.

Cross section through skin, subcutis and muscle layer

MLD on the other hand is a very gentle manual technique, designed to have an effect on fluid components and lymphatic structures located in superficial tissues, i.e. the skin and the subcutis. Lymphedema almost exclusively manifests itself in the subcutis, which is a layer of connective tissue between the skin and muscle tissues.
The only commonality between MLD and traditional massage is that both techniques are applied manually. There are significant differences in technique, pressure and indications for which these two therapeutic measures are used.
There are a number of reasonable explanations why MLD and massage are often confused with each other. One is that there is a tendency to call any hands-on manual therapeutic technique a form of massage; the other is that massage can be very helpful if applied to treat edema.
However, lymphedema and edema are two very different conditions and it is important to understand the differences. Although both conditions involve swelling, edema and lymphedema have very different causes and are treated differently. A previous blog post “When is it Lymphedema?” compares these two conditions:
Additional Resources:
http://www.lymphedemapeople.com/thesite/edema_or_lymphedema.htm

Join Lymphedema Guru, a Facebook page solely dedicated to inform about all things related to lymphedema – news, support groups, treatment centers, and much more

Update on Lymphedema: Exercise After Breast Cancer Treatment Is OK

By Heidi Anne Duerr, MPH | December 20, 2011

---

Lymphedema, swelling caused by a blockage in the lymphatic system, can occur as a result of surgical or radiation therapy associated with breast cancer treatment. Since some research has shown that exercise after breast cancer treatment has been associated with developing lymphedema, clinicians often advise patients to avoid exercising. But is this truly necessary?

To better understand the actual risk, Dr Marilyn L. Kwan, research scientist at the Kaiser Permanente Northern California Division of Research, and colleagues conducted a systematic literature review of contemporary studies. After applying exclusion criteria, Kwan et al. identified 19 articles for review and synthesis. The researchers rated the evidence in the studies utilizing the Oncology Nursing Society Putting Evidence into Practice Weight-of-Evidence Classification.

Of the included studies, seven examined the effects of resistance exercises, seven examined regimens including aerobic and resistance exercises, and the remaining five studies looked at other exercise modalities. Kwan et al. found that slowly progressive exercise of varying modalities was not associated either developing or exacerbating lymphedema associated with breast cancer. Further, the studies indicated that, with careful supervision, patients should be allowed to participate in such exercise regimens. However, data from the studies examining combined aerobic and resistance exercise did not yield as conclusive results or recommendations. While the studies showed that these exercise regimens appeared to be safe, confirmation of their safety requires larger and more rigorous studies.

“Strong evidence is now available on the safety of resistance exercise without an increase in risk of lymphedema for breast cancer patients,” Kwan and colleagues concluded. “With reasonable precautions, it is safe for breast cancer survivors to exercise throughout the trajectory of their cancer experience, including during treatment.”

“Exercise can be beneficial and not harmful for breast cancer survivors,” Dr Jane Armer, one of the study’s co-authors and director of nursing research at the Ellis Fischel Cancer Center at Sinclair School of Nursing, explained in a statement to the press. “Each individual should balance the pros and cons of the activity she chooses, but keep in mind that being sedentary has risks and being active is beneficial in many ways, including possibly reducing the risk of cancer recurrence.”

References:
Kwan ML, Cohn JC, Armer JM, et al. Exercise in patients with lymphedema: a systematic review of the contemporary literature. J Cancer Surviv. 2011;5(4):320-3.
Craven S. MU researchers recommend exercise for breast cancer survivors, lymphedema patients. University of Missouri Press Release. Nov. 30, 2011.

Cancer, Research, Stanford News, Women's Health

New Stanford registry to track lymphedema in breast cancer patients

John Stafford on December 12th, 2011 No Comments

Increasing numbers of women are surviving breast cancer, but some of the therapies used to treat the cancer can cause a serious side effect: lymphedema. That disorder is, unfortunately, often misdiagnosed or ignored in breast-cancer survivors, so Stanford researchers are launching a registry to aid in better understanding the problem. As my co-worker explains:

…The information and records of breast cancer survivors gathered in the registry will be used in a study to determine whether early diagnosis of lymphedema can help treat and, possibly, prevent it.
“There is early evidence to suggest that prompt diagnosis may reduce the severity or eliminate this problem,” said Stanley Rockson, MD, the Allan and Tina Neill Professor of Lymphatic Research and Medicine, the lead investigator of the study. “If you take a wait-and-see treatment approach, by the time the lymphedema becomes noticeable, it can be quite advanced. Caught earlier, it may be more manageable, or even reversible.”

Head over to our release for the rest of the story.

New registry will track lymphedema among breast cancer patients

http://www.healthcanal.com/cancers/24492-New-registry-will-track-lymphedema-among-breast-cancer-patients.html

BY TRACIE WHITE - More and more woman are surviving breast cancer, but lifesaving surgical and radiation therapies can cause a grave side effect: an incurable chronic condition called lymphedema that involves swelling of the arms and often debilitating pain and discomfort.

Stanley Rockson

While this disorder frequently has been ignored, misdiagnosed and untreated in breast-cancer survivors, that’s beginning to change.
In an effort to find better treatment and preventive strategies for lymphedema, researchers at the Stanford University School of Medicine are launching a patient registry to study breast-cancer-related lymphedema. The information and records of breast cancer survivors gathered in the registry will be used in a study to determine whether early diagnosis of lymphedema can help treat and, possibly, prevent it.
“There is early evidence to suggest that prompt diagnosis may reduce the severity or eliminate this problem,” said Stanley Rockson, MD, the Allan and Tina Neill Professor of Lymphatic Research and Medicine, the lead investigator of the study. “If you take a wait-and-see treatment approach, by the time the lymphedema becomes noticeable, it can be quite advanced. Caught earlier, it may be more manageable, or even reversible.
“Oncologists and surgeons are becoming more aware of the need, and there are new technologies that help with early diagnosis.”

A leading expert in lymphatic diseases, Rockson, who directs the Center for Lymphatic and Venous Disorders at Stanford, helped establish the first patient registry and tissue bank for patients with lymphatic disorders in 2009.
For this new study, Stanford researchers hope to recruit an estimated 1,000 breast-cancer survivors for the Stanford National Breast Cancer Lymphedema Registry.
“Members of the American Society of Breast Surgeons will have the opportunity to collaborate in this project,” according to a statement from the society. “Member surgeons can choose to help Stanford in the identification of patients to be enrolled in the registry and will facilitate participation through the society's web-based quality reporting initiative.”
Participants will periodically update information about any symptoms, test results or treatments in 15-minute online sessions. They’ll give approval for their surgeons to provide their treatment information to the registry. Identifying information will be removed.
Currently, there is no cure for lymphedema, a disorder that arises in 15-60 percent of breast cancer survivors. A lifelong problem of disrupted lymph circulation characterized by fatigue, limb swelling and loss of the integrity of the skin, the condition’s severity can range from mild discomfort to disabling disfigurement, pain and loss of function.
When lymph circulation is delayed or interrupted, swelling and inflammation can result from a traffic jam of lymph that builds up in the limbs. There are multiple sources of blockages but often they are caused by tumor removal surgery, radiation treatment or lymph node biopsy. The only available treatments are physical therapies, including skin massage, drainage and pressure bandages, though the long-term effectiveness of these therapies has not been carefully studied.
Patients interested in enrolling can log into the Stanford National Breast Cancer Lymphedema Registry website at: http://breastcancer-lymphedema.stanford.edu. For more information, patients can call (650) 723-1396 or email lymphatic@stanfordmed.org.
Stanford University Medical Center integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital. For more information, please visit the Office of Communication & Public Affairs site at http://mednews.stanford.edu/.

Treatment of various secondary lymphedemas by microsurgical lymph vessel transplantation

Felmerer G, Sattler T, Lohrmann C, Tobbia D.
Microsurgery. 2011 Nov 24. doi: 10.1002/micr.20968. [Epub ahead of print]

Source
Division of Plastic Surgery, Department of Trauma Surgery, Plastic and Reconstructive Surgery, University of Medicine, Göttingen, Germany; Department of Plastic, Aesthetic and Hand Surgery, Klinikum Kassel, Kassel, Germany; Department of Radiology, University of Freiburg Medical Centre, Freiburg, Germany. gunther.felmerer@med.uni-goettingen.de.

Abstract
Chronic lymphedema is a debilitating complication of cancer diagnosis and therapy and poses many challenges for health care professionals. It remains a poorly understood condition that has the potential to occur after any intervention affecting lymph node drainage mechanism. Microsurgical lymph vessel transplantation is increasingly recognized as a promising method for bypassing the obstructed lymph pathways and promoting long-term reduction of edema in the affected limb. A detailed review of 14 patients with postoperative lymphedema treated with autologous lymph vessel transplantation between October 2005 and November 2009 was performed. In this report, the authors gave an account of their experience in utilizing this operative method to alleviate secondary lymphedema including upper limb, lower limb, genital, and facial edemas. Lymph vessel transplantation enhanced lymphatic drainage in patients with secondary lymphedema. In the upper and lower extremities, three patients had completed symptomatic recovery and another nine patients achieved reasonable reduction of lymphedema, four of these needed no further lymph drainage or compression garments and the remaining maintained their improvement with further decongestive therapy with or without compression garments. The patients with facial and genital edemas also experienced significant symptomatic improvement. The authors were able to establish long-term patency of the lymph vessel anastomosis by magnetic resonance lymphangiography. © 2011 Wiley Periodicals, Inc. Microsurgery, 2011.

http://www.ncbi.nlm.nih.gov/pubmed/2211 ... t=Abstract

Mohawk College Offers Lymphedema Program

Submitted by LymphedemaDepot on Dec 05, 2011

Lymphedema is one of the most feared and least understood complications of breast cancer treatment. Mohawk College in Hamilton, Ontario, is offering a day-long overview that will prepare the student to understand the causes of lymphedema as well as its treatment and management.
John Mulligan, RMT/CLT-LANA will present an Overview of Lymphology and Lymphedema Management at Mohawk College at the Mohawk/McMaster Institute of Applied Health Sciences Hamilton Campus in the Applied Health Sciences building, on Saturday February 4th, 2012, 9:00 a.m. to 4:30 p.m.
This unique one day workshop will explore the different types and stages of lymphedema, clinical pathways for treatment and the need for skilled care. Topics include basic lymphology, differentiating among different types of edema, the role and mechanics of compression, manual lymph drainage and complex decongestive therapy. We will also discuss the International Lymphedema Framework Movement, research resources and educational opportunities in the field of lymphology.
This one-day introduction to the basics of lymphedema and lymphedema management will immediately give the attendees a solid base of knowledge of the lymphatic system and disorders of the lymphatic system.
For more information visitwww.LymphedemaDepot.com and click on EVENTS in the left-side menu. This will bring you to the Mohawk online course catalogue where register for the daylong overview. To locate the course listing, simply go to page 53 of the catalogue. To register, click on Registration Information.
For further assistance contact John Mulligan directly at john@lymphedematherapist.com.
For more information about Mr. Mulligan and his practice, please visit www.LymphedemaTherapist.com.

MLD/CDP Manual Lymphatic Lymphedema Certification course, February 14-19th, 2012

The course layout would be as follows: 

Module I:  30 hours/home study.  Start as soon as you can.  It consists of a paperback book to read, questions to answer, and CD's to listen to.

Module II:  Tuesday/Wed the 14th-15th, of February, 8am-6pm,  (plus a few hours of practice/homework in the evenings)

Module III:  Thursday the 16th-19th, 8am-4:30pm, except for Sunday, we release at 2pm.   The students just starting Module II on Tuesday the 14th will continue until 6pm

Module IV:  Compression bandaging portion, April 19th-22nd.  8am-4:30pm

See the attached document for costs, and content/objectives and then let me know what questions you have!.  Looking forward to having you.  We have a great time and the classes are very relaxed. 

email me for complete course details:  carmenethompson@gmail.com

Great article on Lymphedema of the Trunk and Breast, by Joachim Zuther

Lymphedema Affecting the Breast and Trunk

By Joachim Zuther, on October 5th, 2011

Lymphedema affecting the chest, breast and posterior thorax, also known as trunkal lymphedema, is a common problem following breast cancer surgery, but is often difficult to diagnose, especially if the patient does not also present with lymphedema of the arm, or it may be dismissed as a side-effect of breast cancer surgery, which will resolve by itself over time.
While trunkal lymphedema is often not reported, poorly documented and available studies are not easy to compare, the literature suggests an incidence of up to 70% of lymphedema affecting the trunk and/or breast following breast cancer treatment.
Given the fact that the breast, anterior and posterior thorax and the upper extremity share the axillary nodes as regional lymph nodes, it is predictable that disruption of lymphatic drainage pathways by partial or complete removal of axillary lymph nodes, with or without radiation therapy can cause the onset of swelling in the chest wall and breast on the same side. The swelling can either be subtle or quite obvious in presentation and may be present with or without swelling in the arm.
The disruption of the natural lymphatic drainage pattern is further complicated by scars on the upper trunk wall following lumpectomy, mastectomy, and reconstructive breast surgery, biopsies or drain sites. Fibrotic tissues in the chest wall or armpit following radiation treatments may further inhibit sufficient lymphatic drainage.
Certain breast reconstructive procedures, such as the TRAM-flap reconstruction also disrupt lymphatic drainage in the abdominal area, which may cause the onset of additional swelling in the lower trunkal (abdominal) area.
Like lymphedema in the extremities, swelling affecting the breast, chest and posterior thorax is typically asymmetrical in appearance if compared with the other side. However, there are often other symptoms present prior to the onset of visible swelling, which may include altered sensation (numbness, tingling, diffuse fullness and pressure, heat), pain and decreased shoulder mobility. Once lymphedema is visibly present, the swelling may include the entire thorax wall, or may be localized to the armpit, the scapula, the area over the clavicle or around mastectomy/lumpectomy scar lines, around the reconstructed breast or implants, or it may be limited to the breast tissue only.
The breast in patients who underwent lumpectomy or reconstructive surgery may be larger and heavier, or the shape and height of the breast tissue may change due to fibrotic tissue, resulting in added psychological distress due to problems involving clothing, bra fit and body image issues.
Post-operative swelling following breast cancer surgery is to be expected and generally lasts up to about three months; it appears almost immediately following surgery and places additional stress on the lymphatic system by contributing to the lymphatic workload. The difference between “normal” post-operative edema and lymphedema is its perseverance following the completion of treatment, and the presence of changes in tissue texture, such as lymphostatic fibrosis.

skin fold caliper

While several methods are available to assess trunkal and breast edema (skin fold calipers, bioimpedance), subjective examination of the anterior and posterior aspect of the thorax and breast focused on the observation of signs of swelling (asymmetry, bra strap and seam indentations, orange peel phenomenon, changes in skin color), palpation of the tissue texture and comparison of skin folds between the affected and non-affected side, remain the most practical means for assessment of lymphedema affecting the trunk. Serial photographs depicting the anterior and posterior view are helpful tools in assessing changes before and after treatment.
Most of the symptoms associated with trunkal lymphedema can be treated successfully with Complete Decongestive Therapy (CDT), to include Manual Lymph Drainage (MLD), especially if combined with self-MLD, skin care, exercises and compression therapy. Fortunately, trunkal swelling responds well to treatment, often with markable improvement within 10 treatments. Treatment may be necessary only during the initial period following breast cancer treatment to facilitate edema removal and wound healing, or it may be applied at a later point; trunkal lymphedema with or without the involvement of the arm may appear at any time following surgery for breast cancer.
Manual Lymph Drainage: In case of localized trunkal lymphedema without involvement of the arm, MLD techniques concentrate on the neck, the anterior and posterior aspects of the upper trunk, as well as the inguinal lymph nodes, followed by techniques focused to redirect lymphatic fluid from congested areas into areas with sufficient lymphatic drainage. If necessary, additional techniques aimed to soften fibrotic tissues may also be applied.
For patients who underwent TRAM-flap procedures, careful attention should be given to address scar tissue that could lead to trapping of lymphatic fluid.
During the initial stages of the treatment, patients should be instructed in self-MLD and encouraged to perform self treatment for at least 20-30 minutes daily.
Skin Care: Patients who have lymphedema are susceptible to infections of the skin; areas between skin folds or the underside of the breast are particularly prone to skin damage and infections. Edematous areas should be kept clean and dry and suitable ointments or lotions formulated for sensitive skin, radiation dermatitis and lymphedema should be applied.
Exercises: Trunkal lymphedema is often associated with restrictions in thorax and shoulder movements, which should be evaluated by a Physical or Occupational Therapist. Specific exercises addressing these issues and to increase range of motion and function with daily activities should be performed.
Depending on the location and quality of scars, mobilization of adhered scar tissue by a qualified therapist may be necessary to improve range of motion. Breathing and aerobic exercises further facilitate decongestion by improving drainage in superficial and deep lymphatic pathways.
Compression Therapy: Oftentimes compression of the affected area may be challenging due to tenderness of the tissue, or irritated skin secondary to

compression bra

radiation therapy. However, in order to address fluid accumulation and to avoid worsening of the swelling, the application of compression bandages and/or compression bras or vests is very important. Compression bandages are applied circumferentially around the chest with special care not to impair blood supply to grafts and/or healing scars.
Due to the lack of muscle pump activity in the trunkal area, the use of wide-width (15-20cm) medium and long-stretch bandages is preferable over the normally used short-stretch bandages for lymphedema affecting the extremities.
Custom cut or commercially manufactured foam pads or foam chips may be inserted underneath the bandages or compression bra/vest to increase localized pressure in areas of excess fluid pooling, or to soften localized fibrotic tissue. Flat foam pieces can be used to shape and stabilize the compression bandages and to distribute the pressure evenly over a greater surface area.
The patient should be fitted with a specially designed lymphedema bra or compression vest following decongestion of the trunk to assist with maintaining the positive results of CDT. Compression bras and vests have minimal seams and wide straps, are available as off-the-shelf or custom-made garments and ensure that the trunk and breast tissues are properly supported. Compression bras and vests should fit comfortably, provide sufficient support around the trunk and not squeeze breast tissue; pockets to accommodate a prosthesis can be sewn into these garments.
Patients using regular bras or sports bras should make sure to avoid narrow bra straps and obtain bra strap pads or wideners, if necessary, to avoid restriction of lymphatic pathways on the shoulder.
Additional Resources:
http://www.stepup-speakout.org/breast_chest_trunckal_lymphedema.htm
http://www.lymphoedema-uk.com/journal/0101_breasttrunk.pdf

Join Lymphedema Guru, a Facebook page solely dedicated to inform about all things related to lymphedema – news, support groups, treatment centers, and much more

Welbox For Cellulite Reduction and Lymphatic Stimulation

Product Description and Benefits:

Clinically proven, the Wellbox Lipomassage LPG Machine revitalizes deep tissue action and stimulates the skin to repair itself for a wide variety of beauty, health and wellness treatments. Easy-to-use and operate at home, Wellbox Lipomassage can be used on the face and body to reduce the appearance of cellulite and trim one's figure, achieve smoother, softer skin, restore firmer skin with more elasticity, soften and reduce lines, wrinkles, and sagging skin, and silken and soften the skin for glowing, radiant complexion. The Wellbox Lipomassage Cellulite & Fat Reduction Device is based on the most efficient non-invasive professional technique cleared by the FDA for reduction in the appearance of cellulite. Used by leading spas, plastic surgeons and celebrities such as Paris Hilton, Celine Dion and Sharon Stone, Well box is also a highly effective post-operative healing device to use following liposuction, tummy tuck, or any facial or body plastic surgery to help stimulate circulation, reduce swelling and bruising, treat lumpiness that can occur following surgery, break down hardened fibrosis tissue, and achieve a smooth finish on one's surgically operated body. Wellbox Lipomassage also relieves the body of aches and pains, and when used on the face, it can help achieve a radiant appearance through its delicate exfoliation mechanism and achieve rejuvenated skin through its optimized microcirculation mechanism that oxygenates and brings precious nutrients to the skin. Wellbox features five high-performance, interchangeable treatment heads that cater to all skin types and sensitivity levels. Designed for use in the comfort and convenience of your home, Wellbox is compact, lightweight, and portable. For frequent travelers, the sleek, compact machine comes fully equipped with a training video and universal adapter.

From microdermabrasion to gym equipment, the trend toward professional-grade beauty technology with at-home convenience is transforming the beauty and health industries. Scientifically proven and world renowned, Wellbox Lipomassage™ is a home-use version of the professional Lipomassage machine currently found in medical spas and cosmetic surgeon's offices.

Click here to see Wellbox Before/After Pictures

Clinically proven, Wellbox's revitalizing deep tissue action stimulates the skin to repair itself for a wide variety of beauty, health and wellness treatments.

• Stimulate fat metabolism, even in diet & exercise-resistant fatty areas
• Fight cellulite, stubborn fat retention and figure flaws
• Nourish and revitalize aging skin
• Restore youthful, radiant skin
• Beautify and redefine the figure
• Relieve tension, aches and pain
• Soothe and relax the entire body
• Silken and soften skin for a flawless, radiant complexion
• Experience dramatically younger-looking body
• Re-energize skin for a healthy glow

Regardless of age, gender or ethnicity, Wellbox personal Lipomassage is the only real, scientifically proven home solution to effectively fight body imperfections on a cellular and structural level.

How does Wellbox fight cellulite and promote weight loss?

Often referred to as the "orange-peel" or "cottage-cheese" effect, cellulite plagues over 90% of women today. ‘Love Handles,' ‘muffin top' and ‘saddlebags' are all affectionate terms for the stubborn fatty areas that accumulate on the waist, hips and thighs. Although age, lifestyles, hormonal factors and body types may predispose certain woman to such cellulite and fat retention, all women -even young, thin women and devoted followers of stringent exercise and nutritional regimens - are at risk.

Though not directly responsible for providing weight loss, recent studies have shown that Lipomassage directly and quantifiably ‘reboots' fat cell metabolism for a more slenderized, streamlined waistline and a redefined physique. With Lipomassage, ‘superficial trapped fat' (stored fat resistant to diet, exercise and not addressed by surgical procedures) is actually expelled from fat cells. Wellbox's Lipomassage action is the most effective home-solution to fight cellulite and fat on a cellular and structural level.

For thirty million Americans, though, beauty - or the lack thereof- is more than skin deep. Women suffering from such by-products of poor circulation as unsightly veins, swelling and heavy-leg syndrome are concerned with much more than having a bikini-ready body. Revitalizing blood circulation, Wellbox reduces the feeling of tingling, cramps, pressure and heaviness. Flushing the system of waste products as well as removing and preventing fluid retention, Wellbox soothes, refreshes and energizes legs as it diminishes the visible signs of unhealthy skin.

How can Wellbox help me before or after my cosmetic surgery?

Having adequate blood supply before, during and after any surgery - whether for breast or buttock augmentations, liposuction, thigh and tummy tucks, or the like - is vital for a positive outcome and speedy recovery time. Hematomas, Seromas, hyperpigmentation and permanent bruising are all related to circulatory deficiencies. After surgery, residual blood collects in tissues, waiting to be broken down and reabsorbed. Although very rare, in severe cases, lack of blood supply may also result in necrosis (dead tissue), which causes major infections and even gangrene. More commonly, fibrosis results - the formation of scar-like structures in lymphedema affected tissues - causing tissue to harden, losing softness and flexibility. With reduced circulatory exchanges, cells are prevented from receiving essential nutrients and worse, protein deposits form and aggravate the condition. With this impaired circulation, the lymph cannot drain properly and there is a greater risk of swelling, tissue infection and skin problems, not to mention a much longer healing time. To reduce tissue swelling, bruising and numb, hardened fibrosis tissue, proper lymphatic circulation is vital.

Plastic Surgeons use a professional version of Lipomassage technology to dramatically boost circulatory exchanges - venous and lymphatic - thereby preventing post-surgical trauma, unhealthy connective tissue and structural irregularities. Like the FDA-cleared professional machines, Wellbox improves lymphatic and local blood circulation.

Combined with Wellbox's astounding aesthetic and therapeutic results, the relaxing, pain-relieving effects loosen stiffness, calm and de-stress the entire body for improved healing and wellness.

Wellbox is highly beneficial even for persons who are not candidates for surgical augmentation. Life-sustaining blood must circulate freely; working within the lymphatic system; it is responsible for oxygenating tissues and purifying the body to flush out wastes. Rejuvenating circulation and accelerating the process of metabolic exchanges, Wellbox benefits the body's largest organ - skin. Pampering and relaxing the body and the mind, Wellbox gives skin a radiant glow and makes it feel nourished, refreshed and smooth.

Wellbox provides consumers with a comprehensive, non-invasive mini-spa for the face and body that is simple, stylish and safe. The ideal gift for men and women alike, Wellbox is smart and simple to operate, offering a user friendly display with simple settings for each pre-programmed application. Fully equipped with a detailed instructional video and five high-performance, interchangeable treatment heads, Wellbox caters to all skin types and sensitivity levels. Designed for the comfort and convenience of the home, Wellbox is compact, lightweight and portable. For frequent travelers, a universal adapter is also included.

Three Treatment Heads for Targeted Results:

Wellbox technology comes with interchangeable, high-performance treatment heads. Designed for all skin types and sensitivity levels, they treat a variety of beauty, health, sport and well-being needs.

1) Treatment Head 45 millimeters:

Developed from mechanical ROLL technology, this is the largest treatment head. Press once to start frontal rotation and press a second time to start rear rotation. As the treated area is gently pulled up, tissue fibers are stimulated, drained, and made suppler. This head is designed primarily for large bodily surfaces, such as the chest, thighs, buttocks, and back.

2) Treatment Head 30 millimeters:

Developed from mechanical ROLL technology, this is the medium-sized treatment head. Consult the Wellbox user manual for objective-specific programs and continuous vs. rhythmic treatment settings. This head is designed primarily for medium-sized bodily surfaces, such as arms, forearms, and calves.

3) Treatment Head 15 millimeters:

Developed from mechanical ROLL technology, this is the smallest treatment head. Applying targeted, in-depth action, these rollers gently lift tissues to mobilize, drain, sculpt, and relax every inch of skin they touch. This head is designed primarily for small bodily surfaces, such as palms, knees, ankles and foot arches.

4) Treatment Head Developed from LIFT technology:

- Largest treatment head: Small valves perform steady micro-pulsation, giving constant stimulation to each and every millimeter of treated skin. Like natural skin calisthenics, this workout truly restructures skin at a cellular level. Move the treatment head slowly for maximum comfort and stimulation. This head is designed primarily for use on body parts that require a firming treatment, such as the face (excluding the eyes), neck, and décolleté.

- Smallest treatment head: Tenderly lifting the skin, the constant movement of the small valves provides the gentlest of deep tissue stimulation. The LIFT effect is a gradual one; as the underlying support network is reinforced, skin becomes visibly firm and smooth. This head is primarily designed for use on the most delicate and sensitive body parts, such as fine lines, crow's feet, and laugh lines.

Can Wellbox Work In Any Country? Wellbox comes with electrical adaptors that allow the device to work in any country.

www.amazon.com

Manual Lymphatic Drainage Certification Courses beginning October, 2011

Course offerings from Lymphatic Care Specialists, LLC
Lymphedema Treatment Center, Blacksburg, VA,  OR
Provided On-site at YOUR Facility!


Introduction to Manual Lymphatic Drainage-An Overview-8 CEUs 

Manual Lymphatic Drainage-Basic Body and Face Sequence- 8 CEUs

Introduction to Compression Bandaging & Garment Fitting-15 CEUs

Kinesio Taping for edema disorders:  Lymphedema and Orthopedic Trauma-8 CEUs

Three-day  Alternative Techniques for Lymphedema and Swelling disorders course:  24 CEUs 
TBA

Three day Manual Lymphatic Drainage Techniques for Orthopedic Conditions:  24 CEUs
 TBA

Three day Manual Lymphatic Drainage for Autoimmune Conditions:  24 CEUs
TBA

Two day Comprehensive Visceral Organ Manual Lymph Drainage:  16 CEUs


Three day Manual Lymphatic Drainage and CDP therapy with special populations:  24 CEUs
 TBA

Three day Manual Lymphatic Drainage for Aesthetics/Post Plastic Surgery:  24 CEUs 

 Three day Manual Lymphatic Drainage for head, neck, and genitalia:  24 CEUs

Full MLD/CDP 140 hour certification program.  Accredited by the National Lymphedema Network. 

My 2011 Certification Class

Carmen,

Thanks for the information. 

I’m doing great.  My cardiologist thinks he figured out why my legs have started swelling.   A lower chamber of my heart has narrowed.  It is probably scar tissue from a past surgery.  Since I’m doing well, no plan to fix it right now. 

Thanks once again for the education about lymphedema.  It has really improved my quality of life.  The swelling in my legs had been gradual over the years and I didn’t realize how bad it had gotten until you fixed me.

Julie 

Pharmaceutical Options in the Treatment of Lymphedema

By Joachim Zuther, on July 5th, 2011

The use of drugs in the treatment of lymphedema in the Western Hemisphere is generally limited to antibiotics, which are used to prevent and treat infections commonly associated with lymphedema. As stated in the Position Paper of the National Lymphedema Network, lymphedema should not be treated exclusively with drugs or dietary supplements.
Following is a list of medications, which are mentioned for possible use in the treatment of lymphedema.
DiureticsThese drugs promote excess fluid in the body to be excreted. Although diuretics may be beneficial in the short-term, and may be indicated in those cases when lymphedema is associated with systemic conditions (ascites, hydrothorax, protein-loosing enteropathy), they may be harmful and contribute to the worsening of lymphedema-related symptoms if used long-term.
Here is why: Lymphedema is an abnormal accumulation of water and protein molecules in the body’s soft tissues, which is caused by a dysfunction of the lymphatic system. Swelling (edema) other than lymphedema may be caused by a variety of conditions, such as congestive heart failure, renal diseases, or venous insufficiencies. These swellings do not contain a higher level of proteins in the accumulated fluid, and are defined as edemas.
Diuretics used for lymphedema are limited to remove the water content of the swelling, while the protein molecules remain in the soft tissues. The dehydration effect of diuretics causes a higher concentration of the protein mass in the edema fluid, which may cause the tissues to become more fibrotic and increase the potential for secondary inflammations. In addition, the remaining proteins characteristically draw more water to the swollen areas as soon as the diuretic looses its effectiveness and may cause the volume of the lymphedema to increase.
The 2009 Consensus Document of the International Society of Lymphology states: “Diuretic agents are occasionally useful during the initial treatment phase of complete decongestive therapy (CDT). Long-term administration, however, is discouraged for its marginal benefits in treatment of peripheral lymphedema and potentially may induce fluid and electrolyte imbalance”
BenzopyronesThese drugs include Coumarin, Hydroxyethylrutin and flavonoids (Diosmin) and have been shown to promote the breakdown of proteins present in lymphedema. Research has shown that their practical usefulness in the treatment of lymphedema is questionable. The United States and Australia abandoned the use of Coumarin due to liver toxicity and lack of effectiveness.
Diethylcarbamazine (DEC) and AlbendazoleThese medications are used in the treatment of lymphatic filariasis, which is very rare in the United States, but endemic in more than 80 countries in the

Lymphatic Filariasis

tropics and subtropics. Filariasis is caused by threadlike, parasitic filarial worms that live almost exclusively in humans. It is estimated that over 120 million individuals are affected by this disease, which is transmitted when a mosquito bites an infected person and then goes on to bite others, thus infecting them with the parasites. During the worms lifetimes inside the host’s lymphatic system they produce dilation and damage to the lymphatics, restricting the normal flow of lymph, causing swelling, fibrosis and infections to lymph vessels and nodes (lymphangitis, lymphadenitis), leading to often extreme swellings. The goal of these drugs is to eliminate the parasitic worms, so the transmission of the disease by mosquitoes can be interrupted.

  

 

Endemic Countries for Filariasis

Antibiotics and AntimycoticsBacterial (dermato-lymphangio-adenitis [DLA]) and fungal infections of the skin and nails are common in patients with lymphedema. These complications can be treated effectively with broad spectrum antibiotics and antimycotic drugs. In cases where cellulitis is a frequent complication, prophylactic antibiotic treatment may be indicated.

National Lymphedema Network
Lymph e-Channel vol. 4 May-June 2011
In This Issue · Welcome · Therapist's Article · Patient Perspective · MySassySleeve · Sponsor A Patient · Educate Your Legislator Patients: We want to share your stories! Don't forget to send us a short paragraph of your experiences with lymphedema for us to publish! You can also send us photo to accompany your article if you are interested. All submissions should go torobin@lymphnet.org. Net Pals / Pen Pals Looking to correspond with with a special person in a faraway (or not so faraway) place who also has lymphedema? Look no further than the NLN Lymphedema Pen Pals/NetPals Network! Net Pals / Pen Pals Position Papers    Diagnosis & Treatment of Lymphedema     New! Breast Cancer Related Lymphedema  Risk Reduction     Exercise       Air Travel Quick Links National Lymphedema Network Cafepress Store	Welcome to Lymph e-Channel  Dear friends of the NLN, My staff and I are thrilled to send you our latest issue of Lymph e-Channel. In this May/June edition you will find a range of inspirational and educational articles contributed by therapists and patients. This month we highlight a perplexing phenomenon - cording. Cording frequently occurs shortly after breast cancer surgery, and it is only in the last decade that practitioners have seriously addressed these unknown painful symptoms. Jodi Winicour, a lymphedema therapist and expert in BC rehabilitation, shares her knowledge and guidance on this subject. Dr. Nancy Hutchison, the chair of the NLN Medical Advisory Committee, recently invited her state representatives to visit her hospital where she educated them about lymphedema. One of her patients even showed the representatives her leg and demonstrated self-care. We are lucky to have a knowledgeable LE doctor who makes time to advocate for patients rights, and we hope that you will organize a similar meeting in your community. In our patient perspective, Margaret Omori recounts her initial dismay with her lymphedema diagnosis following BC surgery, but also how she found a positive outlook from it all. Margaret and her sister, Monica, created a fashionable lightweight stretchable coverlet which adds a "sassy" flair to her sleeve. The sisters are co-founders of "MySassySleeve" company and their brand of colorful and fun coverlets are shared in our product review section. I am also excited to introduce a new regular feature to e-Channel - patient stories from our Marilyn Westbrook Garment Fund (MWGF). The MWGF directly impacts a patient's life and in this issue we share the story of one beneficiary, Ms. Gray. Hopefully these stories inspire you to share your own experiences and go out and make a difference in your communities. This issue is full of interesting articles and information, and I hope you take the time to read and thoroughly enjoy this Lymph e-Channel. In Good Health,  Saskia RJ Thiadens, RN Executive Director, NLN Painful Cording of the Arm by Jodi Winicour PT, CMT, CLT-LANA *References listed at the bottom of issue.    If you have upper extremity lymphedema caused by breast cancer surgery or treatments, you may have experienced a painful and bothersome condition called axillary web syndrome, or AWS. [Figure 1] Unfortunately, most lymphedema certification programs do not have the time to teach the treatment of AWS, which leaves lymphedema patients well treated for their swelling conditions but inadequately cared for regarding their cording. As few as 6% [1] to as many as 72%  [2] of women who have had lymph nodes removed from their armpit (axilla) will develop AWS. Considering the pain it causes along with its frequent relationship with lymphedema, knowledge of its characteristics, onset and treatment is necessary to provide safe, holistic care for breast cancer survivors. AWS characteristics: AWS has certainly been around since the first radical mastectomies of the early 1900s, but the phrase "Axillary Web Syndrome" was coined in 2001 by Alexander Moskovitz, MD et al. [1] He describes painful cords of tissue that originate in the axilla, run along the inside of the upper arm to the elbow, and sometimes even to the wrist or the base of the thumb. These cords are made more taught by reaching out to the side and frequently can be seen as well as felt.  Painful cording typically limits overhead and forward reaching along with elbow and forearm movements which makes activities such as cooking, cleaning, exercise, reaching and dressing difficult or impossible during the more painful stages. How and when does AWS happen? Typical onset of cording is 2 to 4 weeks after axillary node removal. [1, 2, 4, 5] Some with AWS have so much pain that it is difficult to use their arm while others feel that stretching and massage techniques are very helpful.  Studies consistently report that the AWS will resolve on its own between 3 and 4 months after onset, but therapists who treat AWS have noted it lasting up to 1 year or longer without treatment.  Untreated AWS may cause problems during the planning period for radiation therapy in those not needing chemotherapy. If unresolved, the cording can make CT scanning for radiation planning a very painful procedure which can delay the start of radiation therapy. It is much less common to see AWS after chemotherapy is completed, which is typically 3 to 6 months post surgery, but it does occur. What is the stuff called AWS? Although there are few tissue samples of AWS that have been looked at under the microscope, we do know that AWS can be hardened and enlarged lymphatic vessels that are filled with lymphatic fluid. This fluid cannot exit the arm normally through lymphatic pathways to the axilla due to lymph node removal.  [1, 5, 10]  AWS may also be small veins near the skin that are clotted or hardened. [1]  In some cases, the webbing is hardened and clotted lymphatic fluid that causes inflammation of the vessels and makes them stick to the fatty tissues of the arm resulting in pain when moving or stretching the arm. What increases my risk of having AWS? While weight gain [11,13], obesity [11,13]  & higher Body Mass Index (BMI of 25-26 kg/m2 [2,12,13]) have been associated with the onset of lymphedema,  a lower BMI of 23[2] and 25.1 [ 3]) have been associated with the onset of AWS.  These are confusing findings especially considering that both lymphedema and AWS seem to be caused by the axillary node removal and tissue scarring. Thinner women have both the increased risk of AWS and difficulties with shoulder movement after lymph node surgeries for breast cancer, while their risk for lymphedema should be lower than heavier women. [2, 11, 13] What can I do about AWS? While studies written by physician researchers  state that AWS will resolve on its own, therapists around the world who frequently treat AWS  agree that gentle massage, manual lymphatic drainage techniques and range of motion exercise can accelerate pain relief and tissue healing. Physical therapy may shorten the natural course of AWS to 6-8 weeks. [3] In some cases, the AWS presents with a mild lymphedema of the forearm. While traditional CDT (Complete Decongestive Therapy) techniques may reduce the lymphedema, it may become a chronic condition unless the AWS is treated. Soft tissue techniques for cording include very gentle tissue "bending" or "traction" techniques applied along the taut cord in a comfortable position of stretch. Localized thumb and whole handed MLD techniques along the cording is also useful. Do combine active stretching with massage techniques to further improvements and do not be surprised if a "pop" is heard along the cording during your gentle treatments or during stretching. This "pop" will usually ensure immediate pain relief during movement but can also lead to lymphedema on rare occasions. Please avoid being overly aggressive (causing pain) during your treatments as this can cause an inflammatory reaction that may increase the lymphedema risk of your affected arm. Knowledge of safe and effective techniques to hasten the resolution of AWS is necessary in the treatment of those recovering from breast cancer treatments and arm lymphedema.  Hopefully reading this article will help to ease you or your patients' discomfort and increase your awareness of the treatments that are available. Jodi Winicour PT, CMT, CLT-LANA Longmont United Hospital, Longmont, Colorado. Jodi is a full time clinician specializing in the treatment of lymphedema and cancer related dysfunction. She also is a Lymphedema Certification and Breast Cancer Rehabilitation Course instructor for Klose Training & Consulting. Contact her at: Jodi@KloseTraining.com   Be Sassy!   by Margaret Omori      I didn't know enough, in the summer of '04, to be devastated by the news that I had developed lymphedema. I didn't know about the physical limits that would forever dictate how much I could lift, or the precautions that I would have to take in order to work in my garden. I didn't count on the huge financial burden that accompanied that diagnosis. The cost of multiple, custom-made compression garments that had to be factored into our family budget every three or so months or the expense of periodic "tune-ups" with my therapist. And I certainly wasn't prepared for the emotional toll that living under the cloud of this chronic condition would take on me or my family. The fact of the matter is: I am a breast cancer survivor and I have lymphedema.  Believe me, I'm thrilled to BE a survivor, grateful for the wonderful medical care that I received, and thankful to the dedicated professionals; the doctors, therapists and fitters who have successfully treated and continue to help me manage my condition.   But what I most wanted, after I had battled and beat the breast cancer beast, was to look and feel like my old self.  Needless to say, wrapping my arm in multiple layers of cumbersome bandages and wearing bland compression garments not only served as a constant reminder of my cancer battle, my self-esteem was assaulted on a daily basis!  Facing endless questions from well-meaning strangers asking, "How did you hurt yourself?" or, "Why are you wearing a bandage?" made me feel less like a "survivor" and more like a casualty.  Discouraging? Yep!  Depressing? You bet! And that would have been the end of my story had it not been for a timely gift in the form of some pirate tattoos (full disclosure: I'm a huge Johnny Depp fan!). The novelty of imagining my affected arm covered entirely in bold tattoos not only made me laugh, it gave me the courage to envision turning a negative into something positive. I thought, why not create something stylish and fun to wear over the dreaded "bandage"?  Since wearing a compression sleeve draws attention anyway, why not do it in a way that attracts smiles instead of sympathy? Instead of feeling self-conscious, why not sassy? Thus inspired, my sister and I created a line of vibrant, tattoo-like coverlets called "MySassySleeve." Our goal is to provide an affordable and fashionable coverlet to help women regain a positive self-image and to change how others interact with us.  While lymphedema wasn't on my radar back in '04, it is now. My sister and I have joined our efforts with those in the medical community to actively raise awareness about lymphedema. We've helped advocate to get more comprehensive coverage for patients with lymphedema. And, most gratifyingly, we've raised funds through our business to aid those in need to purchase medical compression wear. Along with the talented artists, local manufacturers and others who help to create our product, our shared goal is to make a difference in the lives of those with lymphedema... one sleeve at a time. MySassySleeve  Therapist Review: by: Guenter Klose, MLD/CDT Certified Instructor, CLT, founder of Klose Lymphedema Care in Lafayette, CO., Executive Director of Klose Training and Consulting. When Monica (co-founder of MySassySleeve) introduced me to her decorative coverlets and brought several samples in to our office, I was happy to see such a fresh and innovative product offered for people with lymphedema. It is exciting that patients who wear compression garments to manage their lymphedema now have a design choice with these interchangeable, non-medical sleeves.  Instead of feeling like they need to hide their compression sleeve under a jacket or long-sleeved shirt, they can wear these light-weight, stretchable coverlets over their garment to add a bit of light-hearted fun. I often hear from many of my patients that having to wear a medical garment is not only unattractive but makes them feel self-conscious. We immediately saw emotional benefits in patients who wear the MySassySleeve coverlets. By drawing attention to the colorful, tattoo designs and away from the medical looking therapeutic compression sleeve, my patients have rediscovered their self-esteem and self-confidence. They feel good about themselves and that has empowered them. While MySassySleeve is only decorative and does not manage lymphedema, it certainly provides an emotional, feel-good benefit that medical garments alone cannot provide. Congratulations on a wonderful and beneficial product. Fitter Review:  "The best part of having MySassySleeves for my customers is the spontaneous moment of surprise and joy they create. The bright colors and bold designs immediately transform a medical product into a fashion statement, and in the same moment transform a patient's experience from 'a little bit awful' to 'a little bit fun'. The tattoo patterns ARE sassy and we've watched so many women change their thinking from 'Not for me.' to 'Why NOT me!?' And you have to love the smile that goes along with trying something just a little outside their comfort zone. We have spent many years providing our customers with outstanding therapeutic garments- We are now delighted to provide them with the opportunity to see their compression sleeve as a blank canvas for their newest accessory!" Claudia Boyle Van Driel's Medical Support Wear  Patient Reviews: "What MySassySleeve is doing is so wonderful! It will make wearing my dull and boring compression sleeve so much fun to wear. It will also make me want to wear it more often which will benefit my condition. I will wear it proudly...thanks again!" Emmie B. "I am very excited about the MySassySleeve. Great idea- the fact that you are not trying to compete with medical grade sleeves but compliment them is perfect! I brought them to two breast cancer care education nurses and they loved them!" Syndi S., CMF, BOC, ABC Wilmette, IL This Product Review is a paid advertisement.    Marilyn Westbrook Garment Fund   The Marilyn Westbrook Garment Fund (MWGF) holds a special place in the hearts of the NLN staff. It gives us the opportunity to not only help our patients, but connect with them on a personal level and see firsthand the profound impact the fund has on their lives. Because of this, we have decided to share their stories with you. In every issue of Lymph e-Channel, we will feature the story of a MWGF patient. We hope you find them as inspiring and courageous as we do.      Ms. Gray is a breast cancer survivor who developed lymphedema shortly after her surgery in 2007. Initially, she was able to afford a sleeve and gauntlet, but the cost of replacing these garments was a burden for her. Instead, Ms. Gray continued wearing the same sleeve and gauntlet for the next two years. No longer providing adequate compression, her sleeve started rolling down, cutting off the circulation in her arm. Ms. Gray's swelling progressively worsened as a result. Fortunately, Ms. Gray's therapist told her about the MWGF and she quickly contacted us. With Juzo's generosity, we were able to supply Ms. Gray with a new set of garments.    "I wish to take this opportunity to thank you for all your efforts on my behalf and to thank the organization for financially supporting my need. At the time of the initial application I did not know what to do about getting a new sleeve and gauntlet. And everyday the old one was getting more and more uncomfortable. It is very comforting to know that there are people and organizations that help when you need it and with what you need. I can only say thank you again, though that seems to be very little for the great thing you have done for me! Sincerely yours, G. Gray" Ms. Gray's case is not unique. Across the country, there are many patients that need lymphedema garments. For many of us, the benefit of proper garments is clear - they are crucial to the success of lymphedema therapy. You can help! This year we plan to raise at least $25,000 to continue the work of the MWGF. As part of our Sponsor-A-Patient Campaign, a $50 pledge will support one patient by: Sponsoring a patient's application including a yearly membership to the NLN Covering program costs to administer and continue to grow the fund.   Click Here to make a donation to the MWGF.   For only $50 you can positively affect someone's life. But don't feel limited by one amount; you can make a contribution in any amount. Large or small, every dollar supports a patient. Check back frequently to track our progress on the thermometer! (Donors can also choose to have their name and/or logo listed) On behalf of the many patients, therapists, affiliated clinics, and the NLN staff, we thank you from the bottom of our hearts. Federal Health Policy Staffers Visit Sister Kenny Rehabilitation Institute to Learn About Lymphedema   April 26, 2011 On Tuesday, April 26, leaders from Allina and the Sister Kenny Rehabilitation Institute in Minneapolis, MN met with the health policy staffers from the offices of Senator Amy Klobuchar, Senator Al Franken and Congressman Keith Ellison to talk about lymphedema.    Erika Nelson, Sen. Klobuchar's office, Bethany Snyder, Sen. Franken's office and Mike Siebenaler, Congressman Ellison's office learned about lymphedema, proper treatment of the disease, innovative work being led by the Sister Kenny Rehabilitation Institute, and the challenges faced by providers and patients due to the lack of Medicare and some private insurance coverage. Nancy Hutchison, MD, Medical Director of the Sister Kenny Lymphedema and Cancer Rehabilitation Program and chair of the Medical Advisory Committee of the National Lymphedema Network, gave a presentation about lymphedema, the gaps in coverage for lymphedema and the need for federal legislation.    The group heard the facts and read the statistics but what really drove the message home was the presence and story of Kris Maser, a Sister Kenny Rehabilitation Institute patient with lymphedema. Maser, a wife, mother, attorney and cancer survivor, has been a patient of Dr. Hutchison's for several years and wanted to help educate our officials on this disease. She told them her personal story, showed them what lymphedema looks like and demonstrated how she has to wear several types of garments, compression bandages and home lymphatic drainage to control her lymphedema. It is Allina's hope that The Lymphedema Diagnosis and Treatment Cost Savings Act will once again be introduced at a federal level that starts to address some of the many concerns around this disease. The Health Policy staffers for the Minnesota Senators Klobuchar and Franken and Congressman Ellison stated that the information was very helpful. They recommended that other lymphedema providers and patients around the country hold similar meetings with their legislators and staff.   Learn more about lymphedema and the care provided by certified professionals at Sister Kenny Rehabilitation Institute on Allina.com. The Sister Kenny Rehabilitation Institute at Allina Hospitals & Clinics is a national leader in lymphedema treatment. It has one of the largest lymphedema programs in the United States and is the only physician- directed multisite, multi-hospital lymphedema program in Minnesota with programs at eight Allina hospitals and nine Sister Kenny outpatient centers, with over 30 Certified Lymphedema Therapists on staff. References from Painful Cording of the Arm:   Moskovitz AH, Anderson BO, Yeung RS, Byrd DR, Lawton TH, Moe RE. Axillary web syndrome after axillary dissection. Am J Surg. 2001; 181:434-439. Leidenius M, Leppanen E, Krogerus L, von Smitten K. Motion restriction and axillary web syndrome after sentiniel node biopsy and axillary clearance in breast cancer. Am J Surg. 2003;185(2):127-130. Lacomba MT, Orlando M, Coperias Zazo J et al. Axillary Web Syndrome after axillary dissection in breast cancer: a prospective study. Breast Cancer Res Treat 2009; 117: 625-630. Craythorne E. Axillary Web Syndrome or Cording, a Variant of Mondor Disease, Following Axillary Surgery. Arch Dermatol, 2009; 145(10):  1199-1200 Reedjik M, Boerner S, Ghazarian D et al. A case of axillary web syndrome with subcutaneous nodules following axillary surgery. The Breast. 2006; Vol. 15, 411-413. Lauridson MC, Christiansen P, Hessov I. The effect of physiotherapy on shoulder function in patients surgically treated for breast cancer:  A randomized study. Acta Oncologies, 2005; 44:  449-457. Opie EL. Thrombosis and occlusion of lymphatics. Journal of Medical Research 1913; 29: 131-146. Kepics JM., 2004. Physical therapy treatment of axillary web syndrome[online]. Look Smart, Rehabilitation in Oncology. Available from:http://www.findarticles.com/p/articles/mi_qa3946/is_200401/ai_n9370189[Accessed 25 November 2005]. Mera K, Terasaki K, Kanzaki T, et al. Mondor's Disease of the Neck. Journal of Dermatology, 2009; 36: 179-180. Marcus RT, Pawade J, Vella EJ. Painful lymphatic occlusion following axillary lymph node surgery. Br. J. Surg. 1990; Vol 77, 683. Petrek JA, Senie RT, Peters M et al. Lymphedema in a Cohort of Breast Carcinoma Survivors 20 Years after Diagnosis. Cancer, 2001; 92, (6)  1368-1377. Sagen A, Karesen R, Risberg MA. Physical Activity for the Affected Limb and Arm Lymphedema after Breast Cancer Surgery. A Prospective, Randomized Controlled Trial with Two Years Follow-up. Acta Oncologica, 2009; 48:  1102-1110. Shaw C, Mortimer P, Judd PA. A Randomized Controlled Trial of Weight Reduction as a Treatment for Breast Cancer-related Lymphedema. Cancer, 2007; 110 (8) 1868-1874. Boneti C, Korourian S, Diaz Z et al. Scientific Impact Award:  Axillary Reverse Mapping (ARM) to Identify and Protect Lymphatics Draining the Arm During Axillary Lymphadenectomy. The American Journal of Surgery, 2009; 198, 482-487.
National Lymphedema Network, Inc. 116 New Montgomery Street, Suite 235 San Francisco, CA 94105 Hotline: 1.800.541.3259 Tel: 415.908.3681