Tuesday, February 15, 2011

Lymphedema Awareness Day from the NLN!

Lymphedema Awareness D-Day 
 
We are excited to remind you that our annual Lymphedema Awareness D-Day will be March 6, 2011.
 
This special day is set aside to honor inspirational lymphedema patients, those who have contributed to the community or who have shown great courage in their struggle with the disease. Every year, we take this opportunity to promote awareness of lymphedema and to advocate for improved treatment and care.
 
On Lymphedema Awareness D-Day, you can honor a lymphedema patient for his or her courage in living with lymphedema. You can also honor a patient advocate, doctor, therapist, or a caregiver for his or her special care and support. In past years, some have been honored at gala events, some in small, intimate gatherings, and others privately by their health-care provider, family or friend. It's up to you!
 
To Participate:
Once you've chosen your honoree(s) and planned your special event, be sure to contact the NLN office and request an official NLN Lymphedema Awareness D-Day Certificate for your honoree(s).
 
Did you know you can also have your honoree listed on our website and in Lymphlink? For more information visit: www.lymphnet.org/lymphedemaFAQs/legislation/awarenessDDay/dDay.htm 
 
 
Self Care Techniques to Make it Easier to Bandage Lower Extremities
Karen Ashforth, MS, OTR, CHT, CLT-LANA
Bandaging is part of the gold standard of treatment for lymphedema. However, a degree of strength and mobility is required to self-bandage, particularly when wrapping the legs. A number of clients in my practice have chronic lymphedema in one or both legs and are concerned about their future ability to apply bandages. Thankfully, there are techniques available that make the process easier.  
 
Put the spine in a neutral position: Most people sit to wrap their legs and feet, but holding that position for the amount of time it takes to apply bandages can place a strain on the back. Instead, try lying on the floor or bed while wrapping the feet and lower legs. This allows the back to be supported.  
 
Daily stretching to maintain good flexibility: Just as athletes warm up their muscles and joints prior to an event, gentle stretching prior to bandaging can increase the body's ability to hold the position of bent hips and knees. It is important to stretch without compression to maintain good range of motion; even elastic compression garments can be bulky enough to limit full joint motion. Stretching in water is ideal because the water compresses without the restriction of a bandage or garment. Daily stretching at home can also be very effective and may be especially helpful just before performing self-bandaging.
Perform gentle, prolonged stretches:  Gentle stretches, held for several minutes at a time, can be very beneficial in the long run by elongating muscle fibers, which leads to increased flexibility. Stretching also helps to warm up joints before an activity. Use deep breathing to engage the diaphragm, to help pump and empty the abdominal lymphatics. Start by holding each stretch for one or two breaths and gradually build the length of time. Never overstretch to the point of feeling pain. Check with your doctor or therapist before starting a program if you have special needs or problems.
What to stretch:
Hamstrings: These are muscles on the back of the thighs that cross the hip and knee joints. They are tight in most people because they shorten during sitting, the position of choice for most of us during the daytime. When tightened, the hamstrings may pull on the pelvis and throw the spine out of alignment, which can cause back pain. One way to stretch the hamstrings is to bend forward from the hips to touch your toes. This is done while standing with the knees slightly bent to take the pressure off the low back, with the feet shoulder width apart, pointing straight ahead. It might be helpful to start by placing hands on the knees, and then "walk" the hands towards the ankles.
While it is a great goal to touch the toes, if you feel a stretch in your back or the backs of your legs, stop there and gradually work downward in future stretching sessions. You'll find your flexibility can get a little better each time! A more advanced way to stretch the hamstrings that is particularly helpful for protecting the lower back is to lie on the floor or bed and position the legs up the wall. At first it might be necessary to bend the knees and leave some space between the buttocks and the wall. As the body becomes more and more flexible, eventually the buttocks will be flush against wall, the back of the legs will touch the wall from heel to thigh, and the toes can bend down towards the face to increase the stretch.
Knees: Warm up knee joints by lying on the back and hug the knees to the chest.  Start with one knee at a time.  Another method is to stand and hold onto a table, and bend the knees slightly, then straighten them.
Ankles: While doing the knee stretches, warm up the ankle joints by doing ankle circles and bending each foot forward and back.
Keep the upper body strong and flexible: When the arms and shoulders are securely anchored by the upper back muscles, there is less strain on the entire body.
Roll the shoulders backwards and downward slowly while squeezing the shoulders together. Focus on engaging the muscles between and below the shoulder blades and keep the neck relaxed.
Be aware of the body's signals: Take time while stretching to do a "check in" with the body to identify any emerging problems. Possible signals of infection are changes in skin temperature and color, swelling and/or pain. Also look for areas that have had too much or uneven pressure and are vulnerable to skin breakdown. 
Self care is a good investment: Giving yourself time to breathe, stretching, and monitoring your body will pay off in the long run by keeping you healthy and flexible, and in top condition for self-bandaging.
 
© 2010 Karen Ashforth
Karen Ashforth, MS, OTR, CHT, CLT-LANA
Dominican Santa Cruz Hospital
Lymphedema Management Program
  
Karen.ashforth@chw.edu
 
Karen works full time in a hospital-based outpatient lymphedema clinic. An occupational therapist for 30 years, she combines technology, creativity and innovation in her practice of lymphedema.
 
 A Man's Guide To All Things Lymphedema
One man's journey of coping with Lymphedema through humor and male bonding
by Kevin L. Donahue
 
If you are reading this, at some point in your life a surgeon removed a part from your body that you'd much rather have kept. Perhaps it was a testicle, a section of your esophagus, your colon, or that big ugly mole on the top off your balding head. Sometime after surgery, you ended up with lymphedema, a chronic condition that can be managed if you adopt some simple routines such as a skin maintenance regimen and daily physical exercise. Although seemingly easy, these recommendations present men with some real challenges. 
           
I know this is true because at fifty-seven, I'm a two-time cancer survivor who has been diagnosed with melanoma in 1970 AND esophageal cancer in 2000. Managing to get through treatment for both cancers, I happily assumed all was well until last winter when I began to have severe swelling in my right hand. The next thing I heard was my General Practitioner diagnosing me with lymphedema and referring me to a vascular clinic. I decided to remain calm and Googled "lymphedema." To my chagrin, I kept being directed to websites devoted to women with breast cancer.
            
Now don't get me wrong, I'm very sensitive and supportive of breast cancer survivors. My issue wasn't with the female focus regarding lymphedema, it was the lack of information available for men.
       
 
At my first vascular appointment I was filled with trepidation - okay, fear. Flipping through the basket of dog-eared waiting room magazines, I searched for a Car & Driver or Popular Mechanics. Instead my selection was: Redbook, Scrap Booking Today, Better Homes and Gardens, and Celebrity Hairstyles. The magazine selection should have been a clue. When I looked at the others patients around me and realized I was the only man in the room, I instantly felt uncomfortable and very much out of place.    
              
Here are two simple truths that I accepted after that first vascular appointment, and that we, the men of lymphedema, must accept:
When we go to doctors' offices we are going to be completely surrounded by women and there will be nothing of interest in the magazine racks. Either we start scrapbooking or we start bringing our own reading material. Better yet, we could all bring in some manly magazines and leave them in the rack for the next one of us who'll come around. Whining is not going to do us any good - I already tried it.
 
The only way to win the lymphedema battle is for us to care for ourselves in a consistent and purposeful way. We are going to learn some simple exercises, wear goofy looking compression garments, pay attention to cuts in our skin that we normally would have ignored, and we will have to become familiar with this stuff called moisturizer. It is guerrilla warfare that we will have to face every day. WHOOAHHH!             
So get up, suit up, and walk point. Unless we hang tough and push our agenda we will never see a camouflage compression gauntlet or a copy of the Sports Illustrated Swimsuit Edition in our doctors' waiting rooms. Contact me at LEMenUnite@gmail.com to share your story and receive support. I am looking forward to hearing from other "men of lymphedema." 

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