Re: [MOL] Lymphadema of breast due to breast ca/radiation/ Reply [00883] Medicine On Line


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Re: [MOL] Lymphadema of breast due to breast ca/radiation/ Reply



Welcome to our wonderful forum, I was sorry to hear of your lymphadema.  I
am a breast cancer survivor and had minimal swelling with slight pain, still
do for that matter.  I am including the information you requested, if I can
help you further, please feel free to ask.  Your friend lillian

Lymphedema Management
with Complete Decongestive Physiotherapy
Lymphedema is a serious complication for many cancer survivors which causes
swelling, usually in an arm or leg, and sometimes the adjacent trunk
quadrant. Anyone who has undergone lymph node dissection and/or radiation in
the axillary, groin or neck region is at risk to develop lymphedema. If
untreated, chronic lymphedema progresses to a fibrous, brawny texture and
significantly impacts quality of life by :  1) acting as a constant reminder
of the patient's cancer experience; 2) frequently causing pain or
discomfort; 3) interfering with clothing fit;  and 4) requiring lifelong
management. Patients also express frustration that health professionals lack
knowledge about  the disorder and its treatment.
Since 1995, the Barbara Ann Karmanos Cancer Institute's Lymphedema
Management Program nurses have used both traditional United States methods
and innovative European methods of lymphedema management:

1) Pneumatic compression pumps: Intermittent pumps provide equal
intermittent compression  along the entire limb at a prescribed pressure,
duration and frequency. Sequential therapy pumps deliver gradient pressure,
with each air compartment inflating in sequence from wrist to axilla or from
ankle to hip. Pumps sessions are about 2?3 hours per day.

2) Complete Decongestive Physiotherapy (C.D.P.): This is the Dr. Vodder
approach, which actually combines four methods for lymphedema management: a)
Bandaging with short-stretch bandages (ACE is long stretch); worn 24 hour
per day during the initial two to four week phase, and every night for life.
b) Manual Lymphatic Drainage (M.L.D.) is a light , sequential massage
technique which stimulates lymph flow from areas of congested lymphatics (on
the side of surgery) to functioning lymph vessels and nodes in the
neighboring quadrant.  c) Exercises, also sequential, stimulate flow in a
similar manner.  d) Protective measures are the self care methods of
preventing inflammation (infection, trauma, insect bites, needle sticks,
etc.), constriction (BP, binding clothing), overexertion (muscle strain), or
overheating (sauna, exercise in hot weather), which increase the edema.
Whatever method is used,  a daytime pressure gradient garment is essential
for life, as the limb refills between compression periods.

The Lymphedema Management nurses provide care in the Karmanos Cancer
Institute outpatient area. Because all methods require a lifelong commitment
to self-care, patients and families receive intensive instruction,
comprehensive assessment, and counseling about the best approach for them.
In four weekly 2 hour classes the nurses explain lymphedema and all
management options, and teach exercise, basic self-massage and community
resources.

The nurses individualize the therapy according to the patient/family's
goals, motivations and abilities. The best lymphedema management is the one
the patient will employ for life. Patients who use traditional pump therapy
are also taught the lymphedema exercises, which enhance the response to
pneumatic therapy. Those using C.D.P. receive the therapy from the nurses
daily for 2 - 4 weeks, during which time they learn the bandaging, the only
portion of C.D.P. not taught in the lymphedema classes. Both groups are
followed regularly after initial treatment, in decreasing frequency, ending
in yearly and as needed evaluation. Referrals are made as appropriate:
Physical and Occupational Therapy, Social Work, Nutrition, and Community
Services.

Mary Connell, RN, BSN, OCN, CDPT
Christine Rymal, RN, BSN, OCN, CETN
Rehabilitation Nurses
Lymphedema Management Program
(313) 745-4645

Navalt (North American Vodder Association of Lympathic Therapy) is a
professional non-profit association dedicated to the advancement of the
Vodder Method of Manual Lymph Drainage (MLD) through high standards,
education, and research. NAVALT maintains a list of Certified MLD Therapists
who have received advanced training from the Dr. Vodder School. To maintain
on the referral list, these therapists must be recertified every two years.
Vodder Certified Therapists have received extensive training in MLD,
including the treatment of lymphadema utilizing intensive Combined
Decongestive Therapy.






Lymphedema is a swelling of a body part, most often an extremity, resulting
from an accumulation of fluids, in such proportions to be palpable and
visible. Lymphedema occurs when the lymph vascular system is not able to
fill its function of reabsorption and transport of the protein and lymph
load. Lymphedema occurs whenever lymphatic vessels are absent,
underdevelopment or obstructed.



The condition most often causes a feel of embarrassment and causes decreased
mobility, discomfort and often repeated episodes of infection, cellulitus
and lymphangitis. This can lead to general depression and a general
worsening of the patient's life and health.


Lymphedema is a serious condition, indicating that the lymph system is
unable to handle the lymph load. Treatment should being as soon as
lymphedema is diagnosed. The goal of treatment is to reduce the swelling,
and facilitate the flow of lymph fluid to the venous circulation of the
affected area.


The most effective approach used by therapists in many European countries is
a method called COMBINE OR COMPLEX DECONGESTIVE THERAPY; a four step
process, carried out over a 4 week period. The individual elements are
Manual Lymph Drainage, compression therapy, remedial exercises, breathing
techniques and excellent skin hygiene. The patient visits the clinic once or
twice a day, 5 times a week, or in accordance with the physician's
recommendations.




Health Touch Therapeutic Massage Clinic
269 Lesperance Road
Tecumseh, ON N8N 1W2
 Phone: 519-979-4880
Fax: 519-735-4367



Payment Forms Accepted:
Cheques, Cash  Business Hours:
Mon.-Fri. 7:00am-9:30pm
Sat.-Sun. 8:00am-5:00pm











Warmly, lillian

We invite you to take a look at our Album.
www.angelfire.com/sc/molangels/index.html

  ( Very informational, good tips, Molers pictures, art work and much
more....

----- Original Message -----
From: <CDZACH@AOL.COM>
To: <mol-cancer@lists.meds.com>
Sent: Friday, October 22, 1999 11:28 PM
Subject: [MOL] Lymphadema of breast due to breast ca/radiation


> please send me any info re: what I can do to relieve pain and swelling of
> breast and arm due to node diss and radiation - my surgeon & radiation
oncol.
> can't seem to give me relief or possible physical therapy/exercises to
> relieve swelling?   HELP!@!!!!!!!
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