Page updated 4/27/10
 |
| |
 |
| |
 |
Lymphland International Lymphedema Online
| 1. Eileen Rhodes, 86, to take part in Jane Tomlinson York 10K - The Press, York - By Jennifer Bell - Thursday, 1 April 2010 A DEDICATED fundraiser who suffers from an incurable condition that leaves her barely able to walk is set to take part in the York 10k to help suffers of the disease which robbed her of two husbands. It will be the second consecutive year that Eileen Rhodes, 86, will line up alongside thousands of runners in the Jane Tomlinson York 10K to raise money for cancer sufferers. Eileen, of Prior’s Walk, in Poppleton, lost her first husband of 40 years, Jim Smart, in 1983, when he died of prostate cancer. Two years later, Eileen was remarried, to Cliff Rhodes, only eight weeks after meeting him. But once again she had to deal with losing a husband when he fell ill with leukaemia and died in 1994. Eileen began fundraising to help cancer sufferers and last year won praise and admiration when she battled her way around the 10K course despite suffering from lymphedema. The condition causes Eileen’s legs to swell due to the abnormal retention of lymph fluid in her body tissues – and it means she often struggles to walk. Eileen raised £4,000 for St Leonard’s Hospice, in York, where Cliff spent his final days. Eileen, who has two daughters, and a grandson, said: “I couldn’t have done it last time without the help of my daughter, Kath, who came with me. “A friend lent me a pram and I pushed it round with a teddy. “I couldn’t run it – but I could walk it.” Now inspirational Eileen is once again set to take part in the Race For All event on August 1 and hopes to raise a similar amount of cash for Jane’s Appeal. Eileen, who met Jane Tomlinson during a charity event in York, said: “I’m really looking forward taking part in the race again. “I had to get the permission of my GP and he has given me the go-ahead. “I’m going to do my best and I have already got several sponsors. “I admire Jane so much. In spite of having cancer she cycled and ran for charity and raised an enormous amount of money and the Jane’s Appeal carries on the work she did.” To enter the race, visit runforall.com 2. Too much radiation? The FDA wants to know - By Steven Reinberg - TUESDAY, March 30 (HealthDay News) Fears that Americans are being exposed to too much radiation will get a public airing this week as the U. S. Food and Drug Administration holds two days of meetings on what should be done to increase the safety of increasingly popular imaging procedures. Specifically, the agency is seeking ideas to get manufacturers of the devices used for CT scans and fluoroscopy to set higher standards for their equipment and increase the amount of training they offer those who use the equipment. The aim is to "help reduce unnecessary patient exposure to ionizing radiation" during these procedures, the FDA said in announcing the Tuesday and Wednesday sessions. The imaging techniques, which are two of the top three contributors to total radiation exposure among Americans, use much higher radiation doses than standard X-rays, dental X-rays and mammography, potentially increasing the lifetime risk for cancer. In addition, accidental radiation exposure can result in injuries, such as burns, hair loss and cataracts. Dr. Jorge Guerra Jr., a professor of radiology at the University of Miami Miller School of Medicine, agreed that manufacturers need to "give us the best equipment [and] teach us how to use it properly." Scanning should only be done by trained professionals, he stressed. But, Guerra, said, "it's the overuse of CT that's really killing it." There need to be clearer guidelines for the use of CT and other radiological devices, he said, including specific criteria on who should be getting scans for what particular conditions. "Yes, there is an increased risk of cancer in the general population from the overuse of radiation," he said. "Let's work on cutting down on the overuse of radiation -- not cutting out the technology." According to the U.S. National Cancer Institute, about 70 million CT scans are now done in the United States each year. In the early 1980s, only 3 million were done annually. The institute also estimates that up to 14,000 people die every year from radiation-induced cancers. "The amount of radiation Americans are exposed to from medical imaging has dramatically increased over the past 20 years," Dr. Jeffrey Shuren, director of the FDA's Center for Devices and Radiological Health, said in a statement released in February when the agency unveiled a plan to increase communication between doctors and patients about the pros and cons of medical imaging. "The goal of FDA's initiative is to support the benefits associated with medical imaging while minimizing the risks." Though the extent of a cancer risk remains a topic of debate, most experts agree that exposure to unnecessary radiation from these devices should be reduced. The radiation from a CT scan of the abdomen equals that of about 400 chest X-rays, and a dental X-ray has about half the radiation of a chest X-ray, according to the FDA. An article in the March 28 edition of The New York Times reported that the FDA ignored warnings from its scientists about the risks of routinely using CT scans to screen people for colon cancer, a procedure sometimes called a virtual colonoscopy. After an FDA official recommended approving the application for a device made by General Electric, Dr. Julian Nicholas, a gastroenterologist who worked under contract with the FDA, said he felt strongly that approving the application could "expose a number of Americans to a risk of radiation that is unwarranted and may lead to instances of solid organ abdominal cancer," according to the Times report. Nicholas told The Times that he was later urged to change his view: "I was first ignored, then pressured to change my scientific opinion, and when I refused to do that, I was intimidated and ultimately terminated. And I'm going to tell the committee exactly that at this meeting." Guerra, however, has a different view of the situation involving virtual colonoscopy. He described it as "mostly a turf battle." Radiologists, he says, tend to like the newer "virtual" procedure, contending that the dose of radiation is a minimal risk, compared with the benefit. Gastroenterologists, on the other hand, tend to still see the traditional colonoscopy as the diagnostic gold standard. Guerra noted that the two procedures find about the same number of colorectal cancers and, if a CT colonoscopy was done at age 50 and nothing was found, the person wouldn't need another one for 10 years. "You are not going to do more than three or four in a lifetime," he said. In February, the FDA noted that the benefits of medical imaging were considerable because they've led to disease being diagnosed earlier, allowing better treatment options, including "image-guided therapies that help save lives every day." But to keep radiation exposure to a minimum, the agency asked that doctors and patients keep two principles in mind: that each procedure must be justified and that the radiation be given at the minimum dose required. More information The U.S. Food and Drug Administration has more on radiation from CT scans. ---- Komen drive tops $1M By David Pittman The Amarillo affiliate of Susan G. Komen for the Cure topped $1 million in local giving and recently announced its latest round of grants to four cancer programs. Susan G. Komen for the Cure grants Susan G. Komen for the Cure recently announced it distributed $275,000 in grants to four cancer programs: $228,000 - The Don & Sybil Harrington Cancer Center's breast cancer detection and treatment program. Will cover screening, detection and some treatment for medically underserved women. $30,000 - Moore County Hospital District's breast cancer screening and education program. Provides breast cancer screening and treatment to underserved women in Moore County. $10,000 - Amarillo Area Breast Health Coalition's WISE (Women Inspiring, Serving and Educating) Woman program. Increase's general knowledge about positive breast health practices and merits of early detection of breast cancer. $7,000- American Cancer Society's breast prosthesis and lymphedema accessory program. Trained volunteers visit newly diagnosed patients, giving the patient emotional support and information. The Amarillo chapter of the breast cancer advocacy group doled out $275,000 this year and presented its largest single grant - $228,000 - to the Don & Sybil Harrington Cancer Center. The money will be used for screening and treating uninsured and underinsured women. "We have tremendous community support," Executive Director Lisa Hoff Davis said. "I think the Panhandle takes care of their people." Harrington expects to help more than 500 women this year with the grant money. "Without the Komen grant, there would be so many people we couldn't take care of; it would be unjust," said Harrington Breast Center Director Aneta Younger. Komen awarded a $30,000 grant to the Moore County Hospital District for similar efforts in that county. In all, $47,000 went to three programs other than Harrington. "Dumas can do that out in the Panhandle where people are less likely to come to Amarillo for medical services," Davis said. A group of Amarillo medical professionals, community leaders and businessmen rank the grant applications based on how well they fit the affiliate's needs assessment. The affiliate's board of directors approves or rejects the slate and funds projects with money from that year. "We're always looking for new and innovative programs to fund," Davis said. The chapter raises money through its September road race, the Race for the Cure, its March In the Pink Luncheon and other third-party events. The Amarillo chapter formally started in 2003 and began giving grant money the following year. Local Komen officials say they're proud that nearly 75 percent of the money raised locally stays in the Panhandle, with the remainder funding national breast cancer research. Yahoo! Alerts Lymphedema: Risk Reduction and Management Strategies - Newswise - 18 Feb 2010 - Newswise — There are no scientific studies showing that lymphedema can be prevented, but there are ways to lower your risk of developing this treatment side effect. During the 10th Annual Conference for Young Women Affected by Breast Cancer, we will explore the myths and recent scientific evidence about lymphedema, learn about risk reduction techniques and discuss approaches to lymphedema management, including exercise, physical therapy, lymphatic drainage, massage and other treatment methods. The 10th Annual Conference for Young Women Affected by Breast Cancer is the only international conference dedicated to the critical issues of young breast cancer survivors and those who care about them. Nearly 1,000 young breast cancer survivors, caregivers and medical professionals from around the world are expected to attend the Conference, to be held Friday, Feb. 26-Sunday, Feb. 28 at the Sheraton Atlanta Hotel in Atlanta, Ga. The Lymphedema: Risk Reduction and Management Strategies workshop will take place from 3:30 - 5: 00 p.m. on Friday, Feb. 26 , and will be led by physical therapist Jill Binkley, PT, MSc, FAAOMPT, executive director of TurningPoint Women's Healthcare in Alpharetta, Ga. To learn more about the Conference and for a complete list of workshops, visit www. youngsurvivorsconference.org. Editors Note: Complimentary press registration is available. Please contact Yarissa Reyes at (484) 708- 1547 or Yarissa@lbbc.org, or Dana Griffin at (646) 257-3006 or dgriffin@youngsurvival.org. **** About Living Beyond Breast Cancer (LBBC) Living Beyond Breast Cancer, based outside Philadelphia, is a national nonprofit organization dedicated to empowering all women affected by breast cancer to live as long as possible with the best quality of life. Programs and services include: conferences; teleconferences; the toll-free Survivors’ Helpline (888- 753-5222); a website, lbbc.org; free quarterly newsletters; publications for African-American and Latina women; recordings; networking programs for young survivors and women of color; healthcare- provider trainings; and the Paula A. Seidman Library and Resource Center. For more information about Living Beyond Breast Cancer, visit lbbc.org or call (610) 645-4567. About The Young Survival Coalition (YSC) The Young Survival Coalition, based in New York with 26 national affiliates, is the premier international organization dedicated to the critical issues unique to young women and breast cancer. YSC offer resources, connections, and outreach so women feel supported, empowered and hopeful. Through action, advocacy and awareness, YSC seeks to educate and influence the medical, research, breast cancer and legislative communities to address breast cancer in young women, and to ensure that no women diagnosed under 40 faces breast cancer alone. For more information about the Young Survival Coalition, visit youngsurvival.org or call (877) YSC-1011. Researchers develop guidelines for assessment, treatment and management of lymphedema - News- Medical-Net - 17 Feb 2010 Lymphedema, a chronic swelling condition that can appear after breast cancer surgery, is a risk for 1.3 million breast cancer survivors. Although lymphedema can cause lifelong swelling in the arms, back, neck and chest, there is no national standard of diagnosis or care. Now, University of Missouri researchers are leading the American Lymphedema Framework Project (ALFP), a national, multi- disciplinary collaboration to develop comprehensive guidelines for the assessment, treatment, and management of lymphedema. "We can't cure lymphedema today - we can only manage it," said Jane Armer, MU nursing professor and director of the project at the MU Ellis Fischel Cancer Center. "Lymphedema is a complex, chronic condition. Currently, there are inconsistent approaches to care for lymphedema, and often the most common form of self-management is to not treat it at all." The ALFP, established in 2008, has two main goals: establish a best practices document with evidence- based lymphedema treatment guidelines for health practitioners, and create a minimum data set of all available lymphedema research and clinical data. The ALFP researchers plan to publish the best practices document in 2011. "Part of why there isn't a standard of care is the lack of reliance on current evidence by health practitioners and third party payers, which in turn causes problems with reimbursement from health insurance companies. Many people with lymphedema have to pay out-of-pocket for care," Armer said. "There isn't a clear, national consensus for how to diagnose lymphedema and when to start treating it. The ALFP collaborators aim to document a standard of care reflecting a consensus on best practices that will help solve these problems." Researchers, including those at MU, have found that the most effective method of care for lymphedema is complete decongestive physiotherapy, in which therapists use specialized lymphatic massage techniques to reduce protein-rich fluid buildup. Bandages and compression garments also help to reduce swelling. One of Armer's innovations at MU is measuring patients' arms with a perometer, a machine that was first used to fit garments for swollen limbs. First implemented in a research setting at MU, the machine has a large optoelectric frame that glides over a patient's arm, scans its image and records an estimated limb volume reading. Perometer measurement is as, or more, accurate than several previous methods to measure arm circumference and volume. The machine is now used in about 20 sites across the country. Highlights of MU Sinclair School of Nursing research from the past 10 years reveal that there is a 40 percent higher risk of developing lymphedema in women with a body mass index (BMI) classified as overweight or obese compared to normal-weight women. The researchers also found that younger patients may have less occurrence of the condition but tend to report more symptoms, which could be a result of psychological and aging-related factors. "In addition to our previous findings, we're currently studying whether there are any genetic factors that increase the risk of lymphedema," Armer said. "A pilot study now underway and a proposed multi-site research study will look at the possibility of genetic predisposition for secondary lymphedema. The results could be applied to cancer treatment in which surgery and radiation affect the lymphatic system." Source: University of Missouri-Columbia Lymphedema: Risk Reduction And Management Strategies - Medical News Today = 19 Feb 2010 There are no scientific studies showing that lymphedema can be prevented, but there are ways to lower your risk of developing this treatment side effect. During the 10th Annual Conference for Young Women Affected by Breast Cancer, we will explore the myths and recent scientific evidence about lymphedema, learn about risk reduction techniques and discuss approaches to lymphedema management, including exercise, physical therapy, lymphatic drainage, massage and other treatment methods. The 10th Annual Conference for Young Women Affected by Breast Cancer is the only international conference dedicated to the critical issues of young breast cancer survivors and those who care about them. Nearly 1,000 young breast cancer survivors, caregivers and medical professionals from around the world are expected to attend the Conference, to be held Friday, Feb. 26-Sunday, Feb. 28 at the Sheraton Atlanta Hotel in Atlanta, Ga. The Lymphedema: Risk Reduction and Management Strategies workshop will take place from 3:30 - 5: 00 p.m. on Friday, Feb. 26 , and will be led by physical therapist Jill Binkley, PT, MSc, FAAOMPT, executive director of TurningPoint Women's Healthcare in Alpharetta, Ga. To learn more about the Conference and for a complete list of workshops, visit http://www. youngsurvivorsconference.org. MU Researchers Collaborate To Develop Standard Of Care For Breast Cancer Survivors With Lymphedema - Medical News Today - 19 Feb 2010 Lymphedema, a chronic swelling condition that can appear after breast cancer surgery, is a risk for 1.3 million breast cancer survivors. Although lymphedema can cause lifelong swelling in the arms, back, neck and chest, there is no national standard of diagnosis or care. Now, University of Missouri researchers are leading the American Lymphedema Framework Project (ALFP), a national, multi- disciplinary collaboration to develop comprehensive guidelines for the assessment, treatment, and management of lymphedema. "We can't cure lymphedema today - we can only manage it," said Jane Armer, MU nursing professor and director of the project at the MU Ellis Fischel Cancer Center. "Lymphedema is a complex, chronic condition. Currently, there are inconsistent approaches to care for lymphedema, and often the most common form of self-management is to not treat it at all." The ALFP, established in 2008, has two main goals: establish a best practices document with evidence- based lymphedema treatment guidelines for health practitioners, and create a minimum data set of all available lymphedema research and clinical data. The ALFP researchers plan to publish the best practices document in 2011. "Part of why there isn't a standard of care is the lack of reliance on current evidence by health practitioners and third party payers, which in turn causes problems with reimbursement from health insurance companies. Many people with lymphedema have to pay out-of-pocket for care," Armer said. "There isn't a clear, national consensus for how to diagnose lymphedema and when to start treating it. The ALFP collaborators aim to document a standard of care reflecting a consensus on best practices that will help solve these problems." Researchers, including those at MU, have found that the most effective method of care for lymphedema is complete decongestive physiotherapy, in which therapists use specialized lymphatic massage techniques to reduce protein-rich fluid buildup. Bandages and compression garments also help to reduce swelling. One of Armer's innovations at MU is measuring patients' arms with a perometer, a machine that was first used to fit garments for swollen limbs. First implemented in a research setting at MU, the machine has a large optoelectric frame that glides over a patient's arm, scans its image and records an estimated limb volume reading. Perometer measurement is as, or more, accurate than several previous methods to measure arm circumference and volume. The machine is now used in about 20 sites across the country. Highlights of MU Sinclair School of Nursing research from the past 10 years reveal that there is a 40 percent higher risk of developing lymphedema in women with a body mass index (BMI) classified as overweight or obese compared to normal-weight women. The researchers also found that younger patients may have less occurrence of the condition but tend to report more symptoms, which could be a result of psychological and aging-related factors. "In addition to our previous findings, we're currently studying whether there are any genetic factors that increase the risk of lymphedema," Armer said. "A pilot study now underway and a proposed multi-site research study will look at the possibility of genetic predisposition for secondary lymphedema. The results could be applied to cancer treatment in which surgery and radiation affect the lymphatic system." In recognition of the leadership in lymphedema research at MU, the ALFP is housed at the MU Ellis Fischel Cancer Center. Armer's research is funded by the National Institutes of Health and is published in several journals, including the Journal of Lymphoedema; Lymphology; Lymphatic Research and Biology; and the Journal of Cancer Survivorship, and presented at conferences throughout the world. The activities of the ALFP have been funded by industry partnerships and grants from the American Cancer Society through The Longaberger Company, a direct-selling company offering home products, and the Longaberger Horizon of Hope Campaign, which provided a grant for breast cancer research and education. Source: Emily Martin University of Missouri-Columbia Google News Alert for: lymphedema UAW Local 651 to host benefit for woman who needs kidney transplant The Flint Journal - MLive.com - FLINT, Michigan — Cynthia Powser was born with Down Syndrome 22 years ago and hasn’t had an easy life since. “She got diabetes when she was 1 years old,” said her mother, Tina Kollek, 39, of Shiawassee County’ s Venice Township. “We almost lost her then.” Powser’s had problems with congenital heart failure and lymphedema in her arm. And about a year ago, her kidneys failed and she needs a kidney transplant. With medical bills piling up, Kollek taking time off to care for Powser and Kollek’s husband currently laid off, Kollek’s friends and co-workers at the General Motors Service and Parts Operations Davison Road Packaging Center in Burton are stepping up to help. “I’m behind on everything,” Kollek said. “The house went for foreclosure. The Consumers (bill) is outrageous. I’m trying to do what I can do.” Kollek’s co-workers have organized a benefit spaghetti dinner 5-7 p.m. Saturday for Powser at UAW Local 651, 3518 Longway Blvd. The benefit also will include a raffle and a live auction beginning at 7 p.m., said Art Reyes, UAW Local 651 president. Among the donated items include a teeth whitening kit and auto detailing, Reyes said. “I’m so glad to see people have come together to help this family,” he said. Tricia Sermeno and about 10 other people have been working on pulling the event together for the past several weeks. Sermeno, 27, of Burton said that Powser’s character, spirit and courage inspired the group to help. “She always has a smile on her face and is constantly battling and going through all these surgeries,” Sermeno said of Powser. Management at the Davison Road SPO plant recently held an employee raffle for a special parking space at the plant, matching what employees raised dollar-for-dollar. And Sermeno said they plan to present the family with about $1,400 on Saturday. “Everybody has just really jumped on board to help, from the people on the floor to the management to our local leadership,” Sermeno said. Kollek said she is working on getting family — including Powser’s two brothers — tested to see if they are matches to donate a kidney. She said she is overwhelmed by the outpouring from her co-workers and is hoping her daughter — whom she described as strong through it all — will be well enough to attend the benefit. “You just don’t know how many people care until they do something like this,” Kollek said. Benefit • Who: Cynthia Powser, 22, of Shiawassee County’s Venice Township, has Down Syndrome and needs a kidney transplant. • When: A spaghetti dinner fundraiser is 5-7 p.m. Saturday, with a live auction to follow at 7 p.m. • Where: UAW Local 651, 3518 Longway Blvd., Flint. • Cost: Dinner is $10 for adults, $5 for children and donations also can be left for the family at UAW Local 651 A battle she's determined to win - Miami County Republic = February 17, 2010 Beverly Nuessen pulls out a drawer from the table beside her chair. It’s full of pills. Filled to the brim. Some of the more than 30 bottles in the drawer cost $80, $100 or more. But instead of looking down at the pills, Beverly, or “Bev” for short, looks out through the glass door in front of her — out to the pasture, where her horses are. Before the pills, before the chemotherapy and radiation, before the tears, prayers and pain — there were her horses. She pulls out a picture she keeps close to her, close to her heart, a photo from the ‘60s of her and her dad at a rodeo. She was young then, a teenager, and a lot has changed since then, but her love for her horses and her father will never falter. Proudly wearing a large belt buckle and cowgirl hat in the picture, one may not recognize Bev now. Her hair is short and a bit thinner, her skin is pale, and one arm is larger than the other. She can hardly walk, which keeps her from enjoying the company of her horses. But that’s what cancer does to some. “I call it the silent killer,” Bev said. “Cancer is the worst disease, killer there is.” IN THE BEGINNING Bev was diagnosed in March of 1991 with breast cancer. Just a regular check-up to her OBGYN lead to the discovery that would change her life and the lives of those closest to her. She was 36, and the doctors couldn’t believe it. “I don’t know how many times I heard, ‘You don’t have cancer, you’re too young,’” she said. But that was just the beginning. Since 1991, Bev has had four major surgeries, if you don’t include the one to put in her portacath, or port, used for injecting chemotherapy so it can be dispersed throughout the body without damaging the skin and veins. She’s had a complete mastectomy, with doctors going down at least three inches below the surface of her skin to make sure the cancer didn’t return a third time, after it had returned in 2004 or 2005. Sometimes the years run together, along with the treatments. She’s undergone a hysterectomy to remove her uterus and a lymphedema surgery to remove a portion of her lymph nodes. “I call them ‘ectomy’ diseases,” Bev said with a laugh. The lymphedema is what has caused her arm and legs to swell, retaining fluid that shouldn’t be there, which in turn has given her problems walking. Then there’s the bone cancer. In 2002, Bev complained of a pain in her right side by her hip that would move down her leg. She thought she’d pinched a nerve. Instead, the cancer had started in her hip and crossed her lower lumbar into her pelvis. Two to three years later, the breast cancer would return, and in 2007, despite the thousands of visits to the hospital, the endless days of being treated with chemo and radiation visits, every single day, Bev began to hurt on the left side. A bone scan was conducted, which Bev said was the worst one she’s had to endure yet, and a tumor was discovered on her hip joint the size of a baseball. Radiation treatments began again in September of 2007. “It was the worst imaginable pain,” she said. She became horribly sick seven days after starting treatment, an abnormal kind of sick, if there is such a thing for cancer patients. The radiation was not only hitting her tumor, but also her bowels and the top of her leg, which caused the fluid to build up in her leg. She recalled there was at least 20 pounds of extra fluid in her leg. Bev had planned to make a trip to Las Vegas with her family for the National Finals Rodeo, but she couldn’t walk down the hallway after the treatments. Needless to say, they didn’t make it to Vegas. In January of 2008, Bev started three different kinds of chemotherapy — she lost all of her hair within the first two months of treatments. “People stare at you,” she said. “I bought everything, the wigs, hats, but your skin color is pale.” A ramp was built last summer to help Bev make it into her own house. She also purchased a scooter. FAMILY TIES Through all of this, Bev and her husband, Richard or “Dick,” have raised three children. They’ve already got one grandchild and another to be born this July. There’s Rick, her oldest, Rodney and Becca, her youngest, who has always known her mother with cancer. It’s when thinking of her children that Bev chokes up, soon she doesn’t hide it anymore, and the tears fall freely. “I feel that it has taken a lot from my family. They’ll never say, ‘Mommy, because of you we never got to do anything.’ Because if you don’t have money, you don’t go anywhere. You can’t buy groceries sometimes because every month you’ve got this medical bill that’s $10,000,” she said with a Kleenex clutched in her hand. “Sometimes I think it’s really unfair — but with determination, prayer — I’m still here.” Bev had been fighting cancer for five years when her own father passed away in 1996 from t-cell leukemia. It hit her like a ton of bricks. “He told me I’d beat it,” she said. “He told me to fight it. I guess I’m still fighting it.” Although her father’s no longer here, others are for Bev. Rebecca, her youngest, has been supportive through it all. “She works her tail off for me,” Bev said. Although no one will take credit, a small group of Bev’s friends and family members will host a dinner and benefit auction at 5 p.m. Feb. 27 at the Miami County Fairgrounds in building No. 2. The Prairie Wine Band will perform, and a $10 donation per person will be accepted at the door. The event will include a chili dinner, silent auction and raffle. Auction and raffle items will include several things donated by the Kansas City Royals baseball team, including 20 sets of tickets for the 2010 season. Bev said her father, Merle Wood, worked as the vice president of government affairs for Marion Laboratories and knew Ewing Kauffman, who formed the company after working as a pharmaceutical salesman and established the Royals. The Major League Baseball team has also donated shirts and autographed baseballs for the auction. Merle and Bev were both heavily involved with the American Quarter Horse Association, and Bev’s children became involved as well. The AQHA has donated a jacket for the auction “I’m totally amazed by it,” Bev said of the event. “I didn’t think it would be this great. It’s overwhelming.” Alisha Williamson, a close family friend, helped put the event together. Williamson said items have been donated, along with local business gift certificates, quilts and photography packages that will be included in the raffle and auction. “I enjoy volunteering my time and helping out others in any way I can,” Williamson said. “That’s why my heart’s in it. I know Bev would step up and be there for me, too.” Flexible Fitness: Swelling could be lymphedema - Milford Daily News - February 16, 2010 Have you ever noticed a difference in the size of one of your arms or legs? Does one arm or leg feel heavy, and the clothes on that side of the body feel tight? If you have certain risk factors, this could be lymphedema. The lymphatic system is a series of vessels that carry a clear fluid that helps the body rid itself of inflammation. Lymphedema is a condition in which the lymphatic system becomes overwhelmed due to injury or structural abnormalities. It then cannot clear the body normally of lymph fluid. Lymph fluid is a protein-rich fluid which the circulatory system (capillaries) cannot reabsorb. The body relies on the lymphatic system to pick up this fluid, filter it and deposit it back into the circulatory system. When this process breaks down, swelling occurs because the fluid simply builds up in the body's tissues. Lymphedema is characterized by an abnormal accumulation of protein-rich fluid resulting in the swelling of an extremity (arm or leg) or the trunk. The neck, head or genitals could also be affected. It most commonly occurs as a result of cancer treatment, such as a mastectomy, lymph node removal and/or radiation. However, lymphedema can also occur due to trauma, liposuction, vein stripping, malignancies and surgery, or even due to a congenital abnormality in the lymph system. It can also occur in combination with chronic venous insufficiency. Risk factors for lymphedema include obesity, history of trauma or injury to a limb, diagnosis of breast cancer at younger than 50 years old, having greater than 10 lymph nodes removed, a history of radiation treatment, and a history of upper extremity infection after cancer treatment. Recent research suggests there is up to a 40 percent prevalence of lymphedema in breast cancer survivors over a five- year period, and onset usually occurs by the third year after treatment. How do you know if you have signs of lymphedema? Lymphedema symptoms tend to have a slow, progressive onset. Early signs might be tighter shirt sleeves, rings and watches, and a heavy, fatigued or achy feeling in a limb. Later, a difference in size between one extremity and the other may be noted, and creases may appear where the toes connected to the foot if the leg is affected. A fluid-filled hump on the top of the foot or back of the hand is common in later stages. Generally the fingers, hand and lower arm swell first (or toes and feet if the leg is affected) and the lymphedema progresses upward. If it is congenital, a person might notice a size difference between the extremities since birth or, more commonly, since adolescence. Lymphedema has four stages of progression. In stage zero, or latent lymphedema, the patient has some symptoms but insignificant difference in limb size. Stage one lymphedema is reversible, transient swelling. There is a small but measurable size difference between limbs, but the swelling can be reduced with elevation. An increase in swelling may be present when an indentation remains when the skin in pressed. It is best to get treatment in these first stages to discourage progression of the condition and potentially reverse it, so noticing signs and symptoms early is important. Stage two involves noticeable swelling of a body part with a more significant size difference. This is considered permanent lymphedema. There is less or no pitting type of swelling, and the affected area may feel hard or firm, due to a process called fibrosis. Stage three lymphedema consists of further swelling, skin changes, no pitting and possibly very large limbs (elephantiasis). It is important to get treatment for stage two and three lymphedema to prevent further progression of the condition, to decrease the risk of infection and to increase functional use of the extremity. Treatment for lymphedema can be as easy as a light compression sleeve for the earlier stages, to manual lymph drainage (MLD), compression wrapping and eventually compression sleeves/gloves at the end of treatment for later stages. It is important to seek out a therapist certified in complete decongestive therapy (CDT), which includes MLD, to ensure the best treatment outcome. The good news is, lymphedema usually responds well to this treatment and the patient can get back to using his/her limb with fewer symptoms and effort. Nicole Tomasino PT, DPT, CLT, is a certified lymphedema therapist specializing in lymphedema treatment and oncology rehabilitation at the Spaulding Framingham Outpatient Center. Solid nursing background leads to executive spot - DesMoinesRegister.com Breast surgery only the beginning - Sunshine Coast Daily - CORAL Cross had a mastectomy eight months ago to save her life, but every day since has been hell. The 64-year-old Mount Coolum breast cancer survivor is bravely speaking out about her journey to draw attention to the disease, which kills 2800 women a year in Australia. She believes her raw account of her diagnosis, treatment and recovery will help stop other women in a similar position from feeling alone. Ms Cross discovered a lump on her right breast in June last year. The month soon became an emotional roller coaster as normally foreign words such as mastectomy, lumpectomy, radiotherapy and chemotherapy became a normal part of her life. “I was shocked. I wasn’t prepared to loose my breast,” Ms Cross said. “I was told that if I didn’t have the surgery I would die a long, painful death and that I would need ‘a mental health evaluation’ if I refused. “I believe there is still a lot of work to be done in training doctors in communication skills when it comes to breast cancer.” Coral said as she walked towards the operating theatre on Tuesday, July 28, 2009, she had a knot in her stomach and a lump in her throat. She spent two days in hospital and was then discharged. On the next Saturday night, the drains fell out. “I had lymph fluid pouring down my side,” she said. “I had to sleep with a towel under my arm until I could come to the hospital on Sunday morning. “By Thursday I had huge swelling under my arm, hot red and very painful. “The doctor drained 300ml of lymph fluid.” Ms Cross said she found out later she had an infection that had triggered severe lymphedema – a problem faced by many women with breast cancer – which can be a disabling and distressing condition. “I made the choice to attend my local GP,” she said. “He drained lymph fluid every second or third day to prevent a recurrence of severe discomfort. “This draining went on for one month, it was painful, frightening and distressing.” Coral said two months after the surgery she experienced a huge bleed across her chest. “The bleed took three months to resolve,” she said. “I’ve gone through so many emotions since the operation. “I’ve been depressed, struggled with thoughts of suicide and now I am angry,” she said. “Before the operation I used to be a confident woman who would power walk every morning and wear beautiful clothes. “I can only wear a bra and prothesis for about an hour because of the deformation under my arm causing pain. “I know the surgery saved my life but the scar is tethered in two places. “I have no armpit, just a folded mess and a hole in my chest that I can put my finger into.” Breast cancer treatment does not always mean major, disfiguring surgery. New knowledge from research means specialists can treat many breast cancer cases by removing the lump itself, leaving the breast intact. There are women, however, like Ms Cross, who suffer complications. She lodged an official complaint with the Health Quality and Complaints Commission but has been told the matter would not be taken further. A National Breast Cancer Foundation spokeswoman said breast cancer survivors could experience difficulties ranging from physical limitations to psychosocial problems. “A significant and enduring complication of breast cancer treatment is in the reduction of upper body strength and mobility,” she said. “These issues are now emerging as new targets for research.” An Australian Society of Plastic Surgeons Incorporated spokesman said that when it came to breast cancer, the first surgery should be focused on curing the patient of the disease. “That said, patients need to know what options are available to them,” he said. “If a women is considering reconstruction, then a plastic surgeon should be involved from the start.” Fifteen per cent of all breast cancers are advanced at diagnosis. “Women whose cancer is diagnosed when it is contained in the breast have a 90% chance of surviving %five years, compared with 20% five-year survival when the cancer has spread at diagnosis,” the spokesman said. FINDING CHANGES IN YOUR BREAST By knowing what is normal for you at different times in the month and at different stages of your life, you should be able to find any changes in your breast that are unusual for you. All women’s breasts are different, but you know better than anyone how your breasts look and feel at different times. Women are advised to: Look at your breasts in the mirror – look at the shape, size and skin of your breasts and nipples. Are there differences between the two breasts or nipples? If so, have they appeared in the last few months? Feel your breasts from time to time, perhaps while you are dressing, bathing or showering. Remember that your breasts extend to under your collarbone, up under the armpit and include the area around the nipples. According to the National Breast Cancer and Ovarian Centre some questions to ask about breast surgery include: What type of surgery is best for me? What will surgery involve? Do you specialise in breast cancer surgery? Can you refer me to someone who specialises in breast cancer surgery? Where will the scars be and what will they look like? How long will I be in hospital? How long will I take to recover? What side effects can I expect? Who should I contact if side effects happen? How much will the surgery cost? One in nine women will be diagnosed with breast cancer by the age of 85 Getting older is the most common risk factor: about 13% of new cases are among women aged 20 to 44, 61% in women aged 45-69 and 26% among women over 70. Women of all ages need to understand the importance of finding and treating breast cancer early. Liposuction provides relief for breast cancer patients - 10 Connects - March 10, 2010 Tampa, Florida -- Imagine not being able to lift your arm because it's so swollen and feels so heavy, you can't extend it all the way. Up to 25 percent of breast cancer patients are at risk for arm lymphedema, a life-altering side effect that can even make your arm numb. A new study may give breast cancer survivors a new treatment option. "I was diagnosed January of '08, and I had an extensive number of lymph nodes removed as part of the surgery. And as a result, after the surgery, several months later, lymphedema developed," patient Cheri Wetzel said. Wetzel survived breast cancer only to be confronted with another debilitating side effect: lymphedema. "The whole arm was, it appeared to me to be, twice as large as the other arm ... I couldn't wear some clothes because my clothing was getting so tight, and so I ended up with a lot of tank tops and very limited motion on the arm because it was feeling so heavy to use it," Wetzel said. Last fall, her doctor asked her to be part of a small study at Moffitt Cancer Center using liposuction to reduce the lymphedema. Dr. Christine Laronga explains how the surgery works, "When the lymph channels are cut because of the sugery to take the lymph nodes out, those lymph channels have no place to go because they go to the lymph nodes that have now been cut. And so the fluid backs up and fluid is very protein rich, and then what it does as it leaks out of those little lymph channels into the surrounding tissue, the fat cells swell in reaction to this high protein because it pulls water into the cell. So it's not that you increase the number of your fat cells, they just get bigger and that's why the arm feels like it's full of fluid. So if you can remove the number of fat cells, you're not preventing the process because those that are left behind can still swell but there's so many less of them." "I had eight incisions, eight spots where they went into the arm and took they essentially drained the arm of the lymphatic fluid... I went home like three hours later. I was walking my dog in the afternoon, so it was really no big deal and my arm didn't bother me," Wetzel said. She'll still have to wear a compressive sleeve to keep the lymphedema from coming back, but otherwise her arm is back to normal. "I can wear clothes again. I can use my arm. My arm doesn't bother me. It's just like my other arm again," Wetzel said. "They find that their arm is much more mobile, less heavy, more comfortable for them, and their range of motion in all their joints is just tremendously better so their quality of life is just so much better for them," Dr. Laronga said. The lipo isn't covered by insurance since it's considered cosmetic, but Dr. Laronga hopes her study will change that. For now, she'll track the six patients' progress over the next year in her trial to prove the lipo can improve their quality of life for the long term. Then, she'll apply for larger grants to enroll more women for the $12,000 to $17,000 procedure. If you would like to make a donation to Dr. Laronga's study, specify Lipo for Lymphedema on any Moffitt donations. To learn more about lymphedema, click on these links: •BreastCancer.org •Compression Sleeves Komen grants help ease breast cancer's financial toll - Florida Weekly - March 11, 2010 When Leesa Crapa was diagnosed with breast cancer last summer, she felt immobilized by the threat of financial devastation. “My insurance company dropped me,” said the Cape Coral resident. “They said because I had family history and all this business that they just weren’t going to pay anything.” Her boyfriend got online to search for help, and they ultimately found it: the means to pay for medical tests, a mastectomy and ongoing care. Home from a therapy session last week, the couple shared a courageous laugh about her bald head. “We’re doing fine,” Ms. Crapa said. “We’re seeing light at the end of the tunnel and it’s not a freight train.” Her treatment, along with many other women who are uninsured or underinsured, was backed by support from Susan G. Komen for the Cure’s Southwest Florida affiliate. Ms. Crapa is being cared for through Lee Memorial Health System’s treatment and referral program, Breast C.A.R.E., which received a $209,350 Komen grant last year. Naples Community Hospital has a similar program, Breast Health Patient Navigation, which received a $92,350 Komen grant in 2009. “These grants are saving women’s lives, especially in this economy,” said Dara Leichter, breast health navigator for the Breast C.A.R.E. program. These are two of 10 community programs to receive Komen grants last year, $963,000 in all, which aims to remove the financial hurdle in the fight against breast cancer. That’s more than 13 times what Komen raised six years ago, its first full year of fundraising as a new Southwest Florida affiliate. Komen’s popular annual fundraising event, Race for the Cure, has made it the region’s most visible and muscular presence in promoting breast cancer education, diagnoses and treatment. Last year the race attracted 8,100 walkers and runners. Organizers are hoping for another record turnout at this year’s race, March 13 at Coconut Point mall in Estero. Supporters of Komen’s Southwest Florida affiliate have been exponentially more numerous and generous, but the number of breast cancer patients who can’t afford treatment in the aftermath of the recession is outpacing that growth. Groups are asking Komen of Southwest Florida for nearly twice as much as last year, a total of $1.8 million in grant requests for the coming fiscal year, starting April 1. “Because so many people are out of work and the way the economy is, there is a huge increase in need,” said Bonnie Olson, grant chair for Komen of Southwest Florida. One of the gaps Komen aims to fill is the lack of medical resources for breast cancer patients in Hendry and Glades counties. Others include areas of breast cancer treatment and education in Southwest Florida that may be overlooked or poorly funded. For example, lymphedema is a condition that breast cancer patients could be at risk for, even decades after their cancer has been in remission, if their lymph nodes are removed during surgery. Lymphedema Resources in Estero was awarded a $29,500 Komen grant last year to help cover education and medical treatment for uninsured or underinsured patients. The Passionate Pinks of Charlotte County was founded in 2007 to educate women about early detection. Every year, a contingent of the group arrives in Estero by bus to participate in the Susan G. Komen Race for the Cure. The group coordinates Project Hope in Charlotte County, a Komen affiliate, which is an educational initiative for people recently diagnosed with breast cancer in Charlotte County. Working with Florida Cancer Specialists, the group provides a tote bag containing a journal, information and items for warmth and comfort. To learn more about the Passionate Pinks, visit passionatepinks. com or e-mail passionatepinks@ comcast.net. Family Health Centers of Southwest Florida was able to assess the risk of breast cancer and provide screening services for 818 women last year. Director Ena Mendez says that wouldn’t have been possible without a $157,453 Komen Grant. Lynn Hurley, breast health navigator at Naples Community Hospital, was recently approached by a woman who didn’t have health insurance. “She was crying because I was telling her about the community resources that are available,” Ms. Hurley said. “She said ‘I found a lump two months ago and I couldn’t do anything about it.’” “They’re saying ‘what if I get a mammogram and I do have cancer?’” Ms. Hurley said. “‘What then? I have no money.’ “We want them to come in. Even if they don’t have money, that’s not an issue for us.” North Fort Myers resident Sharolyn Clayton had no insurance when she was diagnosed with breast cancer two years ago. The Breast C.A.R.E. program helped cover the financial costs of tests like mammograms, MRI’s and cat scans, as well as treatments like chemotherapy, and medication. “There are organizations that can help you to pay for this stuff,” Ms. Clayton said. “So I would say that for anyone with breast cancer, do not ever give up.” ¦ .. in the know >> What: Susan G. Komen Race for the Cure >> When: March 13 starting at 8 a.m. The registration tent opens at 6:30 a.m. >> Where: Coconut Point mall, Estero, at U.S. 41 and Coconut Point Road. >> Details: 5 k races and walks for youth and adults, as well as a 1-mile Fun Walk. >> Cost: Late registration is available on the day of the race, $40 for adults and $20 for under 18. Visit www.komenswfl.org for more information, directions, and to register online. >> Grant money allocated locally by Susan G. Komen for the Cure of Southwest Florida in 2009: (This number represents 75 percent of the total grant money raised each year, which is spent locally. The other 25 percent goes to national organizations to research cures for breast cancer.) 2004-05: $74,000 2005-06: $152,000 2006-07: $306,000 2007-08: $448,000 2008-09: $823,000 2009-10: $963,000 Max Organises 'Breast Cancer Support Group Meeting' - Express Healthcare Management - March 11, 2010 Max Cancer Centre, Patparganj took the initiative of bringing all breast cancer survivors on a common platform on the occasion of 'World Cancer Day' to support the cause. Over 60 breast cancer patients attended the meet along with entire team of Max Cancer Centre. An online blog called 'Pink Connect' has also been started by Max Healthcare on leading social networking website Facebook, where various leading doctors, psychiatrists, cancer patients and their peers can contribute stories, exchange information and share experiences regarding this disease and its cures. Said Dr Geeta K, Senior Consultant, Surgical Oncology, Max Healthcare, "These meetings are a learning experience for the caregivers as well. There are several issues we are unable to address during the course of treatment and are brought to light by people who have lived through the experience. What is more amazing are the novel solutions that they come up with for their problems." Said Dr Vineeta Goel, Consultant Radiation Oncologist, Max Healthcare, "These meetings are aimed at empowering women whose lives are temporarily disrupted by this disease. These meetings reinforce the message that they return to their normal lives and give back to the community by influencing at least 10 other women to become breast aware. This will go a long way in picking up disease early and expecting better outcomes in the long run." Also present at the occasion was Mamta Goenka, who spoke about her own story of victory against breast cancer. "After experiencing the ordeal of breast cancer and emerging victorious, I take it as my responsibility to give back to the society by educating breast cancer sufferers about lymphedema (swelling of arm) and encouraging and motivating them to go on with their normal lives." EH News Bureau Lymphedema Products Effectively Used For Treatment - Release-news.com = March 11, 2010 Treatment of lymphedema involves manual lymph drainage, use of compression garments, bandaging and skin care, and http://www.lymphaticdrainagetherapy.com/">lymphatic drainage therapy. Lymphedema can be effectively managed with treatment that makes use of several http://www. lymphedema-products.com/">lymphedema products which include compression garments, bandages, footwear, foams and padding, accessories like hooks and fasteners, donning aids, pneumatic pumps, compression devices, etc. In order to maintain the edema reduction after decongestive therapy, the patient is required to wear elastic compression garments at all times. You can have a custom-made compression garment or purchase one over the counter. These are to be worn each day and replaced at regular intervals. Lymphedema garments for the upper extremities include compression arm sleeves, bras, gloves and gauntlets. Knee-high and thigh-high stockings, compression pantyhose and compression devices for the legs are also available. However, before purchasing the product, you must consult your physician to find out which garment is right for your condition. Bandaging or wrapping the affected body part is essential so that lymphedema is reduced. Compression bandaging provides a resistance on the skin and the muscles underneath. This resistance helps the tissues to re-absorb the fluid and prevents fluid retention in the limb. Usually short stretch bandages give a better result as they produce the tension required to enhance the pumping action for the lymph vessels. There are various categories of bandages and they come in the form of tubular stockinettes, finger and toe bandages, tapes and adhesive bandages. The patient can choose to use whatever is suitable. Another lymphedema product that plays a major role in the treatment of the condition is the lymphedema pump. The Sequential Gradient Pump and the FlexiTouch Pump are the two types of pumps used for complete decongestive therapy. The lymphedema pump can either be purchased or rented from a surgical supply store. Those who do not have access to a therapist can make use of the lymphedema pump for their treatment. It is crucial for lymphedema patients to maintain a meticulous skin care routine. Various gels, creams, ointments and lotions are available for cleansing and moisturizing the skin. For those suffering from lymphedema, compression therapy and a life-long follow up on the treatment is essential. New lymphedema products are coming in the market and therapists are using them to take care of problem areas of tissue fibrosis and swelling. For instance, a special tape known as the Elastic Therapeutic tape is being used to soften the edemas. Donning and doffing aids, special footwear and accessories like bandage rollers try to make life a bit easier for lymphedema patients. Due to the convenience of online shopping, it is now possible to procure lymphedema products quite easily. Many online stores have trained therapists who can assist you with the selection of a suitable lymphedema product that you might need. Lymphedema Products Effectively Used For Treatment - I-Newswire.com (press release) (I-Newswire) March 11, 2010 - (I-Newswire) March 11, 2010 - Treatment of lymphedema involves manual lymph drainage, use of compression garments, bandaging and skin care, and lymphatic drainage therapy. Lymphedema can be effectively managed with treatment that makes use of several lymphedema products which include compression garments, bandages, footwear, foams and padding, accessories like hooks and fasteners, donning aids, pneumatic pumps, compression devices, etc. In order to maintain the edema reduction after decongestive therapy, the patient is required to wear elastic compression garments at all times. You can have a custom-made compression garment or purchase one over the counter. These are to be worn each day and replaced at regular intervals. Lymphedema garments for the upper extremities include compression arm sleeves, bras, gloves and gauntlets. Knee-high and thigh-high stockings, compression pantyhose and compression devices for the legs are also available. However, before purchasing the product, you must consult your physician to find out which garment is right for your condition. Bandaging or wrapping the affected body part is essential so that lymphedema is reduced. Compression bandaging provides a resistance on the skin and the muscles underneath. This resistance helps the tissues to re-absorb the fluid and prevents fluid retention in the limb. Usually short stretch bandages give a better result as they produce the tension required to enhance the pumping action for the lymph vessels. There are various categories of bandages and they come in the form of tubular stockinettes, finger and toe bandages, tapes and adhesive bandages. The patient can choose to use whatever is suitable. Another lymphedema product that plays a major role in the treatment of the condition is the lymphedema pump. The Sequential Gradient Pump and the FlexiTouch Pump are the two types of pumps used for complete decongestive therapy. The lymphedema pump can either be purchased or rented from a surgical supply store. Those who do not have access to a therapist can make use of the lymphedema pump for their treatment. It is crucial for lymphedema patients to maintain a meticulous skin care routine. Various gels, creams, ointments and lotions are available for cleansing and moisturizing the skin. For those suffering from lymphedema, compression therapy and a life-long follow up on the treatment is essential. New lymphedema products are coming in the market and therapists are using them to take care of problem areas of tissue fibrosis and swelling. For instance, a special tape known as the Elastic Therapeutic tape is being used to soften the edemas. Donning and doffing aids, special footwear and accessories like bandage rollers try to make life a bit easier for lymphedema patients. Due to the convenience of online shopping, it is now possible to procure lymphedema products quite easily. Many online stores have trained therapists who can assist you with the selection of a suitable lymphedema product that you might need. Bill lobbies for compression garments - HME News - March 11, 2010 WASHINGTON - A bill that would require Medicare to cover compression garments and other items used to treat lymphedema began making the rounds in February, but some industry stakeholders say it needs some clarification. Introduced Feb. 23 by Rep. Larry Kissell, D-N.C., the Lymphedema Diagnosis and Treatment Cost Saving Act of 2010, would improve the diagnosis and treatment of lymphedema under the Medicare program. Among other things, the bill, H. R. 4662, seeks to establish Medicare coverage for compression bandage systems, compression garments and compression devices. "The garments are used every day (by patients) and they are the backbone of the treatment," said Robert Weiss, a volunteer advocate with grassroots organization National Lymphedema Network, who helped get the bill introduced. The bill also seeks to define who can provide the garments. The list includes nurses; physicians and physician assistants; chiropractors; licensed massage therapists; licensed home health practitioners; and licensed prosthetists and orthotists. Also on the list: someone certified by the manufacturer of an item to provide that particular item. That's where the bill gets a little gray. "The bill in many ways limits the provision of services to those particular disciplines," said Rhonda Turner, executive director of the American Association of Breast Care Professionals. "It does have some language saying 'anyone else deemed appropriate by the DHHS secretary.' We want to see if they could have a little bit more definition of that provider list." The bill may simply need some tweaks, she said. Ultimately, Weiss said, the bill "attacks" a number of large problems that prevent patients from getting proper care, and proper care would save the government money. "If you treat the lymphedema, you are avoiding very expensive and hard-to-treat cellulitis, which can require hospitalization," he said. At the end of the day, the bill is a step in the right direction, said stakeholders. "While H.R. 4662 leaves many unanswered questions and concerns, we are encouraged that the bill will serve to raise awareness to the issue of lymphedema and the need for services/items to be covered without exception by commercial insurances and Medicare/Medicaid," said Turner. Breast cancer battle can continue after treatment ends - WZVN-TV - March 11, 2010 FORT MYERS: Breast cancer is the most common cancer among women in the U.S. and it will claim the lives of more than 40,000 this year alone. But for those who beat the disease, sometimes the battle isn't always over after treatment ends. After surviving breast cancer, Jane Dinnan thought her troubles were over. "You wanted to feel good about the fact that the cancer is gone, but I couldn't feel that way," said Dinnan. As part of her treatment, doctors removed 17 lymph nodes from Jane's arm - tiny organs that help the immune system fight off infection. But without them, body fluid couldn't drain from the limb. "It felt like I had a lead weight on my arm all the time," she said. Her arm swelled to more than twice its normal size. "It just was miserable. I was miserable. I wanted, I mean the arm could go and I'd be happier," she said. She spent almost all of her time wearing a compression sleeve or using a machine that pushes the lymphatic fluid up the arm so it can get into the system. "The treatment of lymphedema, for the most part in the United States, is management or conservative management of lymphedema," said Marga Massey, a Plastic and Reconstructive Surgeon. After being told there was no other option, Jane found plastic and reconstructive surgeon doctor Massey, who's brought a new surgery to the U.S. Dr. Massey removed three lymph nodes from the inside wall of Jane's abdomen. "Blood vessels are harvested in order to keep the lymph nodes alive," said Massey. She then transplanted them under Jane's arm, into the area missing lymph nodes. Jane spent just one night in the hospital and the swelling went down almost immediately. "I would say overwhelmingly the majority, somewhere even in the range of perhaps maybe 90 percent of patients, show relief from their symptoms," said Massey. It's given Jane a chance to celebrate life cancer-free. "So I never felt the elation that I feel now that I've beat this," said Jane. "I'm back to normal. I feel like my life is back." Dr. Gott: Should reader find a new physician? - Northwest Herald - March 13, 2010 Archive Search Dear Dr. Gott: My doctor has told me that I have lymphedema and should take a water pill. When the 20 milligrams wasn't sufficient, she put me on 40 milligrams. Because I wanted to know more about my condition to better educate myself about things to do and not do, I looked online. It appeared to me that my doctor should be looking for the cause of the swelling, not just treating it. So I pressed her into doing more. She ordered a CT scan of my pelvis, a heart echo and a venous... Click here for complete article TINA - I cant get the whole article because I dont belong to the website that the link went to, sorry Kissell introduces health care bill - Salisbury Post - March 12, 2010 WASHINGTON – N.C. Rep. Larry Kissell has introduced legislation which would require Medicare to offer more treatment coverage for Americans afflicted with primary and secondary lymphedema. The Lymphedema Diagnosis and Treatment Cost Saving Act of 2010, HR 4662, is designed to improve patient care and reduce costs associated with complications related to lymphedema. Lymphedema, also known as lymphatic obstruction, is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system. According to a press release, Kissell introduced the legislation after meeting with constituent Heather Ferguson, whose son Dylan suffers from primary lymphedema. Ferguson, who lives in Charlotte, has been active in working to raise awareness of the disease and to help alleviate the troubles lymphedema sufferers have getting insurance to cover treatment. "I was moved by Heather's story, and all she has gone through to ensure that her son receives this important treatment. Her dedication to helping others in the same situation has inspired me to help her in her quest to make sure lymphedema patients have an opportunity to receive treatment," Kissell said in the press release. "This preventative treatment will help improve life for many people throughout this country." The treatment for lymphedema is known as complex decongestive therapy. The press release said that with treatment, patients can live long, healthy and virtually normal lives. It also said that without treatment, the disease can progressively worsen, causing severe disfigurement, disability, pain and even death. Not all components of the treatment fall under the categories for which Medicare typically provide coverage. Why Richmond, Why?!?: More Potholes - Richmond.com - March 15, 2010 ... And in lieu of a second Why Rich question, I have a follow up to handicap spaces question from a few weeks ago. The question was, basically: why does it seem like able-bodied people are using handicapped decals? You can read the full question and DMV's answer here, but I got some feedback from readers in our print edition on this one. Phyllis said: "People that got handicap license years ago when they had surgery for knee, back, hip or any operation or problem … are allowed to renew these for the rest of their lives. … I know this for a fact … someone I knew …told me, she had kept hers and she used it [because] it was easier and closer to the door." Terri wrote in: "I am not the type of person that responds to articles, but this one got under my skin. I am one of those people that don't look handicapped. I have Lymphedema in my left leg, and do not always have good balance. My leg swells with fluid and has been known to give out on me. I am in my mid 40's, when I get out of my vehicle I try very hard not to limp. I also try very hard to keep my balance and not "fall out" in front of on coming traffic. That is the whole reason that I have a handicapped sticker. I would rather be "normal" and walk, skip or run through the parking lot … People shouldn't judge/question other people or what that person is doing. You don't know someone else's story, and until you do, you should just worry about how to make life in "your own world" better." ------- Komen drive tops $1M By David Pittman The Amarillo affiliate of Susan G. Komen for the Cure topped $1 million in local giving and recently announced its latest round of grants to four cancer programs. Susan G. Komen for the Cure grants Susan G. Komen for the Cure recently announced it distributed $275,000 in grants to four cancer programs: $228,000 - The Don & Sybil Harrington Cancer Center's breast cancer detection and treatment program. Will cover screening, detection and some treatment for medically underserved women. $30,000 - Moore County Hospital District's breast cancer screening and education program. Provides breast cancer screening and treatment to underserved women in Moore County. $10,000 - Amarillo Area Breast Health Coalition's WISE (Women Inspiring, Serving and Educating) Woman program. Increase's general knowledge about positive breast health practices and merits of early detection of breast cancer. $7,000- American Cancer Society's breast prosthesis and lymphedema accessory program. Trained volunteers visit newly diagnosed patients, giving the patient emotional support and information. The Amarillo chapter of the breast cancer advocacy group doled out $275,000 this year and presented its largest single grant - $228,000 - to the Don & Sybil Harrington Cancer Center. The money will be used for screening and treating uninsured and underinsured women. "We have tremendous community support," Executive Director Lisa Hoff Davis said. "I think the Panhandle takes care of their people." Harrington expects to help more than 500 women this year with the grant money. "Without the Komen grant, there would be so many people we couldn't take care of; it would be unjust," said Harrington Breast Center Director Aneta Younger. Komen awarded a $30,000 grant to the Moore County Hospital District for similar efforts in that county. In all, $47,000 went to three programs other than Harrington. "Dumas can do that out in the Panhandle where people are less likely to come to Amarillo for medical services," Davis said. A group of Amarillo medical professionals, community leaders and businessmen rank the grant applications based on how well they fit the affiliate's needs assessment. The affiliate's board of directors approves or rejects the slate and funds projects with money from that year. "We're always looking for new and innovative programs to fund," Davis said. The chapter raises money through its September road race, the Race for the Cure, its March In the Pink Luncheon and other third-party events. The Amarillo chapter formally started in 2003 and began giving grant money the following year. Local Komen officials say they're proud that nearly 75 percent of the money raised locally stays in the Panhandle, with the remainder funding national breast cancer research. Yahoo! Alerts Lymphedema: Risk Reduction and Management Strategies - Newswise - 18 Feb 2010 - Newswise — There are no scientific studies showing that lymphedema can be prevented, but there are ways to lower your risk of developing this treatment side effect. During the 10th Annual Conference for Young Women Affected by Breast Cancer, we will explore the myths and recent scientific evidence about lymphedema, learn about risk reduction techniques and discuss approaches to lymphedema management, including exercise, physical therapy, lymphatic drainage, massage and other treatment methods. The 10th Annual Conference for Young Women Affected by Breast Cancer is the only international conference dedicated to the critical issues of young breast cancer survivors and those who care about them. Nearly 1,000 young breast cancer survivors, caregivers and medical professionals from around the world are expected to attend the Conference, to be held Friday, Feb. 26-Sunday, Feb. 28 at the Sheraton Atlanta Hotel in Atlanta, Ga. The Lymphedema: Risk Reduction and Management Strategies workshop will take place from 3:30 - 5: 00 p.m. on Friday, Feb. 26 , and will be led by physical therapist Jill Binkley, PT, MSc, FAAOMPT, executive director of TurningPoint Women's Healthcare in Alpharetta, Ga. To learn more about the Conference and for a complete list of workshops, visit www. youngsurvivorsconference.org. Editors Note: Complimentary press registration is available. Please contact Yarissa Reyes at (484) 708- 1547 or Yarissa@lbbc.org, or Dana Griffin at (646) 257-3006 or dgriffin@youngsurvival.org. **** About Living Beyond Breast Cancer (LBBC) Living Beyond Breast Cancer, based outside Philadelphia, is a national nonprofit organization dedicated to empowering all women affected by breast cancer to live as long as possible with the best quality of life. Programs and services include: conferences; teleconferences; the toll-free Survivors’ Helpline (888- 753-5222); a website, lbbc.org; free quarterly newsletters; publications for African-American and Latina women; recordings; networking programs for young survivors and women of color; healthcare- provider trainings; and the Paula A. Seidman Library and Resource Center. For more information about Living Beyond Breast Cancer, visit lbbc.org or call (610) 645-4567. About The Young Survival Coalition (YSC) The Young Survival Coalition, based in New York with 26 national affiliates, is the premier international organization dedicated to the critical issues unique to young women and breast cancer. YSC offer resources, connections, and outreach so women feel supported, empowered and hopeful. Through action, advocacy and awareness, YSC seeks to educate and influence the medical, research, breast cancer and legislative communities to address breast cancer in young women, and to ensure that no women diagnosed under 40 faces breast cancer alone. For more information about the Young Survival Coalition, visit youngsurvival.org or call (877) YSC-1011. Researchers develop guidelines for assessment, treatment and management of lymphedema - News- Medical-Net - 17 Feb 2010 Lymphedema, a chronic swelling condition that can appear after breast cancer surgery, is a risk for 1.3 million breast cancer survivors. Although lymphedema can cause lifelong swelling in the arms, back, neck and chest, there is no national standard of diagnosis or care. Now, University of Missouri researchers are leading the American Lymphedema Framework Project (ALFP), a national, multi- disciplinary collaboration to develop comprehensive guidelines for the assessment, treatment, and management of lymphedema. "We can't cure lymphedema today - we can only manage it," said Jane Armer, MU nursing professor and director of the project at the MU Ellis Fischel Cancer Center. "Lymphedema is a complex, chronic condition. Currently, there are inconsistent approaches to care for lymphedema, and often the most common form of self-management is to not treat it at all." The ALFP, established in 2008, has two main goals: establish a best practices document with evidence- based lymphedema treatment guidelines for health practitioners, and create a minimum data set of all available lymphedema research and clinical data. The ALFP researchers plan to publish the best practices document in 2011. "Part of why there isn't a standard of care is the lack of reliance on current evidence by health practitioners and third party payers, which in turn causes problems with reimbursement from health insurance companies. Many people with lymphedema have to pay out-of-pocket for care," Armer said. "There isn't a clear, national consensus for how to diagnose lymphedema and when to start treating it. The ALFP collaborators aim to document a standard of care reflecting a consensus on best practices that will help solve these problems." Researchers, including those at MU, have found that the most effective method of care for lymphedema is complete decongestive physiotherapy, in which therapists use specialized lymphatic massage techniques to reduce protein-rich fluid buildup. Bandages and compression garments also help to reduce swelling. One of Armer's innovations at MU is measuring patients' arms with a perometer, a machine that was first used to fit garments for swollen limbs. First implemented in a research setting at MU, the machine has a large optoelectric frame that glides over a patient's arm, scans its image and records an estimated limb volume reading. Perometer measurement is as, or more, accurate than several previous methods to measure arm circumference and volume. The machine is now used in about 20 sites across the country. Highlights of MU Sinclair School of Nursing research from the past 10 years reveal that there is a 40 percent higher risk of developing lymphedema in women with a body mass index (BMI) classified as overweight or obese compared to normal-weight women. The researchers also found that younger patients may have less occurrence of the condition but tend to report more symptoms, which could be a result of psychological and aging-related factors. "In addition to our previous findings, we're currently studying whether there are any genetic factors that increase the risk of lymphedema," Armer said. "A pilot study now underway and a proposed multi-site research study will look at the possibility of genetic predisposition for secondary lymphedema. The results could be applied to cancer treatment in which surgery and radiation affect the lymphatic system." Source: University of Missouri-Columbia Lymphedema: Risk Reduction And Management Strategies - Medical News Today = 19 Feb 2010 There are no scientific studies showing that lymphedema can be prevented, but there are ways to lower your risk of developing this treatment side effect. During the 10th Annual Conference for Young Women Affected by Breast Cancer, we will explore the myths and recent scientific evidence about lymphedema, learn about risk reduction techniques and discuss approaches to lymphedema management, including exercise, physical therapy, lymphatic drainage, massage and other treatment methods. The 10th Annual Conference for Young Women Affected by Breast Cancer is the only international conference dedicated to the critical issues of young breast cancer survivors and those who care about them. Nearly 1,000 young breast cancer survivors, caregivers and medical professionals from around the world are expected to attend the Conference, to be held Friday, Feb. 26-Sunday, Feb. 28 at the Sheraton Atlanta Hotel in Atlanta, Ga. The Lymphedema: Risk Reduction and Management Strategies workshop will take place from 3:30 - 5: 00 p.m. on Friday, Feb. 26 , and will be led by physical therapist Jill Binkley, PT, MSc, FAAOMPT, executive director of TurningPoint Women's Healthcare in Alpharetta, Ga. To learn more about the Conference and for a complete list of workshops, visit http://www. youngsurvivorsconference.org. MU Researchers Collaborate To Develop Standard Of Care For Breast Cancer Survivors With Lymphedema - Medical News Today - 19 Feb 2010 Lymphedema, a chronic swelling condition that can appear after breast cancer surgery, is a risk for 1.3 million breast cancer survivors. Although lymphedema can cause lifelong swelling in the arms, back, neck and chest, there is no national standard of diagnosis or care. Now, University of Missouri researchers are leading the American Lymphedema Framework Project (ALFP), a national, multi- disciplinary collaboration to develop comprehensive guidelines for the assessment, treatment, and management of lymphedema. "We can't cure lymphedema today - we can only manage it," said Jane Armer, MU nursing professor and director of the project at the MU Ellis Fischel Cancer Center. "Lymphedema is a complex, chronic condition. Currently, there are inconsistent approaches to care for lymphedema, and often the most common form of self-management is to not treat it at all." The ALFP, established in 2008, has two main goals: establish a best practices document with evidence- based lymphedema treatment guidelines for health practitioners, and create a minimum data set of all available lymphedema research and clinical data. The ALFP researchers plan to publish the best practices document in 2011. "Part of why there isn't a standard of care is the lack of reliance on current evidence by health practitioners and third party payers, which in turn causes problems with reimbursement from health insurance companies. Many people with lymphedema have to pay out-of-pocket for care," Armer said. "There isn't a clear, national consensus for how to diagnose lymphedema and when to start treating it. The ALFP collaborators aim to document a standard of care reflecting a consensus on best practices that will help solve these problems." Researchers, including those at MU, have found that the most effective method of care for lymphedema is complete decongestive physiotherapy, in which therapists use specialized lymphatic massage techniques to reduce protein-rich fluid buildup. Bandages and compression garments also help to reduce swelling. One of Armer's innovations at MU is measuring patients' arms with a perometer, a machine that was first used to fit garments for swollen limbs. First implemented in a research setting at MU, the machine has a large optoelectric frame that glides over a patient's arm, scans its image and records an estimated limb volume reading. Perometer measurement is as, or more, accurate than several previous methods to measure arm circumference and volume. The machine is now used in about 20 sites across the country. Highlights of MU Sinclair School of Nursing research from the past 10 years reveal that there is a 40 percent higher risk of developing lymphedema in women with a body mass index (BMI) classified as overweight or obese compared to normal-weight women. The researchers also found that younger patients may have less occurrence of the condition but tend to report more symptoms, which could be a result of psychological and aging-related factors. "In addition to our previous findings, we're currently studying whether there are any genetic factors that increase the risk of lymphedema," Armer said. "A pilot study now underway and a proposed multi-site research study will look at the possibility of genetic predisposition for secondary lymphedema. The results could be applied to cancer treatment in which surgery and radiation affect the lymphatic system." In recognition of the leadership in lymphedema research at MU, the ALFP is housed at the MU Ellis Fischel Cancer Center. Armer's research is funded by the National Institutes of Health and is published in several journals, including the Journal of Lymphoedema; Lymphology; Lymphatic Research and Biology; and the Journal of Cancer Survivorship, and presented at conferences throughout the world. The activities of the ALFP have been funded by industry partnerships and grants from the American Cancer Society through The Longaberger Company, a direct-selling company offering home products, and the Longaberger Horizon of Hope Campaign, which provided a grant for breast cancer research and education. Source: Emily Martin University of Missouri-Columbia Google News Alert for: lymphedema UAW Local 651 to host benefit for woman who needs kidney transplant The Flint Journal - MLive.com - February 18, 2010 FLINT, Michigan — Cynthia Powser was born with Down Syndrome 22 years ago and hasn’t had an easy life since. “She got diabetes when she was 1 years old,” said her mother, Tina Kollek, 39, of Shiawassee County’ s Venice Township. “We almost lost her then.” Powser’s had problems with congenital heart failure and lymphedema in her arm. And about a year ago, her kidneys failed and she needs a kidney transplant. With medical bills piling up, Kollek taking time off to care for Powser and Kollek’s husband currently laid off, Kollek’s friends and co-workers at the General Motors Service and Parts Operations Davison Road Packaging Center in Burton are stepping up to help. “I’m behind on everything,” Kollek said. “The house went for foreclosure. The Consumers (bill) is outrageous. I’m trying to do what I can do.” Kollek’s co-workers have organized a benefit spaghetti dinner 5-7 p.m. Saturday for Powser at UAW Local 651, 3518 Longway Blvd. The benefit also will include a raffle and a live auction beginning at 7 p.m., said Art Reyes, UAW Local 651 president. Among the donated items include a teeth whitening kit and auto detailing, Reyes said. “I’m so glad to see people have come together to help this family,” he said. Tricia Sermeno and about 10 other people have been working on pulling the event together for the past several weeks. Sermeno, 27, of Burton said that Powser’s character, spirit and courage inspired the group to help. “She always has a smile on her face and is constantly battling and going through all these surgeries,” Sermeno said of Powser. Management at the Davison Road SPO plant recently held an employee raffle for a special parking space at the plant, matching what employees raised dollar-for-dollar. And Sermeno said they plan to present the family with about $1,400 on Saturday. “Everybody has just really jumped on board to help, from the people on the floor to the management to our local leadership,” Sermeno said. Kollek said she is working on getting family — including Powser’s two brothers — tested to see if they are matches to donate a kidney. She said she is overwhelmed by the outpouring from her co-workers and is hoping her daughter — whom she described as strong through it all — will be well enough to attend the benefit. “You just don’t know how many people care until they do something like this,” Kollek said. Benefit • Who: Cynthia Powser, 22, of Shiawassee County’s Venice Township, has Down Syndrome and needs a kidney transplant. • When: A spaghetti dinner fundraiser is 5-7 p.m. Saturday, with a live auction to follow at 7 p.m. • Where: UAW Local 651, 3518 Longway Blvd., Flint. • Cost: Dinner is $10 for adults, $5 for children and donations also can be left for the family at UAW Local 651 A battle she's determined to win - Miami County Republic = February 17, 2010 Beverly Nuessen pulls out a drawer from the table beside her chair. It’s full of pills. Filled to the brim. Some of the more than 30 bottles in the drawer cost $80, $100 or more. But instead of looking down at the pills, Beverly, or “Bev” for short, looks out through the glass door in front of her — out to the pasture, where her horses are. Before the pills, before the chemotherapy and radiation, before the tears, prayers and pain — there were her horses. She pulls out a picture she keeps close to her, close to her heart, a photo from the ‘60s of her and her dad at a rodeo. She was young then, a teenager, and a lot has changed since then, but her love for her horses and her father will never falter. Proudly wearing a large belt buckle and cowgirl hat in the picture, one may not recognize Bev now. Her hair is short and a bit thinner, her skin is pale, and one arm is larger than the other. She can hardly walk, which keeps her from enjoying the company of her horses. But that’s what cancer does to some. “I call it the silent killer,” Bev said. “Cancer is the worst disease, killer there is.” IN THE BEGINNING Bev was diagnosed in March of 1991 with breast cancer. Just a regular check-up to her OBGYN lead to the discovery that would change her life and the lives of those closest to her. She was 36, and the doctors couldn’t believe it. “I don’t know how many times I heard, ‘You don’t have cancer, you’re too young,’” she said. But that was just the beginning. Since 1991, Bev has had four major surgeries, if you don’t include the one to put in her portacath, or port, used for injecting chemotherapy so it can be dispersed throughout the body without damaging the skin and veins. She’s had a complete mastectomy, with doctors going down at least three inches below the surface of her skin to make sure the cancer didn’t return a third time, after it had returned in 2004 or 2005. Sometimes the years run together, along with the treatments. She’s undergone a hysterectomy to remove her uterus and a lymphedema surgery to remove a portion of her lymph nodes. “I call them ‘ectomy’ diseases,” Bev said with a laugh. The lymphedema is what has caused her arm and legs to swell, retaining fluid that shouldn’t be there, which in turn has given her problems walking. Then there’s the bone cancer. In 2002, Bev complained of a pain in her right side by her hip that would move down her leg. She thought she’d pinched a nerve. Instead, the cancer had started in her hip and crossed her lower lumbar into her pelvis. Two to three years later, the breast cancer would return, and in 2007, despite the thousands of visits to the hospital, the endless days of being treated with chemo and radiation visits, every single day, Bev began to hurt on the left side. A bone scan was conducted, which Bev said was the worst one she’s had to endure yet, and a tumor was discovered on her hip joint the size of a baseball. Radiation treatments began again in September of 2007. “It was the worst imaginable pain,” she said. She became horribly sick seven days after starting treatment, an abnormal kind of sick, if there is such a thing for cancer patients. The radiation was not only hitting her tumor, but also her bowels and the top of her leg, which caused the fluid to build up in her leg. She recalled there was at least 20 pounds of extra fluid in her leg. Bev had planned to make a trip to Las Vegas with her family for the National Finals Rodeo, but she couldn’t walk down the hallway after the treatments. Needless to say, they didn’t make it to Vegas. In January of 2008, Bev started three different kinds of chemotherapy — she lost all of her hair within the first two months of treatments. “People stare at you,” she said. “I bought everything, the wigs, hats, but your skin color is pale.” A ramp was built last summer to help Bev make it into her own house. She also purchased a scooter. FAMILY TIES Through all of this, Bev and her husband, Richard or “Dick,” have raised three children. They’ve already got one grandchild and another to be born this July. There’s Rick, her oldest, Rodney and Becca, her youngest, who has always known her mother with cancer. It’s when thinking of her children that Bev chokes up, soon she doesn’t hide it anymore, and the tears fall freely. “I feel that it has taken a lot from my family. They’ll never say, ‘Mommy, because of you we never got to do anything.’ Because if you don’t have money, you don’t go anywhere. You can’t buy groceries sometimes because every month you’ve got this medical bill that’s $10,000,” she said with a Kleenex clutched in her hand. “Sometimes I think it’s really unfair — but with determination, prayer — I’m still here.” Bev had been fighting cancer for five years when her own father passed away in 1996 from t-cell leukemia. It hit her like a ton of bricks. “He told me I’d beat it,” she said. “He told me to fight it. I guess I’m still fighting it.” Although her father’s no longer here, others are for Bev. Rebecca, her youngest, has been supportive through it all. “She works her tail off for me,” Bev said. Although no one will take credit, a small group of Bev’s friends and family members will host a dinner and benefit auction at 5 p.m. Feb. 27 at the Miami County Fairgrounds in building No. 2. The Prairie Wine Band will perform, and a $10 donation per person will be accepted at the door. The event will include a chili dinner, silent auction and raffle. Auction and raffle items will include several things donated by the Kansas City Royals baseball team, including 20 sets of tickets for the 2010 season. Bev said her father, Merle Wood, worked as the vice president of government affairs for Marion Laboratories and knew Ewing Kauffman, who formed the company after working as a pharmaceutical salesman and established the Royals. The Major League Baseball team has also donated shirts and autographed baseballs for the auction. Merle and Bev were both heavily involved with the American Quarter Horse Association, and Bev’s children became involved as well. The AQHA has donated a jacket for the auction “I’m totally amazed by it,” Bev said of the event. “I didn’t think it would be this great. It’s overwhelming.” Alisha Williamson, a close family friend, helped put the event together. Williamson said items have been donated, along with local business gift certificates, quilts and photography packages that will be included in the raffle and auction. “I enjoy volunteering my time and helping out others in any way I can,” Williamson said. “That’s why my heart’s in it. I know Bev would step up and be there for me, too.” Flexible Fitness: Swelling could be lymphedema - Milford Daily News - February 16, 2010 Have you ever noticed a difference in the size of one of your arms or legs? Does one arm or leg feel heavy, and the clothes on that side of the body feel tight? If you have certain risk factors, this could be lymphedema. The lymphatic system is a series of vessels that carry a clear fluid that helps the body rid itself of inflammation. Lymphedema is a condition in which the lymphatic system becomes overwhelmed due to injury or structural abnormalities. It then cannot clear the body normally of lymph fluid. Lymph fluid is a protein-rich fluid which the circulatory system (capillaries) cannot reabsorb. The body relies on the lymphatic system to pick up this fluid, filter it and deposit it back into the circulatory system. When this process breaks down, swelling occurs because the fluid simply builds up in the body's tissues. Lymphedema is characterized by an abnormal accumulation of protein-rich fluid resulting in the swelling of an extremity (arm or leg) or the trunk. The neck, head or genitals could also be affected. It most commonly occurs as a result of cancer treatment, such as a mastectomy, lymph node removal and/or radiation. However, lymphedema can also occur due to trauma, liposuction, vein stripping, malignancies and surgery, or even due to a congenital abnormality in the lymph system. It can also occur in combination with chronic venous insufficiency. Risk factors for lymphedema include obesity, history of trauma or injury to a limb, diagnosis of breast cancer at younger than 50 years old, having greater than 10 lymph nodes removed, a history of radiation treatment, and a history of upper extremity infection after cancer treatment. Recent research suggests there is up to a 40 percent prevalence of lymphedema in breast cancer survivors over a five- year period, and onset usually occurs by the third year after treatment. How do you know if you have signs of lymphedema? Lymphedema symptoms tend to have a slow, progressive onset. Early signs might be tighter shirt sleeves, rings and watches, and a heavy, fatigued or achy feeling in a limb. Later, a difference in size between one extremity and the other may be noted, and creases may appear where the toes connected to the foot if the leg is affected. A fluid-filled hump on the top of the foot or back of the hand is common in later stages. Generally the fingers, hand and lower arm swell first (or toes and feet if the leg is affected) and the lymphedema progresses upward. If it is congenital, a person might notice a size difference between the extremities since birth or, more commonly, since adolescence. Lymphedema has four stages of progression. In stage zero, or latent lymphedema, the patient has some symptoms but insignificant difference in limb size. Stage one lymphedema is reversible, transient swelling. There is a small but measurable size difference between limbs, but the swelling can be reduced with elevation. An increase in swelling may be present when an indentation remains when the skin in pressed. It is best to get treatment in these first stages to discourage progression of the condition and potentially reverse it, so noticing signs and symptoms early is important. Stage two involves noticeable swelling of a body part with a more significant size difference. This is considered permanent lymphedema. There is less or no pitting type of swelling, and the affected area may feel hard or firm, due to a process called fibrosis. Stage three lymphedema consists of further swelling, skin changes, no pitting and possibly very large limbs (elephantiasis). It is important to get treatment for stage two and three lymphedema to prevent further progression of the condition, to decrease the risk of infection and to increase functional use of the extremity. Treatment for lymphedema can be as easy as a light compression sleeve for the earlier stages, to manual lymph drainage (MLD), compression wrapping and eventually compression sleeves/gloves at the end of treatment for later stages. It is important to seek out a therapist certified in complete decongestive therapy (CDT), which includes MLD, to ensure the best treatment outcome. The good news is, lymphedema usually responds well to this treatment and the patient can get back to using his/her limb with fewer symptoms and effort. Nicole Tomasino PT, DPT, CLT, is a certified lymphedema therapist specializing in lymphedema treatment and oncology rehabilitation at the Spaulding Framingham Outpatient Center. Solid nursing background leads to executive spot - DesMoinesRegister.com - February 17, 2010 Unfortunately, that page could not be found. Breast surgery only the beginning - Sunshine Coast Daily - February 13, 2010 CORAL Cross had a mastectomy eight months ago to save her life, but every day since has been hell. The 64-year-old Mount Coolum breast cancer survivor is bravely speaking out about her journey to draw attention to the disease, which kills 2800 women a year in Australia. She believes her raw account of her diagnosis, treatment and recovery will help stop other women in a similar position from feeling alone. Ms Cross discovered a lump on her right breast in June last year. The month soon became an emotional roller coaster as normally foreign words such as mastectomy, lumpectomy, radiotherapy and chemotherapy became a normal part of her life. “I was shocked. I wasn’t prepared to loose my breast,” Ms Cross said. “I was told that if I didn’t have the surgery I would die a long, painful death and that I would need ‘a mental health evaluation’ if I refused. “I believe there is still a lot of work to be done in training doctors in communication skills when it comes to breast cancer.” Coral said as she walked towards the operating theatre on Tuesday, July 28, 2009, she had a knot in her stomach and a lump in her throat. She spent two days in hospital and was then discharged. On the next Saturday night, the drains fell out. “I had lymph fluid pouring down my side,” she said. “I had to sleep with a towel under my arm until I could come to the hospital on Sunday morning. “By Thursday I had huge swelling under my arm, hot red and very painful. “The doctor drained 300ml of lymph fluid.” Ms Cross said she found out later she had an infection that had triggered severe lymphedema – a problem faced by many women with breast cancer – which can be a disabling and distressing condition. “I made the choice to attend my local GP,” she said. “He drained lymph fluid every second or third day to prevent a recurrence of severe discomfort. “This draining went on for one month, it was painful, frightening and distressing.” Coral said two months after the surgery she experienced a huge bleed across her chest. “The bleed took three months to resolve,” she said. “I’ve gone through so many emotions since the operation. “I’ve been depressed, struggled with thoughts of suicide and now I am angry,” she said. “Before the operation I used to be a confident woman who would power walk every morning and wear beautiful clothes. “I can only wear a bra and prothesis for about an hour because of the deformation under my arm causing pain. “I know the surgery saved my life but the scar is tethered in two places. “I have no armpit, just a folded mess and a hole in my chest that I can put my finger into.” Breast cancer treatment does not always mean major, disfiguring surgery. New knowledge from research means specialists can treat many breast cancer cases by removing the lump itself, leaving the breast intact. There are women, however, like Ms Cross, who suffer complications. She lodged an official complaint with the Health Quality and Complaints Commission but has been told the matter would not be taken further. A National Breast Cancer Foundation spokeswoman said breast cancer survivors could experience difficulties ranging from physical limitations to psychosocial problems. “A significant and enduring complication of breast cancer treatment is in the reduction of upper body strength and mobility,” she said. “These issues are now emerging as new targets for research.” An Australian Society of Plastic Surgeons Incorporated spokesman said that when it came to breast cancer, the first surgery should be focused on curing the patient of the disease. “That said, patients need to know what options are available to them,” he said. “If a women is considering reconstruction, then a plastic surgeon should be involved from the start.” Fifteen per cent of all breast cancers are advanced at diagnosis. “Women whose cancer is diagnosed when it is contained in the breast have a 90% chance of surviving %five years, compared with 20% five-year survival when the cancer has spread at diagnosis,” the spokesman said. FINDING CHANGES IN YOUR BREAST By knowing what is normal for you at different times in the month and at different stages of your life, you should be able to find any changes in your breast that are unusual for you. All women’s breasts are different, but you know better than anyone how your breasts look and feel at different times. Women are advised to: Look at your breasts in the mirror – look at the shape, size and skin of your breasts and nipples. Are there differences between the two breasts or nipples? If so, have they appeared in the last few months? Feel your breasts from time to time, perhaps while you are dressing, bathing or showering. Remember that your breasts extend to under your collarbone, up under the armpit and include the area around the nipples. According to the National Breast Cancer and Ovarian Centre some questions to ask about breast surgery include: What type of surgery is best for me? What will surgery involve? Do you specialise in breast cancer surgery? Can you refer me to someone who specialises in breast cancer surgery? Where will the scars be and what will they look like? How long will I be in hospital? How long will I take to recover? What side effects can I expect? Who should I contact if side effects happen? How much will the surgery cost? One in nine women will be diagnosed with breast cancer by the age of 85 Getting older is the most common risk factor: about 13% of new cases are among women aged 20 to 44, 61% in women aged 45-69 and 26% among women over 70. Women of all ages need to understand the importance of finding and treating breast cancer early. Liposuction provides relief for breast cancer patients - 10 Connects - March 10, 2010 Tampa, Florida -- Imagine not being able to lift your arm because it's so swollen and feels so heavy, you can't extend it all the way. Up to 25 percent of breast cancer patients are at risk for arm lymphedema, a life-altering side effect that can even make your arm numb. A new study may give breast cancer survivors a new treatment option. "I was diagnosed January of '08, and I had an extensive number of lymph nodes removed as part of the surgery. And as a result, after the surgery, several months later, lymphedema developed," patient Cheri Wetzel said. Wetzel survived breast cancer only to be confronted with another debilitating side effect: lymphedema. "The whole arm was, it appeared to me to be, twice as large as the other arm ... I couldn't wear some clothes because my clothing was getting so tight, and so I ended up with a lot of tank tops and very limited motion on the arm because it was feeling so heavy to use it," Wetzel said. Last fall, her doctor asked her to be part of a small study at Moffitt Cancer Center using liposuction to reduce the lymphedema. Dr. Christine Laronga explains how the surgery works, "When the lymph channels are cut because of the sugery to take the lymph nodes out, those lymph channels have no place to go because they go to the lymph nodes that have now been cut. And so the fluid backs up and fluid is very protein rich, and then what it does as it leaks out of those little lymph channels into the surrounding tissue, the fat cells swell in reaction to this high protein because it pulls water into the cell. So it's not that you increase the number of your fat cells, they just get bigger and that's why the arm feels like it's full of fluid. So if you can remove the number of fat cells, you're not preventing the process because those that are left behind can still swell but there's so many less of them." "I had eight incisions, eight spots where they went into the arm and took they essentially drained the arm of the lymphatic fluid... I went home like three hours later. I was walking my dog in the afternoon, so it was really no big deal and my arm didn't bother me," Wetzel said. She'll still have to wear a compressive sleeve to keep the lymphedema from coming back, but otherwise her arm is back to normal. "I can wear clothes again. I can use my arm. My arm doesn't bother me. It's just like my other arm again," Wetzel said. "They find that their arm is much more mobile, less heavy, more comfortable for them, and their range of motion in all their joints is just tremendously better so their quality of life is just so much better for them," Dr. Laronga said. The lipo isn't covered by insurance since it's considered cosmetic, but Dr. Laronga hopes her study will change that. For now, she'll track the six patients' progress over the next year in her trial to prove the lipo can improve their quality of life for the long term. Then, she'll apply for larger grants to enroll more women for the $12,000 to $17,000 procedure. If you would like to make a donation to Dr. Laronga's study, specify Lipo for Lymphedema on any Moffitt donations. To learn more about lymphedema, click on these links: •BreastCancer.org •Compression Sleeves Komen grants help ease breast cancer's financial toll - Florida Weekly - March 11, 2010 When Leesa Crapa was diagnosed with breast cancer last summer, she felt immobilized by the threat of financial devastation. “My insurance company dropped me,” said the Cape Coral resident. “They said because I had family history and all this business that they just weren’t going to pay anything.” Her boyfriend got online to search for help, and they ultimately found it: the means to pay for medical tests, a mastectomy and ongoing care. Home from a therapy session last week, the couple shared a courageous laugh about her bald head. “We’re doing fine,” Ms. Crapa said. “We’re seeing light at the end of the tunnel and it’s not a freight train.” Her treatment, along with many other women who are uninsured or underinsured, was backed by support from Susan G. Komen for the Cure’s Southwest Florida affiliate. Ms. Crapa is being cared for through Lee Memorial Health System’s treatment and referral program, Breast C.A.R.E., which received a $209,350 Komen grant last year. Naples Community Hospital has a similar program, Breast Health Patient Navigation, which received a $92,350 Komen grant in 2009. “These grants are saving women’s lives, especially in this economy,” said Dara Leichter, breast health navigator for the Breast C.A.R.E. program. These are two of 10 community programs to receive Komen grants last year, $963,000 in all, which aims to remove the financial hurdle in the fight against breast cancer. That’s more than 13 times what Komen raised six years ago, its first full year of fundraising as a new Southwest Florida affiliate. Komen’s popular annual fundraising event, Race for the Cure, has made it the region’s most visible and muscular presence in promoting breast cancer education, diagnoses and treatment. Last year the race attracted 8,100 walkers and runners. Organizers are hoping for another record turnout at this year’s race, March 13 at Coconut Point mall in Estero. Supporters of Komen’s Southwest Florida affiliate have been exponentially more numerous and generous, but the number of breast cancer patients who can’t afford treatment in the aftermath of the recession is outpacing that growth. Groups are asking Komen of Southwest Florida for nearly twice as much as last year, a total of $1.8 million in grant requests for the coming fiscal year, starting April 1. “Because so many people are out of work and the way the economy is, there is a huge increase in need,” said Bonnie Olson, grant chair for Komen of Southwest Florida. One of the gaps Komen aims to fill is the lack of medical resources for breast cancer patients in Hendry and Glades counties. Others include areas of breast cancer treatment and education in Southwest Florida that may be overlooked or poorly funded. For example, lymphedema is a condition that breast cancer patients could be at risk for, even decades after their cancer has been in remission, if their lymph nodes are removed during surgery. Lymphedema Resources in Estero was awarded a $29,500 Komen grant last year to help cover education and medical treatment for uninsured or underinsured patients. The Passionate Pinks of Charlotte County was founded in 2007 to educate women about early detection. Every year, a contingent of the group arrives in Estero by bus to participate in the Susan G. Komen Race for the Cure. The group coordinates Project Hope in Charlotte County, a Komen affiliate, which is an educational initiative for people recently diagnosed with breast cancer in Charlotte County. Working with Florida Cancer Specialists, the group provides a tote bag containing a journal, information and items for warmth and comfort. To learn more about the Passionate Pinks, visit passionatepinks. com or e-mail passionatepinks@ comcast.net. Family Health Centers of Southwest Florida was able to assess the risk of breast cancer and provide screening services for 818 women last year. Director Ena Mendez says that wouldn’t have been possible without a $157,453 Komen Grant. Lynn Hurley, breast health navigator at Naples Community Hospital, was recently approached by a woman who didn’t have health insurance. “She was crying because I was telling her about the community resources that are available,” Ms. Hurley said. “She said ‘I found a lump two months ago and I couldn’t do anything about it.’” “They’re saying ‘what if I get a mammogram and I do have cancer?’” Ms. Hurley said. “‘What then? I have no money.’ “We want them to come in. Even if they don’t have money, that’s not an issue for us.” North Fort Myers resident Sharolyn Clayton had no insurance when she was diagnosed with breast cancer two years ago. The Breast C.A.R.E. program helped cover the financial costs of tests like mammograms, MRI’s and cat scans, as well as treatments like chemotherapy, and medication. “There are organizations that can help you to pay for this stuff,” Ms. Clayton said. “So I would say that for anyone with breast cancer, do not ever give up.” ¦ .. in the know >> What: Susan G. Komen Race for the Cure >> When: March 13 starting at 8 a.m. The registration tent opens at 6:30 a.m. >> Where: Coconut Point mall, Estero, at U.S. 41 and Coconut Point Road. >> Details: 5 k races and walks for youth and adults, as well as a 1-mile Fun Walk. >> Cost: Late registration is available on the day of the race, $40 for adults and $20 for under 18. Visit www.komenswfl.org for more information, directions, and to register online. >> Grant money allocated locally by Susan G. Komen for the Cure of Southwest Florida in 2009: (This number represents 75 percent of the total grant money raised each year, which is spent locally. The other 25 percent goes to national organizations to research cures for breast cancer.) 2004-05: $74,000 2005-06: $152,000 2006-07: $306,000 2007-08: $448,000 2008-09: $823,000 2009-10: $963,000 Max Organises 'Breast Cancer Support Group Meeting' - Express Healthcare Management - March 11, 2010 Max Cancer Centre, Patparganj took the initiative of bringing all breast cancer survivors on a common platform on the occasion of 'World Cancer Day' to support the cause. Over 60 breast cancer patients attended the meet along with entire team of Max Cancer Centre. An online blog called 'Pink Connect' has also been started by Max Healthcare on leading social networking website Facebook, where various leading doctors, psychiatrists, cancer patients and their peers can contribute stories, exchange information and share experiences regarding this disease and its cures. Said Dr Geeta K, Senior Consultant, Surgical Oncology, Max Healthcare, "These meetings are a learning experience for the caregivers as well. There are several issues we are unable to address during the course of treatment and are brought to light by people who have lived through the experience. What is more amazing are the novel solutions that they come up with for their problems." Said Dr Vineeta Goel, Consultant Radiation Oncologist, Max Healthcare, "These meetings are aimed at empowering women whose lives are temporarily disrupted by this disease. These meetings reinforce the message that they return to their normal lives and give back to the community by influencing at least 10 other women to become breast aware. This will go a long way in picking up disease early and expecting better outcomes in the long run." Also present at the occasion was Mamta Goenka, who spoke about her own story of victory against breast cancer. "After experiencing the ordeal of breast cancer and emerging victorious, I take it as my responsibility to give back to the society by educating breast cancer sufferers about lymphedema (swelling of arm) and encouraging and motivating them to go on with their normal lives." EH News Bureau Lymphedema Products Effectively Used For Treatment - Release-news.com = March 11, 2010 Treatment of lymphedema involves manual lymph drainage, use of compression garments, bandaging and skin care, and http://www.lymphaticdrainagetherapy.com/">lymphatic drainage therapy. Lymphedema can be effectively managed with treatment that makes use of several http://www. lymphedema-products.com/">lymphedema products which include compression garments, bandages, footwear, foams and padding, accessories like hooks and fasteners, donning aids, pneumatic pumps, compression devices, etc. In order to maintain the edema reduction after decongestive therapy, the patient is required to wear elastic compression garments at all times. You can have a custom-made compression garment or purchase one over the counter. These are to be worn each day and replaced at regular intervals. Lymphedema garments for the upper extremities include compression arm sleeves, bras, gloves and gauntlets. Knee-high and thigh-high stockings, compression pantyhose and compression devices for the legs are also available. However, before purchasing the product, you must consult your physician to find out which garment is right for your condition. Bandaging or wrapping the affected body part is essential so that lymphedema is reduced. Compression bandaging provides a resistance on the skin and the muscles underneath. This resistance helps the tissues to re-absorb the fluid and prevents fluid retention in the limb. Usually short stretch bandages give a better result as they produce the tension required to enhance the pumping action for the lymph vessels. There are various categories of bandages and they come in the form of tubular stockinettes, finger and toe bandages, tapes and adhesive bandages. The patient can choose to use whatever is suitable. Another lymphedema product that plays a major role in the treatment of the condition is the lymphedema pump. The Sequential Gradient Pump and the FlexiTouch Pump are the two types of pumps used for complete decongestive therapy. The lymphedema pump can either be purchased or rented from a surgical supply store. Those who do not have access to a therapist can make use of the lymphedema pump for their treatment. It is crucial for lymphedema patients to maintain a meticulous skin care routine. Various gels, creams, ointments and lotions are available for cleansing and moisturizing the skin. For those suffering from lymphedema, compression therapy and a life-long follow up on the treatment is essential. New lymphedema products are coming in the market and therapists are using them to take care of problem areas of tissue fibrosis and swelling. For instance, a special tape known as the Elastic Therapeutic tape is being used to soften the edemas. Donning and doffing aids, special footwear and accessories like bandage rollers try to make life a bit easier for lymphedema patients. Due to the convenience of online shopping, it is now possible to procure lymphedema products quite easily. Many online stores have trained therapists who can assist you with the selection of a suitable lymphedema product that you might need. Lymphedema Products Effectively Used For Treatment - I-Newswire.com (press release) (I-Newswire) March 11, 2010 - (I-Newswire) March 11, 2010 - Treatment of lymphedema involves manual lymph drainage, use of compression garments, bandaging and skin care, and lymphatic drainage therapy. Lymphedema can be effectively managed with treatment that makes use of several lymphedema products which include compression garments, bandages, footwear, foams and padding, accessories like hooks and fasteners, donning aids, pneumatic pumps, compression devices, etc. In order to maintain the edema reduction after decongestive therapy, the patient is required to wear elastic compression garments at all times. You can have a custom-made compression garment or purchase one over the counter. These are to be worn each day and replaced at regular intervals. Lymphedema garments for the upper extremities include compression arm sleeves, bras, gloves and gauntlets. Knee-high and thigh-high stockings, compression pantyhose and compression devices for the legs are also available. However, before purchasing the product, you must consult your physician to find out which garment is right for your condition. Bandaging or wrapping the affected body part is essential so that lymphedema is reduced. Compression bandaging provides a resistance on the skin and the muscles underneath. This resistance helps the tissues to re-absorb the fluid and prevents fluid retention in the limb. Usually short stretch bandages give a better result as they produce the tension required to enhance the pumping action for the lymph vessels. There are various categories of bandages and they come in the form of tubular stockinettes, finger and toe bandages, tapes and adhesive bandages. The patient can choose to use whatever is suitable. Another lymphedema product that plays a major role in the treatment of the condition is the lymphedema pump. The Sequential Gradient Pump and the FlexiTouch Pump are the two types of pumps used for complete decongestive therapy. The lymphedema pump can either be purchased or rented from a surgical supply store. Those who do not have access to a therapist can make use of the lymphedema pump for their treatment. It is crucial for lymphedema patients to maintain a meticulous skin care routine. Various gels, creams, ointments and lotions are available for cleansing and moisturizing the skin. For those suffering from lymphedema, compression therapy and a life-long follow up on the treatment is essential. New lymphedema products are coming in the market and therapists are using them to take care of problem areas of tissue fibrosis and swelling. For instance, a special tape known as the Elastic Therapeutic tape is being used to soften the edemas. Donning and doffing aids, special footwear and accessories like bandage rollers try to make life a bit easier for lymphedema patients. Due to the convenience of online shopping, it is now possible to procure lymphedema products quite easily. Many online stores have trained therapists who can assist you with the selection of a suitable lymphedema product that you might need. Bill lobbies for compression garments - HME News - March 11, 2010 WASHINGTON - A bill that would require Medicare to cover compression garments and other items used to treat lymphedema began making the rounds in February, but some industry stakeholders say it needs some clarification. Introduced Feb. 23 by Rep. Larry Kissell, D-N.C., the Lymphedema Diagnosis and Treatment Cost Saving Act of 2010, would improve the diagnosis and treatment of lymphedema under the Medicare program. Among other things, the bill, H. R. 4662, seeks to establish Medicare coverage for compression bandage systems, compression garments and compression devices. "The garments are used every day (by patients) and they are the backbone of the treatment," said Robert Weiss, a volunteer advocate with grassroots organization National Lymphedema Network, who helped get the bill introduced. The bill also seeks to define who can provide the garments. The list includes nurses; physicians and physician assistants; chiropractors; licensed massage therapists; licensed home health practitioners; and licensed prosthetists and orthotists. Also on the list: someone certified by the manufacturer of an item to provide that particular item. That's where the bill gets a little gray. "The bill in many ways limits the provision of services to those particular disciplines," said Rhonda Turner, executive director of the American Association of Breast Care Professionals. "It does have some language saying 'anyone else deemed appropriate by the DHHS secretary.' We want to see if they could have a little bit more definition of that provider list." The bill may simply need some tweaks, she said. Ultimately, Weiss said, the bill "attacks" a number of large problems that prevent patients from getting proper care, and proper care would save the government money. "If you treat the lymphedema, you are avoiding very expensive and hard-to-treat cellulitis, which can require hospitalization," he said. At the end of the day, the bill is a step in the right direction, said stakeholders. "While H.R. 4662 leaves many unanswered questions and concerns, we are encouraged that the bill will serve to raise awareness to the issue of lymphedema and the need for services/items to be covered without exception by commercial insurances and Medicare/Medicaid," said Turner. Breast cancer battle can continue after treatment ends - WZVN-TV - March 11, 2010 FORT MYERS: Breast cancer is the most common cancer among women in the U.S. and it will claim the lives of more than 40,000 this year alone. But for those who beat the disease, sometimes the battle isn't always over after treatment ends. After surviving breast cancer, Jane Dinnan thought her troubles were over. "You wanted to feel good about the fact that the cancer is gone, but I couldn't feel that way," said Dinnan. As part of her treatment, doctors removed 17 lymph nodes from Jane's arm - tiny organs that help the immune system fight off infection. But without them, body fluid couldn't drain from the limb. "It felt like I had a lead weight on my arm all the time," she said. Her arm swelled to more than twice its normal size. "It just was miserable. I was miserable. I wanted, I mean the arm could go and I'd be happier," she said. She spent almost all of her time wearing a compression sleeve or using a machine that pushes the lymphatic fluid up the arm so it can get into the system. "The treatment of lymphedema, for the most part in the United States, is management or conservative management of lymphedema," said Marga Massey, a Plastic and Reconstructive Surgeon. After being told there was no other option, Jane found plastic and reconstructive surgeon doctor Massey, who's brought a new surgery to the U.S. Dr. Massey removed three lymph nodes from the inside wall of Jane's abdomen. "Blood vessels are harvested in order to keep the lymph nodes alive," said Massey. She then transplanted them under Jane's arm, into the area missing lymph nodes. Jane spent just one night in the hospital and the swelling went down almost immediately. "I would say overwhelmingly the majority, somewhere even in the range of perhaps maybe 90 percent of patients, show relief from their symptoms," said Massey. It's given Jane a chance to celebrate life cancer-free. "So I never felt the elation that I feel now that I've beat this," said Jane. "I'm back to normal. I feel like my life is back." Dr. Gott: Should reader find a new physician? - Northwest Herald Archive Search Dear Dr. Gott: My doctor has told me that I have lymphedema and should take a water pill. When the 20 milligrams wasn't sufficient, she put me on 40 milligrams. Because I wanted to know more about my condition to better educate myself about things to do and not do, I looked online. It appeared to me that my doctor should be looking for the cause of the swelling, not just treating it. So I pressed her into doing more. She ordered a CT scan of my pelvis, a heart echo and a venous... Click here for complete article TINA - I cant get the whole article because I dont belong to the website that the link went to, sorry Kissell introduces health care bill - Salisbury Post - WASHINGTON – N.C. Rep. Larry Kissell has introduced legislation which would require Medicare to offer more treatment coverage for Americans afflicted with primary and secondary lymphedema. The Lymphedema Diagnosis and Treatment Cost Saving Act of 2010, HR 4662, is designed to improve patient care and reduce costs associated with complications related to lymphedema. Lymphedema, also known as lymphatic obstruction, is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system. According to a press release, Kissell introduced the legislation after meeting with constituent Heather Ferguson, whose son Dylan suffers from primary lymphedema. Ferguson, who lives in Charlotte, has been active in working to raise awareness of the disease and to help alleviate the troubles lymphedema sufferers have getting insurance to cover treatment. "I was moved by Heather's story, and all she has gone through to ensure that her son receives this important treatment. Her dedication to helping others in the same situation has inspired me to help her in her quest to make sure lymphedema patients have an opportunity to receive treatment," Kissell said in the press release. "This preventative treatment will help improve life for many people throughout this country." The treatment for lymphedema is known as complex decongestive therapy. The press release said that with treatment, patients can live long, healthy and virtually normal lives. It also said that without treatment, the disease can progressively worsen, causing severe disfigurement, disability, pain and even death. Not all components of the treatment fall under the categories for which Medicare typically provide coverage. Why Richmond, Why?!?: More Potholes - Richmond.com - ... And in lieu of a second Why Rich question, I have a follow up to handicap spaces question from a few weeks ago. The question was, basically: why does it seem like able-bodied people are using handicapped decals? You can read the full question and DMV's answer here, but I got some feedback from readers in our print edition on this one. Phyllis said: "People that got handicap license years ago when they had surgery for knee, back, hip or any operation or problem … are allowed to renew these for the rest of their lives. … I know this for a fact … someone I knew …told me, she had kept hers and she used it [because] it was easier and closer to the door." Terri wrote in: "I am not the type of person that responds to articles, but this one got under my skin. I am one of those people that don't look handicapped. I have Lymphedema in my left leg, and do not always have good balance. My leg swells with fluid and has been known to give out on me. I am in my mid 40's, when I get out of my vehicle I try very hard not to limp. I also try very hard to keep my balance and not "fall out" in front of on coming traffic. That is the whole reason that I have a handicapped sticker. I would rather be "normal" and walk, skip or run through the parking lot … People shouldn't judge/question other people or what that person is doing. You don't know someone else's story, and until you do, you should just worry about how to make life in "your own world" better." --- Children urged to harness hobbies and skills Galway Advertiser, April 08, 2010. Every child under the age of seven should be cajoled, persuaded, and encouraged to start developing a hobby or skill, which potentially will have a huge positive impact in their life, this is according to Seán Connaughton who was a guest speaker at the annual conference of the Turner Contact Group Ireland recently. Mr Connaughton was speaking in his capacity of battling with shyness over many years which he explained was stifling, disheartening, and frustrating. Shyness is an undesirable experience which can be overcome with patience, understanding, and focus. It is estimated that just under five per cent of the population suffer from chronic shyness. He explained that most shyness cases stem from early life experience which can have a serious impact on your attitude, approach, and potential throughout your life. Developing a skill or hobby at an early age loosens the impact of shyness and actually helps to avoid it becoming a habit. Mr Connaughton told the audience that by developing a hobby or skill at a young age we allow others to see our identity through our interests, work, or hobby which ultimately helps to break down barriers. He said that it is important for people to understand that a positive sense of self can be embraced at any stage in your life. It can be overcome by focusing on your positives, breathing techniques, altering your focus by living in the moment, being less judgmental on yourself, listening to encouragement, and believing that you want to move forward. Turner Syndrome (TS) is a chromosomal condition that describes girls and women with common features. The syndrome is named after Dr Henry Turner, who was among the first to describe its features in the 1930s. TS occurs in approximately one of every 2,000 females born and in as many as 10 per cent of all miscarriages. Diagnosis is made through a test called a karyotype, which is usually performed on cells in the amniotic fluid before birth and on cells in the blood after birth. A trained specialist counts the chromosomes in the white blood cells and looks for abnormalities. Turner syndrome may be diagnosed throughout the life span, including adulthood, if signs are subtle. Signs that indicate a karyotype is needed can include foetal abnormalities such as cystic hygroma (fluid around the neck). Webbed neck (excess skin) or lymphedema (swelling of hands and feet) in newborns, specific heart problems in infants, slow growth and/or short stature, delayed puberty or amenorrhea (lack of menstrual cycles), infertility or menstrual irregularities are also features of Turner Syndrome. People with TS go on to live normal and healthy lives. For further information on Turner Syndrome and for support and resources phone: 085-704-2627. http://www.advertiser.ie/galway/article/24633 ------ Spend some time with Morrie - Parksville Qualicum Beach News - April 06, 2010 - By Fred Davies - The play has a character who develops ALS but Lynn Holloway, producer of an upcoming production of Tuesdays with Morrie at Parksville’s Knox United Church, said the focus for her is raising awareness and money for the BC Lymphedema Association. The real life-story of Morrie is brought to life by Antony Holland in this short, but revealing, play about the relationship between Morrie Schwartz and Mitch, his student from university a number of years ago. After broken promises of keeping in touch, Mitch rediscovers his old professor and the gift of the older man’s wisdom is at the heart of the moving drama that began as a New York Times best selling book. “I saw Antony on a ferry and he told me he was doing this play. I just thought ‘this is something I can do’. It’s very simple but very rich,” said Holloway, who suffers from lymphedema herself and is a founder of the BCLA. She said the group was formed out of frustration with the lack of education and support. “It is incurable and can be very disfiguring and hard to live with. Often it goes undiagnosed but there are ways to manage it.” Tickets for two performances at 2 p.m. and 7 p.m. on Friday, April 16, in a play that also features Joel Grinke as Mitch Albom, may be purchased online at www.bclymph.org. They will be held at the box office for pickup on the day of the play. You may also call 250-248-1119 to order and leave your surname, number of tickets, and which performance you wish to attend. Price is $15 or $20 at the door. Physiotherapy Associates Announces New Clinic in Erie, PA - PR Newswire via Yahoo! Finance -, 06 Apr 2010 - EXTON, Pa., April 6 /PRNewswire/ -- Physiotherapy Associates, the nation's foremost provider of outpatient physical therapy services, announced a new clinic location in Erie, PA. Known as Keystone Rehabilitation Systems – Erie South, the clinic offers a comprehensive range of physical therapy services, as well as treatment for lymphedema, specialized programs for dancers, gymnasts and other performing artists, and a breast cancer rehabilitation program. Leading the physical therapy services at the new clinic is Elizabeth Darling, DPT, OCS, CLT, ATC. Ms. Darling has been a physical therapist for nine years and an athletic trainer for 10 years. She is a certified lymphedema therapist, and she is also an orthopedic clinical specialist. Ms. Darling has worked with USA Gymnastics for nine years, traveling extensively with the national gymnastics team providing physical therapy and athletic training services. She has also worked with USA Diving and, in 2008, Ms. Darling was the diving team's physical therapist at the Olympic Games in Beijing. Ms. Darling is a graduate of Marquette University, and later this year will accept the honor of most distinguished young alumna. Pete Grabaskas, PT, COO of Physiotherapy Associates, stated, "Opening this clinic in Erie highlights the opportunities we have as a company to provide cutting-edge physical therapy services across the U. S. By combining outstanding clinicians with new facilities, Physiotherapy Associates allows millions of our patients to lead healthier lives." In addition to the clinic's physical therapy services, a new program is available for patients recovering from breast cancer. The program was developed to help patients return to their daily activities quickly and safely. Patients schedule an office visit prior to surgery where baseline measurements are taken. Then, patients are given a personalized home program based on their needs and their corresponding surgical procedure. Last, patients have appointments at the three- and six-month intervals following surgery. Measurements are repeated and, if any deficits are noted, the physician is contacted and an appropriate treatment plan is implemented. This program helps identify any problems early and facilitates a smooth recovery. Ms. Darling stated, "I am excited to help open this new facility. We are providing a set of physical therapy services that are not currently offered in this market. We use Pilates-based exercises for certain patients and offer specific equipment for this type of rehabilitation. The Erie community will benefit by returning to a healthier lifestyle." She added that the clinic provides all conventional outpatient physical therapy services. The new clinic is located at the intersection of Old French Road and Perry Highway (also known as Route 97 and Route 505). There is parking directly in front of the building. For more information or to schedule a consultation at the clinic, call 814.860.7816 during the clinic's convenient office hours of Monday: 10-7pm; Tuesday: 7-1pm; Wednesday: 10-7pm; Thursday: 10- 7pm; and Friday: 7-1pm. Keystone Rehabilitation Systems is a Physiotherapy Associates company. About Physiotherapy Associates Physiotherapy Associates is the nation's foremost provider of outpatient rehabilitation services. Physiotherapy Associates employs an industry-leading team of physical therapists and healthcare practitioners who are dedicated to high-quality patient care. The company provides physical therapy, industrial rehabilitation and orthotics and prosthetics services to millions of patients each year across the United States. With more than 600 clinics, Physiotherapy Associates is national in scope, local in care. For more information, visit http://www.physiocorp.com/, follow us on Twitter (@physiocorp) or become a Physio fan on Facebook FSLH Receives Grant from Komen CNY To Finance Minority Women Diagnosed with Lymphedema - Utica Daily News Mon, 05 Apr 2010 - UTICA, April 5, 2010 -- The Central New York Affiliate of Susan G. Komen for the Cure® has awarded a $23,500 grant to Faxton St. Luke's Healthcare (FLSH) to provide screening and improve access to treatment and early detection of lymphedema. The grant from Komen for the Cure supports the Lymphedema Program’s initiative to provide financial assistance to minority women in Oneida, Herkimer and Madison counties who have been diagnosed with lymphedema secondary to breast cancer, and are uninsured/underinsured. “Lymphedema occurs in about 25 percent of women after they have breast cancer treatments,” said Theresa Strassberger, PT, supervisor of the Lymphedema Program at FSLH. “With these funds, we are able to help women who might otherwise not have access to care. We support them with therapy, education, and early intervention.” “At the Komen Central New York Affiliate, we conducted an assessment of our community and discovered the need for more breast health education, better access to screening and treatment for the uninsured and underinsured, reducing disparities in care for minority groups,” said Kate Flannery, executive director of Komen. “We are confident that through Faxton St. Luke's Healthcare, more minority women will be treated successfully and awareness will be raised about lymphedema identification and risk reduction practices.” Susan G. Komen for the Cure is the world’s largest breast cancer organization, and the Central New York Affiliate is one of 125 Affiliates on the front lines dedicated to ending breast cancer in their communities. Komen Affiliates fund innovative programs that help women and men overcome the cultural, social, educational and financial barriers to breast cancer screening and treatment. For more information about the Lymphedema Program at FSLH or for referral instructions, please call 624-5400. Google News Alert for: lymphedema Who the Morrie is in your life? - BCLocalNews - April 6, 2010 - Interested in seeing Tuesdays With Morrie for free? Lynn Holloway, president of the BC Lymphedema Association, is offering a pair of tickets to the winner of an essay contest on the ‘Morrie’ in your life. The News, in turn, will run the best entry in our pages. One-page or less essays can be about a teacher, or anyone else who has taught you life lessons that you will never forget. Send entries by end of day April 9 to info@bclymph.org. Spend some time with Morrie - BCLocalNews - April 7, 2010 - By Fred Davies The play has a character who develops ALS but Lynn Holloway, producer of an upcoming production of Tuesdays with Morrie at Parksville’s Knox United Church, said the focus for her is raising awareness and money for the BC Lymphedema Association. The real life-story of Morrie is brought to life by Antony Holland in this short, but revealing, play about the relationship between Morrie Schwartz and Mitch, his student from university a number of years ago. After broken promises of keeping in touch, Mitch rediscovers his old professor and the gift of the older man’s wisdom is at the heart of the moving drama that began as a New York Times best selling book. “I saw Antony on a ferry and he told me he was doing this play. I just thought ‘this is something I can do’. It’s very simple but very rich,” said Holloway, who suffers from lymphedema herself and is a founder of the BCLA. She said the group was formed out of frustration with the lack of education and support. “It is incurable and can be very disfiguring and hard to live with. Often it goes undiagnosed but there are ways to manage it.” Tickets for two performances at 2 p.m. and 7 p.m. on Friday, April 16, in a play that also features Joel Grinke as Mitch Albom, may be purchased online at www.bclymph.org. They will be held at the box office for pickup on the day of the play. You may also call 250-248-1119 to order and leave your surname, number of tickets, and which performance you wish to attend. Price is $15 or $20 at the door. Physiotherapy Associates Announces New Clinic in Erie, PA - PR Newswire - April 6, 2010 - Clinic Provides Patients Many Options for Healthy Living EXTON, Pa., April 6 /PRNewswire/ -- Physiotherapy Associates, the nation's foremost provider of outpatient physical therapy services, announced a new clinic location in Erie, PA. Known as Keystone Rehabilitation Systems – Erie South, the clinic offers a comprehensive range of physical therapy services, as well as treatment for lymphedema, specialized programs for dancers, gymnasts and other performing artists, and a breast cancer rehabilitation program. Leading the physical therapy services at the new clinic is Elizabeth Darling, DPT, OCS, CLT, ATC. Ms. Darling has been a physical therapist for nine years and an athletic trainer for 10 years. She is a certified lymphedema therapist, and she is also an orthopedic clinical specialist. Ms. Darling has worked with USA Gymnastics for nine years, traveling extensively with the national gymnastics team providing physical therapy and athletic training services. She has also worked with USA Diving and, in 2008, Ms. Darling was the diving team's physical therapist at the Olympic Games in Beijing. Ms. Darling is a graduate of Marquette University, and later this year will accept the honor of most distinguished young alumna. Pete Grabaskas, PT, COO of Physiotherapy Associates, stated, "Opening this clinic in Erie highlights the opportunities we have as a company to provide cutting-edge physical therapy services across the U. S. By combining outstanding clinicians with new facilities, Physiotherapy Associates allows millions of our patients to lead healthier lives." In addition to the clinic's physical therapy services, a new program is available for patients recovering from breast cancer. The program was developed to help patients return to their daily activities quickly and safely. Patients schedule an office visit prior to surgery where baseline measurements are taken. Then, patients are given a personalized home program based on their needs and their corresponding surgical procedure. Last, patients have appointments at the three- and six-month intervals following surgery. Measurements are repeated and, if any deficits are noted, the physician is contacted and an appropriate treatment plan is implemented. This program helps identify any problems early and facilitates a smooth recovery. Ms. Darling stated, "I am excited to help open this new facility. We are providing a set of physical therapy services that are not currently offered in this market. We use Pilates-based exercises for certain patients and offer specific equipment for this type of rehabilitation. The Erie community will benefit by returning to a healthier lifestyle." She added that the clinic provides all conventional outpatient physical therapy services. The new clinic is located at the intersection of Old French Road and Perry Highway (also known as Route 97 and Route 505). There is parking directly in front of the building. For more information or to schedule a consultation at the clinic, call 814.860.7816 during the clinic's convenient office hours of Monday: 10-7pm; Tuesday: 7-1pm; Wednesday: 10-7pm; Thursday: 10- 7pm; and Friday: 7-1pm. Keystone Rehabilitation Systems is a Physiotherapy Associates company. About Physiotherapy Associates Physiotherapy Associates is the nation's foremost provider of outpatient rehabilitation services. Physiotherapy Associates employs an industry-leading team of physical therapists and healthcare practitioners who are dedicated to high-quality patient care. The company provides physical therapy, industrial rehabilitation and orthotics and prosthetics services to millions of patients each year across the United States. With more than 600 clinics, Physiotherapy Associates is national in scope, local in care. For more information, visit www.physiocorp.com, follow us on Twitter (@physiocorp) or become a Physio fan on Facebook. SOURCE Physiotherapy Associates Back to top RELATED LINKS http://www.physiocorp.com ------------- Lymphedema recognized - Prince Albert Daily Herald - February 25, 2010 - Prince Albert resident Donna Braham thought her health problems were getting better when she received a mastectomy to stop the spread of breast cancer. Instead, a few months later she developed lymphedema, a swelling in her right arm, the same side where the breast was removed. When the breast was removed in January 2009, Braham had 14 lymph nodes removed with it as part of the surgery. In some cases, excess fluid builds up where the nodes were since the drainage system has been affected. "It does impede everything I do. I can't do ordinary housework, like cleaning windows or vacuuming, that will make it swell," said Braham, pointing to her right arm. "If you do anything strenuous to it, it swells." Even with lymphedema being a possible side effect from various types of cancer treatments including radiation and surgeries, it sometimes develops on it's own. There isn't very much information available and it can be difficult for patients to find information, said Eunice Mooney, president of the Saskatchewan Lymphovenous Learning Association (SSLA). "Patients will go to one area, see one professional and get one viewpoint and they go to four or five places and they are all telling them different things. It is very confusing. It's part of SSLA's mandate to get this going and get the information out there," Mooney said. "This is what's puzzling to me as a therapist ... One time they'll get what they need and the next time they won't." The association is trying to increase information available about lymphedema and other conditions. One of their first steps was having a proclamation signed in Prince Albert creating a Lymphedema Awareness Day. The proclamation was signed this week for a day to be recognized March 6. The Ministry of Health covers only some treatments. Braham must wear a compression brace on her arm, which she was able to get through the therapies department at Victoria Hospital. The Saskatchewan Aids to Independent Living Compression Garment Program covers the cost of compression garments for people like Braham, but she is on her own for complex decongestive therapy. "It's high maintenance ... It's expensive for the patient," said Braham, who receives the treatment from Mooney, a registered massage therapist and certified lymphatic therapist. The hands-on treatment - called manual lymph drainage - moves the fluid that causes the swelling to a healthy area where there are lymph nodes, said Mooney. Lymphedema treatments have come a long way since Mooney started working with them in 1993, she said. "There is still a lot of inroads that have been made. We just have to keep doing it." ahill@paherald.sk.ca Health, Diet and Lymphedema Treatment - BigNews.biz - February 25, 2010 - Is there a Lymphedema Cure? Lymphedema is a condition coming from the dysfunctional of the lymphatic system, that might occur due to the removal or damage to the lymph nodes and lymph vessels. It is a condition where swelling occurs because of the pooling of fluids in a certain area of the body, particularly the legs or arms. Till today, it is impossible to cure lymphedema ; however , with the right therapy it is possible to manage the condition. Primary lymphedema could be caused due to genetic factors associated with the genetic makeup of the individual. Cases of first lymphedema are not common ; what is usually seen is secondary lymphedema, which is usually a purchased condition. often, it’s the side-effect of surgery concerning an injury to the lymphatic system of the body, like in the event of cancer treatment. Most cancer patients, especially ladies who have been treated for breast cancer are risky applicants for secondary lymphedema. Usually the lymph vessels or nodes might be removed for treating carcinoma of the groin, abdomen or the breast. In such situations, there’s an obstruction to the smooth flow of the lymph from the extremities of the body towards the trunk area causing a pooling effect leading to swelling. To cure lymphedema would suggest rebuilding a healthy lymphatic system, which isn’t humanly possible . Thus, patients have to get by with treatments that can control the condition. The most accepted form of treatment for lymphedema is called the Complete Decongestive care ( CDT ). It is composed of manual lymph drainage, compression bandaging and use of compression garments, exercises and skin care. The first step in this hospital therapy program is a visit to the lymphedema specialist who performs a gentle massage to direct the flow of the lymphatic fluids towards the blood circulatory system. The impurities in the body and excess liquids are then eliminated thru urination. This massage reduces the swelling in the influenced part and to maintain this reduction or to prevent the return of swelling, compression bandages must be applied to the influenced limb. Exercises help in keeping the fluids moving in the system, so stopping edema. The other aspect lymphedema patients must keep in mind is skin care. Those suffering from lymphedema are prone to skin infections thanks to a feeble immune system. Keeping the skin painstakingly clean and using lotions to keep it soft helps to forestall infections. Lymphedema following surgery can be stopped with certain precautions or at least the development can be slowed. However , if the initial symptoms are ignored, the condition may worsen and curing lymphedema symptoms might be difficult. High-risk applicants must thus stay alert to any sign of lymphedema and try to avoid wounds, cuts and bruises of any type. The skin should be kept soft and lubricated with creams and lotion. It is vital to offer protection to the fingers and be particularly careful while cutting the finger nails. Blood pressure monitoring of the arm or drawing of blood from the surgical side of the body should be avoided. there’s no cure for lymphedema ; on the contrary, long-term effects of the condition may be truly grim. Some of them include acute pain, weight gain, depression, continuous swelling and repeated skin infections. If left untreated or the first symptoms of lymphedema are ignored, fibrosis or toughening of the tissues may set in. This may lead to further complications like blood clots in the affected limb. So, in order to avoid any such Problems it is recommended to recognize the symptoms and consult the doctor during the beginning stages. This is going to be the sole option, but hopefully, continuing research on the topic may come up with a lymphedema cure in future. Susan G. Komen For The Cure Foundation Awards Grants To Memorial - The Chattanoogan - February 22, 2010 - The Susan G. Komen for the Cure Foundation awarded four grants to Memorial Health Care System totaling more than $87,000. The foundation awarded $14,500 to Memorial to provide support for women newly diagnosed with breast cancer. The MaryEllen Locher Breast Center has dedicated itself to providing support every step of the way beginning with education and a review of the lymphatic system and signs and symptoms of lymphedema. The MaryEllen Locher Breast Center also provides assistance with the garments necessary for lymphedema patients who do not have insurance and would be burdened by purchasing them. More than $42,112 was awarded to help provide access to mammograms. The grant will help fund Memorial’s Mobile Coach outreach breast health education program which provides mammograms for insured and uninsured women. A grant totaling $19,870 will help fund a series of breast health educational programs and mammogram screenings to diverse populations with sensitive language and cultural concerns. The foundation awarded $10,525 to fund an annual retreat for breast cancer patients and their families. Vascular Surgery ARNP - Seattle Times - February 22, 2010 - The page you have requested cannot be found. The page you are looking for is not available on nwjobs.com. You may have an incorrect URL or the page may have been removed. If you are an employer or recruiter, you can continue by using the links on this page or go to the Employers and proceed from there. If you are a jobseeker, enter a quick search or go to the nwjobs.com home page. If you feel you have the correct URL and continue to have problems, E-mail: support@nwjobs.com please let us know The page you have requested cannot be found. The page you are looking for is not available on nwjobs.com. You may have an incorrect URL or the page may have been removed. If you are an employer or recruiter, you can continue by using the links on this page or go to the Employers and proceed from there. If you are a jobseeker, enter a quick search or go to the nwjobs.com home page. If you feel you have the correct URL and continue to have problems, E-mail: support@nwjobs.com please let us know This one had no article said it had been deleted, so sorry Lymphedema day proclaimed - Lac du Bonnet Leader - February 26, 2010 - Talk about a victory for Lac du Bonnet's Kim Avanthay. Her ongoing crusade to raise awareness of a medical condition her young son suffers from got a huge boost from the province this week, when Health Minister Theresa Oswald's office proclaimed March 6 as Lymphedema Awareness Day. "I'm so happy about this," Avanthay said. "I can't express how good it feels to get this kind of support." Avanthay sent a request out to 57 Manitoba municipalities earlier this year asking them to proclaim March 6 as Lymphedema Awareness Day. Forty-one RMs have done so. She also decided to send the same request to the province, and was elated when she heard back that they would be doing so. "This really helps us raise awareness," she said. Avanthay's son Austin suffers from the condition, which causes a buildup of fluid in the limbs that causes them to swell. Lymphedema is not a widely understood condition in Canada, but it is surprisingly common — primary lymphedema (caused by congenital abnormalities) only affects around one in every 6,000 people, while secondary lymphedema affects as many as one in every four breast cancer patients. According to the World Health Organization, over 250 million people worldwide suffer from it. There is no cure, but the condition can be managed with proper therapy and skin care. Avanthay is also working on the fact-finding mission with Edith Mulhall, a registered nurse and Lymphedema Association of North America certified therapist working out of Winnipeg. Austin is Mulhall's first pediatric patient with lymphedema. "In Canada, we're just a bit slow about accessing this information," Mulhall said. She said while some places in Europe have facilities dedicated to lymphedema, sometimes seeking information, getting help and getting a diagnosis can still be a challenge in Canada. Avanthay has also attended a number of lymphedema conferences in the United States to learn more about the condition. One day at a time - BCLocalNews - February 23, 2010 - Kathy Repp sits down often, her 80-pound leg an obvious burden and one she will never be rid of. Repp suffers from lymphedema, a condition of localized fluid retention and tissue swelling, caused by a compromised lymphatic system. In her case, a lymph node in her groin area is blocked, and there’s no cure and few treatments or even surgeries which will provide Repp and others with this condition with any relief. Repp experienced her first episode in 1986. While driving with a relative, she became weepy, her leg was inflamed and very sore, all within minutes. Many episodes later, it took a year for doctors to diagnose her condition. “I didn’t know what to think,” she said. “With each episode my leg got bigger and bigger.” But it was explained to Repp that lymph nodes are about the size of a hair and it would be impossible to remove or unblock. In fact, surgery could worsen the condition and her enlarged left leg could become even more permanent. As her left leg got bigger and bigger, Repp’s mobility got less and less. Now, she can walk for about five minutes before she must sit down. Her foot is also affected. Only one pair of lace-up sandals will fit. And she’s also experienced episodes in her right leg but to a lesser extent. “I’m grateful it’s not in my arms as well,” she said with a laugh. Throughout her life, Repp has relied on her religious faith. Now more than ever. “There’s a reason for everything. Without burdens, how do you know God is there to help,” she said. “I lean on the Scriptures and maybe someday I’ll know why. I trust God.” Repp believes God led her to move to Quesnel from her home on Haida Gwaii in 2005. Her first indication was a person from Quesnel, who she didn’t know, reached out to her. Repp asked about opportunities in the town. The second was a query to her husband about moving to Quesnel. “It was a major decision for him, he has disabilities as well,” she said. But her husband agreed without reservation so together they sold everything they had except for what fit in their car and moved to an apartment on the West Side. They joined the Bethel Pentecostal Church and Repp said she’s never felt more welcomed by a congregation in her life. “They’re amazing, we couldn’t asked for a better church family,” she said. “Never, from day one, have we felt like outsiders.” The church has been very helpful as well, especially when Repp has an episode, dropping off food and even helping financially when they were first getting established but now Repp needs help with a much larger problem. Her lymphedema specialist in Vancouver recommends she have an operation which will remove some of the excess tissue and then skin grafting, followed up with a lymph pump. A pneumatic sleeves surrounds the enlarged portion of the leg and gently massages and moves the fluid towards the lymph nodes where it is then taken away from the affected area (this is how the body normally handles lymph fluids.) But this pump costs $3,000. Not affordable on the couple’s $1,500 a month budget. Repp’s hope is there is help in her adopted community. Maybe an organization that assists with this type of purchase. Because her condition is not life-threatening, although infection is a common symptom of lymphedema and Repp keeps antibiotics on hand just in case, the government says they won’t fund the pump. “I try not to feel sorry for myself, it could be much worse,” she said with a smile. “I could be stuck in a bed, or have cancer. I try to have a good attitude and hope for the future.” For now, Repp contents herself with knitting and crocheting, but possibly her most prize possession is her piano (her parents helped her arrange a rent to purchase agreement which she hopes to have paid off next year.) “Music is my comfort, I love to sing and play,” she said. “It’s a gift. I’m so grateful for it.” And Repp is also very grateful for her husband who now takes over most of the things she wishes she could still do. “In the last two years he’s really had to step up,” she said. “He now does just about everything.” Repp has a small income tax business she runs from home, but with her condition, soliciting new clients is difficult. “I just take one day at a time,” she admitted. “You never know what tomorrow may bring.” Memorial opening new, larger rehab clinic - Yakima Herald-Republic - February 20, 2010 - By Leah Ward YAKIMA, Wash. -- Yakima Valley Memorial Hospital is opening a new $1.3 million rehabilitation and occupational therapy clinic in a two-story building near downtown that was formerly a gastroenterology clinic. The Springs, as the clinic is called, is on South 10th Avenue near a complex of doctors' offices and laboratories. Jackie Ray, director of rehabilitation services, said increased demand for such services was making Memorial's existing site on North 16th Avenue -- called 16th Avenue Station -- too small. The new 13,000-square-foot facility will have six exam rooms, five individual treatment rooms and two rooms for treating lymphedema, the swelling of tissues after breast surgery. Services offered include orthopedic medicine, occu- pational therapy, massage therapy and physical thera- py. Aquatic therapy will re-main at 16th Avenue Station. The Springs will also have an "activities of daily living" kitchen and bathroom to help patients with serious medical conditions -- such as stroke and brain injuries -- relearn basic tasks, such as dishwashing and cooking. "We don't have great places to take people on an outpatient basis to get them functional again," Ray said. Ray said hospital chief executive Rick Linneweh came up with the name after she told him she wanted a clinic that was "clean, crisp and sophisticated." It's meant to evoke water, a spa and the sunny high desert of Yakima, she said. The Springs will have a public open house March 6 and begin accepting patients March 8. U.S. EX REL. SANCHEZ v. LYMPHATX, INC. - Leagle.com - February 19, 2010 - U.S. EX REL. SANCHEZ v. LYMPHATX, INC. UNITED STATES OF AMERICA, ex rel. Laika Sanchez, Plaintiff, LAIKA SANCHEZ, Plaintiff-Appellant, v. LYMPHATX, INC., PAMELA COHEN, JACOB COHEN, Defendants-Appellees, LYMPHATICS PLUS OF BOCA RATON, INC., etc. Defendant. No. 09-14275. Non-Argument Calendar. United States Court of Appeals, Eleventh Circuit. February 18, 2010. Before CARNES, MARCUS and KRAVITCH, Circuit Judges. PER CURIAM. Laika Sanchez appeals from the district court's order dismissing her qui tam complaint on behalf of the United States against Lymphatx and its owners for violations of the False Claims Act, 31 U.S.C. §§ 3729-30.[ 1 ] The district court concluded that Sanchez had failed to plead her allegations of fraud with the particularity required by Federal Rule of Civil Procedure 9(b) and that she had failed to state a claim for retaliation under 31 U.S.C. § 3730(h). Sanchez argues that the district court erred in dismissing her complaint for failure to state a claim, see Fed. R. Civ. P. 12(b)(6), and in closing her case without granting her leave to amend. Having carefully reviewed the record in this case, we affirm in part, reverse in part, and remand. After the United States declined to intervene in her qui tam action, Sanchez served an amended complaint on Lymphatx, her former employer, and its owners. The complaint asserted five claims for relief under the False Claims Act. Four of the claims depended on Sanchez's allegations of the defendants' fraudulent Medicare-billing practices under § 3729. The fifth claim, under § 3730(h), was that Sanchez had been fired in retaliation for her complaints to Lymphatx's owners about the illegality of those practices. We review the district court's dismissal of these claims de novo. Corsello v. Lincare, Inc., 428 F.3d 1008, 1012 (11th Cir. 2005) I. Fraudulent Billing Claims To state a claim premised on fraud, Sanchez needed to "state with particularity the circumstances constituting [the] fraud." Fed. R. Civ. P. 9(b); see also United States ex rel. Clausen v. Lab. Corp. of Am., 290 F.3d 1301, 1308 (11th Cir. 2002) ("Rule 9(b) does apply to actions under the False Claims Act."). In her complaint, Sanchez alleged that the defendants had knowingly submitted false claims to Medicare for lymphedema treatments performed by massage therapists.[ 2 ] Sanchez further alleged that the defendants had intentionally billed Medicare for services they did not provide and that she had gained personal knowledge of these billing practices through her employment as Lymphatx's office manager.[ 3 ] In addition to her general accusations of false billing, Sanchez needed to plead "facts as to time, place, and substance of the defendants' alleged fraud, specifically, the details of the defendants' allegedly fraudulent acts, when they occurred, and who engaged in them." Clausen, 290 F.3d at 1310 (quotation marks and citation omitted). Despite her assertion that she had direct knowledge of the defendants' billing and patient records, however, Sanchez failed to provide any specific details regarding either the dates on or the frequency with which the defendants submitted false claims, the amounts of those claims, or the patients whose treatment served as the basis for the claims. Without these or similar details, Sanchez's complaint lacks the "indicia of reliability" necessary under Rule 9(b) to support her conclusory allegations of wrongdoing. See Clausen, 290 F.3d at 1311-12. In other words, because she failed "to allege at least some examples of actual false claims," Sanchez could not "lay a complete foundation for the rest of [her] allegations." Id. at 1314 n.25. The district court therefore appropriately dismissed the four claims alleging fraudulent billing.[ 4 ] We reject Sanchez's argument that the district court should have allowed her to amend her complaint before dismissing these claims. "A district court is not required to grant a plaintiff leave to amend his complaint sua sponte when the plaintiff, who is represented by counsel, never filed a motion to amend [] or requested leave to amend before the district court." Wagner v. Daewoo Heavy Indus. Am. Corp., 314 F.3d 541, 542 (11th Cir. 2002) (en banc). Sanchez was represented by counsel but did not move for leave to amend, and we cannot conclude that the district court abused its discretion by failing to grant leave that was never requested. Burger King Corp. v. Weaver, 169 F.3d 1310, 1318 (11th Cir. 1999). II. Retaliatory Discharge Claim With respect to Sanchez's claim for retaliatory discharge, at the time of her termination the False Claims Act provided relief to any employee discharged because of lawful acts taken "in furtherance of an action under this section, including investigation for, initiation of, testimony for, or assistance in an action filed or to be filed under this section." 31 U.S.C. § 3730(h) (2006), amended by Pub. L. No. 111-21, § 4 (d), 123 Stat. 1617, 1624-25 (2009).[ 5 ] Sanchez argues that she engaged in conduct protected by § 3730(h) because, as alleged in her complaint, she "complained again and again about the unlawful actions of the Defendants" and "told them that they were all incurring significant criminal and civil liability." In Childree v. UAP/GA AG Chem., Inc., we held that § 3730(h) only protected an employee from retaliation when there was at least "a distinct possibility" of litigation under the False Claims Act at the time of the employee's actions. 92 F.3d 1140, 1146 (11th Cir. 1996).[ 6 ] The question here, then, is whether Sanchez's complaints of illegal activity occurred when there was a distinct possibility that she or the government would sue the defendants under the False Claims Act. See id. The defendants compare Sanchez's conduct to the sort of internal reporting that some of our sister circuits have held falls outside the scope of § 3730(h). See, e.g., McKenzie v. BellSouth Telecomms., Inc., 219 F.3d 508, 516 (6th Cir. 2000) ("[Section § 3730(h)'s] `in furtherance of' language requires more than merely reporting wrongdoing to supervisors."); Zahodnick v. IBM Corp., 135 F.3d 911, 914 (4th Cir. 1997) ("Simply reporting his concern of a mischarging to the government to his supervisor does not suffice to establish that Zahodnick was acting `in furtherance of' a qui tam action."). But those courts have also recognized that an employee may put her employer on notice of possible False Claims Act litigation by making internal reports that alert the employer to fraudulent or illegal conduct. McKenzie, 219 F.3d at 516 ("Although internal reporting may constitute protected activity, the internal reports must allege fraud on the government."); Eberhardt v. Integrated Design & Constr., Inc., 167 F. 3d 861, 868 (4th Cir. 1999) ("[C]haracterizing the employer's conduct as illegal or fraudulent . . . let[s] the employer know, regardless of whether the employee's job duties include investigating potential fraud, that litigation is a reasonable possibility."). If an employee's actions, as alleged in the complaint, are sufficient to support a reasonable conclusion that the employer could have feared being reported to the government for fraud or sued in a qui tam action by the employee, then the complaint states a claim for retaliatory discharge under § 3730(h). Cf. Mann v. Olsten Certified Healthcare Corp., 49 F. Supp. 2d 1307, 1314 (M.D. Ala. 1999) (using a similar standard on consideration of a motion for summary judgment). Sanchez's allegations that she complained about the defendants' "unlawful actions" and warned them that they were "incurring significant criminal and civil liability" would have been sufficient, if proven, to support a reasonable conclusion that the defendants were aware of the possibility of litigation under the False Claims Act. Because her retaliation claim did not depend on allegations of fraud, Sanchez's complaint only needed "a short and plain statement of the claim showing that [she was] entitled to relief." Fed. R. Civ. P. 8(a). We conclude that she satisfied this requirement and that the district court therefore erred in dismissing her claim for retaliatory discharge. III. Conclusion In light of our conclusion that Sanchez failed to state claims premised on fraudulent billing but successfully stated a claim for retaliatory discharge under § 3730(h), we AFFIRM the district court's order in part, REVERSE in part, and REMAND for further proceedings consistent with this opinion. 1. Title 31, Section 3730(b) of the U.S. Code empowers private persons ("relators") to sue in the name of the government when it has suffered fraud. 2. Lymphedema is swelling caused by impairments in the body's lymphatic system. One treatment for the condition involves light massage to encourage the drainage of excess fluid. Medicare will not pay for this treatment if it is provided by a massage therapist. See 69 Fed. Reg. 66236, 66351 (Nov. 15, 2004) ("Medicare does not, for example, [cover] therapy services performed by massage therapists . . . ."); Medicare Claims Processing Manual ch. 5 p. 31 (Apr. 24, 2009) (defining manual lymphatic drainage (CPT code 97140) as a "therapy service"). 3. The defendants dispute whether Sanchez was, in fact, an office manager, but on our de novo review of an order dismissing a complaint for failure to state a claim, we assume the truth of all facts alleged in the complaint. Corsello, 428 F.3d at 1012. 4. We distinguish this case from United States ex rel. Walker v. R&F Properties of Lake County, Inc., 433 F.3d 1349, 1360 (11th Cir. 2005), in which we affirmed the denial of a motion to dismiss a qui tam plaintiff's complaint. The plaintiff in that case was a nurse practitioner who alleged a practice of fraudulent Medicare billing by her former employer. Specifically, she alleged that the defendant's office administrator had told her that the defendant billed Medicare at arguably inflated rates. Sanchez's vague allegations that she "found [unspecified] documentation" and "discovered" or "learned" that the defendants had submitted false claims, by contrast, leaves us "wondering whether [she] has offered mere conjecture or a specifically pleaded allegation on an essential element of the lawsuit," Clausen, 290 F.3d at 1313. In any event, to the extent that Walker conflicts with the specificity requirements of Clausen, our prior-panel-precedent rule requires us to follow Clausen. See Walker v. Mortham, 158 F. 3d 1177, 1188-89 (11th Cir. 1998). 5. Congress's recent amendment provides relief to any employee discharged for acting "in furtherance of other efforts to stop 1 or more violations of this subchapter." Pub. L. No. 111-21, § 4(d), 123 Stat. 1617, 1624-25 (2009) (emphasis added). We need not consider the effect of this change on the viability of Sanchez's claim because the amendment only applies to conduct on or after May 20, 2009. See id. § 4(f), 123 Stat. at 1625. Lymphatx fired Sanchez in 2007. 6. Our decision in Childree does not require that this litigation would have ended with the government recovering from the defendant. Section 3730(h) "protects an employee's conduct even if the target of an investigation or action to be filed was innocent." Graham County Soil & Water Conservation Dist. v. United States ex rel. Wilson, 545 U.S. 409, 416 (2005). This copy provided by Leagle, Inc. Lakeland Family YMCA Offers Exercise Program for Cancer Patients ... - The Ledger - February 19, 2010 - Lakeland YMCA Offers Exercise Program to Aid Cancer Survivors, Patients At first glance, it looks like any other fitness class. On a basketball court at the South Lakeland Family YMCA, Debbie Allen calls out instructions as seven women step and bend in rhythm to a bouncy version of "The Tide Is High." "Use your arms," Allen urges the class. "Use your heels. Use your toes." Upon closer inspection, a unifying trait of the exercisers becomes apparent. Two of the women wear compression sleeves on one arm, an indication of lymphedema, a tissue swelling common to people who have had lymph nodes removed during cancer surgery. Another woman wears a T-shirt and rubber wristband in the same shade of pink, the color associated with breast cancer awareness. All of the participants are cancer survivors. The recent floor exercise session is part of LIVESTRONG at the YMCA, a program the center began offering last fall in partnership with the Lance Armstrong Foundation. Lakeland is one of 20 cities across the country now offering the program, said Haley Justice, program manager for the Lance Armstrong Foundation in Austin, Texas. Armstrong is the cyclist who overcame testicular cancer to win seven Tour de France titles. The program began in 2008 in 10 cities, Justice said. The South Lakeland Family YMCA was in the second group of 10. Justice said the foundation plans to add 20 more cities for a total of more than 150 centers by year's end. Justice said research suggests cancer survivors have less chance of a recurrence if they are physically active. Dorothy Cheshire, community service coordinator at the YMCA, learned about the LIVESTRONG at the YMCA program through a New York Times article published in The Ledger in 2008. She checked on the details and spent a weekend putting together a grant proposal. After Lakeland was selected, Cheshire, along with executive director Leonard Speed and aquatics director Sandra Austin, traveled to Chicago, Denver and Austin, Texas, for training sessions. The Lakeland program includes walking, tai chi, water fitness and floor exercises in sessions held four days a week. It is open to survivors of all forms of cancer and of both sexes, though so far most participants are women. The YMCA offers the first 12 weeks at no charge, and participants are free to continue beyond that point. Austin, who was recently treated for melanoma, leads pool fitness classes four times a week. Cheshire, a breast cancer survivor, leads the Monday night nature walk. Cheshire said she forged alliances with local cancer treatments centers and the American Cancer Society to seek participants. While assembling the regimen, Cheshire was approached by Lakeland's Watson Clinic, which had recently created a 12-week program for breast cancer survivors called N.Ex. T. Steps (for nutrition, exercise and training). That programs draws upon grants from Susan G. Komen for the Cure, a national organization, and the Watson Clinic Foundation. Cheshire offered to include N.Ex.T. Steps participants in the LIVESTRONG fitness sessions. ADAPTING EXERCISES The seven women in Allen's floor class displayed varying physical capacities. As Allen led a series of standing exercises, some had difficulty lifting one or both arms above their heads. When Allen led the women in a series of yoga-like stretches and poses, three sat in chairs while the others used mats on the floor. Allen said women who have surgery for breast cancer lose part of their pectoral muscles, leaving them with restricted movement. She said she strives to adapt the exercises to each person's abilities. Allen devoted the last few minutes to relaxation techniques, calling it the most important part of the session. "I want you to visualize how strong your body is," Allen told the women. "Say in your mind to your body, 'Thank you for performing well. Thank you for being strong.'" Retired teacher Sandy Walker of Lakeland learned about the YMCA program through a cancer support group at her church and began attending sessions last fall. Walker, 67, was diagnosed with breast cancer in 2007 and underwent surgery, radiation treatment and chemotherapy. She said she was recently diagnosed with melanoma, a form of skin cancer. In addition, she said she has a brain tumor, though doctors haven't yet determined if it's malignant. MANY BENEFITS Walker, a tall woman with short, auburn hair, said the sessions help her to sleep better and to view her life in a more positive way. "I come here every chance I get," Walker said. "I've met a lot of new friends. We have a lot of things in common, so that helps, too. We're a sounding board for each other." Linda Hite of Lakeland was in her fourth week of the program. Hite, 61, had surgery in 2006 for melanoma and later developed lymphedema. She wore a black compression sleeve that covered her right arm and wrist. Hite said since she began the exercise regimen she hasn't needed to do as much manual drainage of fluid buildup in her arm. She said the pool sessions seem especially beneficial. "You're limited in what you're allowed to do," Hite said of lymphedema patients. "I have a lot of stiffness in my wrist. I just want to get myself as healthy as I can." Another participant, Bev Ray of Lakeland, was in just her third class. Ray said she developed breast cancer in 1994 and had a double mastectomy. Ray, wearing a pink T-shirt and pink wristband, has lymphedema and can't lift her right arm well. "It's been very beneficial already just in the three sessions I've done," she said. "I have better endurance already in a short time." Allen, who has worked part-time at the YMCA for 14 years, says the sessions with cancer survivors are particularly rewarding. "I feel honored to be able to teach a class like this," she said. "It makes me feel good to know I'm helping them and hopefully teaching them something that can improve their lives." ------- ULURU Inc. to Present Altrazeal(TM) Clinical Evidence at the 23rd Annual Symposium on Advanced Wound Care and Wound Healing Society (SAWC/WHS) Follows Highly Successful Oral Presentation at the 2010 American Professional Wound Care Association Conference ADDISON, Texas, April 15, 2010 /PRNewswire via COMTEX/ -- ULURU Inc. /quotes/comstock/14*!ulu/quotes/nls/ulu (ULU 0.18, +0.01, +2.86%) announced today that the company will present clinical evidence at the 2010 joint annual meeting of the Symposium on Advanced Wound Care and the Wound Healing Society (SAWC/WHS) in Orlando, Florida, April 17-20. SAWC/WHS is the premier wound care educational program within this clinical field and is the largest annual gathering of wound care clinicians in the United States. More than 2,000 physicians, podiatrists, nurses, therapists, and researchers are expected to attend the 2010 SAWC/WHS meeting. In addition to the presentation of the clinical evidence, the Company will also be providing educational guidance, showcasing advanced research on Altrazeal(TM) and products in the Altrazeal(TM) pipeline. Posters detailing application techniques and clinical care with Altrazeal(TM) in all major wound types, including diabetic foot, pressure and venous ulcers, will be presented to show how the product can be used in practice to treat these wounds. Altrazeal(TM) has shown a statistically significant decrease in pain in a randomized controlled clinical study. This effect is further demonstrated in a case study detailing pain management in patients with venous ulcers, to be presented by Catherine T. Milne, APRN, MSN, BC-ANP, CWOCN of Connecticut Clinical Nursing Associates, LC Bristol Hospital Wound, Ostomy, Lymphedema Center Bristol, Connecticut. Ms. Milne stated, "Wound pain is a tremendous burden for these patients. Having found a topical, cost effective method to reduce pain enhances patient compliance in wound care." Details of how to incorporate Altrazeal(TM) into the home healthcare practice, including patient selection and clinical protocols, will be demonstrated in a poster authored by Bobbie Spitz, RN CNS - BC CWS of the Aurora Visiting Nurse Association of Wisconsin in Milwaukee, Wisconsin. The poster titled, "Patient Selection and Incorporation of a Novel Transforming Powder Dressing in Home Healthcare" describes cost benefits and nursing time benefits to be derived using Altrazeal(TM) in certain patient populations. A number of clinical posters by Greg Bohn, MD, FACS, Medical Director of the Trinity Center for Wound Care and Hyperbaric Medicine in Bettendorf, Iowa, explain multiple case studies where Altrazeal(TM) has been used successfully in difficult to heal wound types. Also, a poster describes how utilizing total contact casts with Altrazeal(TM) may shorten days to heal in neuropathic diabetic foot ulcers. Another poster will detail cases where techniques were developed to incorporate Altrazeal(TM) in the treatment of pressure ulcers, with pain and moisture management, in this difficult to treat class of wounds. These poster presentations by Dr. Bohn follow his well-attended podium presentation at the American Professional Wound Care Association (APWCA) national conference on Saturday, April 10th. The presentation titled "Transforming Powder Wound Dressing Relieves Pain and Manages Moisture, Restoring Quality of Life" generated significant audience participation in a question and answer session following the presentation, generating very positive feedback on the attributes of Altrazeal(TM). Renaat Van den Hooff, President and CEO of ULURU Inc., commented, "The clinical experience data that will be presented at the SAWC/WHS Symposium is compelling and highlights the clinical, pharma- economic and patient benefits that Altrazeal(TM) provides. This event comes only a week after a highly successful presentation of clinical evidence and Dr. Bohn's presentation at the APWCA conference. These meetings allow more and more clinicians to discover the benefits that Altrazeal(TM) provides." ULURU will also present a poster detailing the preclinical and formulation development of Altrazeal Collagen, a new and important addition to the Altrazeal(TM) family of products. A set of three advanced technology Altrazeal(TM) posters have also been accepted for presentation at the prestigious Wound Healing Society Blue Ribbon Poster contest. These posters include a technique for moisture management of living skin equivalent constructs when combined with Altrazeal, details surrounding the effectiveness and importance of intimate contact between Altrazeal(TM) Silver and tissue and a poster on an innovative Nanoflex(TM) technology advancement utilizing ULURU's gel formulation as a tunneling wound gel. ULURU will also be present at the SAWC/WHS conference with a booth in the exhibit space to provide information on Altrazeal(TM) application techniques, best clinical experiences and the patient and economic benefits to be derived using Altrazeal(TM). Information about SAWC/WHS and the annual spring meeting can be found at spring.sawc.net About ULURU Inc.: ULURU Inc. is a specialty pharmaceutical company focused on the development of a portfolio of wound management and oral care products to provide patients and consumers improved clinical outcomes through controlled delivery utilizing its innovative Nanoflex(TM) Aggregate technology and OraDisc(TM) transmucosal delivery system. For further information about ULURU Inc., please visit our website at www.uluruinc.com. For further information about Altrazeal(TM), please visit www. Altrazeal.com. This press release contains certain statements that are forward-looking within the meaning of Section 27a of the Securities Act of 1933, as amended, including but not limited to statements made relating to the benefits, effectiveness, biocompatibility, ease of application, success in wound healing, clinical outcomes, reimbursement and suitability of Altrazeal(TM), and the success of our clinical efforts. These statements are subject to numerous risks and uncertainties, including but not limited to the risk factors detailed in the Company's Annual Report on Form 10-K for the year ended December 31, 2009, and other reports filed by us with the Securities and Exchange Commission. http://www.marketwatch.com/story/uluru-inc-to-present-altrazealtm-clinical-evidence-at-the-23rd- annual-symposium-on-advanced-wound-care-and-wound-healing-society-sawcwhs-2010-04-15? reflink=MW_news_stmp Contact: Company ---------------- Renaat Van den Hooff President & CEO Terry K. Wallberg Vice President & CFO (214) 905-5145 ------------------------------------------------ http://www.newsday.com/long-island/li-life/way-to-go-jordan-schessler-of-bethpage-high-school- 1.1863024 Way to Go! Jordan Schessler of Bethpage High School April 14, 2010 Jordan Schessler, a senior at Bethpage High School, recently raised $2,000 for the National Lymphedema Network with a schoolwide "scavenger hunt." To participate, 85 students paid a fee and then split into small groups to solve a series of riddles and complete tasks spread among the school's library, gym and other locations. Schessler held the fundraiser to raise awareness of lymphedema,... ------------------- Lymphedema treatment - An interview with Charlottesville physical therapist, James Collins April 15, 11:31 AMCharlottesville Health Care ExaminerDr. Leann MikeshPrevious Comment Subscribe Subscribe Get alerts when there is a new article from the Charlottesville Health Care Examiner. Read Examiner. com's terms of use. Email Address A woman with lymphedema http://en.wikipedia.org/wiki/File:Amyslegsfront.JPG If you like this ... Lymphedema - what you need to know View all » As part of National Occupational Therapy Month, I recently talked with James Collins, PT, CSCS, Physical Therapist and owner of Pantops Physical Therapy, about treatment for lymphedema and the lymphedema therapy service provided at Pantops Physical Therapy. LM: How does lymphedema affect a person's daily life? JC: It creates significant physical and social barriers. Physically the limbs become very heavy and large. That means decreased mobility and poor range of motion (ie. difficulty with stairs or dressing because of an inability to bend a knee secondary to fluid in the thigh and calf). Combine this with pre-existing deconditioning and activities of daily living become difficult. Socially, a person may become very self- conscious. They may not be able to wear shoes (only sandals) because of foot swelling and have to wear dresses or sweat pants. LM: What is the typical cause of lymphedema in the population of people you see at Pantops Physical Therapy? JC: The range of diagnoses is quite broad, but the lymphedema is typically a consequence of another illness or treatment. For instance, many cancer patients develop lymphedema secondary to surgeries. Breast cancer and prostate cancer are two more common forms of the disease with resultant problems. One challenge is that these individuals are often deconditioned as a result of a chronic illness and have a diminished muscle pump (muscles squeezing fluid) effect. LM: What is a typical therapy for lymphedema like/what type of therapy does Pantops Physical Therapy offer? JC: A typical session is about 1.5 hours long and includes extensive massage and wrapping. A mechanical pump may be used and patient/care giver education is emphasized. As the condition improves, functional exercise may be introduced. We offer 2 therapists certified in the treatment of lymphedema. The certification is beyond that of a typical therapist and is crucial because of the delicate nature of the lymphatic system. Each therapist has over 10 years of experience. LM: What type of results do people with lymphedema usually see after treatment and can they continue the therapy at home after the lymphedema is under control? JC: The results are very good. However, because the patients often have chronic diseases and the lymphatic system is delicate, individuals may require treatment in the future. This can often be completed at home or in an abbreviated course of physical therapy. Caregivers often learn wrapping and massage techniques. LM: Tell us about your lymphedema therapist and her training. JC: Our therapist has over ten years of experience and has been called the "Peyton Manning of Lymphedema" by an area physician. She has helped design an entire center in the recent past and always emphasizes a patient's ability to become independent. LM: Does insurance usually cover treatment? JC: Yes, under their physical/occupational benefits. If the patient desires, they can purchase wraps through a separate vendor. Depending on their specific policy, this may not be covered. For more information on lymphedema visit the National Lymphedema Network Also visit Amy's Lymphedema Story - one woman's battle with lymphedema April is National Occupational Therapy Month http://www.examiner.com/x-42183-Charlottesville-Health-Care-Examiner~y2010m4d15- Lymphedema-treatment--An-interview-with-Charlottesville-physical-therapist-James-Collins ------------- 3M Files Lawsuit Against Andover Healthcare Inc. ST. PAUL, Minn., Apr 16, 2010 (BUSINESS WIRE) -- 3M and 3M Innovative Properties Co. filed a lawsuit in the U.S. District Court for the District of Minnesota today against Andover Healthcare Inc. seeking injunctive relief and damages regarding Andover's CoFlex 2 Layer Compression System. The suit alleges, among other claims, a strong likelihood of confusion, mistake and deception between Andover's CoFlex 2 product and 3M's innovative Coban 2 Layer Compression System arising from Andover's wholesale appropriation of 3M's distinctive trade dress, copyrighted packaging and copyrighted instructions. The suit also alleges false advertising and unfair business practices. Compression therapy is considered a standard of care for treating venous hypertension and venous ulcers, which are a serious problem for many Americans, including the elderly and people with vascular disease or poor circulation. 3M has invested in extensive research and new laboratory methods to improve compression therapy for patients. 3M Coban 2 Layer Compression Systems are clinically proven to comfortably deliver sustained, therapeutic compression to reduce the edema associated with venous leg ulcers, lymphedema and other conditions where compression therapy is appropriate. About 3M A recognized leader in research and development, 3M produces thousands of innovative products for dozens of diverse markets. 3M's core strength is applying its more than 40 distinct technology platforms -- often in combination -- to a wide array of customer needs. With $23 billion in sales, 3M employs 75,000 people worldwide and has operations in more than 65 countries. For more information, visit www.3M.com. SOURCE: 3M 3M Media Contact: Donna Fleming Runyon, 651-736-7646 http://www.marketwatch.com/story/3m-files-lawsuit-against-andover-healthcare-inc-2010-04-16? reflink=MW_news_stmp ------------------------------ http://www.azdailysun.com/lifestyles/health-med-fit/article_c729154d-d3bc-53c7-b5d6- 33c5a325b45c.html FMC receives grant worth $50,900 StoryDiscussionDAILY SUN STAFF | Posted: Sunday, April 18, 2010 5:00 am | (0) Comments Font Size:Default font sizeLarger font sizeFor the seventh year in a row, Flagstaff Medical Center's Therapy Services Department has received a grant from the Phoenix Affiliate of the Susan G. Komen for the Cure. The $50,900 grant will provide treatment to breast cancer survivors who suffer with lymphedema, a painful side effect that affects approximately 20 percent of women who have undergone breast cancer treatment. Lymphedema, an often unexpected, secondary condition following breast cancer surgery, brings chronic pain and discomfort, and the risk of serious infection. During breast cancer surgery, surgeons may remove the lymph nodes under the arms to reduce the risk of the cancer spreading. As a result, the fluid in the nodes might not drain adequately, causing abnormal swelling known as lymphedema. The Phoenix Affiliate of Susan G. Komen for the Cure serves central and northern Arizona, and since 1993, has granted more than $16 million to breast cancer treatment, education, prevention and outreach programs, in addition to breast cancer research. For more information about the grant or how to access the funds, call Lori Pearlmutter, FMC Therapy Services director, at 214-3519. ----------------------- http://www.mukilteobeacon.com/community/article.exm/2010-04- 16_family_ties__locks_of_love_inspire_mukilteo_woman_ Family ties, Locks of Love inspire Mukilteo woman Published on Fri, Apr 16, 2010 by Rebecca Carr Read More Community Michelle Keller never saw it coming. The Harbour Pointe woman scheduled her routine annual mammogram during her children's spring break, went through the unpleasant test and didn't give it another thought - until the follow-up call a few days later was anything but routine. "They asked me to come in at my earliest possible convenience," she said. Keller credits the early mammogram, and the confirming MRI, with catching a cancer that's as elusive as it is dangerous. "There were no red flags, no warning signs," she said. "It's one of those tricky lobular cancers; it lay almost flat between the tissues with no lump." Keller returned to the clinic for an ultrasound, then a needle biopsy and MRI. "We knew conclusively then," she said. From that point, Keller recalled, everything kicked into high gear. "I didn't really have time to think about it," she said. "We were forced to go from zero to 60." Two things were for sure in the Keller household that night: Michelle was going to survive this, and the family was going to get through it together. "Dad (Jeff) didn't want to give the girls any more than they asked for - when they asked questions, he answered at an appropriate (age) level," Keller said. "He never, ever wavered from saying I would be fine." Did she believe him? "At times, no," she responded honestly. "But those times, my family held me to it." This was 2006, and Keller was worried whether she would be there for daughter Jordan's graduation in 2008. Telling the girls was the hard part - dad Jeff told oldest daughter Jordan, then 16, and let her break the news to her younger sisters. "One thing that's true in our family is that when something is wrong, we always know there's a better side," Jordan, now 20, said. "We knew (the hospital and clinic) this was a place for her to get better, not a place for her to be hurt." The family attended one of Keller's chemotherapy sessions, so they could see it didn't hurt Mom to go through it, she said. "I wanted them to see it wasn't a scary thing," she said. Chemotherapy was no picnic, of course, but Keller said it was easier than she thought - eight rounds spaced 20 days apart, with about three days of misery for each. "Jessica was my lymphedema specialist," Keller said. "She would put lotion on and rub me down at night.'" "I brought her food and pampered her," Jessica recalled. Youngest daughter Sydney, 8 at the time, remembers being asked at school if her mom was going to lose her hair. She didn't know if she could handle seeing Mom hairless. Off to the wig shop, which was, of course, a family affair. "You have to have humor to get through something like this," Keller laughed. "That means everyone tried the wig on, even Dad." Jessica not only watched her mother fight breast cancer, but also saw a young friend lose his own cancer battle in March after a prolonged fight. That inspired her to grow her hair long enough to donate to Locks of Love, a nonprofit organization that provides wigs for people who lose their hair to medical conditions and treatments. "We watched Brandon go through it for seven years," she said. "He was just a really neat little kid. His mom is a family friend." The family ran together in a Race for the Cure competition two years ago, with daughter Sydney doing double time, skipping back and forth, with "In celebration of my mom" written on the back of her shirt. "Everyone kept coming up saying 'God bless you,' and that I had made them run faster," she said. "It's funny how crystal your life becomes," Keller said. "The saying, 'Don't sweat the small stuff' doesn't come true until you go through something like this." You learn to appreciate the small, daily things in life rather than trying to rush through them, she said. "People tell you how fast your children grow up. You don't realize it until you're almost at the end - middle school, then high school, then it's over." Husband Jeff was a rock throughout, Keller said, never letting her feel overwhelmed. "He kept it real and in front of me; I never had to do this alone." Keller said she's fully recovered from her breast cancer, and refuses to let it define her. Her twice- yearly checkups are the only time she gives it much thought. The good news - yes, there is good news in these situations - is that her cancer was a mutant form rather than hereditary, and her three daughters have no more chance of breast cancer than any other woman. "I don't feel this is something I live with," Keller said. "I treat it as something I've beaten, some problematic thing that was a short period of time." All three girls are thinking about growing their hair for another Locks of Love donation. ------------------------- Nihon Kokyuki Gakkai Zasshi. 2010 Mar;48(3):224-8. [A case of yellow nail syndrome associated with fibrosarcoma of the skin successfully treated with pleurodesis][Article in Japanese] Fujita T, Sakurai T, Miki Y, Tomita K, Nakamura T, Toyoda H, Nakamura H. Department of Respiratory Medicine, Seirei Hamamatsu General Hospital. Abstract A 72-year-old man was referred to our hospital because of bilateral pleural effusion. Although examination of pleural effusion obtained by thoracentesis did not show any specific etiology, we diagnosed yellow nail syndrome due to his yellow nails and lymphedema of both lower limbs. Diuretics were effective for the control of his pleural effusion. Subsequently, fibrosarcoma was found in his abdominal skin and was resected. The pleural effusion gradually increased after the cessation of oral diuretics. Histological examination of a pleural biopsy specimen obtained by thoracoscopy showed chronic lymphocytic inflammation, but no malignancy. His previously intractable right pleural effusion was successfully treated with pleurodesis using OK-432, suggesting that pleurodesis with OK-432 could be an effective method for the control of pleural fluid in this disease. PMID: 20387528 [PubMed - in process] ======================================= Study Offers First Clinical Evidence Of Anti-Cancer Drug Triggering Viral Infection - 13 April 2010 Important advances in the fight against cancer have come as researchers proved that viruses and cancers interact in ways that were previously unknown to scientists. A new study led by UNC scientists shows that a common cancer drug can activate a viral infection that, paradoxically, can help anti-viral medications eradicate virus-associated cancer. The cooperative study, conducted by a team of UNC School of Medicine scientists and the UNC Project in Malawi, demonstrated for the first time in humans that a common drug used to treat Burkitt lymphoma can activate infection by the Epstein-Barr virus (EBV), a virus which typically lies latent inside the tumor cells of affected patients. The finding paves the way for a future study using both a cancer drug and an antiviral agent to eradicate both the active virus infection and the tumor. The findings are reported in the April 1 issue of the journal Clinical Cancer Research. Margaret Gulley, MD, professor of pathology and laboratory medicine, said, "What we have learned from this work is a potential means of capitalizing on presence of viral genomes within tumor cells to alter those tumor cells in a way that makes them more susceptible to treatment. Our findings have implications for other EBV- related malignancies that, overall, are among the most common cancers worldwide." Gulley is a member of UNC Lineberger Comprehensive Cancer Center. EBV infects more than 90 percent of the world's population and is associated with diseases ranging from infectious mononucleosis to lymphomas, gastric cancer and cancer of the nose and throat. Burkitt lymphoma, which is associated with EBV, is rare in most parts of the world, but is endemic in sub-Saharan Africa. Burkitt lymphoma is an aggressive, fast-growing type of non-Hodgkin lymphoma that often occurs in children. The disease may affect the jaw, bowel, lymph nodes, or other organs. The study demonstrated that initiating treatment with the anti-cancer drug cyclophosphamide in children with Burkitt lymphoma simultaneously triggered an active EBV infection. The increased replication of EBV in cancer tissue makes these cells more susceptible to the antiviral drugs that kill cells containing replicating virus. Antiviral agents such as ganciclovir and valacyclovir are already in routine clinical use for treating active viral infections. Researchers enrolled 21 patients with a confirmed diagnosis of EBV-related Burkitt lymphoma. The patients ranged in age from 5-15 and were under treatment with cyclophosphamide for their cancer. Through laboratory analysis of biopsy samples, researchers found that cyclophosphamide seems to induce the phase of viral infection most susceptible to antiviral therapy. "The next step," explains Gulley," is to design a clinical trial using both cytoxan and an antiviral agent simultaneously." Plans for such a trial are already underway under the leadership of Carol Shores, MD, PhD, associate professor of surgery in UNC's Department of Otolaryngology/Head and Neck Surgery and senior author of the study. Other UNC scientists involved in the study are members of the departments of pathology, otolaryngology, and medicine/infectious disease division. Additional collaborators are affiliated with Kamuzu Central Hospital and the UNC Malawi Project, and Dr. Shannon Kenney who was Sarah Graham Kenan professor at UNC before joining the departments of medicine and oncology at the University of Wisconsin in Madison. Source: University of North Carolina at Chapel Hill School of Medicine ------------------------------- HMH lands breast cancer grant The News-Enterprise HARDIN COUNTY — Hardin Memorial Hospital’s breast cancer program once again will benefit from grant funding through the Louisville affiliate of Susan G. Komen for the Cure. The hospital has received $39,617 this year through the affiliate’s community grant program, which is an increase of more than $2,000 from last year’s amount. The money will be used to advance patient and community education regarding breast health and breast cancer, said Michelle Murphy, director of marketing and public relations for HMH. The money also will assist underinsured and uninsured breast cancer patients with transportation, breast prostheses and fittings, lymphedema compression sleeves, PET/CT scans and genetic testing. In all, the Louisville affiliate of Susan G. Komen for the Cure awarded $618,000 to nonprofit organizations in the affiliate’s eight-county area, which includes Bullitt, Hardin, Jefferson, Oldham, Shelby and Spencer counties in Kentucky, and Clark and Floyd counties in Indiana. http://www.thenewsenterprise.com/cgi-bin/c2.cgi?053+article+News. Local+20100420124730053053019 ------ UHS offers lymphedema treatment programs United Health Services offers effective treatment programs for those suffering from lymphedema. Outpatient services are available at Wilson Medical Center in Johnson City and Chenango Memorial Hospital’s C.V. Stratton Center for Therapies in Norwich, while Twin Tier Home Health provides lymphedema treatment therapy for patients in their home. Lymphedema is a build-up of lymph fluid in the tissue or just under the skin. This build-up causes swelling (or edema), most often in the arms or legs, but in rare cases it can also affect the face, neck, abdomen, or genitals. Lymphedema is a common disease, affecting an estimated three million Americans. There are two types of lymphedema: [1] primary lymphedema, an uncommon, hereditary condition caused when the patient’s lymph nodes or vessels are missing or are not working the way they should; and [2] secondary (or acquired) lymphedema, the most common form of the disease, which results from surgery, radiation, trauma, infection, tumors, or anything else that changes or damages the normal, healthy lymph system. There is no cure for lymphedema; however, treatment is available. The lymphedema therapists at United Health Services have clinical training in Complete Decongestive Therapy. This gentle, non-invasive treatment has proven to be effective for patients with mild to severe primary or secondary lymphedema. Complete Decongestive Therapy uses a combination of manual lymph drainage, compression therapy, decongestive exercises, and skin care to treat the patient. Therapy is delivered in two phases. During the first phase, the therapist works with the patient to decongest the affected body part; the duration of this phase varies depending on the severity of the condition. Once decongestion is attained, the second phase starts and the patient assumes responsibility for managing, improving, and maintaining the results achieved during the first phase. Most insurance plans and Medicare cover Complete Decongestive Therapy, but a physician referral is needed. For more information about United Health Services’ lymphedema treatment programs, please contact one of the following: Outpatient programs Wilson Medical Center, Outpatient Therapy Department, 607.763.6033 Chenango Memorial Hospital, C.V. Stratton Center for Therapies, 607.337.4227 Home health care program Twin Tier Home Health, 607.763.8946 or 800.295.2212 United Health Services also offers a free, monthly lymphedema support group. Led by a trained lymphedema therapist, the group meets the second Thursday of each month from 5:30 to 6:30 p.m. at the Stay Health Center at Oakdale Mall in Johnson City (near Sears). To register, please call 607.763.5092. ------ Physiotherapy Associates Adds Another Clinic to the Map Physiotherapy Associates, Exton, Pa, a provider of outpatient physical therapy, industrial rehabilitation, and orthotics and prosthetics services at more than 600 locations throughout the United States, has a new clinic location in Erie, Pa. Known as Keystone Rehabilitation Systems—Erie South, the clinic offers a comprehensive range of physical therapy services, as well as treatment for lymphedema, specialized programs for dancers, gymnasts, and other performing artists, and a breast cancer rehabilitation program. "Opening this clinic in Erie highlights the opportunities we have as a company to provide cutting-edge physical therapy services across the US. By combining outstanding clinicians with new facilities, Physiotherapy Associates allows millions of our patients to lead healthier lives," said Pete Grabaskas, PT, COO of Physiotherapy Associates. Leading the physical therapy services at the new clinic is Elizabeth Darling, DPT, OCS, CLT, ATC. In addition to the clinic's physical therapy services, a new program is available for patients recovering from breast cancer. The breast cancer rehabilitation program was developed to help patients return to their daily activities quickly and safely. Patients schedule an office visit prior to surgery where baseline measurements are taken. Then, patients are given a personalized home program based on their needs and their corresponding surgical procedure. Last, patients have appointments at the 3- and 6-month intervals following surgery. Measurements are repeated, and, if any deficits are noted, the physician is contacted and an appropriate treatment plan is implemented. This program helps identify any problems early and facilitates a smooth recovery. "I am excited to help open this new facility. We are providing a set of physical therapy services that are not currently offered in this market. We use Pilates-based exercises for certain patients and offer specific equipment for this type of rehabilitation. The Erie community will benefit by returning to a healthier lifestyle," Darling said. She also emphasized that the clinic provides all conventional outpatient physical therapy services. Source: Physiotherapy Associates http://www.ptproductsonline.com/news/2010-04-14_03.asp -------------------------------------------------------------------------------- Most-read story in Health: 100% CERTIFIED ORGANIC POMEGRANATE FACIAL OIL New outreach program for kids with lymphedema Published on Wednesday, April 14, 2010 Children diagnosed wtih Lymphedema at the Hospital for Sick Children will be provided with a wonderful new picture and activity book, The Big Book of Lymphoedema, to help them understand the changes that will happen to their bodies and prepare them to cope with this life long condition. BIG BOOK FOR KIDS is a new outreach program by the Lymphedema Association of Ontario and is the organization's first initiative to focus on children. In collaboration with the Hospital for Sick Children's Department of Rehabilitation Services, a donated book will be provided to each newly diagnosed and follow-up lymphedema patient, aged newborn to eleven. This program is supported by a unique fundraising model that provides an opportunity for children and their families to help other children less fortunate. By making a donation of $35.00 to the Lymphedema Association of Ontario's Big Book for Kids Program, a child or family can personalize a bookplate with their name that is placed inside the book for a child with lymphedema. An initial donation of $1150 was provided by the Grade 6S students at Montcrest School in Toronto, through a classroom fundraiser. One of their students has lymphedema and introduced her class to the Big Book of Lymphoedema. This book is a valuable resource that only only helped her, but also her friends, classmates and teachers to understand the challenges of living with lymphedema. The Montcrest School Grade 6S students and their teacher, will be participaing in the official launch of the program at The Hospital For Sick Children on Thursday, April 15 between 12:30 and 1:30pm. They will be presenting their donated books to Pam Hilliard, a physiotherapist at the hospital's Department of Rehabilitation Services, who treats most of the lymphedema patients. The children and families of United Synogogue Day School were also generous in providing over $1,200 in donations to the program during their recent school book fair. Lymphedema is a chronic and often debilitating condition that occurs due to an abnormal buildup of lymphatic fluid because of a failure in lymph drainage. While Secondary Lymphedema, caused by damage to the lymphatic pathways through cancer treatment, is the most common form of lymphedema in Canada, Primary Lymphedema develops as a result of a malfunctioning lymphatic system, usually as a result of genetic underdevelopment. Lymphedema manifests itself as chronic swelling of one or more limbs and may also affect areas such as the head, neck and trunk. The accumulation of lymph fluid causes a wide range of effects that can include impairement of daily activities, due to swelling, pain and lack of mobility. Additionally, many patients are affected by physosocial issues as well. Increased susceptibility to acute cellulitis can result in frequent hospitalizations and long term dependency on antibiotics. Under treated lymphedema can lead to irreversible complications and further damage to the lymphatic system. According to a study by the Lymphedema Association of Ontario in 2006, there are an estimated 63,000 people living with lymphedema in this province. Yet for many patients, a diagnosis is difficult to find and treatment is not accessible to all. There is no cure for lymphedema. A diagnosis of lymphedema presents a significant change in quality for a child's life. The Big Book of Lymphoedema, is authored by Dr. Jacquelyne Todd, who has been working in the field of lymphedema for the last twenty years in England. It is the only book that is designed specifically to teach children about lymphedema, and it encourages them to feel in control of their condition and treatment. The Lymphedema Association of Ontario launched this new program to help all children with lymphedema in Ontario feel better about living with this condition and to enable them to explain lymphedema in simple terms to their friends, classmates, teachers and relatives. The Lymphedema Association of Ontario is a registered charity that has been providing support, education and awareness about lymphedema to patients, their families, and health care professionals since 1997. Their signature event is an annual education and awareness conference that brings in world renowned lymphedema experts. This year's one day conference will take place on Saturday, November 21, 2010 at the conference facilities of the CNIB. More information about this program and Lymphedema can be obtained by contacting the Lymphedema Association of Ontario's Executive Director, Anna Kennedy at 4161 Dundas Street West, Toronto, Ontario M8X 1Y2 416-410-2250 or lymphontario@yahoo.com http://www.wireservice.ca/index.php?name=News&file=article&sid=2401 ===== On January 12, 2010 Palmetto GBA, the Jurisdiction 1 A/B Medicare Administrative Contractor, hosted an Open Draft Meeting in Los Angeles which included the review of the Part B Draft Local Coverage Determination (LCD) Physical Medicine and Rehabilitation Policy (DL28290): Northern California and Southern California. Lymphedema Patient Advocate Robert Weiss attended the meeting and submitted extensive comments on the LCD, intending to clarify the policy with respect to lymphedema protocols. The following comments and responses reflect the comments submitted by Bob Weiss as well as comments submitted by two southern California physical therapists in attendance. While not all of the comments and suggestions were accepted by the MAC, their answers shed light on Medicare policy with respect to areas of uncertainty and ambiguity such as lymphedema patient education, bandaging, integration of lymphedema treatment modalities, and billing. This policy covers only the region including California. Whether Palmetto will make similar changes to the LCDs in their other regions and Jurisdictions is unknown. Drafts of current and proposed LCDs may be found on the CMS website: http://www.cms. gov/mcd/search. asp?from2= search.asp& and CMS has an established comment procedure for proposed draft changes. Bob Robert Weiss, MS Lymphedema Patient Advocate National Lymphedema Network LymphActivist@ aol.com ============ ========= ========= ========= ========= ========= ========= ========= ===== Jurisdiction 1 Part A Response to Comments for Physical Medicine and Rehabilitation (L29290) Comment: One commenter requested that therapists must have met the additional training equivalent to national lymphedema therapist certification levels of the Lymphology Association of North America (LANA). Response: While this recommendation was not included in the final policy, it should be noted that in order to provide the best quality of care therapists serving patients with lymphedema, should maintain their skills and participate in continuing education courses. Comment: A commenter requested that the administering of manual lymph drainage (CPT 97140) concurrently with treatment with a vasopneumatic pump is medically necessary and should be addressed in this LCD. Also compression bandaging or a compression garment or device after treatment with a vasopneumatic device is essential, and should be addressed in this LCD. Response: This LCD addresses modalities and procedures and not devices. Coverage of the vasopneumatic pump and compression bandaging and/or a compression garment must first be determined to be reasonable and necessary according to the policies established by the Durable Medical Equipment Medicare Administrative Contractors (DMAC). If the vasopneumatic device is reasonable and necessary, the DME supplier would then be expected to train the beneficiary on the use of the device in the home. This training is already included in the Medicare reimbursement paid to the DME supplier of the vasopneumatic device via the appropriate E code and is not separately reimbursable. Comment: On commenter suggested that coordination is needed to integrate the required treatment modalities [manual lymph drainage (CPT 97140), bandaging (HCPCS code A6452, A6448, A6451) and exercises (CPT 97110)] for a lymphedema treatment session. Billing edits should accommodate the combination of modalities for one session. Response: Palmetto GBA claims-processing system would be able to process all of the codes. The policy reflects Palmetto GBA’s position that reasonable and necessary MLD/CDT would include several interventions that could be described by more than one CPT code. The therapeutic exercise component of decongestive therapy should be billed under CPT code 97110, and the time spent by the physical therapist or physical therapist assistant performing serial compression bandaging should be billed under CPT code 97140. The training and education associated with associated with teaching the patient and/or caregiver to do the serial compression bandaging at home and how to care for the extremity should also be billed under CPT code 97140, rather than CPT code 97535. Comment: One commenter requested that the bandaging services requiring special skills of a qualified professional need an appropriate home in this LCD. Also MLD may be required in conjunction and coordinated with vasopneumatic compression (CPT 97016). Response: The LCD does address MLD and CDT using CPT codes 907110 and 97140. The compression bandages are reimbursed by DMAC. If you are supplying the compression bandages you should have a DMAC Supplier Number for reimbursement of the supplies you are furnishing for when the beneficiary wears the new compression bandage home. Normally, a patient has several bandages at home, one for wearing and one to wash and dry. The bandage the patient wears for treatment is the bandage they would be wearing home as the bandage can be worn repeatedly. Comment: One commenter stated that the strapping code 29540 and 29550 and UNNA Boot code 29580 are inappropriate in the absence of an open debrideable wound, sprains or fractures even though the medical procedures are similar. (1) Response: These codes are not addressed in our LCD. Comment: A commenter stated that patient or patient aide education should be explicitly covered (CPT 97001–4, 97535, 97110, 97140, 97150. Instructions should include the following: Self MLD or simple lymphatic draining, self bandaging of lymph edematous limb, decongestive exercise program, care instructions for compression bandaging and garments, measurement instructions, dietary and health issues relating to lymphedema and recognizing infection and loss of lymphedema control. Response: The LCD does address education regarding these codes. Reasonable and necessary education and training on the proper use of vasopneumatic devices for home use is described in the LCD. Comment: A commenter stated that patient history, evaluation of patient symptomatology and physical exam remain the key methods of evaluating and grading lymphedema. Certain measurements are useful for measuring the effectiveness of treatment and determining when to terminate treatment. Response: Our LCD addresses assessment and evaluation. Comment: The words Advanced Beneficiary Notice (ABN) appears throughout the LCD. The correct title of this form is Advance Beneficiary Notice of Noncoverage (ABN), these needs to be corrected in the LCD. Response: Agree Comment: A commenter suggested the term ‘Medicare-certified’ therapist is used, but it is not defined anywhere in the LCD. Is this the same as the defined ‘Qualified Therapist’ who is licensed or certified by the state of practice (defined on page four), or is it something more specific such as registration in PECOS? Response: Yes, the therapist is certified by the state if certification exists and is another way to say qualified therapist. States license and/or certify therapists differently. The word ‘Medicare’ is removed from the LCD. Comment: A commenter suggested the definition of ‘Qualified professional,’ physical therapist assistants are referred to as physical therapy assistants. Please change this to physical therapist assistants. Under the definition of ‘Qualified Personnel,’ the first sentence states ‘Qualified professional means staff (auxiliary personnel) who may or may not be licensed as therapists but who meet all of the requirements for therapists with the exception of licensure.’ The term professional should be changed to personnel to ensure the definition is accurately describing qualified personnel. Response: The term a ‘Qualified professional’ comes from the CMS Manual System, Publication 100- 02, Chapter 15, Section 220. Agree to remove the word professional under the definition Qualified Personnel and insert the word personnel. Comment: A comment was received requesting the definition of supervision levels as the definition of direct supervision is contradictory when compared to previous guidance within the LCD. Direct supervision was previously defined as ‘in the office suite’ twice within the LCD and then changes to ‘in the room supervision.’ Federal Medicare policy does not require in the room supervision for physical therapy services either provided by physical therapist assistants supervised by a physical therapist or therapy services provided incident to a physician. The definition of direct supervision as in the office suite is upheld in Chapter 15 of the Medicare Benefit Policy Manual. Because this policy is not upheld in the Federal regulations, Palmetto GBA should remove the last two sentences of the second paragraph. Also, requested ‘Physical therapy assistants’ should be changed to ‘physical therapist assistants’ as this is the standard designation. Response: Agree, we will make the changes as requested. Comment: A commenter questioned if an automated denial would occur if treatment was less than 30 minutes. Response: The documentation should support the services provided. Comment: Commenter questioned the statement in the LCD stating, ‘Services performed by persons who are not employees of the therapist are not covered.’ The commenter stated his understanding based on Medicare regulations was that a physical therapist working under a contractual relationship also constitutes an employee and their services are covered. Response: We will adjust the statement to ‘direct employees or contracted employees’ Comment: Commenter requested the statement ‘Physical or occupational therapy services that do not require the professional skills of a qualified physical or occupational therapist to perform or supervise and, therefore, are not covered’ be replaced with ‘are not medically necessary.’ Response: If the service does not require a professional then the service is not reasonable and necessary. We will change the wording of not covered and replace with is not reasonable and necessary. Comment: Commenter requested the language regarding the frequency of service for CPT codes (97010–97039) and in the coding guidance for nearly every code should be removed. Citing the limitation on therapy services limits the physical therapists ability to make appropriate treatment decisions for a patient based on the patient’s presentation. Response: The frequencies identified in the policy are for guidance, any service exceeding the number of sessions would need to be justified in the patient’s medical records. Comment: Commenter requested that since occupational therapists use heating modalities as do physical therapists the sentence be modified to include occupational therapy. Response: Agree, with the recommended change. Comment: Commenter requested that the statement ‘Further treatment of lymphedema by the provider after the educational visits is generally not medically necessary’ have the words ‘with a vasopneumatic device be added to the statement.’ Response: Agree with the recommended change. Comment: Commenter requested the removal of the statement ‘These services, in addition to all other therapy services, must be prescribed by the attending physician’ for ‘CPT code 97028 under Specific Modality Guidelines.’ Response: Agree, sentence will be removed. Comment: Commenter suggested Under General Guidelines for Therapeutic Procedures for CPT code 97124, second bullet, postural drainage and pulmonary exercise are within the scope of practice of a physical therapist. We are requesting that this bullet should be removed from the Specific Modality for CPT code 97124. Response: Agree with recommended change. Comment: Commenter suggested under General Guidelines for Therapeutic Procedures for CPT code 97150, third bullet states: ‘Group therapy is defined as payment for physical therapy services (which includes speech-language pathology services) and occupational therapy services provided simultaneously to two or more individuals by a practitioner. The individuals can be, but need not be, performing the same activity. The physician or therapist involved in group therapy services must be in constant attendance, but one-on-one patient contact is not required.’ As of July 2009, speech language pathologists were eligible to bill for their services in outpatient settings independent of physical therapists. As a result it would not be appropriate to bundle speech therapy services provided in a group with physical therapy services. Please remove the reference to speech language pathology services in this guidance. Response: Agree to remove speech language pathology services from parenthesis and include it as a separate service. Comment: Commenter suggested under General Guidelines for Therapeutic Procedures for CPT 97755 does not appear to be applicable to the code itself. CPT code 97755 is for assessment, however, the guidance seems to be specific to training. CPT code 97535 and 97542, Self Care/Home Management training and Wheelchair Management/Propulsi on Training, respectively, would be more appropriate for billing related to training. Please change the third bullet of this guidance to state: ‘Documentation must relate to the assessment of the expected functional goals that are attainable by the patient.’ Response: Agree with recommended change. Comment: Commenter requested under Documentation Requirements number one states that the medical record must identify the physician or qualified non-physician who has prescribed the physical medicine and rehabilitation services for the patient. Palmetto should remove number one from the LCD. Response: Agree with recommended change. last updated on 04/20/10 ------- New wellness center to open in Middletown April 23, 2010 5:22 PM MIDDLETOWN, R.I. — Women & Infants Hospital is opening a new wellness center at 333 Valley Road in Middletown this month, as part of its Integrative Care Program. Operating within the hospital's Program in Women's Oncology, the Center for Health and Well-Being will offer a menu of complementary therapies for oncology patients as well as wellness programming to appeal to all women. "We will offer the full range of complementary therapies, traditional and innovative health and wellness programming, and a women's health library full of resource materials on a variety of topics, from cancer to infertility to post-partum depression," said Sandra Scuncio, director of the Integrative Care Program. Lymphedema therapy, specialized massage for women who have had surgery for breast or gynecologic cancer, is one of the treatments that will be offered at the Middletown site. Others include acupuncture, therapeutic massage, reiki, hypnotherapy, guided imagery, reflexology, meditation, facials and skin care. In addition, there will be programs dedicated to weight loss, exercise, and nutrition, plus lectures, a weight loss clinic and yoga sessions. Eventually, there are plans to offer counseling services for cancer patients. Funding to establish Newport the site was provided through a grant from the van Beuren Charitable Foundation http://www.southcoasttoday.com/apps/pbcs.dll/article?AID=/20100423/NEBULLETIN/5010311 ------------------------------ Baylor All Saints opens Joan Katz Breast Center BY ELIZABETH BASSETT April 26, 2010 Baylor All Saints Medical Center at Fort Worth is taking cancer patients into a new part of its campus as medical and supportive staff move into the Joan Katz Breast Center. The center, which has been under construction in a part of the Andrews Women’s Hospital, is not only for breast cancer patients, and it’s not only for women, either, said Sherree Bennett, director of the center and a certified breast nurse navigator. “It doesn’t matter if it’s breast cancer, colon cancer or melanoma. You need hope, help guidance and education,” Bennett said. The center is named in honor of Joan Katz, a three-time breast cancer survivor who teamed with Baylor All Saints to develop the concept of an all-inclusive cancer center where patients can find resources for the medical and non-medical aspects of dealing with the disease. It occupies roughly 5,400 square feet. In addition to patient and family waiting areas, offices and meeting rooms, there also is a larger conference room that seats about 46 and also has high-definition TV screens for physicians to review detailed pathology slides or mammograms or other images. Part of the center is a supply room that has specially-made camisoles, pillows, bras and compression garments to be used right after surgery, and adjoining the medical side of the center is Survivor Gals, a boutique that includes wigs, scarves and hats for women and men, mastectomy products, other compression garments, skin care products and gifts. Bennett said she and Terri Sexton, development officer for the All Saints Health Foundation, initially planned on hospital staff opening and running a boutique themselves. “We began to research, we realized that I am a nurse and she is an accountant,” Bennett said. “…We began to realize this is not our calling. We didn’t know what to do.” Instead, Survivor Gals is owned and operated by Angie Prince and Jennifer Grunwald, who also have a location in Plano. Prince, who is a master stylist and certified to fit mastectomy and lymphedema garments, said the private styling area and fitting room will always be staffed by people who can assist in finding products or styling or cutting wigs, even if they weren’t purchased there. “We’ll have someone here all the time who can cut,” she said. Leanne Weber, another stylist and Survivor Gals employee, said the boutique also will bill private insurance and Medicare. If a patient wants, staff can run pre-certification before he or she comes in and pinpoint a budget. “We can do that before they even come in, that way they know what they’re working with,” she said. For patients who may not have insurance coverage or who are in financial dire straits, there will be some funds set up to assist them, Saxton said. The entire Joan Katz Breast Center is dependent on philanthropy and donors who wish to support cancer patients, she said. “This is 100 percent funded by donors,” she said. So far, $4.6 million has been raised out of a $13.5 million total goal. Construction and three years of operating costs already have been set aside, totaling $3.3 million, she said, and now the development office is working on creating a $10 million endowment. An additional $200,000 will go into reserve for underserved patients, she said, because some women may have to choose between buying groceries or buying a wig or a mastectomy bra. “We don’t want women to have to choose,” she said. “ . . . Regardless of what happens with health care, regardless of what happens with the economy, we want to be able to provide services.” Donations are welcome in any amount, Sexton said; the smallest to date is $5.32, and the largest was $1,067,000. The average is about $10,000, she said, but any amount can contribute toward the care of a person with cancer. There also are plans for a contemplative garden, which will be visible from the conference room and a smaller meeting room, and that will be part of a $1 million campaign. Bennett said this center, within a hospital that can provide all sorts for cancer treatments and including access to non-medical services, is the first in the area that fully encompasses what is generally a piecemeal journey through cancer. What is most important is being able to easily point patients in the right direction for whatever they may need, she said. “That’s why we’re here,” she said. “Nobody has to go through it alone.” http://www.fwbusinesspress.com/display.php?id=12450 ------------------------ http://www.foxcharlotte.com/news/top-stories/92063454.html Charlotte Mom Fights for Insurance Coverage Marvin Beach Story Created: Apr 25, 2010 at 10:00 PM EDT (Story Updated: Apr 26, 2010 at 9:32 AM EDT ) Dylan Ferguson looks and acts like any healthy three-year-old boy. But he suffers from Lymphedema, a condition that can cause extreme swelling in the arms and legs. “And then if you don’t take the daily precautions to keep that swelling under control, it's very disfiguring,” says his mom Heather. She says his treatment includes wearing very tight compression garments. “And if you don’t have that compression, literally, 24-hours a day, the affected body part just swells larger and larger and larger,” Ferguson says. But when her husband changed jobs, their insurance company refused to cover his treatments, leaving her family footing over $3000 in annual medical bills. That’s when she pushed to change state law and got a bill passed to require treatment here in North Carolina. Now she’s looking to go further… to Washington, D.C. Congressman Larry Kissell has already introduced a bill in the House to require coverage under Medicare. “Next month at the end of May, a group of about twelve people are going DC to lobby for the bill, meet with Representatives and Senators to try to build more support,” Ferguson says. Support she hopes will make it easier for families coping with the condition across all 50 states. “There are people who have died from complications of Lymphedema, so when your child's health and quality of life are at stake there's really nothing you won't do as a parent to try and help them,” she says. ----------------------------------- Exercise classes benefit women with breast cancer and survivors Hope, Faith & Fitness classes, designed for women with breast cancer and survivors, will be held from 9:30 to 10:30 a.m. Mondays and Thursdays, May 10 to Aug. 19 at Westminster Presbyterian Church. Until recently, exercise has taken a back seat for women diagnosed with breast cancer as emphasis is mostly on detection and treatment. However, exercise is an important component of the long-term recovery process for both recent and long-term survivors. Exercise has been shown to hold off or improve lymphedema, a side-effect of breast surgery which often appears years later, and allows participants to take a more active role in recovery and the healing process. It improves their self-esteem and body image, prevents post-surgery complications and increases their fitness level. After years of teaching a resistance training class at Westminster Presbyterian Church, instructor Gailya Woodyard found a few of her students either had breast cancer or were survivors. One, Donna Evans, contributed her relationship with the Lord and this workout in helping her with recovery. Together, the two have decided to focus the class on women with breast cancer and survivors. Evans will begin class with a short devotion. Woodyard will then teach the fitness class specifically designed for women with cancer but is open to all women so that friends can benefit from a workout while offering support. Classes will be held in the fitness room. Cost is $88 (or two payments of $44). Preregistration required for child care. Visit www.wroc.west-mister-church.org for details. http://www.thealmanac.net/ALM/Story/04-28-2010-breast-cancer-exercise ----- Clif Garboden No coverage is a chronic condition By Clif Garboden April 30, 2010 E-mail this article To: Invalid E-mail address Add a personal message:(80 character limit) Your E-mail: Invalid E-mail address Sending your articleYour article has been sent. E-mail| Print| Reprints| Yahoo! Buzz| ShareThisText size – + IF YOU wrestle your way through the Harvard-Pilgrim website, you can find the clause for concern. It’s listed under “Other Health Services,’’ and reads: “Physical and occupational therapies up to 60 consecutive days per condition.’’ If your therapist calls and asks, the insurer’s service rep will assuredly say that restriction is interpreted as “for life.’’ Discuss COMMENTS (30) Harvard-Pilgrim recently took time out from stonewalling state regulators over proposed double-digit premium increases to deny me coverage for therapy to treat my chronic lymphedema, an expected after- effect of stage-four neck-cancer treatment during which 39 lymph nodes were removed from my neck and shoulder. Harvard-Pilgrim turned me down simply because I’d been treated for previous attacks. That was several years ago, but no matter, the clause in the policy says “per condition,’’ and that’s that. Doesn’t Harvard-Pilgrim understand what “chronic condition’’ means? Yes, I believe it understands perfectly. “Chronic’’ means it happens over and over again, so if an insurer wants to cut costs, what better place to begin than by eliminating payments for recurring problems? I have the right to appeal this rejection (the process takes 180 days), but frankly, I have better things to do with my remaining time on earth than play against a stacked deck with a bunch of bandits. And, this time, it isn’t that huge a deal for me. Lymphedema, poor drainage of bodily fluids due to a compromised lymphatic system, crops up any time something provokes my body to produce excess fluid — in this case a six-hour airplane ride in a poorly pressurized Aer Lingus cabin. Aside from a lopsided fat face highlighted by a Nixonian left jowl, the consequences for me are increased difficulty talking and swallowing. This round, fortunately, was not a debilitating attack. But that’s not why Harvard-Pilgrim turned me down. I was denied coverage sight-unseen on a strictly interpreted technicality. This raises some questions. What if the attack had been worse and the swelling, compounded by residual radiation fibrosis, had closed my esophagus? Would Harvard-Pilgrim have paid (a lot more) for a feeding tube? And what about people whose chronic conditions leave them in pain? Take two aspirin? If you break your leg twice in the same place (not uncommon) does that count as a single “condition’’? Hip-replacement physical therapy? As for lymphedema, the therapies I sought were developed originally to treat breast-cancer survivors, for whom the condition can be far more serious than mine is. The folks at Spaulding rehab tell me this sort of thing happens all the time. Another friend ran into the same technicality a few years back and was told by the Harvard-Pilgrim rep that the company hoped she’d pay to treat any recurrence “to protect her health.’’ A rule’s a rule, you know, and Harvard-Pilgrim’s business model, which famously involves collecting more money than it pays out, seems to be betting that patients will die or change insurers before they contract any expensive-to-treat condition the therapy could have forestalled. To be fair, the same insurer did cover most of my cancer-treatment costs, which were extensive. But Harvard-Pilgrim’s failure to cover routine follow-up therapies is as uncaring as it is short-sighted. It labels them as penny-wise/pound-foolish bureaucrats indifferent to their customers’ suffering or long- term health. We pay dearly for this poor health management, and now they want us to pay more. Would a nationalized system (or Obamacare, which addresses this issue) be any less flawed? That remains to be seen, but removing the insurer’s profit motive seems like a good first step. My friend Jerry, a US citizen married to a French woman and living in Paris, recently had a triple-bypass heart operation and is still undergoing numerous follow-up treatments. His out-of-pocket cost to date? Zero. Clif Garboden is a Boston-area freelance writer. http://www.boston. com/bostonglobe/editorial_opinion/oped/articles/2010/04/30/no_coverage_is_a_chronic_condition/? comments=all&plckCurrentPage=1 tinabudde wrote: First off, Cliff you have an obligation to appeal! Not only for you but for others in the same situation. The first thing you shouldn't be doing is complaining about how they didn't cover you and do nothing about it, what are you accomplishing? I'm owner of Lymphland International Lymphedema Online website and support group. I also am the editor of eLymphNotes lymphedema magazine. I have hundreds of members and we are working our butts off trying to get HR 4662 lymphedema legislation passed so ALL insurers are forced to cover all aspects of lymphedema needs, so after working my butt off to get this passed and to run into someone like you who complains but does nothing, well it's stupid. Get off your butt and write an appeal or contact me. I have one man in my group who volunteers endless hours writing appeals for anyone in need so there is no excuse for you to sit there and complain!!!! Tina Budde, CEO Lymphland. ---- |
