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Lymphland International Lymphedema Online
June 1, 2011
Secret donor helps 770-pound patient - MyFox Tampa Bay – by Ken Suarez –
LAKELAND - A Lakeland woman rendered immobile by a medical condition with no place to live will
have a home, thanks to an anonymous donor.
Yvonne Gallimore didn't know where to turn. A medical condition called lymphedema left her weighing 770
pounds and in the hospital. Firefighters had to knock the wall out of her apartment to get her out.
Lakeland Regional Medical Center was ready to discharge her, but she had no place to go back to.
And any place she would go would have to be adapted for her at a cost of at least $70,000.
After FOX 13 aired her story, an anonymous donor came to the rescue the following day. She said to get
Gallimore the new place she needs whatever the cost.
Gallimore got the incredible news on Wednesday.
"I don't know who it is," she said from her hospital bed. "Whoever you is, I thank you. I love you, and I
really appreciate it."
Tears began welling up in her mom's eyes when she found out.
"I tell you, God is good, and I thank you very much because that's exactly what she needs, and I am so
grateful," said Margaret Moore.
Gallimore is 51. Seventeen years ago, she was diagnosed with lymphedema, a malady that causes the body
to hold onto fluids. Moving around became harder and harder as she gained weight, and she eventually
became bedridden.
Details about where she will go when she leaves the hospital have not been worked out yet. The money
could go towards adapting an apartment or house, or building a new home.
Fat, lazy taunts stole Amanda Bell's dignity - Herald Sun – by Marianne Betts –
A SEVERELY obese woman claims constant taunting by hospital staff has robbed her of her dignity.
Amanda Bell, 51, who spent 45 days seriously ill with blood poisoning at Monash Medical Centre, said on
one occasion a nurse told her it was about time she got her "lazy fat a---" out of bed and had a shower.
"I just burst into tears ... I am physically unable to get out of bed, and I wasn't being regularly sponged
down - my hair hadn't even been washed in 21 days."
Ms Bell weighs 220kg and has been house-bound for nearly two years, with her weight ballooning because
of lymphedema, a condition causing her body to retain fluid.
She decided to speak out because she wanted to prevent others being treated the same way.
Ms Bell, who left hospital a fortnight ago, said she had often been given filthy looks by nurses, and felt she
had been constantly judged because of her size.
"They looked me up and down like I was a piece of dirt, and once I said: 'Please don't look at me like that,
I'm a human being, and I have feelings'."
Ms Bell, who shared a ward with three other patients, was also forced to lie in her own waste for eight
hours.
A Southern Health spokesman said: "We are sorry to hear that the care provided did not meet the patient's
expectations.
"We have looked into this case and our review has shown that the care provided to the patient was
appropriate."
The hospital said extra staff and equipment were allocated to meet Ms Bell's needs.
June 2, 2011
Beyond Cancer: Living with Lymphedema - NBC2 News –
Many cancer patients may find themselves dealing with a lifelong side effect.
Lymphedema is extreme swelling that comes as a result of lymph node damage. It can show up at any time.
Sandy Hawkins introduction to lymphedema came as a complete surprise.
"Well, it was an unpleasant surprise," says Hawkins. "I woke up one morning in January and my whole
upper body was swollen."
Lymphedema occurs when the lymphatic system is disrupted. If fluid can't get to the heart, it pools up,
causing the swelling.
" And, of course, there's the psychological implications," Hawkins says. "It doesn't feel very nice to look in
the mirror and see all that."
Sandy reached out to a certified lymphedema therapists to help her manage the swelling in her arm.
"We teach manual lymph drainage which is a massage technique," says Jackie Speas, a lymphedema
therapist with Lee Memorial Health System. "It redirects the fluid to parts of the body that do not have
edema."
Therapists also teach patients how to keep their condition under wraps.
"We'll also do compressive wrapping," Speas says. Which we use short stretch bandages and actually wrap
the extremity to reduce the edema."
Once the swelling is under control, the challenge is to keep it that way. That generally requires wearing
compression garments.
"We ordered these sleeves and gauntlets which are the hand part. I
tried the gloves but wasn't happy with that so these gauntlets are much easier to use daily."
While there is no cure for lymphedema, there is also no reason to live with the swelling. For patients like
Sandy, the work is worth the effort as she's regained control of her life and limbs
June 3, 2011
NEW: Several medical ailments don't keep man from living life - The Morning Sun – By RYAN BERLIN –
John Brandon spends 12 hours and three days a week receiving treatment.
He is suffering from End stage kidney failure and goes through dialysis.
Kidney failure is only one of Brandon’s many problems.
“I have several medical maladies that I have to contend with,” Brandon said.
“(I have) end stage kidney failure, I have scoliosis, I am diabetic so I have neuropathy in my limbs. I can’t
feel much of anything anymore.”
Brandon has an ulcer on the bottom of his foot that has been there for 10 years.
His current treatment for that requires a doctor scraping away at it with no anesthesia.
He also has lymphedema in his left leg. It causes swelling due to a blockage of the lymph passages.
Of everything Brandon goes through Dialysis is the toughest on him.
“I get here about 1:30 p.m. I’ll work on my business or fall asleep because it is absolutely draining,” he said.
Dialysis filters patients’ blood by removing it from their body and purifying it of any fluids or toxins,
according to RN-CDN Jan Snyder.
Dialysate is a fluid that is used to help clean a patients’ blood.
“Dialysate is composed of electrolytes and also sodium as a buffer and bicarbonate to balance the blood,”
Snyder said.
“The filter also traps toxins in excess metabolic waste. Our patients either don’t urinate or their urine rate
has greatly decreased.”
When that happens toxins build up in the blood and it needs to be cleaned and removed.
No matter how tough things may get for John he never allows himself to get down.
He spends a lot of his time, when he isn’t getting treatment, ordering and selling replica celebrity jewelry.
John bought a Filthy Rich of Mid-Michigan franchise for the Mt. Pleasant area.
“I have several vendors that I get the jewelry from. I have always been thoroughly interested in celebrity,”
he said.
“When I came across this business opportunity I thought I can do that. I can buy this stuff and have an open
house.”
Some of the replica celebrity jewelry that Brandon sells comes from artist collections like Humphrey
Bogart, Katherine Hepburn, and his favorite, Elvis Presley.
Brandon decided to sell the jewelry because he didn’t want to go on welfare and sit around doing nothing.
Each piece of jewelry has a story behind it, according to Brandon.
One Elvis ring he was wearing, Elvis wore in Hawaii at a concert.
“He had a personal jeweler that flew around with him where ever he went,” Brandon said.
“One concert Elvis was at a cute little girl handed him a rose and he handed her a ring. He gave away tens
of thousands of dollars worth of jewelry that night.”
Brandon’s show will be held Sunday June 12 in the community room at the Crossings on Broadway from
11 a.m. to 7 p.m.
“John has raised the bar. Not only for dialysis patients but for everybody else out there whether it be they’
re out of a job because they’re over qualified or under qualified,” Snyder said.
“If you really make a concerted effort there is something you can do to become a contributing member of
society not only in the work force but also with volunteering.”
Elastic Therapeutic Taping: A Valuable Fit for Chiropractic - Dynamic Chiropractic – By Kenzo Kase, DC
–
The concept of elastic therapeutic taping first came to me in the 1970s while I was practicing as a
chiropractor and teaching. The taping is non-invasive, free from drugs, and integrates well into the
chiropractic model.
Many conditions, including whiplash, herniated disc, muscle strain and sprain, headaches and degenerative
joint disease are commonly treated with therapeutic taping in conjunction with traditional chiropractic.
Tracy Barnes, DC, DICCP, of Louisville, Ky., uses elastic therapeutic taping on many different kinds of
patients. She enumerates: "For all those patients who continue to need a tactile cue to stay in certain
postural positions, tape is great. For all those patients in pain from swelling, inflammation and injury, tape is
great. For those patients who just need an extra 'umph' to feel better, tape is perfect." In fact, Barnes notes,
"I wouldn't want to practice for long without it."
For many DCs, it is a standard in their practice. Dr. Scott Hainz practices in Missouri. He notes, "To help
prevent prolonged recovery times, we incorporate [therapeutic taping] to enhance the in-office treatment,
whether it be an adjustment or soft-tissue therapy."
Michigan chiropractor Dr. Tim Dunne observes that "Taping allows the patient to leave with a prescription
for the body to follow through with as it heals in the proper functional motion. This leads to a significant
increase in patient outcomes." Chiropractic is based on the knowledge that the human body has an innate
self-healing ability and seeks balance. Therapeutic taping is based on the same assumption. Taken together,
the whole concept is grounded in treating the cause of the patient's pain or weakness. In his experience, Dr.
Dunne says, taping "always works." He has found that "if you are not getting the results you are looking for,
reassess and retape; you haven't figured out the problem."
In the 1970s, it had became clear that the patient's response to treatment was the most important aspect of
medicine. For example, allopathic practitioners received respect because they were able to implement
pharmaceutical drugs with demonstrated effectiveness. While chiropractic adjustments have also been
demonstrated to be effective, patients who are seeking pain relief may have a tendency to gravitate toward
pharmaceutical treatments.
For this reason, it is important to search for the cause of the pain in order to treat patients more effectively
using chiropractic techniques. The sensory receptors in the dermis turn out to be the key: upon specific
stimulation of these receptors, which are plentiful in the skin, pain signals can be generated. Because of the
abundance of these receptors, a cut or burn on the skin will hurt more than visceral pain. With this in mind, I
considered how to best approach the management of painful conditions.
When we feel pain, we have a tendency to touch the area; however, it is not the application of pressure to
the site, but the action of lifting with the palm of the hand that affects the sensation of pain. The lifting motion
stimulates the mechanoreceptors in that particular region and decreases the pressure on the site, thereby
decreasing the feeling of pain. Accordingly, I wanted to create a material that would simulate this action. At
first, I was using athletic tape in an effort to avoid applying pressure to the painful site, but found that athletic
taping was too constricting. This compression is helpful in stabilizing the area; however, it limits motion and
circulation, and is consequently ineffective in managing pain. To solve this problem, I designed a unique
elastic therapeutic tape. This creation allows for therapeutic taping treatment that does not involve drugs or
surgery and is easily assimilated into common chiropractic protocol.
Studies have demonstrated the effectiveness of therapeutic taping for pain. A 2005 case study followed
three patients who complained of patellofemoral pain and documented positive outcomes for all three.
Patient #1, a 91-year-old woman, had improvements of "no pain with gait; no night pain, knee pain was
immediately resolved following the application." For patient #2, age 56, treatment resulted in "no pain with
normal walking, no pain with ascend or descend stairs." This patient also reported less pain at the end of
her day. After treatment, 12-year-old patient #3 experienced no pain with running or during athletic
activities such as running and snowboarding.
In a United Kingdom study yet to be released, South African MDs compared the use of ibuprofen versus
elastic therapeutic taping for pain. Their results found the taping to be as effective as ibuprofen.
My own education is not only in spinal manipulation, but also includes training and experience with
acupuncture, topical herbs, applied kinesiology and electrostimulation, among other modalities. Taking these
into consideration, it is clear that the concept behind them all correlates with the way tissues need to be
addressed.
Since being a chiropractic student, I have also been interested in the osteopathic fluid system and how this
affects the body. Between the epidermis and the dermis lies the fluid lymphatic layer which has a close
relationship with the capillary beds and often becomes congested. One can affect this layer by utilizing the
hydrokinetic system: by creating more space and increasing the amount of fluid in that area. A secondary
effect is an increase in circulation of the fluid. Third, there is a pumping effect propelled by the movements
of the body. The movement of the cerebrospinal fluid (CSF) circulation has a pumping muscle at the base of
its motion. Hence, a wasted, weak muscle can form a blockage to the movement of the fluid system in the
body.
A Colorado case study2 published in 2007 looked at conservative treatment of a collegiate athlete.
Researchers reported, "The application of the [elastic therapeutic tape] seemed to enhance proprioceptive
function to reduce irritation during activities. The athlete reported being more aware of the stress she
applied while playing. Another desired effect was to improve lymph flow from the injured area. The patient
noted improvement in pain and functional performance levels during and after wearing the tape."
In a 2010 case study3 from Poland, researchers observed that "Complex Decongestive Therapy (CDT)
often needs modifying in advanced cancer patients. One of the options is using [taping] instead of multi-
layer bandaging. It can be particularly helpful in patients who cannot undergo compression treatment due to
pain." The article presents the case of an advanced cancer patient whose painful skin tension, caused by
lymphedema, was successfully reduced with the use of therapeutic taping.
Stimulation of the muscle spindles balances the contraction of the muscle and also increases the movement
of the muscle, which enhances circulatory flow and helps in changing metabolism. Therapeutic taping has the
ability to move fluid to the correct area. In the case of joint subluxations or restrictions, chiropractors
consider soft tissue and the movement of fluid; as such, in any profession, but especially in the chiropractic
profession, this unique ability of therapeutic taping to influence the movement of fluid must be considered.
Thirty-five years ago, I introduced this idea to the chiropractic community in Japan, and its use there
became widespread. Other medical groups, as well as athletes and patients, began utilizing the taping
treatment. Elastic therapeutic taping has been widely accepted, and seen in many Olympic and professional
sports and consequently, those interested in healing are using the tape on their own. Still, there is a limit to
the amount of healing that can be done by a patient without the guidance of a knowledgeable practitioner.
As a result, each practice should consider using therapeutic taping to manage patient healing, especially
considering that it can be used in place of drugs. In this manner, therapeutic taping can be a perfect
connection between the doctor's manipulation and the patient healing process.
Taping also provides a marked non-therapeutic benefit, as patients using the tape become walking
billboards for the practice. I don't know how many times patients have asked for it, either because they've
seen it on some famous athlete or – more commonly – because a relative or acquaintance has used it and
recommended not only the tape, but also the DC who first applied it.
References
Brandon R, Paradiso L. The use of Kinesio tape in patients diagnosed with patellofemoral pain (PFP).
2005. Case study of three patients.
Aspegren D, et al. Conservative treatment of a female collegiate volleyball player with costochondritis.
Journal of Manipulative and Physiological Therapeutics, 2007;30(4):321-325.
Pyszora A, Krajnik M. Is Kinesio taping useful for advanced cancer lymphoedema treatment? A case
report. Advances in Palliative Medicine, 2010;9(4):141-144.
MD Anderson Radiation Oncologist Brings New Option, Experience to Katy – WebWire –
APBI Joins Growing Range of Breast Services
The University of Texas MD Anderson Cancer Center’s Regional Care Center in Katy now offers some
women newly diagnosed with early-stage breast cancer a newer treatment option.
Adding to a growing complement of breast cancer services, the MD Anderson Regional Care Center in
Katy now offers accelerated partial breast irradiation (APBI), or brachytherapy, a radiation therapy
technique delivered after lumpectomy. The use of APBI steadily has been growing, and for the appropriate
patient, is a suitable treatment option.
For some women, accelerated partial breast irradiation may be an alternative to the current standard which
is four to six weeks of daily external beam radiation after breast-sparing surgery. With the newer technique,
the number of radiation treatments is reduced to only five days of twice-daily treatments after surgery.
Bringing the technique to MD Anderson’s Regional Care Center in Katy is radiation oncologist Elizabeth
Bloom, M.D., associate professor in Radiation Oncology. Bloom recently moved to the center, but has
been with MD Anderson since 1999 and was one of the first to bring APBI to Houston. She has treated
about 150 patients with APBI since 2008 when she first introduced it at MD Anderson’s Radiation
Treatment Center in Bellaire.
According to Bloom, APBI, given after lumpectomy, directly treats the area in the breast at highest risk for
recurrence while minimizing the dose to the remaining healthy breast tissue.
With APBI, the breast surgeon inserts a small device into the lumpectomy cavity and expands it to fill the
small, hollowed-out area of the breast where the tumor once was. The devices, composed of several small
catheters (tubes), are designed specifically for APBI and come in a wide variety of sizes and shapes to
accommodate the needs of each patient.
The device is left in place for approximately eight to 10 days for treatment planning and delivery.
When treatment begins, a radioactive seed is inserted through the individual catheters of the implanted
device and left in place for about five to 10 minutes - the length of one radiation treatment - and then
removed when the patient leaves the Katy center. The procedure is repeated twice daily for a total of five
days.
The ideal candidate for APBI typically is a woman who is more than 50 years old and has a relatively small
tumor that is confined to the breast, she said.
"Communication between the patient and her MD Anderson care team and communication within her MD
Anderson team is even more vital when it comes to APBI" said Bloom. "Every day we work in synch to
leverage our specialties in radiation, surgery, medical oncology, radiation physics, pathology and radiology,
but our collaboration is especially evident with APBI"
She said the team at MD Anderson is ideal because of its breadth and depth of experience with the
technique and the focus on breast cancer diagnosis, treatment, support and recovery.
Susan Hoover, M.D., associate professor of Surgical Oncology and a breast surgeon who cares for
patients at MD Anderson Regional Care Center in Katy, agrees that collaboration is key with APBI.
"When it’s clear that a patient would do well with APBI and is interested in pursuing the treatment, the
communication starts immediately" said Hoover, who trained in breast surgery as a fellow of The University
of Texas Southwestern Breast Oncology Fellowship Program funded through Susan G. Komen For the
Cure. "While this technique may not be for everyone, we want to make it as accessible as possible to as
many patients as we can. It is an effective option for a select group of patients"
In addition to APBI and other radiation techniques, MD Anderson’s Regional Care Center in Katy offers a
growing range of breast cancer services, including care for benign breast disease and suspicious lumps. The
Katy center’s breast team includes medical oncologists, oncology nurses experienced in breast care,
radiation oncologists, breast surgeons, social workers, pain management specialists, rehabilitation therapists
experienced in lymphedema, nutritionists and genetic counselors.
MD Anderson’s Regional Care Center in Katy is located on the campus of CHRISTUS St. Catherine
Hospital. MD Anderson also has regional care centers in The Woodlands, Sugar Land and the Bay Area
(Nassau Bay).
Breast cancer survivors race for rehabilitation - Focus Taiwan News Channel – by Nancy Liu -
For many breast cancer survivors, the rehabilitation process can be daunting, but it is not so for a group of
women who have found a way of integrating sports into their daily lives.
Liaw Pey-jiun, a seven-year breast cancer survivor, said that rehabilitation has not been a problem for her
because she exercises regularly and participates in various sports events, the most recent being the dragon
boat races.
Liaw, 56, is a retired nurse and the newly elected captain of the nation's first Breast Cancer Survivors
Dragon Boat team, which was formed last year to encourage patients to take part in public sporting
activities.
The initiative was so successful that 60 people signed up, which meant they had to be split into two teams.
"It has helped me profoundly, " Liaw said. "Now I want to introduce more breast cancer survivors to the
sport."
"Not only do I feel healthier, I also think that (literally) being in the same boat helps to forge a valuable bond
between the team members," she said.
At Bi Tan and Da-Jia Riverbank Park where teams often train for the dragon boat races, the women, some
in their 70s, practice at their own pace and keep up a steady stream of chatter.
Liaw said they talk about everything, from family life to fighting depression, which often besets breast
cancer survivors.
"We don't want to bother our loved ones all the time, and this activity offers the perfect opportunity to share
our problems, " she said.
In medical circles, there has been more of a focus in recent times on the rehabilitation aspect of breast
cancer treatment, according to one professional.
"In the past, doctors paid more attention to surgical or chemical treatment than to rehabilitation," said Chen
Huo-mu, director of the Department of Breast Surgery at Taipei City Hospital.
"But the high survival rate over the years has led us to think about how breast cancer patients can live longer
and lead happier lives," said Chen, who strongly supporters the boat racing activity as a form of
rehabilitation.
There are more than 8,000 new breast cancer survivors each year and more than 70 percent surpass the
10-year survival estimate, he said.
Dragon boat racing, which originated in China as a ritual, was highly recommended by a Canadian
professor Donald McKenzie in 1996 as an activity that could help decrease lymphedema among breast
cancer patients.
"There are more than 100 racing teams composed of breast cancer patients around the world now, so there
is no reason why we should not support the activity," Chen said.
Asked about the physiological benefits, he said that various types of research have proven that rowing
strengthens the upper body muscles and helps reduce tissue swelling, or lymphedema, which usually results
from the removal of lymph nodes.
"Any form of exercise is helpful as long as the muscles are being worked on a regular basis, " said Lin Wei-
chieh, secretary-general of the Taiwan Breast Cancer Alliance (TBCA) and an organizer of water dance
lessons.
"It is best if the instructor becomes familiar with the specific needs of breast cancer survivors and integrates
therapeutic massage into the movements," she suggested.
For Liaw, however, the psychological benefits gained from boat racing far outweigh the physical advantages.
"The scariest thing is to fight breast cancer alone, but I feel a sense of identity and belonging when I'm
working with my teammates, " she said.
June 4, 2011
Breast cancer surgery patients benefit from adding radiation therapy – EurekAlert – Veronica McGuire –
Breast cancer surgery patients benefit from adding radiation therapy
(Hamilton, ON) June 4, 2011 - Additional radiation treatment improves disease free survival lessening the
chance of cancer recurring in women with early breast cancer who have had breast conserving surgery
(lumpectomy), interim results of a new study found. The results will be presented Monday, June 6 at the
annual meeting of the American Society of Clinical Oncology.
"These results are potentially practice-changing," said Dr. Timothy J. Whelan, professor of oncology at
McMaster University's Michael G. DeGroote School of Medicine and lead study investigator for the NCIC
Clinical Trials Group, which is funded by the Canadian Cancer Society.
In the study of more than 1,800 women with breast conserving surgery, participants received whole breast
radiation (WBI) alone or WBI plus radiation to the surrounding lymph nodes called regional lymph node
irradiation (RNI). Most of the women had one to three positive lymph nodes while 10 per cent had high-
risk, node-negative breast cancer. All had been treated with breast-conserving surgery and adjuvant
chemotherapy or endocrine therapy.
After a five-year follow-up, interim analysis of the data showed a greater than 30 per cent improvement in
disease-free survival for those receiving RNI. This resulted from a 41 per cent lower rate of recurrences in
the breast and lymph nodes and a 36 per cent lower rate of cancer recurrence in other parts of the body.
There was a low, but statistically significant, increased risk of moderate pneumonitis (lung inflammation) and
lymphedema (excess lymphatic fluid) in the arm on the radiated side.
Whelan, division head of radiation oncology at McMaster and the Juravinski Cancer Centre and a Canada
Research Chair, expects the results will encourage physicians to offer all women with node-positive disease
the option of receiving regional nodal irradiation.
"Adding regional nodal irradiation improved disease-free survival, lowered the risk of recurrences, and
there was a positive trend toward improved overall survival, while not greatly increasing toxicities," he said.
"For women with node positive breast cancer who are at high risk of recurrence of their breast cancer,
these findings provide an important new treatment option," says Dr. Christine Williams, Director of
Research, Canadian Cancer Society. "Ultimately, this finding will help more women survive and thrive after
treatment."
Treatment for women with node-positive breast cancer has been breast-conserving surgery plus axillary
lymph node dissection, followed by radiation to the breast (WBI). If a woman's cancer is considered high-
risk, such as a tumour larger than 5 cm or more than three positive axillary nodes, she often receives RNI.
However, until now, the benefit of adding RNI for women with one to three positive nodes has been
unclear.
###
The NCIC CTG receives programmatic funding from the Canadian Cancer Society Research Institute. The
MA.20 trial was supported by the US National Cancer Institute / Cancer Therapy Evaluation Program and
with funds provided by the Canadian Breast Cancer Research Alliance.
More radiation better for breast cancer patients - healthzone.ca – Joseph Hall –
Targeting lymph nodes with radiation after tumour removal surgery dramatically reduces the risk that breast
cancer will spread to distant parts of the body, a Canadian-led study shows.
In research that will likely change standard treatment for the ailment, women with tumours that had spread
to the lymph nodes reduced their risk the cancer would metastasize even further by 36 per cent with the
extra radiation.
The risk the cancer would return in the breast area also plunged by 41 per cent.
“The big finding was that it prevented cancer from spreading,” says Dr. Timothy Whelan, an oncologist at
Hamilton’s McMaster University.
The danger that cancer would spread to the spine, lungs or other organs was reduced from about 13 to just
over seven per cent, says Whelan, the lead study author.
“That’s a pretty significant finding for women . . . and that’s a bit surprising,” he says.
Whelan presented the paper Saturday at a meeting of the American Society of Clinical Oncology in
Chicago.
He says current treatments typically limit radiation to the breast, all of which is irradiated following tumour-
removing lumpectomies. But because radiation can cause some side effects, such as arm-swelling
lymphedema, physicians have not gone after the nearby lymph system, which often acts as a way station for
cancer spread.
“We (also) didn’t think there would be that much added benefit,” Whelan says.
The study looked at more than 1,800 Canadian, U.S. and Australian women, 90 per cent of whom had
seen their cancer spread to one or more lymph nodes. The other 10 per cent had primary tumours that
were deemed aggressive.
More than 90 per cent of the patients had been given chemotherapy and about three-quarters of them had
received hormone treatments to combat their cancer.
But for the study, about half the patients had standard breast radiation while the other 50 per cent received
additional lymph-node treatments in the lower neck and chest areas. After five years, the lymph-node
cohort faired significantly better than the group which had radiation confined to the breast.
Whelan says the results will have to persist beyond that time frame before physicians can be absolutely
certain additional lymph radiation works best.
But the preliminary results are so striking, he says, that many cancer specialists will likely take it up
immediately with their patients.
Christine Williams, director of research with the Canadian Cancer Society thinks such a move is more than
warranted given the study’s results.
“The results are so strong that I think we certainly expect it to change clinical practice,” Williams says,
adding that it would only mean a modest change in the radiation techniques already being done in clinics.
Williams cautions, however, that the patients will have to be followed further to ensure the results hold true
over time.
Study: Pfizer drug lowers risk of breast cancer – Forbes – By MARILYNN MARCHIONE –
CHICAGO -- Millions of women at higher-than-usual risk of breast cancer have a new option for
preventing the disease. Pfizer Inc.'s Aromasin cut the risk of developing breast cancer by more than half,
without the side effects that have curbed enthusiasm for other prevention drugs, a major study found.
It was the first test in healthy women of newer hormone-blocking pills called aromatase inhibitors, sold as
Arimidex, Femara and Aromasin, and in generic form. They're used now to prevent recurrences in breast
cancer patients who are past menopause, and doctors have long suspected they may help prevent initial
cases, too.
Prevention drugs aren't advised for women at average risk of breast cancer. Those at higher risk because of
gene mutations or other reasons already have two choices for prevention - tamoxifen and raloxifene. But
these drugs are unpopular because they carry small risks of uterine cancer, blood clots and other problems.
"Here's a third breast cancer prevention drug that may in fact be safer," said Dr. Allen Lichter, chief
executive of the American Society of Clinical Oncology.
The study was discussed Saturday at the society's annual meeting in Chicago, along with another one that
could change care for thousands of women each year with breast cancer that has spread to lymph nodes. It
found that giving radiation to the armpit - not just the breast - after surgery significantly lowered the chances
the cancer would come back.
The prevention study involved 4,560 women from the U.S., Canada, Spain and France. They had at least
one risk factor - being 60 or older, a prior breast abnormality or pre-invasive cancer, or a high score on a
scale that takes into account family history and other things.
They were given daily doses of exemestane, sold as Aromasin, or dummy pills. After about three years,
there were 11 cases of invasive breast cancer among those on the drug versus 32 among the others. That
worked out to a 65 percent reduction in risk for those on the drug - enough of a benefit that independent
monitors decided all participants should be offered it.
Serious side effects, such as broken bones, high cholesterol and heart problems, were similar in both
groups. Slightly more women on the drug reported hot flashes, fatigue, sweating, insomnia and joint pain,
but quality-of-life scores were similar.
Earlier studies of aromatase inhibitors found they can cause bone loss, vaginal dryness, problems having
sex, joint pain and muscle aches, so it will take longer study to see if these occur, Lichter said.
The study's leader, Dr. Paul Goss of Massachusetts General Hospital, figured that 26 women would need
to take exemestane for five years to prevent a single case of breast cancer. Even though this study did not
compare the drug to tamoxifen, previous studies suggest 96 women would need to take it for five years for
each breast cancer prevented.
"This is a new option for prevention of invasive breast cancer for a wide pool of women," without the
serious side effects of tamoxifen or raloxifene, Goss said.
Results were published online by the New England Journal of Medicine. The Canadian Cancer Society,
Pfizer ( PFE - news - people ) and the Avon Foundation helped pay for the study. Goss and some other
researchers have been paid speakers for Pfizer and other cancer drug makers.
Brand-name aromatase inhibitors cost from $340 to $420 a month, although some are available as
generics. Aromasin's U.S. patent expired in April and will expire in Europe and Japan in July.
A second study at the conference focused on treating breast cancer that has spread to the lymph nodes.
Standard treatment is surgery followed by chemotherapy or hormone therapy and several weeks of
radiation to the breast. Women with large tumors or many cancerous nodes also get radiation to the armpit
and lower neck, but doctors don't know if this helps women with smaller tumors or only one to three
cancerous nodes - a common situation.
Dr. Timothy Whelan of McMaster University in Hamilton, Ontario, Canada, led a study of 1,832 such
women. All were given standard treatment with radiation to the breast, and half also had radiation to the
armpit and lower neck area.
After about five years, 90 percent of those given wider radiation were cancer-free versus 84 percent of the
others, and there was a trend toward better survival with more radiation.
Lung inflammation and lymphedema - painful arm swelling caused by poor drainage - were more common
with wider radiation, but doctors said these side effects were worth the benefit of fewer cancer recurrences.
The results are "potentially practice-changing" and will encourage doctors to offer wider radiation, Whelan
said.
Worldwide, about 1.3 million women are diagnosed with breast cancer each year and nearly 500,000
women die of the disease. Last year in the United States, there were about 207,000 new cases and 40,000
deaths from breast cancer.
Online:
Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast,
rewritten or redistributed.
June 5, 2011
An explanation of lymphedema - Bismarck Tribune – By JEN NEWMAN –
What is lymphedema?
When the lymphatic system has been damaged or is impaired, a clear, light yellow protein-rich fluid can
build up and cause swelling, thickening of the tissues, and skin changes. This condition, referred to as
lymphedema, can occur in the arms, legs, trunk, face, and/or genitals.
Who is at risk for developing lymphedema?
It's possible for a malformation of the lymphatic system to occur at birth or later in life; this is called primary
lymphedema. Secondary lymphedema refers to individuals who are at risk if they have had surgery, trauma,
infection, scarring, or radiation therapy of the lymphatic system (including lymph nodes). Any of these
conditions can cause a disruption to the lymphatic system that can result in an abnormal flow of lymphatic
fluid leading to lymphedema.
How is lymphedema treated?
Complete decongestive physiotherapy is an effective treatment. Certified lymphedema therapists
incorporate four CDP components, including manual lymph drainage, compression bandaging and/or
garments, lymphatic exercises, and skin and nail care. These therapists also provide education on managing
lymphedema at home.
Is it necessary to treat lymphedema?
The lymphatic system plays a very important role in immunity and circulation.
If lymphedema is left untreated, the involved part of the body may become more swollen and the tissues
increasingly hard. Skin changes may occur, as well as additional complications such as infections or
cellulitis. It is never too late to treat lymphedema; however, early intervention is best.
How can I reduce my chances for developing lymphedema?
If you are at risk, take precautions to avoid any type of trauma or injury to the at risk area to prevent onset
of an infection. Perform exercises or activities in moderation. Avoid applying heat or constricting the
involved area. To learn more, visit medcenterone.com/lymphedema.
(Jen Newman is an occupational therapist and certified lymphedema therapist at the Medcenter One
Rehabilitation Center. Newman is a graduate of Colorado State University with a master's degree in
occupational therapy. She is certified as a lymphedema therapist by the Norton School of Lymphatic
Therapy and the Lymphology Association of North America.)
Practice-Changing Radiation Study in Early Breast Cancer? – Medscape –
Tina – you have to be a member of something to access this article, sorry
June 6, 2011
ASCO: Nodal RT May Lessen Risk of Breast Ca Mets - MedPage Today – By Ed Susman –
CHICAGO -- Radiation therapy to regional lymph nodes appears to lessen the risk of metastases in
women undergoing treatment for high-risk breast cancer, researchers reported here.
However, the primary endpoint of the multinational study did not achieve statistical significance, said
Timothy Whelan, MD, from Juravinski Cancer Center, Hamilton, Ontario. The relative risk of death was
24% lower if women were treated with whole-breast irradiation and regional lymph node radiation rather
than whole-breast irradiation alone (P=0.07).
In a press briefing at the annual meeting of the American Society of Clinical Oncology, Whelan also said
that in the trial:
Locoregional recurrence was reduced by 42% among women who were treated for early breast cancer
with whole-breast irradiation including the regional lymph nodes compared with whole-breast irradiation
alone (P=0.02).
Distant recurrence was reduced 36% if regional nodal radiation was given (P=0.002).
At five years, disease-free survival was increased by 33% if regional nodal radiation was done (P=0.003).
Women who received extra-nodal radiation, however, did experience more radiation pneumonitis and
lymphedema.
"This study suggests that all women with node-positive disease [should] be offered regional nodal
irradiation, provided they are made aware of the associated toxicities," Whelan said.
The researchers enrolled 1,832 women, between March 2000 to March 2007, who had high-risk, node-
negative or node-positive breast cancer. The patients had undergone breast-conserving therapy and
adjuvant chemotherapy and/or endocrine therapy.
Whelan and colleagues stratified the patients by positive nodes, axillary nodes removed, chemotherapy, and
endocrine therapy. They were then randomized to whole-breast irradiation at the following doses:
50 Gy in 25 fractions with or without 10 Gy boost
50 Gy in 25 fractions with or without 10 Gy boost plus regional nodal radiation of 45 Gy in 25 fractions
Regional nodal radiation was delivered to the internal mammary, supraclavicular, and high axillary lymph
nodes.
In the trial, the researchers assigned 916 women to receive whole-breast irradiation and regional nodal
radiation. A second group of 916 women was treated with whole-breast irradiation alone.
Of those women who only received whole-breast irradiation, 5.5% experienced locoregional recurrence
compared with 3.2% of those who had whole-breast irradiation and regional nodal radiation.
About 13% of the women who were treated with whole-breast irradiation alone experienced distant
metastases compared with 7.6% of those who received the combination therapy.
The researchers are currently following these patients so additional analysis might show a survival benefit, he
said.
The combination treatment was associated with a 50% rate of dermatitis compared with 40% for whole-
breast irradiation only (P<0.001).
The women who received radiation to the nodes had a 1.3% rate of pneumonitis compared with 0.2% of
those who only received whole-breast irradiation (P=0.01). There was a 7% rate of lymphedema in the
combination group versus 4% who just received whole-breast irradiation (P=0.004).
Commenting on the study, Jose Baselga, MD, from Massachusetts General Hospital/Harvard Medical
School in Boston, noted, that "local recurrence is one of the most devastating things that can happen to a
women with beast cancer, so we would encourage any mode of treatment that can lessen that possibility."
"The extra radiation to the lymph nodes does increase the risk of lymphedema, so there are adverse events
involved in [this] therapy," he told MedPage Today.
Baselga added that defining which patients are truly at a high risk of recurrence needs clarification. If a
woman had three or more involved lymph nodes, he would consider her at high risk and would offer
extensive radiation along with other therapies, such as chemotherapy.
"Node positive breast cancer is curable, and we need to do everything we can to prevent metastases," he
said, adding that once metastasis occurs, the possibility of cure is remote.
June 7, 2011
Humiliated patient hits out at Monash Medical Centre for treatment - Oakleigh Monash Leader –
A SEVERELY obese Ashwood resident, who claims she was left lying in her own waste for eight hours at
Monash Medical Centre, says she feels humiliated and depressed.
Amanda Bell has lymphedema, which causes her body to retain fluid. She said her 45-day stay in the
Clayton hospital for blood poisoning was marred by “horrible” comments about her weight.
The 51-year-old said she was told by a nurse that she “stunk” and it was about time she got her “lazy fat
a—- up and had a shower”.
“I said it’s not my fault. I’d been in bed for 21 days and I hadn’t had my hair washed, they were supposed
to be looking after my hygiene,” Ms Bell said. “I just don’t think it’s right that I was spoken to like that.”
Ms Bell weighs 220kg and said she felt she was on a “knife’s edge” and was “completely screwed up”
from her experience.
“Why at 51 should I be spoken to like a piece of dirt?” she said.
“There are all different reasons why people are the size they are and I think people need to take that into
account.
“I kept being told to not take things so personally, but to my way of thinking it did matter - it mattered a lot.”
Southern Health spokeswoman Suzana Talevski said the hospital was “sorry to hear that the care provided
did not meet the patient’s expectations”.
“We have looked into this case and our review has shown that the care provided to the patient was
appropriate,” she said.
“As the patient’s needs were complex a specific treatment plan was developed by our multi-disciplinary
team of clinicians and discussed with the patient at all times.
“This resulted in the requirement to source specialised equipment externally.”
June 8, 2011
Compression Therapy Equipment Company Launches New Website - Online PR News (press release) –
Online PR News – 08-June-2011 –Vascular PRN's new website provides health care professionals in all
50 states quick access to renting pneumatic compression therapy devices, including lymphedema pumps
and sequential compression devices – also known as SCD boots – for their patients. The website also
shares information about the benefits of compression therapy for patients and their caregivers.
“Every day we help health care professionals get the compression therapy equipment they need for their
patients in preventative situations or critical care,” said Vascular PRN’s President Greg Grambor. “The new
website provides access to quality compression therapy information and our excellent customer service.”
The redesign of the company’s website allows visitors to learn more about how compression therapy
equipment can prevent deep vein thrombosis and treat lymphedema, venous stasis ulcers, intermittent
claudication and accommodate bariatric patients. Frequently asked questions are answered so that
directors of nursing, nursing home administrators, and patients can find out more about compression
therapy. An innovative blog features timely news and features, and another section focuses on director of
nursing and health care jobs.
“We partner with the best compression therapy equipment brands that have a solid reputation for quality
and are built to withstand even the most rigorous medical demands,” Grambor said. “The new site shows
you product images and sizing guides to help professionals choose the right compression booties for their
patient.”
Vascular PRN has decades of experience meeting the health care industry’s urgent compression therapy
needs. Their knowledgeable specialists have helped hospitals, nursing homes, surgery centers, managed
care organizations, and other institutions.
To learn more, visit www.vascularprn.com or call 800-886-4331.
Cancer group sets three activities - South Bend Tribune –
SOUTH BEND — RiverBend Cancer Services has scheduled free events at RiverBend Wellness Center,
919 E. Jefferson Blvd.
“Lymphedema: Isn’t That Swell?” will be at 10 a.m. Tuesday. Participants will learn causes, treatments and
when to seek medical help.
Wellness Wednesday chair massage will be June 15. A free 10-minute chair message will be offered.
Appointments begin at 1 p.m. and reservations are required. Call 574-287-4197 to schedule an
appointment.
June 9, 2011
New Video Continuing Education Course: Compression Therapy for Lymphedema - Online PR News –
HomeCEUConnection.com is excited to announce the release of Compression Therapy for Lymphedema,
a new Seminars-On-Demand course by Carmen Thompson, BS, LPTA, CMT, CLT for Physical
Therapists, Occupational Therapists, and Massage Therapists
Online PR News – 09-June-2011 –Compression Therapy for Lymphedema is a three-contact-hour course
available to physical therapists, occupational therapists, and massage therapists. Compression Therapy for
Lymphedema focuses on the basic uses of compression therapy, primarily in relation to lymphedema. The
case studies presented in this Seminar-On-Demand use clinical reasoning based on the highest level of
evidence available.
The use of demonstrative video, slides, graphs and other visual aids, in combination with Thompson’s
lecture, creates a virtual classroom setting. As a fully-interactive, physical therapy, occupational therapy,
and massage therapy, Continuing Education program, the user has complete control of the course and is
able to navigate between various segments. As with all HomeCEUConnection.com online continuing
education courses for physical therapists, occupational therapists, massage therapists and athletic trainers,
Compression Therapy for Lymphedema offers users the opportunity to interact with the author.
About the Continuing Education Course Author: Carmen Thompson
Thompson earned a Bachelor of Science in Health Care Management, an Associate of Science in Physical
Therapy and is a practicing Licensed Physical Therapist Assistant and Certified Massage Therapist, with a
specialty certification in lymphatic therapy. Having completed a 140-hour certification course in Manual
Lymphatic Drainage and Complex Decongestive Physiotherapy through the Upledger Institute, she now
teaches lymphatic pathology treatment methods and MLD/CDP therapy nationwide. Additionally she
educates professionals at the local and state level on the prevention and management of lymphedema in
cancer patients and on developing lymphedema programs in acute care and subacute care.
Compression Therapy for Lymphedema is now available for immediate purchase in an online format (PDF
Download) or mail format (USB Flash Drive).
All available Seminars-On-Demand online continuing education courses have been approved by the
American Occupational Therapy Association (AOTA) by means of HomeCEUConnection.com’s
approved provider status. For physical therapists, Seminars-On-Demand online physical therapy continuing
education courses are approved by states. For approval information, please visit https://www.
homeceuconnection.com and take advantage of the online continuing education state and profession specific
course catalog. For additional information regarding Seminars-On-Demand, please visit
HomeCEUConnection.com’s website or call 1-800-554-2387.
About HomeCEUConnection.com
Specializing in quality online continuing education courses, HomeCEUConnection.com offers CEUs for
physical therapists, occupational therapists, speech language pathologists, massage therapists, athletic
trainers and certified strength and conditioning specialists that are convenient, affordable and user-friendly.
Kudos & Applause Celebrating those who make a difference - Ottawa Citizen –
Breast Cancer Action is a resource and support centre for breast cancer patients and survivors. We are the
here and now for women providing FREE programs such as pre-operative & lymphedema workshops,
peer counseling, dragon boat teams and fitness programs. As we receive no government support, all our
funding comes from membership, donations, grants and events.
All monies raised stay in the Ottawa region and are used directly to fund our programs. For more
information regarding what we do, check out our website at www.bcaott.ca.
OTTAWA GUILD OF POTTERS www.ottawaguildofpotters.ca 613 230-2446.
Celebrating its 36th year of developing and promoting ceramic arts and artists in the Ottawa region, the non-
profit Ottawa Guild of Potters sets a high standard of artistic expression and craftsmanship for members'
work. Its local potters and new students to clay are supported and encouraged to further their knowledge
of ceramics via talks and workshops. An extensive library of ceramic information is maintained and made
accessible to all members. The Guild also enables members to organize and showcase their clay creations in
semi-annual sales and an exhibition. Increasing the communities' awareness of the challenges of creating
with clay via demonstrations and info sessions is another big goal. For our youth, The Guild awards
bursaries to high school students working with clay.
Over those 36 years, the Guild's potters continue to give back generously to Ottawa. Several local
organizations or charities have directly benefited as the chosen recipient of proceeds from the Spring and
Fall sales of donated pieces. For the past six years, the Ottawa Guild of Potters has been incredibly
successful at organizing the major fundraiser, Great Bowls of Fire, to support the Ottawa Food Bank to the
tune of over $70,000. Potters donate handmade bowls as well as their time to run this popular event. With
an original "take home" bowl of their choice, ticket purchasers can sample delicious soups and breads
donated by area restaurants and bakeries. It's a winning combo for all involved.
ALLISON RANDALL Friends of the Farm 613-230-3276 www.friendsofthefarm.ca
Allison Randall is the quintessential volunteer. In 23 years as a Friends' of the Farm volunteer, she has
compiled an impressive record. She has gardened, baked, served tea, made and sold crafts, led tours,
tended cash, and even stuffed envelopes in support of the Friends of the Farm.
Allison is one of the Friends' original volunteers. In 1988, having recently moved from Bermuda to Ottawa,
she "terribly missed" her volunteer work at Bermuda's Botanical Gardens. A neighbour suggested the name
of contact who was organizing a new group called the Friends of the Farm.
Allison's volunteer experience in Bermuda was quickly put to work. She was asked to "do a review of the
Farm to make it more people friendly." The result? More signage placed strategically around the Farm to
enhance the public's enjoyment and appreciation of the historical site. Allison also fondly recalls the group of
ladies who met regularly in the basement of Building 72 to make dried flower pictures, which were then sold
in the Agriculture Museum shop.
After 23 years, Allison is still an active volunteer - helping out wherever she can. The passage of time May
have reduced her energy level, but it certainly hasn't dampened her enthusiasm for the Friends of the Farm.
For information on the Friends of the Farm: 613-230-3276; www.friendsofthefarm.ca
Winthrop Breast Health Center Offering Free Program - Garden City News –
Winthrop-University Hospital’s Breast Health Center is offering a free program,“Managing Post-Treatment
Side Effects for Breast Cancer Patients” on Thursday, June 23, 2011, from 6:00 to 7:30 PM. The event
will be held at Winthrop’s Community Outreach Center, located at 101 Mineola Boulevard at the corner of
Second Street in Mineola, and will highlight preventing and managing treatment-related pain, lymphedema
and stress.
Speakers include Donna Cox, MSN, ONC, CCRC, RN-BC, from the Pain Management Center at
Winthrop, and Bonnie B. Lasinski, MA, PT, CLT-LANA from Lymphedema Therapy, an organization
specializing in treating the condition. Linda Hacker, RYT, from the Svadharma Yoga Project, will give
attendees the opportunity to decompress during a 30-minute yoga session. The program will also include a
question and answer period.
“This program was developed in response to our patients’ expressed need for assistance with these
problems,” said Alisha Ellis, LMSW, MA, Breast Cancer Social Worker. “Whether women are newly
diagnosed or have completed treatment, they have voiced a common need to have these issues addressed.
We are pleased to offer this program in response to their concerns.”
Attendees are asked to arrive at 5:45 PM for registration and to park in the rear of the building. Seating is
limited and pre-registration is required. To register, please contact Alisha Ellis at (516) 663-2556.
Winthrop’s Breast Health Center provides unparalleled, comprehensive breast care guided by a deep sense
of compassion and respect for the dignity of every patient. For information about services at the Center,
please call (516) 663-3887.
June 10, 2011
Tina, the stuff below in itilacs copied from somewhere and not Im not sure, I left it in case it is info you can
use but hopefully it also copied under the article info it belongs to somewhere else, sorry
Photos
Prevention and management
Here are some tips for preventing the development, or worsening, of lymphedema.
• Wear a therapeutic sleeve when flying.
• Avoid prolonged heat, like a Jacuzzi or a sauna.
• If you’re swimming in a pool, use a moisture barrier cream (and waterproof sunscreen) and a good
moisturizing lotion when you’re finished swimming.
• Avoid tight clothing, bra or jewelry.
• Be careful of insect bites; ask physician about best repellent.
• Wash your hands often.
• Exercise.
• Don’t get a shot in your affected arm.
• Don’t have blood pressure taken on at-risk arm.
• Wear gloves when you garden or do outside chores.
• Inform your doctor of any symptoms such as redness, swelling, heaviness, warmth or tenderness in at-risk
arm.
For more information
National Lymphedema Network: www.lymphnet.org (includes listing of support groups internationally).
Swelling in the arm can signal lymphedema - MiamiHerald.com - By Rochelle Koff
Experts want to see a greater emphasis on educating the public about lymphedema, an often painful, chronic
condition that can occur following the removal or damage of lymph nodes.
First there was the breast cancer diagnosis. Then a year and a half after all the testing, surgery and
chemotherapy was over, Sherry Churly learned she had yet another health hurdle to overcome:
lymphedema.
It’s one of the chronic, sometimes “underemphasized” complications of breast cancer surgery that many
patients don’t learn about until they’re already suffering from symptoms that include swelling, pain and in
more serious cases, infection of the arm, said breast cancer surgeon Dr. Robert DerHagopian, medical
director of the Baptist Health Breast Center.
But lymphedema isn’t limited to breast cancer — or women.
The primary form of lymphedema can be manifested at birth (called lymphedema praecox) and appears at
the onset of puberty or later; lymphederma tarda, a rare form, sets in after age 35.
Secondary lymphedema is the most pervasive type.
“Certain surgeries, such as surgery for melanoma or breast, gynecological, head and neck, prostate or
testicular, bladder or colon cancer, all of which currently require removal of lymph nodes, put patients at
risk of developing secondary lymphedema,” according to the National Lymphedema Network.
The risk is higher with the higher number of lymph nodes removed and if the patient received radiation
therapy. The condition can also be caused by damage to the lymph nodes or vessels from burns and other
trauma.
In lymphodema, “there’s a problem with the mechanical transport of lymph fluid that can cause the
lymphatic system, which eliminates toxins and bacteria from the body, to stop functioning normally,” said
Maria Josette Mullins, director of Rehabilitative Services at Memorial Hospital Pembroke. This
accumulation of protein-rich fluid may form — primarily in the arms, hands, feet, legs, face or chest — and
lead to abnormal swelling that doesn’t go away on its own.
In more serious cases, it impacts a patient’s mobility and quality of life.
Lymphedema “is recognized all over the world as a hidden epidemic” impacting 300 million people, said
Dr. John M. MacDonald, of the University of Miami’s Department of Dermatology and secretariat of the
World Alliance for Wound and Lymphedema Care.
The condition can show up right away or years later.
“Sometimes the condition is latent and something can activate it, like a cut, an insect’s bite or the altitude on
a plane,” said Ana María Mendieta, a lymphatic therapist and director of the Midas Touch Institute in
Miami.
At first, “many patients are not aware of what is happening to them,” Mendieta said. “That can go on for a
period of time until the lymphatic system is so filled up with fluid that it is unable to drain on its own.”
Mary Crosswell, a physical therapist certified in lymphedema treatment at South Miami Hospital, said what
often alerts women “is that their bra becomes too tight in the affected shoulder, they feel a heaviness and
they’re swollen around their shoulder and under their armpit.”
Churly, 55, said that when she first started feeling a heaviness in her arm, “I didn’t connect it to the breast
cancer surgery.”
“The inside of my arm got bright red and was very hot,” said Churly, of Miramar, whose arm became
infected. “In the acute stages, it was very painful. I could feel the heat more inside my arm than outside. It
felt like I was burning from the inside out.”
After being treated with antibiotics, Churly saw a lymphedema therapist at Memorial Pembroke for a hands-
on treatment called manual drainage.
“The goal is to retrain the lymphatic system so that it can function as before,” Mullins said.
The amount of therapy needed depends on whether someone has mild, moderate or serious lymphedema.
To an outsider, manual drainage may look like a massage, but “it’s not muscular,” said Renee Romero,
founder of The Lymphedema Institute in Doral. “We work the lymphatic system. It’s a different approach
to the body.”
Therapists use “light, not painful” motions that last about 45 minutes to an hour, she said, in order to “help
the body reroute the fluid.”
Romero said she went to Austria in 1992 to learn the Dr. Vodder Method of Manual Lymph Drainage that’
s now the accepted treatment here.
“At that time there weren’t lymphatic treatment centers in South Florida,” she said. “It’s been slow on the
scene in the United States.”
Once her drainage treatments were done, Churly’s arm was wrapped with tight bandages from her fingers
to shoulders to reduce swelling. Now she wears a maintenance compression sleeve every day, but she
takes it off at night. She’s feeling much better, but she’s concerned about the condition reappearing. “It’s
always on my mind,” she said.
There are ways lymphedema sufferers can avoid getting a flare up. One is exercise.
Kim Bonomo knows first-hand the mental and physical benefits of being fit.
A breast cancer survivor who has lymphedema, she is the captain of Save Our Sisters, “the only dragon
boat racing team in South Florida that’s made up of breast cancer survivors.”
“When I get out of the boat, my arm is actually better,” said Bonomo, 57, of Pinecrest. “The swelling goes
down. Exercise encourages the lymphatic system to cooperate.”
Dr. Carmen Calfa, breast oncologist at the Memorial Breast Cancer Center, said there’s more research
pointing to the importance of exercise, even weight-lifting if it’s done in a supervised program. “Weight
lifting in an unorganized manner can hurt you,” Calfa said. But being trained in gradual weightlifting
exercises, she said, is proving to be effective.
Doctors may be complacent discussing lymphedema, DerHagopian said, because of less aggressive surgery
and techniques, including sentinel node biopsies.
Sentinel node biopsies are a surgical procedure used to determine if cancer has spread. The first node that
the fluid passes through in a group of lymph nodes is called the sentinel lymph node. The premise is that if
the first node is negative, then the other nodes will be negative, and physicians won’t have to remove as
many nodes as they did in the past. The more nodes removed, the more the system is disrupted.
Physicians should still be “reminding” patients years after surgery or radiation about lymphedema because
“you’re never out of the woods, DerHagopian said. “It’s a lifetime risk.”
But it’s one that doesn’t have to be incapacitating.
With the right treatment and vigilance, Crosswell said, “women can go back to leading full lives.”
Peterson Aims to Make Residents Feel at Home - Wheeling Intelligencer – By JOSELYN KING –
Officials say changes at Peterson Rehabilitation Hospital and Geriatric Center are resulting in a new life and
atmosphere there for long-term residents.
"We're de-institutionalizing our long-term care center and changing it to a long-term 'living center,'" said
Diane Miller, director of marketing and business development. "We want to make it more like a home
environment."
The white walls on the second floor where long-term residents live will be painted a warmer color, she
noted.
And a full-service cafe is about to open on the second floor, Miller continued. The hope is that the smell of
food - and maybe even cookies - in their living space will whet residents' appetites.
Presently, food - and the occasional birthday cake - are prepared in the basement at Peterson and brought
to the residents.
"As most people know, seniors don't always want to eat," she said. "We're hoping this will increase their
appetites."
Long-term residents also are getting more of a voice in their care, according to Miller. They are getting to
choose what times of day they like to do certain activities, such as taking a bath.
"Their interests, hobbies and what's important to them also are being taken into account," she said.
Miller noted the practice of involving patients in their care is part of the "Eden Alternative" philosophy
toward long-term living that has been in place at the center since February. Through this philosophy,
Peterson's staff has made a commitment to fight "the three plagues of loneliness, hopelessness and
boredom" that affect residents in nursing homes.
Peterson, a division of Guardian Elder Care, won the corporate "Distinguished Service Award" last year for
the changes implemented there under Barbara Sisarcick, executive director.
Miller pointed out there are actually four levels of care at the center. In addition to long-term living, there is
acute in-patient rehabilitation, post-hospital short-term rehabilitation and nursing, and out-patient therapy.
Both in-patient and out-patient care is available at Peterson's new lymphedema clinic, where staff members
work to help patients battle the swelling that occurs when fluid accumulates in their body tissue.
Typically such swelling occurs after surgeries, according to Betsy Myers, a therapist with the lymphedema
clinic. She said the clinic has had "tremendous outcomes" with reducing the swelling that can lead to cellulitis
and infections.
"As we get better with surgeries, over time lymphedema from surgery is likely going to go away," she said.
"But that doesn't mean lymphedema is going away. We are becoming an overweight society, and being
overweight puts pressure on the lymphatic system and causes swelling."
Lymphedema can be treated through manual lymph drainage, compression bandaging, remedial exercise
and through meticulous skin and nail care, according to Myers.
June 11, 2011
New Medical Achievements in Cuban Hospital - Cuba Headlines –
Cubans are using stem cells in treating knee osteoporosis and lower limb lymphedema - By: Yuliet Gutiérrez
Delgado.
The comprehensive treatment of pregnant women with coagulation disorders and the use of stem cells to
deal with osteoporosis and lymphedema are some of the most recent achievements presented by medical
specialists with the Havana-based Hematology Institute and the Enrique Cabrera Hospital, as part of a
scientific forum of this institution in the context of fiftieth anniversary.
Promising enough is the cellular treatment applied by Dr. Aymara Baganet on knee osteoporosis, a
technique used in degenerative damage that appears in people over 50 years of age, who feel the benefits
just three months after the treatment, with the fading of pain, walking difficulties and uncomfortable sleep.
Angiologist Pedro Goicochea is also successful in the application of stem cells on patients suffering from
lower limb lymphedema, following lymphangitis, a condition causing swollen legs and which do not respond
satisfactorily to traditional treatment.
Dr. Goicochea said that the treatment is simple and not very invasive, while it allows relieving swollen limbs
and forming new lymphatic vessels. He said they expect to expand the treatment to patients suffering from
lymphedema caused by other diseases.
Comprehensive treatment to pregnant women with coagulation deficiency is a proposal by Dr. Dunia
Castillo, head of the Hospital´s Hemosthasia Department. The doctor told JR that over 90 percent of
women with this condition may have a delivery without any hemorrhagic complication if they are given
appropriate obstetric and hematologic attention in coordination with other medical specialties, which allows
adequate treatment for each hematologic disorder.
The scientific meeting also learned of the results of an over-20-year immune-hematological study on
different blood group conflicts that may cause perynatal hemolytic disease, a pathology that if not treated
inflicts serious anemia on the newborns, plus jaundice and irreversible cerebral damage.
Doctor in Medical Sciences Antonio Bencomo, leading the research study, explained that the major
contribution is the identification in the mother of antibodies against the antigens of the blood groups that
cause the disease, as a response to genetic differences in parents.
“This research study guarantees a safe diagnosis of these disorders, and of associated complications, as it
also provides hemo-therapeutic treatment required by the baby,” he said.
770 lb. Lakeland grandmother gets free home - 10 Connects – by Tammie Fields –
Lakeland, Florida - A frustrating struggle for a Lakeland grandmother who was just trying to get medical
help has led to a generous offer. An anonymous donor has volunteered to build her and her family a free
home that will accommodate her special needs.
51 year old Yvonne Gallimore has endured a lot of heartache the past 17 years. Her family members say
she's done so in private until recently.
Gallimore battled a medical condition called lymphedema which is caused by a blockage that allows fluids
to build up in the body causing excessive swelling. It's caused her weight to tip the scale at 770 pounds
which makes it impossible to get around.
Gallimore cries as she explains, "I don't like that. I don't like not being able to do nothing for my
grandchildren and stuff and the only time they see me is lying in the bed."
She was admitted to the hospital after she developed an infection in her leg but because of her size
emergency crews ran into trouble trying to get her out.
In tears her sister Alnieta McKenzie says, "They had to take 8 to 9 hours just to tear the window open to
get her out the house."
Gallimore's Section 8 apartment was badly damaged and as ready as she's been to leave the hospital after
her infection was cleared up she knows she has nowhere for her and her family to go back to. She says,
"When it was time for me to go home - then I had to tell these people I don't have nowhere to go. I'm
destitute."
But word spread about Gallimore's situation through the news media and a generous anonymous donor
stepped in and volunteered to build her a new home that will accommodate her and allow her to be more
independent. She'll no longer have to miss out on family gatherings like her grandson's birthdays.
McKenzie says, "You know she could sing happy birthday - but she couldn't come out there to sing happy
birthday because she couldn't go through the hallway."
Meanwhile Gallimore says words can hardly describe how grateful she feels. "Whoever it was that decided
to give me a house I appreciate it and I thank you so much because it was a true blessing."
There's no word on where the house is going to be built and how long it will take. When Gallimore is
released from the hospital she will stay in temporary housing though.
Meanwhile her family has found her a specialist in Miami that can help her too but they'll have to find her a
way to get there because she needs a specially equipped van to get to appointments.
June 12, 2011
Canada Playing Catch-up on Lymphedema Care for Patients - Wire Service Canada - by akennedy –
Awareness of lymphedema among Canadian health professionals lags far behind those in Europe and
Australia resulting in inadequate management and risk reduction of this chronic disease. “We in Canada,
need to take charge,” says Dr Anna Towers. “So much needs to be done to understand the prevalence of
lymphedema in Canada, to implement best practices and provide standardized comprehensive care
accessible to all patients.”
An international conference in Toronto may just jump start the lymphedema bandwagon. Seventy key
medical and scientific lymphedema experts from around the world are gathering in Toronto June 14 – 18 to
present the latest research and clinical advances at an international lymphedema conference for health
professionals. Approximately 400 delegates are coming from far and wide, representing many different
countries and disciplines.
The conference is a collaboration between the International Lymphoedema Framework, the Canadian
Lymphedema Framework and the Lymphedema Association of Ontario. Anna Towers, Founding Co-
Chair of the Canadian Lymphedema Framework, and Clinical Director of the McGill University
Lymphedema clinic (and one of the few Canadian medical experts on lymphedema) states: "Hosting an
international lymphedema event of this magnitude in Toronto gives hope that Canada will start catching up
to the countries where more research, education and comprehensive treatment plans exist for lymphedema.
We need to elevate this condition in order to place lymphedema and its management as a priority on
regional, provincial and national health care agendas. This event is a tremendous step in educating the health
professionals who see lymphedema patients in their daily practise and need to be better equipped."
Lymphedema is a common post-treatment condition that one in every four breast cancer survivors has to
face. It is also common after gynaecological cancers, prostate cancer and melanoma. However, cancer
treatment is not the only cause of lymphedema and as many as 250 million worldwide suffer with this
chronic and often disabling condition, according to the World Health Organization. Lymphedema is
characterized by chronic swelling in the arms or legs, trunk, head or genital areas.
Christine Moffatt, the Chair of the International Lymphoedema Framework (based in England) and host of
the conference states, “This event symbolizes that passion that many of us feel in striving to improve the care
of patients throughout the world and the desperate need for recognition of this neglected problem.”
A comprehensive conference programme covers best practices, developments in compression, global
issues, children and lymphedema, psychosocial aspects of lymphedema, treatment options around the
world, diagnostics and a special symposium on breast cancer survivors and lymphedema.
A one-day patient conference is being held on Saturday, June 18. Anna Kennedy, Executive Director of the
Lymphedema Association of Ontario and co-host of the event states, “This is a unique opportunity for
Canadians to participate in a lymphedema global event, networking and learning from their international
colleagues, and visiting a comprehensive exhibit hall with products, some of which might not yet be available
in Canada. Being exposed to the advances in other countries will incentivize us even more to advocate for
better treatment of lymphedema here in our own country. Canadian lymphedema patients deserve no less”.
For more information about the 3rd International Lymphoedema Framework Conference, or the work of
the Canadian Lymphedema Framework and the Lymphedema Association of Ontario, please contact Anna
Kennedy, Executive Director (LAO) at 416-410-2250 or anna@lymphontario.ca
June 13, 2011
3M COBAN 2™ COMPRESSION SYSTEM: REDEFINING COMPRESSION BANDAGING FOR
LYMPHEDEMA PATIENTS - Canada NewsWire –
Two-layer compression therapy improves comfort, mobility and quality of life
LONDON, ON, June 13, 2011 /CNW/ - 3M Skin and Wound Care now offers Coban 2™ Compression
System, a breakthrough in intensive therapy compression bandaging for patients suffering with lymphedema
in Canada. Lymphedema is a chronic, debilitating condition characterized by extreme swelling that affects
many thousands of Canadians1.
"Patients suffering with lymphedema experience a wide range of psychological and physical hardships that
can include impaired mobility, pain, anxiety, depression, poor body image, and embarrassment," said Tim
Brown, General Manager of 3M Canada's Healthcare business. "At 3M Canada, we're proud of Coban 2
Compression System because of its ability to significantly improve the intensive therapy experience for
patients of lymphedema, as well as clinicians."
Carry on with everyday life: With only two thin layers of compression bandages, Coban 2 provides
clinically effective volume reduction with an unparalleled comfort and mobility for patients, without the bulk
of traditional reusable bandages.
Fewer and less taxing wrapping sessions: New application techniques and only a twice-weekly application
regimen significantly reduces the total number of wrapping sessions required to reduce edema, meaning less
time in the clinic for patients.
Increased function with sizing variations: Of course a patient's toes and legs vary greatly in size and so
should their bandages. Coban 2 accommodates each body part with sizing variations for the upper
extremities, lower extremities, fingers, and toes.
Coban 2 is a disposable single-use system that is cost-effective and eliminates the time and expense of
washing and re-rolling bandages while minimizing the risk associated with potential contamination. The
materials used in the two thin layers of the system are safe for skin and were developed with unique stretch
and cohesion properties to provide ideal compression and help patients overcome the challenges of wearing
bandages during lymphedema intensive therapy.
For more information, visit www.3m.ca/coban2giraffe.
About 3M Canada
Established in 1951, 3M Canada Company was one of the first international subsidiaries opened by 3M
and remains one of the largest. 3M Canada's head office and original manufacturing site is in London,
Ontario where approximately half of the company's 1,800 employees work. Other locations include
Toronto, Brockville, and Perth, Ontario and Morden, Manitoba. Globally, 3M has operations in more than
65 countries and captures the spark of new ideas and transforms them into thousands of ingenious
products. Our culture of creative collaboration inspires a never-ending stream of powerful technologies that
make life better.
Dragon boat team gets financial lift - www.kamloopsnews.ca –
The Spirit Warriors of Kamloops are among several dragon boat teams sharing $56,000 from the Canadian
Breast Cancer Foundation.
The teams are all made up of breast cancer survivors and will use the money to help offset their 2011
competitive season.
Dragon boating is popular among breast cancer survivors because medical studies show that upper body
exercise can help or prevent lymphedema - the significant swelling some women experience due to
accumulation of fluid in the arm and chest after the removal of lymph nodes during treatment.
The Spirit Warriors spend their summer competing in dragon boat festivals around B.C. Their next event is
the Shuswap Dragon Boat Festival in Salmon Arm on Saturday, June 25.
June 14, 2011
Experts from Montefiore Einstein Center for Cancer Care are Available for Interviews: Breast Cancer
Team – Newswise –
Newswise — New York, NY (June 14, 2011) – At Montefiore Einstein Center for Cancer Care, a multi-
disciplinary team of experts help women with the many aspects of this disease and are available for
interviews on the latest research, clinical trials, surgical techniques, imaging and advances in treatments for
breast cancer.
SURGICAL ONCOLOGY:
Leslie Montgomery, Chief of the Division of Breast Surgery, Director of the Breast Service, Montefiore-
Einstein Center for Cancer Care
As an Attending Surgeon at Memorial Sloan Kettering Cancer Center for over 11 years, Dr. Montgomery
worked extensively investigating the accuracy of sentinel node biopsy for breast cancer patients in a variety
of clinical scenarios. She is currently the institution Principal Investigator for ACOSOG Z-1071 which is
investigating the accuracy of sentinel node after chemotherapy. She has collaborated with the Department of
Radiation Oncology to establish a protocol for partial breast radiotherapy for patients receiving breast
conservation. She is currently focused on work involving disparities in the diagnosis and treatment of breast
cancer in underserved and minority communities.
Lisa S. Wiechmann, MD, Division of Breast Surgery
A main area of concern for women undergoing surgery for the removal of axillary
lymph nodes is post-surgical arm swelling called lymphedema. This condition can limit a woman’s daily
activities and cause disfigurement. Lisa Wiechmann, MD, is enrolling women in a pilot randomized trial of
bioimpedence measurements to determine the best method to detect lymphedema before symptoms occur
and, hopefully, reverse the process. Dr. Wiechmann also runs the MECCC Special Surveillance Breast
Program for women who are at high-risk for the development of breast cancer. Dr. Wiechmann is also the
institution PI for ECOG 2108 which is a clinical trial investigating the role of breast surgery on the overall
survival of patients with stage IV breast cancer.
MEDICAL ONCOLOGY:
Joseph Sparano, MD, Associate Chairman of the Department of Oncology
Joseph Sparano, MD, is a member of a research team that has developed a new gene expression test for
preinvasive breast cancer. Currently, he is the lead investigator in a national clinical trial called TAILORx,
which integrates a gene expression profiling test in clinical decision making in invasive breast cancer
treatment. In addition, Dr. Sparano has been widely quoted in the media in opposition to the FDA’s
revocation of the use of Avastin for breast cancer treatment. He is the Chair of the Eastern Cooperative
Oncology Group Breast Cancer Steering Committee and a member of the NCI Breast Cancer Steering
Committee.
Eleni Andreopoulou, MD, Department of Medical Oncology
Eleni Andreopoulou, MD, is continuing her work from MD Anderson and is studying the response of
tumors pre-operatively to chemotherapy and other treatments. The goal is to tailor therapies to the clinical
pathology and molecular and genetic makeup of locally advanced tumors. She is also the institution PI of a
clinical trial investigating the efficacy of Veliparib in patients with Stage IV breast cancer.
Christine Pellegrino, MD, Department of Medical Oncology
A new Breast Cancer Survivorship Program has been introduced at the Montefiore-Einstein Center for
Cancer Care for women who are out at least two years from diagnosis. Pioneered by Christine Pellegrino,
MD, this program focuses on issues faced by cancer survivors including treatment related to long-term side
effects such as heart, thyroid and neurologic complications. In
addition, psychosocial issues such as body image, sexual issues, and fears of having cancer are addressed.
RADIATION ONCOLOGY:
Jana Fox, MD, Department of Radiation Oncology
Radiation oncologists such as Jana Fox, MD, are proponents of prone breast irradiation as a way of
protecting healthy tissue during radiation therapy. The technique involves a patient laying comfortably on
their stomachs, allowing the breast to be "separated" from the rest of the body. She is also the institution
Principal Investigator of NSABP-B43 which is a clinical trial investigating whether the drug Herceptin can
improve the outcome of patient with ductal carcinoma in-situ following lumpectomy and radiotherapy.
RADIOLOGY:
Tova Koenigsberg, MD, Chief of the Division of Breast Imaging
Dr. Koenigsberg and her division screen tens of thousands of women each year for breast cancer through
their screening mammography program. In addition, dedicated mammographers provide diagnostic
evaluation of patients with a history of breast cancer or patients presenting with a new breast finding. Their
state of the art mammography centers include digital mammography, breast ultrasound, and breast MRI.
PATIENT ADVOCACY/LEGISLATION:
Evan Garfein, MD, Division of Plastic and Reconstructive Surgery
Evan Garfein, MD, was instrumental in the passage of a 2010 New York State law requiring hospitals and
doctors to inform breast cancer patients of the options for breast reconstruction before surgery. When he
became aware of research that demonstrated women in underserved areas are less likely to be told about
breast reconstruction prior to undergoing mastectomy than women in wealthier areas, he felt it was
imperative for all patients to be educated about their reconstruction options.
PATIENT NAVIGATORS:
Maureen Patrickakos, RN, MSN, OCN
Nurse Maureen Patrickakos is an Oncology Patient Navigator helping patients
understand the complexities of breast cancer treatment. Working closely with surgical and medical
oncologists, she ensures that each patient is fully prepared and thoroughly understands each procedure,
from initial testing through surgery and discussion of treatment options and plans. She helps patients
understand the option of clinical trials if they fit the criteria for entry. Ms. Patrickakos uses Spanish
interpreters to navigate a large number of Hispanic patients
through the process of breast cancer treatment. Moreover, using a data base, she tracks patient follow-up
care to maintain continuity.
PSYCHOSOCIAL ONCOLOGY PROGRAM:
Alyson Moadel, Ph.D, Director of Psychosocial Oncology Program at Albert
Einstein Cancer Center and Department of Medical Oncology
The Psychosocial Oncology Program, housed within the Einstein Cancer Center, promotes quality of life
among those affected by cancer in the underserved and ethnically diverse community of the Bronx. The
program called The Bronx Oncology Living Daily (or B.O.L.D.) offers a variety of free services including
individual counseling, stress management, yoga, spiritual groups and smoking cessation counseling.
Elizabeth Salgado, LMSW
Social worker Elizabeth Salgado leads a weekly support group, Mujeres Unidas
(Women United), which helps Hispanic women cope with breast cancer diagnosis, treatment and recovery.
The group is a collaborative effort between the Montefiore Einstein Center for Cancer Care and Gilda’s
Club and is sponsored by the Susan B. Komen Race for the Cure. Within this group the women can speak
their native language, support and educate one another.
Gloria Nelson, LMSW
With the guidance of senior oncology social worker Gloria Nelson, Strength through Laughter groups have
been meeting once a month at the Montefiore Einstein Cancer Center in the Bronx for the past five years.
The program is usually attended by 35-40 adult cancer patients, nearly half of them in the late stages of the
disease. Group members say that laughter can help them come to terms with their disease. Though
researchers are not certain of the effect laughter has on the course of cancer, medical experts agree that
laughter promotes a sense of well-being, and improves muscle function and breathing.
RESEARCH:
Clinical Trials
The MECCC Breast Team is involved in many investigator-initiated and multi-institutional clinical trials
including many phase II and phase III trials investigating new agents for pre-operative chemotherapy, post-
operative chemotherapy, post-operative hormonal therapy, and post-operative targeted biologic agents.
Basic Science
A strong relationship exists between the MECCC Breast Team and the Albert Einstein College of
Medicine. As such, the team collaborates with a number of basic scientists looking for breast cancer tumor
markers and markers of a tumor’s potential for metastasis.
Montefiore Medical Center
As the University Hospital for Albert Einstein College of Medicine, Montefiore is a premier academic
medical center nationally renowned for its clinical excellence, scientific discovery and commitment to its
community. Recognized among the top hospitals nationally and ranked sixth out of 180 in the New York
metropolitan area by U.S. News & World Report, Montefiore provides compassionate, patient- and family-
centered care and educates the healthcare professionals of tomorrow. The Children’s Hospital at
Montefiore is consistently named in U.S. News’ “America’s Best Children’s Hospitals,” and is second
among those in the New York metro area. With four hospitals, 1,491 beds and 93,000 annual hospital
discharges, Montefiore is an integrated health system seamlessly linked by advanced health information
technology. State-of-the-art primary and specialty care is provided through a network of nearly 100
locations across the region, including the largest school health program in the nation and a home health
program. Montefiore, inspired by its patients and its community, continues to be on the frontlines of
developing innovative approaches to care.
June 15, 2011
Human Race brings in $235000 for local nonprofits - Santa Cruz Sentinel – By SHANNA MCCORD –
SANTA CRUZ --" The Volunteer Center of Santa Cruz County raised $235,000 at its 31st annual Human
Race.
An awards ceremony was held June 9 at Resurrection Church in Aptos with approximately 100 community
members receiving donation checks.
Race day was May 7.
About 140 nonprofit organizations, schools, faith-based organizations and community groups collaborated
with local businesses and individual residents to raise more than $235,000 at the race.
"This year's event was one of the most successful ever," said Chris Bracinni, the Volunteer Center's race
coordinator. "An event like this takes the time and goodwill of thousands of people from every part of our
community. We can't thank each of them enough."
Businesses known as "champion teams" were honored at the ceremony. Employees of the businesses
fundraised for specific organizations.
This year's top champion teams were Santa Cruz County Bank, Wells Fargo, Green Valley Dentistry,
Bookshop Santa Cruz and Niemann Capital Management.
They raised more than $67,000 in in-kind contributions and donations.
Top individual fundraisers Cynthia Chase and Aaron Noble were honored for each raising $5,000.
Other top fundraisers include Balance for Kids with $26,000, Santa Cruz County Animal Services with
more than $12,000 and the Diabetes Health Center with $8,000
June 15, 2011
New therapist at medical center - Decorah Journal –
Winneshiek Medical Center recently welcomed Allison Herman, OTR/L to the Rehabilitation and Sports
Medicine Department.
Herman, an occupational therapist, joined the comprehensive and advanced occupational therapy practice
in May, 2011. She received her undergraduate degree from Luther College and her Masters of
Occupational Therapy from St. Ambrose University in Davenport.
Prior to coming to Winneshiek Medical Center, Herman worked at Finley Hospital in Dubuque.
Of her chosen career, Herman says, "I find the level of progression patients make very rewarding. Whether
it is a functional task or a small change in range of motion, the therapy we provide can make a significant
difference in a patient's quality of life."
Herman says she is inspired by current health professionals here.
"I hope to bring the same enthusiasm to patient care as I have observed in my colleagues. They truly work
to make a difference in the lives of their patients and I am inspired by their dedication."
Coordinators at the local medical center said occupational therapists are health professionals who are
trained to help you "live better" with your illness, injury or disability.
Winneshiek Medical Center occupational therapists have earned specialist certification in occupational
health, hand therapy, urinary incontinence retraining, lymphedema management, specialized pediatric feeding
programs, sensory integration for pediatrics, home safety assessments, and pool therapy for those with
arthritis. Winneshiek Medical Center occupational therapists provide care for outpatients, inpatients, home
health, and local nursing homes.
For more information, contact your primary health care provider or call the Winneshiek Medical Center
Rehabilitation and Sports Medicine Department at 563-387-3031.
June 16, 2011
Patients name Donna Bateman their favorite nurse at The Memorial Hospital of Salem County - Today's
Sunbeam - NJ.com
MANNINGTON TWP. — The secret to finding a good nurse — no, an exceptional one — is simple:
Listen to her patients.
And when listening to the patients of Wound Care Center nurse Donna Bateman, the story that unfolds is
one that would make any nurse proud.
“I am 85 years old and Donna is always very gentle with me,” said Alice Dalbow of Pennsville. “She is a
caring nurse. When I fell in February, I couldn’t get around for awhile and I developed ulcers on my foot
that wouldn’t heal. I came to the Wound Care Center and Donna has been helping them heal very nicely.
She doesn’t rush or push you out — she takes her time and makes me feel really good.”
In the more than 35 entries she received for the 2011 Patient Choice Award — which gives the community
a chance to honor nursing excellence at The Memorial Hospital of Salem County — patients (and family
members) struck a common theme: Donna Bateman, RN, BSN, CWCN, makes a difference in their lives.
“Donna has a genuine concern for her patients,” said Penny Smith of Alloway. “She goes the extra mile for
her patients and is always up on the latest medical care for wounds. I had been to many others for the
treatment of my wounds, but I am finally making progress under Donna.”
“When it comes to caring for patients, there is no one quite like Donna,” added Chief Nursing Officer
Patricia Scherle, RN, BSN, MHA. “She bonds with her patients and knows each of them individually. She
is an asset to our nursing team and we are all very proud of her.”
Bateman specializes in wound care and is one of the very few nurses in the South Jersey region with this
expertise. She has been on staff at MHSC for five years and she has been a wound care nurse for more
than 20.
“I love wound care — and all the aspects that go with,” she said. “I love caring for the patients, teaching
them, working with their families, getting to know them — the overall interaction is so very important to
understand the nature of their wound and how best to heal it.”
Bateman stressed the importance of caring for the “whole” person — not just the wound.
“It’s critical because sometimes the underlying factors for a wound that won’t heal are rooted in socio-
economic factors, poor nutrition, their environment, or just a lack of knowledge of their wounds,” she
explained. “You have to really listen to the patient because you can pick up on subtle things that they may
not express directly.”
Bateman’s areas of expertise include diabetic ulcers, vascular ulcers (due to poor circulation in the lower
extremities) and pressure ulcers (bed sores).
She encourages her patients to get to know one another and develop a common bond.
“They scold one another for not keeping up with certain parts of their care, and they help encourage one
another. I often hear them say things such as, ‘Just keep doing what Ms.
Donna says if you want that wound to heal. Do what she says and you won’t be coming back. Don’t do it,
and you will be coming back.’ They chide each other and prod each other and I think that’s a good thing.”
Bateman began her professional love affair with wounds “way back when” — in the mid-seventies. “At that
time wound care was little more than Duoderm — gauze and saline. It was anything but a specialty. Now,
there are more than 2,000 products to choose from to heal in wound care. It’s come a long way.”
She recalls one career highlight that made a lasting impact on her. “I had the opportunity of a lifetime,” she
recalled. “A physician I knew from The Children’s Hospital of Philadelphia had received a grant to develop
a wound care clinic in Guyana, Africa. He wanted someone to evaluate what it would take to set up a
wound care clinic. I spent several weeks overseas and it was an experience that I will never forget.”
Over the course of her career, Bateman has worked at several hospitals, nursing homes and hospices. She
is a member of the Wound, Ostomy, Continence Nurses Society,
American Society for Pain Management Nursing, the Association for the Advancement of Wound Care and
the Lymphedema Nurses Association, to name a few. She received her Bachelor of Science in nursing
degree from Widener University and is board certified in wound care nursing.
As the 2011 Patient Choice winner, Donna will receive an assortment of prizes that range from a $500
check to a special luncheon in her honor with members of her family. She will also be featured in a poster
that will recognize her as being the MHSC Patient Choice Award winner.
June 17, 2011
Dr. Ragsdale Named Alpha Homecare Medical Director - Space Coast Medicine and Healthy Living –
CENTRAL FLORIDA, USA – Alpha Homecare & Therapy Agency announced that Dr. V. Denny
Ragsdale has joined the agency as medical director.
“We’re very pleased to have Dr. Ragsdale as our new medical director,” said Wendy Morgan, Marketing
Liaison for Alpha Homecare.
“As a Board Certified family practitioner, he has a long and well-respected career in the Brevard
community. In addition to overseeing patient care, Dr. Ragsdale will offer home visits for patients with
limited mobility,” said Morgan.
Alpha Homecare will hold a community Open House on Friday, June 24, 10 a.m. – 2 p.m., to welcome Dr.
Ragsdale and give the public an opportunity to meet the doctor.
During the Open House, Alpha Homecare will offer blood pressure checks, fall risk screenings, raffles and
refreshments at their Melbourne office located at 3040 North Wickham Road in Melbourne, Florida.
“I’m very happy to be affiliated with Alpha Homecare as their primary goal is to provide exceptional
medical care.” said Dr. Ragsdale.
As medical director, Dr. Ragsdale offers the rare service of conducting home visits.
“Offering home visits is not for every doctor, but personally, I enjoy getting to know the patient, and not the
disease,” said Dr. Ragsdale.
With a wink, Dr. Ragsdale comments that he has the largest – and albeit only – house call practice in South
Brevard.
Originally from Tennessee, Dr. Ragsdale completed both his medical degree and fellowship at the
University of Miami in Coral Gables.
A veteran of the U.S. Air Force, Dr. Ragsdale is Board Certified in Family Medicine and is a Fellow of the
American Academy of Family Practice. A father of five children, he enjoys volunteering as a gospel pianist.
Alpha is a Joint Commission Accredited home health agency owned by Art and Joy Casingal, who are both
physical therapists.
The Medicare Certified agency provides skilled nursing, physical therapy, occupational therapy,
lymphedema therapy, and home health aide service countywide.
For more information about Alpha Homecare & Therapy Agency call 321-254-1070 or e-mail
alphahomecare09@att.net.
Comprehensive Lymphedema Management - MD News –
Siskin Hospital for Physical Rehabilitation in Chattanooga, TN, offers all-inclusive inpatient and outpatient
services for patients suffering from lymphedema.
In 1999, Siskin Hospital for Physical Rehabilitation launched an outpatient lymphedema program. When it
became clear that patients with advanced disease were experiencing transportation, home, and traditional
outpatient therapy challenges, an inpatient program was developed. Since then, patients throughout the
region — with some coming from as far as Oklahoma and Illinois — have turned to Siskin Hospital for help
managing their lymphedema.
Inpatient Care for Advanced Lymphedema
Patients with stage III lymphedema — characterized by severe swelling and the presence of fibrotic tissue
— are indicated for inpatient care. At this stage, limbs are so swollen that the ability to carry out daily
activities is compromised. Patients also usually suffer from other comorbidities and have an increased risk of
developing nonhealing wounds. These complications make it necessary to provide an intensive inpatient
multidisciplinary treatment program.
Siskin Hospital for Physical Rehabilitation requires a physician’s referral for inpatient lymphedema
treatment. As soon as a referral and medical records are received, the lymphedema program coordinator
and the medical director determine the patient’s appropriateness for the inpatient level of care. Treatment
typically starts on the day of admission and discharge plans are rapidly developed as specific information
related to the patient’s needs are identified. In addition to lymphedema therapy, treatment includes physical
therapy, occupational therapy, nutritional counseling, nursing care and education.
“Extensive training is necessary to help patients achieve success,” says John Jordi, B.S., PTA, CLT-
LANA, CI, Lymphedema Program Coordinator at Siskin Hospital. “Our goal is to eventually work
ourselves out of a job, so that patients with this chronic condition can manage it on their own, allowing them
to live a more normal and functional lifestyle.”
Therefore, a large focus of the inpatient lymphedema program is educating patients on how to self-manage
this chronic condition for the long term. Patients are taught self-MLD (manual lymphatic drainage), a
customized exercise plan, how to wrap their limbs to maintain the right amount of compression, how and
why to wear compression garments and how to do regular skin checks to help prevent skin breakdown,
wounds and infections.
When patients arrive for inpatient care, they spend three hours a day with a certified lymphedema therapist.
Patients generally begin seeing results during their first week of therapy. “While they are here, we expect
that patients will have a fair amount of independence,” says Jordi. “Most patients with severe lymphedema
have limited range of motion, so our occupational therapists work with them and assist with activities of
daily living, such as bathing, toileting and dressing. Their limbs have often become so swollen that they have
stopped performing basic tasks at home, such as tying their own shoes or even wearing shoes.”
Physical therapy is initially a large part of the program because patients have to learn proper and safe
walking techniques, particularly while wearing compression wraps. The Fitness Center at Siskin Hospital
located on the hospital’s main campus offers a multitude of adaptive fitness equipment that can
accommodate patients who have limitations.
According to Jordi, family support is also paramount to achieving successful outcomes. Family members
and caregivers are encouraged to participate during therapy sessions to learn how to assist lymphedema
patients with wrapping, while also helping the patients to maintain as much independence as possible.
Enhancing Patient Convenience
As more patients have sought care through Siskin Hospital for Physical Rehabilitation’s inpatient
lymphedema program, it has recently expanded to include an in-house durable medical equipment (DME)
company. This service allows patients to be fitted with the proper compression garments on site. It is
especially beneficial for breast cancer patients who have trunk swelling following lymph node removal, as it
can be difficult for them to find the correct garments.
“With wrapping, we expect change every day,” says Jordi. “As patients’ limbs continue to shrink and
approach normal size, we have to customize wrappings to accommodate these changes. Once the limbs
have reached optimal size, patients can be fitted for more permanent compression garments. Having the
DME component on site is advantageous for everyone involved. Patients can receive their bandages and
garments much faster than if they ordered them online.”
Transitioning to Outpatient Care
Following four weeks of inpatient care, most patients complete two to four weeks of outpatient therapy.
“To ensure success, we make the transition from inpatient to outpatient care as seamless as possible,” says
Jordi. “After completion of the inpatient program, most patients experience great improvements in their
overall health. Wounds resolve or improve and blood sugar levels improve in patients with diabetes. It is
essential that patients maintain the skills and healthy habits they have learned. We don’t want them to lose
any ground that they have gained.”
During the outpatient phase, their customized garments are ready, so a large portion of therapy focuses on
teaching patients how to use them appropriately. “These garments can be difficult for patients to get on and
off when they first receive them,” says Jordi. “Currently, we are working with a research team at Western
Carolina University to develop a product to assist patients with putting on their compression garments.”
Collaborating With Referring Physicians
The staff at Siskin Hospital for Physical Rehabilitation puts special emphasis on ensuring that patients’
primary care physicians are kept updated on their progress, so physicians can see how patients improve
once the excess fluid has been removed. Every patient who completes the lymphedema program at Siskin
Hospital for Physical Rehabilitation is referred back to his or her primary care physician for follow-up.
June 19, 2011
Lakeland celebrates new cancer center - Niles Daily Star –
A ceremony and ribbon-cutting marked the official dedication of Lakeland HealthCare’s new Marie Yeager
Cancer Center Thursday.
More than 300 guests toured the two-story, 30,000-square-foot center located in the Lakeland Health
Park in Royalton Township, St. Joseph. The cancer center will provide a single location for most cancer
care needs, including medical oncology, a pharmacy, laboratory services, a health and appearance center,
holistic support services, lymphedema therapy and clinical research. The facility will open to patients July 11.
“Those who will receive care here will benefit not only by the convenience and coordination of their
interdisciplinary care, their experience will be marked by more comfort, more confidence, and more hope,”
said Dr. Loren Hamel, president and CEO, Lakeland HealthCare, in his opening remarks during the
ceremony.
Myrna Hunt, a breast cancer survivor and musician, shared her personal story about fighting the disease
followed by a moving instrumental version of “You’ll Never Walk Alone” on the piano by Rodgers and
Hammerstein.
Later in the program, a marble sculpture by renowned artist Fritz Olsen of Sawyer, Mich. was unveiled in
the cancer center’s Healing Garden. Martha Cares, a nationally regarded soprano opera singer and wife of
Olsen, sang a song for which she had written the lyrics in honor of the occasion and unveiling.
The cancer center is named after Marie Yeager, a long-time oncology nurse at Lakeland. Her husband,
Tom, recalled her dedication and passion for caring for her patients.
“This cause was very dear to her heart, and our family knows she would be proud to continue to make a
difference for southwest Michigan patients affected by cancer,” Yeager said.
Lakeland HealthCare is a non-profit, community-owned health system, which includes four hospitals, an
outpatient surgery center, rehabilitation centers, long-term care residencies, hospice, home care services
and physician practices. Lakeland has nearly 4,000 employees who provide clinical and support services at
locations throughout southwest Michigan, and partners with approximately 400 affiliated physicians and
other providers.
For more information, visit www.lakelandhealth.org.
Turn to kinesiology tape for 'treatment between treatment' - Globe and Mail – by AMY VERNER –
Since last week, people have been asking whether I have been sporting some stylish, new body art. In fact,
I have had my foot and ankle covered in SpiderTech kinesiology tape to help heal a soft-tissue injury.
But while I am new to the world of kinesiology tape, kinesiology tape is not new to the world.
It dates back to the 1970s when Japanese chiropractor Kenzo Kase developed a cotton tape with an
acrylic adhesive that could be used to treat a variety of conditions, from reducing inflammation to activating
underused muscles. It also may offer some relief for cancer patients suffering from lymphedema.
The water-resistant tape was created to have the same weight, elasticity and thickness as skin, which means
it can provide microcirculatory and structural in addition to cellular stimulation. Kevin Jardine, a
chiropractor who developed the SpiderTech brand three years ago, refers to it as “treatment between
treatment.”
Kinesiology tape catapulted into public consciousness when cyclist Lance Armstrong referred to it in one of
his books as “magic tape.” Throughout the Beijing Olympics, many athletes could be seen wearing various
patterns of what looked to be painter’s tape, and it has become a staple among Ironman competitors.
There are several brands on the market and to the untrained eye there’s little difference. They come in a roll
format (average $10 to $20 a roll), stretch only lengthwise and can be cut to measure and applied
anywhere on the body. Knees, shoulders and necks are the most common spots.
SpiderTech, however, offers a range of 16 “precuts” (average $10 a precut), to reduce the guesswork
when applying the tape.
On the one hand, a precut is far more user-friendly than a standard roll. The Ankle Spider, as an example,
consists of one long strip with a hole in the centre to accommodate two centre toes and a slit at one end to
allow a range of motion up the posterior leg. To try to achieve this exact shape using strips cut from a roll
would be a challenge.
But don’t bodies come in all different shapes and sizes? Mr. Jardine says yes, adding that precuts are not
limited to their designated body area, so a Knee Spider could be used on a shoulder and a Groin Spider
could be used on the glutes (website: spidertech.com). “There was a lot of confusion in how to apply [the
roll],” he says. “This offers a standardized way to implement the practice.”
And if you are wondering why the brand name, he says it’s because when people would see the tape
applied, they say it looks like a spider.
Mark Scappaticci, a Toronto-based sports chiropractor who is a certified instructor in kinesiology tape,
prefers customizing each application from the roll, maintaining that precuts often need to be modified and
may not work as effectively. He says his patients will take pictures or film him applying the tape so that they
can do it themselves the next time around. There are also scores of instructional videos online.
There is a definite art to the application. Mr. Jardine took great care in rubbing the tape along my skin as he
laid it down. I have yet to try doing this myself.
Mr. Jardine, who has an integrative fitness and wellness facility called Urban Athlete in midtown Toronto,
underscores that people should first seek professional diagnosis. “The goal is not to give a mechanism to
self-diagnose,” he says. “But in the interim, this can alleviate the discomfort.”
While long-time users of the tape may turn to it for repetitive strain, Mr. Scappaticci adds that it is never a
replacement for actual treatment and, in some cases, can prolong the recovery.
Work in Montreal drew me away from two treatments last week and the SpiderTape could not have come
at a better time. While it did not heal my injury, it secured my foot in a way that provided some pain relief
and staved off swelling. Mostly, it made me feel protected.
As an aside, my aesthetic ego appreciates that the tape comes in black, bright blue and pink in addition to
beige (apparently, when first introduced in Japan, the blue signified “cool” and the pink “warm,” but there’s
no additional difference). So as I continue to heal, I can at least enjoy the compliments that the tape looks
like a fashion trend. But trends come and go, whereas kinesiology tape will be sticking around for some
time.
June 20, 2011
Klose Training & Consulting: Professional Training for Lymphedema Therapy – SBWire –
Lymphedema therapy certification at Washington University School of Medicine in St. Louis, MO. The
educational program will provide training for occupational therapists, physical therapists, and massage
therapists.
Lafayette, CO -- (SBWIRE) -- 06/20/2011 -- Klose Training & Consulting, a lymphedema certification
and education company, will provide professional training for lymphedema therapy certification at
Washington University School of Medicine in St. Louis, MO, July 15 – 23, 2011. The educational program
will provide training for occupational therapists, physical therapists, and massage therapists to obtain
certification in lymphedema therapy.
This training will be hosted by the program in physical therapy at Washington University School of
Medicine. As noted on the Washington University School of Medicine website, the school “is a leader in
improving human health throughout the world.” The school conveniently accommodates its students and
visitors with on campus parking and access to public transportation.
Klose Training’s lymphedema certification course totals 135 combined hours of a 45-hour internet-based
home-study program and 90 hours of classroom (lab) instruction. Course curriculum includes full training in
the four components of Complete Decongestive Therapy (CDT), the most successful treatment for chronic
extremity lymphedema. In addition to CDT training, professionals receive adequate training in Anatomy,
Physiology, Manual Lymph Drainage (MLD), Measurement, and exercises for patients with lymphedema.
Course instructors are Jan Weiss, DHS, PT, CLT-LANA, and Christopher Cobb, PT, CLT-LANA. Jan
Weiss received her MLD/CDT certification in 1996. She established the Lymphedema Clinic at CoxHealth
in Springfield, MO, and currently serves as the Lymphedema Resource Therapist for her hospital while
treating a variety of patients with edema lymphedema. Christopher Cobb works as a staff therapist in the
outpatient physical therapy department for CoxHealth in Springfield, Missouri. He has been actively treating
lymphedema patients in a variety of settings including acute care, skilled nursing, and outpatient since his
certification in October 2002.
Cancer survivor works with therapist to control lymphedema - Daytona Beach News-Journal – by Kathy
Page –
Daytona Beach resident Dotti Lewis is a longtime breast cancer survivor but now, 24 years after her
mastectomy, she has developed lymphedema. Usually diagnosed shortly after surgery, lymphedema is
swelling caused by fluid accumulating in the affected areas. It can be treated and kept under control, but not
cured. Recently, Dotti shared her story with The News-Journal.
Q. What is lymphedema and what are its symptoms?
Lymphedema is an abnormal accumulation of protein and water caused when there is a mechanical
insufficiency in the lymphatic system, an important part of your immune and circulatory system. This
blockage prevents fluid from draining and, as it builds up, swelling results ... and continues to grow. It can
be treated and kept under control, BUT NOT CURED. It affects both men and women, and for reasons
other than cancer.
If it's not controlled, the swelling will become painful. The skin can only stretch so far and uncontrolled
swelling can force the skin to split and ooze--leaving an opening for bacteria.
Q. Were you told about the possibility of developing lymphedema when you had your mastectomy?
Yes, I was warned about the possibility because some of the lymph nodes in my left armpit were removed
to see if the cancer had spread. Fortunately, the nodes were free of cancer, but apparently the lymph
system was compromised.
My surgeon, Dr. James Sutton, told me to protect my left arm, to avoid any injury to it, not to have any
manicures and not to let anyone take my blood pressure or draw blood from that arm.
As the years went by, several nurses said I didn't have to worry about those rules anymore. I still kept to
the rules as much as possible and I thought I was safe from any side effects of the Big C. Especially after 24
years. But apparently lymphedema set in when I accidentally tore some skin off my left arm.
Q. What type of treatment are you receiving?
My primary care physician, Dr. Henri Nammour, sent me to Carmen Yu, a certified lymphedema therapist
at Pro-Motion Physical Therapy in Port Orange.
I had sessions of manual lymph drainage, followed by compression bandaging, starting three times a week
and then increasing to five times a week since I was not responding fast enough. With my arm wrapped, I
was instructed to do daily exercises at home.
The manual lymph drainage is gentle and designed to assist the flow of lymph fluid that causes the swelling. I
had thought lymph nodes were only in the armpits and groin, but I soon learned they are almost everywhere
in your body and close to the skin.
Carmen explained as she massaged and showed me the difference as the swelling drained from various
parts of my arm and hand. Then she got out the pressure bandages.
In my case they consisted of a type of gauze wrapped around my fingers and hand, layers of a soft cotton
material, a layer of a thin foam and several layers of a bandage similar in appearance to the Ace bandages
commonly used for orthopedic problems. And there were foam paddings added on my forearm where the
swelling was at its worst and the tissue was tough and fibrotic.
When she was through, my arm looked like that of a mummy in a horror movie. (My sister said I looked
like the Michelin tire man.) Most people thought I had a broken arm with a cast under the outer bandages,
or had recent surgery. When my sister was with me, we both just laughed and said we'd had a fight.
I wore the bandages day and night, occasionally removing them to wash and dry them shortly before going
to an appointment with Carmen. She had to remove them each time anyway for the massages and re-
bandage them when she was through. It's a job that takes a lot of patience, but Carmen was always
cheerful and encouraging.
Every so often, Carmen measured my arm to see if I was ready for a pressure sleeve, which looks like a
nylon stocking on your arm, and a pressure gauntlet, which leaves the tips of your fingers sticking out.
I finally made the grade! My gauntlet has an additional foam pad on the back of the hand, which also swells.
At first glance, it looks a little as though I have a prosthetic arm. I wear the sleeve and gauntlet at least eight
hours each day.
Q. Who do you count on for support?
My sisters, my children and my grandchildren are very supportive -- as are my friends. There is also a
breast cancer/lymphedema support group at Halifax Health which I plan to join as soon as possible.
Q. What role does diet and exercise play in trying to maintain a healthy lifestyle?
I have received no special recommended diet ... but there are a series of special exercises for lymphedema.
Also, Carmen has given me instructions in self-massage to be performed daily.
Q. Are you active in creating an awareness of lymphedema and what it takes to manage it?
I am trying to make as many mastectomy patients as possible aware that the affected arm must be treated
with special care, no matter who tells you that you are safe from side effects. I do this by openly discussing
my need for the obvious pressure garments with anyone who looks at them quizzically --even if they are too
polite to ask questions.
Q. Do you have any advice for others who have been diagnosed with lymphedema?
Get treatment as soon as you notice the swelling and don't let it embarrass you or interfere with your
activities any more than is absolutely necessary.
Q. Anything else you'd like to share?
The lymphedema control routine is not something I look forward to the rest of my life. I'll be checking all
available sources and bugging Carmen and my doctor periodically to see if any possible cures are being
considered.
And to my fellow mastectomy patients ... don't forget ... always treat the affected arm with special care, no
matter who says you're safe now from side effects!!!
Kangoo Jumps: Hot workout trend puts a spring in your step - Denver Post – By Ellen Nordberg –
Bouncing around like kangaroos with huge smiles on their faces, Kangoo jumpers burn extra calories,
stimulate their lymphatic systems and reduce the impact on their joints by up to 80 percent.
Kangoo Jumps, a hot workout trend in Europe and South America, have bounded into Colorado.
Resembling a cross between the boot of a Rollerblade and the treads on the bottom of a snowcat, Kangoo
Jumps were originally designed by a Swiss engineer whose aging knees hindered his passion for running.
Bands or coils in the center of the shell underneath the boot stretch when compressed, creating spring or
rebound. This rebound effect is the key to their appeal and success, according to Beth Kruper, Kangoo
Jumps master trainer.
"The great thing is the reduction in impact," says Kruper, a fitness instructor for more than 20 years. "In my
classes, I have everyone from a 9-year-old to a 70-year-old. These are mostly people who want a good
workout, but many just can't do cardio any other way. I've put boots on over 3,000 people, and I see
people with so many different joint problems. Whatever hurts them when they run or do aerobics — it
doesn't hurt them with Kangoo."
Health clubs in the metro area — Denver Athletic Club, Lakeshore Athletic Club in Broomfield and Body
Dynamics Studio in Boulder — have begun offering Kangoo Jumps classes. The classes offer
choreographed moves in a studio setting, which allows users to get comfortable with the boots and move in
multidimensional directions. Many of the participants have found relief from joint issues.
"I took the Kangoo Jump class at the Denver Athletic Club for a specific reason," says Denver resident
Austin Murr. "I hadn't been able to get out and run for over six years. The pain in my knees had led me to
the boring elliptical machine. Then I put on Kangoo Jumps. Spring in the step again — literally."
In addition to studio classes, Kangoo Jumps can be worn outside on pavement, dirt trails, and potentially
even snow or sand. Many Kangoo owners take classes and also run outside with their boots.
"I haven't been able to run for years due to foot pain," says Shawn Ellis, a Lakeshore Athletic Club
member. "Kangoos allow me to run and jump as much as I want. I can run outdoors if it's a nice day. You
look kind of goofy running around the neighborhood in your boots, but it's fun."
Both the Center for Exercise Science and Sport Management at Southern Cross University in Lismore,
Australia, and the Division of Sports Medicine at The Swiss Federation Institute of Technology conducted
studies that determined that wearing Kangoo Jumps while jogging significantly reduced impact compared
with jogging in regular running shoes. However, according to the Southern Cross University study, "Further
research work is required to assess the changes in gait pattern that the Kangoo Jumps may produce."
Multiple benefits
Dr. Lorri J. Fulkerson, an orthopedic surgeon with Boulder Orthopedics who has tried Kangoos herself,
agrees that they can reduce impact on joints versus using traditional running shoes.
"Patients with mild forms of osteoarthritis may find the boots improve their tolerance for impact activity," she
says. "However, since the boots are a less-stable platform, they may not be appropriate for people with
more severe arthritis."
Kangoo offers benefits to populations beyond folks with joint issues or injury rehabilitation, according to
Wendy McClure, ACSM-certified Personal Trainer, Lakeshore instructor and co-owner of Body
Dynamics Studio. The rebounding effect increases circulation and heart rate, and facilitates lymphatic
drainage.
"The boots are great for obesity in children, and great for women with metabolic and tissue issues," says
McClure. "It's also an efficient way to exercise because the heart rate gets up easily, and your calorie burn
can be up to 50 percent more than the same exercise without the boots.
"There's also a lymphatic flush that comes with rebounding," she says. "Our organs don't flush as well as we
age. Toxins build up. A huge volume of blood is pumped through during a Kangoo workout, and it cleanses
our system like a massage."
Christy Thiel, a personal trainer in Fort Collins, struggled with digestive issues, skin problems and low
energy until she tried rebounding.
"My lymph system was stagnant. I was not metabolizing toxins," Thiel says. "I started rebounding on a mini-
tramp for two minutes a day. Within a month, I felt so much better."
Thiel went on to become a certified Kangoo Jumps instructor who has also produced a basic home weight-
loss video for Kangoo Jumps.
Trudy Turvey, a physical therapist and certified lymphedema specialist in Boulder, agrees with the benefits
of lymphatic drainage but isn't sold on the superiority of Kangoo Jumps on this process.
"Lymphatic flow is extremely important to cleanse your body of foreign toxins," she says. "But most any
kind of exercise will increase lymphatic flow. Whether or not rebounding is more beneficial than walking or
swimming on the lymph system — I'm not sure we have the research to support that."
While many people are finding benefits from the boots, Kangoo Jumps are not necessarily for everyone.
They're contraindicated for pregnant women, people with heart or blood- pressure problems and potentially
people with balance issues or a current injury.
"Anyone with an injury should definitely be led through the use of Kangoos to make sure it's appropriate for
them," McClure says. "And the boots can help people with balance issues, but they need to be guided, as
well."
Proper fit is crucial
The boots have a variety of levels of adjustments for size, strength and weight, so it's important to be fitted
by an instructor or Kangoo representative. There are adjustments from 45 pounds to over 300 pounds. A
specialist can help you find the proper tension.
Lots of local Kangoo users have purchased their own boots (see box at left), but many choose to rent or
use the boots provided by the facility for their classes. Body Dynamics charges $10-$17 per class, Denver
Athletic Club charges a one-time $15 fee for members, and Lakeshore Athletic Club charges a $2 boot
rental fee per class.
All three clubs have growing programs. Petra Storm, group exercise coordinator of the Denver Athletic
Club, touts the ease of use and positive feeling that comes from using Kangoos as the reason for the
popularity at her club.
"There's a sense of euphoria from the rebound effect," she says. "The classes are fun. We laugh and jump
around. You kind of forget you're exercising."
Treatment May Help Ease Effect of Cancer - New York Times – By RONI CARYN RABIN –
Top plastic surgeons from around the country met in Manhattan last month to observe an experimental
surgery that may cure lymphedema, a serious complication of breast cancer treatment.
As some surgeons crowded into an operating room at New York Eye and Ear Infirmary and others
watched a live video broadcast, Dr. Corinne Becker, the French doctor who pioneered the procedure,
harvested lymph nodes from a patient’s groin to transplant to her underarm, where nodes had been
removed earlier during cancer treatment.
“Voila!” she exclaimed, motioning to her colleagues as she rubbed a small piece of tissue between thumb
and fingertips to check for the presence of the small, pearl-shaped lymph nodes. “Look what is here — a
wonderful node.”
She warned that extracting too much tissue could injure the patient, even causing lymphedema in another
limb. Using the French word for ‘greedy,’ she said, “It’s better not to be ‘gourmand’ — aggressive.”
This innovative procedure, called an autologous vascularized lymph node transfer, is used to treat
lymphedema, a common side effect of breast cancer treatment. Removal of the lymph nodes under the arm
closest to the affected breast is believed to stem the spread of cancer, although new research suggests it can
be avoided in many cases. But the loss of lymph nodes often leads to chronic swelling and soreness in the
arm.
In the new experimental surgery, the missing lymph nodes are replaced with a handful of healthy nodes
transplanted from elsewhere in the patient. If all goes according to plan, the lymph nodes make themselves
at home in their new location and connect with lymph vessels and start doing their job, filtering waste and
draining fluid that has accumulated in the arm.
But the operation is controversial and not without risk, and though it is reported to have cured some
patients and improved the condition in many others, it is seldom performed in the United States. Even
proponents say it should be reserved for patients who don’t respond to conventional treatment.
The first randomized clinical trial of its effectiveness is just getting underway, led by Dr. Constance Chen, a
New York City plastic surgeon who specializes in muscle-sparing reconstructive breast surgery that uses
the patient’s own tissue.
Even in the absence of good data, however, demand for the procedure is bound to grow. More than 2
million women in the United States have been treated for breast cancer, and some studies suggest
lymphedema develops within five years in up to 40 percent of women who have undergone breast cancer
surgery. While the condition can be managed with constant care and physical therapy, it often severely
restricts activity and is generally considered incurable.
In the absence of better data about the benefits of lymph node transfer, however, insurers may balk at
covering the procedure, which involves expensive, complex microvascular surgery to connect tiny blood
vessels.
“From just a plumbing standpoint, it makes sense — someone took out the lymph nodes, you put them
back in,” said Dr. Babak Mehrara, a reconstructive plastic surgeon at Memorial Sloan-Kettering Hospital
in Manhattan. “The problem is that some of the science doesn’t support it. It probably works for some
people and doesn’t for others.”
Prior to transferring nodes to their new location, Dr. Becker aggressively clears away dense scar tissue
under the arm that may be “clogging up” the lymphatic channels and preventing fluid circulation. That is one
of the riskiest aspects of the surgery, because nerves and blood vessels leading to the arm could be affected.
“We worry that if a person already has a compromised lymphatic surgery, you can go in there and do
further damage. We always say the less surgery the better,” said Saskia Thiadens, executive director of the
National Lymphedema Network.
But, she added, “Obviously we’re eager to see what the outcomes are.”
Dr. Chen, who co-organized the symposium hosting Dr. Becker with Dr. Joshua L. Levine, director of
breast reconstructive services at New York Eye and Ear Infirmary, agrees that more scientific evidence is
needed. But she is optimistic the surgery will benefit patients and says the toll lymphedema takes has not
been fully appreciated by the medical community.
“Treatment for lymphedema generally doesn’t end,” Dr. Chen said. “Women will say managing their
lymphedema is worse than coping with breast cancer — now they have to deal with an every day affliction
that affects their day to day lives.”
She is launching the first double-blinded randomized clinical trial of lymph node transfer, a multicenter study
that will enroll 88 patients with lymphedema in one arm. Half will be randomly assigned to lymph node
transfer, while the others will undergo a dummy surgical procedure. The patients will be followed for two
years after the operation to see if their quality of life improves.
“There are naysayers with every single surgical innovation that comes along,” Dr. Chen said.
Dr. Becker claims to have had enormous success, but while she has operated prolifically in Europe and
other parts of the world on patients with cancer as well as those with congenital lymphedema, she has
published only sporadically.
In a 2006 paper in Annals of Surgery, she reported that 90 percent of patients improved after surgery and
almost half were cured, but the sample included only 24 women and there was no control group.
One of the patients operated on by Dr. Becker and Dr. Chen during the daylong symposium, Jennifer
Miller, 40, a portfolio manager at an investment firm in Manhattan, said she has already felt a dramatic
improvement.
“I used to have this pain that was like my whole arm had a headache, and that’s gone,” Ms. Miller said.
Ten days after surgery the swelling in her right arm was reduced by half, compared with measurements
taken 10 days prior to the operation, and she has been able to bare her arm, which she used to keep
covered in a compression treatment sleeve most of the day.
Though her right arm is still swollen and larger than her left, she said, “It already feels more manageable, and
I’m still recovering from surgery. Even if this is all the improvement I get, I’m happy.”
But whether the change is a true effect of the transfer or a placebo effect of undergoing treatment is not
known. Doctors say it is unlikely the transplanted nodes are already functioning, and it’s possible some
other aspect of the surgery is having a beneficial effect, Dr. Chen suggested.
June 23, 2011
Rehab Rally Announces Featured Continuing Education Session Lineup: Lymphedema - PR Web (press
release)
HomeCEUConnection.com is proud to announce that Rehab Rally Conference & Expo will feature five,
live continuing education sessions focused on Lymphedema Management and Myofascial Release for
Massage Therapists, Physical Therapists, Physical Therapist Assistants, Occupational Therapists,
Occupational Therapist Assistants and Athletic Trainers.
The Lymphedema Management and Myofascial Release session lineup will feature five, four hour, live
continuing education sessions covering such topics as, Myofascial Release Clinical Applications for the
Upper and Lower Body, Manual Lymphatic Drainage, and Pharmacology Considerations in the
Lymphatically Impaired Patient. Each of these sessions will be led by renowned speakers, Suzanne Tinsley,
PhD, PT, NCS, Carmen Thompson, BS, LPTA, CMT, CLT, and Theresa Schmidt, MS, PT, OCS, LMT,
CEAS, CHy. For a full Rehab Rally Continuing Education session lineup, including information about the
other continuing education tracts at Rehab Rally, please visit http://www.RehabRally.com
Each of the courses featured at Rehab Rally will satisfy continuing education requirements for Athletic
Trainers, Physical Therapists, Physical Therapist Assistants, Occupational Therapists, and Occupational
Therapist Assistants. The Lymphedema Management and Myofascial Release session lineup will satisfy
continuing education requirements for all of the previous rehabilitation professionals, as well as, Massage
Therapists. Rehab Rally is approved for up to 20 hours of live continuing education, with the option to
receive up to 75 hours by bundling the live event with approved home study courses available from
HomeCEUConnection.com. To learn more about Rehab Rally approvals please visit RehabRally.com.
About Rehab Rally
Rehab Rally Conference & Expo 2011 is a national continuing education conference hosted by
HomeCEUConnection.com, and designed for Physical Therapists, Physical Therapist Assistants,
Occupational Therapists, Occupational Therapist Assistants, Athletic Trainers, and Massage Therapists.
Rehab Rally will take place from July 28-31, 2011 in sunny Orlando, Florida and will be hosted at the
Gaylord Palms Resort. For more information about Rehab Rally please visit http://www.rehabrally.com.
About HomeCEUConnection.com
HomeCEUConnection.com specializes in quality online continuing education courses.
HomeCEUConnection.com offers CEUs for physical therapists, physical therapist assistants, occupational
therapists, occupational therapist assistants, speech language pathologists, athletic trainers, massage
therapists, and certified strength and conditioning specialists that are convenient, affordable and user
friendly. Visit HomeCEUConnection.com to learn more about our continuing education courses.
Difficult to diagnose condition gets exposure on second annual Lymphedema Awareness Day - Burnaby
Now - By Janaya Fuller-Evans –
Despite its obvious physical appearance, lymphedema is a difficult condition for doctors to recognize,
according to Lucette Wesley, president of the B.C. Lymphedema Association.
To change that, the association is holding its second annual Lymphedema Day event at the British Columbia
Institute of Technology to educate medical professionals and others about the condition.
Lymphedema is a condition where lymph - protein rich fluid - gathers in the limbs, or sometimes other parts
of the body such as the face or groin.
"A lot of people can feel alone with this condition," Wesley says.
It generally only affects one limb, and not bilateral limbs, as lipedema does. The resulting swelling can cause
pain, decreased mobility and even wounds, if not cared for properly.
Elephantitis is a chronic, severe version of the condition.
There are two kinds of lymphedema - a congenital condition passed down genetically, usually presenting in
infancy, or secondary lymphedema, which can occur after damage to the lymphatic system.
"Lots of people who have cancer develop lymphedema, and especially those with breast cancer," Wesley
says.
"People who've had cancer and have been free of the cancer for years, and think, 'Hey I'm past it," she
said, "and then they get lymphedema, and now they're stuck for life. It's a condition that never goes away."
Doctors often don't know much about it, Wesley says, making it difficult to get a correct diagnosis.
"Sometimes it starts off with very mild swelling and that's the problem," she explains. "They often don't
know what causes it and there's no easy way to test it."
There is no diagnostic test for the condition.
Those with lymphedema often work with massage practitioners, and use compression garments to keep the
swelling down.
It is very costly and time-consuming, according to Wesley.
"There are people who have to spend two hours a day putting on their compression bandages," she says.
The right amount of pressure is key, she adds.
The association hopes to educate people, particularly doctors, about the condition, Wesley says.
To that end, the registered non-profit is hosting a Lymphedema Awareness Day event at BCIT this
Saturday from 10 a.m. to 4 p.m.
It will include an address from keynote speaker Dr. Neil Piller, the director of the Lymphedema
Assessment Clinic in Australia, as well as forums for healthcare professions, and for patients on how to
approach self-care. Other topics include compression, current approaches, and new directions in treatment.
The event includes a breakfast and buffet lunch.
The Lymphedema Awareness Day event is being sponsored by the Canadian Breast Cancer Foundation's
B.C. and Yukon branch, with a $5,000 donation.
Those interested in attending can register online until Friday at www.bclymph.org. The cost is $30 for
members of the association and $40 for non-members.
June 24, 2011
Treatment May Help Ease Effect of Cancer – Ocala – by RONI CARYN RABIN –
Top plastic surgeons from around the country met in Manhattan last month to observe an experimental
surgery that may cure lymphedema, a serious complication of breast cancer treatment.
As some surgeons crowded into an operating room at New York Eye and Ear Infirmary and others
watched a live video broadcast, Dr. Corinne Becker, the French doctor who pioneered the procedure,
harvested lymph nodes from a patient’s groin to transplant to her underarm, where nodes had been
removed earlier during cancer treatment.
“Voila!” she exclaimed, motioning to her colleagues as she rubbed a small piece of tissue between thumb
and fingertips to check for the presence of the small, pearl-shaped lymph nodes. “Look what is here — a
wonderful node.”
She warned that extracting too much tissue could injure the patient, even causing lymphedema in another
limb. Using the French word for ‘greedy,’ she said, “It’s better not to be ‘gourmand’ — aggressive.”
This innovative procedure, called an autologous vascularized lymph node transfer, is used to treat
lymphedema, a common side effect of breast cancer treatment. Removal of the lymph nodes under the arm
closest to the affected breast is believed to stem the spread of cancer, although new research suggests it can
be avoided in many cases. But the loss of lymph nodes often leads to chronic swelling and soreness in the
arm.
In the new experimental surgery, the missing lymph nodes are replaced with a handful of healthy nodes
transplanted from elsewhere in the patient. If all goes according to plan, the lymph nodes make themselves
at home in their new location and connect with lymph vessels and start doing their job, filtering waste and
draining fluid that has accumulated in the arm.
But the operation is controversial and not without risk, and though it is reported to have cured some
patients and improved the condition in many others, it is seldom performed in the United States. Even
proponents say it should be reserved for patients who don’t respond to conventional treatment.
The first randomized clinical trial of its effectiveness is just getting underway, led by Dr. Constance Chen, a
New York City plastic surgeon who specializes in muscle-sparing reconstructive breast surgery that uses
the patient’s own tissue.
Even in the absence of good data, however, demand for the procedure is bound to grow. More than 2
million women in the United States have been treated for breast cancer, and some studies suggest
lymphedema develops within five years in up to 40 percent of women who have undergone breast cancer
surgery. While the condition can be managed with constant care and physical therapy, it often severely
restricts activity and is generally considered incurable.
In the absence of better data about the benefits of lymph node transfer, however, insurers may balk at
covering the procedure, which involves expensive, complex microvascular surgery to connect tiny blood
vessels.
“From just a plumbing standpoint, it makes sense — someone took out the lymph nodes, you put them
back in,” said Dr. Babak Mehrara, a reconstructive plastic surgeon at Memorial Sloan-Kettering Hospital
in Manhattan. “The problem is that some of the science doesn’t support it. It probably works for some
people and doesn’t for others.”
Prior to transferring nodes to their new location, Dr. Becker aggressively clears away dense scar tissue
under the arm that may be “clogging up” the lymphatic channels and preventing fluid circulation. That is one
of the riskiest aspects of the surgery, because nerves and blood vessels leading to the arm could be affected.
“We worry that if a person already has a compromised lymphatic surgery, you can go in there and do
further damage. We always say the less surgery the better,” said Saskia Thiadens, executive director of the
National Lymphedema Network.
But, she added, “Obviously we’re eager to see what the outcomes are.”
Dr. Chen, who co-organized the symposium hosting Dr. Becker with Dr. Joshua L. Levine, director of
breast reconstructive services at New York Eye and Ear Infirmary, agrees that more scientific evidence is
needed. But she is optimistic the surgery will benefit patients and says the toll lymphedema takes has not
been fully appreciated by the medical community.
“Treatment for lymphedema generally doesn’t end,” Dr. Chen said. “Women will say managing their
lymphedema is worse than coping with breast cancer — now they have to deal with an every day affliction
that affects their day to day lives.”
She is launching the first double-blinded randomized clinical trial of lymph node transfer, a multicenter study
that will enroll 88 patients with lymphedema in one arm. Half will be randomly assigned to lymph node
transfer, while the others will undergo a dummy surgical procedure. The patients will be followed for two
years after the operation to see if their quality of life improves.
“There are naysayers with every single surgical innovation that comes along,” Dr. Chen said.
Dr. Becker claims to have had enormous success, but while she has operated prolifically in Europe and
other parts of the world on patients with cancer as well as those with congenital lymphedema, she has
published only sporadically.
In a 2006 paper in Annals of Surgery, she reported that 90 percent of patients improved after surgery and
almost half were cured, but the sample included only 24 women and there was no control group.
One of the patients operated on by Dr. Becker and Dr. Chen during the daylong symposium, Jennifer
Miller, 40, a portfolio manager at an investment firm in Manhattan, said she has already felt a dramatic
improvement.
“I used to have this pain that was like my whole arm had a headache, and that’s gone,” Ms. Miller said.
Ten days after surgery the swelling in her right arm was reduced by half, compared with measurements
taken 10 days prior to the operation, and she has been able to bare her arm, which she used to keep
covered in a compression treatment sleeve most of the day.
Though her right arm is still swollen and larger than her left, she said, “It already feels more manageable, and
I’m still recovering from surgery. Even if this is all the improvement I get, I’m happy.”
But whether the change is a true effect of the transfer or a placebo effect of undergoing treatment is not
known. Doctors say it is unlikely the transplanted nodes are already functioning, and it’s possible some
other aspect of the surgery is having a beneficial effect, Dr. Chen suggested.
Digging deeper into lymphatic vessel formation in vitro and in vivo - 7thSpace Interactive (press release) –
Abnormal lymphatic vessel formation (lymphangiogenesis) is associated with different pathologies such as
cancer, lymphedema, psoriasis and graft rejection. Lymphatic vasculature displays distinctive features than
blood vasculature, and mechanisms underlying the formation of new lymphatic vessels during physiological
and pathological processes are still poorly documented.
Most studies on lymphatic vessel formation are focused on organism development rather than
lymphangiogenic events occurring in adults. We have here studied lymphatic vessel formation in two in vivo
models of pathological lymphangiogenesis (corneal assay and lymphangioma).
These data have been confronted to those generated in the recently set up in vitro model of lymphatic ring
assay. Ultrastructural analyses through Transmission Electron Microscopy (TEM) were performed to
investigate tube morphogenesis, an important differentiating process observed during endothelial cell
organization into capillary structures.
Results: In both in vivo models (lymphangiogenic corneal assay and lymphangioma), migrating lymphatic
endothelial cells extended long processes exploring the neighboring environment and organized into cord-
like structures.
Signs of intense extracellular matrix remodeling were observed extracellularly and inside cytoplasmic
vacuoles. The formation of intercellular spaces between endothelial cells led to tube formation.
Proliferating lymphatic endothelial cells were detected both at the tips of sprouting capillaries and inside
extending sprouts. The different steps of lymphangiogenesis observed in vivo are fully recapitulated in vitro,
in the lymphatic ring assay and include: (1) endothelial cell alignment in cord like structure, (2) intracellular
vacuole formation and (3) matrix degradation.
Conclusions: In this study, we are providing evidence for lymphatic vessel formation through tunneling
relying on extensive matrix remodeling, migration and alignment of sprouting endothelial cells into tubular
structures.
In addition, our data emphasize the suitability of the lymphatic ring assay to unravel mechanisms underlying
lymphangiogenesis.
Author: Benoit DetryFrancoise BruyereCharlotte ErpicumJenny PaupertFrancoise LamayeCatherine
MaillardBenedicte LenoirJean-Michel FoidartMarc ThiryAgnes Noel
Credits/Source: BMC Cell Biology 2011, 12:29
June 20, 2011
Kangoo Jumps: Hot workout trend puts a spring in your step - Denver Post – By Ellen Nordberg –
Bouncing around like kangaroos with huge smiles on their faces, Kangoo jumpers burn extra calories,
stimulate their lymphatic systems and reduce the impact on their joints by up to 80 percent.
Kangoo Jumps, a hot workout trend in Europe and South America, have bounded into Colorado.
Resembling a cross between the boot of a Rollerblade and the treads on the bottom of a snowcat, Kangoo
Jumps were originally designed by a Swiss engineer whose aging knees hindered his passion for running.
Bands or coils in the center of the shell underneath the boot stretch when compressed, creating spring or
rebound. This rebound effect is the key to their appeal and success, according to Beth Kruper, Kangoo
Jumps master trainer.
"The great thing is the reduction in impact," says Kruper, a fitness instructor for more than 20 years. "In my
classes, I have everyone from a 9-year-old to a 70-year-old. These are mostly people who want a good
workout, but many just can't do cardio any other way. I've put boots on over 3,000 people, and I see
people with so many different joint problems. Whatever hurts them when they run or do aerobics — it
doesn't hurt them with Kangoo."
Health clubs in the metro area — Denver Athletic Club, Lakeshore Athletic Club in Broomfield and Body
Dynamics Studio in Boulder — have begun offering Kangoo Jumps classes. The classes offer
choreographed moves in a studio setting, which allows users to get comfortable with the boots and move in
multidimensional directions. Many of the participants have found relief from joint issues.
"I took the Kangoo Jump class at the Denver Athletic Club for a specific reason," says Denver resident
Austin Murr. "I hadn't been able to get out and run for over six years. The pain in my knees had led me to
the boring elliptical machine. Then I put on Kangoo Jumps. Spring in the step again — literally."
In addition to studio classes, Kangoo Jumps can be worn outside on pavement, dirt trails, and potentially
even snow or sand. Many Kangoo owners take classes and also run outside with their boots.
"I haven't been able to run for years due to foot pain," says Shawn Ellis, a Lakeshore Athletic Club
member. "Kangoos allow me to run and jump as much as I want. I can run outdoors if it's a nice day. You
look kind of goofy running around the neighborhood in your boots, but it's fun."
Both the Center for Exercise Science and Sport Management at Southern Cross University in Lismore,
Australia, and the Division of Sports Medicine at The Swiss Federation Institute of Technology conducted
studies that determined that wearing Kangoo Jumps while jogging significantly reduced impact compared
with jogging in regular running shoes. However, according to the Southern Cross University study, "Further
research work is required to assess the changes in gait pattern that the Kangoo Jumps may produce."
Multiple benefits
Dr. Lorri J. Fulkerson, an orthopedic surgeon with Boulder Orthopedics who has tried Kangoos herself,
agrees that they can reduce impact on joints versus using traditional running shoes.
"Patients with mild forms of osteoarthritis may find the boots improve their tolerance for impact activity," she
says. "However, since the boots are a less-stable platform, they may not be appropriate for people with
more severe arthritis."
Kangoo offers benefits to populations beyond folks with joint issues or injury rehabilitation, according to
Wendy McClure, ACSM-certified Personal Trainer, Lakeshore instructor and co-owner of Body
Dynamics Studio. The rebounding effect increases circulation and heart rate, and facilitates lymphatic
drainage.
"The boots are great for obesity in children, and great for women with metabolic and tissue issues," says
McClure. "It's also an efficient way to exercise because the heart rate gets up easily, and your calorie burn
can be up to 50 percent more than the same exercise without the boots.
"There's also a lymphatic flush that comes with rebounding," she says. "Our organs don't flush as well as we
age. Toxins build up. A huge volume of blood is pumped through during a Kangoo workout, and it cleanses
our system like a massage."
Christy Thiel, a personal trainer in Fort Collins, struggled with digestive issues, skin problems and low
energy until she tried rebounding.
"My lymph system was stagnant. I was not metabolizing toxins," Thiel says. "I started rebounding on a mini-
tramp for two minutes a day. Within a month, I felt so much better."
Thiel went on to become a certified Kangoo Jumps instructor who has also produced a basic home weight-
loss video for Kangoo Jumps.
Trudy Turvey, a physical therapist and certified lymphedema specialist in Boulder, agrees with the benefits
of lymphatic drainage but isn't sold on the superiority of Kangoo Jumps on this process.
"Lymphatic flow is extremely important to cleanse your body of foreign toxins," she says. "But most any
kind of exercise will increase lymphatic flow. Whether or not rebounding is more beneficial than walking or
swimming on the lymph system — I'm not sure we have the research to support that."
While many people are finding benefits from the boots, Kangoo Jumps are not necessarily for everyone.
They're contraindicated for pregnant women, people with heart or blood- pressure problems and potentially
people with balance issues or a current injury.
"Anyone with an injury should definitely be led through the use of Kangoos to make sure it's appropriate for
them," McClure says. "And the boots can help people with balance issues, but they need to be guided, as
well."
Proper fit is crucial
The boots have a variety of levels of adjustments for size, strength and weight, so it's important to be fitted
by an instructor or Kangoo representative. There are adjustments from 45 pounds to over 300 pounds. A
specialist can help you find the proper tension.
Lots of local Kangoo users have purchased their own boots (see box at left), but many choose to rent or
use the boots provided by the facility for their classes. Body Dynamics charges $10-$17 per class, Denver
Athletic Club charges a one-time $15 fee for members, and Lakeshore Athletic Club charges a $2 boot
rental fee per class.
All three clubs have growing programs. Petra Storm, group exercise coordinator of the Denver Athletic
Club, touts the ease of use and positive feeling that comes from using Kangoos as the reason for the
popularity at her club.
"There's a sense of euphoria from the rebound effect," she says. "The classes are fun. We laugh and jump
around. You kind of forget you're exercising."
Ellen Nordberg is a Louisville-based freelance writer and fitness instructor.
June 27, 2011
WeCanRow is a team for survivors By Amy Laskowski - BU Today – By Amy Laskowski
After Jeanette Millard was diagnosed with breast cancer and underwent a mastectomy, friends warned her
to take it easy. Exercise might aggravate her stitches, they said, or even worse, lead to lymphedema, a
potentially dangerous condition that causes chronic swelling and often affects breast cancer survivors who
have had surgery.
But after Millard read about new research that found that exercise helps rather than hampers recovery from
breast cancer, she joined the Boston chapter of the nonprofit WeCanRow, which helps women who have
had cancer rebuild their strength and mental focus through rowing with other women who are, well, in the
same boat. The organization was originally for women with breast cancer, but today includes women
recovering from all kinds of cancer.
Millard’s decision to join the group got positive reinforcement after her eight-year-old son came to one of
her first rowing events. “He met me afterwards and told me that he didn’t have to worry about me anymore,
because he saw how strong I was,” Millard says. “Rowing made me push myself, and it really helped me
lose my fear.”
WeCanRow, which began in Boston in 2002, has strong ties to BU. University coaches, alums, and current
students help support the 30 female cancer survivors who gather each week to row. Women’s crew team
head coach Stacey Rippetoe invited the Boston chapter to become affiliated with BU after arriving here in
2008. Rippetoe had earlier founded an affiliate chapter in Lansing, Mich., while coaching at Michigan State.
She secured permission for the women to use the DeWolfe Boathouse and the rowing tanks at the
Babcock Street athletic facilities and began encouraging her squad to help coach the women.
Rippetoe says that rowing is beneficial to cancer survivors because it is not a weight-bearing or impact
sport. “You can start out at a recreational level and progress from there,” she says. “It’s a wellness program
with no expiration date, and it bridges the gap between being a patient and being an athlete.”
Hannah Rooney (SED’13), a coxswain for BU’s crew team, helps at WeCanRow practices during the
school year.
“When I’m with them I give pointers, like technical changes,” she says. “They love it when I act as if this is a
real race, yelling at them from the front of the boat.” Volunteering with the organization has been a life-
changing experience for her, she says. “These women are such an inspiration and are so strong and excited
about life. I aspire to have their courage.”
“Being diagnosed with breast cancer is a very solitary event in your life, because everything is focused on
you,” says Boston chapter president Phyllis Groskin after a recent practice. “WeCanRow shifts your focus
because you’re one of 30 women on the team—your impact makes a difference. It’s huge that in this group
we can talk about our cancer if we want, or choose not to.”
Studies show that exercise benefits breast cancer survivors, says Michael Stone, chief of surgical oncology
at Boston Medical Center and a School of Medicine professor. “Exercise improves breast cancer
survivors’ quality of life,” he says. “In the old days, they were told not to exercise, but I think that has been
largely debunked. It helps with confidence and body image, and they feel better.”
Women must get signed permission from their doctors before joining the team. In addition to their once-a-
week practices, they meet monthly with a physical therapist and coaches to go over their personal fitness
plan.
If a cancer survivor has a weak immune system, a splinter from an oar could lead to a blister or a cut and
cause a dangerous infection, so team members are advised to wear gloves. “On other rowing teams, that
would be considered bad etiquette,” says Groskin. “But if the blister or cut became infected, that could be
really serious.”
A great metaphor for life
The team takes to the Charles Tuesday nights after work, weather permitting—30 women all sporting bright
jackets so they are visible on the water. They pull the heavy racing shell out of the racks of boats and carry
it over their heads to the water, a few yards away. Their ages span three decades, a reminder that breast
cancer can strike anyone. Some are in remission; some are still living with their cancer.
On a recent summer night, the women mill about on the dock at 6:15. Coaches Alice Taggart and Molly
Jordan (SSW’00) split them into two groups: the newer, less experienced rowers climb into an old blue
tubby (it’s nearly impossible to tip) and the more experienced settle into a sleek, narrow racing shell.
Taggart lays out the night’s workout, called “odds up, evens down.” The women will row full speed for one
minute, then take a break the next minute. “Everyone ready?” Taggart yells into her megaphone. “Sit on the
square, row! Watch the woman in front of you. Short, sharp, and quick. Short, sharp, and quick. Good!”
Once they have been out on the water for a few minutes, the women begin rowing in unison. Their chatter
and banter stop when they are in the boat, their focus instead on form and technique. If a rower is off in
time from the person in front of her, the boat will not gain full speed.
Under Taggart’s direction, the women build up incrementally to a nine-minute sprint before easing back
down to a slower pace. (In inclement weather, they use the Babcock Street rowing tanks.)
The full-body workout, a combination of sliding and pulling, uses the quadriceps, back muscles, and arms.
Rowing depends on teamwork. “We rely on each other to put forth our best effort,” Millard says. “The
coaches make their lineup with people in specific seats. It’s really making a commitment to putting
everything on the line to support your teammates.”
The goal of the organization is not only to help women cancer survivors bond with one another, but to
renew their self-image and give them a sense of control.
“It’s a great metaphor for life: you face more challenges, and then you learn how to rise from the challenge,”
Groskin says. “It’s been great to be able to lose myself in the rowing. The teamwork piece has been huge
for me. Before I wouldn’t have described myself as a joiner. It’s showing me that with the right
circumstances, I can be part of a team.”
WeCanRow is seeking original, rowing-related poetry and photography submissions for Rowetry in
Motion, a journal that will published in fall 2011. Proceeds from the sale will benefit the program. For more
information, contact rowetryinmotion@gmail.com.
More information about WeCanRow can be found here.
Amy Laskowski can be reached at amlaskow@bu.edu.
June 28, 2011
Free exercise class for breast cancer patients - Bradenton Herald –
BRADENTON -- Mondays at Blake Medical Center, occupational therapist Marsha Shuford leads special
exercise classes for breast cancer patients from noon to 1 p.m.
She teaches techniques to improve breast health, increase strength and range of motion, and minimize or
prevent a complication from breast-cancer surgery called lymphedema.
There’s no charge for the classes and participants don’t have to be patients of the hospital.
Lymphedema causes fluid retention and discomfort in the affected arm and some women must wear
compression sleeves routinely to reduce the swelling.
Typically, women are told to avoid lifting anything heavy -- even a bag of groceries -- to keep the condition
from getting worse.
However, “there has been a big change in thought about lymphedema,” said Shuford, who is a certified as a
hand specialist and lymphedema specialist.
Controlled exercise to strengthen the arm and improve range of motion not only doesn’t cause harm, it can
be beneficial, she said.
Shuford tailors the class according to the needs of participants and most exercises are done sitting or
standing, she said. Classes are drop-in and held in the Cancer Resource Room at Blake Medical Center,
2010 59th St. W., Bradenton.
Shuford recommends that women who recently had surgery get approval from their doctors. For more
information about the classes, call her at 798-2141. A calendar of health events at Blake Medical Center
can be found at www.blakemedicalcenter.com/calendar.
HIV/AIDS screening advised as routine health measure
MANATEE -- This year marks the 30th anniversary of when health officials first identified a new disease
that would later be called AIDS.
Today groups such as the HIV/AIDS Network of Southwest Florida recommend that screening for HIV be
a routine part of taking care of your health.
HIV, the virus that causes AIDS, can occur silently before progressing to AIDS, which means people can
be unaware they are infected. Risk factors for acquiring HIV include unprotected sex and intravenous drug
abuse.
“Knowing their HIV status means people can get into treatment earlier, and prevent spreading it to others,”
said Dianne Shipley, a health educator at the Sarasota County Health Department.
To find HIV test sites or learn more about HIV/AIDS, visit these locations:
n Manatee County Health Department, 410 Sixth Ave. E., Bradenton. Tests are available weekdays on a
walk-in basis, or through the department’s mobile health van. For more information, call 748-0747 or visit
www.doh.state.fl.us/chdmanatee.
n Sarasota County Health Department. Test sites include a walk-in clinic at its downtown Sarasota Health
Center, 2200 Ringling Blvd. For more information, call 861-2919 or visit www.sarasotahealth.
org/services/std.htm.
n HIV/AIDS Network of Southwest Florida, 2200 Ringling Blvd., Sarasota, offers a listing of testing sites
in Manatee and Sarasota, plus information about HIV/AIDS and resources. Visit www.hivsarasota.org or
call 861-2976.
Lakeland Dedicates New Marie Yeager Cancer Center - Benton Spirit – by Patricia Plaut-Payne –
A poignant and memorable ceremony and ribbon cutting marked the official dedication of Lakeland
HealthCare’s new Marie Yeager Cancer Center on Thursday, June 16. Over 300 guests toured the two-
story, 30,000-square-foot center located in the Lakeland Health Park in Royalton Township, St. Joseph.
The cancer center will provide a single location for most cancer care needs, including medical oncology, a
pharmacy, laboratory services, a health and appearance center, holistic support services, lymphedema
therapy, and clinical research. The facility will open to patients on July 11.
“Those who will receive care here will benefit not only by the convenience and coordination of their
interdisciplinary care, their experience will be marked by more comfort, more confidence, and more hope,”
said Loren B. Hamel, MD, President and CEO, Lakeland HealthCare, in his opening remarks during the
ceremony.
Myrna Hunt, a breast cancer survivor and musician, shared her personal story about fighting the disease
followed by a moving instrumental version of “You’ll Never Walk Alone” on the piano by Rodgers and
Hammerstein.
Later in the program, a marble sculpture by renowned artist Fritz Olsen of Sawyer, Michigan was unveiled
in the cancer center’s Healing Garden. Martha Cares, a nationally regarded soprano opera singer and
spouse of Olsen, sang a song for which she had written the lyrics in honor of the occasion and unveiling.
The cancer center is named after Marie Yeager, a long-time oncology nurse at Lakeland. Her husband,
Tom, recalled her dedication and passion for caring for her patients.
“This cause was very dear to her heart, and our family knows she would be proud to continue to make a
difference for southwest Michigan patients affected by cancer,” Yeager said.
Lakeland HealthCare is a non-profit, community-owned health system, which includes four hospitals, an
outpatient surgery center, rehabilitation centers, long-term care residencies, hospice, home care services,
and physician practices. Lakeland has nearly 4,000 employees who provide clinical and support services at
locations throughout southwest Michigan, and partners with approximately 400 affiliated physicians and
other providers. For more information, visit www.lakelandhealth.org. — Benton Spirit
June 30, 2011
National Alliance of Wound Care® Announces a New Advanced Certification in the Specialty of
Lymphedema Lower Extremity Management – DigitalJournal.com
Lymphedema in the lower extremity is an accumulation of lymphatic fluid in the interstitial tissue that causes
excessive swelling in the leg(s), and occasionally in other parts of the body. Lymphedema can develop
when lymphatic vessels are missing or impaired, or when lymph vessels are damaged or lymph nodes have
been removed.
In the United States, the number of Medicare age individuals afflicted with lymphedema, or at risk of
developing it, exceeds 6.8 million.
The incidence of lymphedema as a consequence of cancer therapy ranges from 10- 50% and increases with
time.
The National Alliance of Wound Care® (NAWC®) announced today, the introduction of its newest
certification in the specialty of Lymphedema Lower Extremity Management (LLE™). The LLE is an
advanced credential that demonstrates a candidate’s proficiency and mastery of essential knowledge and
skills of lower extremity lymphedema and associated wound management. “The LLE validates a wound
care professional’s expertise in lymphedema lower extremity management. It enhances their marketability,
while assuring employers they are hiring a leader with tested competency in lower extremity lymphedema,”
said Debbie Hecker, executive director of the National Alliance of Wound Care. The LLE is the third
certification offered by the NAWC. Prerequisite education for LLE certification will be offered by
Lymphedema and Wound Care Education, LLC (LWCE).
About NAWC
The NAWC is a non-profit organization dedicated to the advancement and promotion of excellence in
wound care through the certification of wound care practitioners. It is the largest professional wound care
credentialing and membership organization in the United States. The NAWC is among an elite group of
more than 90 credentialing organizations that have received and maintained National Commission for
Certifying Agencies (NCCA) accreditation. For more information about the LLE, DWC® and WCC®
certifications, visit their website at http://www.nawccb.org.
About LWCE
Lymphedema and Wound Care Education, LLC (LWCE) is an organization created as a result of the joint
partnership of the Wound Care Education Institute and the Norton School of Lymphatic Therapy. LWCE
is the exclusive provider of the advanced course in Lower Extremity Lymphedema Management, a
prerequisite for the LLE certification. LWCE is the second approved education partner for the National
Alliance of Wound Care. For more information about LWCE, visit their website at http://www.lwce.net.
About Norton School of Lymphatic Therapy
The Norton School of Lymphatic Therapy is the premier educational institution for training qualified medical
professionals to become experts in the treatment of pathologies related to the lymphatic system. Taught by
the finest and most experienced faculty in the field, Norton School students receive thorough and rigorous
training in the Foeldi Method of Complete Decongestive Therapy (CDT), the therapeutic system regarded
as the "Gold Standard" for the treatment of lymphedema by the International Society of Lymphology (ISL).
Founded by Steve Norton, renowned authority in the field of lymphedema therapy, the Norton School
offers lymphatic therapy certification courses throughout the United States, Canada, within prestigious
hospital and out-patient clinical settings. For more information about the Norton School of Lymphatic
Therapy, visit their website at http://www.nortonschool.com
About WCEI
The mission of the Wound Care Education Institute is to develop multi-disciplinary wound care
professionals in the United States by offering educational programs and clinical support, based on up-to-
date wound care research, trends, and evidence-based practice. The Wound Care Education Institute
offers a comprehensive skin and wound care training program at locations throughout the United States.
For more information about WCEI, visit their website at http://www.wcei.net
Secret donor helps 770-pound patient - MyFox Tampa Bay – by Ken Suarez –
LAKELAND - A Lakeland woman rendered immobile by a medical condition with no place to live will
have a home, thanks to an anonymous donor.
Yvonne Gallimore didn't know where to turn. A medical condition called lymphedema left her weighing 770
pounds and in the hospital. Firefighters had to knock the wall out of her apartment to get her out.
Lakeland Regional Medical Center was ready to discharge her, but she had no place to go back to.
And any place she would go would have to be adapted for her at a cost of at least $70,000.
After FOX 13 aired her story, an anonymous donor came to the rescue the following day. She said to get
Gallimore the new place she needs whatever the cost.
Gallimore got the incredible news on Wednesday.
"I don't know who it is," she said from her hospital bed. "Whoever you is, I thank you. I love you, and I
really appreciate it."
Tears began welling up in her mom's eyes when she found out.
"I tell you, God is good, and I thank you very much because that's exactly what she needs, and I am so
grateful," said Margaret Moore.
Gallimore is 51. Seventeen years ago, she was diagnosed with lymphedema, a malady that causes the body
to hold onto fluids. Moving around became harder and harder as she gained weight, and she eventually
became bedridden.
Details about where she will go when she leaves the hospital have not been worked out yet. The money
could go towards adapting an apartment or house, or building a new home.
Fat, lazy taunts stole Amanda Bell's dignity - Herald Sun – by Marianne Betts –
A SEVERELY obese woman claims constant taunting by hospital staff has robbed her of her dignity.
Amanda Bell, 51, who spent 45 days seriously ill with blood poisoning at Monash Medical Centre, said on
one occasion a nurse told her it was about time she got her "lazy fat a---" out of bed and had a shower.
"I just burst into tears ... I am physically unable to get out of bed, and I wasn't being regularly sponged
down - my hair hadn't even been washed in 21 days."
Ms Bell weighs 220kg and has been house-bound for nearly two years, with her weight ballooning because
of lymphedema, a condition causing her body to retain fluid.
She decided to speak out because she wanted to prevent others being treated the same way.
Ms Bell, who left hospital a fortnight ago, said she had often been given filthy looks by nurses, and felt she
had been constantly judged because of her size.
"They looked me up and down like I was a piece of dirt, and once I said: 'Please don't look at me like that,
I'm a human being, and I have feelings'."
Ms Bell, who shared a ward with three other patients, was also forced to lie in her own waste for eight
hours.
A Southern Health spokesman said: "We are sorry to hear that the care provided did not meet the patient's
expectations.
"We have looked into this case and our review has shown that the care provided to the patient was
appropriate."
The hospital said extra staff and equipment were allocated to meet Ms Bell's needs.
June 2, 2011
Beyond Cancer: Living with Lymphedema - NBC2 News –
Many cancer patients may find themselves dealing with a lifelong side effect.
Lymphedema is extreme swelling that comes as a result of lymph node damage. It can show up at any time.
Sandy Hawkins introduction to lymphedema came as a complete surprise.
"Well, it was an unpleasant surprise," says Hawkins. "I woke up one morning in January and my whole
upper body was swollen."
Lymphedema occurs when the lymphatic system is disrupted. If fluid can't get to the heart, it pools up,
causing the swelling.
" And, of course, there's the psychological implications," Hawkins says. "It doesn't feel very nice to look in
the mirror and see all that."
Sandy reached out to a certified lymphedema therapists to help her manage the swelling in her arm.
"We teach manual lymph drainage which is a massage technique," says Jackie Speas, a lymphedema
therapist with Lee Memorial Health System. "It redirects the fluid to parts of the body that do not have
edema."
Therapists also teach patients how to keep their condition under wraps.
"We'll also do compressive wrapping," Speas says. Which we use short stretch bandages and actually wrap
the extremity to reduce the edema."
Once the swelling is under control, the challenge is to keep it that way. That generally requires wearing
compression garments.
"We ordered these sleeves and gauntlets which are the hand part. I
tried the gloves but wasn't happy with that so these gauntlets are much easier to use daily."
While there is no cure for lymphedema, there is also no reason to live with the swelling. For patients like
Sandy, the work is worth the effort as she's regained control of her life and limbs
June 3, 2011
NEW: Several medical ailments don't keep man from living life - The Morning Sun – By RYAN BERLIN –
John Brandon spends 12 hours and three days a week receiving treatment.
He is suffering from End stage kidney failure and goes through dialysis.
Kidney failure is only one of Brandon’s many problems.
“I have several medical maladies that I have to contend with,” Brandon said.
“(I have) end stage kidney failure, I have scoliosis, I am diabetic so I have neuropathy in my limbs. I can’t
feel much of anything anymore.”
Brandon has an ulcer on the bottom of his foot that has been there for 10 years.
His current treatment for that requires a doctor scraping away at it with no anesthesia.
He also has lymphedema in his left leg. It causes swelling due to a blockage of the lymph passages.
Of everything Brandon goes through Dialysis is the toughest on him.
“I get here about 1:30 p.m. I’ll work on my business or fall asleep because it is absolutely draining,” he said.
Dialysis filters patients’ blood by removing it from their body and purifying it of any fluids or toxins,
according to RN-CDN Jan Snyder.
Dialysate is a fluid that is used to help clean a patients’ blood.
“Dialysate is composed of electrolytes and also sodium as a buffer and bicarbonate to balance the blood,”
Snyder said.
“The filter also traps toxins in excess metabolic waste. Our patients either don’t urinate or their urine rate
has greatly decreased.”
When that happens toxins build up in the blood and it needs to be cleaned and removed.
No matter how tough things may get for John he never allows himself to get down.
He spends a lot of his time, when he isn’t getting treatment, ordering and selling replica celebrity jewelry.
John bought a Filthy Rich of Mid-Michigan franchise for the Mt. Pleasant area.
“I have several vendors that I get the jewelry from. I have always been thoroughly interested in celebrity,”
he said.
“When I came across this business opportunity I thought I can do that. I can buy this stuff and have an open
house.”
Some of the replica celebrity jewelry that Brandon sells comes from artist collections like Humphrey
Bogart, Katherine Hepburn, and his favorite, Elvis Presley.
Brandon decided to sell the jewelry because he didn’t want to go on welfare and sit around doing nothing.
Each piece of jewelry has a story behind it, according to Brandon.
One Elvis ring he was wearing, Elvis wore in Hawaii at a concert.
“He had a personal jeweler that flew around with him where ever he went,” Brandon said.
“One concert Elvis was at a cute little girl handed him a rose and he handed her a ring. He gave away tens
of thousands of dollars worth of jewelry that night.”
Brandon’s show will be held Sunday June 12 in the community room at the Crossings on Broadway from
11 a.m. to 7 p.m.
“John has raised the bar. Not only for dialysis patients but for everybody else out there whether it be they’
re out of a job because they’re over qualified or under qualified,” Snyder said.
“If you really make a concerted effort there is something you can do to become a contributing member of
society not only in the work force but also with volunteering.”
Elastic Therapeutic Taping: A Valuable Fit for Chiropractic - Dynamic Chiropractic – By Kenzo Kase, DC
–
The concept of elastic therapeutic taping first came to me in the 1970s while I was practicing as a
chiropractor and teaching. The taping is non-invasive, free from drugs, and integrates well into the
chiropractic model.
Many conditions, including whiplash, herniated disc, muscle strain and sprain, headaches and degenerative
joint disease are commonly treated with therapeutic taping in conjunction with traditional chiropractic.
Tracy Barnes, DC, DICCP, of Louisville, Ky., uses elastic therapeutic taping on many different kinds of
patients. She enumerates: "For all those patients who continue to need a tactile cue to stay in certain
postural positions, tape is great. For all those patients in pain from swelling, inflammation and injury, tape is
great. For those patients who just need an extra 'umph' to feel better, tape is perfect." In fact, Barnes notes,
"I wouldn't want to practice for long without it."
For many DCs, it is a standard in their practice. Dr. Scott Hainz practices in Missouri. He notes, "To help
prevent prolonged recovery times, we incorporate [therapeutic taping] to enhance the in-office treatment,
whether it be an adjustment or soft-tissue therapy."
Michigan chiropractor Dr. Tim Dunne observes that "Taping allows the patient to leave with a prescription
for the body to follow through with as it heals in the proper functional motion. This leads to a significant
increase in patient outcomes." Chiropractic is based on the knowledge that the human body has an innate
self-healing ability and seeks balance. Therapeutic taping is based on the same assumption. Taken together,
the whole concept is grounded in treating the cause of the patient's pain or weakness. In his experience, Dr.
Dunne says, taping "always works." He has found that "if you are not getting the results you are looking for,
reassess and retape; you haven't figured out the problem."
In the 1970s, it had became clear that the patient's response to treatment was the most important aspect of
medicine. For example, allopathic practitioners received respect because they were able to implement
pharmaceutical drugs with demonstrated effectiveness. While chiropractic adjustments have also been
demonstrated to be effective, patients who are seeking pain relief may have a tendency to gravitate toward
pharmaceutical treatments.
For this reason, it is important to search for the cause of the pain in order to treat patients more effectively
using chiropractic techniques. The sensory receptors in the dermis turn out to be the key: upon specific
stimulation of these receptors, which are plentiful in the skin, pain signals can be generated. Because of the
abundance of these receptors, a cut or burn on the skin will hurt more than visceral pain. With this in mind, I
considered how to best approach the management of painful conditions.
When we feel pain, we have a tendency to touch the area; however, it is not the application of pressure to
the site, but the action of lifting with the palm of the hand that affects the sensation of pain. The lifting motion
stimulates the mechanoreceptors in that particular region and decreases the pressure on the site, thereby
decreasing the feeling of pain. Accordingly, I wanted to create a material that would simulate this action. At
first, I was using athletic tape in an effort to avoid applying pressure to the painful site, but found that athletic
taping was too constricting. This compression is helpful in stabilizing the area; however, it limits motion and
circulation, and is consequently ineffective in managing pain. To solve this problem, I designed a unique
elastic therapeutic tape. This creation allows for therapeutic taping treatment that does not involve drugs or
surgery and is easily assimilated into common chiropractic protocol.
Studies have demonstrated the effectiveness of therapeutic taping for pain. A 2005 case study followed
three patients who complained of patellofemoral pain and documented positive outcomes for all three.
Patient #1, a 91-year-old woman, had improvements of "no pain with gait; no night pain, knee pain was
immediately resolved following the application." For patient #2, age 56, treatment resulted in "no pain with
normal walking, no pain with ascend or descend stairs." This patient also reported less pain at the end of
her day. After treatment, 12-year-old patient #3 experienced no pain with running or during athletic
activities such as running and snowboarding.
In a United Kingdom study yet to be released, South African MDs compared the use of ibuprofen versus
elastic therapeutic taping for pain. Their results found the taping to be as effective as ibuprofen.
My own education is not only in spinal manipulation, but also includes training and experience with
acupuncture, topical herbs, applied kinesiology and electrostimulation, among other modalities. Taking these
into consideration, it is clear that the concept behind them all correlates with the way tissues need to be
addressed.
Since being a chiropractic student, I have also been interested in the osteopathic fluid system and how this
affects the body. Between the epidermis and the dermis lies the fluid lymphatic layer which has a close
relationship with the capillary beds and often becomes congested. One can affect this layer by utilizing the
hydrokinetic system: by creating more space and increasing the amount of fluid in that area. A secondary
effect is an increase in circulation of the fluid. Third, there is a pumping effect propelled by the movements
of the body. The movement of the cerebrospinal fluid (CSF) circulation has a pumping muscle at the base of
its motion. Hence, a wasted, weak muscle can form a blockage to the movement of the fluid system in the
body.
A Colorado case study2 published in 2007 looked at conservative treatment of a collegiate athlete.
Researchers reported, "The application of the [elastic therapeutic tape] seemed to enhance proprioceptive
function to reduce irritation during activities. The athlete reported being more aware of the stress she
applied while playing. Another desired effect was to improve lymph flow from the injured area. The patient
noted improvement in pain and functional performance levels during and after wearing the tape."
In a 2010 case study3 from Poland, researchers observed that "Complex Decongestive Therapy (CDT)
often needs modifying in advanced cancer patients. One of the options is using [taping] instead of multi-
layer bandaging. It can be particularly helpful in patients who cannot undergo compression treatment due to
pain." The article presents the case of an advanced cancer patient whose painful skin tension, caused by
lymphedema, was successfully reduced with the use of therapeutic taping.
Stimulation of the muscle spindles balances the contraction of the muscle and also increases the movement
of the muscle, which enhances circulatory flow and helps in changing metabolism. Therapeutic taping has the
ability to move fluid to the correct area. In the case of joint subluxations or restrictions, chiropractors
consider soft tissue and the movement of fluid; as such, in any profession, but especially in the chiropractic
profession, this unique ability of therapeutic taping to influence the movement of fluid must be considered.
Thirty-five years ago, I introduced this idea to the chiropractic community in Japan, and its use there
became widespread. Other medical groups, as well as athletes and patients, began utilizing the taping
treatment. Elastic therapeutic taping has been widely accepted, and seen in many Olympic and professional
sports and consequently, those interested in healing are using the tape on their own. Still, there is a limit to
the amount of healing that can be done by a patient without the guidance of a knowledgeable practitioner.
As a result, each practice should consider using therapeutic taping to manage patient healing, especially
considering that it can be used in place of drugs. In this manner, therapeutic taping can be a perfect
connection between the doctor's manipulation and the patient healing process.
Taping also provides a marked non-therapeutic benefit, as patients using the tape become walking
billboards for the practice. I don't know how many times patients have asked for it, either because they've
seen it on some famous athlete or – more commonly – because a relative or acquaintance has used it and
recommended not only the tape, but also the DC who first applied it.
References
Brandon R, Paradiso L. The use of Kinesio tape in patients diagnosed with patellofemoral pain (PFP).
2005. Case study of three patients.
Aspegren D, et al. Conservative treatment of a female collegiate volleyball player with costochondritis.
Journal of Manipulative and Physiological Therapeutics, 2007;30(4):321-325.
Pyszora A, Krajnik M. Is Kinesio taping useful for advanced cancer lymphoedema treatment? A case
report. Advances in Palliative Medicine, 2010;9(4):141-144.
MD Anderson Radiation Oncologist Brings New Option, Experience to Katy – WebWire –
APBI Joins Growing Range of Breast Services
The University of Texas MD Anderson Cancer Center’s Regional Care Center in Katy now offers some
women newly diagnosed with early-stage breast cancer a newer treatment option.
Adding to a growing complement of breast cancer services, the MD Anderson Regional Care Center in
Katy now offers accelerated partial breast irradiation (APBI), or brachytherapy, a radiation therapy
technique delivered after lumpectomy. The use of APBI steadily has been growing, and for the appropriate
patient, is a suitable treatment option.
For some women, accelerated partial breast irradiation may be an alternative to the current standard which
is four to six weeks of daily external beam radiation after breast-sparing surgery. With the newer technique,
the number of radiation treatments is reduced to only five days of twice-daily treatments after surgery.
Bringing the technique to MD Anderson’s Regional Care Center in Katy is radiation oncologist Elizabeth
Bloom, M.D., associate professor in Radiation Oncology. Bloom recently moved to the center, but has
been with MD Anderson since 1999 and was one of the first to bring APBI to Houston. She has treated
about 150 patients with APBI since 2008 when she first introduced it at MD Anderson’s Radiation
Treatment Center in Bellaire.
According to Bloom, APBI, given after lumpectomy, directly treats the area in the breast at highest risk for
recurrence while minimizing the dose to the remaining healthy breast tissue.
With APBI, the breast surgeon inserts a small device into the lumpectomy cavity and expands it to fill the
small, hollowed-out area of the breast where the tumor once was. The devices, composed of several small
catheters (tubes), are designed specifically for APBI and come in a wide variety of sizes and shapes to
accommodate the needs of each patient.
The device is left in place for approximately eight to 10 days for treatment planning and delivery.
When treatment begins, a radioactive seed is inserted through the individual catheters of the implanted
device and left in place for about five to 10 minutes - the length of one radiation treatment - and then
removed when the patient leaves the Katy center. The procedure is repeated twice daily for a total of five
days.
The ideal candidate for APBI typically is a woman who is more than 50 years old and has a relatively small
tumor that is confined to the breast, she said.
"Communication between the patient and her MD Anderson care team and communication within her MD
Anderson team is even more vital when it comes to APBI" said Bloom. "Every day we work in synch to
leverage our specialties in radiation, surgery, medical oncology, radiation physics, pathology and radiology,
but our collaboration is especially evident with APBI"
She said the team at MD Anderson is ideal because of its breadth and depth of experience with the
technique and the focus on breast cancer diagnosis, treatment, support and recovery.
Susan Hoover, M.D., associate professor of Surgical Oncology and a breast surgeon who cares for
patients at MD Anderson Regional Care Center in Katy, agrees that collaboration is key with APBI.
"When it’s clear that a patient would do well with APBI and is interested in pursuing the treatment, the
communication starts immediately" said Hoover, who trained in breast surgery as a fellow of The University
of Texas Southwestern Breast Oncology Fellowship Program funded through Susan G. Komen For the
Cure. "While this technique may not be for everyone, we want to make it as accessible as possible to as
many patients as we can. It is an effective option for a select group of patients"
In addition to APBI and other radiation techniques, MD Anderson’s Regional Care Center in Katy offers a
growing range of breast cancer services, including care for benign breast disease and suspicious lumps. The
Katy center’s breast team includes medical oncologists, oncology nurses experienced in breast care,
radiation oncologists, breast surgeons, social workers, pain management specialists, rehabilitation therapists
experienced in lymphedema, nutritionists and genetic counselors.
MD Anderson’s Regional Care Center in Katy is located on the campus of CHRISTUS St. Catherine
Hospital. MD Anderson also has regional care centers in The Woodlands, Sugar Land and the Bay Area
(Nassau Bay).
Breast cancer survivors race for rehabilitation - Focus Taiwan News Channel – by Nancy Liu -
For many breast cancer survivors, the rehabilitation process can be daunting, but it is not so for a group of
women who have found a way of integrating sports into their daily lives.
Liaw Pey-jiun, a seven-year breast cancer survivor, said that rehabilitation has not been a problem for her
because she exercises regularly and participates in various sports events, the most recent being the dragon
boat races.
Liaw, 56, is a retired nurse and the newly elected captain of the nation's first Breast Cancer Survivors
Dragon Boat team, which was formed last year to encourage patients to take part in public sporting
activities.
The initiative was so successful that 60 people signed up, which meant they had to be split into two teams.
"It has helped me profoundly, " Liaw said. "Now I want to introduce more breast cancer survivors to the
sport."
"Not only do I feel healthier, I also think that (literally) being in the same boat helps to forge a valuable bond
between the team members," she said.
At Bi Tan and Da-Jia Riverbank Park where teams often train for the dragon boat races, the women, some
in their 70s, practice at their own pace and keep up a steady stream of chatter.
Liaw said they talk about everything, from family life to fighting depression, which often besets breast
cancer survivors.
"We don't want to bother our loved ones all the time, and this activity offers the perfect opportunity to share
our problems, " she said.
In medical circles, there has been more of a focus in recent times on the rehabilitation aspect of breast
cancer treatment, according to one professional.
"In the past, doctors paid more attention to surgical or chemical treatment than to rehabilitation," said Chen
Huo-mu, director of the Department of Breast Surgery at Taipei City Hospital.
"But the high survival rate over the years has led us to think about how breast cancer patients can live longer
and lead happier lives," said Chen, who strongly supporters the boat racing activity as a form of
rehabilitation.
There are more than 8,000 new breast cancer survivors each year and more than 70 percent surpass the
10-year survival estimate, he said.
Dragon boat racing, which originated in China as a ritual, was highly recommended by a Canadian
professor Donald McKenzie in 1996 as an activity that could help decrease lymphedema among breast
cancer patients.
"There are more than 100 racing teams composed of breast cancer patients around the world now, so there
is no reason why we should not support the activity," Chen said.
Asked about the physiological benefits, he said that various types of research have proven that rowing
strengthens the upper body muscles and helps reduce tissue swelling, or lymphedema, which usually results
from the removal of lymph nodes.
"Any form of exercise is helpful as long as the muscles are being worked on a regular basis, " said Lin Wei-
chieh, secretary-general of the Taiwan Breast Cancer Alliance (TBCA) and an organizer of water dance
lessons.
"It is best if the instructor becomes familiar with the specific needs of breast cancer survivors and integrates
therapeutic massage into the movements," she suggested.
For Liaw, however, the psychological benefits gained from boat racing far outweigh the physical advantages.
"The scariest thing is to fight breast cancer alone, but I feel a sense of identity and belonging when I'm
working with my teammates, " she said.
June 4, 2011
Breast cancer surgery patients benefit from adding radiation therapy – EurekAlert – Veronica McGuire –
Breast cancer surgery patients benefit from adding radiation therapy
(Hamilton, ON) June 4, 2011 - Additional radiation treatment improves disease free survival lessening the
chance of cancer recurring in women with early breast cancer who have had breast conserving surgery
(lumpectomy), interim results of a new study found. The results will be presented Monday, June 6 at the
annual meeting of the American Society of Clinical Oncology.
"These results are potentially practice-changing," said Dr. Timothy J. Whelan, professor of oncology at
McMaster University's Michael G. DeGroote School of Medicine and lead study investigator for the NCIC
Clinical Trials Group, which is funded by the Canadian Cancer Society.
In the study of more than 1,800 women with breast conserving surgery, participants received whole breast
radiation (WBI) alone or WBI plus radiation to the surrounding lymph nodes called regional lymph node
irradiation (RNI). Most of the women had one to three positive lymph nodes while 10 per cent had high-
risk, node-negative breast cancer. All had been treated with breast-conserving surgery and adjuvant
chemotherapy or endocrine therapy.
After a five-year follow-up, interim analysis of the data showed a greater than 30 per cent improvement in
disease-free survival for those receiving RNI. This resulted from a 41 per cent lower rate of recurrences in
the breast and lymph nodes and a 36 per cent lower rate of cancer recurrence in other parts of the body.
There was a low, but statistically significant, increased risk of moderate pneumonitis (lung inflammation) and
lymphedema (excess lymphatic fluid) in the arm on the radiated side.
Whelan, division head of radiation oncology at McMaster and the Juravinski Cancer Centre and a Canada
Research Chair, expects the results will encourage physicians to offer all women with node-positive disease
the option of receiving regional nodal irradiation.
"Adding regional nodal irradiation improved disease-free survival, lowered the risk of recurrences, and
there was a positive trend toward improved overall survival, while not greatly increasing toxicities," he said.
"For women with node positive breast cancer who are at high risk of recurrence of their breast cancer,
these findings provide an important new treatment option," says Dr. Christine Williams, Director of
Research, Canadian Cancer Society. "Ultimately, this finding will help more women survive and thrive after
treatment."
Treatment for women with node-positive breast cancer has been breast-conserving surgery plus axillary
lymph node dissection, followed by radiation to the breast (WBI). If a woman's cancer is considered high-
risk, such as a tumour larger than 5 cm or more than three positive axillary nodes, she often receives RNI.
However, until now, the benefit of adding RNI for women with one to three positive nodes has been
unclear.
###
The NCIC CTG receives programmatic funding from the Canadian Cancer Society Research Institute. The
MA.20 trial was supported by the US National Cancer Institute / Cancer Therapy Evaluation Program and
with funds provided by the Canadian Breast Cancer Research Alliance.
More radiation better for breast cancer patients - healthzone.ca – Joseph Hall –
Targeting lymph nodes with radiation after tumour removal surgery dramatically reduces the risk that breast
cancer will spread to distant parts of the body, a Canadian-led study shows.
In research that will likely change standard treatment for the ailment, women with tumours that had spread
to the lymph nodes reduced their risk the cancer would metastasize even further by 36 per cent with the
extra radiation.
The risk the cancer would return in the breast area also plunged by 41 per cent.
“The big finding was that it prevented cancer from spreading,” says Dr. Timothy Whelan, an oncologist at
Hamilton’s McMaster University.
The danger that cancer would spread to the spine, lungs or other organs was reduced from about 13 to just
over seven per cent, says Whelan, the lead study author.
“That’s a pretty significant finding for women . . . and that’s a bit surprising,” he says.
Whelan presented the paper Saturday at a meeting of the American Society of Clinical Oncology in
Chicago.
He says current treatments typically limit radiation to the breast, all of which is irradiated following tumour-
removing lumpectomies. But because radiation can cause some side effects, such as arm-swelling
lymphedema, physicians have not gone after the nearby lymph system, which often acts as a way station for
cancer spread.
“We (also) didn’t think there would be that much added benefit,” Whelan says.
The study looked at more than 1,800 Canadian, U.S. and Australian women, 90 per cent of whom had
seen their cancer spread to one or more lymph nodes. The other 10 per cent had primary tumours that
were deemed aggressive.
More than 90 per cent of the patients had been given chemotherapy and about three-quarters of them had
received hormone treatments to combat their cancer.
But for the study, about half the patients had standard breast radiation while the other 50 per cent received
additional lymph-node treatments in the lower neck and chest areas. After five years, the lymph-node
cohort faired significantly better than the group which had radiation confined to the breast.
Whelan says the results will have to persist beyond that time frame before physicians can be absolutely
certain additional lymph radiation works best.
But the preliminary results are so striking, he says, that many cancer specialists will likely take it up
immediately with their patients.
Christine Williams, director of research with the Canadian Cancer Society thinks such a move is more than
warranted given the study’s results.
“The results are so strong that I think we certainly expect it to change clinical practice,” Williams says,
adding that it would only mean a modest change in the radiation techniques already being done in clinics.
Williams cautions, however, that the patients will have to be followed further to ensure the results hold true
over time.
Study: Pfizer drug lowers risk of breast cancer – Forbes – By MARILYNN MARCHIONE –
CHICAGO -- Millions of women at higher-than-usual risk of breast cancer have a new option for
preventing the disease. Pfizer Inc.'s Aromasin cut the risk of developing breast cancer by more than half,
without the side effects that have curbed enthusiasm for other prevention drugs, a major study found.
It was the first test in healthy women of newer hormone-blocking pills called aromatase inhibitors, sold as
Arimidex, Femara and Aromasin, and in generic form. They're used now to prevent recurrences in breast
cancer patients who are past menopause, and doctors have long suspected they may help prevent initial
cases, too.
Prevention drugs aren't advised for women at average risk of breast cancer. Those at higher risk because of
gene mutations or other reasons already have two choices for prevention - tamoxifen and raloxifene. But
these drugs are unpopular because they carry small risks of uterine cancer, blood clots and other problems.
"Here's a third breast cancer prevention drug that may in fact be safer," said Dr. Allen Lichter, chief
executive of the American Society of Clinical Oncology.
The study was discussed Saturday at the society's annual meeting in Chicago, along with another one that
could change care for thousands of women each year with breast cancer that has spread to lymph nodes. It
found that giving radiation to the armpit - not just the breast - after surgery significantly lowered the chances
the cancer would come back.
The prevention study involved 4,560 women from the U.S., Canada, Spain and France. They had at least
one risk factor - being 60 or older, a prior breast abnormality or pre-invasive cancer, or a high score on a
scale that takes into account family history and other things.
They were given daily doses of exemestane, sold as Aromasin, or dummy pills. After about three years,
there were 11 cases of invasive breast cancer among those on the drug versus 32 among the others. That
worked out to a 65 percent reduction in risk for those on the drug - enough of a benefit that independent
monitors decided all participants should be offered it.
Serious side effects, such as broken bones, high cholesterol and heart problems, were similar in both
groups. Slightly more women on the drug reported hot flashes, fatigue, sweating, insomnia and joint pain,
but quality-of-life scores were similar.
Earlier studies of aromatase inhibitors found they can cause bone loss, vaginal dryness, problems having
sex, joint pain and muscle aches, so it will take longer study to see if these occur, Lichter said.
The study's leader, Dr. Paul Goss of Massachusetts General Hospital, figured that 26 women would need
to take exemestane for five years to prevent a single case of breast cancer. Even though this study did not
compare the drug to tamoxifen, previous studies suggest 96 women would need to take it for five years for
each breast cancer prevented.
"This is a new option for prevention of invasive breast cancer for a wide pool of women," without the
serious side effects of tamoxifen or raloxifene, Goss said.
Results were published online by the New England Journal of Medicine. The Canadian Cancer Society,
Pfizer ( PFE - news - people ) and the Avon Foundation helped pay for the study. Goss and some other
researchers have been paid speakers for Pfizer and other cancer drug makers.
Brand-name aromatase inhibitors cost from $340 to $420 a month, although some are available as
generics. Aromasin's U.S. patent expired in April and will expire in Europe and Japan in July.
A second study at the conference focused on treating breast cancer that has spread to the lymph nodes.
Standard treatment is surgery followed by chemotherapy or hormone therapy and several weeks of
radiation to the breast. Women with large tumors or many cancerous nodes also get radiation to the armpit
and lower neck, but doctors don't know if this helps women with smaller tumors or only one to three
cancerous nodes - a common situation.
Dr. Timothy Whelan of McMaster University in Hamilton, Ontario, Canada, led a study of 1,832 such
women. All were given standard treatment with radiation to the breast, and half also had radiation to the
armpit and lower neck area.
After about five years, 90 percent of those given wider radiation were cancer-free versus 84 percent of the
others, and there was a trend toward better survival with more radiation.
Lung inflammation and lymphedema - painful arm swelling caused by poor drainage - were more common
with wider radiation, but doctors said these side effects were worth the benefit of fewer cancer recurrences.
The results are "potentially practice-changing" and will encourage doctors to offer wider radiation, Whelan
said.
Worldwide, about 1.3 million women are diagnosed with breast cancer each year and nearly 500,000
women die of the disease. Last year in the United States, there were about 207,000 new cases and 40,000
deaths from breast cancer.
Online:
Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast,
rewritten or redistributed.
June 5, 2011
An explanation of lymphedema - Bismarck Tribune – By JEN NEWMAN –
What is lymphedema?
When the lymphatic system has been damaged or is impaired, a clear, light yellow protein-rich fluid can
build up and cause swelling, thickening of the tissues, and skin changes. This condition, referred to as
lymphedema, can occur in the arms, legs, trunk, face, and/or genitals.
Who is at risk for developing lymphedema?
It's possible for a malformation of the lymphatic system to occur at birth or later in life; this is called primary
lymphedema. Secondary lymphedema refers to individuals who are at risk if they have had surgery, trauma,
infection, scarring, or radiation therapy of the lymphatic system (including lymph nodes). Any of these
conditions can cause a disruption to the lymphatic system that can result in an abnormal flow of lymphatic
fluid leading to lymphedema.
How is lymphedema treated?
Complete decongestive physiotherapy is an effective treatment. Certified lymphedema therapists
incorporate four CDP components, including manual lymph drainage, compression bandaging and/or
garments, lymphatic exercises, and skin and nail care. These therapists also provide education on managing
lymphedema at home.
Is it necessary to treat lymphedema?
The lymphatic system plays a very important role in immunity and circulation.
If lymphedema is left untreated, the involved part of the body may become more swollen and the tissues
increasingly hard. Skin changes may occur, as well as additional complications such as infections or
cellulitis. It is never too late to treat lymphedema; however, early intervention is best.
How can I reduce my chances for developing lymphedema?
If you are at risk, take precautions to avoid any type of trauma or injury to the at risk area to prevent onset
of an infection. Perform exercises or activities in moderation. Avoid applying heat or constricting the
involved area. To learn more, visit medcenterone.com/lymphedema.
(Jen Newman is an occupational therapist and certified lymphedema therapist at the Medcenter One
Rehabilitation Center. Newman is a graduate of Colorado State University with a master's degree in
occupational therapy. She is certified as a lymphedema therapist by the Norton School of Lymphatic
Therapy and the Lymphology Association of North America.)
Practice-Changing Radiation Study in Early Breast Cancer? – Medscape –
Tina – you have to be a member of something to access this article, sorry
June 6, 2011
ASCO: Nodal RT May Lessen Risk of Breast Ca Mets - MedPage Today – By Ed Susman –
CHICAGO -- Radiation therapy to regional lymph nodes appears to lessen the risk of metastases in
women undergoing treatment for high-risk breast cancer, researchers reported here.
However, the primary endpoint of the multinational study did not achieve statistical significance, said
Timothy Whelan, MD, from Juravinski Cancer Center, Hamilton, Ontario. The relative risk of death was
24% lower if women were treated with whole-breast irradiation and regional lymph node radiation rather
than whole-breast irradiation alone (P=0.07).
In a press briefing at the annual meeting of the American Society of Clinical Oncology, Whelan also said
that in the trial:
Locoregional recurrence was reduced by 42% among women who were treated for early breast cancer
with whole-breast irradiation including the regional lymph nodes compared with whole-breast irradiation
alone (P=0.02).
Distant recurrence was reduced 36% if regional nodal radiation was given (P=0.002).
At five years, disease-free survival was increased by 33% if regional nodal radiation was done (P=0.003).
Women who received extra-nodal radiation, however, did experience more radiation pneumonitis and
lymphedema.
"This study suggests that all women with node-positive disease [should] be offered regional nodal
irradiation, provided they are made aware of the associated toxicities," Whelan said.
The researchers enrolled 1,832 women, between March 2000 to March 2007, who had high-risk, node-
negative or node-positive breast cancer. The patients had undergone breast-conserving therapy and
adjuvant chemotherapy and/or endocrine therapy.
Whelan and colleagues stratified the patients by positive nodes, axillary nodes removed, chemotherapy, and
endocrine therapy. They were then randomized to whole-breast irradiation at the following doses:
50 Gy in 25 fractions with or without 10 Gy boost
50 Gy in 25 fractions with or without 10 Gy boost plus regional nodal radiation of 45 Gy in 25 fractions
Regional nodal radiation was delivered to the internal mammary, supraclavicular, and high axillary lymph
nodes.
In the trial, the researchers assigned 916 women to receive whole-breast irradiation and regional nodal
radiation. A second group of 916 women was treated with whole-breast irradiation alone.
Of those women who only received whole-breast irradiation, 5.5% experienced locoregional recurrence
compared with 3.2% of those who had whole-breast irradiation and regional nodal radiation.
About 13% of the women who were treated with whole-breast irradiation alone experienced distant
metastases compared with 7.6% of those who received the combination therapy.
The researchers are currently following these patients so additional analysis might show a survival benefit, he
said.
The combination treatment was associated with a 50% rate of dermatitis compared with 40% for whole-
breast irradiation only (P<0.001).
The women who received radiation to the nodes had a 1.3% rate of pneumonitis compared with 0.2% of
those who only received whole-breast irradiation (P=0.01). There was a 7% rate of lymphedema in the
combination group versus 4% who just received whole-breast irradiation (P=0.004).
Commenting on the study, Jose Baselga, MD, from Massachusetts General Hospital/Harvard Medical
School in Boston, noted, that "local recurrence is one of the most devastating things that can happen to a
women with beast cancer, so we would encourage any mode of treatment that can lessen that possibility."
"The extra radiation to the lymph nodes does increase the risk of lymphedema, so there are adverse events
involved in [this] therapy," he told MedPage Today.
Baselga added that defining which patients are truly at a high risk of recurrence needs clarification. If a
woman had three or more involved lymph nodes, he would consider her at high risk and would offer
extensive radiation along with other therapies, such as chemotherapy.
"Node positive breast cancer is curable, and we need to do everything we can to prevent metastases," he
said, adding that once metastasis occurs, the possibility of cure is remote.
June 7, 2011
Humiliated patient hits out at Monash Medical Centre for treatment - Oakleigh Monash Leader –
A SEVERELY obese Ashwood resident, who claims she was left lying in her own waste for eight hours at
Monash Medical Centre, says she feels humiliated and depressed.
Amanda Bell has lymphedema, which causes her body to retain fluid. She said her 45-day stay in the
Clayton hospital for blood poisoning was marred by “horrible” comments about her weight.
The 51-year-old said she was told by a nurse that she “stunk” and it was about time she got her “lazy fat
a—- up and had a shower”.
“I said it’s not my fault. I’d been in bed for 21 days and I hadn’t had my hair washed, they were supposed
to be looking after my hygiene,” Ms Bell said. “I just don’t think it’s right that I was spoken to like that.”
Ms Bell weighs 220kg and said she felt she was on a “knife’s edge” and was “completely screwed up”
from her experience.
“Why at 51 should I be spoken to like a piece of dirt?” she said.
“There are all different reasons why people are the size they are and I think people need to take that into
account.
“I kept being told to not take things so personally, but to my way of thinking it did matter - it mattered a lot.”
Southern Health spokeswoman Suzana Talevski said the hospital was “sorry to hear that the care provided
did not meet the patient’s expectations”.
“We have looked into this case and our review has shown that the care provided to the patient was
appropriate,” she said.
“As the patient’s needs were complex a specific treatment plan was developed by our multi-disciplinary
team of clinicians and discussed with the patient at all times.
“This resulted in the requirement to source specialised equipment externally.”
June 8, 2011
Compression Therapy Equipment Company Launches New Website - Online PR News (press release) –
Online PR News – 08-June-2011 –Vascular PRN's new website provides health care professionals in all
50 states quick access to renting pneumatic compression therapy devices, including lymphedema pumps
and sequential compression devices – also known as SCD boots – for their patients. The website also
shares information about the benefits of compression therapy for patients and their caregivers.
“Every day we help health care professionals get the compression therapy equipment they need for their
patients in preventative situations or critical care,” said Vascular PRN’s President Greg Grambor. “The new
website provides access to quality compression therapy information and our excellent customer service.”
The redesign of the company’s website allows visitors to learn more about how compression therapy
equipment can prevent deep vein thrombosis and treat lymphedema, venous stasis ulcers, intermittent
claudication and accommodate bariatric patients. Frequently asked questions are answered so that
directors of nursing, nursing home administrators, and patients can find out more about compression
therapy. An innovative blog features timely news and features, and another section focuses on director of
nursing and health care jobs.
“We partner with the best compression therapy equipment brands that have a solid reputation for quality
and are built to withstand even the most rigorous medical demands,” Grambor said. “The new site shows
you product images and sizing guides to help professionals choose the right compression booties for their
patient.”
Vascular PRN has decades of experience meeting the health care industry’s urgent compression therapy
needs. Their knowledgeable specialists have helped hospitals, nursing homes, surgery centers, managed
care organizations, and other institutions.
To learn more, visit www.vascularprn.com or call 800-886-4331.
Cancer group sets three activities - South Bend Tribune –
SOUTH BEND — RiverBend Cancer Services has scheduled free events at RiverBend Wellness Center,
919 E. Jefferson Blvd.
“Lymphedema: Isn’t That Swell?” will be at 10 a.m. Tuesday. Participants will learn causes, treatments and
when to seek medical help.
Wellness Wednesday chair massage will be June 15. A free 10-minute chair message will be offered.
Appointments begin at 1 p.m. and reservations are required. Call 574-287-4197 to schedule an
appointment.
June 9, 2011
New Video Continuing Education Course: Compression Therapy for Lymphedema - Online PR News –
HomeCEUConnection.com is excited to announce the release of Compression Therapy for Lymphedema,
a new Seminars-On-Demand course by Carmen Thompson, BS, LPTA, CMT, CLT for Physical
Therapists, Occupational Therapists, and Massage Therapists
Online PR News – 09-June-2011 –Compression Therapy for Lymphedema is a three-contact-hour course
available to physical therapists, occupational therapists, and massage therapists. Compression Therapy for
Lymphedema focuses on the basic uses of compression therapy, primarily in relation to lymphedema. The
case studies presented in this Seminar-On-Demand use clinical reasoning based on the highest level of
evidence available.
The use of demonstrative video, slides, graphs and other visual aids, in combination with Thompson’s
lecture, creates a virtual classroom setting. As a fully-interactive, physical therapy, occupational therapy,
and massage therapy, Continuing Education program, the user has complete control of the course and is
able to navigate between various segments. As with all HomeCEUConnection.com online continuing
education courses for physical therapists, occupational therapists, massage therapists and athletic trainers,
Compression Therapy for Lymphedema offers users the opportunity to interact with the author.
About the Continuing Education Course Author: Carmen Thompson
Thompson earned a Bachelor of Science in Health Care Management, an Associate of Science in Physical
Therapy and is a practicing Licensed Physical Therapist Assistant and Certified Massage Therapist, with a
specialty certification in lymphatic therapy. Having completed a 140-hour certification course in Manual
Lymphatic Drainage and Complex Decongestive Physiotherapy through the Upledger Institute, she now
teaches lymphatic pathology treatment methods and MLD/CDP therapy nationwide. Additionally she
educates professionals at the local and state level on the prevention and management of lymphedema in
cancer patients and on developing lymphedema programs in acute care and subacute care.
Compression Therapy for Lymphedema is now available for immediate purchase in an online format (PDF
Download) or mail format (USB Flash Drive).
All available Seminars-On-Demand online continuing education courses have been approved by the
American Occupational Therapy Association (AOTA) by means of HomeCEUConnection.com’s
approved provider status. For physical therapists, Seminars-On-Demand online physical therapy continuing
education courses are approved by states. For approval information, please visit https://www.
homeceuconnection.com and take advantage of the online continuing education state and profession specific
course catalog. For additional information regarding Seminars-On-Demand, please visit
HomeCEUConnection.com’s website or call 1-800-554-2387.
About HomeCEUConnection.com
Specializing in quality online continuing education courses, HomeCEUConnection.com offers CEUs for
physical therapists, occupational therapists, speech language pathologists, massage therapists, athletic
trainers and certified strength and conditioning specialists that are convenient, affordable and user-friendly.
Kudos & Applause Celebrating those who make a difference - Ottawa Citizen –
Breast Cancer Action is a resource and support centre for breast cancer patients and survivors. We are the
here and now for women providing FREE programs such as pre-operative & lymphedema workshops,
peer counseling, dragon boat teams and fitness programs. As we receive no government support, all our
funding comes from membership, donations, grants and events.
All monies raised stay in the Ottawa region and are used directly to fund our programs. For more
information regarding what we do, check out our website at www.bcaott.ca.
OTTAWA GUILD OF POTTERS www.ottawaguildofpotters.ca 613 230-2446.
Celebrating its 36th year of developing and promoting ceramic arts and artists in the Ottawa region, the non-
profit Ottawa Guild of Potters sets a high standard of artistic expression and craftsmanship for members'
work. Its local potters and new students to clay are supported and encouraged to further their knowledge
of ceramics via talks and workshops. An extensive library of ceramic information is maintained and made
accessible to all members. The Guild also enables members to organize and showcase their clay creations in
semi-annual sales and an exhibition. Increasing the communities' awareness of the challenges of creating
with clay via demonstrations and info sessions is another big goal. For our youth, The Guild awards
bursaries to high school students working with clay.
Over those 36 years, the Guild's potters continue to give back generously to Ottawa. Several local
organizations or charities have directly benefited as the chosen recipient of proceeds from the Spring and
Fall sales of donated pieces. For the past six years, the Ottawa Guild of Potters has been incredibly
successful at organizing the major fundraiser, Great Bowls of Fire, to support the Ottawa Food Bank to the
tune of over $70,000. Potters donate handmade bowls as well as their time to run this popular event. With
an original "take home" bowl of their choice, ticket purchasers can sample delicious soups and breads
donated by area restaurants and bakeries. It's a winning combo for all involved.
ALLISON RANDALL Friends of the Farm 613-230-3276 www.friendsofthefarm.ca
Allison Randall is the quintessential volunteer. In 23 years as a Friends' of the Farm volunteer, she has
compiled an impressive record. She has gardened, baked, served tea, made and sold crafts, led tours,
tended cash, and even stuffed envelopes in support of the Friends of the Farm.
Allison is one of the Friends' original volunteers. In 1988, having recently moved from Bermuda to Ottawa,
she "terribly missed" her volunteer work at Bermuda's Botanical Gardens. A neighbour suggested the name
of contact who was organizing a new group called the Friends of the Farm.
Allison's volunteer experience in Bermuda was quickly put to work. She was asked to "do a review of the
Farm to make it more people friendly." The result? More signage placed strategically around the Farm to
enhance the public's enjoyment and appreciation of the historical site. Allison also fondly recalls the group of
ladies who met regularly in the basement of Building 72 to make dried flower pictures, which were then sold
in the Agriculture Museum shop.
After 23 years, Allison is still an active volunteer - helping out wherever she can. The passage of time May
have reduced her energy level, but it certainly hasn't dampened her enthusiasm for the Friends of the Farm.
For information on the Friends of the Farm: 613-230-3276; www.friendsofthefarm.ca
Winthrop Breast Health Center Offering Free Program - Garden City News –
Winthrop-University Hospital’s Breast Health Center is offering a free program,“Managing Post-Treatment
Side Effects for Breast Cancer Patients” on Thursday, June 23, 2011, from 6:00 to 7:30 PM. The event
will be held at Winthrop’s Community Outreach Center, located at 101 Mineola Boulevard at the corner of
Second Street in Mineola, and will highlight preventing and managing treatment-related pain, lymphedema
and stress.
Speakers include Donna Cox, MSN, ONC, CCRC, RN-BC, from the Pain Management Center at
Winthrop, and Bonnie B. Lasinski, MA, PT, CLT-LANA from Lymphedema Therapy, an organization
specializing in treating the condition. Linda Hacker, RYT, from the Svadharma Yoga Project, will give
attendees the opportunity to decompress during a 30-minute yoga session. The program will also include a
question and answer period.
“This program was developed in response to our patients’ expressed need for assistance with these
problems,” said Alisha Ellis, LMSW, MA, Breast Cancer Social Worker. “Whether women are newly
diagnosed or have completed treatment, they have voiced a common need to have these issues addressed.
We are pleased to offer this program in response to their concerns.”
Attendees are asked to arrive at 5:45 PM for registration and to park in the rear of the building. Seating is
limited and pre-registration is required. To register, please contact Alisha Ellis at (516) 663-2556.
Winthrop’s Breast Health Center provides unparalleled, comprehensive breast care guided by a deep sense
of compassion and respect for the dignity of every patient. For information about services at the Center,
please call (516) 663-3887.
June 10, 2011
Tina, the stuff below in itilacs copied from somewhere and not Im not sure, I left it in case it is info you can
use but hopefully it also copied under the article info it belongs to somewhere else, sorry
Photos
Prevention and management
Here are some tips for preventing the development, or worsening, of lymphedema.
• Wear a therapeutic sleeve when flying.
• Avoid prolonged heat, like a Jacuzzi or a sauna.
• If you’re swimming in a pool, use a moisture barrier cream (and waterproof sunscreen) and a good
moisturizing lotion when you’re finished swimming.
• Avoid tight clothing, bra or jewelry.
• Be careful of insect bites; ask physician about best repellent.
• Wash your hands often.
• Exercise.
• Don’t get a shot in your affected arm.
• Don’t have blood pressure taken on at-risk arm.
• Wear gloves when you garden or do outside chores.
• Inform your doctor of any symptoms such as redness, swelling, heaviness, warmth or tenderness in at-risk
arm.
For more information
National Lymphedema Network: www.lymphnet.org (includes listing of support groups internationally).
Swelling in the arm can signal lymphedema - MiamiHerald.com - By Rochelle Koff
Experts want to see a greater emphasis on educating the public about lymphedema, an often painful, chronic
condition that can occur following the removal or damage of lymph nodes.
First there was the breast cancer diagnosis. Then a year and a half after all the testing, surgery and
chemotherapy was over, Sherry Churly learned she had yet another health hurdle to overcome:
lymphedema.
It’s one of the chronic, sometimes “underemphasized” complications of breast cancer surgery that many
patients don’t learn about until they’re already suffering from symptoms that include swelling, pain and in
more serious cases, infection of the arm, said breast cancer surgeon Dr. Robert DerHagopian, medical
director of the Baptist Health Breast Center.
But lymphedema isn’t limited to breast cancer — or women.
The primary form of lymphedema can be manifested at birth (called lymphedema praecox) and appears at
the onset of puberty or later; lymphederma tarda, a rare form, sets in after age 35.
Secondary lymphedema is the most pervasive type.
“Certain surgeries, such as surgery for melanoma or breast, gynecological, head and neck, prostate or
testicular, bladder or colon cancer, all of which currently require removal of lymph nodes, put patients at
risk of developing secondary lymphedema,” according to the National Lymphedema Network.
The risk is higher with the higher number of lymph nodes removed and if the patient received radiation
therapy. The condition can also be caused by damage to the lymph nodes or vessels from burns and other
trauma.
In lymphodema, “there’s a problem with the mechanical transport of lymph fluid that can cause the
lymphatic system, which eliminates toxins and bacteria from the body, to stop functioning normally,” said
Maria Josette Mullins, director of Rehabilitative Services at Memorial Hospital Pembroke. This
accumulation of protein-rich fluid may form — primarily in the arms, hands, feet, legs, face or chest — and
lead to abnormal swelling that doesn’t go away on its own.
In more serious cases, it impacts a patient’s mobility and quality of life.
Lymphedema “is recognized all over the world as a hidden epidemic” impacting 300 million people, said
Dr. John M. MacDonald, of the University of Miami’s Department of Dermatology and secretariat of the
World Alliance for Wound and Lymphedema Care.
The condition can show up right away or years later.
“Sometimes the condition is latent and something can activate it, like a cut, an insect’s bite or the altitude on
a plane,” said Ana María Mendieta, a lymphatic therapist and director of the Midas Touch Institute in
Miami.
At first, “many patients are not aware of what is happening to them,” Mendieta said. “That can go on for a
period of time until the lymphatic system is so filled up with fluid that it is unable to drain on its own.”
Mary Crosswell, a physical therapist certified in lymphedema treatment at South Miami Hospital, said what
often alerts women “is that their bra becomes too tight in the affected shoulder, they feel a heaviness and
they’re swollen around their shoulder and under their armpit.”
Churly, 55, said that when she first started feeling a heaviness in her arm, “I didn’t connect it to the breast
cancer surgery.”
“The inside of my arm got bright red and was very hot,” said Churly, of Miramar, whose arm became
infected. “In the acute stages, it was very painful. I could feel the heat more inside my arm than outside. It
felt like I was burning from the inside out.”
After being treated with antibiotics, Churly saw a lymphedema therapist at Memorial Pembroke for a hands-
on treatment called manual drainage.
“The goal is to retrain the lymphatic system so that it can function as before,” Mullins said.
The amount of therapy needed depends on whether someone has mild, moderate or serious lymphedema.
To an outsider, manual drainage may look like a massage, but “it’s not muscular,” said Renee Romero,
founder of The Lymphedema Institute in Doral. “We work the lymphatic system. It’s a different approach
to the body.”
Therapists use “light, not painful” motions that last about 45 minutes to an hour, she said, in order to “help
the body reroute the fluid.”
Romero said she went to Austria in 1992 to learn the Dr. Vodder Method of Manual Lymph Drainage that’
s now the accepted treatment here.
“At that time there weren’t lymphatic treatment centers in South Florida,” she said. “It’s been slow on the
scene in the United States.”
Once her drainage treatments were done, Churly’s arm was wrapped with tight bandages from her fingers
to shoulders to reduce swelling. Now she wears a maintenance compression sleeve every day, but she
takes it off at night. She’s feeling much better, but she’s concerned about the condition reappearing. “It’s
always on my mind,” she said.
There are ways lymphedema sufferers can avoid getting a flare up. One is exercise.
Kim Bonomo knows first-hand the mental and physical benefits of being fit.
A breast cancer survivor who has lymphedema, she is the captain of Save Our Sisters, “the only dragon
boat racing team in South Florida that’s made up of breast cancer survivors.”
“When I get out of the boat, my arm is actually better,” said Bonomo, 57, of Pinecrest. “The swelling goes
down. Exercise encourages the lymphatic system to cooperate.”
Dr. Carmen Calfa, breast oncologist at the Memorial Breast Cancer Center, said there’s more research
pointing to the importance of exercise, even weight-lifting if it’s done in a supervised program. “Weight
lifting in an unorganized manner can hurt you,” Calfa said. But being trained in gradual weightlifting
exercises, she said, is proving to be effective.
Doctors may be complacent discussing lymphedema, DerHagopian said, because of less aggressive surgery
and techniques, including sentinel node biopsies.
Sentinel node biopsies are a surgical procedure used to determine if cancer has spread. The first node that
the fluid passes through in a group of lymph nodes is called the sentinel lymph node. The premise is that if
the first node is negative, then the other nodes will be negative, and physicians won’t have to remove as
many nodes as they did in the past. The more nodes removed, the more the system is disrupted.
Physicians should still be “reminding” patients years after surgery or radiation about lymphedema because
“you’re never out of the woods, DerHagopian said. “It’s a lifetime risk.”
But it’s one that doesn’t have to be incapacitating.
With the right treatment and vigilance, Crosswell said, “women can go back to leading full lives.”
Peterson Aims to Make Residents Feel at Home - Wheeling Intelligencer – By JOSELYN KING –
Officials say changes at Peterson Rehabilitation Hospital and Geriatric Center are resulting in a new life and
atmosphere there for long-term residents.
"We're de-institutionalizing our long-term care center and changing it to a long-term 'living center,'" said
Diane Miller, director of marketing and business development. "We want to make it more like a home
environment."
The white walls on the second floor where long-term residents live will be painted a warmer color, she
noted.
And a full-service cafe is about to open on the second floor, Miller continued. The hope is that the smell of
food - and maybe even cookies - in their living space will whet residents' appetites.
Presently, food - and the occasional birthday cake - are prepared in the basement at Peterson and brought
to the residents.
"As most people know, seniors don't always want to eat," she said. "We're hoping this will increase their
appetites."
Long-term residents also are getting more of a voice in their care, according to Miller. They are getting to
choose what times of day they like to do certain activities, such as taking a bath.
"Their interests, hobbies and what's important to them also are being taken into account," she said.
Miller noted the practice of involving patients in their care is part of the "Eden Alternative" philosophy
toward long-term living that has been in place at the center since February. Through this philosophy,
Peterson's staff has made a commitment to fight "the three plagues of loneliness, hopelessness and
boredom" that affect residents in nursing homes.
Peterson, a division of Guardian Elder Care, won the corporate "Distinguished Service Award" last year for
the changes implemented there under Barbara Sisarcick, executive director.
Miller pointed out there are actually four levels of care at the center. In addition to long-term living, there is
acute in-patient rehabilitation, post-hospital short-term rehabilitation and nursing, and out-patient therapy.
Both in-patient and out-patient care is available at Peterson's new lymphedema clinic, where staff members
work to help patients battle the swelling that occurs when fluid accumulates in their body tissue.
Typically such swelling occurs after surgeries, according to Betsy Myers, a therapist with the lymphedema
clinic. She said the clinic has had "tremendous outcomes" with reducing the swelling that can lead to cellulitis
and infections.
"As we get better with surgeries, over time lymphedema from surgery is likely going to go away," she said.
"But that doesn't mean lymphedema is going away. We are becoming an overweight society, and being
overweight puts pressure on the lymphatic system and causes swelling."
Lymphedema can be treated through manual lymph drainage, compression bandaging, remedial exercise
and through meticulous skin and nail care, according to Myers.
June 11, 2011
New Medical Achievements in Cuban Hospital - Cuba Headlines –
Cubans are using stem cells in treating knee osteoporosis and lower limb lymphedema - By: Yuliet Gutiérrez
Delgado.
The comprehensive treatment of pregnant women with coagulation disorders and the use of stem cells to
deal with osteoporosis and lymphedema are some of the most recent achievements presented by medical
specialists with the Havana-based Hematology Institute and the Enrique Cabrera Hospital, as part of a
scientific forum of this institution in the context of fiftieth anniversary.
Promising enough is the cellular treatment applied by Dr. Aymara Baganet on knee osteoporosis, a
technique used in degenerative damage that appears in people over 50 years of age, who feel the benefits
just three months after the treatment, with the fading of pain, walking difficulties and uncomfortable sleep.
Angiologist Pedro Goicochea is also successful in the application of stem cells on patients suffering from
lower limb lymphedema, following lymphangitis, a condition causing swollen legs and which do not respond
satisfactorily to traditional treatment.
Dr. Goicochea said that the treatment is simple and not very invasive, while it allows relieving swollen limbs
and forming new lymphatic vessels. He said they expect to expand the treatment to patients suffering from
lymphedema caused by other diseases.
Comprehensive treatment to pregnant women with coagulation deficiency is a proposal by Dr. Dunia
Castillo, head of the Hospital´s Hemosthasia Department. The doctor told JR that over 90 percent of
women with this condition may have a delivery without any hemorrhagic complication if they are given
appropriate obstetric and hematologic attention in coordination with other medical specialties, which allows
adequate treatment for each hematologic disorder.
The scientific meeting also learned of the results of an over-20-year immune-hematological study on
different blood group conflicts that may cause perynatal hemolytic disease, a pathology that if not treated
inflicts serious anemia on the newborns, plus jaundice and irreversible cerebral damage.
Doctor in Medical Sciences Antonio Bencomo, leading the research study, explained that the major
contribution is the identification in the mother of antibodies against the antigens of the blood groups that
cause the disease, as a response to genetic differences in parents.
“This research study guarantees a safe diagnosis of these disorders, and of associated complications, as it
also provides hemo-therapeutic treatment required by the baby,” he said.
770 lb. Lakeland grandmother gets free home - 10 Connects – by Tammie Fields –
Lakeland, Florida - A frustrating struggle for a Lakeland grandmother who was just trying to get medical
help has led to a generous offer. An anonymous donor has volunteered to build her and her family a free
home that will accommodate her special needs.
51 year old Yvonne Gallimore has endured a lot of heartache the past 17 years. Her family members say
she's done so in private until recently.
Gallimore battled a medical condition called lymphedema which is caused by a blockage that allows fluids
to build up in the body causing excessive swelling. It's caused her weight to tip the scale at 770 pounds
which makes it impossible to get around.
Gallimore cries as she explains, "I don't like that. I don't like not being able to do nothing for my
grandchildren and stuff and the only time they see me is lying in the bed."
She was admitted to the hospital after she developed an infection in her leg but because of her size
emergency crews ran into trouble trying to get her out.
In tears her sister Alnieta McKenzie says, "They had to take 8 to 9 hours just to tear the window open to
get her out the house."
Gallimore's Section 8 apartment was badly damaged and as ready as she's been to leave the hospital after
her infection was cleared up she knows she has nowhere for her and her family to go back to. She says,
"When it was time for me to go home - then I had to tell these people I don't have nowhere to go. I'm
destitute."
But word spread about Gallimore's situation through the news media and a generous anonymous donor
stepped in and volunteered to build her a new home that will accommodate her and allow her to be more
independent. She'll no longer have to miss out on family gatherings like her grandson's birthdays.
McKenzie says, "You know she could sing happy birthday - but she couldn't come out there to sing happy
birthday because she couldn't go through the hallway."
Meanwhile Gallimore says words can hardly describe how grateful she feels. "Whoever it was that decided
to give me a house I appreciate it and I thank you so much because it was a true blessing."
There's no word on where the house is going to be built and how long it will take. When Gallimore is
released from the hospital she will stay in temporary housing though.
Meanwhile her family has found her a specialist in Miami that can help her too but they'll have to find her a
way to get there because she needs a specially equipped van to get to appointments.
June 12, 2011
Canada Playing Catch-up on Lymphedema Care for Patients - Wire Service Canada - by akennedy –
Awareness of lymphedema among Canadian health professionals lags far behind those in Europe and
Australia resulting in inadequate management and risk reduction of this chronic disease. “We in Canada,
need to take charge,” says Dr Anna Towers. “So much needs to be done to understand the prevalence of
lymphedema in Canada, to implement best practices and provide standardized comprehensive care
accessible to all patients.”
An international conference in Toronto may just jump start the lymphedema bandwagon. Seventy key
medical and scientific lymphedema experts from around the world are gathering in Toronto June 14 – 18 to
present the latest research and clinical advances at an international lymphedema conference for health
professionals. Approximately 400 delegates are coming from far and wide, representing many different
countries and disciplines.
The conference is a collaboration between the International Lymphoedema Framework, the Canadian
Lymphedema Framework and the Lymphedema Association of Ontario. Anna Towers, Founding Co-
Chair of the Canadian Lymphedema Framework, and Clinical Director of the McGill University
Lymphedema clinic (and one of the few Canadian medical experts on lymphedema) states: "Hosting an
international lymphedema event of this magnitude in Toronto gives hope that Canada will start catching up
to the countries where more research, education and comprehensive treatment plans exist for lymphedema.
We need to elevate this condition in order to place lymphedema and its management as a priority on
regional, provincial and national health care agendas. This event is a tremendous step in educating the health
professionals who see lymphedema patients in their daily practise and need to be better equipped."
Lymphedema is a common post-treatment condition that one in every four breast cancer survivors has to
face. It is also common after gynaecological cancers, prostate cancer and melanoma. However, cancer
treatment is not the only cause of lymphedema and as many as 250 million worldwide suffer with this
chronic and often disabling condition, according to the World Health Organization. Lymphedema is
characterized by chronic swelling in the arms or legs, trunk, head or genital areas.
Christine Moffatt, the Chair of the International Lymphoedema Framework (based in England) and host of
the conference states, “This event symbolizes that passion that many of us feel in striving to improve the care
of patients throughout the world and the desperate need for recognition of this neglected problem.”
A comprehensive conference programme covers best practices, developments in compression, global
issues, children and lymphedema, psychosocial aspects of lymphedema, treatment options around the
world, diagnostics and a special symposium on breast cancer survivors and lymphedema.
A one-day patient conference is being held on Saturday, June 18. Anna Kennedy, Executive Director of the
Lymphedema Association of Ontario and co-host of the event states, “This is a unique opportunity for
Canadians to participate in a lymphedema global event, networking and learning from their international
colleagues, and visiting a comprehensive exhibit hall with products, some of which might not yet be available
in Canada. Being exposed to the advances in other countries will incentivize us even more to advocate for
better treatment of lymphedema here in our own country. Canadian lymphedema patients deserve no less”.
For more information about the 3rd International Lymphoedema Framework Conference, or the work of
the Canadian Lymphedema Framework and the Lymphedema Association of Ontario, please contact Anna
Kennedy, Executive Director (LAO) at 416-410-2250 or anna@lymphontario.ca
June 13, 2011
3M COBAN 2™ COMPRESSION SYSTEM: REDEFINING COMPRESSION BANDAGING FOR
LYMPHEDEMA PATIENTS - Canada NewsWire –
Two-layer compression therapy improves comfort, mobility and quality of life
LONDON, ON, June 13, 2011 /CNW/ - 3M Skin and Wound Care now offers Coban 2™ Compression
System, a breakthrough in intensive therapy compression bandaging for patients suffering with lymphedema
in Canada. Lymphedema is a chronic, debilitating condition characterized by extreme swelling that affects
many thousands of Canadians1.
"Patients suffering with lymphedema experience a wide range of psychological and physical hardships that
can include impaired mobility, pain, anxiety, depression, poor body image, and embarrassment," said Tim
Brown, General Manager of 3M Canada's Healthcare business. "At 3M Canada, we're proud of Coban 2
Compression System because of its ability to significantly improve the intensive therapy experience for
patients of lymphedema, as well as clinicians."
Carry on with everyday life: With only two thin layers of compression bandages, Coban 2 provides
clinically effective volume reduction with an unparalleled comfort and mobility for patients, without the bulk
of traditional reusable bandages.
Fewer and less taxing wrapping sessions: New application techniques and only a twice-weekly application
regimen significantly reduces the total number of wrapping sessions required to reduce edema, meaning less
time in the clinic for patients.
Increased function with sizing variations: Of course a patient's toes and legs vary greatly in size and so
should their bandages. Coban 2 accommodates each body part with sizing variations for the upper
extremities, lower extremities, fingers, and toes.
Coban 2 is a disposable single-use system that is cost-effective and eliminates the time and expense of
washing and re-rolling bandages while minimizing the risk associated with potential contamination. The
materials used in the two thin layers of the system are safe for skin and were developed with unique stretch
and cohesion properties to provide ideal compression and help patients overcome the challenges of wearing
bandages during lymphedema intensive therapy.
For more information, visit www.3m.ca/coban2giraffe.
About 3M Canada
Established in 1951, 3M Canada Company was one of the first international subsidiaries opened by 3M
and remains one of the largest. 3M Canada's head office and original manufacturing site is in London,
Ontario where approximately half of the company's 1,800 employees work. Other locations include
Toronto, Brockville, and Perth, Ontario and Morden, Manitoba. Globally, 3M has operations in more than
65 countries and captures the spark of new ideas and transforms them into thousands of ingenious
products. Our culture of creative collaboration inspires a never-ending stream of powerful technologies that
make life better.
Dragon boat team gets financial lift - www.kamloopsnews.ca –
The Spirit Warriors of Kamloops are among several dragon boat teams sharing $56,000 from the Canadian
Breast Cancer Foundation.
The teams are all made up of breast cancer survivors and will use the money to help offset their 2011
competitive season.
Dragon boating is popular among breast cancer survivors because medical studies show that upper body
exercise can help or prevent lymphedema - the significant swelling some women experience due to
accumulation of fluid in the arm and chest after the removal of lymph nodes during treatment.
The Spirit Warriors spend their summer competing in dragon boat festivals around B.C. Their next event is
the Shuswap Dragon Boat Festival in Salmon Arm on Saturday, June 25.
June 14, 2011
Experts from Montefiore Einstein Center for Cancer Care are Available for Interviews: Breast Cancer
Team – Newswise –
Newswise — New York, NY (June 14, 2011) – At Montefiore Einstein Center for Cancer Care, a multi-
disciplinary team of experts help women with the many aspects of this disease and are available for
interviews on the latest research, clinical trials, surgical techniques, imaging and advances in treatments for
breast cancer.
SURGICAL ONCOLOGY:
Leslie Montgomery, Chief of the Division of Breast Surgery, Director of the Breast Service, Montefiore-
Einstein Center for Cancer Care
As an Attending Surgeon at Memorial Sloan Kettering Cancer Center for over 11 years, Dr. Montgomery
worked extensively investigating the accuracy of sentinel node biopsy for breast cancer patients in a variety
of clinical scenarios. She is currently the institution Principal Investigator for ACOSOG Z-1071 which is
investigating the accuracy of sentinel node after chemotherapy. She has collaborated with the Department of
Radiation Oncology to establish a protocol for partial breast radiotherapy for patients receiving breast
conservation. She is currently focused on work involving disparities in the diagnosis and treatment of breast
cancer in underserved and minority communities.
Lisa S. Wiechmann, MD, Division of Breast Surgery
A main area of concern for women undergoing surgery for the removal of axillary
lymph nodes is post-surgical arm swelling called lymphedema. This condition can limit a woman’s daily
activities and cause disfigurement. Lisa Wiechmann, MD, is enrolling women in a pilot randomized trial of
bioimpedence measurements to determine the best method to detect lymphedema before symptoms occur
and, hopefully, reverse the process. Dr. Wiechmann also runs the MECCC Special Surveillance Breast
Program for women who are at high-risk for the development of breast cancer. Dr. Wiechmann is also the
institution PI for ECOG 2108 which is a clinical trial investigating the role of breast surgery on the overall
survival of patients with stage IV breast cancer.
MEDICAL ONCOLOGY:
Joseph Sparano, MD, Associate Chairman of the Department of Oncology
Joseph Sparano, MD, is a member of a research team that has developed a new gene expression test for
preinvasive breast cancer. Currently, he is the lead investigator in a national clinical trial called TAILORx,
which integrates a gene expression profiling test in clinical decision making in invasive breast cancer
treatment. In addition, Dr. Sparano has been widely quoted in the media in opposition to the FDA’s
revocation of the use of Avastin for breast cancer treatment. He is the Chair of the Eastern Cooperative
Oncology Group Breast Cancer Steering Committee and a member of the NCI Breast Cancer Steering
Committee.
Eleni Andreopoulou, MD, Department of Medical Oncology
Eleni Andreopoulou, MD, is continuing her work from MD Anderson and is studying the response of
tumors pre-operatively to chemotherapy and other treatments. The goal is to tailor therapies to the clinical
pathology and molecular and genetic makeup of locally advanced tumors. She is also the institution PI of a
clinical trial investigating the efficacy of Veliparib in patients with Stage IV breast cancer.
Christine Pellegrino, MD, Department of Medical Oncology
A new Breast Cancer Survivorship Program has been introduced at the Montefiore-Einstein Center for
Cancer Care for women who are out at least two years from diagnosis. Pioneered by Christine Pellegrino,
MD, this program focuses on issues faced by cancer survivors including treatment related to long-term side
effects such as heart, thyroid and neurologic complications. In
addition, psychosocial issues such as body image, sexual issues, and fears of having cancer are addressed.
RADIATION ONCOLOGY:
Jana Fox, MD, Department of Radiation Oncology
Radiation oncologists such as Jana Fox, MD, are proponents of prone breast irradiation as a way of
protecting healthy tissue during radiation therapy. The technique involves a patient laying comfortably on
their stomachs, allowing the breast to be "separated" from the rest of the body. She is also the institution
Principal Investigator of NSABP-B43 which is a clinical trial investigating whether the drug Herceptin can
improve the outcome of patient with ductal carcinoma in-situ following lumpectomy and radiotherapy.
RADIOLOGY:
Tova Koenigsberg, MD, Chief of the Division of Breast Imaging
Dr. Koenigsberg and her division screen tens of thousands of women each year for breast cancer through
their screening mammography program. In addition, dedicated mammographers provide diagnostic
evaluation of patients with a history of breast cancer or patients presenting with a new breast finding. Their
state of the art mammography centers include digital mammography, breast ultrasound, and breast MRI.
PATIENT ADVOCACY/LEGISLATION:
Evan Garfein, MD, Division of Plastic and Reconstructive Surgery
Evan Garfein, MD, was instrumental in the passage of a 2010 New York State law requiring hospitals and
doctors to inform breast cancer patients of the options for breast reconstruction before surgery. When he
became aware of research that demonstrated women in underserved areas are less likely to be told about
breast reconstruction prior to undergoing mastectomy than women in wealthier areas, he felt it was
imperative for all patients to be educated about their reconstruction options.
PATIENT NAVIGATORS:
Maureen Patrickakos, RN, MSN, OCN
Nurse Maureen Patrickakos is an Oncology Patient Navigator helping patients
understand the complexities of breast cancer treatment. Working closely with surgical and medical
oncologists, she ensures that each patient is fully prepared and thoroughly understands each procedure,
from initial testing through surgery and discussion of treatment options and plans. She helps patients
understand the option of clinical trials if they fit the criteria for entry. Ms. Patrickakos uses Spanish
interpreters to navigate a large number of Hispanic patients
through the process of breast cancer treatment. Moreover, using a data base, she tracks patient follow-up
care to maintain continuity.
PSYCHOSOCIAL ONCOLOGY PROGRAM:
Alyson Moadel, Ph.D, Director of Psychosocial Oncology Program at Albert
Einstein Cancer Center and Department of Medical Oncology
The Psychosocial Oncology Program, housed within the Einstein Cancer Center, promotes quality of life
among those affected by cancer in the underserved and ethnically diverse community of the Bronx. The
program called The Bronx Oncology Living Daily (or B.O.L.D.) offers a variety of free services including
individual counseling, stress management, yoga, spiritual groups and smoking cessation counseling.
Elizabeth Salgado, LMSW
Social worker Elizabeth Salgado leads a weekly support group, Mujeres Unidas
(Women United), which helps Hispanic women cope with breast cancer diagnosis, treatment and recovery.
The group is a collaborative effort between the Montefiore Einstein Center for Cancer Care and Gilda’s
Club and is sponsored by the Susan B. Komen Race for the Cure. Within this group the women can speak
their native language, support and educate one another.
Gloria Nelson, LMSW
With the guidance of senior oncology social worker Gloria Nelson, Strength through Laughter groups have
been meeting once a month at the Montefiore Einstein Cancer Center in the Bronx for the past five years.
The program is usually attended by 35-40 adult cancer patients, nearly half of them in the late stages of the
disease. Group members say that laughter can help them come to terms with their disease. Though
researchers are not certain of the effect laughter has on the course of cancer, medical experts agree that
laughter promotes a sense of well-being, and improves muscle function and breathing.
RESEARCH:
Clinical Trials
The MECCC Breast Team is involved in many investigator-initiated and multi-institutional clinical trials
including many phase II and phase III trials investigating new agents for pre-operative chemotherapy, post-
operative chemotherapy, post-operative hormonal therapy, and post-operative targeted biologic agents.
Basic Science
A strong relationship exists between the MECCC Breast Team and the Albert Einstein College of
Medicine. As such, the team collaborates with a number of basic scientists looking for breast cancer tumor
markers and markers of a tumor’s potential for metastasis.
Montefiore Medical Center
As the University Hospital for Albert Einstein College of Medicine, Montefiore is a premier academic
medical center nationally renowned for its clinical excellence, scientific discovery and commitment to its
community. Recognized among the top hospitals nationally and ranked sixth out of 180 in the New York
metropolitan area by U.S. News & World Report, Montefiore provides compassionate, patient- and family-
centered care and educates the healthcare professionals of tomorrow. The Children’s Hospital at
Montefiore is consistently named in U.S. News’ “America’s Best Children’s Hospitals,” and is second
among those in the New York metro area. With four hospitals, 1,491 beds and 93,000 annual hospital
discharges, Montefiore is an integrated health system seamlessly linked by advanced health information
technology. State-of-the-art primary and specialty care is provided through a network of nearly 100
locations across the region, including the largest school health program in the nation and a home health
program. Montefiore, inspired by its patients and its community, continues to be on the frontlines of
developing innovative approaches to care.
June 15, 2011
Human Race brings in $235000 for local nonprofits - Santa Cruz Sentinel – By SHANNA MCCORD –
SANTA CRUZ --" The Volunteer Center of Santa Cruz County raised $235,000 at its 31st annual Human
Race.
An awards ceremony was held June 9 at Resurrection Church in Aptos with approximately 100 community
members receiving donation checks.
Race day was May 7.
About 140 nonprofit organizations, schools, faith-based organizations and community groups collaborated
with local businesses and individual residents to raise more than $235,000 at the race.
"This year's event was one of the most successful ever," said Chris Bracinni, the Volunteer Center's race
coordinator. "An event like this takes the time and goodwill of thousands of people from every part of our
community. We can't thank each of them enough."
Businesses known as "champion teams" were honored at the ceremony. Employees of the businesses
fundraised for specific organizations.
This year's top champion teams were Santa Cruz County Bank, Wells Fargo, Green Valley Dentistry,
Bookshop Santa Cruz and Niemann Capital Management.
They raised more than $67,000 in in-kind contributions and donations.
Top individual fundraisers Cynthia Chase and Aaron Noble were honored for each raising $5,000.
Other top fundraisers include Balance for Kids with $26,000, Santa Cruz County Animal Services with
more than $12,000 and the Diabetes Health Center with $8,000
June 15, 2011
New therapist at medical center - Decorah Journal –
Winneshiek Medical Center recently welcomed Allison Herman, OTR/L to the Rehabilitation and Sports
Medicine Department.
Herman, an occupational therapist, joined the comprehensive and advanced occupational therapy practice
in May, 2011. She received her undergraduate degree from Luther College and her Masters of
Occupational Therapy from St. Ambrose University in Davenport.
Prior to coming to Winneshiek Medical Center, Herman worked at Finley Hospital in Dubuque.
Of her chosen career, Herman says, "I find the level of progression patients make very rewarding. Whether
it is a functional task or a small change in range of motion, the therapy we provide can make a significant
difference in a patient's quality of life."
Herman says she is inspired by current health professionals here.
"I hope to bring the same enthusiasm to patient care as I have observed in my colleagues. They truly work
to make a difference in the lives of their patients and I am inspired by their dedication."
Coordinators at the local medical center said occupational therapists are health professionals who are
trained to help you "live better" with your illness, injury or disability.
Winneshiek Medical Center occupational therapists have earned specialist certification in occupational
health, hand therapy, urinary incontinence retraining, lymphedema management, specialized pediatric feeding
programs, sensory integration for pediatrics, home safety assessments, and pool therapy for those with
arthritis. Winneshiek Medical Center occupational therapists provide care for outpatients, inpatients, home
health, and local nursing homes.
For more information, contact your primary health care provider or call the Winneshiek Medical Center
Rehabilitation and Sports Medicine Department at 563-387-3031.
June 16, 2011
Patients name Donna Bateman their favorite nurse at The Memorial Hospital of Salem County - Today's
Sunbeam - NJ.com
MANNINGTON TWP. — The secret to finding a good nurse — no, an exceptional one — is simple:
Listen to her patients.
And when listening to the patients of Wound Care Center nurse Donna Bateman, the story that unfolds is
one that would make any nurse proud.
“I am 85 years old and Donna is always very gentle with me,” said Alice Dalbow of Pennsville. “She is a
caring nurse. When I fell in February, I couldn’t get around for awhile and I developed ulcers on my foot
that wouldn’t heal. I came to the Wound Care Center and Donna has been helping them heal very nicely.
She doesn’t rush or push you out — she takes her time and makes me feel really good.”
In the more than 35 entries she received for the 2011 Patient Choice Award — which gives the community
a chance to honor nursing excellence at The Memorial Hospital of Salem County — patients (and family
members) struck a common theme: Donna Bateman, RN, BSN, CWCN, makes a difference in their lives.
“Donna has a genuine concern for her patients,” said Penny Smith of Alloway. “She goes the extra mile for
her patients and is always up on the latest medical care for wounds. I had been to many others for the
treatment of my wounds, but I am finally making progress under Donna.”
“When it comes to caring for patients, there is no one quite like Donna,” added Chief Nursing Officer
Patricia Scherle, RN, BSN, MHA. “She bonds with her patients and knows each of them individually. She
is an asset to our nursing team and we are all very proud of her.”
Bateman specializes in wound care and is one of the very few nurses in the South Jersey region with this
expertise. She has been on staff at MHSC for five years and she has been a wound care nurse for more
than 20.
“I love wound care — and all the aspects that go with,” she said. “I love caring for the patients, teaching
them, working with their families, getting to know them — the overall interaction is so very important to
understand the nature of their wound and how best to heal it.”
Bateman stressed the importance of caring for the “whole” person — not just the wound.
“It’s critical because sometimes the underlying factors for a wound that won’t heal are rooted in socio-
economic factors, poor nutrition, their environment, or just a lack of knowledge of their wounds,” she
explained. “You have to really listen to the patient because you can pick up on subtle things that they may
not express directly.”
Bateman’s areas of expertise include diabetic ulcers, vascular ulcers (due to poor circulation in the lower
extremities) and pressure ulcers (bed sores).
She encourages her patients to get to know one another and develop a common bond.
“They scold one another for not keeping up with certain parts of their care, and they help encourage one
another. I often hear them say things such as, ‘Just keep doing what Ms.
Donna says if you want that wound to heal. Do what she says and you won’t be coming back. Don’t do it,
and you will be coming back.’ They chide each other and prod each other and I think that’s a good thing.”
Bateman began her professional love affair with wounds “way back when” — in the mid-seventies. “At that
time wound care was little more than Duoderm — gauze and saline. It was anything but a specialty. Now,
there are more than 2,000 products to choose from to heal in wound care. It’s come a long way.”
She recalls one career highlight that made a lasting impact on her. “I had the opportunity of a lifetime,” she
recalled. “A physician I knew from The Children’s Hospital of Philadelphia had received a grant to develop
a wound care clinic in Guyana, Africa. He wanted someone to evaluate what it would take to set up a
wound care clinic. I spent several weeks overseas and it was an experience that I will never forget.”
Over the course of her career, Bateman has worked at several hospitals, nursing homes and hospices. She
is a member of the Wound, Ostomy, Continence Nurses Society,
American Society for Pain Management Nursing, the Association for the Advancement of Wound Care and
the Lymphedema Nurses Association, to name a few. She received her Bachelor of Science in nursing
degree from Widener University and is board certified in wound care nursing.
As the 2011 Patient Choice winner, Donna will receive an assortment of prizes that range from a $500
check to a special luncheon in her honor with members of her family. She will also be featured in a poster
that will recognize her as being the MHSC Patient Choice Award winner.
June 17, 2011
Dr. Ragsdale Named Alpha Homecare Medical Director - Space Coast Medicine and Healthy Living –
CENTRAL FLORIDA, USA – Alpha Homecare & Therapy Agency announced that Dr. V. Denny
Ragsdale has joined the agency as medical director.
“We’re very pleased to have Dr. Ragsdale as our new medical director,” said Wendy Morgan, Marketing
Liaison for Alpha Homecare.
“As a Board Certified family practitioner, he has a long and well-respected career in the Brevard
community. In addition to overseeing patient care, Dr. Ragsdale will offer home visits for patients with
limited mobility,” said Morgan.
Alpha Homecare will hold a community Open House on Friday, June 24, 10 a.m. – 2 p.m., to welcome Dr.
Ragsdale and give the public an opportunity to meet the doctor.
During the Open House, Alpha Homecare will offer blood pressure checks, fall risk screenings, raffles and
refreshments at their Melbourne office located at 3040 North Wickham Road in Melbourne, Florida.
“I’m very happy to be affiliated with Alpha Homecare as their primary goal is to provide exceptional
medical care.” said Dr. Ragsdale.
As medical director, Dr. Ragsdale offers the rare service of conducting home visits.
“Offering home visits is not for every doctor, but personally, I enjoy getting to know the patient, and not the
disease,” said Dr. Ragsdale.
With a wink, Dr. Ragsdale comments that he has the largest – and albeit only – house call practice in South
Brevard.
Originally from Tennessee, Dr. Ragsdale completed both his medical degree and fellowship at the
University of Miami in Coral Gables.
A veteran of the U.S. Air Force, Dr. Ragsdale is Board Certified in Family Medicine and is a Fellow of the
American Academy of Family Practice. A father of five children, he enjoys volunteering as a gospel pianist.
Alpha is a Joint Commission Accredited home health agency owned by Art and Joy Casingal, who are both
physical therapists.
The Medicare Certified agency provides skilled nursing, physical therapy, occupational therapy,
lymphedema therapy, and home health aide service countywide.
For more information about Alpha Homecare & Therapy Agency call 321-254-1070 or e-mail
alphahomecare09@att.net.
Comprehensive Lymphedema Management - MD News –
Siskin Hospital for Physical Rehabilitation in Chattanooga, TN, offers all-inclusive inpatient and outpatient
services for patients suffering from lymphedema.
In 1999, Siskin Hospital for Physical Rehabilitation launched an outpatient lymphedema program. When it
became clear that patients with advanced disease were experiencing transportation, home, and traditional
outpatient therapy challenges, an inpatient program was developed. Since then, patients throughout the
region — with some coming from as far as Oklahoma and Illinois — have turned to Siskin Hospital for help
managing their lymphedema.
Inpatient Care for Advanced Lymphedema
Patients with stage III lymphedema — characterized by severe swelling and the presence of fibrotic tissue
— are indicated for inpatient care. At this stage, limbs are so swollen that the ability to carry out daily
activities is compromised. Patients also usually suffer from other comorbidities and have an increased risk of
developing nonhealing wounds. These complications make it necessary to provide an intensive inpatient
multidisciplinary treatment program.
Siskin Hospital for Physical Rehabilitation requires a physician’s referral for inpatient lymphedema
treatment. As soon as a referral and medical records are received, the lymphedema program coordinator
and the medical director determine the patient’s appropriateness for the inpatient level of care. Treatment
typically starts on the day of admission and discharge plans are rapidly developed as specific information
related to the patient’s needs are identified. In addition to lymphedema therapy, treatment includes physical
therapy, occupational therapy, nutritional counseling, nursing care and education.
“Extensive training is necessary to help patients achieve success,” says John Jordi, B.S., PTA, CLT-
LANA, CI, Lymphedema Program Coordinator at Siskin Hospital. “Our goal is to eventually work
ourselves out of a job, so that patients with this chronic condition can manage it on their own, allowing them
to live a more normal and functional lifestyle.”
Therefore, a large focus of the inpatient lymphedema program is educating patients on how to self-manage
this chronic condition for the long term. Patients are taught self-MLD (manual lymphatic drainage), a
customized exercise plan, how to wrap their limbs to maintain the right amount of compression, how and
why to wear compression garments and how to do regular skin checks to help prevent skin breakdown,
wounds and infections.
When patients arrive for inpatient care, they spend three hours a day with a certified lymphedema therapist.
Patients generally begin seeing results during their first week of therapy. “While they are here, we expect
that patients will have a fair amount of independence,” says Jordi. “Most patients with severe lymphedema
have limited range of motion, so our occupational therapists work with them and assist with activities of
daily living, such as bathing, toileting and dressing. Their limbs have often become so swollen that they have
stopped performing basic tasks at home, such as tying their own shoes or even wearing shoes.”
Physical therapy is initially a large part of the program because patients have to learn proper and safe
walking techniques, particularly while wearing compression wraps. The Fitness Center at Siskin Hospital
located on the hospital’s main campus offers a multitude of adaptive fitness equipment that can
accommodate patients who have limitations.
According to Jordi, family support is also paramount to achieving successful outcomes. Family members
and caregivers are encouraged to participate during therapy sessions to learn how to assist lymphedema
patients with wrapping, while also helping the patients to maintain as much independence as possible.
Enhancing Patient Convenience
As more patients have sought care through Siskin Hospital for Physical Rehabilitation’s inpatient
lymphedema program, it has recently expanded to include an in-house durable medical equipment (DME)
company. This service allows patients to be fitted with the proper compression garments on site. It is
especially beneficial for breast cancer patients who have trunk swelling following lymph node removal, as it
can be difficult for them to find the correct garments.
“With wrapping, we expect change every day,” says Jordi. “As patients’ limbs continue to shrink and
approach normal size, we have to customize wrappings to accommodate these changes. Once the limbs
have reached optimal size, patients can be fitted for more permanent compression garments. Having the
DME component on site is advantageous for everyone involved. Patients can receive their bandages and
garments much faster than if they ordered them online.”
Transitioning to Outpatient Care
Following four weeks of inpatient care, most patients complete two to four weeks of outpatient therapy.
“To ensure success, we make the transition from inpatient to outpatient care as seamless as possible,” says
Jordi. “After completion of the inpatient program, most patients experience great improvements in their
overall health. Wounds resolve or improve and blood sugar levels improve in patients with diabetes. It is
essential that patients maintain the skills and healthy habits they have learned. We don’t want them to lose
any ground that they have gained.”
During the outpatient phase, their customized garments are ready, so a large portion of therapy focuses on
teaching patients how to use them appropriately. “These garments can be difficult for patients to get on and
off when they first receive them,” says Jordi. “Currently, we are working with a research team at Western
Carolina University to develop a product to assist patients with putting on their compression garments.”
Collaborating With Referring Physicians
The staff at Siskin Hospital for Physical Rehabilitation puts special emphasis on ensuring that patients’
primary care physicians are kept updated on their progress, so physicians can see how patients improve
once the excess fluid has been removed. Every patient who completes the lymphedema program at Siskin
Hospital for Physical Rehabilitation is referred back to his or her primary care physician for follow-up.
June 19, 2011
Lakeland celebrates new cancer center - Niles Daily Star –
A ceremony and ribbon-cutting marked the official dedication of Lakeland HealthCare’s new Marie Yeager
Cancer Center Thursday.
More than 300 guests toured the two-story, 30,000-square-foot center located in the Lakeland Health
Park in Royalton Township, St. Joseph. The cancer center will provide a single location for most cancer
care needs, including medical oncology, a pharmacy, laboratory services, a health and appearance center,
holistic support services, lymphedema therapy and clinical research. The facility will open to patients July 11.
“Those who will receive care here will benefit not only by the convenience and coordination of their
interdisciplinary care, their experience will be marked by more comfort, more confidence, and more hope,”
said Dr. Loren Hamel, president and CEO, Lakeland HealthCare, in his opening remarks during the
ceremony.
Myrna Hunt, a breast cancer survivor and musician, shared her personal story about fighting the disease
followed by a moving instrumental version of “You’ll Never Walk Alone” on the piano by Rodgers and
Hammerstein.
Later in the program, a marble sculpture by renowned artist Fritz Olsen of Sawyer, Mich. was unveiled in
the cancer center’s Healing Garden. Martha Cares, a nationally regarded soprano opera singer and wife of
Olsen, sang a song for which she had written the lyrics in honor of the occasion and unveiling.
The cancer center is named after Marie Yeager, a long-time oncology nurse at Lakeland. Her husband,
Tom, recalled her dedication and passion for caring for her patients.
“This cause was very dear to her heart, and our family knows she would be proud to continue to make a
difference for southwest Michigan patients affected by cancer,” Yeager said.
Lakeland HealthCare is a non-profit, community-owned health system, which includes four hospitals, an
outpatient surgery center, rehabilitation centers, long-term care residencies, hospice, home care services
and physician practices. Lakeland has nearly 4,000 employees who provide clinical and support services at
locations throughout southwest Michigan, and partners with approximately 400 affiliated physicians and
other providers.
For more information, visit www.lakelandhealth.org.
Turn to kinesiology tape for 'treatment between treatment' - Globe and Mail – by AMY VERNER –
Since last week, people have been asking whether I have been sporting some stylish, new body art. In fact,
I have had my foot and ankle covered in SpiderTech kinesiology tape to help heal a soft-tissue injury.
But while I am new to the world of kinesiology tape, kinesiology tape is not new to the world.
It dates back to the 1970s when Japanese chiropractor Kenzo Kase developed a cotton tape with an
acrylic adhesive that could be used to treat a variety of conditions, from reducing inflammation to activating
underused muscles. It also may offer some relief for cancer patients suffering from lymphedema.
The water-resistant tape was created to have the same weight, elasticity and thickness as skin, which means
it can provide microcirculatory and structural in addition to cellular stimulation. Kevin Jardine, a
chiropractor who developed the SpiderTech brand three years ago, refers to it as “treatment between
treatment.”
Kinesiology tape catapulted into public consciousness when cyclist Lance Armstrong referred to it in one of
his books as “magic tape.” Throughout the Beijing Olympics, many athletes could be seen wearing various
patterns of what looked to be painter’s tape, and it has become a staple among Ironman competitors.
There are several brands on the market and to the untrained eye there’s little difference. They come in a roll
format (average $10 to $20 a roll), stretch only lengthwise and can be cut to measure and applied
anywhere on the body. Knees, shoulders and necks are the most common spots.
SpiderTech, however, offers a range of 16 “precuts” (average $10 a precut), to reduce the guesswork
when applying the tape.
On the one hand, a precut is far more user-friendly than a standard roll. The Ankle Spider, as an example,
consists of one long strip with a hole in the centre to accommodate two centre toes and a slit at one end to
allow a range of motion up the posterior leg. To try to achieve this exact shape using strips cut from a roll
would be a challenge.
But don’t bodies come in all different shapes and sizes? Mr. Jardine says yes, adding that precuts are not
limited to their designated body area, so a Knee Spider could be used on a shoulder and a Groin Spider
could be used on the glutes (website: spidertech.com). “There was a lot of confusion in how to apply [the
roll],” he says. “This offers a standardized way to implement the practice.”
And if you are wondering why the brand name, he says it’s because when people would see the tape
applied, they say it looks like a spider.
Mark Scappaticci, a Toronto-based sports chiropractor who is a certified instructor in kinesiology tape,
prefers customizing each application from the roll, maintaining that precuts often need to be modified and
may not work as effectively. He says his patients will take pictures or film him applying the tape so that they
can do it themselves the next time around. There are also scores of instructional videos online.
There is a definite art to the application. Mr. Jardine took great care in rubbing the tape along my skin as he
laid it down. I have yet to try doing this myself.
Mr. Jardine, who has an integrative fitness and wellness facility called Urban Athlete in midtown Toronto,
underscores that people should first seek professional diagnosis. “The goal is not to give a mechanism to
self-diagnose,” he says. “But in the interim, this can alleviate the discomfort.”
While long-time users of the tape may turn to it for repetitive strain, Mr. Scappaticci adds that it is never a
replacement for actual treatment and, in some cases, can prolong the recovery.
Work in Montreal drew me away from two treatments last week and the SpiderTape could not have come
at a better time. While it did not heal my injury, it secured my foot in a way that provided some pain relief
and staved off swelling. Mostly, it made me feel protected.
As an aside, my aesthetic ego appreciates that the tape comes in black, bright blue and pink in addition to
beige (apparently, when first introduced in Japan, the blue signified “cool” and the pink “warm,” but there’s
no additional difference). So as I continue to heal, I can at least enjoy the compliments that the tape looks
like a fashion trend. But trends come and go, whereas kinesiology tape will be sticking around for some
time.
June 20, 2011
Klose Training & Consulting: Professional Training for Lymphedema Therapy – SBWire –
Lymphedema therapy certification at Washington University School of Medicine in St. Louis, MO. The
educational program will provide training for occupational therapists, physical therapists, and massage
therapists.
Lafayette, CO -- (SBWIRE) -- 06/20/2011 -- Klose Training & Consulting, a lymphedema certification
and education company, will provide professional training for lymphedema therapy certification at
Washington University School of Medicine in St. Louis, MO, July 15 – 23, 2011. The educational program
will provide training for occupational therapists, physical therapists, and massage therapists to obtain
certification in lymphedema therapy.
This training will be hosted by the program in physical therapy at Washington University School of
Medicine. As noted on the Washington University School of Medicine website, the school “is a leader in
improving human health throughout the world.” The school conveniently accommodates its students and
visitors with on campus parking and access to public transportation.
Klose Training’s lymphedema certification course totals 135 combined hours of a 45-hour internet-based
home-study program and 90 hours of classroom (lab) instruction. Course curriculum includes full training in
the four components of Complete Decongestive Therapy (CDT), the most successful treatment for chronic
extremity lymphedema. In addition to CDT training, professionals receive adequate training in Anatomy,
Physiology, Manual Lymph Drainage (MLD), Measurement, and exercises for patients with lymphedema.
Course instructors are Jan Weiss, DHS, PT, CLT-LANA, and Christopher Cobb, PT, CLT-LANA. Jan
Weiss received her MLD/CDT certification in 1996. She established the Lymphedema Clinic at CoxHealth
in Springfield, MO, and currently serves as the Lymphedema Resource Therapist for her hospital while
treating a variety of patients with edema lymphedema. Christopher Cobb works as a staff therapist in the
outpatient physical therapy department for CoxHealth in Springfield, Missouri. He has been actively treating
lymphedema patients in a variety of settings including acute care, skilled nursing, and outpatient since his
certification in October 2002.
Cancer survivor works with therapist to control lymphedema - Daytona Beach News-Journal – by Kathy
Page –
Daytona Beach resident Dotti Lewis is a longtime breast cancer survivor but now, 24 years after her
mastectomy, she has developed lymphedema. Usually diagnosed shortly after surgery, lymphedema is
swelling caused by fluid accumulating in the affected areas. It can be treated and kept under control, but not
cured. Recently, Dotti shared her story with The News-Journal.
Q. What is lymphedema and what are its symptoms?
Lymphedema is an abnormal accumulation of protein and water caused when there is a mechanical
insufficiency in the lymphatic system, an important part of your immune and circulatory system. This
blockage prevents fluid from draining and, as it builds up, swelling results ... and continues to grow. It can
be treated and kept under control, BUT NOT CURED. It affects both men and women, and for reasons
other than cancer.
If it's not controlled, the swelling will become painful. The skin can only stretch so far and uncontrolled
swelling can force the skin to split and ooze--leaving an opening for bacteria.
Q. Were you told about the possibility of developing lymphedema when you had your mastectomy?
Yes, I was warned about the possibility because some of the lymph nodes in my left armpit were removed
to see if the cancer had spread. Fortunately, the nodes were free of cancer, but apparently the lymph
system was compromised.
My surgeon, Dr. James Sutton, told me to protect my left arm, to avoid any injury to it, not to have any
manicures and not to let anyone take my blood pressure or draw blood from that arm.
As the years went by, several nurses said I didn't have to worry about those rules anymore. I still kept to
the rules as much as possible and I thought I was safe from any side effects of the Big C. Especially after 24
years. But apparently lymphedema set in when I accidentally tore some skin off my left arm.
Q. What type of treatment are you receiving?
My primary care physician, Dr. Henri Nammour, sent me to Carmen Yu, a certified lymphedema therapist
at Pro-Motion Physical Therapy in Port Orange.
I had sessions of manual lymph drainage, followed by compression bandaging, starting three times a week
and then increasing to five times a week since I was not responding fast enough. With my arm wrapped, I
was instructed to do daily exercises at home.
The manual lymph drainage is gentle and designed to assist the flow of lymph fluid that causes the swelling. I
had thought lymph nodes were only in the armpits and groin, but I soon learned they are almost everywhere
in your body and close to the skin.
Carmen explained as she massaged and showed me the difference as the swelling drained from various
parts of my arm and hand. Then she got out the pressure bandages.
In my case they consisted of a type of gauze wrapped around my fingers and hand, layers of a soft cotton
material, a layer of a thin foam and several layers of a bandage similar in appearance to the Ace bandages
commonly used for orthopedic problems. And there were foam paddings added on my forearm where the
swelling was at its worst and the tissue was tough and fibrotic.
When she was through, my arm looked like that of a mummy in a horror movie. (My sister said I looked
like the Michelin tire man.) Most people thought I had a broken arm with a cast under the outer bandages,
or had recent surgery. When my sister was with me, we both just laughed and said we'd had a fight.
I wore the bandages day and night, occasionally removing them to wash and dry them shortly before going
to an appointment with Carmen. She had to remove them each time anyway for the massages and re-
bandage them when she was through. It's a job that takes a lot of patience, but Carmen was always
cheerful and encouraging.
Every so often, Carmen measured my arm to see if I was ready for a pressure sleeve, which looks like a
nylon stocking on your arm, and a pressure gauntlet, which leaves the tips of your fingers sticking out.
I finally made the grade! My gauntlet has an additional foam pad on the back of the hand, which also swells.
At first glance, it looks a little as though I have a prosthetic arm. I wear the sleeve and gauntlet at least eight
hours each day.
Q. Who do you count on for support?
My sisters, my children and my grandchildren are very supportive -- as are my friends. There is also a
breast cancer/lymphedema support group at Halifax Health which I plan to join as soon as possible.
Q. What role does diet and exercise play in trying to maintain a healthy lifestyle?
I have received no special recommended diet ... but there are a series of special exercises for lymphedema.
Also, Carmen has given me instructions in self-massage to be performed daily.
Q. Are you active in creating an awareness of lymphedema and what it takes to manage it?
I am trying to make as many mastectomy patients as possible aware that the affected arm must be treated
with special care, no matter who tells you that you are safe from side effects. I do this by openly discussing
my need for the obvious pressure garments with anyone who looks at them quizzically --even if they are too
polite to ask questions.
Q. Do you have any advice for others who have been diagnosed with lymphedema?
Get treatment as soon as you notice the swelling and don't let it embarrass you or interfere with your
activities any more than is absolutely necessary.
Q. Anything else you'd like to share?
The lymphedema control routine is not something I look forward to the rest of my life. I'll be checking all
available sources and bugging Carmen and my doctor periodically to see if any possible cures are being
considered.
And to my fellow mastectomy patients ... don't forget ... always treat the affected arm with special care, no
matter who says you're safe now from side effects!!!
Kangoo Jumps: Hot workout trend puts a spring in your step - Denver Post – By Ellen Nordberg –
Bouncing around like kangaroos with huge smiles on their faces, Kangoo jumpers burn extra calories,
stimulate their lymphatic systems and reduce the impact on their joints by up to 80 percent.
Kangoo Jumps, a hot workout trend in Europe and South America, have bounded into Colorado.
Resembling a cross between the boot of a Rollerblade and the treads on the bottom of a snowcat, Kangoo
Jumps were originally designed by a Swiss engineer whose aging knees hindered his passion for running.
Bands or coils in the center of the shell underneath the boot stretch when compressed, creating spring or
rebound. This rebound effect is the key to their appeal and success, according to Beth Kruper, Kangoo
Jumps master trainer.
"The great thing is the reduction in impact," says Kruper, a fitness instructor for more than 20 years. "In my
classes, I have everyone from a 9-year-old to a 70-year-old. These are mostly people who want a good
workout, but many just can't do cardio any other way. I've put boots on over 3,000 people, and I see
people with so many different joint problems. Whatever hurts them when they run or do aerobics — it
doesn't hurt them with Kangoo."
Health clubs in the metro area — Denver Athletic Club, Lakeshore Athletic Club in Broomfield and Body
Dynamics Studio in Boulder — have begun offering Kangoo Jumps classes. The classes offer
choreographed moves in a studio setting, which allows users to get comfortable with the boots and move in
multidimensional directions. Many of the participants have found relief from joint issues.
"I took the Kangoo Jump class at the Denver Athletic Club for a specific reason," says Denver resident
Austin Murr. "I hadn't been able to get out and run for over six years. The pain in my knees had led me to
the boring elliptical machine. Then I put on Kangoo Jumps. Spring in the step again — literally."
In addition to studio classes, Kangoo Jumps can be worn outside on pavement, dirt trails, and potentially
even snow or sand. Many Kangoo owners take classes and also run outside with their boots.
"I haven't been able to run for years due to foot pain," says Shawn Ellis, a Lakeshore Athletic Club
member. "Kangoos allow me to run and jump as much as I want. I can run outdoors if it's a nice day. You
look kind of goofy running around the neighborhood in your boots, but it's fun."
Both the Center for Exercise Science and Sport Management at Southern Cross University in Lismore,
Australia, and the Division of Sports Medicine at The Swiss Federation Institute of Technology conducted
studies that determined that wearing Kangoo Jumps while jogging significantly reduced impact compared
with jogging in regular running shoes. However, according to the Southern Cross University study, "Further
research work is required to assess the changes in gait pattern that the Kangoo Jumps may produce."
Multiple benefits
Dr. Lorri J. Fulkerson, an orthopedic surgeon with Boulder Orthopedics who has tried Kangoos herself,
agrees that they can reduce impact on joints versus using traditional running shoes.
"Patients with mild forms of osteoarthritis may find the boots improve their tolerance for impact activity," she
says. "However, since the boots are a less-stable platform, they may not be appropriate for people with
more severe arthritis."
Kangoo offers benefits to populations beyond folks with joint issues or injury rehabilitation, according to
Wendy McClure, ACSM-certified Personal Trainer, Lakeshore instructor and co-owner of Body
Dynamics Studio. The rebounding effect increases circulation and heart rate, and facilitates lymphatic
drainage.
"The boots are great for obesity in children, and great for women with metabolic and tissue issues," says
McClure. "It's also an efficient way to exercise because the heart rate gets up easily, and your calorie burn
can be up to 50 percent more than the same exercise without the boots.
"There's also a lymphatic flush that comes with rebounding," she says. "Our organs don't flush as well as we
age. Toxins build up. A huge volume of blood is pumped through during a Kangoo workout, and it cleanses
our system like a massage."
Christy Thiel, a personal trainer in Fort Collins, struggled with digestive issues, skin problems and low
energy until she tried rebounding.
"My lymph system was stagnant. I was not metabolizing toxins," Thiel says. "I started rebounding on a mini-
tramp for two minutes a day. Within a month, I felt so much better."
Thiel went on to become a certified Kangoo Jumps instructor who has also produced a basic home weight-
loss video for Kangoo Jumps.
Trudy Turvey, a physical therapist and certified lymphedema specialist in Boulder, agrees with the benefits
of lymphatic drainage but isn't sold on the superiority of Kangoo Jumps on this process.
"Lymphatic flow is extremely important to cleanse your body of foreign toxins," she says. "But most any
kind of exercise will increase lymphatic flow. Whether or not rebounding is more beneficial than walking or
swimming on the lymph system — I'm not sure we have the research to support that."
While many people are finding benefits from the boots, Kangoo Jumps are not necessarily for everyone.
They're contraindicated for pregnant women, people with heart or blood- pressure problems and potentially
people with balance issues or a current injury.
"Anyone with an injury should definitely be led through the use of Kangoos to make sure it's appropriate for
them," McClure says. "And the boots can help people with balance issues, but they need to be guided, as
well."
Proper fit is crucial
The boots have a variety of levels of adjustments for size, strength and weight, so it's important to be fitted
by an instructor or Kangoo representative. There are adjustments from 45 pounds to over 300 pounds. A
specialist can help you find the proper tension.
Lots of local Kangoo users have purchased their own boots (see box at left), but many choose to rent or
use the boots provided by the facility for their classes. Body Dynamics charges $10-$17 per class, Denver
Athletic Club charges a one-time $15 fee for members, and Lakeshore Athletic Club charges a $2 boot
rental fee per class.
All three clubs have growing programs. Petra Storm, group exercise coordinator of the Denver Athletic
Club, touts the ease of use and positive feeling that comes from using Kangoos as the reason for the
popularity at her club.
"There's a sense of euphoria from the rebound effect," she says. "The classes are fun. We laugh and jump
around. You kind of forget you're exercising."
Treatment May Help Ease Effect of Cancer - New York Times – By RONI CARYN RABIN –
Top plastic surgeons from around the country met in Manhattan last month to observe an experimental
surgery that may cure lymphedema, a serious complication of breast cancer treatment.
As some surgeons crowded into an operating room at New York Eye and Ear Infirmary and others
watched a live video broadcast, Dr. Corinne Becker, the French doctor who pioneered the procedure,
harvested lymph nodes from a patient’s groin to transplant to her underarm, where nodes had been
removed earlier during cancer treatment.
“Voila!” she exclaimed, motioning to her colleagues as she rubbed a small piece of tissue between thumb
and fingertips to check for the presence of the small, pearl-shaped lymph nodes. “Look what is here — a
wonderful node.”
She warned that extracting too much tissue could injure the patient, even causing lymphedema in another
limb. Using the French word for ‘greedy,’ she said, “It’s better not to be ‘gourmand’ — aggressive.”
This innovative procedure, called an autologous vascularized lymph node transfer, is used to treat
lymphedema, a common side effect of breast cancer treatment. Removal of the lymph nodes under the arm
closest to the affected breast is believed to stem the spread of cancer, although new research suggests it can
be avoided in many cases. But the loss of lymph nodes often leads to chronic swelling and soreness in the
arm.
In the new experimental surgery, the missing lymph nodes are replaced with a handful of healthy nodes
transplanted from elsewhere in the patient. If all goes according to plan, the lymph nodes make themselves
at home in their new location and connect with lymph vessels and start doing their job, filtering waste and
draining fluid that has accumulated in the arm.
But the operation is controversial and not without risk, and though it is reported to have cured some
patients and improved the condition in many others, it is seldom performed in the United States. Even
proponents say it should be reserved for patients who don’t respond to conventional treatment.
The first randomized clinical trial of its effectiveness is just getting underway, led by Dr. Constance Chen, a
New York City plastic surgeon who specializes in muscle-sparing reconstructive breast surgery that uses
the patient’s own tissue.
Even in the absence of good data, however, demand for the procedure is bound to grow. More than 2
million women in the United States have been treated for breast cancer, and some studies suggest
lymphedema develops within five years in up to 40 percent of women who have undergone breast cancer
surgery. While the condition can be managed with constant care and physical therapy, it often severely
restricts activity and is generally considered incurable.
In the absence of better data about the benefits of lymph node transfer, however, insurers may balk at
covering the procedure, which involves expensive, complex microvascular surgery to connect tiny blood
vessels.
“From just a plumbing standpoint, it makes sense — someone took out the lymph nodes, you put them
back in,” said Dr. Babak Mehrara, a reconstructive plastic surgeon at Memorial Sloan-Kettering Hospital
in Manhattan. “The problem is that some of the science doesn’t support it. It probably works for some
people and doesn’t for others.”
Prior to transferring nodes to their new location, Dr. Becker aggressively clears away dense scar tissue
under the arm that may be “clogging up” the lymphatic channels and preventing fluid circulation. That is one
of the riskiest aspects of the surgery, because nerves and blood vessels leading to the arm could be affected.
“We worry that if a person already has a compromised lymphatic surgery, you can go in there and do
further damage. We always say the less surgery the better,” said Saskia Thiadens, executive director of the
National Lymphedema Network.
But, she added, “Obviously we’re eager to see what the outcomes are.”
Dr. Chen, who co-organized the symposium hosting Dr. Becker with Dr. Joshua L. Levine, director of
breast reconstructive services at New York Eye and Ear Infirmary, agrees that more scientific evidence is
needed. But she is optimistic the surgery will benefit patients and says the toll lymphedema takes has not
been fully appreciated by the medical community.
“Treatment for lymphedema generally doesn’t end,” Dr. Chen said. “Women will say managing their
lymphedema is worse than coping with breast cancer — now they have to deal with an every day affliction
that affects their day to day lives.”
She is launching the first double-blinded randomized clinical trial of lymph node transfer, a multicenter study
that will enroll 88 patients with lymphedema in one arm. Half will be randomly assigned to lymph node
transfer, while the others will undergo a dummy surgical procedure. The patients will be followed for two
years after the operation to see if their quality of life improves.
“There are naysayers with every single surgical innovation that comes along,” Dr. Chen said.
Dr. Becker claims to have had enormous success, but while she has operated prolifically in Europe and
other parts of the world on patients with cancer as well as those with congenital lymphedema, she has
published only sporadically.
In a 2006 paper in Annals of Surgery, she reported that 90 percent of patients improved after surgery and
almost half were cured, but the sample included only 24 women and there was no control group.
One of the patients operated on by Dr. Becker and Dr. Chen during the daylong symposium, Jennifer
Miller, 40, a portfolio manager at an investment firm in Manhattan, said she has already felt a dramatic
improvement.
“I used to have this pain that was like my whole arm had a headache, and that’s gone,” Ms. Miller said.
Ten days after surgery the swelling in her right arm was reduced by half, compared with measurements
taken 10 days prior to the operation, and she has been able to bare her arm, which she used to keep
covered in a compression treatment sleeve most of the day.
Though her right arm is still swollen and larger than her left, she said, “It already feels more manageable, and
I’m still recovering from surgery. Even if this is all the improvement I get, I’m happy.”
But whether the change is a true effect of the transfer or a placebo effect of undergoing treatment is not
known. Doctors say it is unlikely the transplanted nodes are already functioning, and it’s possible some
other aspect of the surgery is having a beneficial effect, Dr. Chen suggested.
June 23, 2011
Rehab Rally Announces Featured Continuing Education Session Lineup: Lymphedema - PR Web (press
release)
HomeCEUConnection.com is proud to announce that Rehab Rally Conference & Expo will feature five,
live continuing education sessions focused on Lymphedema Management and Myofascial Release for
Massage Therapists, Physical Therapists, Physical Therapist Assistants, Occupational Therapists,
Occupational Therapist Assistants and Athletic Trainers.
The Lymphedema Management and Myofascial Release session lineup will feature five, four hour, live
continuing education sessions covering such topics as, Myofascial Release Clinical Applications for the
Upper and Lower Body, Manual Lymphatic Drainage, and Pharmacology Considerations in the
Lymphatically Impaired Patient. Each of these sessions will be led by renowned speakers, Suzanne Tinsley,
PhD, PT, NCS, Carmen Thompson, BS, LPTA, CMT, CLT, and Theresa Schmidt, MS, PT, OCS, LMT,
CEAS, CHy. For a full Rehab Rally Continuing Education session lineup, including information about the
other continuing education tracts at Rehab Rally, please visit http://www.RehabRally.com
Each of the courses featured at Rehab Rally will satisfy continuing education requirements for Athletic
Trainers, Physical Therapists, Physical Therapist Assistants, Occupational Therapists, and Occupational
Therapist Assistants. The Lymphedema Management and Myofascial Release session lineup will satisfy
continuing education requirements for all of the previous rehabilitation professionals, as well as, Massage
Therapists. Rehab Rally is approved for up to 20 hours of live continuing education, with the option to
receive up to 75 hours by bundling the live event with approved home study courses available from
HomeCEUConnection.com. To learn more about Rehab Rally approvals please visit RehabRally.com.
About Rehab Rally
Rehab Rally Conference & Expo 2011 is a national continuing education conference hosted by
HomeCEUConnection.com, and designed for Physical Therapists, Physical Therapist Assistants,
Occupational Therapists, Occupational Therapist Assistants, Athletic Trainers, and Massage Therapists.
Rehab Rally will take place from July 28-31, 2011 in sunny Orlando, Florida and will be hosted at the
Gaylord Palms Resort. For more information about Rehab Rally please visit http://www.rehabrally.com.
About HomeCEUConnection.com
HomeCEUConnection.com specializes in quality online continuing education courses.
HomeCEUConnection.com offers CEUs for physical therapists, physical therapist assistants, occupational
therapists, occupational therapist assistants, speech language pathologists, athletic trainers, massage
therapists, and certified strength and conditioning specialists that are convenient, affordable and user
friendly. Visit HomeCEUConnection.com to learn more about our continuing education courses.
Difficult to diagnose condition gets exposure on second annual Lymphedema Awareness Day - Burnaby
Now - By Janaya Fuller-Evans –
Despite its obvious physical appearance, lymphedema is a difficult condition for doctors to recognize,
according to Lucette Wesley, president of the B.C. Lymphedema Association.
To change that, the association is holding its second annual Lymphedema Day event at the British Columbia
Institute of Technology to educate medical professionals and others about the condition.
Lymphedema is a condition where lymph - protein rich fluid - gathers in the limbs, or sometimes other parts
of the body such as the face or groin.
"A lot of people can feel alone with this condition," Wesley says.
It generally only affects one limb, and not bilateral limbs, as lipedema does. The resulting swelling can cause
pain, decreased mobility and even wounds, if not cared for properly.
Elephantitis is a chronic, severe version of the condition.
There are two kinds of lymphedema - a congenital condition passed down genetically, usually presenting in
infancy, or secondary lymphedema, which can occur after damage to the lymphatic system.
"Lots of people who have cancer develop lymphedema, and especially those with breast cancer," Wesley
says.
"People who've had cancer and have been free of the cancer for years, and think, 'Hey I'm past it," she
said, "and then they get lymphedema, and now they're stuck for life. It's a condition that never goes away."
Doctors often don't know much about it, Wesley says, making it difficult to get a correct diagnosis.
"Sometimes it starts off with very mild swelling and that's the problem," she explains. "They often don't
know what causes it and there's no easy way to test it."
There is no diagnostic test for the condition.
Those with lymphedema often work with massage practitioners, and use compression garments to keep the
swelling down.
It is very costly and time-consuming, according to Wesley.
"There are people who have to spend two hours a day putting on their compression bandages," she says.
The right amount of pressure is key, she adds.
The association hopes to educate people, particularly doctors, about the condition, Wesley says.
To that end, the registered non-profit is hosting a Lymphedema Awareness Day event at BCIT this
Saturday from 10 a.m. to 4 p.m.
It will include an address from keynote speaker Dr. Neil Piller, the director of the Lymphedema
Assessment Clinic in Australia, as well as forums for healthcare professions, and for patients on how to
approach self-care. Other topics include compression, current approaches, and new directions in treatment.
The event includes a breakfast and buffet lunch.
The Lymphedema Awareness Day event is being sponsored by the Canadian Breast Cancer Foundation's
B.C. and Yukon branch, with a $5,000 donation.
Those interested in attending can register online until Friday at www.bclymph.org. The cost is $30 for
members of the association and $40 for non-members.
June 24, 2011
Treatment May Help Ease Effect of Cancer – Ocala – by RONI CARYN RABIN –
Top plastic surgeons from around the country met in Manhattan last month to observe an experimental
surgery that may cure lymphedema, a serious complication of breast cancer treatment.
As some surgeons crowded into an operating room at New York Eye and Ear Infirmary and others
watched a live video broadcast, Dr. Corinne Becker, the French doctor who pioneered the procedure,
harvested lymph nodes from a patient’s groin to transplant to her underarm, where nodes had been
removed earlier during cancer treatment.
“Voila!” she exclaimed, motioning to her colleagues as she rubbed a small piece of tissue between thumb
and fingertips to check for the presence of the small, pearl-shaped lymph nodes. “Look what is here — a
wonderful node.”
She warned that extracting too much tissue could injure the patient, even causing lymphedema in another
limb. Using the French word for ‘greedy,’ she said, “It’s better not to be ‘gourmand’ — aggressive.”
This innovative procedure, called an autologous vascularized lymph node transfer, is used to treat
lymphedema, a common side effect of breast cancer treatment. Removal of the lymph nodes under the arm
closest to the affected breast is believed to stem the spread of cancer, although new research suggests it can
be avoided in many cases. But the loss of lymph nodes often leads to chronic swelling and soreness in the
arm.
In the new experimental surgery, the missing lymph nodes are replaced with a handful of healthy nodes
transplanted from elsewhere in the patient. If all goes according to plan, the lymph nodes make themselves
at home in their new location and connect with lymph vessels and start doing their job, filtering waste and
draining fluid that has accumulated in the arm.
But the operation is controversial and not without risk, and though it is reported to have cured some
patients and improved the condition in many others, it is seldom performed in the United States. Even
proponents say it should be reserved for patients who don’t respond to conventional treatment.
The first randomized clinical trial of its effectiveness is just getting underway, led by Dr. Constance Chen, a
New York City plastic surgeon who specializes in muscle-sparing reconstructive breast surgery that uses
the patient’s own tissue.
Even in the absence of good data, however, demand for the procedure is bound to grow. More than 2
million women in the United States have been treated for breast cancer, and some studies suggest
lymphedema develops within five years in up to 40 percent of women who have undergone breast cancer
surgery. While the condition can be managed with constant care and physical therapy, it often severely
restricts activity and is generally considered incurable.
In the absence of better data about the benefits of lymph node transfer, however, insurers may balk at
covering the procedure, which involves expensive, complex microvascular surgery to connect tiny blood
vessels.
“From just a plumbing standpoint, it makes sense — someone took out the lymph nodes, you put them
back in,” said Dr. Babak Mehrara, a reconstructive plastic surgeon at Memorial Sloan-Kettering Hospital
in Manhattan. “The problem is that some of the science doesn’t support it. It probably works for some
people and doesn’t for others.”
Prior to transferring nodes to their new location, Dr. Becker aggressively clears away dense scar tissue
under the arm that may be “clogging up” the lymphatic channels and preventing fluid circulation. That is one
of the riskiest aspects of the surgery, because nerves and blood vessels leading to the arm could be affected.
“We worry that if a person already has a compromised lymphatic surgery, you can go in there and do
further damage. We always say the less surgery the better,” said Saskia Thiadens, executive director of the
National Lymphedema Network.
But, she added, “Obviously we’re eager to see what the outcomes are.”
Dr. Chen, who co-organized the symposium hosting Dr. Becker with Dr. Joshua L. Levine, director of
breast reconstructive services at New York Eye and Ear Infirmary, agrees that more scientific evidence is
needed. But she is optimistic the surgery will benefit patients and says the toll lymphedema takes has not
been fully appreciated by the medical community.
“Treatment for lymphedema generally doesn’t end,” Dr. Chen said. “Women will say managing their
lymphedema is worse than coping with breast cancer — now they have to deal with an every day affliction
that affects their day to day lives.”
She is launching the first double-blinded randomized clinical trial of lymph node transfer, a multicenter study
that will enroll 88 patients with lymphedema in one arm. Half will be randomly assigned to lymph node
transfer, while the others will undergo a dummy surgical procedure. The patients will be followed for two
years after the operation to see if their quality of life improves.
“There are naysayers with every single surgical innovation that comes along,” Dr. Chen said.
Dr. Becker claims to have had enormous success, but while she has operated prolifically in Europe and
other parts of the world on patients with cancer as well as those with congenital lymphedema, she has
published only sporadically.
In a 2006 paper in Annals of Surgery, she reported that 90 percent of patients improved after surgery and
almost half were cured, but the sample included only 24 women and there was no control group.
One of the patients operated on by Dr. Becker and Dr. Chen during the daylong symposium, Jennifer
Miller, 40, a portfolio manager at an investment firm in Manhattan, said she has already felt a dramatic
improvement.
“I used to have this pain that was like my whole arm had a headache, and that’s gone,” Ms. Miller said.
Ten days after surgery the swelling in her right arm was reduced by half, compared with measurements
taken 10 days prior to the operation, and she has been able to bare her arm, which she used to keep
covered in a compression treatment sleeve most of the day.
Though her right arm is still swollen and larger than her left, she said, “It already feels more manageable, and
I’m still recovering from surgery. Even if this is all the improvement I get, I’m happy.”
But whether the change is a true effect of the transfer or a placebo effect of undergoing treatment is not
known. Doctors say it is unlikely the transplanted nodes are already functioning, and it’s possible some
other aspect of the surgery is having a beneficial effect, Dr. Chen suggested.
Digging deeper into lymphatic vessel formation in vitro and in vivo - 7thSpace Interactive (press release) –
Abnormal lymphatic vessel formation (lymphangiogenesis) is associated with different pathologies such as
cancer, lymphedema, psoriasis and graft rejection. Lymphatic vasculature displays distinctive features than
blood vasculature, and mechanisms underlying the formation of new lymphatic vessels during physiological
and pathological processes are still poorly documented.
Most studies on lymphatic vessel formation are focused on organism development rather than
lymphangiogenic events occurring in adults. We have here studied lymphatic vessel formation in two in vivo
models of pathological lymphangiogenesis (corneal assay and lymphangioma).
These data have been confronted to those generated in the recently set up in vitro model of lymphatic ring
assay. Ultrastructural analyses through Transmission Electron Microscopy (TEM) were performed to
investigate tube morphogenesis, an important differentiating process observed during endothelial cell
organization into capillary structures.
Results: In both in vivo models (lymphangiogenic corneal assay and lymphangioma), migrating lymphatic
endothelial cells extended long processes exploring the neighboring environment and organized into cord-
like structures.
Signs of intense extracellular matrix remodeling were observed extracellularly and inside cytoplasmic
vacuoles. The formation of intercellular spaces between endothelial cells led to tube formation.
Proliferating lymphatic endothelial cells were detected both at the tips of sprouting capillaries and inside
extending sprouts. The different steps of lymphangiogenesis observed in vivo are fully recapitulated in vitro,
in the lymphatic ring assay and include: (1) endothelial cell alignment in cord like structure, (2) intracellular
vacuole formation and (3) matrix degradation.
Conclusions: In this study, we are providing evidence for lymphatic vessel formation through tunneling
relying on extensive matrix remodeling, migration and alignment of sprouting endothelial cells into tubular
structures.
In addition, our data emphasize the suitability of the lymphatic ring assay to unravel mechanisms underlying
lymphangiogenesis.
Author: Benoit DetryFrancoise BruyereCharlotte ErpicumJenny PaupertFrancoise LamayeCatherine
MaillardBenedicte LenoirJean-Michel FoidartMarc ThiryAgnes Noel
Credits/Source: BMC Cell Biology 2011, 12:29
June 20, 2011
Kangoo Jumps: Hot workout trend puts a spring in your step - Denver Post – By Ellen Nordberg –
Bouncing around like kangaroos with huge smiles on their faces, Kangoo jumpers burn extra calories,
stimulate their lymphatic systems and reduce the impact on their joints by up to 80 percent.
Kangoo Jumps, a hot workout trend in Europe and South America, have bounded into Colorado.
Resembling a cross between the boot of a Rollerblade and the treads on the bottom of a snowcat, Kangoo
Jumps were originally designed by a Swiss engineer whose aging knees hindered his passion for running.
Bands or coils in the center of the shell underneath the boot stretch when compressed, creating spring or
rebound. This rebound effect is the key to their appeal and success, according to Beth Kruper, Kangoo
Jumps master trainer.
"The great thing is the reduction in impact," says Kruper, a fitness instructor for more than 20 years. "In my
classes, I have everyone from a 9-year-old to a 70-year-old. These are mostly people who want a good
workout, but many just can't do cardio any other way. I've put boots on over 3,000 people, and I see
people with so many different joint problems. Whatever hurts them when they run or do aerobics — it
doesn't hurt them with Kangoo."
Health clubs in the metro area — Denver Athletic Club, Lakeshore Athletic Club in Broomfield and Body
Dynamics Studio in Boulder — have begun offering Kangoo Jumps classes. The classes offer
choreographed moves in a studio setting, which allows users to get comfortable with the boots and move in
multidimensional directions. Many of the participants have found relief from joint issues.
"I took the Kangoo Jump class at the Denver Athletic Club for a specific reason," says Denver resident
Austin Murr. "I hadn't been able to get out and run for over six years. The pain in my knees had led me to
the boring elliptical machine. Then I put on Kangoo Jumps. Spring in the step again — literally."
In addition to studio classes, Kangoo Jumps can be worn outside on pavement, dirt trails, and potentially
even snow or sand. Many Kangoo owners take classes and also run outside with their boots.
"I haven't been able to run for years due to foot pain," says Shawn Ellis, a Lakeshore Athletic Club
member. "Kangoos allow me to run and jump as much as I want. I can run outdoors if it's a nice day. You
look kind of goofy running around the neighborhood in your boots, but it's fun."
Both the Center for Exercise Science and Sport Management at Southern Cross University in Lismore,
Australia, and the Division of Sports Medicine at The Swiss Federation Institute of Technology conducted
studies that determined that wearing Kangoo Jumps while jogging significantly reduced impact compared
with jogging in regular running shoes. However, according to the Southern Cross University study, "Further
research work is required to assess the changes in gait pattern that the Kangoo Jumps may produce."
Multiple benefits
Dr. Lorri J. Fulkerson, an orthopedic surgeon with Boulder Orthopedics who has tried Kangoos herself,
agrees that they can reduce impact on joints versus using traditional running shoes.
"Patients with mild forms of osteoarthritis may find the boots improve their tolerance for impact activity," she
says. "However, since the boots are a less-stable platform, they may not be appropriate for people with
more severe arthritis."
Kangoo offers benefits to populations beyond folks with joint issues or injury rehabilitation, according to
Wendy McClure, ACSM-certified Personal Trainer, Lakeshore instructor and co-owner of Body
Dynamics Studio. The rebounding effect increases circulation and heart rate, and facilitates lymphatic
drainage.
"The boots are great for obesity in children, and great for women with metabolic and tissue issues," says
McClure. "It's also an efficient way to exercise because the heart rate gets up easily, and your calorie burn
can be up to 50 percent more than the same exercise without the boots.
"There's also a lymphatic flush that comes with rebounding," she says. "Our organs don't flush as well as we
age. Toxins build up. A huge volume of blood is pumped through during a Kangoo workout, and it cleanses
our system like a massage."
Christy Thiel, a personal trainer in Fort Collins, struggled with digestive issues, skin problems and low
energy until she tried rebounding.
"My lymph system was stagnant. I was not metabolizing toxins," Thiel says. "I started rebounding on a mini-
tramp for two minutes a day. Within a month, I felt so much better."
Thiel went on to become a certified Kangoo Jumps instructor who has also produced a basic home weight-
loss video for Kangoo Jumps.
Trudy Turvey, a physical therapist and certified lymphedema specialist in Boulder, agrees with the benefits
of lymphatic drainage but isn't sold on the superiority of Kangoo Jumps on this process.
"Lymphatic flow is extremely important to cleanse your body of foreign toxins," she says. "But most any
kind of exercise will increase lymphatic flow. Whether or not rebounding is more beneficial than walking or
swimming on the lymph system — I'm not sure we have the research to support that."
While many people are finding benefits from the boots, Kangoo Jumps are not necessarily for everyone.
They're contraindicated for pregnant women, people with heart or blood- pressure problems and potentially
people with balance issues or a current injury.
"Anyone with an injury should definitely be led through the use of Kangoos to make sure it's appropriate for
them," McClure says. "And the boots can help people with balance issues, but they need to be guided, as
well."
Proper fit is crucial
The boots have a variety of levels of adjustments for size, strength and weight, so it's important to be fitted
by an instructor or Kangoo representative. There are adjustments from 45 pounds to over 300 pounds. A
specialist can help you find the proper tension.
Lots of local Kangoo users have purchased their own boots (see box at left), but many choose to rent or
use the boots provided by the facility for their classes. Body Dynamics charges $10-$17 per class, Denver
Athletic Club charges a one-time $15 fee for members, and Lakeshore Athletic Club charges a $2 boot
rental fee per class.
All three clubs have growing programs. Petra Storm, group exercise coordinator of the Denver Athletic
Club, touts the ease of use and positive feeling that comes from using Kangoos as the reason for the
popularity at her club.
"There's a sense of euphoria from the rebound effect," she says. "The classes are fun. We laugh and jump
around. You kind of forget you're exercising."
Ellen Nordberg is a Louisville-based freelance writer and fitness instructor.
June 27, 2011
WeCanRow is a team for survivors By Amy Laskowski - BU Today – By Amy Laskowski
After Jeanette Millard was diagnosed with breast cancer and underwent a mastectomy, friends warned her
to take it easy. Exercise might aggravate her stitches, they said, or even worse, lead to lymphedema, a
potentially dangerous condition that causes chronic swelling and often affects breast cancer survivors who
have had surgery.
But after Millard read about new research that found that exercise helps rather than hampers recovery from
breast cancer, she joined the Boston chapter of the nonprofit WeCanRow, which helps women who have
had cancer rebuild their strength and mental focus through rowing with other women who are, well, in the
same boat. The organization was originally for women with breast cancer, but today includes women
recovering from all kinds of cancer.
Millard’s decision to join the group got positive reinforcement after her eight-year-old son came to one of
her first rowing events. “He met me afterwards and told me that he didn’t have to worry about me anymore,
because he saw how strong I was,” Millard says. “Rowing made me push myself, and it really helped me
lose my fear.”
WeCanRow, which began in Boston in 2002, has strong ties to BU. University coaches, alums, and current
students help support the 30 female cancer survivors who gather each week to row. Women’s crew team
head coach Stacey Rippetoe invited the Boston chapter to become affiliated with BU after arriving here in
2008. Rippetoe had earlier founded an affiliate chapter in Lansing, Mich., while coaching at Michigan State.
She secured permission for the women to use the DeWolfe Boathouse and the rowing tanks at the
Babcock Street athletic facilities and began encouraging her squad to help coach the women.
Rippetoe says that rowing is beneficial to cancer survivors because it is not a weight-bearing or impact
sport. “You can start out at a recreational level and progress from there,” she says. “It’s a wellness program
with no expiration date, and it bridges the gap between being a patient and being an athlete.”
Hannah Rooney (SED’13), a coxswain for BU’s crew team, helps at WeCanRow practices during the
school year.
“When I’m with them I give pointers, like technical changes,” she says. “They love it when I act as if this is a
real race, yelling at them from the front of the boat.” Volunteering with the organization has been a life-
changing experience for her, she says. “These women are such an inspiration and are so strong and excited
about life. I aspire to have their courage.”
“Being diagnosed with breast cancer is a very solitary event in your life, because everything is focused on
you,” says Boston chapter president Phyllis Groskin after a recent practice. “WeCanRow shifts your focus
because you’re one of 30 women on the team—your impact makes a difference. It’s huge that in this group
we can talk about our cancer if we want, or choose not to.”
Studies show that exercise benefits breast cancer survivors, says Michael Stone, chief of surgical oncology
at Boston Medical Center and a School of Medicine professor. “Exercise improves breast cancer
survivors’ quality of life,” he says. “In the old days, they were told not to exercise, but I think that has been
largely debunked. It helps with confidence and body image, and they feel better.”
Women must get signed permission from their doctors before joining the team. In addition to their once-a-
week practices, they meet monthly with a physical therapist and coaches to go over their personal fitness
plan.
If a cancer survivor has a weak immune system, a splinter from an oar could lead to a blister or a cut and
cause a dangerous infection, so team members are advised to wear gloves. “On other rowing teams, that
would be considered bad etiquette,” says Groskin. “But if the blister or cut became infected, that could be
really serious.”
A great metaphor for life
The team takes to the Charles Tuesday nights after work, weather permitting—30 women all sporting bright
jackets so they are visible on the water. They pull the heavy racing shell out of the racks of boats and carry
it over their heads to the water, a few yards away. Their ages span three decades, a reminder that breast
cancer can strike anyone. Some are in remission; some are still living with their cancer.
On a recent summer night, the women mill about on the dock at 6:15. Coaches Alice Taggart and Molly
Jordan (SSW’00) split them into two groups: the newer, less experienced rowers climb into an old blue
tubby (it’s nearly impossible to tip) and the more experienced settle into a sleek, narrow racing shell.
Taggart lays out the night’s workout, called “odds up, evens down.” The women will row full speed for one
minute, then take a break the next minute. “Everyone ready?” Taggart yells into her megaphone. “Sit on the
square, row! Watch the woman in front of you. Short, sharp, and quick. Short, sharp, and quick. Good!”
Once they have been out on the water for a few minutes, the women begin rowing in unison. Their chatter
and banter stop when they are in the boat, their focus instead on form and technique. If a rower is off in
time from the person in front of her, the boat will not gain full speed.
Under Taggart’s direction, the women build up incrementally to a nine-minute sprint before easing back
down to a slower pace. (In inclement weather, they use the Babcock Street rowing tanks.)
The full-body workout, a combination of sliding and pulling, uses the quadriceps, back muscles, and arms.
Rowing depends on teamwork. “We rely on each other to put forth our best effort,” Millard says. “The
coaches make their lineup with people in specific seats. It’s really making a commitment to putting
everything on the line to support your teammates.”
The goal of the organization is not only to help women cancer survivors bond with one another, but to
renew their self-image and give them a sense of control.
“It’s a great metaphor for life: you face more challenges, and then you learn how to rise from the challenge,”
Groskin says. “It’s been great to be able to lose myself in the rowing. The teamwork piece has been huge
for me. Before I wouldn’t have described myself as a joiner. It’s showing me that with the right
circumstances, I can be part of a team.”
WeCanRow is seeking original, rowing-related poetry and photography submissions for Rowetry in
Motion, a journal that will published in fall 2011. Proceeds from the sale will benefit the program. For more
information, contact rowetryinmotion@gmail.com.
More information about WeCanRow can be found here.
Amy Laskowski can be reached at amlaskow@bu.edu.
June 28, 2011
Free exercise class for breast cancer patients - Bradenton Herald –
BRADENTON -- Mondays at Blake Medical Center, occupational therapist Marsha Shuford leads special
exercise classes for breast cancer patients from noon to 1 p.m.
She teaches techniques to improve breast health, increase strength and range of motion, and minimize or
prevent a complication from breast-cancer surgery called lymphedema.
There’s no charge for the classes and participants don’t have to be patients of the hospital.
Lymphedema causes fluid retention and discomfort in the affected arm and some women must wear
compression sleeves routinely to reduce the swelling.
Typically, women are told to avoid lifting anything heavy -- even a bag of groceries -- to keep the condition
from getting worse.
However, “there has been a big change in thought about lymphedema,” said Shuford, who is a certified as a
hand specialist and lymphedema specialist.
Controlled exercise to strengthen the arm and improve range of motion not only doesn’t cause harm, it can
be beneficial, she said.
Shuford tailors the class according to the needs of participants and most exercises are done sitting or
standing, she said. Classes are drop-in and held in the Cancer Resource Room at Blake Medical Center,
2010 59th St. W., Bradenton.
Shuford recommends that women who recently had surgery get approval from their doctors. For more
information about the classes, call her at 798-2141. A calendar of health events at Blake Medical Center
can be found at www.blakemedicalcenter.com/calendar.
HIV/AIDS screening advised as routine health measure
MANATEE -- This year marks the 30th anniversary of when health officials first identified a new disease
that would later be called AIDS.
Today groups such as the HIV/AIDS Network of Southwest Florida recommend that screening for HIV be
a routine part of taking care of your health.
HIV, the virus that causes AIDS, can occur silently before progressing to AIDS, which means people can
be unaware they are infected. Risk factors for acquiring HIV include unprotected sex and intravenous drug
abuse.
“Knowing their HIV status means people can get into treatment earlier, and prevent spreading it to others,”
said Dianne Shipley, a health educator at the Sarasota County Health Department.
To find HIV test sites or learn more about HIV/AIDS, visit these locations:
n Manatee County Health Department, 410 Sixth Ave. E., Bradenton. Tests are available weekdays on a
walk-in basis, or through the department’s mobile health van. For more information, call 748-0747 or visit
www.doh.state.fl.us/chdmanatee.
n Sarasota County Health Department. Test sites include a walk-in clinic at its downtown Sarasota Health
Center, 2200 Ringling Blvd. For more information, call 861-2919 or visit www.sarasotahealth.
org/services/std.htm.
n HIV/AIDS Network of Southwest Florida, 2200 Ringling Blvd., Sarasota, offers a listing of testing sites
in Manatee and Sarasota, plus information about HIV/AIDS and resources. Visit www.hivsarasota.org or
call 861-2976.
Lakeland Dedicates New Marie Yeager Cancer Center - Benton Spirit – by Patricia Plaut-Payne –
A poignant and memorable ceremony and ribbon cutting marked the official dedication of Lakeland
HealthCare’s new Marie Yeager Cancer Center on Thursday, June 16. Over 300 guests toured the two-
story, 30,000-square-foot center located in the Lakeland Health Park in Royalton Township, St. Joseph.
The cancer center will provide a single location for most cancer care needs, including medical oncology, a
pharmacy, laboratory services, a health and appearance center, holistic support services, lymphedema
therapy, and clinical research. The facility will open to patients on July 11.
“Those who will receive care here will benefit not only by the convenience and coordination of their
interdisciplinary care, their experience will be marked by more comfort, more confidence, and more hope,”
said Loren B. Hamel, MD, President and CEO, Lakeland HealthCare, in his opening remarks during the
ceremony.
Myrna Hunt, a breast cancer survivor and musician, shared her personal story about fighting the disease
followed by a moving instrumental version of “You’ll Never Walk Alone” on the piano by Rodgers and
Hammerstein.
Later in the program, a marble sculpture by renowned artist Fritz Olsen of Sawyer, Michigan was unveiled
in the cancer center’s Healing Garden. Martha Cares, a nationally regarded soprano opera singer and
spouse of Olsen, sang a song for which she had written the lyrics in honor of the occasion and unveiling.
The cancer center is named after Marie Yeager, a long-time oncology nurse at Lakeland. Her husband,
Tom, recalled her dedication and passion for caring for her patients.
“This cause was very dear to her heart, and our family knows she would be proud to continue to make a
difference for southwest Michigan patients affected by cancer,” Yeager said.
Lakeland HealthCare is a non-profit, community-owned health system, which includes four hospitals, an
outpatient surgery center, rehabilitation centers, long-term care residencies, hospice, home care services,
and physician practices. Lakeland has nearly 4,000 employees who provide clinical and support services at
locations throughout southwest Michigan, and partners with approximately 400 affiliated physicians and
other providers. For more information, visit www.lakelandhealth.org. — Benton Spirit
June 30, 2011
National Alliance of Wound Care® Announces a New Advanced Certification in the Specialty of
Lymphedema Lower Extremity Management – DigitalJournal.com
Lymphedema in the lower extremity is an accumulation of lymphatic fluid in the interstitial tissue that causes
excessive swelling in the leg(s), and occasionally in other parts of the body. Lymphedema can develop
when lymphatic vessels are missing or impaired, or when lymph vessels are damaged or lymph nodes have
been removed.
In the United States, the number of Medicare age individuals afflicted with lymphedema, or at risk of
developing it, exceeds 6.8 million.
The incidence of lymphedema as a consequence of cancer therapy ranges from 10- 50% and increases with
time.
The National Alliance of Wound Care® (NAWC®) announced today, the introduction of its newest
certification in the specialty of Lymphedema Lower Extremity Management (LLE™). The LLE is an
advanced credential that demonstrates a candidate’s proficiency and mastery of essential knowledge and
skills of lower extremity lymphedema and associated wound management. “The LLE validates a wound
care professional’s expertise in lymphedema lower extremity management. It enhances their marketability,
while assuring employers they are hiring a leader with tested competency in lower extremity lymphedema,”
said Debbie Hecker, executive director of the National Alliance of Wound Care. The LLE is the third
certification offered by the NAWC. Prerequisite education for LLE certification will be offered by
Lymphedema and Wound Care Education, LLC (LWCE).
About NAWC
The NAWC is a non-profit organization dedicated to the advancement and promotion of excellence in
wound care through the certification of wound care practitioners. It is the largest professional wound care
credentialing and membership organization in the United States. The NAWC is among an elite group of
more than 90 credentialing organizations that have received and maintained National Commission for
Certifying Agencies (NCCA) accreditation. For more information about the LLE, DWC® and WCC®
certifications, visit their website at http://www.nawccb.org.
About LWCE
Lymphedema and Wound Care Education, LLC (LWCE) is an organization created as a result of the joint
partnership of the Wound Care Education Institute and the Norton School of Lymphatic Therapy. LWCE
is the exclusive provider of the advanced course in Lower Extremity Lymphedema Management, a
prerequisite for the LLE certification. LWCE is the second approved education partner for the National
Alliance of Wound Care. For more information about LWCE, visit their website at http://www.lwce.net.
About Norton School of Lymphatic Therapy
The Norton School of Lymphatic Therapy is the premier educational institution for training qualified medical
professionals to become experts in the treatment of pathologies related to the lymphatic system. Taught by
the finest and most experienced faculty in the field, Norton School students receive thorough and rigorous
training in the Foeldi Method of Complete Decongestive Therapy (CDT), the therapeutic system regarded
as the "Gold Standard" for the treatment of lymphedema by the International Society of Lymphology (ISL).
Founded by Steve Norton, renowned authority in the field of lymphedema therapy, the Norton School
offers lymphatic therapy certification courses throughout the United States, Canada, within prestigious
hospital and out-patient clinical settings. For more information about the Norton School of Lymphatic
Therapy, visit their website at http://www.nortonschool.com
About WCEI
The mission of the Wound Care Education Institute is to develop multi-disciplinary wound care
professionals in the United States by offering educational programs and clinical support, based on up-to-
date wound care research, trends, and evidence-based practice. The Wound Care Education Institute
offers a comprehensive skin and wound care training program at locations throughout the United States.
For more information about WCEI, visit their website at http://www.wcei.net