| LYMPHLAND |
| 83-year-old’s fundraising efforts for disease victims
By Nicola Fifield Eileen Rhodes, 83, is fundraising for MacMillan Cancer Support. LIFE has been full of heartbreak for a mother-of-two, who has lost two husbands to cancer and is now facing her own battle with a non-curable disease. But despite the rough deal life has dealt her, Eileen Rhodes is more concerned about the suffering of other people - and has raised thousands of pounds for charities over the years. The 83-year-old, who lives off Poppleton Road, in York, had only one week to say goodbye to her first husband, Jim Smart, who died of prostate cancer in 1983. She said: "We were living in the Scottish Borders at the time. He suddenly fell in and was rushed to hospital in Edinburgh, where he was told he had a week to live. "I was devastated. Neither of us had any idea he had cancer until that moment. It was so sudden. "During that last week he was unconscious throughout and I couldn't even say goodbye properly. That was very upsetting." advertisement Eileen, who is a retired special needs teacher, met Jim when she was 23 and they had been married for 40 years before his sudden death. She said: "After Jim died, I said to my children that I would never get married again. But I moved to York and started working as a volunteer at the St Sampson's Centre and it was there I met Cliff. "After losing Jim, it was so wonderful to be happy again. Cliff was one of those rare gems - everybody loved him. "He proposed to me under the Queen Mother's portrait at the centre and we were married in 1985. For our honeymoon, we went to California. It was so romantic." But her happiness was short-lived after Cliff also fell ill in 1994 - and was diagnosed with leukaemia at York Hospital. Eileen said: "We had just one month together after he was diagnosed before he died. I can't really describe the pain, I was completely devastated. "But I knew I had to get on with my life. My motto has always been to keep going." A year after Cliff's death, Eileen developed the incurable condition lymphedema, which causes her legs to swell to three times their usual size due to an abnormal collection of lymph fluid in her body tissues. She said: "There's no point in feeling sorry for myself because I know there are many people far worse of than myself. "Lymphedema isn't life-threatening, but every day a district nurse has to come to my home to dress both my legs. "It gives me some pain in my back because it increases your body weight so much, but I'm still active." Eileen now focuses all her efforts on fundraising for Macmillan Cancer Support, which provides medical, emotional and financial support for cancer patients and their families. On Saturday, September 29, she is holding a marathon coffee morning at 26 Prior's Walk, in York, from 10am to 6pm. 10:46am Saturday 8th September 2007 CommentPosted by: Tina of Lymphland, New York State USA on 4:17am today Eileen, I'm sorry you lost your husband, what you are doing for the fundraising is awesome. I do have to say though that what you said about lymphedema not being life threatening is not 100% correct. We have to be careful of infections called cellulitis which can and are deadly. I have know 3 people in my group who have lost relatives due to cellulitis, so please be careful. I own Lymphland.com and Lymphland International Support Group, you and anyone else interested can join, the button to join is on the front page of Lymphland.com We have a chatroom that is open daily and alot of information about all aspects of lymphedema and living with the condition. Education is the best thing you can do for any condition especially lymphedema. Tina Budde of Lymphland |
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| SEPTEMBER 2007 |
| Treating lymphedema
Rezin Orthopedics is the last option for some patients September 5, 2007 Roberta Messmer, of Morris, thought her ordeal with cancer was long over. She had a mastectomy some 22 years ago when she was only 48 and was cancer-free. But after slipping on some wet grass about 13 years ago and breaking her fall with her left arm, she started noticing some swelling in her arm. Lymphedema patients must continue their at-home treatments the rest of their lives. ( At first she just thought it was from the fall itself, but she came to realize that her swelling had its roots in her cancer. Nineteen of Messmer's lymph nodes had been removed during her mastectomy, causing permanent damage to her lymphatic system. Her body had coped with her compromised lymphatic system for years, but the fall had added just enough overload to her lymph system that inflammation and swelling ensued. Her arm and hand swelled so much she had to have her wedding ring cut off her finger. Messmer's situation is not unusual. She had developed lymphedema, an abnormal accumulation of tissue fluids in the soft tissues of the body. Horrendous timing The irony is, just when many recovering cancer patients think their difficult ordeals are over, lymphedema rears its ugly head. American Cancer Society's statistics show that one third of women who have lymph node dissection suffer from lymphedema symptoms. Most commonly seen following breast cancer interventions, lymphedema can also occur after ovarian and cervical cancers. Men can get it after prostate or testicular cancers. Lymphedema can also appear with surgeries, infections, diabetes and some cardiac disorders. A person can be born with lymphedema, too. Doctors often refer to it as "thick legs." Traditional treatments for lymphedema have included diuretics and compression pumps. Julia Rodrick, a master clinician and lymphedema expert at the Hand and Lymphedema Center, a branch of Rezin Orthopedics and Sports Medicine in Morris and Ottawa, believes there is a better way. Rodrick uses manual lymph drainage and complete decongestive therapy. This is a combination of manual tissue techniques, exercise and special compression garments and wraps. Rodrick says she sees many patients who come to her as a last option after seeing health care professionals who do not fully understand the latest treatments. "Lymphedema is not something people have to live in misery with," Roderick says. "It is not curable, but it's manageable. There is hope, and we are excited to get the word out." Common symptoms Rodrick has studied lymphedema treatments with Dr. Michael Foldi in Germany, a leader in the field of lymphology. She's been using his methods successfully on patients since 1999 and has assisted in developing treatment programs throughout Illinois. Symptoms of lymphedema usually begin with a slight swelling in the arms and legs. Rings on the fingers might be tight, or there might be difficulty fitting into a shirt sleeve or pant leg because of the swelling. Left untreated, the limb can grow larger, swelling with fluid and protein trapped in the soft tissues. Cases have turned into major disabilities, disfigurement and even dangerous infections, such as cellulitis. Lymphedema can cause hard-to-heal wounds in limbs, too, leading to complications. The first week Rodrick sees a lymphedema patient she does the treatments daily. After that, she teaches her patients how to do the manual techniques and exercises themselves at home. They return now and then to perfect their techniques. Lymphedema patients must continue their at-home treatments the rest of their lives. When Roberta Messmer finally came to Rodrick for her lymphedema, her goal was to get her arm down to a nice size to fit into a special dress she had bought for an Alaskan cruise for her 50th wedding anniversary. By the time her treatments were through she was able to wear the dress. "It was just such an improvement over the previous therapy I had," she said. "Julia just really knows her stuff. She did a great job." For more information, contact Rezin Orthopedics and Sports Medicine at (815) 318-5650. Reported September 14, 2007 Freezing Away Cancer BALTIMORE, Md. (Ivanhoe Broadcast News) -- Many people think of heartburn as something that's slightly uncomfortable. But for some people, it can develop into a life-threatening condition. Years of heartburn forced Bill Mohler to trade in orange juice for coffee at breakfast. "One of my vices is coffee," he says. "I drink about three cups a day." After 50 years of acid reflux, Mohler was still shocked to learn he'd developed Barrett's esophagus -- a condition where acid eats away the esophagus' lining and precancerous cells grow in their place. "They couldn't have cured it," Mohler says. "It would have become cancer." But timing was on Mohler's side. He soon found out he was eligible to take part in a pilot study testing a new device designed to kill precancerous cells. "The low-pressure spray liquid nitrogen is a new technique," says Bruce Greenwald, M.D., a gastroenterologist at the University of Maryland Medical Center in Baltimore. During the procedure, doctors anesthetize patients, send an endoscope down the esophagus and spray the abnormal area with liquid nitrogen. The liquid nitrogen freezes the bad cells and kills them. Doctors let the cells thaw for 45 seconds before spraying and thawing the area three more times. "The patients tolerate the treatment very well," says Dr. Greenwald. "We're seeing a regression of the bad cells." The procedure takes about 20 minutes, and patients feel little discomfort. In fact, they're usually up and about the same day. Dr. Greenwald says the results of the study are promising. "To some degree, [the procedure] helped everyone," he says. Larger trials will now be conducted at several hospitals to confirm the results, and patients like Mohler will continue to be followed. For now, Mohler's bad cells are gone, and he feels great. "I'm blessed," he says. "It's almost like hitting the lottery." Now, he and his wife can enjoy the retirement they always planned on. If you would like more information, please contact: Karen Warmkessel Public Relations University of Maryland Medical Center (410) 328-8919 kwarmkessel@umm.edu http://www.ivanhoe.com/channels/p_channelstory.cfm?storyid=16959 Recovery through rhythm -- Lebed Method of exercise helps breast cancer survivors By: PATTY McCORMAC - For the North County Times "Surviving is important, but thriving is elegant." That is the motto of Sherry Lebed Davis, one of the founders of The Lebed Method, a program of movement and dance that helps women heal emotionally and physically after breast cancer surgery. She and her two brothers created the program when their mother became depressed after breast cancer surgery in 1979. Lebed Davis, who was formerly a professional dancer with dance studios, used it nearly 20 years later when she herself underwent surgery for breast cancer. The method is so effective that it is practiced today in about 600 hospitals worldwide, she said. And because of growing interest, Lebed Davis will be visiting North County this week to provide a three-day certification program for new teachers and to refresh the skills of existing ones. "We need teachers. California is a big state, and there are a lot of hospitals we need to get into," Davis said. Two main goals The Lebed Method helps reduce two common side effects experienced by breast cancer survivors ---- frozen shoulder, a surgical complication, and lymphedema, or swelling of the lymph glands. "Both of these complications result in a decreased range of motion in the upper body. We have found that the ... classes prevent or minimize this loss of mobility," wrote Simone R. Zappa, a registered nurse and administrator of the Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center in New York City. She was quoted in Radiology Today magazine in 2001. Locally, the Lebed Method is taught at Sharp Hospital in San Diego by Rancho Bernardo resident Terri Wyatt, a registered nurse and the hospital's oncology case manager. She said the exercise and restoration of mobility are not the only positive results of the class. "It is a support group. They bond with each other, and there is a lot of camaraderie," she said. Isobel Chisum of San Carlos, who has been following the program for almost a year now at Sharp Hospital in San Diego, agreed. She and her husband, Bill, met Lebed Davis on a cruise ship where she was teaching the method. Isobel, 71, had been diagnosed with breast cancer the day before leaving for the cruise and had surgery the day after returning. "This has helped with lymphedema (swelling), plus it is uplifting and very much fun, and it's great that my husband can come and support me," she said. Open to all Classes are not limited just to breast cancer survivors. "We open the classes to the community," Wyatt said. According to the Lebed Method Web site, classes are also offered at fitness centers, dance centers, churches and wellness centers nationally. Other local sites include Scripps Center for Integrative Medicine in La Jolla; the U.S. Naval Hospitals at Camp Pendleton and in San Diego; the Green Cancer Center in La Jolla; and through the California Multiple Sclerosis Society. Laurie Mort, who teaches the method at Inner Strength Yoga in Oceanside, said it is very gentle exercise. "Another byproduct of the program is that it creates a positive environment and positive reinforcement, which is a big part of the program as well," Mort said. And positive reinforcement is important. Lebed Davis recalled how devastated her mother had been after her cancer surgery. "My mom used to be a ballroom dancer with my dad, and after surgery she couldn't hook her bra and she couldn't brush her hair. She was from that era of Marilyn Monroe, when breasts were a symbol of sexuality. She went into a crash kind of depression." A family creation Lebed Davis's two brothers, Marc and Joel Lebed, both surgeons at Albert Einstein Medical Center in Philadelphia, wanted to help their mom. "They said, 'Let's all get together: You bring the dance and we will put together a program that is medically sound,' " said Lebed Davis. "So we put together a program for my mom. "Our house was always filled music and dance. That is how my brothers were raised, and they always felt there was more to medicine than just medicine." The results were so impressive that her mother's doctor wanted to know what she was doing and adopted the program at Einstein. In 1996, Lebed Davis underwent surgery for breast cancer. "Recovery was very hard for me. I couldn't move my arm. I called up my brother and said 'I'm so depressed. I don't know what to do.' He said, 'Sherry. Do your program.' It was like, 'Duh.' " That experience convinced her to quit her job as director of marketing for a health care company and devote herself full-time to the Lebed Method. Since then, she said, the program has helped thousands. Lebed Davis will teach Wyatt's class at 10 and 11 a.m. on Thursday at the outpatient pavilion at Sharp Hospital, 3075 Health Center Drive, San Diego. From 8 a.m. to 5 p.m. Friday through Sept. 16, she will give the certification class at Inner Strength Yoga, 2124 El Camino Real, Oceanside. The cost of the three-day class is $500, but scholarships are available to those who might not be able to afford the full fee. Those interested in taking the class for instructors need no prerequisites, Lebed Davis said, and no special skills other than wanting to help others not just to survive, but to thrive. "To me, surviving is just barely holding on," Lebed Davis said. For more information, call (877) 365-6014 or visit www.lebedmethod.com. Patty McCormac is a freelance writer. |
| SCO Breast: Lymphedema Diagnosis Should Take Patient Perception into Account
By Crystal Phend, Staff Writer, MedPage Today Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine. September 10, 2007 Add Your Knowledge™ Additional ASCO Breast Coverage SAN FRANCISCO, Sept. 10 -- Arm measurements alone may not identify clinically relevant lymphedema for breast cancer patients after axillary lymph node dissection or sentinel biopsy, researchers said. Action Points Explain to interested patients that the study suggests lymphedema may be experienced even in the absence of changes in arm circumference after axillary lymph node surgery. This study was published as an abstract and presented orally at a conference. These data and conclusions should be considered to be preliminary until they have been published in a peer-reviewed publication. Lymphedema prevalence was 16% to 27% after axillary lymph node dissection and 3% to 5% after sentinel lymph node biopsy in a large study presented here at the American Society of Clinical Oncology's Breast Cancer Symposium. However, patient perception of swelling often did not correlate with clinical measurement, reported Sarah A. McLaughlin, M.D., of Memorial Sloan-Kettering Cancer Center in New York, and colleagues. Only 52% of patients with arm swelling of more than 2 cm reported experiencing it, whereas twice as many reported symptoms in their dominant arm as actually had measurable swelling (P=0.002). Diagnosis "should incorporate both measurements and patient perceptions," Dr. McLaughlin said. Although "lymphedema is one of the most feared complications of breast cancer surgery," definition and measurement of this complication have not been standardized, leading to wide ranges for incidence, she noted. Her group prospectively followed 936 women with clinically node-negative breast cancer for a median of five years after they had sentinel lymph node biopsy (600, mean three nodes removed) or lymph node biopsy followed by axillary lymph node dissection (336, mean 19 nodes removed). Measurements of both arms were taken for all women before the procedure and at follow-up. Lymphedema was also determined by patient report of perceived arm swelling during a standardized interview that also elicited risk factors and precautionary behaviors. The prevalence of lymphedema was higher for axillary lymph node dissection than for sentinel lymph node biopsy regardless of the method used to define lymphedema. The respective findings were: 16% for axillary lymph node dissection versus 5% for sentinel lymph node biopsy when defined by arm swelling of more than 2 cm (P<0.0001). 27% versus 3% when defined by patient perception only (P<0.0001). 16% versus 4% when defined by a validated instrument (P<0.0001). Although clinical measurement and patient perception agreed in most cases (786 without and 45 with), there were 64 women who perceived swelling without measured swelling of more than 2 cm and 41 women who had measured swelling without symptoms. Notably, symptomatic lymphedema was experienced by only 52% of patients with clinically measured swelling (45 of 86). Risk factors for lymphedema included higher body weight (P<0.0001), higher baseline and current body mass index (both P<0.0001), infection since surgery (P=0.004), and injury since surgery (P=0.03). Surgery in the dominant arm was not a risk factor (P=0.46), but may impact the way women perceive lymphedema, Dr. McLaughlin said. The difference in prevalence was most pronounced in women's dominant arm; 37 perceived swelling when there was no clinical swelling and 15 had swelling without sensing it (P=0.002). The difference was not significant for the non-dominant arm (27 versus 26, P=0.89). "This suggests that patients having axillary surgery ipsilateral to their dominant arm may be more sensitive to subtle changes in arm measurements or may be more significantly affected by sensory changes in that arm," she said. Overall, most women were careful to avoid activities that could contribute to lymphedema. Avoidance behaviors averaged 5.1 among women who had an axillary lymph node dissection, whereas those who had sentinel lymph node dissection practiced 4.3 of these behaviors on average (P<0.0001). The women most commonly avoided intravenous catheters (99% and 81%, respectively), blood pressure measurement (98% and 82%), and blood draws in the affected arm (99% and 82%). They also commonly avoided carrying a purse on the affected arm (33% and 26%) and picking up children (9% and 8%). A substantial proportion of women who had had an axillary lymph node dissection also wore a compression garment on the affected arm (15%). The clinical significance of one additional precautionary behavior is unknown and impact on quality of life warrants further study, she said. Future studies should also correlate the number of nodes removed with lymphedema, commented Emiel J. Rutgers, M.D., Ph.D., of the Netherlands Cancer Institute in Amsterdam, who was a chair of the session at which the study was presented. The researchers provided no information on conflicts of interest. Complete ASCO Breast Coverage Primary source: ASCO Breast Cancer Symposium Source reference: McLaughlin SA, et al "Prevalence of lymphedema in 903 women with breast cancer 5 years after sentinel node biopsy or axillary dissection: Measurements and patient perceptions" ASCO Breast 2007; Abstract 145. Managing chronic pain: Some things really do help Their chronic pain may not go away, but they've found a way to fight through it and keep going 12:00 AM CDT on Tuesday, September 11, 2007 By NANCY CHURNIN / The Dallas Morning News nchurnin@dallasnews.com For the lucky ones, pain is a passing thing. REX C. CURRY/Special Contributor Breast-cancer survivor Bettye McQueen receives treatment from massage therapist Jane Kinman at Harris Methodist Hospital's Healing Arts Center. Ms. McQueen began receiving massage therapy after her cancer treatment to help alleviate pain from lymphedema. It's a problem with a solution: Take the right medication; get on the right health and fitness program; wait for the wound to heal, the fever to pass, the bone to set. But there are many for whom the aches, the stiffness, the sensitivity will never fully go away. It can be managed and minimized, but for people with chronic pain, life is a battle that requires constant vigilance, courage and a love of life that refuses to surrender. JUAN GARCIA/DMN A complication from a twisted ankle kept 14-year-old Megan Valdez from being active. Treatment and therapy have lessened the pain and taught her to minimize the pain she still feels. Helping them in their journey is the growing field of pain management. We talked with four patients and their doctors and therapists about how to put chronic pain in its place and keep it from interfering with life. They shared their hard-won knowledge, which took a couple of them decades to acquire, about how essential it is to get the proper medical care, to consider complementary alternative therapies, to exercise even when it hurts and to draw on the emotional support of family and friends through the tough times. Here are their stories. Bettye McQueen, 56, lymphedema MIKE STONE/Special Contributor A lumbar spinal-cord stimulator has helped Don Bell control chronic back pain. A breast cancer diagnosis in 1996 was a shock for Bettye McQueen of Grand Prairie. But even the lumpectomy, chemotherapy and radiation did not prepare her for the pain that hit a year ago. LOUIS DeLUCA/DMN Lifestyle changes and a positive, aggressive attitude help 68-year-old Bob Johnston live with the pain of rheumatoid arthritis. "I don't have any movement in my left hand or my thumb at all. And the pain was so bad, I could hardly bear it." It turned out that she had developed lymphedema, a condition in which a body area collects protein-rich fluid that causes it to swell. It can be caused by trauma injuries, such as the surgery for carpal-tunnel syndrome that Ms. McQueen had just before the pain started. Breast-cancer patients are at particular risk if they have had their lymph nodes removed, as Ms. McQueen did. MIKE STONE/Special Contributor 'I used to have a walker to get from room to room, and now, I can walk throughout the house,' Don Bell says. She's grateful, she says, for the Healing Arts Center at Harris Methodist Fort Worth Hospital, where she is learning the benefits of massage therapy, reflexology, lymphedema therapy and aromatherapy under the guidance of Ellen Kerr, a registered nurse and licensed massage and lymphedema therapist. "It surprised me that the massage therapy, along with the lymphedema therapy, reduced the amount of swelling, which reduced the pain," Ms. McQueen says. "I've been able to reduce the amount of pain medication." That's given her hope. "I'm feeling much better, and I'm hoping to get back 100 percent. They've told me they can't make any guarantees. But along with the therapist and my faith in God, I feel I can get total use in my arm and hand again. I have the fighting spirit, and I intend to fight this." Her advice: Study your condition: "There are women out there who don't even know there is treatment for lymphedema. Consult with your physician on how to get relief." She suggests seeking out complementary methods, "because sometimes we can help manage pain in different ways." Therapy is work: "You have to take on extra pain if you want to get better. I go to therapy every day, Monday through Friday. By the time I'm finished, I'm so wiped out I have to lie down and rest. But while it's painful going through it, in the evenings when I sit down to rest, the pain isn't there. I also have exercises they've given me to do at home. They're painful, but I'm resolved to do them." Family support: "I have three nieces and a brother and friends. They have taken time off from work to take me to my treatments. You don't know how that makes you feel that someone thinks enough of you to take time off from his job to take you where you need to be." Don Bell, 69, lumbar spinal stenosis Don Bell of Lucas has suffered from back problems for 35 years. As a young man, he compensated for spinal weakness by working out. But when he went into sales to support his wife and five children, the sitting reduced the muscles that had been keeping his back straight. He developed chronic pain syndrome and lumbar spinal stenosis – a narrowing of the back spinal canals that causes compression of the nerve roots. At age 40, Mr. Bell had the second of two back surgeries to alleviate the condition, but he was left with so much pain that he could barely get out of bed for the next two years. "It became a depressing situation. You can't sleep good, so you don't care to go to bed," he says. "Then it's hard to face the day. The hardest part is that I had to stop being active with my kids, and I couldn't carry any of my grandchildren. That's a big part of my life I had to miss. That makes me ache." He suffered for years until someone at his health club advised him to look into pain management. Mr. Bell had never heard of that field. Then he met Dr. Jerry W. Lewis, a pain-management specialist at Baylor Regional Medical Center at Plano, who "turned my life around," he says. Dr. Lewis gave him injections that alleviated the nerve pain and told him he was a good candidate for a lumbar spinal-cord stimulator, which Mr. Bell had implanted in his back six months ago. The implant blocks the pain signal at the spinal cord before it reaches the brain, so the brain doesn't recognize the pain. Mr. Bell says he feels 80 percent to 90 percent better. The stimulator also helped correct his posture. "I used to have a walker to get from room to room, and now, I can walk throughout the house," he says. "Recently, I was playing golf with my son. It's the first time I've played golf in more than 10 years." Mr. Bell also enjoys his job as a security guard at Allen High School. Before the implant, he worried that he might not be able to continue. Now, if he sits too long, all he has to do is reach for the bionic implant, "crank it up for five minutes," and it relieves the pain. "I love it," he says. "I get to intermingle with all the teenagers. That's an experience!" His advice: Family helps: "I married a good woman. And all our children built homes around us. I have 13 grandchildren, and they like to come over on weekends. We're so blessed." Take care of yourself: "I had to lose some weight and start exercising. That got me through several years. Now that I feel better, I can start exercising again, and I think I will be much better off." Embrace technology: "My wife got me a PlayStation for Christmas, and my grandsons and I really enjoy playing while I charge my bionic implant. I always keep this unit with me. I hook it around my belt like a cellphone." Bob Johnston, 68, rheumatoid arthritis Bob Johnston first noticed that something was wrong during a trip from Oklahoma to the State Fair of Texas 28 years ago. His legs were cramping, and he struggled to walk. He had no idea then that he had rheumatoid arthritis, a condition in which painful, widespread inflammation leads to an increased risk of heart disease and early death. And that it was going to get worse, a lot worse. "I didn't know what it was for a couple of months," says Mr. Johnston, who now lives in Farmers Branch. "It just devastated me. Once you get in that cycle of pain, stress and fatigue, it's real hard to get out of it. If you're not seeing a good doctor who knows what he's doing, and you're not on good medication, it will drive you to despair." He consulted a series of doctors, some more helpful than others. Among "the others" was one who prescribed liniment used for racehorses. Mr. Johnston has tried various medications over the years and is very happy with the ones prescribed by Dr. Yijun Fan, a rheumatologist at Presbyterian Hospital of Dallas. After a stroke in 2000, he followed Dr. Fan's lifestyle advice, too. He had been a smoker, so he quit. He gave up red meat in favor of turkey and chicken. He retired, started exercising and began taking time to enjoy life. He recently returned from a cruise he and his wife took to celebrate their 25th wedding anniversary. No doubt about it, he says, he feels better at 68 than he did at 45. His advice: Get help: "You've got to find a good physician and have support at home, because you're not going to always feel up to things. When you're in pain, sometimes just putting on your pants can be a struggle." Don't give up: "The alternative isn't good. You can't just sit there and feel sorry for yourself. I'm not brave, but I feel better when I get on the treadmill about 30 minutes every other day." It gets better: He retired six years ago, which, he says, reduced his stress level. That lifestyle change, along with giving up smoking, making more healthful food choices and exercising, has helped a lot. "I've been lucky," he says, noting that it's important not to give up, because by taking the right steps and getting the proper help and support, things can improve over time. Megan Valdez, 14, complex regional pain syndrome In March 2006, Megan Valdez twisted her ankle in gym class. But as the ankle healed, the pain got worse. She began using one, then two crutches. It hurt when air from a fan hit the ankle. Putting on her shoes and socks was excruciating. Megan had developed complex regional pain syndrome. In the condition, diagnosed by the multidisciplinary pain-management clinic at Children's Medical Center Dallas, the nerves don't get the message that the injury has healed. Symptoms include swelling, a change in skin color, a change in nail and hair growth patterns and a cool temperature at the original injury site. The diagnosis was a relief, the Lewisville teen says, because it meant that she would get help and had an answer for kids who teased her for making "a big deal" out of what they thought was nothing. "I would cry a lot because it would be hurting," Megan says. "People thought I was lying. I felt sad, and I would get mad because people were not believing me." Understanding the condition didn't make the pain itself easier to handle, however. Dr. Alan Farrow-Gillespie at Children's gave her spinal blocks and inserted an IV line for epidural injections when needed. After the hospital treatment, she struggled to do intensive physical therapy at Greater Lewisville Therapy Center for a year. "I would always want to stop because it hurt so much. Sometimes, I was crying at physical therapy, but my physical therapist was very nice and would always make me laugh." It's been hard, too, to accept that the pain will never fully go away. But Megan is happy because, on Aug. 20, she did something she never thought she'd do again. She ran a half-mile around her neighborhood. "At the beginning, I thought I would always be on crutches. Now, I feel better about myself. I'll be happy when I start school and can be in athletics because I love playing volleyball." Her advice: Face it: At first, Megan wanted to do anything she could to avoid the pain, including exercises that made her foot hurt. But now she's glad she persevered. And she's made peace with it. "I'm OK with the pain. I can fight through it because distraction is the best thing for it." Love that bro: It's hard when others don't believe you. That's why it means so much to have family members who understand. Megan's brother, Mark, now 10, "was very supportive" and would get things she needed when it hurt too much for her to move. Tough love helps: On orders from the doctor and therapist, Megan's parents would touch her injured foot. "I would start crying, and they would keep doing it. My mother said it was tough love because they were trying to help me get better." |
| Tuesday, September 11, 2007
Shop offers dose of dignity for patients By BLYTHE BERNHARD The Orange County Register A boutique specializing in products for breast cancer patients and new mothers recently opened alongside Saddleback Memorial Medical Center in Laguna Hills. Transitions for Women, which is sponsored by the nonprofit hospital, offers custom-fitted bras, prosthetics, wigs, scarves and more. Compression garments for women with lymphedema are also available. Items for nursing mothers include specialty bras, pumps and pads. Mary Bowman, a registered nurse and manager of the boutique, talks about the new store and how it will serve women in Orange County. Q: How did the idea for the separate store come about? A: Our vision was basically continuum of care. We wanted to be able to provide a full-service cancer center. We wanted a full line for women. It was very frustrating for them and for us to have to send them to three different places to get the things they needed such as mastectomy bras, (arm) compressions and wigs. Q: Where do women typically find these items? A: Some went to department stores, some went to pharmacies, some went to wig stores. The problem was they had to go to different places to find different things. It's such an emotional time in a woman's life. Transitions represents our commitment to fulfilling all of a woman's health care needs, whether it's motherhood or facing cancer. Q: Can you describe the store? A: It doesn't look clinical, which is what we wanted. It's lavender, very warm colors. It's 2,000 square feet. We have a wig room. When they're in that room they're in there by themselves. If they want to be fitted for a bra or a prosthetic, that's also a separate room. They need their dignity. We wanted them to be able to come in and try on hats and try on wigs without everyone else there as well. When they would go into a regular store, there would be other people around. We definitely felt there was a need in the community; there really isn't another place like this. Q: Where did the name for the store come from? A:The way we came up with the name Transitions was from one of our employees who is a survivor of breast cancer. Women have many transitions they go through in their lives. Some are happy, some are sad. We wanted to help them in the happy times and in the times that they're struggling. Q: How does it work to have products for both new mothers and cancer patients? A: Our theme is hope and inspiration and belief. We have formed a sisterhood. It signals to new mothers that doing those self-breast exams is very important. The women who are going through cancer see that life. They see the babies. With the two combined, it's women helping women. Q: How many people work in the store? A: We have two certified fitters for maternity and oncology. We have an assistant for the office who helps women get pre-authorization for insurance. There are some oncology products you can get reimbursement for. We have five registered nurses who are also lactation consultants that do inpatient and outpatient services. Q: What have you learned from working in the store? A:I'm amazed how strong these women are. They come in here and they want to fight. They want to fight the disease. We have learned a lot from them. I used to work labor and delivery and that was so rewarding and gratifying, but this is just as rewarding. To be in a position to help women who are going through cancer is phenomenal. Q: What would you like to say to women who have been diagnosed with breast cancer? A:What is really important for women to know is that Transitions is a sensitive and professional setting where they can shop with dignity for these personal health care products. We spend time with them. The other thing is we went out shopping. We went to see what the best products were. The products we have to offer are the best out there, and we have variety. Contact the writer: 714-796-6880 or bbernhard@ocregister.com |
| Artificial lymph node transplanted into mice
NewScientist.com news service Michael Reilly An artificial lymph node has been transplanted into mice, where it successfully produced immune cells. The new form of bioengineered tissue marks a significant step towards transplanting an entire immune system into patients dying of AIDS, cancer or other diseases, say the researchers who carried out the transplant. Takeshi Watanabe at the RIKEN Institute in Japan and colleagues used a "bioscaffold" made of collagen impregnated with stromal and dendritic cells extracted from the thymus of newborn mice. The entire package – a collagen sponge about 3 to 4 millimetres across – was then implanted into mice with healthy immune systems that had been vaccinated against a harmless antigen (something that triggers an immune response). In a natural lymph node, stromal cells act as "organiser" cells, arranging the various components of the node and aiding its development. Watanabe found that the same was true of the artificial nodes. The implanted stromal cells attracted T and B immune cells (lymphocytes) that were already circulating in the healthy mouse, then organised them into compartments segregated from one another, just as they appear in natural nodes. Empty nodes After the artificial node had filled with antigen-specific T and B cells, Watanabe transplanted it into a mouse with no functioning immune system. The lymphocytes quickly spread out from the artificial node into the animals' own lymph nodes, which lay empty due to the lack of immune activity. When Watanabe injected the same harmless antigen into the immuno-deficient mouse, its transplanted immune system responded vigorously, producing massive numbers of lymphocytes to neutralise the foreign molecule. After a month, these cells’ "memory" was still maintained, and they were able to fight off challenges from the antigen. “It’s one tiny step towards use in humans,” says Watanabe. “The next step is to use human cells in humanised mice. Then, maybe in four or five years, we might be able to make the first prototypes of a human model.” Eventually, Watanabe hopes this technology will provide a revolutionary treatment for patients with AIDS or cancer. By implanting artificial nodes plump with healthy T and B cells in AIDS patients, he believes he might be able to revitalise their damaged immune systems. For cancer, he hopes to adopt a similar approach in which the transplanted nodes will contain T cells trained to hunt down the antigens produced by tumour cells and kill them off. Journal reference: Journal of Clinical Investigation, doi:10.1172/JCI30379 |
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Healthcare Professional: General Public: UroToday.com- Lymph node density is a surrogate marker of the extent (i.e. 'quality') of lymph node dissection during radical cystectomy and impacts patient outcome There is a growing body of literature which suggests that the quality of a lymph node dissection radical cystectomy for bladder cancer is a predictor of recurrence-free survival of patients with node positive bladder cancer after cystectomy involvement. However, the 'ideal template' for pelvic node dissections is not standardized and there is a wide variation in extent of dissection. A surrogate marker of quality of node dissection is lymph node density defined as the ratio (percentage) of the number of positive nodes divided by the total number of nodes examined. In the April issue of Journal of Urology, Herr presents data from 5 studies on a total of 979 patients. In 4 studies, higher lymph node density (> 25 or 25%) was a significant predictive factor for survival when adjusted for various patient, tumor and treatment co variables. This remained true even when adjuvant chemotherapy was accounted for, in the one study which examined the same. What is also worth noting from the article is that the range of lymph nodes removed, even in academic centers, can be as few as 1 to as many as 96. Amazingly, data from the SEER registry suggest that, across the country, as many as 40% patients do not undergo a lymph node dissection at all. While the ideal situation would be to have a standardized template which all can agree upon, this is likely to prove difficult to 'regulate'. Lymph node number (and density) is more objective data which can be used to not only risk stratify patients more appropriately, but also serve as a surrogate marker for quality of surgical dissection. Herr HW J Urol. 2007 Apr; 177(4):1273-5 Reviewed by UroToday.com Contributing Editor Ashish M. Kamat, MD UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to: www.urotoday.com Immune cells known as macrophages linked to growth of lymph vessels in eyes, Medical Studies/Trials Scientists at Schepens Eye Research Institute have discovered that a particular immune cell contributes to the growth of new lymph vessels, which aid in healing. This cell, known as a macrophage, is called in by the body during the wound healing process. The discovery of this new role for the macrophage, published in the September 2005 Journal of Clinical Investigation, may ultimately inspire innovative treatments for blinding eye disease, as well as for other diseases, such as cancer, that rely on the lymph vessels to spread abnormal cells throughout the body. "This is a very significant finding," according to Joan Stein-Streilein, PhD, and Patricia A. D'Amore, PhD, senior authors of the study, Senior Scientists at SERI and members of the Departments of Medicine and Ophthalmology at Harvard Medical School, respectively. "It unlocks a whole new dimension in our understanding of these important cells." The body uses lymph vessels to bring immune cells to an injured organ to carry away debris and fluid to aid healing. Lymph vessels can play a different kind of role in cancer, offering tumor cells a pathway for spreading to other body parts, in a process known as metastasis. Macrophages are large white blood cells called in during wound healing to ingest foreign invaders such as bacteria. They can also present pieces of those intruders to the immune system to jump-start the immune response. Produced in the bone marrow, they can be found in almost all tissues of the body. Unlike many other parts of the body, the clear outer layer of the eye, known as the cornea, does not normally have lymph vessels, except when injury causes lymph vessels to sprout from the edge of the cornea to help heal the wound. Dr. Kazuichi Maruyama, a post-doctoral fellow in D'Amore's and Stein-Streilein's laboratories at SERI, began to suspect a new connection between macrophages and lymph vessels while studying corneal transplants in mice. He became aware of lymph vessels that seemed to be forming "in place," away from those produced at the edge of the cornea. He also noticed that these lymph vessels disappeared after the wounds were healed. Because the cell structure of the new vessels resembled that of macrophages, he began to believe there might be a relationship. In the JCI study, he tested this idea by placing sutures in the corneas of two groups of mice to create injuries that would induce a healing response. Then he gave one group of mice a drug to cause macrophages to commit suicide. When he examined the eyes of both groups, he found those given the drug did not grow as many lymph vessels as the control group without the drug. The implications of this link between macrophages and lymph vessels are far-reaching, according to Stein-Streilein, D'Amore, and Maruyama. D'Amore and Stein-Streilein believe that harnessing this newly found ability of the macrophages could lead to the creation of new drugs or therapies for eye disease. For instance, inducing new "temporary" lymph vessels in retinas could aid in treating diabetic retinopathy by removing fluids leaking from abnormal blood vessels. It is this leaking fluid, characteristic of diabetic retinopathy that can permanently damage the retina and vision. Maruyama speculates that the involvement of macrophages in forming lymph vessels may be universal and may also be involved in spreading cancer. If that were the case, blocking macrophages from helping to grow lymph vessels could inhibit the spread of tumors. The team is now researching the same process in skin wounds and cancer. http://www.eri.harvard.edu/ |
