January 2, 2011 - StoneCrest offers
Lymphedema management - The Daily News Journal –
The
StoneCrest Medical Center Physical Medicine Department is now offering
lymphedema management
provided
by certified lymphedema therapists. Lymphedema can be managed, but not cured.
Since
lymphedema
treatment is often ongoing and frequent, StoneCrest is proud to make this
treatment
conveniently
accessible to the community.
Lymphedema
is swelling in various parts of the body caused by a build-up of lymphatic
fluid in the tissues. It
can
be caused by damage to lymph nodes or vessels as a result of surgery or
radiation treatments for cancer
patients.
It can also be caused by other trauma, infections, or the result of rare
inherited conditions.
StoneCrest’s
certified lymphedema therapists are specially trained in the treatment and
management of
lymphedema.
They may provide patient education on proper skin care and hygiene, manual
lymph drainage
(by
skin moving techniques), or compression therapy.
January
4, 2011 - Pensioner without heating for 12 days tells of "worst Christmas ever"
– This is Scunthorpe
–
A
PENSIONER said she had the "worst Christmas ever" after she was left without
heating or hot water for
12
days over the festive period.
Sheila
Harvey, 68, of Willoughby Road, Scunthorpe, suffers from lymphedema (fluid
retention) in her legs
and
has to bathe them with hot water every day.
But
she was left without central heating or hot water after her boiler broke down
on December 18.
She
contacted social housing landlords North Lincolnshire Homes and it took three
visits before her heating
was
fully restored.
She
said: "It's the worst Christmas I've ever had. I can't believe they've left me
this long.
"Somebody
came out to sort it on December 18 because they thought it was a frozen pipe,
but when they
realised
it was the boiler they said they would have to send a gas man.
"At
dinner on Christmas Eve, a joiner came to look at it. He said a gas man would
be sent, but nobody has
been
since.
"I've
not had a bath for 11 days. I've had to use the kettle to have a strip wash and
I've had to use two
electric
heaters, which I cannot afford to use."
A
spokesman for North Lincolnshire Homes said: "We are really disappointed to
find that some of our
customers
have had a very difficult time over this period.
"The
reason that some of our tradesmen have been attending to heating problems which
they were not
necessarily
qualified to solve is that some repairs involved frozen condensing pipes, an
operation which does
not
break rules or law.
"It
is true that Mrs Harvey has not had any reliable heating since December
18.
"We
have tremendous sympathy for Mrs Harvey. During that time our tradesmen
attended the property
twice
and on the third occasion we are not able to say whether the tradesman gained
access to the property,
as
Mrs Harvey stayed with family over this period.
"A
full repair was carried out on Thursday."
January
5, 2011 - Docs say breast cancer survivors should lift weights - Newsworks.org
(blog) – By
Meggan
Kole –
Research
from the University of Pennsylvania school of Medicine reverses long-running
advice that breast
cancer
survivors should avoid lifting anything over five-pounds to prevent lymphedema
-- an incurable side
effect
of cancer treatment.
The
study shows a slow progressive weightlifting regimen not only didn't increase
lymphedema, but reduced
the risk by 35
percent in the 154 participants. These results go against typical doctor's
orders.
The
debilitating condition prevents women from living a normal life after cancer.
It causes chronic swelling
in
the arm. It's so common, some survivors are warned not to pick-up their own
children because it may
bring
on the disorder.
Lead
author Kathryn Schmitz said the conclusions from the study are game changing.
“I am at this point on a
mission
to make it standard of care for breast cancer survivors to be automatically
referred for evaluation of
arm
and shoulder problems at the end of their breast cancer treatment,” Scgnutz
said. “It is my hope that
some
day breast cancer rehabilitation will be as common as cardiac rehabilitation
after a heart attack," she
said.
Schmitz
also said, the weightlifting should only be done with a certified fitness
professional.
Marie
McCrone participated in the study. McCrone said other than cancer returning,
the fear of
lymphedema
is huge. Developing it would be a constant reminder of the cancer. She said,
“You know you
do
your treatment and then they kind of send you on your way. Things have changed
and it's nice to have
someone
understands that we do want to survive and we do want go on and live a normal
life instead of
always
being a breast cancer survivor”
McCrone
says she is still lymphedema-free. Her arm, where the nodes were removed is
stronger.
January
6, 2011 - Start Out Your New Year By Helping With a Great Project - BlogHer
(blog) – by
Melissa
Ford –
BlogHer
Susan Niebur of Toddler Planet was speaking with her lymphedema therapist
during a session to
reduce
the swelling in her arms post-mastectomy when she learned that many cancer
survivors cannot afford
the
compression sleeves worn to deal with the swelling brought on by lymphatic
fluid.
Susan
thought, "Can't afford lymphedema sleeves? Well of course that's true, isn't
it, as they cost $100 and
up
for each arm, and it's important to have two sets - one to wash, and one to
wear. I started rolling
solutions
around in my brain."
And
out of adversity a great advocacy project was born. Creating a union between a
foundation and a
compression
sleeve company, Susan is working to bring these sleeves to cancer survivors who
can't afford
the
cost. And she is opening up this project to all of us -- and here is what you
can do to help:
Put
it on Twitter and Facebook or blog about the project.
Donate
your connections, money, or time by leaving a comment on the post stating how
you can help.
Connect
those in need with the project so they can receive these much needed
sleeves.
See,
simple.
I
spoke with Susan about her new project on Wednesday:
So
many people don't realize the on-going side effects from cancer and surgery.
What is lymphedema and
how
does it affect your day-to-day world?
Three
years ago, I had chemotherapy, radiation, and a double mastectomy to fight
inflammatory breast
cancer.
Like many of us, I assumed that after that treatment, I'd be fine. Or at least
after recovery, I'd be
fine.
I was surprised to learn that the act of having a mastectomy, the removal of a
breast, also typically
includes
the removal of one or all of the lymph nodes under that arm. Now these lymph
nodes normally act
to
remove waste fluid and proteins from the tissue in the arm, wrist, and hand.
When the nodes are
removed,
the waste fluid isn't removed. I quickly learned that every time I exercised,
cooked, or went
outside
in warm weather, my arm would swell, up to an inch in diameter. They call this
"congestion" in the
arm,
and it feels about as great as congestion in your sinuses. And I don't know
about everyone, but it
makes
me crabby!
Because
of lymphedema, I limited myself to indoor activity. I stopped going to
playgroups at the park, and I
turned
down the opportunity to coach my kids in preschool soccer. In fact, I pulled my
kids from soccer
entirely
last summer, and we all missed it.
What
is the role of lymphedema sleeves?
Compression
sleeves play an important part in the treatment of lymphedema, whether it is a
side effect of
treatment
for breast cancer or a stand-alone disease. Sleeves are made of knit, latex,
and/or silicone fabrics
that
stretch as a person moves, allowing them to be worn all day, but they apply
enough pressure that the
arm
does not swell as quickly, allowing people to be outside for longer periods, to
do strengthening
exercises,
and to cook on or near a hot stove (but don't tell my husband that last part,
okay?).
And
the need for lymphedema sleeves remains with the person forever?
Yes.
Sleeves typically cost about $100 each and have a typical lifespan of about six
months. Each patient
needs
two sets (and this is important) because the garments need to be washed after
each wearing to
maintain
the graduated compression in the fabric. Patients also need to do manual
lymphedema therapy each
day
and/or see a professional for reduction of the swelling, but the sleeves are an
essential part of therapy,
so
that the progress isn't lost the moment a patient steps outside.
The
two places you're working with to bring these sleeves to people in need are the
foundation Crickett's
Answer,
and the company, LympheDIVAs. Can you tell people a little bit about this
organization and
company?
Crickett’s
Answer is a 501(c)3 nonprofit organization founded in memory of Crickett
Julius. Crickett
survived
breast cancer only four months after her diagnosis at 39, but her mother and
cousin are dedicated
to
helping other women enjoy their life post-diagnosis by providing wigs,
mastectomy products,
oncology/mastectomy/
lymphedema massage, facials, and other pampering services as a way to help
women
feel
feminine and beautiful after losing their hair and/or breasts.
LympheDIVAs
was founded by Rachel Troxell and Robin Miller, friends and breast cancer
survivors who
wanted
to create a more elegant and comfortable compression sleeve. Rachel continued
to build the
company
during her later recurrence. Even though she died two years ago, at the age of
37, her father,
mother,
and brother continue to grow the company in her honor and in the hope that
LympheDIVAs’
compression
apparel will continue to inspire breast cancer survivors everywhere to feel as
beautiful, strong,
and
confident as Rachel was.
How
did life change for you when you went from wearing the original sleeve to the
LympheDIVA sleeve? I
think
for many people, when they think about appearance and cancer treatments, they
think about hair. How
do
you think these compression sleeves will change the emotional lives of other
cancer survivors?
From
the first, I wore my sleeve and glove everywhere, but it was hard. More often
than not, even well-
meaning
friends and former associates looked shocked when I approached with the thick
work-glove like
glove
outstretched, and they thought the thick sleeve was a kind of cast. Strangers
commented regularly, and
everyone
and anyone would ask brusquely: “What on Earth happened to your arm?” When I
dutifully
answered
their questions, saying that I had had inflammatory breast cancer, had a
mastectomy, and now
wear
these sleeves, yes, for the rest of my life, the questioners would react
strongly, and conversation would
be
difficult. I didn’t like going out to meet new people anymore, and I stuck
close to friends when we did. It
wasn't
good for me. I love being around people, and it got harder and harder to force
myself to go out,
when
I knew I'd have to answer strangers' questions.
Now,
I hear "Ooh, that's so pretty!" or "Girl, where did you get those tats?" as
often as I do rude questions,
as
the pretty designs on my LympheDIVAs sleeves prompt people to smile first, and
ask questions later.
I
hope that by providing lymphedema sleeves to women who need them but can't
afford them, it will help
breast
cancer survivors to continue to step out of the shadows and get back into
life.
The
announcement for this project falls during a difficult time for you. How has
working on this project been
as
you wait for your next oncology appointment?
When
I asked Crickett's Answer and LympheDIVAs to help other women in this way, it
was at a time when
I
was finishing chemo for my third cancer, and I was happy to wrap up my
treatment with this project,
forcing
something good to come of this horrible disease and its recurrence. I had hoped
to announce it on
Monday
along with the news of clear scans (meaning that my cancer was still gone, and
I would be in
remission
again). Well, I didn't get clear scans, but I'm moving ahead on the project
anyway.
Cancer
takes so much from us, but it cannot take away two things: love and the power
to act. Nothing the
oncologist
can tell me on Thursday will change that.
Please
help spread word about this very important project and help connect those in
need with this
incredible
gift of tools that can aid in life with cancer.
January
6, 2011 - Seroma After Breast Cancer Surgery Triples Lymphedema Risk - Internal
Medicine
News
Digital Network – BY Bruce Jancin –
SAN
ANTONIO – Women who form a seroma following breast cancer surgery are at
threefold increased
risk
of developing lymphedema, a case-control study has shown.
Of
135 breast cancer survivors (26%) participating in the study, 35 developed
postsurgical symptomatic
seromas
requiring needle aspiration. The seromas were located in the axilla, upper
chest, and breast.
Of
the 35 women with a seroma, 33 had a greater than 200-mL increase in arm
volume. Based on the
International
Criteria for Lymphedema Diagnosis, 26 of the 35 women with a seroma had severe
lymphedema,
6 had moderate lymphedema, and 3 had mild lymphedema symptoms, Mei R. Fu,
Ph.D.,
reported
at the annual San Antonio Breast Cancer Symposium.
Patients
with a higher body mass index were significantly more likely to form a seroma;
however, age, type
of surgery
performed, axillary lymph node status, and number of nodes removed proved
unrelated to the
occurrence
of a seroma, according to Dr. Fu of the New York University College of
Nursing.
Lymphedema
is caused by accumulation of lymphatic fluid in interstitial spaces due to
injury to the lymphatic
system
as a consequence of breast cancer therapy. Patients dread this common,
distressing, long-term, and
indeed
often lifelong complication, she said.
Lymphedema
is a syndrome with multiple symptoms. In this study, seroma formation – that
is, excessive
build-up
of serous fluid – was associated with a markedly increased likelihood of the
lymphedema-related
symptoms
of arm swelling, heaviness, numbness, stiffness, firmness, tenderness, and
redness, as well as
increased
arm temperature. Patients with a seroma had a greater number of
lymphedema-related symptoms
than
did women who developed lymphedema without a seroma.
A
seroma is believed to form in response to surgical trauma and leakage of
inflammatory exudates in the
acute
phase of wound healing. The excessive build-up of serous fluid leads to delayed
wound healing, with
tissue
inflammation followed by fibrosis and necrosis.
Current
standard management of a symptomatic seroma consists of needle aspiration,
which may need to be
done
repeatedly. The clinical implication of this study is that aspiration of serous
fluid isn’t sufficient to
prevent
lymphedema, Dr. Fu said. Further research is warranted on a novel means of
preventing
symptomatic
seroma formation as a means of avoiding the development of lymphedema.
Possibilities include
the
use of ultrasound for early detection and drainage of subclinical seromas, as
well as potent anti-
inflammatory
therapy.
Her
study was funded by the Avon Foundation and grants from other nonprofit
organizations. She said she
had
no relevant financial disclosures.
January
7, 2011 - Gottfried Medical, Inc. celebrates its anniversary in its new
facility - Healthcare Digital
(press
release) - BY: Nargis Namazi –
Medical
device manufacturer Gottfried Medical talks about its stint in the healthcare
industry on its
anniversary
For
Gottfried Medical, Inc., the American Dream is alive and well. This second
generation, family-owned
and operated business settles in to their new facility, doubling their size. In 2011 they celebrate 30 years in
business
in Toledo, Ohio, the city of its birth.
Gottfried
Medical manufactures medical devices. They specialize in the engineering and
manufacturing of
made-to-measure
compression garments, including: stockings and sleeves. The majority of their
products aid
in
controlling numerous vascular conditions and lymphedema. They also manufacture
compression garments
specially
engineered to suppress and control hypertrophic scarring, resulting (most
often) from serious burn
injury.
Their
new facility is almost 12,000 square feet, nearly double the
previous.
What
amenities, or improvements, does the new location provide, that previous did
not?
“We
absolutely love our drop docks, as well as the additional warehouse capacity
and a spacious parking
lot,
all notably absent at our previous location.”
What
prompted the re-location and was it anticipated?
“Based
upon our historical growth and projections, we anticipated needing either a
newer, larger facility or
an
extensive expansion of our (then) current one within three years. Previous
experience and the state of the
Real
Estate market suggested we begin our search when we did.”
“The
building we ultimately purchased was (curiously enough) one of the first ones
we considered. Six
months
later and after $75,000 in renovations and upgrades, it was ready for Gottfried
Medical to occupy.
From
our initial search to the move-in, everything came together much faster than we
had experienced
previously.”
“Much
of our good fortune is a result of the wonderful companies that helped make it
all happen. The entire
project
was financed by: Signature Bank N.A. Our general contractor was: JMS Real
Estate Services. Both
companies
are (like us) also Toledo-based and worked very closely with us.”
“Our
30 year success story is due (in large part) to our customer service. Even
today, every call Gottfried
Medical
receives is answered by a person. No voicemail, no buttons to push. In our new
facility, we
invested
in state-of-the-art fiber optics for even more efficient communication both
internally and with our
customers.”
“It’s
not just about getting bigger,” Brent continued, “As we grow, we are constantly
evaluating our methods
and
workflow. Our new facility provides the added space we need to accommodate the
staff and equipment
necessary
to meet the increased demand. By design, the facility has also allowed us to
streamline some of
our
operations, thereby increasing our efficiency, so that we may continue to
provide the delivery service our
customers
have come to expect.”
Why
Toledo? What keeps your business from moving offshore?
“Toledo,”
said Brent, “is not only my home and birthplace; it is the birthplace of the
industry Gottfried
Medical
serves. Conrad Jobst, who originated and developed the concepts for gradient
pressure stockings,
lived
in Toledo and worked for Owens-Illinois, then a Toledo-based company. Jobst
(Conrad Jobst’s
namesake)
was also originally a Toledo-based company. My father, Max Gottfried, the
founder of Gottfried
Medical,
began his career in this field working for Jobst.”
“Manufacturing
offshore is not practical for our business model. Virtually everything we
produce is one of a
kind;
therefore, economies of scale do not apply. Our products are time-sensitive.
For the reason of efficacy
alone,
from the time an order is placed, engineered, manufactured and finally
delivered, is counted in days.
Although
it might be possible to save a few pennies (in my opinion) the loss in time and
quality control could
never
justify the savings of moving manufacturing offshore.”
You
mentioned Max Gottfried, your father, and the company’s founder. How did it all
start?
“Max
Gottfried believed a lower cost and longer life made-to-measure compression
garment could be made
without
reducing its quality or compromising its efficacy. With three employees in
1,000 square feet of
space,
he proved he was right and so in 1981 Gottfried Medical, Inc. was born. His
dream lives-on in our
new
facility, now employing 30 people.”
How
will e-business, technology and virtual world affect Gottfried
Medical?
“To
look into our future, we must look at our past. Our first fax machine was very
expensive. At the time we
wondered
if its cost would ever be justified, yet we made the investment to better serve
our customers.
Before
there were PC’s, we had an internal computer network that could multi-task.
This provided us a
means
for efficient and accurate recordkeeping, helping to keep costs
down.”
“We were also
early entrants into Internet and are proud of our website:
www.GottfriedMedical.com, going
through
several major upgrades over the years. We continue to work on improvements and
online content.
Soon,
we hope to be offering online ordering.”
“Reflecting
on how the company technology has changed in the last 30 years makes the future
look very
exciting.
3D imaging and ultrasonic sewing are just two of many areas that hold promise.
It’s simple: at
Gottfried
Medical, we embrace technology we feel will improve our products and
service.”
How
do you envision the move to the new location will affect your role at Gottfried
Medical and why?
(Brent
Gottfried, President) “The move has taken some pressure off me. We now have
elbow room and the
space
to grow. That’s what we have done every year of our existence. We also now have
the space to
evaluate
some of the new technologies we are interested in. Personally, I am gratified
by the level at which
the
employees are enjoying our new home.”
(Beth
Joy, General Manager) “By moving to the new building and including the entire
staff throughout the
process,
the sense of ownership is heightened for each employee. This sense of ownership
creates more of a
team
atmosphere. We all love our new surroundings and want to continue to grow the
business and provide
the
service we are known for. The move has affected my role as General Manager by
the positive attitude of
the
employees and their willingness to do what it takes.”
(Brandon
Scanes, Sales Manager) “A move such as this, by default, puts added pressure on
all those
involved.
As an example, my role expanded and shifted to one of logistics – organizing
the transfer of
product
and inventory to the new location. Prior to and throughout the move itself, new
situations required
quick
and decisive decisions. As we settle-in to our new offices although things are
returning to ‘normal,’ as
a
result of that move (going forward) I now possess new skills to call upon that
will help me deal with my
workday.”
(Darla
Hredzak, National Sales Representative) “What the move represents has a huge
impact on my
motivation.
To be a part of a company that grows every year is an honor. It stands upon the
promise of its
President, Brent Gottfried: ‘do one thing and do it well.’ As their national sales rep, that means providing our
customers
the highest quality products to aid in their patients’ journey to either
recovery or maintenance of
their
unique health concerns.”
As
Gottfried Medical turns the corner on thirty years in business, their future
remains bright, as does their
commitment
to the Toledo-area as their home and to their promise to remain a company
sought-out by
employee
and customer alike.
January
7, 2011 - Tahoe Forest Health System's 'Exercise for Energy' for current and
recovering cancer
patients
- Sierra Sun –
TAHOE/TRUCKEE,
Calif. —This free six-week class, Exercise for Energy, is a supportive care
program
for
current and recovering cancer patients. It offers patients guidance, support,
and useful tools to return to
and
maintain health and wellness. The class will incorporate strengthening,
stretching, breathing, balance,
cardio,
yoga and wellness education. Education topics may include foods that fight
cancer, cooking
demonstration,
lymphedema prevention, stress, Feldenkrais and exercise strategies. All classes
are
supportive,
medically managed and taught by health professionals, giving you the tools you
need in a
supervised
environment.
Classes
are offered in Truckee and Incline Village. New sessions begin in Incline
Village Jan. 12 and April
13.
Class meets Wednesdays and Fridays, 12:30-1:30 p.m., with Wednesday Wellness
Educational Topics
1:30-2:30
p.m. at IVCH Physical Therapy and Medical Fitness, 333 Village Blvd. Suite 201,
on the corner
of
Village and Alder, one block from Incline Village Community Hospital. Truckee
sessions begin March 1
and
May 31.
Prescreening
required. For more information or to sign up call 582-7415 or e-mail
[email protected]. Visit
www.tfhd.com.
January
9, 2011 - Weight lifting does not appear to increase risk of arm swelling,
discomfort for breast
cancer
survivors - The Virtual Medical Centre –
A
slowly progressive weight lifting program for breast cancer survivors did not
increase their risk of
lymphedema
(arm swelling and discomfort), according to a study in the December 22/29 issue
of JAMA.
The
study is being released early online to coincide with its presentation at the
San Antonio Breast Cancer
Symposium.
Lymphedema
is a frequent complication among breast cancer survivors and ranks high among
their
concerns,
as it may impair arm function and quality of life. "Breast cancer survivors at
risk for lymphedema
alter
activity, limit, activity, or both from fear and uncertainty about their
personal risk level, and upon
guidance
advising them to avoid lifting children, heavy bags, or other objects with the
at-risk arm. Such
guidance
is often interpreted in a manner that de-conditions the arm, increasing the
potential for injury,
overuse,
and, ironically, lymphedema onset," according to background information in the
article. The authors
add
that adherence to these precautions may limit physical recovery after breast
cancer.
Lymphedema
often occurs after lymph vessels or lymph nodes in the axilla (armpit) are
removed by surgery
or
damaged by radiation, impairing the normal drainage of lymphatic
fluid.
Kathryn
H. Schmitz, PhD, MPH, of the University of Pennsylvania School of Medicine and
Abramson
Cancer
Center, Philadelphia, and colleagues examined the incidence of lymphedema after
a one year weight
lifting
intervention among survivors at risk for breast cancer related lymphedema
(BCRL). The randomised
controlled
trial included 154 female breast cancer survivors who had been diagnosed one to
five years prior
to
entry in the study and had at least twio lymph nodes removed and were without
clinical signs of BCRL at
study
entry. Participants (ages 36 to 75 at the beginning of the study) were
randomised to either the weight
lifting
intervention, which included a gym membership and thirteen weeks of supervised
instruction, with the
remaining
nine months unsupervised, or no exercise (control group). Data collection ended
in August 2008.
A
total of 134 participants completed follow-up measures at one year.
The
researchers found that the proportion of women who experienced new BCRL onset
was 11% (eight
out
of 72) in the weight lifting intervention group and 17% (thirteen out of 75) in
the control group. "Among
women
with five or more lymph nodes removed, the proportion who experienced incident
BCRL onset was
7%
(three out of 45) in the weight lifting intervention group and 22% (eleven otu
of 49) in the control group.
Clinician-defined
BCRL onset occurred in one woman in the weight lifting intervention group and
three
women
in the control group (1.5% vs 4.4%)."
"The
majority of breast cancer survivors do not have lymphedema; however, they alter
the use of their arms
and
upper body activities out of fear of developing lymphedema. The findings from
our trial should help
clarify
clinical advice to patients who have completed breast cancer treatment
regarding the safety of
resuming
or beginning a weight lifting program," the authors write.
The
researchers note that the primary goal of this study was to test safety of
weight lifting, not superiority,
and
that additional research is needed before concluding that weight lifting
prevents lymphedema. "However,
even
with the finding of no harm, our results combined with previously published
results for women with
breast
cancer related lymphedema suggest that the many health benefits of weight
lifting should now become
available
to all breast cancer survivors."
January
11, 2011 - Manual Drainage Fails to Prevent Lymphedema in Breast Cancer
Patients - Internal
Medicine
News Digital Network – by Kerri Wachter –
SAN
ANTONIO – Adding manual lymph drainage to exercise therapy did not prevent
lymphedema in a
study
of 160 breast cancer patients who underwent axillary lymph node
dissection.
Researchers
reported that the incidence of lymphedema following axillary lymph node
dissection (ALND)
was
similar whether or not women had manual drainage in a randomized trial
presented at the annual San
Antonio
Breast Cancer Symposium.
[Check
out our comprehensive coverage of the San Antonio Breast Cancer
Symposium.]
Based
on these findings and previous data, "breast cancer patients have to perform
exercise therapy
immediately
started after the axillary dissection to prevent arm lymphedema," said Nele
Devoogdt, a
physical
therapist at University Hospitals Leuven in Belgium.
Manual
lymph drainage involves stretching/massaging the skin around lymph nodes to
improve resorption by
the
lymph capillaries, increase lymph transport (by stimulating lymph collectors),
and to create collateral
pathways
of lymph transport, Ms. Devoogdt said. Although manual lymph drainage is used
in several
countries,
including Belgium, to prevent lymphedema, the preventive effect has not been
previously
demonstrated
in a peer-reviewed randomized trial.
For
this study, the researchers recruited 160 breast cancer patients, who underwent
ALND in one arm.
Both
arms were assessed prior to the procedure to assess the natural difference in
size.
A
total of 79 patients were randomized to exercise therapy and manual lymph
drainage, while 81 patients
had
only exercise therapy. Both groups were given lifestyle guidelines for
minimizing lymphedema.
Patients
in both groups attended 1-2 sessions per week (29 exercise therapy sessions on
average). In the
treatment
group, manual lymph drainage was performed 1-3 times per week (34 sessions on
average).
At
1 month post-ALND, patients started treatment and an arm assessment was
performed. Arm
assessments
followed at 3 months, 6 months (at which point treatment was stopped), and 12
months.
The
primary outcome measure was the incidence of arm lymphedema – defined as a
circumference increase
of
at least 2 cm at two successive measurements. The researchers found no
significant difference in
lymphedema
incidence between the two groups at any time point. At 3 months, the incidence
was 7% in the
drainage
group, compared with 5% in the exercise-only group; at 6 months, the incidence
was 12% and
10%,
respectively; and at 12 months, it was 23% and 18%.
Secondary
outcomes also showed no significant differences in time to lymphedema, increase
in arm volume,
mental
and physical health-related quality of life, and functional problems related to
arm lymphedema.
The
investigators reported that they have no relevant financial
relationships.
January
11, 2011 - Support Groups, updated Jan. 11 – TCPalm –
DATED
MEETINGS
Lymphedema
Support Group: Focus on encouragement, education, socialization. Advanced
Motion
Therapeutic,
2965 20th St., Vero Beach, 6:30 p.m., Jan. 13, Feb. 10, Mar. 10. RSVP:
772-567-8585;
AMTvero.com.
Lymphedema:
St. Lucie Medical Center, 1800 S.E. Tiffany Ave., Port St. Lucie, 5:30 p.m.,
Jan. 28, Feb.
24,
March 24, April 28, May 26, June 23, July 28, Aug. 25, Sept. 22, Oct. 27.
772-335-4000;
StLucieMed.com
January
11, 2011 - HOUSE CALL: Lymphedema —yes, it's treatable - San Angelo Standard
Times –
SAN
ANGELO, Texas — Lymphedema is the result of an abnormal accumulation of
protein-enriched fluid
that
causes swelling of a body part, usually the arm or leg. Approximately 2.5
million Americans suffer from
lymphedema,
and many of them go undiagnosed or untreated.
If
left untreated, lymphedema can potentially cause repeated soft tissue
infections, inability to use the arm or
leg,
and could possibly lead to amputation of the arm or leg.
Lymphedema
often develops after cancer-related treatments, surgery, obesity, injury,
rheumatoid arthritis, or
chronic
venous insufficiency. Approximately 30 percent of women who develop breast
cancer and undergo
radiation
will develop lymphedema, and approximately 74 percent of men who develop
prostate cancer will
develop
it. With age, a person who undergoes total knee or hip replacement is at higher
risk of developing
lymphedema.
Whereas in the past a person may have been told there was no treatment
available, now
through
lymphedema therapy, there is hope for alleviating this debilitating
condition.
Untreated
lymphedema could progress through the following stages:
*
Stage I is identified when lymphedema fluctuates throughout the day. Patients
often express, “My legs are
only
swollen at the end of the day.” Or, “The swelling comes and goes, but I’m
fine.” Symptoms include
feeling
of tightness, achy discomfort, heavy feeling of the arm or leg, and pitting. If
left untreated, it can
progress
to Stage II.
*
Stage II is the state when the soft tissue turns hard and it becomes difficult
to press a finger into the
affected
skin, skin color begins to change, repeated infections (cellulitis) occur, and
leakage of fluid through
the
skin (weeping edema) appears.
*
State III, termed elephantiasis, may be more difficult to treat. However,
through lymphedema therapy, the
person
may regain the quality of life they may have lost.
Lymphedema
therapy, a specialized therapy also known as Complete Decongestive Therapy,
consists of:
(1)
Manual lymph drainage, a gentle specialized massaging technique used to
reroute lymph flow around
the
blocked areas into more centrally located healthy lymph vessels that drain into
the venous system;
(2)
Compression therapy that applies short stretch bandaging to the affected body
part to maintain the
progress
made through manual lymph drainage, prevent back flow of the lymph fluid, and
improve the
muscle
pumping action that assists proper lymph flow;
(3)
Lymphedema exercises;
(4)
Skin care and infection prevention education;
(5)
Compression garment measurement and fitting, which will help the person
maintain the progress made
through
lymphedema therapy.
Cost
of lymphedema therapy is covered by Medicare, Medicaid, and most private
insurances. A doctor’s
referral
is required to receive therapy.
At
San Angelo Community Medical Center, a medical admissions specialist is
available at (325) 947-6989
to
answer questions regarding insurance coverage to receive this therapy. For more
information or to
schedule
an appointment, please call (325) 949-5900.
Selina Elder, is an Occupational Therapist,
Certified Lymphedema Therapist and Certified Custom Garment
Fitter
who practices at San Angelo Community Outpatient Therapy.
February 1, 2011 - A Spa Dedicated to
Complementary Cancer Care - MD News –
Expanding
upon its impressive array of services for cancer care, The START Center for
Cancer Care in
San
Antonio, TX, recently celebrated the opening of Inspiritas, an integrative
wellness spa designed
specifically
to meet the unique needs of cancer patients and their families.
“The
development of Inspiritas has been several years in the making and serves as an
important
complement
to the first-class medical care that is provided to cancer patients through The
START Center
for
Cancer Care,” says Amy Lang, M.D., medical oncologist at The START Center for
Cancer Care.
“Cancer
is not just a physical disease — it affects a person’s physical, mental and
spiritual well-being. We
knew
that our patients were suffering in ways that medications were not able to
address, so we made a
commitment
as a group to create an integrative oncology wellness center that would address
the whole
patient.”
Caring
for Body, Mind and Spirit
Inspiritas
is the only spa of its kind in South Texas. Designed to provide a tranquil and
relaxing area for
cancer
patients to be pampered, it features treatment rooms, changing rooms and
showers, an outdoor Zen
garden,
lounge, waterfall and a multipurpose studio designed for movement classes,
yoga, guided imagery,
meditation,
nutritional and other classes. The spa’s retail area offers paraben-free,
fragrance-free organic
skin
care products, inspirational books, soothing music and guided imagery CDs,
nutritional supplements
and
organic tea.
Mindful
of the issues women face with hair loss and mastectomies, Inspiritas dedicated
an area for wigs,
prosthetics,
head coverings and other beauty products. Women in need of these services are
seen by
certified
prosthetic fitters and beauty consultants in the privacy of two beautiful
rooms.
Based
on the five domains of complementary and alternative medicine developed by the
National Institutes
of
Health — alternative medicine systems, mind-body interventions, biologically
based therapies,
manipulative
and body-based methods, and energy therapy — services include massage,
meditation,
guided
imagery, Reiki, acupuncture, spiritual counseling, nutrition counseling and
free movement classes,
such
as yoga and tai chi.
Staff
members at Inspiritas have considerable experience caring for cancer patients.
For example, the
nutritionist
on staff is a certified oncology dietitian with more than 10 years of
experience in the field. In
addition,
all of the massage therapists employed by Inspiritas are certified oncology
massage therapists.
“When
developing Inspiritas, we surveyed our patients and found that many of them
were seeking these
services
elsewhere and, sometimes, not very safely,” says Dr. Lang. “For example, many
of our cancer
patients
were receiving massages to help with pain management. However, if a patient has
cancer in their
bones,
massage techniques must be adjusted to prevent harm. This same principle is
also true for patients
who
have had lymph nodes removed and are at increased risk for lymphedema. If they
receive a massage
from
a massage therapist who is not trained in oncology, the massage could
exacerbate this condition.”
Complementary
therapies, including guided imagery, spiritual direction and energy therapy,
have shown to
increase
quality of life for cancer patients as well.
Guided
imagery helps empower patients to deal with the mental challenges of cancer and
its related
treatments.
This provides a way for patients to channel their inner strength to help manage
anxiety,
depression
and other disturbing emotions. When this is achieved, patients gain control
over the stress
response
that accompanies a cancer diagnosis.
“By
providing guided imagery, patients are able to tap into their inner resources,
which help them heal,”
says
Ginger Kemmy, R.N., B.S.N., Director of Inspiritas. “Research has shown that
addressing these
emotions
can even help improve immune function.”
Spiritual
direction helps patients work through any spiritual concerns that may arise due
to their cancer
diagnosis,
and energy therapy is ideal for patients who are suffering from severe pain
that makes touch
uncomfortable.
An
Evidence-Based Approach
Research
has shown that cancer patients who have access to supportive services,
including massage,
guided
imagery and other integrative modalities, have better outcomes than patients
who receive traditional
medical
care only. In fact, a recent study published in The New England Journal of
Medicine analyzed the
effectiveness
of palliative care in patients with metastatic lung disease and showed that
patients who
received
palliative care and complementary medicine in addition to chemotherapy and
other medical
modalities
experienced increased quality of life, less depression and reduced need for
aggressive treatment
measures.
Patients who received palliative care also had an average survival that was two
and a half
months
longer than patients who did not.
“Patients
who are engaged and participate in supportive care do better than patients who
just see their
oncologists
alone,” says Kemmy. “Because these services help address both the physical pain
and mental
ramifications
of cancer, patients experience less stress, an improved quality of life and
enhanced immune
function.”
Providing
Support for Family Members
Even
though the services provided through Inspiritas have been designed with cancer
patients in mind, all
services
are open to the public. The facility offers a variety of classes that are free
to the community.
Anyone
who is interested in achieving better balance and enhancing his or her overall
health can benefit
from
the services available. For caregivers of cancer patients, this can be
especially beneficial, as they often
experience
stress and anxiety while caring for their loved ones.
“All
of the services provided through Inspiritas can help caregivers manage the
stress they experience,”
says
Kemmy. “I recently conducted a guided imagery class, and a couple attended. The
wife had breast
cancer,
but the class was beneficial to her spouse as well because he was able to deal
with his own
emotions
regarding her diagnosis. Caregivers are also welcome to participate in our spa
services, including
massage.”
Caregivers
have access to the quiet room and Zen garden at Inspiritas. These areas provide
a relaxing
environment
for them while waiting for their loved ones to finish their
treatments.
To
learn more about the services provided for cancer patients, survivors and
caregivers through Inspiritas,
please
visit ?thestartcenter.com.
February
2, 2011 - SA has highest number of gunshot assaults - Primedia Broadcasting -
Eyewitness
News
– by Catherine Rice –
South
Africa has the highest number of gunshot assaults in the world.
Local
doctors treat gunshot wounds daily.
Seven
hundred delegates have gathered at Cape Town International Convention Centre
for a global wound
care
conference, in a bid to educate primary healthcare workers about effective
wound treatment and
exchange
ideas on best practices.
Wounds
International is hosting the event and hopes to leave a legacy by providing
hands-on information
about
the effective treatment of wounds.
The
World Alliance for Wound and Lymphedema Care’s Secretary-General John McDonald
said there
are
significant consequences for patients if wounds are not treated
properly.
McDonald
said 70 percent of all leg amputations are done on diabetic patients, but this
could be avoided
with
proper prevention care.
February
2, 2011 - New Clinical Research Study Aims to Prevent Lymphedema in Women
Treated for
Breast
Cancer - HealthCanal.com –
Washington,
D.C. – Pain and swelling in the arm or hand can occur as a side effect of
breast cancer
surgery,
but a new national clinical research study underway at Georgetown Lombardi
Comprehensive
Cancer
Center, part of Georgetown University Medical Center and Georgetown University
Hospital, is
looking
at ways that might prevent the onset of these symptoms called
lymphedema.
“Lymphedema
is a complication that many women dread. It can negatively impact a woman’s
ability to
complete
simple daily activities and can take a toll on her physical and emotional
well-being,” says
Georgetown’s
chief breast surgeon Shawna Willey, MD, director of the Betty Lou Ourisman
Breast Health
Center
and lead researcher of the study. “As we understand more about what triggers
lymphedema, we’re
learning
of possible ways to prevent it.”
Lymphedema
can occur in some women who have lymph nodes removed from their underarm as
part of
their
breast cancer surgery. (Lymphedema can also occur with other cancer surgeries
when lymph nodes
are
removed such as with the removal of the prostate). Lymph nodes filter fluid as
it circulates in the body
and
help to mobilize this fluid throughout the body. Swelling and pain can occur
when the fluid pools in the
arm
or hand and isn’t able to be removed because of a decrease in the number of
lymph nodes.
The
Lombardi study looks at the impact that an education program has in preventing
lymphedema
compared
to education plus a customized exercise plan. Information about quality of life
for these women
also
will be gathered.
Women
interested in the study sign up before having surgery for their breast cancer.
If lymph nodes are not
removed
during the study, then those women do not continue in the study because
lymphedema is not likely
to
occur. Those who have lymph nodes removed continue in the research program and
are randomly
assigned
to one of two groups: the education-only group or the group with education plus
an exercise plan.
The
women will be asked to participate in about four surveys throughout the
two-year study.
“It’s
possible that exercise can improve or even prevent the onset of lymphedema,”
explains lymphedema
specialist
Johanna C. Murphy, MS, PT, CLT, director of physical medicine and
rehabilitation at
Georgetown.
“Having a tailored exercise program, however, is important because there are
activities that
might
actually trigger the swelling and pain. For the women assigned to the education
plus exercise, learning
the
correct way of doing the exercises will be an important part of the
study.”
In
addition to exercise, women in this group will be fitted for a special sleeve
and glove that apply light
pressure,
which might also help prevent lymphedema when combined with the exercise plan.
The education
program,
exercise plan, and sleeve are offered without cost to the patient. Standard
instruction and written
material
about lymphedema will be provided for those choosing not to participate in the
study.
“We
don’t yet know if the exercise plan and sleeve will be better than education
only to prevent the
symptoms,”
Willey concludes. “We’re grateful to all of our study participants, past and
present, as they
truly
help in advancing our knowledge about this issue.”
Patients
interested in learning more about this study should contact Ann Gallagher at
[email protected]
or
call 202-687-7606.
The
study is sponsored by the Cancer and Leukemia Group B, a cooperative group of
cancer centers.
Willey
and Murphy report no personal financial interests related to the
study.
About
Georgetown Lombardi Comprehensive Cancer Center
Georgetown
Lombardi Comprehensive Cancer Center, part of Georgetown University Medical
Center
and
Georgetown University Hospital, seeks to improve the diagnosis, treatment, and
prevention of cancer
through
innovative basic and clinical research, patient care, community education and
outreach, and the
training
of cancer specialists of the future. Lombardi is one of only 40 comprehensive
cancer centers in the
nation,
as designated by the National Cancer Institute, and the only one in the
Washington, DC, area. For
more
information, go to http://lombardi.georgetown.edu.
About
Georgetown University Medical Center
Georgetown
University Medical Center is an internationally recognized academic medical
center with a
three-part
mission of research, teaching and patient care (through MedStar Health). GUMC’s
mission is
carried
out with a strong emphasis on public service and a dedication to the Catholic,
Jesuit principle of
cura
personalis -- or "care of the whole person." The Medical Center includes the
School of Medicine and
the
School of Nursing and Health Studies, both nationally ranked, the
world-renowned Georgetown
Lombardi
Comprehensive Cancer Center and the Biomedical Graduate Research Organization
(BGRO).
In
fiscal year 2009-2010, GUMC accounted for 79 percent of Georgetown University's
extramural
research
funding.
February
2, 2011 - Multiple Hurdles in Treating Lymphatic Filariasis in Haiti - Angels
in Medicine – by
Zeena
Nackerdien, PhD –
Lymphatic
Filariasis in Haiti
Beset
by the plagues of poverty, political instability and infectious diseases, Haiti
remains on the world's
radar
as a place of ongoing suffering. Headlines skim the surface of its promising
origins as the world's first
black-led
republic,[1] and linger on the more familiar tales of political violence under
the leadership of past
presidents,
notably the Duvaliers ("Papa" and "Baby Doc") and Jean-Bertrand Aristide. As if
political
disasters
were not enough, Haiti has had to deal with an alphabet soup of hurricanes,
storms, earthquakes
and
tsunamis, recorded as early as 1770.[1]
Compounding
the country's problems is the lack of sanitation and an inadequate health
infrastructure, which
have
created a perfect breeding ground for infectious diseases. Among these
scourges, lymphatic filariasis
(LF),
a mosquito-transmitted parasitic disease, is known to be endemic to the region
and is a leading cause
of
permanent disability worldwide.[2,3] Viewed as a remnant of the slave trade,
this disease occurs mainly
in
Haiti in the Western hemisphere, where at least 10% of individuals are
symptomatic. More than half the
population
in high transmission areas could be asymptomatic carriers.[4]
Although
the disease is seldom fatal, the passage and procreation of the roundworm,
Wuchereria bancrofti,
wreaks
havoc to the lymphatic system of affected individuals.[4] Threadlike worms lurk
in their favorite
nesting
areas (breasts, genitals and legs),[5] releasing millions of baby worms into
the blood and causing
lymphedema
in many affected individuals. The one-two combination of untreated parasitic
disease and
accompanying
microbial infection cause the debilitating and disfiguring condition of
elephantiasis.
Fortunately,
individuals and health organizations have waged an ongoing war against this
emblematic
"disease
of the poor." One such effort is the LF-elimination initiative directed by
Father Tom Streit,
affectionately
known as Pere Tom,[4] who directs the program under the auspices of the
University of
Notre
Dame (UND). Sarah Craig, the program manager, estimated that there are about 45
people
currently
engaged in efforts in Leogane, a coastal town, as well as in offices and at the
Hopital Sainte Croix
in
the capital, Port-au-Prince.
The
UND group, together with other researchers in Haiti, had determined that the
only option for effective
LF
elimination was mass drug administration to the local population for the
duration of the worm life cycle
--
5 years.[4] The UND initiative, in partnership with IMA World Health, and in
support of the Haitian
government,
achieved its goal of 5.2 million treatments per annum in the 2009/2010
treatment cycle. In
2008,
50 of the most at-risk 140 communities were treated for this disease using the
WHO-recommended
approach
of mass drug administration with drugs that target both LF and intestinal worms
(S. Craig,
personal
communication).
Aftermath
of the 2010 Earthquake
Located
on the western side of the island of Hispaniola, Haiti is perched on a fault
zone predicted in 1979
to
have the highest probability of rupturing into a big quake.[7] The date,
January 12 2011, marks the one-
year
anniversary of the devastating earthquake which hit this impoverished nation.
Its painful consequences
unfolded
in television images and stories of untold suffering and death. The earthquake
killed as many as
300,000
people, toppled buildings and left 1.5 million homeless.[6] This disaster also
slowed the LF
program
and many other health initiatives in the country.
Moments
before the event, UND workers and their collaborators were enjoying drinks on
the fourth floor
of
a Port-au-Prince hotel on that fateful day. Ms. Craig recalled feeling the
building collapse until "we
ended
up somewhere between the first and second floor with rubble beneath us." The
survival of the
workers
and heroic relief efforts by others are outlined in a Science article[4] and
further described on the
UND
website.[8]
By
January 20, at least 52 4.5-rated aftershocks had been reported. Like other
health initiatives in the
country,
the program switched immediately from research to disaster management mode.
Leogane,
eighteen
miles away from Port Au Prince and near the epicenter of the quake, which
registered 7.0 on the
Richter
scale, counted 30,000 to 40,000 dead and 80-90% of its buildings completely
decimated.[9]
Medical
supplies rapidly dwindled as the staff treated thousands of hungry, dehydrated
and wounded
Leogane
residents. It was the UND staff on the ground who facilitated the
transformation of a local
highway
into a makeshift landing strip so that much-needed additional supplies could be
flown in to save
lives.
Against a distant backdrop of debris and growing refugee camps, a number of
medical teams worked
feverishly
to treat the traumatized residents. Similar stories of suffering and medical
relief echoed across
Port
Au Prince.
Cholera:
A Dire Blow to the Program
Taking
care of the injured and providing humanitarian relief proved only to be the
beginning of the new
challenges
facing the UND initiative and other health programs operating in Haiti.
Cholera, all too familiar in
developing
countries as a disease transmitted mainly through contaminated water and food,
provided an
unexpected
new challenge. This disease, first reported on 21 October in the rural
Artibonite region, far
away
from Port Au Prince, spread rapidly through the country. As of December 2010,
there have been
121,518
cases reported, resulting in 63,711 hospitalizations and 2,591
deaths.[10]
Crowded
refugee camps, a population with no immunity against the microbe and a
teetering healthcare
system
provided the fuel for the cholera epidemic. Politics inevitably crept into
containment efforts once the
microbe
was genetically matched with a South Asian strain. UN peacekeeping troops from
Nepal were
accused
of being carriers of this virulent strain, precipitating riots against the UN
and further impeding
medical
relief efforts.[6] The rationale that the epidemic was imported flies in the
face of expert opinion that
Vibrio
cholerae likely spread via the environmental route.[11] This assessment is
based on knowledge that
the
microbe, normally resident in low numbers in brackish water or found in
association with small
crustaceans
in rivers and lakes, can proliferate in the presence of environmental stimuli
such as increasing
water
temperatures and nutrient levels, causing zooplankton blooms. Locals ingesting
the water and poor
sanitation
facilitate the spread of the disease.[11]
Regardless
of debates about the origins of the epidemic, the reality is that the LF
program faces a
formidable
obstacle in cholera. Experts predict that cholera is likely to persist in
Haiti, with the country
facing
100,000 cases in the next few years, given its low ranking on the socioeconomic
development scale.
[11]
The current global cholera vaccine supply of approximately 100,000 doses is
inadequate to protect all
Haitian
citizens. Since medications are consumed with local water to keep costs at a
minimum, it is perhaps
understandable
that the Haitian government has asked the LF program to halt medication
distribution due
to
the cholera outbreak. Thus, from a public health standpoint, cholera damaged
the program far more than
the
earthquake. One estimate given was that 5 to 10 years would be needed to put an
infrastructure in
place
to deal with the country's health woes. Post-election riots may prolong the
journey towards
economic
and health stability.
Dateline
NBC featured the heroic efforts of Remote Area Medical to provide some Haitians
with cholera
medicines.
While these heroic efforts bear testament to the depths of human compassion,
sustainable
solutions
are being sought for the plight of the Haitians. Chlorinated water and
innovative biosand filter
projects
devised by the Clean Water for Haiti program may provide part of the answer,
but each approach
is
subject to the need for additional funding. Given its commitment and successful
public health track record
in
the country, the UND and its collaborators are seeking additional financial
resources to expand the
scope
of the neglected tropical disease program in order to improve the overall
quality of life of the Haitian
people.
About
the Author
Zeena
Nackerdien, PhD is a microbiologist and writer and can be reached at
[email protected].
edu.
References
1.
Haiti country profile, from the BBC.
2.
WHO. World Health Report. Geneva: World Health Organization.
3.
Beau de Rochars MV, Milord MD, St Jean Y, et al. Geographic distribution of
lymphatic filariasis in
Haiti.
Am J Trop Med Hyg 2004;71(5):598-601.
4.
Roberts L. Relief among the rubble. Science 2010;327(5966):634-637.
5.
Reynolds M. Blessed are the healers. Notre Dame Magazine, Summer 2001
6.
Fraser B. Haiti still gripped by cholera as election looms. Lancet
2010;376(9755):1813-1814.
7.
Kerr RA. Seismology. Foreshadowing Haiti's catastrophe. Science
2010;327(5964):398.
8.
University of Notre Dame - Haiti Program
9.
Demas N. Wes, Jean Marc and the Fighting Irish of Leogane!
10.
Update on cholera --- Haiti, Dominican Republic, and Florida, 2010. MMWR Morb
Mortal Wkly
Rep
2010;59(50):1637-1641.
11.
Enserink M. Infectious diseases. Haiti's outbreak is latest in cholera's new
global assault. Science 2010;
330(6005):738-739.
Links
Related to This Article
University
of Notre Dame Haiti Program
Sarah
Craig
Program
Manager
309
Brownson
Notre
Dame, IN 46556
Phone:
574-631-3273
Fighting
Poverty by Treating Parasites
by
Zeena Nackerdien, PhD and Toni Nicholls, PhD
Neglected
Tropical Diseases and Drug Donation Programs: Successes and
Challenges
by
Zeena Nackerdien, PhD
About
Angels in Medicine
Angels
in Medicine is a volunteer site dedicated to the humanitarians, heroes, angels,
and bodhisattvas of
medicine.
The site features physicians, nurses, physician assistants and other healthcare
workers and
volunteers
who reach people without the resources or opportunities for quality care, such
as teens, the
poor,
the incarcerated, the elderly, or those living in poor or war-torn regions.
Read their stories at www.
medangel.org.
February
2, 2011 - Community Bulletin and Business Briefs - Winter Park/Maitland
Observer –
Dr.
Stuart Dropkin, DMD, of Winter Park participated in the TeamSmile clinic,
Friday, Jan. 21.
Several
hundred low-income kids from Orange County came in for free dental
treatment.
The
following students were named to the President’s or Dean’s List of their
college or school at Mercer
University
for the Fall 2010 semester: Justin D. Burchett of Winter Park and Bryan B.
Danley of Maitland
Jonathan
Hill, a resident of Maitland and a junior at Southern Methodist University in
Dallas, is listed on the
honor
roll with high distinction.
Chad
Modomo of Winter Park has been named to the 2010 fall semester Dean’s List at
West Virginia
Wesleyan.
The
Metropolitan Opera National Council Auditions/Vocal Competition took place on
Saturday, Jan. 22
at
Trinity Prep School in Winter Park. “Thanks to donations collected from the
audience, we were able to
send
four winners to Atlanta instead of the usual three,” Swantje Knye-Levin and
Kathleen Miller wrote in
an
e-mail.
Tax-Aide
volunteers, trained and certified by the IRS, will provide free income tax
assistance at the Winter
Park
Library, 460 E. New England Ave., from 11:30 a.m. to 3:30 p.m., Tuesday,
Wednesday and
Thursday,
through April 14. Visit aarp.org/taxaide or call 1-800-227-7669.
The
Winter Park Chamber of Commerce recognized its members at the organization’s
annual Membership
Awards
Celebration on Friday, Jan. 21, at Full Sail. Florida House of Representatives
Speaker Dean
Cannon
was honored as the Winter Park Citizen of the Year. The Chamber
presented
the first Chamber Hero award to Ronnie Moore, assistant director for Parks and
Recreation for
the
City of Winter Park. Visit WinterPark.org
Over
400 brave souls were “freezin’ for a reason” at Aquatica on Saturday, Jan. 22,
for the second annual
Polar
Plunge, benefiting Special Olympics Florida. The event raised more than
$191,000!
On
Jan. 26, Jewish Academy of Orlando held its annual Invention Convention.
Students’ challenge was to
create
a machine, using at least 15 steps and no form of electricity, to put a .5L
water bottle into a
recycling
bin. The students presented a short video presentation of the building process
on iPads. Visit
JewishAcademyOrlando.org
The
Dr. Phillips Center for the Performing Arts received a $1.5 million gift from
Winter Park
residents
Marc and Sharon Hagle, who previously pledged $1 million to the project in
2007. Visit
DrPhillipsCenter.org
Tickets
are now on sale for CHOICES 2011, held March 16 at the Westin Lake Mary on
International
Parkway.
This annual event is the largest fundraising event for the Jewish Federation of
Greater Orlando
Women’s
Division. Call 407-645-5933 or visit jfgo.org
Registration
is now open for the 31st Annual Conference of the Florida Native Plant Society.
It will take
place
at the Sheraton Orlando North in Maitland on May 19-22. Visit
www.fnps.org/pages/conference or
for
sponsorship opportunities or to receive information by mail, contact FNPS at
321-271-6702 or e-mail
[email protected]
The
National MS Society Mid Florida Chapter is looking for anyone who wants to
support their
community
to take part in Walk MS 2011 and Bike MS: The Citrus Tour 2011. Visit
MidFloridaMSwalks.
org
and FLC.NationalMSsociety.org or call 813-889-8363.
The
Orlando Garden Club is looking for new members. Monthly meetings are at 10 a.m.
on the third
Friday
of the month during Sept.-May, 710 E. Rollins St. Call 407-682-1726 or e-mail
[email protected]
Seniors
First is seeking drivers to deliver Meals on Wheels to elderly clients in
Orange County. Contact
Lorraine
Shumaker at 407-615-8982.
Business
Briefs
Cocina
214 has leased the 10,000-square-foot building at 151 E. Welbourne Ave. for a
Mexican
restaurant
and bar, called Cocina 214. Formerly Apenberry’s, the building is owned by the
Charles
Hosmer
Morse Foundation. After a total reconstruction of the interior, opening is
planned for Spring 2011.
Margarita
Correa MD, Board Certified in Physical Medicine and Rehabilitation, announces
the opening of
her
new office, Physical Medicine Institute at Winter Park North Pointe Place, 2900
N. Orange Ave. Suite
205,
starting on Friday, May 6. Services include cancer rehabilitation, lymphedema
treatment, pain
medicine,
EMG & NCS. For appointments, call 352-404-6959. Visit
PhysMedi.com
Winter
Park-based A.T. Thomas LLC, which owns and operates Kennedy’s All-American
Barber Club in
Winter
Park, has opened a new location in downtown Orlando. The new Kennedy’s Club is
located at
716
E. Washington St. Suite C.
Fifth
Third Bank’s 47 Central Florida branches recently collected more than $17,000
for the Camaraderie
Foundation,
an Orlando-based nonprofit that provides counseling services at a discounted
rate to veterans
and
their families.
Posting
79 fourth quarter closings for $27.63 million, Fannie Hillman + Associates of
Winter Park saw its
annual
closings of existing homes increase by 6 percent over the previous year, a sign
that company
officials
feel bodes well for 2011. Visit FannieHillman.com
Full
Sail University announced that eight of its alumni are nominated for this
year’s Grammy Awards airing
live
on CBS Sunday, Feb.13. A total of 74 Full Sail graduates worked on 53 nominated
projects.
NAI
Realvest recently completed a lease agreement for 9,675 square feet of
office/industrial space at
Winter
Park Commerce Center near downtown Winter Park.
Larry
Vershel Communications, based in Winter Park, has added five new clients since
the start of 2011
and
projects major growth through the end of the year.
February
3, 2011 - Lymphedema Products Demonstrates Compassionate, Effective Lymphedema
Management
– Benzinga –
Lymphedema
Products has spent years promoting safe, ethical, and compassionate treatment
for
lymphedema.
Its expertise and track record show how lymphedema treatment should be
supplied.
Matawan,
NJ (Vocus/PRWEB) February 03, 2011
Bringing
its industry-leading expertise and understanding of ethical and effective
lymphedema treatment to
the
supply of lymphedema treatment tools for more than ten years, Lymphedema
Products has established
itself
as a lymphedema supplies provider that prioritizes patient satisfaction. It
emphasizes its staff's first-
hand
knowledge of every phase of lymphedema and the importance of providing only the
most medically-
safe,
cutting-edge treatment tools, offering its clients the power to effectively
combat the condition on their
own
terms.
About
Lymphedema Products' Founders
Lymphedema
Products was established by Steve Norton, a Complete Decongestive Therapy
Instructor,
Certified
Lymphedema Therapist (CLT), and highly-regarded lymphedema educator. Steve is a
renowned
authority
in the field of lymphedema therapy who personally trained many of today's
practicing
lymphedema
therapists. His educational company, the Norton School of Lymphatic Therapy, is
the leading
resource
for comprehensive education in this medical specialty.
His
vision for Lymphedema Products as a trend-setter in the industry, with product
selections based on the
expertise
of long-time lymphedema care experts, was inspired by his experiences treating
the condition, his
extensive
involvement in the field of lymphedema management and lymphedema care
education, and his
passion
for treating this condition with the utmost compassion and integrity.
Steve
founded Lymphedema Products with the goal of providing the highest quality
service to individuals
with
lymphedema who have successfully completed lymphedema treatment, but continue
to need the best
products
and expertise available to manage their condition. As the leading exclusive
supplier of
lymphedema
treatment supplies, it carries only the most advanced and medically-responsible
products
available
for the safe and effective management of primary and secondary lymphedema,
venous edema,
and
other edemas. Steve and his team of lymphedema experts personally vet products
based on years of
experience
to assure that they are effective, safe, and appealing for customers.
In
this way, Lymphedema Products harnesses the broad range of medical and
technical expertise of its
founder
and advisory staff, to the benefit of customers. When patients and medical
professionals choose to
purchase
their lymphedema supplies from Lymphedema Products, they are initiating a
relationship with the
industry-leading
resource for lymphedema-related treatment, knowledge, and expertise. Steve and
his team
don't
take this relationship lightly.
About
Lymphedema Products' Commitment to the Cutting Edge
Lymphedema
Products carries only the most current, ethically-sound, and medically-safe
treatment tools
for
lymphedema. It is constantly updating its catalogue with the newest in
treatment tools to offer clients
more
custom-tailored options to meet their needs and allow them to make managing
lymphedema an easier
part
of a normal life. All its products have been approved by many of the world's
leading authoritative
organizations
including the International Society of Lymphology (ISL), the National
Lymphedema Network
(NLN),
and many prominent educational institutions in the field of lymphedema
management. Steve
believes
that by holding all his lymphedema-related projects to the highest possible
standard when selecting
product
lines and lymphedema experts, he ensures that his customers will receive the
best treatment
available.
This is the philosophy that has made Lymphedema Products one of the most
trusted leaders and
valued
partners in the field of lymphedema management.
February
3, 2011 - Benefit planned for New Richmond businesswoman - Richmond-News – By
Jackie
Grumish
–
More
than a year ago, Carla Kelley was tired of her shoes and clothes not fitting.
She started dieting but
couldn’t
shed the weight.
Last
June, with swollen legs, she decided to consult a doctor. She tried a reduced
diet, but it didn’t do the
trick.
Eventually, she was diagnosed with lymphedema.
In
September, the swelling progressed into pain — horrific pain.
In
November, Kelley visited a specialist in St. Paul, Minn. After several tests,
doctors discovered a
problem
with her adrenal gland — which led to even more tests.
Eventually,
Kelley was diagnosed with Cushing’s syndrome, a hormone disorder caused by high
levels of
cortisol
in the blood. When doctor’s discovered the cause of Cushings syndrome — a
large, cortisol
producing
tumor — Kelley’s diagnosis changed to adrenal cancer.
After
being diagnosed and finding the tumor, things moved relatively
quickly.
Major
surgery was needed to remove the tumor; however, the tumor needed to be reduce
before the
surgery.
That’s when Kelley started an aggressive nine-day, seven dose chemotherapy
routine.
Dawn
Mahoney, Kelley’s sister, said Kelley has been in good spirits through the
whole process.
“Here
is my sister, actually choosing to look forward to shopping for a wig already
as she collects them for
use
in community theatre,” Mahoney said.
The
two actually went shopping in December, well before Kelley started losing her
hair.
At
one appointment, the family was able to see a 3D image of the tumor. That’s
when the family realized
the
“honkin’ big tumor” was actually a large cluster of tumors measuring roughly 10
inches long, 4.5 inches
wide
and 4.5 inches deep. It’s believed the cluster started in the right adrenal
gland, which sits on top of
the
kidneys.
At
the conclusion of Kelley’s chemo, doctors confirmed that the tumor mass had
shrunk. The next step
was
scheduling the “big surgery” for Jan. 24.
Five
surgical teams were assembled to remove the tumor cluster, Mahoney said. The
day started with a
laparoscopy
to look for other clusters and ended eight hours later after surgeons removed
part of Kelley’s
liver,
right kidney and adrenal gland.
Kelley’s
surgical team deemed the procedure a success and believe all tumors have been
removed. Now,
Kelley
is working to recover.
“To
say we’re cautiously optimistic is true, but probably as far out on the limb as
we’ll go right now,”
Mahoney
said. “Recovery will be a steep climb with pain for a while. But she has made
it through honkin’
chemo
with flying colors and now this honking huge surgery.”
As
most could imagine, a “honkin’ big tumor” creates equally big medical
bills.
To
help Kelley with the costs associated with numerous trips to Rochester, Minn.,
treatments, countless
prescriptions,
hotel rooms and gas, friends and family are organizing a benefit.
The
benefit is scheduled for Saturday, Feb. 12, at Ready Randy’s Sports Bar and
Grill, 1490 131st St.,
just
south of New Richmond.
A
spaghetti dinner and silent auction will begin at 4 p.m. and end at 7 p.m.
Dinner costs $10 per person;
kids
younger than 3 eat free. At 7:30 p.m., Pete Neuman and the Real Deal will hit
the stage.
Those
who are unable to attend, but would like to contribute, can send donations to:
First National
Community
Bank, c/o Carla Kelley Benefit, P.O. Box 89, New Richmond, WI 54017.
“We’ve
been going through a lot in a very short amount of time,” Mahoney said. “We’re
still very much
grieving,
healing, stunned and in a state of disbelief.”
February
4, 2011 - Business Notes - Brainerd Daily Dispatch –
Byland
completes training for certified lymphedema therapist
STAPLES
— Lakewood Health System occupational therapist Janet Byland recently completed
intensive
training
to become a certified lymphedema therapist.
To
become a certified lymphedema therapist, attendance of 135 hours of instruction
and successful
completion
of written and practical examinations are required.
Lymphedema
is a swelling of a body part, most often the extremities. Lymphedema may be
present at birth
or
develop later in life, and is often the result of surgery or radiation therapy
for cancer.
February
5, 2011 - North State Marketplace: Feb. 5, 2011 - Record-Searchlight - By David
Benda –
Tina,
this is notification of a meeting that has now passed, sorry.
February
9, 2011 - Some breast cancer patients can get less surgery - Boston Globe
(blog) – by Deborah
Kotz
–
Treatment
of breast cancer has been moving further and further away from the slash and
burn tactics of the
last
century. Most patients now get lumpectomies instead of mastectomies, less
extensive radiation and less
toxic
chemotherapy. And now some will be offered the option of not having their
underarm lymph nodes
removed
-- even if they contain cancer cells.
A
new study published Tuesday in the Journal of the American Medical Association
has found that women
with
early breast cancer (stage 1 or 2) who have lumpectomies with radiation do just
as well in terms of
cancer
recurrence and survival regardless of whether they retain potentially-malignant
lymph nodes.
The
big upside to sparing the lymph nodes is fewer adverse effects like arm pain,
frozen shoulder,
infections,
and lymphedema, which is permanent swelling in the arm. Some 70 percent of the
446 patients
who
were randomly assigned in the study to have their lymph nodes removed developed
such
complications
compared to 25 percent of the 445 patients who retained their lymph
nodes.
"Lymphedema
and quality of life become huge issues after breast surgery," says Dr. Mehra
Golshan,
director
of breast surgery at the Dana-Farber/Brigham and Women's Cancer Center who was
not involved
in
the study, "and it's a great thing to find that lymph node sparing surgery can
provide the same shot at
survival
with fewer complications."
Golshan
says he and his colleagues at the various Harvard hospitals decided last fall
to offer the lymph
sparing
surgery to some women with one or two positive nodes after hearing the study
presented by the
researchers
at a spring cancer meeting.
Until
then, Harvard surgeons removed just a few nodes to see if they contained cancer
and would only
leave
the rest of the nodes intact if that first node was cancer-free -- which has
been standard practice in
the
U.S. for the past decade.
While
the majority of cancer patients are diagnosed early before the cancer has
spread to the lymph nodes,
up
to 20 percent have an early stage cancer with some lymph node involvement.
Those who opt for
lumpectomies
with radiation, rather than mastectomies, can now be offered the lymph sparing
surgery since
the
radiation could kill any cancer cells left in the nodes, Golshan
says.
Oncologists
at other Boston hospitals, however, may differ somewhat in how they change
their practice as
a
result of the new finding. "This is exciting data, but it certainly doesn?t
apply to everyone," says Maureen
Kavanah,
a surgical oncologist at Boston Medical Center.
She
says oncologists at her institution often like to know the extent of lymph node
spread to determine
whether
to use radiation on that area or to offer the option of an experimental
treatment. Also, oncologists
might
be more willing to spare lymph node removal in those who have
"estrogen-receptor" positive cancers
that
can be treated with anti-estrogen drugs like tamoxifen. These drugs could
destroy any remaining cells
in
the lymph nodes.
And
even with the new study finding, surgeons aren't comfortable leaving
potentially positive nodes in
women
who had mastectomies without radiation -- since they weren't included in the
study -- nor in those
who
have enlarged lymph nodes that can be felt on a physical exam.
A
study now being conducted in Europe that involves 4,000 breast cancer patients
will answer the question
as
to whether it's safe to spare cancerous lymph nodes in women who don't get
radiation.
While
doctors up-to-date on the latest research may be eager to spare patients
unnecessary side effects,
they
may have a tough time convincing some women that it's okay to leave potentially
cancerous lymph
nodes
in the body.
Golshan
says he saw two patients yesterday who had a single positive node and early
stage cancer. He
offered
both the lymph node sparing surgery but only one took him up on it.
February
9, 2011 - Toronto Physiotherapy promotes awareness, education, and treatment of
chronic
swelling
called Lymphedema – by rdavey –
Toronto
, Ontario - February, 2011 - Toronto Physiotherapy, a leading provider of
healthcare in Toronto,
is
providing free Lymphedema services to individuals in financial need, and
offering on-line education
resources
to promote disease awareness.
Lymphedema
is a serious condition caused by a failure of the lymphatic system to maintain
the proper
balance
of fluid in an affected tissue. The resultant accumulation of lymphatic fluid,
usually in an arm or leg,
can
be painful, disabling, and disfiguring. In extreme cases, Lymphedema can lead
to serious infection or
even
a rare form of cancer called lymphangiosarcoma. Lymphedema frequently arises
in cancer patients
(in
particular breast cancer) following surgical lymph node removal or radiation
treatment, but can also
occur
congenitally. Although Lymphedema is a chronic disease, with proper symptom
management and
prevention
individuals with Lymphedema can enjoy a normal and active lifestyle.
Unfortunately,
many individuals with Lymphedema are unaware of simple self-management
practices, or
the
availability of effective tools to combat the disease including compression
garments and manual
lymphatic
drainage therapy. “To further compound this problem, proper Lymphedema
education and
therapy
is often unavailable or too costly for individuals with limited financial
resources” says Clinic
Director
Lindsay Davey, “as a consequence, patients with Lymphedema tend to withdraw
from normal
activities
due to discomfort, physical restrictions, or embarrassment”.
To
combat the lack of awareness and treatment of Lymphedema, Toronto Physiotherapy
is developing
educational
tools including online resources and self-management video
(http://www.torontophysiotherapy.ca/services/toronto_lymphedema_treatment.html),
as well as offering
Certified
Lymphedema Physiotherapy services including a complimentary service for
individuals with
limited
financial resources.
To
assist low-income individuals, Toronto Physiotherapy provides a complimentary
assessment of the
patient's
Lymphedema case history, as well as education on effective self-management
techniques and
other
treatment options available including the suitability of compression garments.
Toronto Physiotherapy
is
also a Certified Compression Garment Authorizer through the Government of
Ontario’s Assistive
Devices
Program (ADP), and can recommend and authorize therapeutic garments to
Lymphedema
patients
so that they can access the ADP subsidization.
About
Toronto Physiotherapy
Toronto
Physiotherapy (http://www.torontophysiotherapy.ca) is a leading Toronto-based
provider of allied
health
care services including traditional Orthopedic Physiotherapy and Massage
Therapy, as well as a
suite
of specialized services that includes Neurological Physiotherapy, Nutrition
Counseling, Acupuncture,
Manual
Lymphatic Drainage and Home Care Physiotherapy. Toronto Physiotherapy is
certified in
Combined
Decongestive Therapy for Lymphedema and is also a Certified Compression
Garment
Authorizer.
Contact:
Lindsay
Davey
Clinic
Director
416-792-5115
741
Broadview Ave., Suite 206
Toronto,
Ontario, Canada, M4K 3Y3
[email protected]
http://www.torontophysiotherapy.ca
February
9, 2011 - Will Treatment For Early-Stage Breast Cancer Change? - Wall Street
Journal (blog) -
By
Katherine Hobson –
New
research published in the Journal of the American Medical Association — on top
of previous studies
—
should change how certain early-stage breast cancer patients are treated, the
New York Times reports.
The
study subjects were breast cancer patients with early-stage tumors and cancer
in one or two lymph
nodes
in the armpits but no further spread. These women were treated with a
lumpectomy followed by
radiation
and chemo or other drug treatment. (About 20% of breast cancer patients fit
that bill, the NYT
says.)
The study found that these patients don’t benefit from having the cancerous
lymph nodes — as well
as
others — removed (beyond the initial biopsy, that is).
Given
the breast surgery and other treatments, you might think that taking out a few
lymph nodes is no big
deal,
but that’s not true. There can be painful complications, including lymphedema,
a debilitating swelling
of
the arm. An author of an editorial accompanying the study tells the paper that
he has a feeling “we’ve
been
doing a lot of harm” by taking out so many nodes as a matter of
course.
But
the story raises the question of how quickly surgeons will change their
practice. The paper says
Memorial
Sloan-Kettering Cancer Center changed its own guidelines already, based on an
early peek at
this
study, but that “more widespread change may take time, experts say, because the
belief in removing
nodes
is so deeply ingrained.”
A
study author and Sloan-Kettering physician tells the NYT that it’s much easier
for doctors and patients
to
accept a study pointing to an increase in cancer treatment rather than a
decrease.
February
9, 2011 - Consults: Q. & A.: Breast Cancer and Lymph Nodes - New York Times
(blog) –
An
article in Wednesday’s Times describes how a routine procedure for the
treatment of early breast
cancer
— the surgical removal of cancerous lymph nodes from the armpit — has been found
unnecessary
for
many patients. The finding turns 100 years of standard medical practice on its
head.
Today
the author of the article, Denise Grady, is taking questions about the finding
and its implications.
Please
post your questions in the Comments box below.
Q.From
what I understand, removing even only one or two lymph nodes can result in
chronic swelling of
the
arm. How certain is it that taking fewer nodes will result in a measurable
reduction in the risk of
developing
lymphedema?
—
Claudia Boyle, Mount Prospect, Ill.
A.There
is still a risk of lymphedema even after only a few nodes are taken for
sentinel biopsy, but the risk
is
much lower than when many nodes are removed.
Q.Is
there any information on the advisability of not doing the lymph node removal
for women who had a
mastectomy,
chemotherapy and radiation rather than lumpectomy?
—
Donna Landerman, Bloomfield, Conn.
A.The
results apply to women whose condition is like those in the study: stage T1 or
T2 tumors (less than
two
inches across), no palpable lymph nodes, no metastases to other parts of the
body and no more than
two
positive lymph nodes on the sentinel node biopsy. A woman with these
characteristics who is having a
mastectomy
and the other treatments would seem to fit the bill, but the ultimate decision
has to be made
with
a surgeon and an oncologist.
Q.My
breast surgeon told me that lymph node ratio is also important, and I’ve seen
studies to support it.
They’ve
shown that a person who has 1 positive lymph node out of 20 removed does better
than a person
who
had 1 out of 5 who does better than the person who had 1 out of 1. This implies
that that there is
some
survival benefit to the patient who has more nodes removed. Can you find out
from your sources:
what
about the studies that show that lymph node ratio is important? Does this new
study trump them, and
if
so why? Also, what about the length of follow-up in this study?
Breast
cancer can recur at any time — even 25 years after initial diagnosis. I’m very
glad for all these
treatments
that improve 5-year survival rates, but are they just pushing back our relapses
to a later date? If
so,
the results of this study may be premature. Are they planning to continue
following-up on these patients?
—
Breast Cancer Patient, NYC
A.There
is evidence that a higher number of positive nodes is associated with a worse
outcome, because it
may
mean that the cancer is more advanced or spreading more quickly. In the past,
the number was used
to
help plan what kind of chemotherapy to give. But the doctors interviewed for
the article published on
Wednesday
said that in most cases nowadays, the number of lymph nodes does not determine
the
treatment.
Women with any positive nodes are advised to have chemotherapy or
hormone-blocking
treatment,
or both, and the chemotherapy is the same regardless of the number of
nodes.
As
the article states, the researchers considered the follow-up time long enough
to detect a difference in
local
cancer recurrence rates, meaning in the armpit, because those tend to occur
fairly early. There was no
difference.
A local recurrence is not trivial: It would require more treatment, and 20 to
25 percent of
women
who have local recurrences ultimately die from the cancer.
It
is true that cancer can return at any time. More follow-up time would be more
reassuring. I don’t know
whether
there will be continuing follow-up of these women, but I will ask and post the
answer.
Q.My
niece has Stage 3C melanoma. She recently had a number of lymph nodes removed.
She originally
had
two nodes removed that were diagnosed as positive. Thereafter, she had
additional nodes removed
that
were negative. Does the data you’ve written about, as it pertains to lymph
nodes, translate to specific
cancers
other than breast cancer?
—
Dave Collopy, Hilo, Hawaii
A.No,
the data really applies only to patients with breast cancer, and only to breast
cancer patients like the
women
in the study.
Q.I
am curious about your opinion of reaching a negative conclusion based on a
statistical sample. First of
all,
the type of error that may be associated with such a conclusion — i.e. that
there is in fact a difference
that
was not detected — is typically not controlled and therefore can float to
unknown values.
Second,
there is little discussion in the newspapers about the fact that your or any
metanalysis is no more a
guarantee
than any initial study, but merely a statistical evaluation of the likelihood
of having detected (or
not
detected) a real effect.
—
Dr. S, Valhalla, N.Y.
A.The
New York Times did not reach a conclusion. We are reporting the conclusion that
the authors of a
peer-reviewed
journal article reached, that the editorialist in the journal supported, and
that cancer centers
are
already putting into practice. We did ask two independent experts on medical
statistics at two different
universities
to evaluate the study. They had some quibbles, but nothing serious enough to
throw the findings
into question. This was not the first study in this area; there have been others in the past, all pointing in the
same
direction — to the idea that at least some patients can be spared axillary
dissection and the serious
complications
that it can cause.
Q.I
have not seen raised in this discussion the issue of genetic findings related
to the familial propensity for
breast
cancer if that diagnosis is a part of the clinical picture. How are suspected
lymphatic involvement
and
possible surgical intervention influenced by genetic findings? Thank
you.
—
MJM, Shenandoah Valley, Va.
A.We
asked this question of Dr. Monica Morrow, an author of the study and chief of
the breast service at
Memorial
Sloan-Kettering Cancer Center in Manhattan. Her reply:
Genetic
breast cancer doesn’t influence how we treat the nodes. Due to the increased
risk of second
breast
cancers, many of these women chose mastectomy. Women with mastectomy require
axillary
dissection
if the nodes are involved.
Q.Surgeons
have been removing lymph nodes from the armpits of breast cancer patients for
100 years.
Why
has it taken so long to find out that not every patient needs this
surgery?
A.The
procedure is a holdover from the era of the radical mastectomy, before
radiation treatment and
chemotherapy
existed and when the only hope for controlling cancer was to try to cut it all
out. Removing
lymph
nodes became part of the standard of care, because the nodes might harbor
cancer cells that could
spread
around the body.
Before
the sentinel node technique was developed, there was no way to find which nodes
were most likely
to
be the ones where cancer cells would land; to be on the safe side, the only
thing surgeons could do was
to
take out as many nodes as possible. Women suffered from side effects, like
lymphedema, that could be
severe,
but the prospect of a cancer recurrence was worse, so doctors and patients
alike were afraid of
what
would happen if the nodes were not removed. Only when it became apparent that
the sentinel node
biopsy
was reliable did it become possible to ask the next question: If just one or
two nodes are positive,
do
they all have to come out? The answer seems to be no.
Part
of what makes it possible to leave the nodes alone is that there are now more
effective combinations
of
chemotherapy and radiation, which can wipe out microscopic traces of disease
that might be left behind.
Q.Which
women still need to have their lymph nodes dissected?
A.Surgeons
say that the lymph nodes must come out if they are big enough to feel or show
up as cancerous
on
imaging. Surgeons will also remove nodes if there are three or more positive
sentinel lymph nodes
(sentinel
lymph node biopsy is described in the article).
Surprises
can also turn up in the operating room, doctors say. Occasionally, the sentinel
node biopsy will
give
a false-negative result, which means failing to find cancer even though it is
present. That can happen if,
for
instance, the sentinel node is very cancerous and the lymphatic vessels that
feed it are choked off and
do
not pick up the dye. Then, the dye may go to a different node, one that does
not have cancer. Knowing
this
is possible — and knowing that the sentinel node biopsy, though highly
reliable, is not infallible —
surgeons
look and feel around in the armpit carefully during the operation and make
judgment calls about
what
to remove and what to leave alone.
Q.Why
are the study findings said to apply only to women who have whole-breast
irradiation, and not
partial
breast irradiation?
A.Whole-breast
irradiation hits part of the armpit, and therefore some of the lymph nodes.
This is what the
women
in the study received, and researchers think it may have wiped out any cancer
in the nodes that
were
left behind. They say they are also unsure about whether the findings would
apply to women who
have
irradiation while lying prone, on their stomachs. In that position, the
radiation may not reach the armpit.
Q.The
study findings apply to 20 percent of patients — about 40,000 women a year in
the United States,
according
to your article. What about the other 80 percent?
–
Brandon, Berkeley, Calif.
A.Here
is a further explanation: First of all, 20 percent (the estimate of the study’s
lead author, Dr.
Armando
E. Giuliano) refers to 20 percent of all the newly diagnosed cases of invasive
breast cancer each
year.
This does not include noninvasive breast cancer, or DCIS, ductal carcinoma in
situ. The total is about
207,000,
so 20 percent is roughly 40,000 women. That is about how many women would match
those in
the
study, in terms of tumor status, affected lymph nodes and course of
treatment.
To
answer the question about the other 80 percent, we need to look at how many
women get a breast
cancer
diagnosis at various stages. The figures from the American Cancer Society
indicate that 60 percent
of
all patients have “localized” breast cancer. That means they do not have
affected lymph nodes. They do
not
have to worry about extensive axillary dissection, as lymph node removal is
known; their sentinel node
will
be clean. Another 33 percent of women have “regional” disease, meaning that the
cancer has reached
lymph
nodes. These are the patients who might match those in the study.
By
Dr. Giuliano’s estimate, about two-thirds of these women will match the study
criteria, and one-third
will
not, so for that one-third, about 10 percent of breast cancer patients over
all, node dissection may be
needed.
Another 5 percent of all patients have “distant” disease at the time of
diagnosis, meaning the
cancer
has already spread to organs or bones. I don’t know if lymph node surgery is of
use or benefit to
women
whose disease is already advanced. In the remaining 2 percent of cases, the
stage of the disease at
diagnosis
is not known.
February
9, 2011 - Lymphedema Awareness Day is March 6th - Wire Service Canada (press
release) –
by
LymphedemaDepot –
The
17th annual Lymphedema Awareness Day will be observed across Canada and the US
on March 6,
2011.
Lymphedema is a condition of chronic swelling that affects a limb or other body
part due to an
accumulation
of lymph fluid.
Lymphedema
Depot, the importer and distributor of Solaris lymphedema care products in
Canada, is
helping
to promote Lymphedema Awareness Day this year.
February,
2011--- Lymphedema Awareness Day will be observed across Canada and the US on
March
6,
2011. Lymphedema Awareness Day is meant to bring public attention to this
medical condition.
Lymphedema
Depot, the importer and distributor of Solaris lymphedema care products in
Canada, is
helping
to promote Lymphedema Awareness Day this year.
“As
a therapist and clinician, I have been in a position to hear from patients
firsthand how frustrating it is to
try
to get treated for lymphedema,” says Lymphedema Depot Clinical Specialist John
Mulligan, a
Registered
Massage Therapist and Certified Lymphedema Therapist.
“Lymphedema
is diagnosed more than it used to be, but it is still under-treated. There are
not enough
practicing
lymphedema therapists,” said Mulligan. “I would hope that with increased public
awareness of
lymphedema
more therapists would be moved to get trained in lymphedema therapy. It is a
fascinating
field.”
Lymphedema
is a condition of chronic swelling that affects a limb or other body part due
to an
accumulation
of lymph fluid. You can be born with lymphedema or it can be acquired after a
traumatic
injury,
severe infection or surgical removal of lymph nodes. Lymph nodes are often
removed for the staging
of
cancer, to determine if cancer cells are spreading to the lymph system. In
sub-tropical countries
lymphedema
can be acquired from parasites.
Lymphedema
is not curable, but it can be managed through a blend of therapy techniques
that do not
involve
surgery or drugs.
In
North America, lymphedema has become known as the most-feared complication of
cancer, and yet
those
who fear it know very little about it. Lymphedema Awareness Day is a chance to
share information
about
lymphedema, clearing away some of the mystery and helping to raise awareness of
the condition and
the
need for effective treatment, funding for treatment and further
research.
In
Germany lymphedema treatment became reimbursable by national health insurance
in 1974, based on
research
done throughout the 1960’s by Dr. Johannes Asdonk and others. The treatment for
lymphedema
is
called Complex Decongestive Therapy and consists of manual lymph drainage,
multi-layer compression
bandaging,
exercise and meticulous skin care. In Canada, Complex Decongestive Therapy is
not
reimbursable
by any private, federal or provincial funding source, although separate aspects
of the protocol
can
be reimbursable on their own.
This
lack of comprehensive reimbursement causes real hardship to many lymphedema
patients. This is a
condition
that involves expert treatment, with costs being incurred by the need for
hands-on therapy and
education.
The patient requires hundreds of dollars’ worth of compression bandaging
supplies in addition
to
compression garments for day and night use. Without comprehensive coverage for
therapy the patient
must
seek funding for each aspect of lymphedema care separately, and often they must
pay for some parts
of
this complex therapy out of their own pockets.
In
Canada lymphedema patients must navigate a patchwork of payment sources in
order to obtain therapy.
These
payment sources are typically a mix of third party health insurance and cash
out of the patient’s own
pocket.
Patients without health insurance or the means to pay privately will simply not
get the therapy they
need.
This means living with a progressively swelling limb. Untreated lymphedema
leads to an increased
risk
of cellulitis infections, the most serious and common of lymphedema
complications. The cost of treating
patients
with these infections can be greater than the cost of proper, timely
treatment.
In
observance of Lymphedema Awareness Day on March 6, 2011, we encourage you to
print this article
and
give copies to your doctor, friends, MP or anybody who might be interested in
the treatment of
lymphedema
and associated costs and risks.
To
learn more about lymphedema, see the Lymphedema Depot’s page of links, a
clickable list of
lymphedema
resources: http://www.lymphedemadepot.com/links
To
learn more about Lymphedema Awareness Day please visit our website at
http://www.
lymphedemadepot.com
and click on the Lymphedema Awareness Day logo.
To
contact Lymphedema Depot directly email [email protected]
February
10, 2011 - health calendar - Washington Post –
Tina,
this is announcing stuff that has now happened, sorry
February
10, 2011 - Cancer Treatment: Breast Cancer Surgery Could Become Less Invasive –
ThirdAge
–
By Nina Sen –
Breast
cancer treatment could become less invasive, according to a new
study.
According
to a new study published in the Journal of American Medical Association, some
women may
not
need to have a painful procedure called axillary lymph node dissection. This
procedure aims to remove
nodes
around tumors that could also be cancerous. However, it is often painful and
could cause infection
or
lymphedema.
“Women
really dread the axillary dissection,” said chief investigator Dr. Giuliano,
head of surgical oncology
at
the John Wayne Cancer Institute at St. John’s Health Center in Santa Monica,
Calif., according to the
New
York Times. “They fear lymphedema. There’s numbness, shoulder pain, and some
have limitation of
motion.
There are a fair number of serious complications. Women know it.”
The
study examined more than 800 patients with early-stage tumors. All the patients
had only part of their
breast
removed in a lumpectomy. Additionally, they had radiation therapy and some had
chemotherapy.
February
10, 2011 - Pharmacy boutique focuses on needs of breast-cancer patients –
ModernMedicine -
By:
Christine Blank –
An
independent drugstore recently expanded its boutique section for breast-cancer
patients to include a
wide
variety of medical products and clothing.
Lehan
Drugs and Home Medical Equipment in DeKalb, Ill., now includes a
2,500-square-foot Women's
Health
Department and Boutique that boasts 3 private dressing rooms and 3 certified
lymphedema garment
fitters.
The
Lehan family, which includes owners Tim and Ann Lehan; their daughter-in-law
and pharmacist son;
Tim's
brother, Patrick; and his sister, Terri Lehan Hettel, first added women's
health products to the drug-
and
medical-equipment store 7 or 8 years ago, after cancer patients visiting the
store asked for
lymphedema
compression socks. "We wanted to be certified fitters in lymphedema garments,
and it
became
obvious to us that we needed to start looking into being a mastectomy fitter,"
said Lehan Hettel,
who
manages the store. Many specialized products followed.
Today's
expanded Women's Health Department and Boutique features products for all
women. "We do
bra
fittings for everyone, and we have everything from 'hot flash pajamas' to
scarves to hats with built-in
sun
protection," Lehan Hettel said.
More
than 90 area doctors refer their breast-cancer patients to Lehan's. And because
it is the only
drugstore
in the community to offer this service, new patients consistently seek out
Lehan Drugs.
February
10, 2011 - New Breast Cancer Treatment: Don't Remove Lymph Nodes – NewsTabulous
–
posted
by Mary –
For
years if you had breast cancer, then doctors would remove your lymph nodes
which can cause
extreme
swelling, pain, and even Lymphedema. New studies show that in early stages of
breast cancer the
lymph
nodes do not have to be removed.
This
may come as a shock to most women and families. Before this discover, when ever
you were thought
to
have breast cancer the doctors would take a sample of the sentinel lymph nodes.
These are the first
nodes
that they find in the channel of lymph nodes, and then test them to see if they
were positive or
negative
for cancer. If you were positive they would just remove all of the lymph
nodes.
This
was thought to be the best way to help to prevent the spread of the disease
into other parts of the
body
including the liver and brain. New studies show that if you are in the early
stages of breast cancer
and
your tumor isn’t more than 1 1/2 – 2 cm, then you don’t have to have these
lymph nodes removed.
The
reason, Dr. Cynara Coomer, says: “it doesn’t effect survival rates or
reoccurrance rates” and it “doesn’
t
help cure breast cancer”. Dr. Cynara Coomer, says that this is only for about
20% of women with breast
cancer.
It’s important to catch the cancer in the early stages, have a small tumor, and
minimal disease in
sentinel
lymph nodes.
Women
who have been diagnosed with breast cancer still need radiation and chemo
treatment.
Dr.
Cynara Coomer, is a Fox News medical contributor who is fighting thyroid cancer
and is undergoing
Radioactive
Iodine Treatments and is playing a big part in these new findings and in
getting the word out.
It’s
estimated that 207,000 women were diagnosed with breast cancer in 2010 and that
there is 2.5 million
breast
cancer survivors living in the United States alone. About 1 in 4 cancers are
breast cancer. This will
be
a nice alternative for many breast cancer patients that are looking for an
alternative breast cancer
treatment.
February
11, 2011 - New Study Supports Less Surgery for Breast Cancer - Huffington Post
(blog) – by
Dr. Elaine
Schattner –
A
new report in the Journal of the American Medical Association may influence --
and reduce -- surgical
treatment
for many women diagnosed with breast cancer. The key finding is that for women
with
apparently
limited disease before lumpectomy and what's called a positive sentinel node,
taking out all the
cancerous
nodes from the axilla (armpit) has no survival advantage after five
years.
I've
reviewed the study in more detail, elsewhere. It's got a lot of strengths: it's
randomized, Phase III and
multi-institutional
-- meaning that the trial was carried out by many surgeons caring for patients
at a variety
of
medical centers. In total, 891 women were enrolled, all of whom had clinically
small tumors and a
positive
sentinel node. Half of the patients underwent complete axillary lymph node
dissection; the others
did
not. Nearly all got chemotherapy; some received endocrine treatments.
What
the researchers found is that removing additional glands didn't improve
survival in women who had
positive
(involved) sentinel nodes upon lumpectomy. This finding supports that for
breast cancer patients
with
small tumors who will undergo radiation and chemotherapy, it's OK for surgeons
to leave malignant
lymph
nodes in place rather than remove those by more aggressive surgery.
Why
this matters:
For
women with apparently limited (stage I or II) breast cancer at the time of
diagnosis, approximately 20
percent
will turn to have a positive lymph node. Up until now, the usual care of those
patients has included
a
complete axillary lymph node dissection. During that part of surgery, typically
10 to 25 lymph nodes are
removed.
This procedure can lead to lymphedema, a condition of chronic arm and hand
swelling that can
be
painful and disabling.
Lymphedema
affects a small but significant fraction of the growing ranks of women
--approaching 3 million
in
the U.S. -- who are alive after breast cancer treatment. So if the axillary
lymph node dissection can be
eliminated
from the standard breast cancer surgery process, that would spare a lot of
women from an
uncomfortable,
compromising situation.
The
implications bear on costs and risks of breast cancer care, apart from the
lymphedema effects. There
would
be less time in the O.R. and reduced costs of pathology (think of examining one
lymph node instead
of
20 in 100,000 to 200,000 surgeries per year in the U.S.). There'd be less time
under anesthesia. With
fewer
lymph nodes removed, the risk of infection in a woman's hand or arm
diminishes.
An
irresistible aside to this story is that the findings should lessen the "costs"
side of any mammography
equation:
With the application of these results, expenses and potential complications of
breast cancer
treatment
will be reduced.
Why
aren't the results surprising?
Breast
cancer treatment, and our understanding of breast cancer biology, has advanced
steadily in the past
25
years. Now it's routine to give treatments -- like chemotherapy, hormone
modulators or antibodies like
Herceptin
-- that target breast cancer cells wherever they reside in the body. The whole
point of adjuvant
therapy
is to destroy malignant cells remaining after surgery. If there are residual
lymph nodes with
malignant
cells in the armpit region after surgery, those would likely be destroyed by
chemotherapy and
other
treatments, combined with radiation to the affected chest and underarm
area.
What
are the study's limitations?
What's
not adequately addressed in the paper and editorial, I think, is the situation
of women who undergo
mastectomy
and don't get radiation to the region, as is standard after lumpectomy. As much
as I'm drawn
to
the "less is more" approach to cancer therapy, I don't know that we can
extrapolate these data to the
circumstances
of women who don't get radiation.
Another
limitation is the study's relatively short follow-up of just over five years.
This is a valid concern in
any
study of breast cancer survival, but my own opinion is that the axillary node
intervention is unlikely to
result
in a big difference later. That's because in 2011 what matters most for
treatment decisions in breast
cancer,
after diagnosis and initial surgery, is the nature -- in terms of genetic and
molecular features -- of
the
malignant cells.
General
implications:
When
I studied oncology, the dogma was that the prognosis in breast cancer rests on
the size of the tumor
and
the number of lymph nodes involved. But that was 20 years ago. Now we know that
tumor markers --
if
the cells express estrogen or progesterone receptors, HER2, as well as other
factors including genetic
mutations
that affect the malignant cells's aggressiveness and responsiveness to
treatment -- are at least as
important
in determining outcome. So although some physicians will express concern that
we need the full
lymph
node pathology results to establish the prognosis and formulate treatment
recommendations, I think
in
2011 we can do better using molecular, modern predictors of disease
responsiveness.
Finally,
there's a suggestion in some of the coverage that doctors and patients may have
a hard time
accepting
"less" as better treatment for this disease. I don't really think that's the
case anymore, at least not
for
patients. From my experiences as an oncologist, as a breast cancer patient and
knowing so many
women
who've undergone debilitating treatments, I expect most patients will accept
this development as
progress
and a sound reason to avoid extra surgery. It may be the physicians who need be
persuaded that
taking
out all the lymph nodes does not improve a breast cancer patient's
prognosis.
Toronto
Physiotherapy, a leading provider of healthcare in Toronto, is providing free
Lymphedema
services
to individuals in financial need, and offering on-line education resources to
promote disease
awareness.
Toronto,
Canada, February 11, 2011 --(PR.com)-- Lymphedema is a serious condition caused
by a
failure
of the lymphatic system to maintain the proper balance of fluid in an affected
tissue. The resultant
accumulation
of lymphatic fluid, usually in an arm or leg, can be painful, disabling, and
disfiguring. In
extreme
cases, Lymphedema can lead to serious infection or even a rare form of cancer
called
lymphangiosarcoma.
Lymphedema frequently arises in cancer patients (in particular breast cancer)
following
surgical lymph node removal or radiation treatment, but can also occur
congenitally. Although
Lymphedema
is a chronic disease, with proper symptom management and prevention individuals
with
Lymphedema
can enjoy a normal and active lifestyle.
Unfortunately,
many individuals with Lymphedema are unaware of simple self-management
practices, or
the
availability of effective tools to combat the disease including compression
garments and manual
lymphatic
drainage therapy. “To further compound this problem, proper Lymphedema
education and
therapy
is often unavailable or too costly for individuals with limited financial
resources,” says Clinic
Director
Lindsay Davey, “as a consequence, patients with Lymphedema tend to withdraw
from normal
activities
due to discomfort, physical restrictions, or embarrassment.”
To combat the
lack of awareness and treatment of Lymphedema, Toronto Physiotherapy is
developing
educational
tools including online resources and self-management video
(http://www.torontophysiotherapy.
ca/services/toronto_lymphedema_treatment.html),
as well as offering Certified Lymphedema Physiotherapy
services
including a complimentary service for individuals with limited financial
resources.
To
assist low-income individuals, Toronto Physiotherapy provides a complimentary
assessment of the
patient's
Lymphedema case history, as well as education on effective self-management
techniques and
other
treatment options available including the suitability of compression garments.
Toronto Physiotherapy
is
also a Certified Compression Garment Authorizer through the Government of
Ontario’s Assistive
Devices
Program (ADP), and can recommend and authorize therapeutic garments to
Lymphedema
patients
so that they can access the ADP subsidization.
About
Toronto Physiotherapy
Toronto
Physiotherapy (http://www.torontophysiotherapy.ca) is a leading Toronto-based
provider of allied
health
care services including traditional Orthopedic Physiotherapy and Massage
Therapy, as well as a
suite
of specialized services that includes Neurological Physiotherapy, Nutrition
Counseling, Acupuncture,
Manual
Lymphatic Drainage and Home Care Physiotherapy. Toronto Physiotherapy is
certified in
Combined
Decongestive Therapy for Lymphedema and is also a Certified Compression
Garment
Authorizer.
Contact:
Lindsay
Davey
Clinic
Director
416-792-5115
741
Broadview Ave., Suite 206
Toronto,
Ontario, Canada, M4K 3Y3
[email protected]
http://www.torontophysiotherapy.ca
February
12, 2011 - Cape docs: Aggressive breast cancer surgery likely reduced – TMCnet
–
Feb
12, 2011 (Cape Cod Times - McClatchy-Tribune Information Services via COMTEX)
-- Doctors
expect
a decline in the number of Cape patients who undergo extensive lymph node
removal to combat
early-stage
breast cancer, following a new study on the efficacy of the surgery.
The
study, which appeared Wednesday in the Journal of the American Medical
Association, said there
was
virtually no difference in the survival rates of early-stage breast cancer
patients who had all their lymph
nodes
removed and those who had only a few nodes removed.
"We
kind of knew it was coming," said Dr. David Lovett, a medical oncologist at the
Davenport-Mugar
Cancer
Center at Cape Cod Hospital.
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"We
were probably doing too much surgery on folks with breast cancer," he
said.
Annually,
about 75 out of 300 newly diagnosed breast cancer patients at Cape Cod Hospital
have a
procedure
called axillary lymph node dissection, which removes all the lymph nodes found
in the armpit,
said
Dr. Robyn Sachs, breast surgeon at the Hyannis hospital.
She
expects that number to go down by about 50 patients because the new study shows
the benefits of
less
radical surgery.
Researchers
studied women who had undergone a lumpectomy to remove a breast cancer tumor as
well as
radiation
and, in some cases, chemotherapy.
By
removing a few lymph nodes through a process called sentinel lymph node
dissection they identified
890
women whose cancer had spread to one or two "sentinel" nodes, to which fluid
first drains from the
breast.
Of
these women nearly half -- 446 -- were randomly selected to receive the more
extensive axillary
surgery.
After
following the women for just more than six years, researchers found mortality
and five-year survival
rates
were virtually the same in both groups of women, as was the rate at which women
were disease-free
after
five years. But those who experienced the more radical surgery had higher rates
of swelling, called
lymphedema,
as well as tingling, numbness, pain and wound infection.
The
complication rate was 25 percent among those who'd just had a few nodes removed
but 70 percent
among
axillary patients.
"This
leaves patients with all kinds of problems," Nancy Ferzoco, breast care nurse
at Falmouth Hospital,
said
of the more radical surgery.
Lymphedema
can become a lifelong issue, she said. "It's painful. The arm can swell up to
three times its
normal
size," requiring breast cancer survivors to wear a special compression
sleeve.
Women
have 10 to 40 lymph nodes under their armpits. Balls of fluid the size of an
orange, called seromas,
also
can collect under the armpit and need to be aspirated, Ferzoco said.
Some
patients complain for years about damage to sensory nerves, she said.
Now,
the standard practice of going after all or most of the lymph nodes after
getting a positive cancer
reading
on one node will end, Lovett said.
Most
of the time, the cancer in one or two "simple" sentinel nodes has not spread,
Sachs said. She said that
patients
with aggressive tumors and a large amount of disease in the surrounding lymph
nodes will still need
the
axillary procedure.
The
new information is part of the evolutionary refinement of breast cancer
treatment, which has gone from
mastectomy
as the mainstay of treatment to the less invasive use of lumpectomy, Lovett
said.
Some
patients may need a measure of convincing that the less radical treatment is
just as good.
Jane
Mullenhour of Mashpee had a double mastectomy and 17 lymph nodes removed from
the area
around
her right breast five years ago and says she is happy with that
decision.
"How
do they know if it has gone into the lymph nodes if they don't take the lymph
nodes?" she asked,
adding
that she insisted on early treatment for her lymphedema symptoms.
"I
would rather be safe than sorry." To see more of the Cape Cod Times, or to
subscribe to the
newspaper,
go to http://www.capecodonline.com. Copyright (c) 2011, Cape Cod Times,
Hyannis, Mass
February
12, 2011 - Strength training does more than bulk up muscles - Los Angeles Times
– By Jeannine
Stein
–
It
may reduce depression, give older people better cognitive function, boost good
cholesterol and more.
Strength
training has strong-armed its way beyond the realm of bodybuilding.
A
growing body of research shows that working out with weights has health
benefits beyond simply bulking
up
one's muscles and strengthening bones. Studies are finding that more lean
muscle mass may allow
kidney
dialysis patients to live longer, give older people better cognitive function,
reduce depression, boost
good
cholesterol, lessen the swelling and discomfort of lymphedema after breast
cancer and help lower the
risk
of diabetes.
"Muscle
is our largest metabolically active organ, and that's the backdrop that people
usually forget," said
Kent
Adams, director of the exercise physiology lab at Cal State Monterey Bay.
Strengthening the muscles
"has
a ripple effect throughout the body on things like metabolic syndrome and
obesity."
Historically,
strength training was limited to athletes, but in the last 20 years, its
popularity has spread to the
general
public, said Jeffrey Potteiger, an exercise physiologist at Grand Valley State
University in Grand
Rapids,
Mich., and a fellow of the American College of Sports Medicine. "One can argue
that if you don't
do
some resistance training through your lifespan, you're missing out on some
benefits, especially as you get
older
or battle weight gain," he said.
When
we hit middle age, muscle mass gradually diminishes by up to about 1% a year in
a process called
sarcopenia.
Women also are in danger of losing bone mass as they age, especially after the
onset of
menopause.
Some studies have shown that moderate to intense strength training not only
builds skeletal
muscle
but increases bone density as well.
Strength
training often takes a back seat to cardiovascular training, but it can benefit
the heart in ways that
its
more popular cousin can't.
During
cardio exercise, the heart loads up with blood and pumps it out to the rest of
the body: As a result,
Potteiger
said, "the heart gets better and more efficient at pumping."
But
during resistance training, muscles generate more force than they do during
endurance exercises, and
the
heart is no exception, Potteiger said. During a strength workout, the heart's
muscle tissue contracts
forcefully
to push the blood out. Like all muscles, stress causes small tears in the
muscle fibers. When the
body
repairs those tears, muscles grow. The result is a stronger heart, not just one
that's more efficient at
pumping.
Another
big advantage of working out with weights is improving glucose metabolism,
which can reduce the
risk
of diabetes. Strength training boosts the number of proteins that take glucose
out of the blood and
transport
it into the skeletal muscle, giving the muscles more energy and lowering
overall blood-glucose
levels.
"If
you have uncontrolled glucose levels," Potteiger said, "that can lead to kidney
damage, damage to the
circulatory
system and loss of eyesight."
The
benefits don't end there. A 2010 study in the Clinical Journal of the American
Society of Nephrology
suggested
that people on dialysis can benefit from building muscle. Researchers found
that kidney dialysis
patients
who had the most lean muscle mass — a measurement derived from the
circumference of the mid-
arm
muscle — were 37% less likely to die than the patients who had the
least.
"This
is something that has an impact on survival," said Dr. Kamyar Kalantar-Zadeh, a
principal researcher
at
the Los Angeles Biomedical Research Institute and coauthor of the study. "It's
not just about having
more
muscle and looking better — we're talking about life and death."
Even
people who already have chronic kidney disease could benefit from strength
workouts. Germany
began
to incorporate modified exercise equipment into dialysis treatment centers in
1995, and a 2004
study
in the American Journal of Kidney Diseases examining that policy found that
exercise may improve
the
efficiency of dialysis by increasing blood flow through the muscle and
improving phosphate removal.
The
brain may get a boost from the body's extra muscle as well. A 2010 study in
Archives of Internal
Medicine found
that women ages 65 to 75 who did resistance training sessions once or twice a
week over
the
course of a year improved their cognitive performance, while those who focused
on balance and tone
training
declined slightly. One reason for the improvement, researchers believe, may be
that strength
training
triggers the production of a protein beneficial for brain growth.
This
study was triggered by another that looked at resistance training as a way to
reduce the risk of falls in
older
people, said coauthor Teresa Liu-Ambrose, a researcher at the University of
British Columbia's
Centre
for Hip Health and Mobility in Vancouver. As the study progressed, she said she
noticed that
participants
"were able to take on new tasks, like taking the bus by themselves. They were
able to prepare
and
plan for things and execute them."
Strength
training could be easier for people with mobility problems who might find it
easier to navigate a
stationary
weight than a moving treadmill.
"It's
never too late to start," Adams said. "The benefits are great."
February
13, 2011 - Women With Early Breast Cancer May Not Need Surgery - Care2.com
(blog) -
posted
by: Amelia Thomson-DeVeaux –
According
to new research findings, many early breast cancer patients won't have to have
the painful lymph
node
removal surgery that has, for over a century, been routine. This was because
the women in the study
had
chemotherapy and radiation, which most likely removed disease from the nodes,
despite the previous
assumption
that once these nodes are cancerous, they have the potential to spread to vital
organs and can
only
be removed by surgery.
According
to the new results, does not improve the patient's chance of survival or
decrease the likelihood
that
the cancer will return. And the surgery has significant complications, like
infection and lymphedema, a
chronic
swelling in the arm. It's not clear, though, whether the results are the same
for women who don't
have
chemotherapy or radiation.
The
study is especially newsworthy because it should change medical practice for
many patients. And it
may
take a while for doctors and patients to adjust to the idea that surgery is not
the best option. "This is
such
a radical change in thought that it’s been hard for many people to get their
heads around it,” said Dr.
Monica
Morrow, one of the study's authors. According to her, people find it easier to
accept the idea of
more
treatment instead of less, even if the data supports decreased
intervention.
In
the New York Times, Denise Grady points out the recent trend toward less
invasive treatments for
breast
cancer; mastectomy rates have dropped since the 1980's, and doctors now remove
large, dense
tumors
while using radiation to destroy smaller traces of the disease.
Although
it's good that doctors are responding well to the new research, this is a
reminder that medical
authority
is not infallible. That's why it's so crucial that studies like this continue,
and that we don't
unquestioningly
accept doctors' advice. One study co-author admitted that, by removing large
numbers of
nodes,
"I have a feeling we’ve been doing a lot of harm." And it does seem that if
women have been
having
these surgeries unnecessarily, they suffered through infection and lymphedema,
in addition to
chemotherapy
and radiation, for nothing. But we can't expect medicine to be perfect. And
so in that
sense,
a study like this is ultimately encouraging, if it means that women in the
future will be spared a painful
surgery.
February
13, 2011 -Toronto Physiotherapy Promotes Awareness, Education, and Treatment of
Chronic
swelling
called Lymphedema - PR-USA.net (press release)
Lymphedema
is a serious condition caused by a failure of the lymphatic system to maintain
the proper
balance
of fluid in an affected tissue. The resultant accumulation of lymphatic fluid,
usually in an arm or leg,
can
be painful, disabling, and disfiguring. In extreme cases, Lymphedema can lead
to serious infection or
even
a rare form of cancer called lymphangiosarcoma. Lymphedema frequently arises in
cancer patients (in
particular
breast cancer) following surgical lymph node removal or radiation treatment,
but can also occur
congenitally.
Although Lymphedema is a chronic disease, with proper symptom management and
prevention
individuals with Lymphedema can enjoy a normal and active lifestyle.
Unfortunately,
many individuals with Lymphedema are unaware of simple self-management
practices, or
the
availability of effective tools to combat the disease including compression
garments and manual
lymphatic
drainage therapy. “To further compound this problem, proper Lymphedema
education and
therapy
is often unavailable or too costly for individuals with limited financial
resources,” says Clinic
Director
Lindsay Davey, “as a consequence, patients with Lymphedema tend to withdraw
from normal
activities
due to discomfort, physical restrictions, or embarrassment.”
To
combat the lack of awareness and treatment of Lymphedema, Toronto Physiotherapy
is developing
educational
tools including online resources and self-management video
(http://www.torontophysiotherapy.
ca/services/toronto_lymphedema_treatment.html),
as well as offering Certified Lymphedema Physiotherapy
services
including a complimentary service for individuals with limited financial
resources.
To
assist low-income individuals, Toronto Physiotherapy provides a complimentary
assessment of the
patient's
Lymphedema case history, as well as education on effective self-management
techniques and
other
treatment options available including the suitability of compression garments.
Toronto Physiotherapy
is also a
Certified Compression Garment Authorizer through the Government of Ontario’s
Assistive
Devices
Program (ADP), and can recommend and authorize therapeutic garments to
Lymphedema
patients
so that they can access the ADP subsidization.
About
Toronto Physiotherapy
Toronto
Physiotherapy (http://www.torontophysiotherapy.ca) is a leading Toronto-based
provider of allied
health
care services including traditional Orthopedic Physiotherapy and Massage
Therapy, as well as a
suite
of specialized services that includes Neurological Physiotherapy, Nutrition
Counseling, Acupuncture,
Manual
Lymphatic Drainage and Home Care Physiotherapy. Toronto Physiotherapy is
certified in
Combined
Decongestive Therapy for Lymphedema and is also a Certified Compression
Garment
Authorizer.
Contact:
Lindsay
Davey
Clinic
Director
416-792-5115
741
Broadview Ave., Suite 206
Toronto,
Ontario, Canada, M4K 3Y3
[email protected]
http://www.torontophysiotherapy.ca
February
13, 2011 - Lymphedema Awareness in Ontario - Wire Service Canada (press
release) – by
LymphedemaDepot
–
Lymphedema
is a permanent condition of chronic swelling that is not difficult to treat.
Unfortunately, patient
access
to treatment is limited.
February,
2011---On March 6, 2011, lymphedema therapists, patients, patient advocates and
others will
observe
Lymphedema Awareness Day. While it is known that the condition of lymphedema is
under-
diagnosed
and under-treated, it is very difficult to find statistics on how many patients
in Canada suffer with
lymphedema.
In 2004, the Lymphedema Association of Ontario arrived at an estimate based in
part on
data
from Cancer Care Ontario:
Over
63,000 children and adults* live with primary or secondary lymphedema in
Ontario.
246,000
Ontario cancer survivors** are at a lifetime risk of developing
lymphedema.
Currently,
Ontario has just over 100 certified lymphedema therapists.
<>Some
parts of Ontario have little or no access to a certified lymphedema
therapist.
*
Lymphedema Association of Ontario estimate (2004).
**
Based on Cancer Care Ontario data (2004).
At
this time, this is the best estimate we have for how many people in Ontario
have lymphedema.
Lymphedema
is a condition of chronic swelling that affects a limb or other body part due
to an
accumulation
of lymph fluid. You can be born with lymphedema or it can be acquired after a
traumatic
injury,
severe infection or surgical removal of lymph nodes. Lymph nodes are often
removed for the staging
of
cancer, to determine if cancer cells are spreading to the lymph system. In
sub-tropical countries
lymphedema
can be acquired from parasites.
Lymphedema
is not curable, but it can be managed through a blend of therapy techniques
that do not
involve
surgery or drugs. This technique is known as Complex Decongestive Therapy
(CDT).
Unfortunately,
many physicians are not familiar with CDT, and, as a result, proper treatment
is under-
prescribed.
If
you know a cancer survivor, then you know someone who is at risk for developing
lymphedema. You
may
be able to help them understand this risk. Please learn more about this
condition by following the links
provided
below, and by talking about what you have learned.
Lymphedema
Depot, the importer and distributor of Solaris lymphedema care products in
Canada, is
helping
to promote Lymphedema Awareness Day this year.
To
learn more about lymphedema, see the Lymphedema Depot’s page of links, a
clickable list of
lymphedema
resources: http://www.lymphedemadepot.com/links
To
learn more about Lymphedema Awareness Day please visit our website at
http://www.
lymphedemadepot.com
and click on the Lymphedema Awareness Day logo.
February
14, 2011 - Breast cancer treatment in Minn. already following new study
guidelines - Minnesota
Public
Radio – by Lorna Benson –
St.
Paul, Minn. — Breast cancer care in the Twin Cities is rapidly moving toward
less aggressive surgery
for
the disease when it has migrated to a woman's lymph nodes.
Doctors
at several metro-area cancer centers say they have already dialed back their
surgical policies after
learning
about a stunning new study. The data showed there is no difference in survival
between women
who
had more of their lymph nodes removed and those who did not.
Breast
cancer patients say they're thrilled to have a less invasive treatment option,
that's equally effective.
The
study, published in the influential Journal of the American Medical
Association, captured news
headlines
across the nation last week.
But
as early as last September, breast cancer surgeon Todd Tuttle remembers reading
some preliminary
results
from the study in another, smaller journal, the Annals of Surgery. That article
prompted a lively
discussion
among Tuttle's colleagues at the University of Minnesota's Masonic Cancer
Center.
"This
is a practice-changing study. Breast centers all across the country are
deciding what to do with the
results
of this study," said Tuttle. "We've had the same discussions here. And it has
dramatically changed
our
practice."
Tuttle
says almost immediately after reading the study last fall, he and his
colleagues agreed they would no
longer remove
additional lymph nodes in early-stage breast cancer patients who had
microscopic disease in
their
lymph nodes.
Doctors
at the Piper Breast Center in Minneapolis made the same decision in December,
after bringing one
of
the study's authors to their center to answer questions about the data. Margit
Bretzke is a surgeon at
Piper.
"Whenever
we present a lumpectomy option to a patient now, and their nodes ... appear to
be negative,
we
talk about this study," said Bretzke.
Restraining
their surgical approach wasn't as easy as it sounds. Bretzke says there's a
long tradition among
breast
cancer surgeons of removing lymph nodes with any sign of cancer. But she says
the results of the
study
are just too compelling to ignore.
There
was no difference in recurrence of disease or survival between the women who
had the lymph node
procedure
and those who did not.
For
many patients, the change in treatment means they will have a much lower risk
of developing
lymphedema
-- a painful condition that causes swelling and numbness in the arm.
"That
was really comforting to know that I might not have to have more invasive
surgery," said Lucille, one
of
Dr. Bretzke's patients. "I was very aware of the possible outcome, and I know
people who have had
lymph
nodes removed and who suffer from lymphedema."
MPR
news agreed not to use Lucille's full name because she hasn't told all of her
family members about her
cancer
diagnosis.
Lucille,
53, says she feels fortunate that she received her diagnosis in time to take
advantage of the study.
Without
it, she probably would have had her lymph nodes removed
unnecessarily.
"It's
fantastic," she said. "It's wonderful that there's so much research going on.
And that the research
continues
to provide treatments that are less invasive."
But
patients should not assume that all breast cancer surgeons will be familiar
with the new data.
Margit
Bretzke at the Piper Breast Center says patients may need to advocate for
themselves.
"I
would tell women that when they're talking to their surgeon, to bring it up to
see if they're in fact a
candidate
for avoiding a node dissection," said Bretzke. "They need to challenge their
surgeon and ask the
question.
I would say if their surgeon doesn't seem to know what they're talking about,
they ought to get a
second
opinion."
Women
who are most likely to qualify for a less invasive breast cancer surgery must
have small breast
tumors
with no obvious sign of significant cancer in their lymph nodes on imaging
scans or during a physical
exam.
Candidates
must be willing to undergo a lumpectomy, followed by whole breast radiation and
possibly
chemotherapy
or hormone therapy to destroy any remaining cancer cells.
Women
who receive mastectomies without radiation or chemotherapy where not part of
the study, and
therefore,
not considered good candidates for this treatment option.
February
14, 2011 - Breast cancer finding to greatly change treatment - The Republic –
By Lindy
Washburn
–
HACKENSACK,
N.J. — Many women with breast cancer will no longer face a potentially
devastating
side
effect of their cancer surgery, as the conclusions of a newly published study
about the need to remove
underarm
lymph nodes are taken to heart by breast surgeons.
"This
was a celebratory day for me," said Dr. Laura Klein , medical director of The
Valley Hospital's
breast
center. "It's practice-changing. I personally will no longer be performing
axillary node dissections" on
women
who match the study criteria.
At
Holy Name Medical Center in Teaneck, N.J. , Dr. Erika Brinkmann , director of
the breast center, said
she
would act on the study results "immediately."
"It
will influence not only my practice but everyone's practice," said Dr. David
Pearlstone , chief of breast
surgery
at Hackensack University Medical Center . The medical center's breast-cancer
team, including
surgeons,
radiologists, medical oncologists and nurse practitioners, will discuss the
findings at its next
weekly
meeting on Wednesday, he said.
The
study, published Wednesday in the Journal of the American Medical Association ,
found that women
who
underwent lumpectomies for tumors of less than 2 inches and whose lymph nodes
did not have
obvious
signs of disease, showed no difference in survival if many lymph nodes were
removed or if only
their
sentinel nodes were removed.
Surgeons
will still remove one to three sentinel nodes, the first nodes that drain
lymphatic fluid from the
breast,
to see if the cancer is spreading beyond the breast. Finding cancer in those
nodes indicates that
disease
cells have migrated and could cause metastases elsewhere. Such patients almost
always are treated
with
chemotherapy.
But until now,
a finding of cancer in the sentinel node had led surgeons to remove more nodes
— either at
the
same time as the lumpectomy or with a return to the operating room later — to
try to make sure that no
cancer
cells remained in the body. The study showed that this makes no difference in
terms of cancer
recurrence
in the same breast, disease-free survival, or overall survival.
With
or without the additional surgery, called an axillary node dissection, more
than 90 percent of the
women
survived for five years. With or without it, the chance of a cancer recurrence
in the same breast
was
less than 4 percent.
That
conclusion upends one of the most closely held beliefs about cancer surgery,
that it is best to "get it all
out."
"As
cancer surgeons, it's anathema to us to know we leave cancer behind,"
Pearlstone said. "But here's a
study
that says, hey, it doesn't matter."
"We
always have felt that the role of the surgeon is to cut it all out," Brinkmann
said. "It's very hard not to
fall
into that hole. But we have to look at the data and the studies that have been
done. This will be the
standard
of care now" for women who match the study criteria.
The
findings further the trend toward less-invasive breast cancer treatment. In
recent decades,
lumpectomies,
when combined with radiation treatment, have been shown to be as effective as
mastectomies
for many women. And sentinel-node biopsies have replaced wholesale initial
excision of
lymph
nodes.
Knowing
how many additional lymph nodes contain cancer does not change decisions about
whether to
use
chemotherapy and what type of chemotherapy to use, said the study, by Dr.
Armando Giuliano of the
John
Wayne Cancer Institute in California and others.
Oncologists
increasingly base their chemotherapy treatment on the specific characteristics
of the patient's
tumor,
including the cells receptivity to estrogen and progesterone and their
molecular composition.
The
study is significant because for many women, the worst side effects of
breast-cancer surgery result not
from
the breast incision, but the lymph node removal. "A few women suffer medical
problems from having
a
sentinel node removed," Pearlstone said. "But many, many, many suffer medical
problems from having a
whole
lot" of nodes removed.
"There's
a lot going on in that area," under the arm, said Carolyn Monroe , a
nurse-practitioner in the
surgical
breast practice at Hackensack, N.J. "It's the junction from your arm to your
torso and shoulder
and
neck." Many muscles and nerves join and intersect.
Side
effects may include pain, tingling, numbness, weakness, tightening or a
cord-like feeling that can
extend
down the arm, and lymphedema, a permanent swelling that can limit motion and
for which there is
no
cure.
Recovery
after surgery is expected to be easier, too, because women will not require
underarm drains for
weeks
if they have not had multiple lymph nodes removed.
Some
surgeons said their patients were asking how the study conclusions would affect
them.
"I
had two new cancer consults (Wednesday)," Pearlstone said. "Both asked me about
it. On the way
home
I got three personal calls about it. Then my wife asked me if I'd seen the
'Today' show about it."
Klein,
at Valley in Ridgewood, N.J. , received several calls from patients whose
operations are on her
calendar.
"They said, 'We're not going to do an axillary lymph node dissection, are we?'"
she said. Women
embrace
the findings because of their worry over developing lymphedema.
For
one patient, the study was published at the perfect time. She won't have to go
back for further surgery
to
remove more lymph nodes, even though the sentinel node was positive for
cancer.
Surgeons
cautioned, however, that the study does not affect all women with breast
cancer. There is no
data
about women who undergo mastectomies, for example, or who have larger tumors.
And everyone in
the
study received "whole-breast radiation," which also irradiates the underarm
area.
They
were not treated with partial radiation, and they did not lie prone for their
radiation treatments, two
recent
innovations.
For
these women and others, more research is needed.
========================
February
15, 2011 - Susan G. Komen for the Cure® Awards Grants to Memorial - WDEF News
12 –
The
Susan G. Komen for the Cure Foundation awarded four grants to Memorial Health
Care System
totaling
more than $87,000.
Lymphedema
Treatment Assistance – The foundation awarded $14,500 to Memorial to provide
support
for
women newly diagnosed with breast cancer. The MaryEllen Locher Breast Center
has dedicated itself
to
providing support every step of the way beginning with education and a review
of the lymphatic system
and
signs and symptoms of lymphedema. The MaryEllen Locher Breast Center also
provides assistance
with
the garments necessary for lymphedema patients who do not have insurance and
would be burdened
by
purchasing them.
Access
to Mammograms – More than $52,600 was awarded to help provide access to
mammograms.
The
grant will help fund Memorial’s Mobile Coach outreach breast health education
program which
provides
mammograms for insured and uninsured women.
Breast
Health Day – A grant totaling $20,000 will help fund a series of breast health
educational programs
and
mammogram screenings to diverse populations with sensitive language and
cultural concerns.
February
15, 2011 - Restorix Health hyperbaric chamber leads to space-age medical
research - Issaquah
Press
– By Laura Geggel –
Mention
hyperbaric chambers, and most people start thinking about pressurized rooms
where scuba divers
afflicted
with the bends go to recover.
But
the chambers can be used for much more, and Issaquah’s Restorix Health plans to
participate in
hyperbaric
treatment and research to find other medical uses for the pressurized
chambers.
“We
think there is great potential nationwide for what they’re doing and what they
started in Issaquah,”
Issaquah
Chamber of Commerce CEO Matt Bott said, congratulating it for receiving one of
the chamber’s
three
Innovation in Issaquah awards.
Restorix
Health, which opened in Issaquah in December, has grand ambitions for its
comprehensive health
care
delivery system. With six hyperbaric chambers, it has the largest collection of
large monoplace
chambers
in the country. The chambers deliver oxygen with an increased atmospheric
pressure, and can
help
heal patients with diverse maladies, including diabetic patients who have dying
tissue deprived of its
regular
dose of oxygen.
“By
putting your whole body under pressure, we dissolve oxygen into the liquid part
of your body,”
Medical
Director Tommy Love said.
Increased
oxygen levels can stimulate different responses in the body, including faster
healing and increased
stem
cells, Medical Director Latisha Smith said.
Hyperbaric
chambers are approved for 14 treatments, and by opening 15 to 20 new clinics
along the West
Coast
in the next five years, Restorix Health will contribute to research looking for
more uses.
“Hyperbaric
therapy is another tool we can use to help heal wounds,” Love said. “We think
hyperbaric
therapy
can be beneficial in more things.”
A
handful of local health care centers have hyperbaric chambers, but their
chambers are often used for
paying
patients, not research, Love said. Restorix Health staff can easily schedule
patients and also have
room
for research participants, which will be double-blind studies in which neither
the patient nor the
doctor
know who is getting hyperbaric treatment in the chamber.
The
company’s nonprofit foundation is raising money to help pay for the research,
Love said. Much of the
research
will be done in concert with other hyperbaric facilities across the
country.
Some
of the studies will address concussions from vehicle accidents and sports
injuries, and traumatic brain
injuries
sustained in the U.S. armed forces.
The
company frowns on other hyperbaric companies that might “prey on desperate
people” looking for
miracle
cures, Love added.
At
Restorix Health, one health care worker monitors two chambers, and can use a
phone to communicate
with
the patients in the giant, clear tubes. Some patients watch TV, others read and
a few fall asleep during
their
two-hour treatments, Love said.
“A
lot of times you forget you’re in a vessel,” he said.
In
addition to its hyperbaric chambers, the clinic will also treat patients with
lymphedema, a disease that
happens
when a person’s lymphatic system is blocked and their leg or arm swells from
the increased fluid.
The
clinic has rooms dedicated to massage — so the patient’s lymphatic fluids can
start moving again —
and
has other rooms with wide doors so patients on stretchers can easily enter and
transfer to the
examination
chair.
A
spacious room with cushy chairs, wood floors and tall windows waits for
lymphedema patients receiving
IV
infusions. A nurses’ station is located behind a glass window, giving health
care workers the opportunity
to
monitor patients while entering information into electronic medical
charts.
Past
the nurses’ station is the pharmacy, a room where Restorix Health pharmacists
can prepare their own
drugs.
A room nearby serves as a dressing room for patients using the hyperbaric
chamber — they can’t
wear
polyester because its friction can cause sparks, a bad idea in a highly
oxygenated environment.
Restorix
Health does not plan to replace family doctors; it wants to work in tandem with
them on a referral
basis,
Smith said.
Bott
praised Restorix Health for its innovative ideas and encouraged it forward with
its research.
“Some
of the criteria that really stood out with them included the potential that we
felt they had with wound
treatment,
and the company’s affiliation with the research foundation,” he said. “We felt
that was an
innovative
model to drive wound treatment in this area.”
February
16, 2011 - Lymph Node Study May Revolutionize Breast Cancer Care - Citizens
Report –
A
recent study finds that women with early breast cancer do not need to undergo a
painful procedure long
thought
to be mandatory: removal of cancerous lymph nodes from the armpit. The news
impacts 40,000
women
a year in the United States for whom the surgery has no advantage.
Although
the treatment is standard, it can also cause complications that include
infection and lymphedema,
a
chronic swelling in the arm. Removing cancerous lymph nodes isn’t always
necessary, researchers say,
because
women in the study already had chemotherapy and radiation. These treatments may
eliminate
disease
in the nodes.
The
study included 891 patients at the median age of mid-50s, followed for a median
of 6.3 years. After
the
initial node biopsy, the women were randomly assigned to either have 10 or more
additional nodes
removed,
or to leave the nodes alone. The nodes were cancerous for 27 percent of the
women studied,
but
the two groups had no difference in rates of survival. More than 90 percent
survived over five years.
February
16, 2011 - Surgeons optimistic on lymph node study - Daily American Online –
Somerset --
Local
surgeons are cautiously optimistic about a new study that finds that many women
with early stage
breast
cancer do not need a procedure that has long been routine: Removal of all
cancerous lymph nodes
from
the armpit.
“This
is a major change,” said Dr. Dianna Craig, breast surgeon at Windber Medical
Center. “Research is
getting
us to be less and less invasive. This is a big step along that
pathway.”
Dr.
Gerard Garguilo, general surgeon at Memorial Medical Center, Johnstown, said a
lot of people had
been
calling into question the value of the more radical surgery.
“It’s
a notion that a lot of us were thinking — more radical surgery was not
necessary,” he said. “These are
quality
of life issues.”
Surgeons
have been removing lymph nodes from under the arms of breast cancer patients
for many years,
believing it
would prolong women’s lives by keeping the cancer from spreading or coming
back. Removal
of
nodes can cause infection and lymphedema, a chronic swelling in the
arm.
Now
researchers report that for women who meet certain criteria, taking out nodes
has no advantage.
“This
is what we have to caution readers about — it is very limited, not for
everybody,” Craig said.
The
criteria include women whose tumors were found at an early stage, five
centimeters or smaller, which
is
less than 2 1/2 inches across. Biopsies of one or two nodes had found cancer,
but the lymph nodes were
not
enlarged enough to be felt during an exam and the cancer had not spread
anywhere else. The women
had
lumpectomies. Most also had radiation to the entire breast or chemotherapy or
both. An estimated 20
percent
of patients, or 40,000 women a year in the United States, fit that
criteria.
“The
study didn’t look at women who had mastectomies, radiation of the partial
breast or chemotherapy
prior
to the surgery,” Craig said. “It was a very limited population, but there was
no difference in survival
rates.
We don’t have long-term data — that will come over time.”
After
armpit surgery, 20 to 30 percent of women develop lymphedema. Radiation
increases that to 40 to
50
percent.
“Women
who develop lymphedema have arm pain, they have to limit the motion of the
shoulder, they have
swelling,
they have to make lifestyle changes,” Garguilo said.
Craig
said there is no cure for lymphedema, but it can be managed.
“The
key is catching it early and using compression bandages and massage therapy,”
she said. “You don’t
lose
the use of your arm, but it’s not fun to deal with.”
Another
thing to be cautious about is that the study only included 891 patients and
they were followed for
just
over six years.
“That
is not as many women as they would have liked to have had in the study,” he
said.
Dr.
Armando E. Giuliano, lead author of the study, is the chief of surgical
oncology at the John Wayne
Cancer
Institute at St. John’s Health Center in Santa Monica, Calif. The study was
published this month in
the
Journal of the American Medical Association and in the Annuals of Surgery. The
National Cancer
Institute
paid for the study.
The
new findings are part of a trend to move away from radical surgery for breast
cancer, Craig said.
Rates
of mastectomy, removal of the whole breast, began declining in the 1980s after
surgeons found that
for
many patients, survival rates after lumpectomy and radiation were just as good
as those who had
mastectomies.
In
the 1990s, surgeons developed a technique called sentinel node biopsy, in which
they injected a dye into
the
breast and then removed just one or a few nodes that the dye reached first. The
theory was that if the
tumor
was spreading, cancer cells would show up in those nodes.
The
new study doesn’t cancel out the need for chemotherapy.
“The
great equalizer is chemotherapy,” Garguilo said. “It’s very effective in
treating nodes that have not
been
removed. Radiation covers part of the nodes as well. These keep the risk of a
reoccurrence (of
cancer)
low.”
He
believes that as more studies are done it will lead to the demise of more
radical surgery.
“To
me, this is the next big advance in treating women,” Garguilo said.
Craig
agrees that there have been a lot of changes in treatment of breast cancer in
the last decade.
“This
is a step in the right direction,” she said. “Right now, it’s a very limited
recommendation. Women
who
have a diagnosis of breast cancer must discuss options with their physicians.
We’re enthusiastic about
the
study, but cautious in going forward.”
February
17, 2011 - Re-teaching daily living at IOOF therapy center - Mason City Globe
Gazette – By
KRISTIN
BUEHNER –
MASON
CITY — A new Community Therapy Center at the IOOF Home in Mason City provides
a
larger,
more convenient area for therapy patients from the IOOF Home and the
community.
Located
on the southeast end of the IOOF Home care center at 1037 19th St. S.W., the
facility includes a
fully
equipped therapy gym, two private treatment rooms and a full kitchen and
bathroom used for re-
teaching
activities of daily living, said IOOF Home Marketing Director Pam
Klukow.
“We’ve
been gradually utilizing the space since Dec. 3,” Klukow said. Residents can
access it from inside
and
there’s public access from a parking lot.
Therapeutic
services are provided by Therapeutic Advantage of Hampton. Physical therapy,
occupational
therapy,
speech therapy and lymphedema therapy are available. Lymphedema is a condition
that results in
tissue
swelling and fluid retention.
Residents
benefit by having a mix of people from the outside using the center, said IOOF
Home
administrator
Deb Haugen.
“Skilled-care
patients know they’re still part of the community,” she said.
After
the patients return home, they will find the center easily accessible to
continue their therapy if
needed,
Klukow said.
“It’s
gorgeous,” said Glenna Putney of Clear Lake, who comes to the center for
lymphedema therapy. “It’s
very
handy.”
Wilma
Schriver, a resident of the IOOF Home, said she enjoys the larger space and the
new equipment.
“It
looks like a gym,” she said.
The
3,000-square-foot addition cost approximately $650,000 to build. It was
designed to blend in with the
existing
facility, which was built in 1994 and remodeled in 2009.
Groundbreaking
for the new addition was in April.
Bergo
Construction of Mason City was general contractor. Skott & Anderson
Architects of Mason City
provided
architectural services.
Regular
hours are 8 a.m. to 5:30 p.m. Monday through Friday.
A
ribbon-cutting ceremony will be at 1:30 p.m. Thursday, Feb. 24, at the IOOF
Home.
A
public open house will be 1:30 to 3:30 p.m. Saturday, Feb. 26.
February
17, 2011 - Head and Neck Lymphedema is Common; Help is Available - Wire Service
Canada
(press
release) – LymphedemaDepot –
Lymphedema
of the head, neck and face is more common than you might think.
If
you do any research on head and neck lymphedema following cancer-related
surgery you may come
across
this statement;
“...approximately
half of patients treated for head and neck cancer develop lymphedema.”
(Cancer.net)
Lymphedema
is a chronic, incurable swelling condition that requires lifelong
management.
Even
postsurgical swelling following cosmetic procedures can take months to
resolve.
Once
swelling develops, what resources are available to the patient?
Lymphedema
Depot is proud to carry the Solaris line of custom-made Tribute lymphedema
garments.
These
therapeutic garments can be tailored to help resolve chronic or acute edema in
the head neck and
face
regions. These garments are comfortable and work while you sleep to soften and
reduce swelling.
These
Tribute garments are available in several styles including a neck piece, a
facial garment and an eye
mask
for addressing swelling around the eyes. On the facial or neck garments
allowances can be made to
accommodate
a tracheotomy .
While
comfortable and relatively simple, the Solaris Tribute garments are the most
advanced garment-
based
therapy available for head, neck and face edema or lymphedema. Chipped foam
sewn into quilted
channels
gently sinks in to the proteins and fluid that make up the swelling, breaking
down fibrosis and
guiding
fluid away from saturated areas. The custom manufacture of each garment insures
a comfortable
and
effective fit.
These
garments are also adjustable to help manage fluctuations and reductions in
swelling without the need
for
a new garment. They can be worn comfortably overnight while sleeping. And
because each one is
measured
to the patient’s exact measurements, the fit is custom and
comfortable.
For
more information about Solaris head, neck and facial Tribute units available
through Lymphedema
Depot,
see our website at http://www.lymphedemadepot.com and look under Tribute to see
the head neck
and
face garments.
For
more information, contact Lymphedema depot at
[email protected]
February
17, 2011 - Family spreads awareness of Turner syndrome - Richmond-News – By:
Jackie
Grumish
–
When
Jozie Lewis was born with severely swollen hands and feet, her doctors thought
it was just because
of
the way she was positioned in the womb.
Derek
and Linda Lewis, Jozie’s parents, weren’t so sure.
“My
brother’s step-son’s nephew’s daughter has Turner syndrome,” Linda said. “When
I asked the
doctor
if that’s what it was, his jaw dropped open.”
Not
many people know about Turner syndrome, Lewis said. If it wasn’t for the case
knowledge in the
family
and the Lewis’ knowledge about the disease, it’s unlikely Jozie would’ve been
diagnosed so early in
life.
Turner
syndrome is a non-inherited chromosomal condition that affects one in 2,000
female births. About
50
percent of girls with Turner syndrome are not diagnosed until their pre-teen or
teenage years, when
puberty
never kicks in.
Part
of the problem with diagnosis is that most cases are different and the symptoms
can vary from girl to
girl.
For
example, other than Jozie’s lymphedema in her lower arms, hands, lower legs and
feet and her low set
ears,
she has no other apparent characteristics symptoms.
“She
doesn’t have anything abnormal,” Linda said. “No one is able to look at her and
know. Even her
lymphedema
is mistaken for chubby.”
Each
case is different and some girls experience different characteristics and
symptoms than others, Lewis
said.
“Jozie
has really been lucky that way,” Lewis said.
Jozie,
who is just 18 months old, was an early walker and is verbally advanced. She
also doesn’t suffer any
social
issues that some girls can experience. She is a very outgoing little
girl.
The
same can’t be said about everyone with the syndrome.
Common
symptoms of the syndrome include heart defects, learning difficulties, kidney
and liver concerns,
hearing
loss, prone to ear infections and social difficulties. Physical traits include
a short stature, and can
include
many moles, low-set ears, a triangular face and a webbed neck among other
things.
The
most common and usually the most obvious symptom of Turner syndrome is the
stunted growth.
Most
women with Turner syndrome only reach 4 feet 8 inches tall, Lewis
said.
“Some
girls take growth hormones just to reach five feet,” she said.
It’s
too early to know whether Jozie will be one of those girls, she said.
“Turner
syndrome girls who take growth hormones are prone to heart issues and dilation
of the heart,”
Lewis
said. “Medicine is always changing so we’ll just have to see where it’s at when
she gets older we are
faced
with making this decision for her.”
Jozie
currently falls in the 30th percentile for girls her age, but when compared to
other children girls with
Turners
syndrome, she falls in the 80th percentile range, Lewis said.
Also
working against Jozie is family genetics, Lewis said with a laugh.
“The
women on her dad’s side are all very short to begin with, it may not be in her
genetics to reach five
feet anyway”
she said.
Right
now the Lewis family’s biggest concern is Jozie’s blood pressure, which
measured in the 90th
percentile
of normal at her last wellness visit.
“If
it’s 90 percent when she’s calm and happy, you know it’s off the chart when
she’s upset,” Lewis said.
“That’s
our biggest concern right now.”
Because
high blood pressure could be an indicator of kidney or heart problems, Jozie
underwent a kidney
ultrasound
on Friday. Luckily, the results came back normal.
“Great
news about her kidneys!” Linda said.
In
the future, it’s likely Jozie will have to undergo hormone therapy to push her
through puberty, Lewis said.
“Without
it she wouldn’t develop the womanly curves, develop breasts or get her period,”
she said.
“Overall
she’s a really happy little girl,” Lewis said. “She just needs to be monitored
a little more closely.”
The
Lewises try their best not to fret about Jozie’s condition.
“You
can sit there and wait and worry or you can go with the flow and deal with it,”
Lewis said. “We just
try
to do as much preventatively as we can and take it one day at a time as it
comes to us.”
Lewis
said she’s thankful that she knew a little bit about the syndrome when Jozie
was diagnosed. Not
many
people — even doctors — know a lot about Turner syndrome, she said.
That’s
why the family recently decided to participate in the Turner Syndrome Society
of the United States’
awareness
campaign.
February
has been deemed National Turner Syndrome Month because it’s the shortest month
of the year,
Lewis
explained. The campaign’s slogan is “Short Happens!”
“We
were pretty scared when we found out she had Turner syndrome,” Lewis said. “We
just hope that by
sharing
Jozie’s story that we can help another family. If someone else gains at least
some knowledge
through
our story it may help them. We were so thankful my nephew and his wife shared
their story and we
want
to pay it forward. It’s also likely that there is a small girl out there
undiagnosed at this point. The
doctors
might be telling the parents that she’s just small and she really has TS. We
hope someone might
read
Jozie’s story and get help if they think that their daughter may have
TS”
Along
with sharing her story, Jozie also participated in a “Positive Exposure” photo
shoot. The goal of the
shoot,
done by former fashion photographer Rick Guidotti, is to educate people and
show the beauty of
the
people behind various syndromes.
“(Guidotti)
was in town talking to medical students at the U of M and trying to get them to
see the people
behind
their patients,” Lewis said. “While he was here, the Turner Syndrome Society of
the United States
got
Jozie and a group of girls and women with Turner syndrome together for the
photo shoot.”
Eventually
Jozie’s picture — along with others — will be on display in an art gallery to
promote the
awareness
of TS.
“If
it can help someone else down the road that would be the greatest gift we could
give,” Lewis said
February
18, 2011 - Breast Cancer Patients May Say Goodbye To Lymphedema - About - News
&
Issues
–
Lymph
node status is part of your breast cancer diagnosis - and many patients have
had large numbers of
nodes
surgically removed - so these can be examined for the possible spread of
cancer. Having the
greater
the number of lymph nodes removed via axillary lymph node dissection results in
a swelling called
arm
lymphedema. But a new study shows that patients with early stage breast cancer
- tumors less than 2
inches
and lymph nodes that appear unaffected - can safely opt for sentinel node
biopsy: the removal of
only
two or three lymph nodes.
This
Phase 3 trial study was designed by The American College of Surgeons Oncology
Group and was
set
at 115 different locations across America. Patients had similar diagnoses and
treatments: lumpectomy,
and
whole-breast radiation. One group had axillary lymph node dissection and the
other group had
sentinel
node biopsy. Patients in both groups had similar 5-year overall survival
rates. The study
concluded
that Sentinel Node Biopsy is all that is needed for early stage breast
cancer.
Axillary
lymph node dissection (ALND) and arm lymphedema will not go away altogether.
For breast
cancer
patients with tumors over two inches, or with swollen lymph nodes, the removal
of extra lymph
nodes
will be needed to determine the risk of metastasis.
This
news will change the way that breast surgeons and oncologists diagnose and
treat early-stage breast
cancer.
While some surgeons already confine lymph node removal to a targeted 2 or 3
nodes, it has long
been
standard surgical practice to remove between 15 and 40 nodes - putting patients
at higher risk for
arm
swelling. Women who have arm lymphedema must take special care of their arm
for the rest of their
lives
- using compression garments, preventing cuts, even small burns, and sometimes
requiring lymphatic
massage
to get relief. Now that more patients may be able to avoid the risk of arm
lymphedema, dealing
with
breast cancer survival will become easier.
February
19, 2011 - In breast cancer treatment, less underarm lymph-node removal may be
better
Los
Angeles Times – By Jill U. Adams –
Removing
many underarm nodes instead of just a few may not improve long-term survival, a
study says.
Sometimes
less is more in breast cancer treatment; so says a study that made headlines
earlier this month:
The finding,
published in the Journal of the American Medical Assn., reported that
surgically removing
multiple
cancer-containing lymph nodes under the arm in women with small tumors —
instead of just one
or
two — may cause more harm than good.
The
finding seems to fly in the face of what most people believe — that cancers
must be treated
aggressively
for the best odds of recovery and survival.
But,
in fact, many breast cancer surgeons say the study puts solid evidence on what
was already becoming
a
trend in practice — moving away from the more radical surgery in certain
patients. "It's not a revolution,
it's
an evolution," says Dr. John Glaspy, an oncologist at UCLA's Jonsson
Comprehensive Cancer Center.
It's
still unclear whether the advice from the study will be broadly accepted as the
new standard of care —
and
how long that will take.
"Many
changes in medicine — believe it or not — take 17 years to take hold," wrote
Dr. Len Lichtenfeld,
deputy
chief medical officer of the American Cancer Society, on his blog after the
JAMA report came out.
Here's
a look at the pros and cons of removing underarm lymph nodes in breast cancer
and who will be
affected.
The
study subjects were women with breast tumors up to two inches across and
evidence of cancer cells
invading
at least one nearby lymph node but not more than two, as determined by a
procedure called
sentinel
lymph node biopsy. In this procedure, a dye is injected near the tumor and the
first lymph nodes to
which
the dye travels are removed and biopsied for cancer cells.
All
891 patients received lumpectomy and radiation therapy, and a majority of them
also underwent
chemotherapy.
In addition to the one or two sentinel lymph nodes removed for diagnosis of
invasive
disease,
one group of women also underwent what surgeons call axillary lymph node
dissection, which
means
surgical removal of at least 10 lymph nodes from under the arm.
Survival
rates were statistically similar in the two groups, with more than 90% of women
surviving and
more
than 80% remaining disease-free for five years after treatment.
These
findings suggest that removing a bunch of lymph nodes from under the arm
doesn't make a difference
in
the long-term prognosis of breast cancer patients. Doctors say this makes
sense, because there are many
paths
by which cancer can escape the breast and spread.
February
21, 2011 - Study challenges need for lymph node removal in cancer patients -
Las Vegas
Review
– Journal - By Paul Harasim –
When
the news broke about a study that found many women with early breast cancer
need not have all
their
underarm lymph nodes removed -- even if they contain cancer cells -- Christine
Wunderlin was both
happy
and disappointed.
She
is happy that more women will be able to escape the lymphedema, a chronic,
often painful swelling in
the
arm caused by the retention of lymph fluid, that she has experienced as a
result of the excision of 11
nodes.
But
she can't help being disappointed about ever having to go through the
major lymph node removal in
the
first place.
"Exactly
a year after I have my procedure done, they come out with this," she said
Tuesday. "My breast
surgery
has been easier to deal with than the lymphedema."
Wunderlin,
who runs a career counseling business, must regularly visit Dr. Richard
Hodnett's Lymphatic
Center
of Las Vegas, where a specialized therapist massages her arm to disperse the
lymph fluid through
pathways
in her body that are still functioning.
And
she must wear a compression garment on her left arm for the rest of her life or
the lymphedema may
well
become disabling.
"If
I don't keep it in check, even being able to wear a blouse can be problematic,"
she said.
According
to the study published in the Feb. 9 Journal of the American Medical
Association, researchers
found
that removing lymph nodes in women with early stage breast cancer -- the
disease strikes about one
in
eight women -- did not improve their chances of a recurrence or surviving when
compared with leaving
the
nodes behind during breast cancer surgery.
Women
in both groups had about a 92 percent chance of survival.
on
the cutting edge
Dr.
Josette Spotts, a 54-year-old breast surgeon affiliated with Comprehensive
Cancer Centers of
Nevada,
was not at all surprised by the findings of the study that promises to change
what has been
standard
medical practice for decades.
"I've
stayed on top of the research and for the last several years have given my
patients who fit the proper
profile
the option of not having their lymph nodes removed," she said. "I just hate to
see women go through
lymphedema
unnecessarily. It can be debilitating and the literature shows there's about a
17 to 20 percent
risk
(of suffering from lymphedema) when you remove many of a woman's lymph
nodes."
Two
of her breast cancer patients who opted not to have lymph node removal as far
back as four years
ago,
Patricia Hovey and Christine Santiago, sat in the physician's Henderson office
last week and
discussed
why they chose to forgo excision when the standard of care at that time was to
have the lymph
nodes
removed. Both are now cancer free.
"In
a way I realize it was a leap of faith," said the 56-year-old Santiago, who was
trained as a registered
nurse
and works in risk management administration for the Clark County Administration
Department. "But
I
was impressed with Dr. Spotts' knowledge of the research and I also know that
medicine is sometimes
slow
to change the legal standard of care. I'm obviously happy that the study
validated my faith."
The
61-year-old Hovey, who has been laid off from her job as a sales manager for
Mexicana Airlines, said
Spotts
carefully explained all the possible pros and cons. "When she said I was a
candidate for not having
the
removal of the lymph nodes, it came down to the fact that I trusted
her."
Nearly
1,000 women, with a median age in the mid-50s, were involved in the study
carried out at more
than
100 medical centers throughout the United States. The women were followed for a
median of 6.3
years.
About
20 percent of breast cancer patients meet the criteria of the study, where
tumors are less than 2
inches
across and cancer has not spread outside the nodes.
Spotts,
a graduate of the Wayne State University School of Medicine in Detroit, had
told the women that
the
research she studied -- later borne out by the study -- found that removing the
cancerous lymph nodes
proved
unnecessary because the standard therapy today in addition to a lumpectomy,
radiation and
chemotherapy
likely killed the disease in the nodes.
Lymph
nodes, small bean-shaped glands, help eliminate bacteria and viruses and are
needed to drain and
regulate
the flow of lymphatic fluid. Spotts said that until research and technology
proved otherwise, it
made
sense to remove lymph nodes as part of breast cancer surgery because the breast
tissue lies close to
the
lymph nodes and lymph can harbor wayward cells that travel out of the original
tumor into other parts
of
the body.
"We
keep making advances, and as a physician you want to make sure your patients
get the best care in as
timely
a fashion as possible," Spotts said. "For a long time we only did mastectomies
(removal of the entire
breast)
and then we found out that lumpectomies (removing only part of the breast)
followed by radiation
have
basically the same survival outcomes."
mapping
the nodes
Both
Hovey and Santiago were found to have cancer in their lymph nodes when Spotts
did a procedure
known
as sentinel node mapping as part of their breast cancer surgery.
The
sentinel node is the first lymph node or nodes to receive drainage from a
cancer-containing area of the
breast.
Generally,
about an hour before a woman enters the operating theater for breast cancer
surgery, she is
injected
with a radioactive tracer that is used for the mapping. Soon after the patient
is on the table, the
surgeon
uses a handheld Geiger counter that sounds off as it finds the radioactive
tracer in the lymph nodes.
A
blue dye helps the physician get visual confirmation of the sentinel node on a
monitor.
With
an incision in the armpit, the surgeon takes out the node, sending it to a
pathologist to be checked for
cancer.
The lumpectomy follows.
"In
the past, if the sentinel node was cancerous, we'd do another surgery later for
the other nodes," Spotts.
"Now,
fortunately, we often don't have to go through that. The chemo and radiation
will kill the disease in
the
nodes."
Spotts
has known that she was taking a risk by telling some of her patients that she
believed they could opt
out
of lymph node removal surgery.
"If
it recurred because of that when the standard of care was removal, I could have
financial liability," she
said. "But I
feel an obligation to my patients to give them an opportunity for the best care
that research
shows
is available.
Dr.
Theodore Potruch, another Las Vegas breast surgeon who has given his patients
the benefit of such an
option,
agrees with Spotts.
"It
is imperative that we stay on top of the research for our patients," Potruch
said, noting that he hopes to
start
a trial therapy soon where cancerous breast lumps are rendered impotent through
freezing rather than
excision.
"It's
important that what we do leaves women scarred as little as possible both
physically and emotionally."
Though
research may indicate that a new treatment option is possible, Spotts said she
is never surprised
when
some women refuse it. Nor is she surprised that some doctors are reluctant to
change what seems to
have
worked.
It
is much easier for both patients and doctors to accept more cancer treatment on
the basis of a study
rather
than less. Given that breast cancer kills 40,000 American women a year, it can
be frightening to try
what
may seem, at first blush, less aggressive care, Spotts said.
"It's
hard for some people to get their arms around the fact that less can actually
be more," she said.
Some
women not only favor lymph node removal regardless of research, but also
mastectomies rather than
lumpectomies
"because they think it's better to be safe than sorry."
"The
fear is very real and very understandable. I want to do what makes the patient
most comfortable."
To
Christine Santiago, it is critical that women weigh carefully what their
doctors say in conjunction with
their
own research.
"You
have to find out as much as you can about what you're going to do with this
disease because it can
mean
your life. And then you have to hope you make the right decision."
February 21,
2011 - Aleva Stores Adds the Zensah Product Line to its Online Stores - openPR
(press
release)
–
Aleva
Stores recognizes the importance of compression therapy, so we’re always
looking for ways to
expand
our compression-related products catalog. Bringing on the Zensah line was an
easy decision due to
their
history of phenomenal compression technology.
Zensah
compression products provide an optimal blend of graduated and pinpoint
compression. The
graduated
compression provides maximum compression at the bottom of the garment and
gradually lessens
upward;
while the pinpoint compression targets the exact source of pain.
While
the Zensah catalog includes compression socks, arm sleeves, thigh sleeves,
bras, and shorts, Zensah
was
the first company to introduce compression leg sleeves.
February
21, 2011 - A continuing quest - Lac du Bonnet Leader - By Lory Mitton
–
Once
again, Lac du Bonnet's Kim Avanthay is promoting the recognition of March 6 as
Lymphedema
Awareness
Day.
Last
year marked significant progress in her mission for recognition of the disease
which is quite common
but
not publicized to any great extent. Many medical professionals have never heard
of lymphedema, which
the
World Health Organization estimates affects more than 250 million people
worldwide.
"The
more people hear, the more they will be aware [of lymphedema] and can seek help
if they need it,"
Avanthay
explained about the importance of making the disease understood.
Forty-one
municipalities across Manitoba and Manitoba's Minister of Health proclaimed
March 6, 2010 as
Lymphedema
Awareness Day a year ago.
"I
hope to have just as much, if not more success this year," Avanthay says. So
far in her correspondence
with
municipalities, 13 districts have agreed to her requests and she anticipates
many more will also.
Avanthay's
efforts are inspired by her young son, Austin, who suffers from the disease.
The Leader first
wrote
about Avanthay two years ago when she graduated from the Lymph Science Advocacy
Program in
California.
She was there to learn more about the illness that's affected four-year-old
Austin since shortly
after
birth.
"Lymphedema
is a chronic disease with no known cure and treatments that for some, are less
than
adequate,"
Avanthay told the Leader.
"Much
work needs to be done in this area as lymphedema requires daily
care."
The
disease can become a disability that prevents those affected by it from
continuing in normal daily
activities
including their professions.
The
condition is an accumulation of lymphatic fluid in the interstitial tissue that
causes swelling, most often in
the
arms and/or legs, and occasionally in other parts of the body. Lymphedema can
develop when
lymphatic
vessels are missing or impaired (primary), or when lymph vessels are damaged or
lymph nodes
removed
(secondary).
"Those
with primary lymphedema face a life of daily treatments and rising costs for
treatment and support
garments,"
Avanthay says. "No other life-time chronic disease has the low level of
awareness and support
from
the provincial health care system, health care professionals and the research
community."
Left
untreated, lymphedema interferes with wound healing, and provides a culture
medium for bacteria that
can result in
lymphangitis (infection).
Since
Avanthay has been promoting awareness, many people have contacted her. "One was
from Selkirk
who
had been living with this condition from childhood and was never diagnosed,"
she said.
The
National Lymphedema Network, based in Oakland, CA describes the importance of
March 6.
"On
this day we show the world that lymphedema is no longer a rare condition by
honoring the many
people
living with it today, and the exceptional health care providers who, with
dedication and support,
have
touched their lives and hearts."
The
International Lymphedema Framework (ILF) will be hosting their third ILF
Conference right here in
Canada,
in Toronto, in June 2011.
"This
is great news for the Lymphedema community," Avanthay says. She hopes Manitoba
will have some
representation
at the conference.
Also
picking up momentum is the Canadian Lymphedema Framework (CLF), which is
working to improve
the
management of lymphedema and related disorders in Canada. "They have three
active working groups
focusing
on education, research and partnership building. The volunteer members of the
working groups
are
from right across Canada," Avanthay explains.
The
forming of an association for Manitoba is also in progress.
February
22, 2011 - Removing Lymph Nodes in Breast Cancer Patients Is Not Essential -
TopNews
New
Zealand – by Neeraj Shahane –
The
new American study has revealed that it's not necessary to remove the
lymph-nodes from breast
cancer
patients as removing lymph nodes hasn't helped in improving survival chances of
breast cancer
patients.
Lymph
nodes are small bean-shaped glands, required to drain and regulate the flow of
lymphatic fluid.
Lymph
nodes also assist in eliminating bacteria and viruses from body. As part of
breast cancer surgery,
removing
lymph nodes was considered logical as lymph nodes are close to the breast
tissue and can
transfer
infection to other parts of body.
Christine
Wunderlin, who runs a career counseling business, had undergone the breast
cancer surgery last
year.
Wunderlin was glad that other women will not have to suffer with lymphedema,
the problem arising
due
to removal of lymph nodes.
Lymphedema,
a chronic swelling in the arm, sometimes painful, is caused by the retention of
lymph fluid.
Wunderlin
has to visit Dr. Richard Hodnett's Lymphatic Center regularly to have the
lymphatic fluid remove
from
her body. A specialist therapist massages her arm to disperse the fluid out of
the body. Moreover, for
rest
of her life, she must wear a compression garment on her left arm as lymphedema
can be disabling.
Spotts,
a graduate of Wayne State University School of Medicine explains that
lumpectomy, radiation and
chemotherapy
in addition with standard therapy these days, likely kill the disease in the
nodes therefore
making
their removal unnecessary.
February
22, 2011 - Study: Lymph node removal not always needed - Sioux Falls Argus
Leader – by
Jon
Walker –
Women
will be spared much pain and anxiety in light of research showing less need to
remove lymph
nodes
from the armpit to fight breast cancer, South Dakota specialists
said.
"With
cancer, it used to be the more treatment the better. This study shows extra
treatment doesn't affect
outcome,"
said Kristi Egland, an associate scientist for Sanford Research-USD.
Women
benefiting most are those in early stages of breast cancer and already
undergoing radiation and
chemotherapy.
Removing lymph nodes is a third step in stopping the disease, but the full
extent of that
approach
might be nonessential and perhaps unnecessarily harmful.
"This
study says having all the lymph nodes out does not increase the chance of
survival," Egland said.
Leaving
more nodes in place would spare women potentially painful surgery and lower the
risk of
lymphedema,
a swelling in the arms causing discomfort and other complications.
The
center of concern is lymph nodes under the the skin, including about 30 in each
armpit. The nodes,
smaller
than a garden pea, are a collection point acting like a river dam in the body's
self-defense system.
The
nodes collect intruding viruses and bacteria migrating under the skin and alert
the body's immune
system
to destroy the microscopic invaders.
Cancer
cells also collect at the lymph nodes, but they are oblivious to the body's
defenses and instead
multiply
out of control. Removing the nodes from the armpits has been a standard
approach to eradicating
the
problem.
"When
women had one to three lymph nodes with cancer, traditionally we said we need
radiation and
chemotherapy
and said we have to be very, very aggressive with treatment," said Dr. Juliann
Reiland, a
breast
surgeon in Sioux Falls.
"The
study shows going back to the operating room and removing more lymph nodes did
not make these
women
better. They also had chemotherapy and radiation. They didn't need all three.
They only needed
two,"
Reiland said.
A
study at 115 hospitals followed 891 women about six years, the New York Times
reported. Surgeons
removed
cancerous nodes in the women and in some, but not all, removed 10 additional
nodes as a
precaution.
Over time, the two groups showed the same survival rates. The National Cancer
Institute paid
for
the study, which Dr. Monica Morrow, from Memorial Sloan-Kettering Cancer Center
in New York,
explained
in the Journal of the American Medical Association.
Reiland
is medical director at interoperative electron radiation therapy at Avera
McKennan Hospital. She
has
been following a protocol for several years toward less aggressive removal of
nodes. Specialists inject
radioactive
material that migrates to the armpit to pinpoint which nodes host cancer
cells.
"For
80 percent of the women, we were overoperating. Now we know how to identify the
one or two
nodes
that have cancer," she said.
Betty
Meyer, South Dakota vice president of Susan G. Komen for the Cure, said the
study might spare
women
considerable difficulty. "Anything we can do to decrease the incidence of
lymphedema is going to
be
really good," she said.
February
23, 2011 - Lymphedema Depot: Lymphedema Awareness Day is March 6, 2011 - Wire
Service
Canada (press release) –
Do
you suffer from lymphedema and don’t know where to get help?
Lymphedema
is gaining notoriety as the “most-feared” complication of breast cancer
surgery. You may
have
heard of lymphedema but what do you know about it? On the other hand, you may
know a lot about
lymphedema,
but do you share what you know?
Do
you know someone with a chronically swollen arm or leg that you have never
asked them about?
Do
you suffer from lymphedema and find yourself reluctant to talk about it with
others?
Do
you suffer from lymphedema and don’t know where to get help?
On
Lymphedema Awareness Day we challenge you to learn something about lymphedema
and to tell
someone
else what you learned. You might start by searching Facebook for “Lymphedema
Awareness
Day
Canada” and seeing what you find.
Some
municipalities have been urged to officially proclaim March 6th as Lymphedema
Awareness Day to
help
bring about increased awareness of this lifelong condition.
February
23, 2011 - Study shows some breast cancer patients can safely keep lymph nodes
- Tampabay.
com
– By Irene Maher –
A
medical study published this month promised good news for thousands of women
whose breast cancer
surgery
might lead to a painful condition known as lymphedema.
This
drastic and persistent arm swelling is a frequent consequence not of breast
surgery itself, but of
removing
nearby lymph nodes.
But
it turns out that the women in the study who kept their nodes, even if cancer
was present, fared just as
well
as those who had them removed.
Still,
will doctors and patients knowingly leave behind anything cancerous, even just
a lymph node or two?
It
will be a tough sell, admits Dr. Peter Blumencranz, director of Morton Plant
Hospital's Comprehensive
Breast
Care Center and a co-author of the study, published in the Journal of the
American Medical
Association.
Leaving behind lymph nodes known to have cancer goes against physician training
and most
current
medical guidelines.
"We
had trouble recruiting patients for the study because surgeons were
uncomfortable with the idea of not
taking
the nodes," he said. Researchers hoped to enroll 1,900 patients, but only about
half that number
signed
up.
"What
we were asking them to do was radical," he said.
•
• •
For
decades, doctors removed all lymph nodes from all breast cancer patients.
Later, researchers found
that
only women with positive sentinel nodes (the first nodes where breast cancer
typically spreads) had to
have
all their nodes removed. Then in 1999, a group of physicians, including
Blumencranz, launched a
study to find
out if breast cancer patients with positive sentinel lymph nodes could be
spared complete
node
removal.
The
thought was that radiation and chemotherapy would eradicate stray cancer cells
in the lymph nodes.
"The
good news is, after six years of followup, those women who kept their nodes did
as well as those
who
had their other nodes removed," Blumencranz said.
Dr.
Christine Laronga, program leader of the Don and Erika Wallace Comprehensive
Breast Program at
the
H. Lee Moffitt Cancer Center in Tampa, helped recruit patients and remembers
the early days of the
study.
"When doctors first heard about this study, everybody thought, are you crazy?"
she said.
But
as results started trickling in and there was virtually no difference in
outcomes, Laronga and other
practitioners
started offering select patients the option.
When
the study made national headlines, "all the women we saw wanted to be
considered for not having
their
lymph nodes out," she said.
Only
certain patients are considered eligible for the node-sparing approach: those
who have early-stage
breast
cancer and are treated with lumpectomy, chemotherapy and whole breast
radiation.
Dr.
Suzanne Lynn, a breast surgeon at St. Joseph's Women's Hospital in Tampa, is
bracing for
disappointed
patients. "They come in so hopeful; you hate to burst their bubble, but this
doesn't apply to
everyone,"
she says. Patients who opt for a mastectomy or for partial breast radiation
were not included in
the
study, and may still be counseled to have their lymph nodes removed.
•
• •
Despite
the research findings and the lowered risk of lymphedema, some patients still
opt for node
removal.
Blumencranz said many women dropped out of the study when they found out their
nodes were
positive.
"They were just uncomfortable with leaving any cancer behind," he
said.
Cheri
Wetzel, 62, of Sun City Center, understands those women. She was diagnosed with
breast cancer in
2008
and had a lumpectomy. Three sentinel nodes were positive for cancer. A patient
of Laronga, Wetzel
wanted
the nodes out then and says she would make the same decision today — even
though she has
suffered from lymphedema (see
box).
"Leaving
lymph nodes behind, where you know there are cancer cells, no," Wetzel said. "I
feel more
comfortable
that it's been removed."
Will
this study change medical treatment guidelines?
Experts
say yes, but it may take time to win over skeptical physicians and
patients.
"Some
will be very happy to know they can keep their nodes," Lynn said. "Others will
still have the fear of
leaving
cancer behind. At least now we can let them know what the facts are."
March 2, 2011 - NBC29Cancer's Dirty Little
Secret - NBC 29 News –
It's
sometimes referred to as cancer's dirty little secret. Lymphedema is a lifelong
condition that can strike
patients
after cancer treatment. Carla Harris was diagnosed with stage three breast
cancer in 2009.
Treatment
included radiation and surgery. When she heard about lymphedema she didn't
think the
sometimes
painful condition would happen to her.
"It
was mentioned as one of the possible, rare, unlikely side effects of surgery,"
Harris said.
Two
months after surgery she was diagnosed with lymphedema and now faces a life
long battle. She's prone
to
infection from bug bites and sunburn and has to be careful of change in
altitude or physical activity that
may
cause her to swell.
"It
affects every minute of my day from getting dressed in the morning and putting
on my compression
garments
to what I can lift. Whether I can lift my children," Harris said.
Lymphedema
is when fluid builds up in the arms, legs or torso. This can happen after
lymphnodes are
removed
or damaged from cancer treatment. In breast cancer patients often times
lymphnodes are removed
in
the arm.
Cyndi
Stabenow is an Occupational Therapist and Certified Lymphedema Therapist at UVA
HealthSouth in
Charlottesville
and said there's no cure but Lymphedema can be controlled.
"This
is a condition that needs to be managed so that fluid build-up doesn't continue
to go on," Stabenow
said.
Treatment
includes fitting patients with compression bandages, garments and special
massage therapy.
"It's
a process that can take sometimes the intensiveness of it maybe five days a
week or two or three weeks
maybe
three times a week after that," Stabenow said.
People
with lymphedema have to be diligent about their care so the swelling stays
under control.
March
2, 2011 - Facts about lymphedema - The Republic –
What
is lymphedema?
The
lymphatic system collects and flushes out bacteria, viruses and waste products
from the body through
infection-fighting
cells in the lymph nodes. If nodes are removed, fluid builds up, causing pain
and swelling.
What
helps
Light
exercise, to keep fluid moving; massage; compression sleeves or stockings to
force fluid out of the
affected
limb.
Research
The H. Lee Moffitt Cancer Center in Tampa, Fla., is participating in an investigation of the use of liposuction
to
remove fat cells from lymphedema patients so fluid can't collect as easily. So
far, a 70 percent reduction
in
symptoms has been reported. Among the research subjects is Cheri Wetzel. "I'm
back into regular
clothing,
have full use of the arm and no discomfort,'' she said. "I still have
lymphedema, but it's not to any
degree
what it was."
Moffitt
is seeking additional funding for more research, estimated to cost $15,000 per
participant.
"Lymphedema
can pop up 20 years after breast-cancer surgery, so we'll need to continue
finding ways to
treat
it," says Moffitt's Dr. Christine Laronga.
(Distributed
by Scripps Howard News Service http://www.scrippsnews.com)
March
2, 2011 - Lymphedema Depot Addresses Hand Swelling - Wire Service Canada (press
release) –
Lymphedema
of the hand is troubling and difficult to treat. Lymphedema Depot offers the
Solaris
compression
glove, in both Caresia and Tribute styles, to control hand swelling.
March
2011, St. Catharines, Ontario
For
many lymphedema patients hand swelling is a particular concern. In lymphedema,
there is chronic
swelling,
usually of a limb. In cases of breast cancer where multiple procedures have
compromised the
ability
of the lymphatic system to drain the arm of excess fluid, arm swelling often
results. Having arm
swelling
does not guarantee that you will experience hand swelling, but if the arm is
swollen there is a risk
that
the hand will swell, too. Once hand swelling begins it can often be difficult
to control. The back of the
hand
can be a problem as there is relatively low tissue pressure there and it will
easily fill with fluid. Finger
swelling,
when it occurs, can be uncomfortable and disturbing and equally difficult to
manage.
Caresia
Glove bandage liners are excellent for those who have hand and/or finger
swelling. Every Caresia
Glove
has individual finger spacers to provide comfortable, non-binding compression.
Many therapists
recommend
this glove for their post-surgical hand patients and patients with arthritis or
lymphedema. It is
designed
to be worn while you sleep, effectively cradling the affected hand and fingers
with mild
compression
and stimulating the lymphatic system to mobilize fluid away from the saturated
area.
Depending
on the nature of the edema, the fingers may not swell, while the back of the
hand does swell.
Where
finger swelling is not a serious problem and more functional mobility of the
hand is desired, the
Caresia is
available in a gauntlet style which stops at the knuckles, leaving the fingers
free.
The
Caresia glove is the standard-sized version of the Solaris Tribute glove. The
Caresia is available in
small,
medium and large while the Tribute is custom made for those who need a more
precise fit.
As
with all Solaris directional-flow products, foam chips address tissue
thickening, and quilted channels help
guide
fluid away from affected areas. Caresia offers a simple, safe and effective way
to eliminate bulky and
troublesome
hand bandaging, and is easy to care for – simply wash and dry on permanent
press settings in
your
home laundry machines as often as needed.
Lymphedema
Depot and Solaris both strive for continuous improvement to make the management
of
lymphedema
less complex, more effective, and ultimately easier for patients.
For
more information, visit http://www.LymphedemaDepot.com
March
3, 2011 - Hallmark Health Cancer Center opens lymphedema clinic - Medford
Transcript –
At
Hallmark Health System, the patient always comes first. The local healthcare
organization is continually
looking
for ways to improve patients’ experience and achieve excellence each and every
day.
With
that goal in mind, Hallmark Health System recently opened a lymphedema clinic
at the Hallmark Health
Cancer Center
in Stoneham. The clinic will be staffed by a certified lymphedema specialist
that will provide
lymphedema
treatment and physical therapy to patients that need it.
Lymphedema
refers to the swelling of various body parts including the arms, legs and face.
It is a common
side
effect among patients that have had their lymph nodes removed due to
cancer.
Hallmark
Health’s certified lymphedema specialist will work one-on-one with patients to
treat their
lymphedema
through compression bandaging, manual lymphatic drainage and exercise. They
will also
address
fatigue and other side effects that result from cancer treatment.
The
new clinic will provide patients with yet another advanced level of service as
well as make scheduling
appointments
easier and more convenient for patients. With all of their appointments under
one roof patients
can
focus on what’s important, completing treatment and getting back on their
feet.
The
Hallmark Health Cancer Center has been honored by highly distinguished
organizations such as the
American
College of Surgeons (ACOS), which recognized the Center for high quality
programs. It received
approval
with commendations following a site visit where ACOS examined cancer registry
data, attended a
tumor
board meeting, toured the Center and reviewed more than 50 patient records. The
approval allows
the
Center to continue its designation as a “Community Hospital Comprehensive
Cancer Program.”
Copyright
2011 Medford Transcript. Some rights reserved
March
3, 2011 - Center educates women on risk with national lymphedema awareness day
- Aiken
Standard
(subscription) – by ROB NOVIT -
When
Peggy Wojtowicz was diagnosed with breast cancer in 1994, she went through a
regimen of
chemotherapy
and radiation and had 22 lymph nodes removed.
Her
doctor mentioned at the time that the surgery and radiation potentially could
lead to a condition called
secondary
lymphedema - a serious fluid buildup caused by damage to the lymphatic
system.
Today
Wojtowicz has become an advocate to educate women about lymphedema, after she
contracted it in
1999.
Hitchcock
Healthcare, which has an occupational therapist certified in treating the
disease, is promoting a
national
lymphedema awareness day on Sunday.
An
Aiken resident since 1985, Wojtowicz has remained cancer-free.
For
five years after her treatment, she avoided lifting heavy weights and, other
than a slight swelling in her left
arm,
had no other symptoms that would indicate lymphedema.
In
1999, the symptoms arrived almost overnight.
"My
arm was red and swollen to twice its normal size, and I got cellulitis,"
Wojtowicz said. "That's the most
dangerous
thing and can be life-threatening within a matter of hours, as the infection
can become systemic. It
was
terrifying and very painful."
Not
long before, Wojtowicz had taken an international flight for a church mission
trip. She was not aware at
the
time that an extended change in air pressure can trigger lymphedema.
Wojtowicz
visited her doctor and got immediate treatment from an occupational therapist
in Augusta.
For
the past three years, she has seen Hitchcock occupational therapist Holly
Shurtleff for periodic therapy.
A
staffer at Hitchcock for the past 20 years, Shurtleff used to refer lymphedema
patients to a Spartanburg
facility.
Hitchcock executives recognized a need for services on-site and sent Shurtleff
to a training program
to
become certified to assist patients with that condition.
As
with any newly-diagnosed person with lymphedema, Wojtowicz spent three weeks
with an occupational
therapist,
getting compression bandages and learning how to change them every 24
hours.
"I
also provide them a daily massage if needed to stimulate the lymphatic system,"
said Shurtleff. "The
purpose
is to decrease the girth of the extremity to as normal as possible - in this
case, the left arm."
Wojtowicz
also wears a compression garment during the day. While she sleeps, she uses a
ReidSleeve,
which
is designed to offer gentle compression that meets the patient's specific
needs.
"I
also continue manual massage, and Holly is always there for me for all kinds of
answers to my questions,"
said
Wojtowicz. "The other thing I've done is exercise. I was afraid to do it at
first, but now I do isometrics,
yoga
and Pilates, and free-weights, using my arm in moderation. I've maintained a
healthy weight, and I still
come
to Hitchcock once a year for measurements and management."
People
can be born with lymphedema, Wojtowicz said.
For
those who have had breast cancer, there is hope, she said.
Survivors
should educate themselves as much as they can about lymphedema, and there are
many sources
online.
Early
detection is important, and a Hitchcock pamphlet warns of symptoms such as
swelling of an extremity,
a
"full" sensation, frequent infections, limited movement of limbs and swelling
that prevents the wearing of a
ring
or watch.
"Lymphedema
doesn't have to stop life," said Tasha Savage, Hitchcock's director of
marketing and
development.
"We want to make sure that people have as much independence as they can. They
don't have
to
stop doing what they love to do."
With
her protective garment in place and bringing along IV antibiotics, Wojtowicz
traveled on mission trips
in
2006 and 2009 to the Central African Republic, where she worked with orphaned
children.
"I
was thrilled to go overseas, and I thank the Lord for all of this," she said.
"I'd rather not be a poster child
for
lymphedema, but this is something God has entrusted me with. If somebody else
can benefit from my
experience,
I can share it with them."
Contact
Rob Novit at [email protected].
March
3, 2011 - Group sheds light on chronic condition - Prince Albert Daily Herald –
by Shannon Lacroix
–
A
chronic condition, rarely heard of and hard to diagnose, will be getting some
attention Sunday.
Members
of the Saskatchewan Lymphovenous Learning Association (SLLA) have declared
March 6
Lymphedema
Awareness Day. The focus will be on bringing to light the condition that can be
mistaken for a
heart
or kidney condition or being overweight according to Barbara Lauterbach,
education chairperson of
the
SLLA.
The
lymph system is spread across the body and helps clean the system by producing
lymph fluid that picks
up
waste and brings it to different nodes. From the nodes the waste goes to the
circulatory system, which
brings
it to the kidneys and liver so they can get rid of it.
Lymphedema
is what someone experiences when the lymph fluid is not being absorbed back
into the body
Lauterbach
explained. The condition causes swelling the in the area where the system is
damaged, which can
eventually
lead to open sores. Lauterbach, who has the condition herself, noted that
diagnosis is vital to stop
the
condition from getting to that point.
“The
sooner you get it diagnosed, the quicker treatment starts, the less pain and
the less time it takes for you
to
get to a point where you can function again,” she explained.
March
4, 2011 - 'That Was Then' - Royal Oak Daily Tribune
This
is for a specific meeting that has now passed (March 10)
March
6, 2011, - Mountain Medicine: Occupational therapists can help cancer patients
- Arizona Daily Sun
MICKIE
TOUTANT –
One
of the most common side effects associated with cancer treatments is the
feeling of being fatigued.
This
feeling can affect many aspects of a person's life. It may affect an
individual's mood or emotions, or the
ability
to do usual daily activities, and it can affect the time they are able to spend
with family and friends or
their
ability to perform their job.
Fortunately
for those battling fatigue due to cancer treatments, there are specific
programs and services
available
that address a person's physical recovery.
It
is extremely important for individuals with cancer to maintain at least a
minimal level of exercise and
activity.
Doing so assists them in staying physically and emotionally strong and healthy
and contributes to
their
overall sense of well being. Even small amounts (three to 10 minutes) of
exercise a few times a day can
be
very beneficial.
Additionally,
it is imperative that those battling cancer, continue to perform their typical
daily activities as
much
as possible. Although it may be tempting to just let things go for a while,
daily activities help the
individual
to maintain energy levels, physical strength and range of motion. Of course,
some days are better
than
others, but the goal is to keep moving.
When
surgery is necessary to remove a lump or tumor, such as lumpectomy or
mastectomy, often there is a
loss
in range of motion and increase in pain, not to mention scar tissue forming and
the skin feeling sensitive
and
tight. Additionally, swelling may also occur around the surgery area causing a
condition called
lymphedema.
Lymphedema
most often is seen in the arm and under-arm areas of breast cancer patients.
The condition
can
be very painful and even debilitating. Patients with this condition can work
with occupational therapists
who
are specially trained to treat lymphedema to minimize the effects. OTs can
offer education, lymphedema
management,
specific exercises and pressure sleeves, all of which can be used to help
relieve and even avoid
this
condition.
In
addition to surgery, cancer treatments such as chemotherapy, radiation,
medication regimes and stress
can
cause fatigue and limit day-to-day activity tolerance. Occupational therapists
can address concepts such
as activity modification, self pacing, simplifying daily activities and strategies for energy restoration. All these
can
help minimize the impact of cancer treatments on the individual.
Focusing
on physical treatments and recovery is just one part of the journey --
emotional support and
recovery
also are extremely important. Support, encouragement and reassurance are a key
part of
rehabilitation
therapy.
Those
battling cancer should remember they do not have to do everything for
themselves. Save energy for
the
things that bring joy to your life and the things that are most
important.
If
you currently are undergoing treatments for cancer, the Cancer Centers of
Northern Arizona Healthcare
and
Flagstaff Medical Center would like to offer a complimentary session to address
an individual's cancer
fatigue
and course for rehabilitation. These services are provided by a licensed
occupational therapist that
specializes
in cancer rehabilitation. For more information on this complimentary program,
call FMC's
Therapy
Services at 773-2125.
Mickie
Toutant, O.T., occupational therapist in Flagstaff Medical Center's Therapy
Services, specializes in
neuro therapy,
hand therapy and working with cancer survivors. Is there a health topic you'd
like to know
more
about? Please write to Mountain Medicine, c/o FMC Public Relations, 1200 N.
Beaver St., Flagstaff,
AZ
86001, or visit FlagstaffMedicalCenter.com.
March
7, 2011 - New Range of Compression Stocking From SocksforLegs - BigNews.biz
(press release)
–
BigNews.Biz
- Mar 07,2011 - Limb swelling and other such diseases are a persistent problem
for a
considerable
number of people. There are certain things that can help you reduce limb
swelling and avoid
other
problems like leg swelling, venous insufficiency, varicose veins, lower and
upper extremity
lymphedema
and other kinds of edemas.
SocksforLegs
is a part of a renowned family owned medical supply store with over 30 years of
experience.
They
have been offering wide varieties of even some hard to find medical equipment
that also includes
compression
stocking. Recently they have launched their new range of compression stockings
that can be
very
effective against limb swelling. They have just boost their existing product
line and included some great
compression
stocking from the top makers like Jobst, Sigvaris, Juzo and medi. SockforLegs
has been
created
with the very aim of providing their customers with all kinds of varieties,
colors, sizes and brands
that
they dream about.
The
www is replete with sources offering almost all kinds of information on
different kinds of compression
garments
and their designs. People looking for reliable information on compression
stocking and other such
stuff
can also make the most of that source and get their desired information without
putting them into any
trouble.
The
wide range of compression stocking available at StockforLegs can make it easier
to find the stuff quite
according
to your different requirements. The nice thing is that whatever they show at
their website is also
available
in stocks. They are carrying thousands of compression products from almost all
renowned brands
and
even some hard to find products and stocking can be easily found from that
source. They are offering
product
ranges from brands like Juzzo, Jobst, Sigvaris and Medi. The new ranges of
compression stockings
from
different brands can definitely make it easier for you to choose compression
stocking quite according
to
your needs.
March
7, 2011 - Phase 3 Randomized Breast Cancer Lymph Node Study Likely to be
Practice-Changing -
Cancer
Network – By Anna Azvolinsky –
Axillary
lymph node dissections (ALND) remain the standard of care for breast cancer
patients that have
sentinel
lymph node metastases. This is based on a meta-analysis of breast cancer
patients showing that
locally
controlling breast cancer via lymph node dissection improved disease patient
survival. However, the
procedure
carries the risk of serious complications such as infection, lymphedema, and
seroma. Sentinel
lymph
node dissection (SLND) was developed to decrease these risks while still
accurately staging lymph
nodes.
Micrograph
showing a lymph node invaded by ductal breast carcinoma and with extranodal
extension of
tumor.
Courtesy of Nephron, Wikimedia Commons
Whether
ALND affects overall survival in breast cancer with SNL metastasis or whether
SNLD alone is
sufficient
is now addressed in a randomized, multi-center, Phase 3 non-inferiority trial
published in a
February
edition of the Journal of the American Medical Association (doi:
10.1001/jama.2011.90). The
study
of state I or IIA breast cancer patients began in 1999, enrolling 891 patients
who were randomized 1:
1
to receive either SLND followed by ALND or SLND alone. Both groups had a
lumpectomy (the removal
of
the tumor) and adjuvant systemic treatment. The study was funded and designed
by the American College
of
Surgeons Oncology Group in collaboration with the National Institute on
Cancer.
The
median number of lymph nodes removed in the ALND group was 17 compared with 2
in the SLND
group.
The adjuvant systemic therapies received by both groups were comparable: 96%
and 97% of the
ALND
and SLND patients, respectively, received similar adjuvant therapies. The
majority of patients
received
whole-breast radiation therapy. Age, stage of cancer, and tumor size did not
vary significantly
between
the two groups.
ALND
does not increase survival
The
use of SLND compared to ALND was not statistically inferior in terms of overall
survival (P=0.008).
The
5-year overall survival rates were 92.5% and 91.8% in the SLND-alone compared
to the ALND
group.
Likewise, disease-free survival did not vary between the groups. Morbidity,
however, was much
higher
in the ALND group: the rate of wound infections, axillary seromas, and
lymphedema were all
significantly
more frequent.
The
authors attributed the overall high frequency of good outcomes on improved
breast cancer management
including
better imaging, more detailed pathological evaluation, and improved surgical
and radiation
approaches.
Study
Implications
The
trial results suggest that women may be exposed to morbidity due to ALND with
no meaningful
improvement
in overall survival, including for women classified as high-risk (estrogen and
progesterone(Drug
information
on progesterone) receptor negative patients). The limitations of the study, as
cited by the
authors,
is a failure to achieve a target accrual of 1900 patients as well as a
potential randomization
imbalance
that favored the SLND-only cohort. Additionally, the patient follow-up was
approximately 6
years
and a longer-term follow-up would be beneficial, as early-stage breast cancer
can reoccur at 10 to 15
years
after diagnosis.
According
to this randomized Phase 3 trial, knowing the number of nodes containing
metastases by ALND
does
not change recommendations for systematic therapy decisions and is obtained at
the cost of higher
morbidity
from surgery, including pain, limited range of motion, and
lymphedema.
As
Gary Lyman, MD, professor of medicine and Chair of the ASCO Sentinel Lymph Node
Biopsy
Guideline
Panel pointed out in an ASCO editorial in response to the publication, the data
will likely change
physician
practice for early stage disease. However, he cautioned that the study results
do not apply to early-
stage
patients with high risk for reoccurrence including those with three or more
positive sentinel lymph
nodes,
larger tumors, or those who received preoperative chemotherapy
March
8, 2011 - Y exercise program helps cancer survivors regain strength -
MyCentralJersey.com (blog)
–
by BOB MAKIN -
EDISON
— Carol Weiss, a breast-cancer survivor, sometimes suffers from lymphedema,
tissue swelling
caused
by a blockage of the lymph nodes, which, in turn, is caused by the cancer.
Longing to exercise but
afraid
to injure her swollen arm, Weiss was thrilled to hear that the Livestrong at
the Y small-group exercise
program
not only was customized for cancer survivors but also for those dealing with
lymphedema.
The
township resident recently graduated with 13 other survivors from the latest
Livestrong class at the
Edison
YMCA.
The
12-week program is offered for free to cancer survivors through cycling great
Lance Armstrong's
Livestrong
Foundation at all branches of the YMCA of Metuchen-Edison-Woodbridge-South
Amboy, as
well
as the Somerset Hills YMCA in the Basking Ridge section of Bernards.
In
Edison, participants meet twice weekly for strength training, cardio work and
yoga.
"They
know how to guide you to do what you need and how to do it safely," said Weiss,
who now manages
lymphedema
through exercise.
Before
addressing a multi-purpose room full of Livestrong graduates past, present and
future and their
families,
Lexy Anderson, the Edison branch's associate executive and wellness director,
described the
program
as life-changing.
The
family of a recently-deceased graduate was so grateful for the program's impact
that they asked that
donations
be made to Livestrong at the Y, Anderson said.
"These
fragile people are not sure how they're going to respond to physical activity,"
she said. "But they
grow
in such a short period of time and get their life back. They begin to feel
stronger."
The
Feb. 17 graduation marked the Edison branch's fifth since the program was
launched a year and a half
ago,
Anderson said.
Halfway through
the program, participants are provided with a free three-month membership to
the Y, as
well
as free monthly yoga sessions for life. Half of the Livestrong graduates said
they plan to join the Y in
order
to keep working out with each other and to get help from their team of four
exercise instructors.
"I
think what I got most out of it was the camaraderie," Weiss said.
"We
all seemed to really meld," said Johanna Minucci, a breast-cancer survivor from
Edison. "We made a
nice
group."
Weiss
continued, "I think we are also a lot more confident now. We want to keep going
so that we will feel
better."
Expansion
of the Edison branch will begin in the spring and be completed in the fall,
Anderson said. The
Livestrong
at the Y program will expand with it, she said.
Sue
Tadros, a breast cancer survivor from the township, said she was looking
forward to the next class (that
started
yesterday).
"I
want to get my energy back," Tadros said. "From what I've seen, I think this
really can help."
The
cancer survivors are not the only ones who benefited from the program. By
getting to work with such a
specialized
population, the trainers grow professionally, said Tim Marshall, one of the
program's four
instructors.
Livestrong
at the Y inspired Marshall, 25, of Highland Park, to write his master's thesis
about cancer
survivors
overcoming exercise barriers.
"A
one-pound weight may seem very light, but a cancer survivor doesn't recover
from exercise in the same
way,"
said Marshall, who soon will receive a master's in exercise science from Kean
University in Union.
"It's
a challenge to create a program that won't make them so sore that they can't
function," he continued.
"The
purpose of the program is for them to function outside. They should have more
energy than when they
walked
through the door. And all of them do. They feel reinvigorated, ready to be
active again, even if
they're
going through chemo. We had one who was going through chemo. She would come in
really tired,
but
she would leave with more energy and a better quality of life."
March
8, 2011 Mather Hospital's Lymphedema Treatment Center Names Roger Geldert of
Bay Shore
Patient of the
Year – NewsLI
(Port
Jefferson, N.Y.) – Roger Geldert of Bay Shore had tried everything to find out
what was causing the
blisters
and fluid buildup in his legs. It wasn’t until Mr. Geldert, 46, was sent to
Mather’s Wound Care
Center
in Melville that he was diagnosed as having Lymphedema. He was immediately
referred to Mather’s
Lymphedema
Treatment Center in Port Jefferson.
Almost
a year after his diagnosis, Mr. Geldert was honored by Mather for his
extraordinary commitment to
his treatment
in recognition of National Lymphedema Awareness “D” Day on March 6. “D” Day a
special
day
set aside by the National Lymphedema Network to honor inspirational lymphedema
patients who have
contributed
to the community or who have shown great courage in their struggle with
disease.
“We
wanted to honor him and his wife, Michelle, for really stepping up to the plate
and exemplifying what
lymphedema
treatment is all about,” said Anne Babcock, a lymphedema therapist at Mather.
Babcock said
treatment
for lymphedema is time consuming and requires commitment on the part of the
patient to be
successful.
Geldert
credited the staff of the Lymphedema Treatment Center for helping him manage
his condition, and
Michael
Petersen, MD, Medical Director of Mather Hospital’s Wound Care Center, with
diagnosing his
illness
and also treating a related non-healing wound.
Lymphedema
is a swelling of the body’s soft tissue, usually in an extremity, caused by an
accumulation of
proteins,
cells and water. Usually, these proteins, along with excess cells and water,
are carried away by our
circulatory
or lymph systems. Lymphedema occurs when these systems are damaged. Although,
Lymphedema
is a chronic condition, it can be managed with proper care and
treatment.
An
adjunct of the Physical Therapy Department, the Lymphedema Treatment Center at
Mather is one of the
largest
hospital-based programs in the northeast. In 2010, Mather’s eight certified
Lymphedema therapists
provided
for more than 2,100 patient visits. The program also offers the only Lymphedema
support group in
Suffolk
County. Treatment is provided by Mather Hospital’s Department of Physical
Therapy.
Geldert
said that he was so pleased with his treatment at Mather that when he decided
to have weight loss
surgery,
he selected Mather’s Bariatric Surgery Center of Excellence. His procedure is
scheduled for later
this
month.
John
T. Mather Memorial Hospital is an acute 248-bed, non-profit community hospital
dedicated to
providing
a wide spectrum of high quality healthcare services to Suffolk County
residents, showing
compassion
and respect and treating each patient in the manner we would wish for our loved
ones.
For
more information on the Lymphedema Treatment Center call 631-686-7648 or online
at www.
matherhospital.org.
March
9, 2011 - Andersen Jones Lands New Breast Cancer Clients - SunHerald.com
–
Get
error code 404 when click on this link
March
9, 2011 - Heart failure can cause feet to swell - Payson Roundup –
DEAR
DR. DONOHUE: Please explain why I have to take my shoes off late every day
because my feet
and
ankles have swollen and don’t fit into the shoes. I flop around in slippers
without heels. In the morning,
after
a night’s sleep, my feet are back to normal. I am 77 and take no medicines. —
K.M.
ANSWER:
I can’t give you an unequivocal response because there are numerous causes of
foot and ankle
swelling.
The
medical name for such swelling is edema. Even in relatively healthy people, it
occurs if people sit or
stand
for any length of time. Gravity pulls fluid out of the circulation, and it
accumulates in the feet and
ankles.
This is especially true at older ages, when the circulatory system becomes
somewhat leaky.
For
this kind of swelling, the solution is to elevate the legs when sitting. The
most effective elevation is raising
the
legs above heart level, something that can be done only by lying down with
pillows propping up the legs.
Getting
up and moving about is another way to prevent fluid accumulation in the
feet.
Heart
failure is a more serious cause of such swelling. When the heart’s pumping
action becomes feeble,
fluid
escapes from blood vessels and again accumulates in the ankles and feet. Kidney
disease with retention
of
body fluid is another cause of edema. Liver disease does the same.
Another
condition called lymphedema produces the same picture. Lymph is fluid that
normally escapes the
circulation
to percolate around tissues and organs to provide nourishment and to wash away
germs. Small
vessels
called lymphatics vacuum up this fluid and return it to the circulation.
Anything that disrupts
lymphatics
can lead to ankle/foot swelling. An old infection and surgery are two such
disruptors.
Since
ankle and foot swelling is a sign of many urgent medical conditions, don’t fool
around with this. See
your
family doctor.
The
booklet on edema and lymphedema clearly describe these conditions and their
treatment. Readers can
obtain
a copy by writing: Dr. Donohue — No. 106W, Box 536475, Orlando, FL 32853-6475.
Enclose a
check
or money order for $4.75 U.S./$6 Canada with the recipient’s printed name and
address. Please
allow
four weeks for delivery
March
10, 2011 - Lymphedema awareness making headway - Lac du Bonnet Leader – By Lory
Mitton –
Last
Sunday was recognized by 43 Manitoban municipalities and by Minister of Health,
Theresa Oswald, as
Lymphedema
Awareness Day.
"I'm
ecstatic, I think that's just awesome!" Kim Avanthay said about the
participation of the province and so
many
communities. Having received only 55 responses to the 100 requests she made
that the day be
recognized,
Avanthay says their could be even more who acknowledged the important
day.
"Hopefully
this is a step forward," she said. "Lymphedema needs more awareness not only
among those
who
suffer from it but among health care officials as well."
Avanthay
has seen a good response to efforts made to promote the day.
"My
first contact came after the Lac du Bonnet Leader was posted on the web. I
received an email from the
UK
offering me information and assistance in finding a Canadian supplier for a
product that is being used in
the
UK for lymphedema treatment."
A
lady in rural Manitoba also contacted Avanthay after coming across an article
in the Selkirk Journal about
lymphedema.
"She
has suffered with severe lymphedema and aside from diagnosis, has not received
any care," Avanthay
told
the Leader.
Four
students from Lac du Bonnet Senior School — Jazlyn Johnston, Jessie Weir,
Kaylin Champagne, and
Justina
Bruchanski — wanted to help raise awareness of lymphedema.
Partnering
with the Fair Trade Action Committee at Centennial School, they decided to sell
ice cream
sundaes
for $3 on Friday at Centennial where Austin Avanthay, who lives with
lymphedema, goes to school.
Most
of the students purchased a sundae and together the students raised
$517.25.
"We
like to do stuff like this," Johnston said about the fundraiser. The four girls
did a similar event in
December
and collected canned goods and money for the food bank.
"I
can't believe that they would just do something like that," Avanthay said about
the student initiative.
Her
efforts to raise awareness for lymphedema this year were also met by an
invitation to speak about
Lymphedema
in April at Pinawa Secondary School.
Avanthay's
message:
"Lymphedema
is an accumulation of lymphatic fluid that causes swelling in arms, legs or
other areas of the
body
and it effects both men, women and children. The swelling caused by lymphedema
can lead to severe
infection
or loss of the use of limbs. Patients suffering from lymphedema must endure
physical discomfort
and
disfigurement and cope with distress caused by these symptoms.
"The
single largest group of people who get lymphedema are cancer patients. Recent
studies have indicated
that
patients that have had lymph nodes surgically removed or treated with radiation
are at a higher risk of
developing
lymphedema. According to Canadian Cancer Society, as of January 1, 2005,
723,000 people in
Canada
have been diagnosed with cancer in the previous 10 years.
"No
drug or effective surgical treatment for lymphedema currently exists and
research in all areas of
lymphedema
has been notably limited.
"Lymphedema,
which has no cure and can occur at anytime, has a severe financial, physical,
and
psychological
impact on patients."
For
more information on lymphedema, Avanthay can be reached at
[email protected].
March
11, 2011 - Lymphedema Depot: We Care For Your Feet Too - Wire Service Canada
(press
release)
–
Everybody
likes to have comfortable feet. Solaris Caresia Footwear and legwear were
designed for the
management
of lymphedema and diabetic feet. As it turns out, they make tired feet more
comfortable too.
March
2011
Lymphedema
Depot sells products for the management of lymphedema. However, those products
have
other
uses, too. Wherever swelling occurs and for whatever reason, Solaris quilted
directional flow garments
can
help to resolve it.
Solaris
Caresia Footwear are a good example. The Caresia Footwear consists of something
often referred
to
as “booties.” They fit over your feet and come up just high enough to cover
most people’s ankles. They
are
quilted into channels and those channels are filled with medical-grade chipped
foam. They are made
from
a soft high-tech material, which is breathable, wickable and thermo-releasing.
The foot and ankle are
completely
surrounded by soft fabric and cushioned by medical grade foam.
Caresia
Footwear were originally designed for patients with diabetic feet. However,
many people have been
finding
these “booties” to be not only comfortable but therapeutic. Feet tend to swell
toward the end of the
day,
and many people have mildly swollen ankles after a day on their feet. With the
Caresia Footwear on
your
feet in the evening hours, your feet receive a treatment that increases micro-
circulation and treats mild
swelling.
Your feet can feel refreshed and renewed. The Caresia footwear are so
comfortable they are
sometimes
worn on airplane flights to relieve restless feet and to reduce
swelling.
Caresia
also comes in a knee high model that is perfect for people suffering from
chronic venous
insufficiency,
a condition where the blood in the lower legs cannot be completely pumped back
from the
lower
extremities. The same combination of soft, high tech fabric and medical grade
chipped foam massage
the
feet and legs and support the venous and lymphatic systems to create a more
dynamic and healthful
environment
for the legs.
While
these garments were originally designed for patients with diabetes, lymphedema
and venous
insufficiency
we find that they are being purchased more generally by people with tired, achy
and mildly
swollen
feet and legs. In fact, this past year a few people told us that they gave
these to their mothers for
Christmas,
and their mothers loved them!
To
learn more about Caresia foot and leg wear visit the Lymphedema Depot website
at :
http://www.lymphedemadepot.com/products/solaris/caresia/selections/foot/
http://www.lymphedemadepot.com/products/solaris/caresia/selections/belowknee/
Contact:
[email protected]
March
15, 2011 - Tickets now on-sale for 2011 Stylin' Against Breast Cancer - Aledo
Times Record –
Bettendorf,
Iowa --
The
Trinity Health Foundation is now accepting reservations for the 2011 Stylin’
Against Breast Cancer.
Trinity
Health Foundation, in partnership with Always a Woman, Midwest Hope and
Healing, The American
Cancer
Society, the Trinity Cancer Center and women who do not represent an
organization but who are
advocates
of breast health and survivors, organize the events each year to raise funds
for projects that
benefit
local breast cancer survivors and promote education about breast cancer and
breast health.
On
Wednesday, April 20, the group will host a wine and cheese party from 6:30-9
p.m., at the Quad-
CitiesWaterfront
Convention Center, 2021 State St., Bettendorf. New this year is Penguins
Entertainment
who
will provide “dueling pianos” during the event. The party will also include a
raffle as well as light hors d’
oeuvres
and wine served by area men who have a personal connection to someone diagnosed
with breast
cancer.
Tickets for the wine and cheese party are $20 per person with a reservation or
$25 at the door.
Groups
of 20 or more will receive 20 free raffle tickets.
The
second winner of the Roxanne Kramer Award will be honored during the sixth
annual Stylin’ against
Breast
Cancer luncheon and fashion show that features local breast cancer survivors
modeling clothing from
area
stores on Thursday, April 21, also at the Quad-Cities Waterfront Convention
Center. Doors open at
11
a.m. with the luncheon beginning at 11:30 a.m. Tickets are $25 per
person.
A
combo ticket for admission to both events is also available for $40. One
hundred percent of the proceeds
from
both events benefit stay in the Quad-Cities area to fund projects that help
local breast cancer patients
and
promote education about breast cancer and breast health. To reserve tickets,
call the Trinity Health
Foundation
at (309) 764-7610 or visit www.trinityhealthfoundation.com.
About
the Roxanne Kramer Award
The
Roxanne Kramer Award is an annual honor to be given to an outstanding
individual(s), organization or
business
that has tirelessly contributed to the quality of life of breast cancer
survivors and which through
deed,
word and ongoing advocacy, has helped educate the community about breast cancer
and breast
health.
Kramer,
a breast cancer survivor herself, owns “Always a Woman” boutique in Moline and
co-founded the
Quad
City Breast Cancer & Lymphedema Support Group.
Copyright
2011 Aledo Times Record. Some rights reserved
March
15, 2011 - Lymph node study may change treatment of breast cancer - ABC Action
News – By:
Linda
Hurtado
CLEARWATER,
Fla. - Marion Mage is a concert pianist whose music overflows into many areas
of her
life.
So when she learned she had breast cancer and may have to have lymph nodes
under her arm removed,
she
said, "My biggest concern was that it would affect my arm."
Surgeons
have been removing lymph nodes from under the arms of breast cancer patients
for 100 years,
believing
it would keep the cancer from spreading, and thereby prolong a woman's
life.
But
removing all lymph nodes often results in debilitating side effects.
Doctor
Peter Blumecranz is a breast surgeon at Morton Plant Hospital’s Breast Care
Center. “The biggest
and
worst of that is lymphedema. That's swelling of the arm. It can get big and
swollen and can stay that way
the
rest of your life. Unfortunately, there is no way to fix it if you have
it."
Marion
would, “Pray every day, ‘Please God, just don't let that happen to me.’ Because
at that point,
playing
was my livelihood."
But
Dr. Blumencranz, Marion’s surgeon, was involved in a study to see if removing
all of a woman's lymph
nodes
had any advantage. The study, eventually published in the Journal of the
American Medical
Association,
included Marion and around 1,000 others over five years.
The
women in the study had surgery followed by radiation and chemotherapy. Some had
lymph nodes
removed,
others did not. Dr. Blumencranz says, “It turns out reoccurrence under arms and
overall survival
from
their breast cancer were identical whether you had other nodes removed or not.
This is practice-
changing.
That's why it so important. This flies in the face of all prior teachings and
changes the way we
manage
breast cancer."
Dr.
Blumencranz took out five of Marion's lymph nodes because cancer had spread to
the first two but he
left
the rest. But she says, “I've had a cousin who had almost the same exact
surgery two years later, not in
this
state. Cancer showed up in two or three of her lymph nodes and they just took
all of them and she's
having
all kinds of problems with the swelling of her arm, the lymph fluid. In
hindsight, we are very glad we
were
part of this study."
Because
after one month of recovery, Marion has had no side effects at all.
March
15, 2011 – Study reveals lymph node removal surgery useless for many breast
cancer patients – by:
David
Gutierrez (NaturalNews)
The
common practice of removing the lymph nodes of breast cancer patients does
nothing to reduce the rate
of
cancer recurrence, according to a study conducted by researchers from the John
Wayne Cancer Institute
and
published in the Journal of the American Medical Association.
In
about one-third of breast cancer cases, the cancer spreads to one or more lymph
nodes in the body. In
these
cases, doctors normally recommend surgical removal of the lymph nodes in the
armpits, regardless of
whether
the cancer has spread to those particular nodes or not. This surgery is meant
to reduce the risk of
cancer
recurrence, but it is painful and leads to a more difficult recovery. In
addition, many women whose
lymph
nodes have been removed suffer from complications such as infection and a
chronic, disabling
swelling
in the arms called lymphedema.
"Of the 161,000
women with breast cancer who have lymph nodes removed every year, 35 to 40
percent
develop
lymphedema," writes Phyllis A. Balch in the book Prescription for Herbal
Healing.
"If
a tumor and the adjacent lymph nodes are removed, the natural drainage of
lymphatic fluid through that
area
is blocked. Fluid accumulates and becomes stagnant in the tissues of the limb
closest to the obstruction.
The
limb may then swell to several times its normal size. Lymphedema is made even
worse by recurrence of
cancer,
as tumors attract sodium and cause fluid retention."
In
the current study, researchers compared women who had been treated for breast
cancer at 115 different
locations
across the United States. All participants had cancer that had spread to lymph
nodes but no
further,
and had relatively small tumors (classified as T1 or T2). The researchers found
no significant
difference
in cancer recurrence rates between the 445 women whose lymph nodes had been
removed and
the
446 women whose lymph nodes had been left in place.
Based
on the new study, as many as 70 percent of women who have lymph node removal
recommended
may
now opt to forego the surgery, said Gary Lyman of the American Society of
Clinical Oncology.
"This
is good news," Lyman said. "It's a substantial number of women."
March
17, 2011 - DCH Opens New Breast Care Center - Eagle 99.3 FM WSCH –
(Lawrenceburg,
Ind.) - The new Breast Care Center at Dearborn County Hospital is now open.
Located
adjacent
to the hospital in Suite 120 of the Dearborn County Hospital Professional
Building, the DCH
Breast
Care Center melds state of the art healthcare with the feel and personalized
service found in upscale
salons
or boutique hotels.
Beyond
the lovely furnishings and attentive personnel, however, is a healthcare
facility comprised of the
latest
imaging technology and staffed by General Surgeons, Oncologists, a
Plastic-Reconstructive Surgeon,
Radiologists,
a Nurse Navigator/Family Nurse Practitioner, Radiologic Technologists and a
Social Service
Consultant.
“The
Breast Care Center is designed to be a positive, welcoming place. Its purpose
is to encompass all
aspects
of breast health,” noted Kelly Ferreira, DCH Breast Care Center Nurse
Navigator/Family Nurse
Practitioner.
“Our intent is for the Center to be a site for routine breast health and
advanced diagnostic and
clinical
services, as well as for education, reference and support.”
Featured
in the Center are two new, state of the art digital mammography units. These
units provide the
latest
technology for both screening and diagnostic mammography and stereotactic
biopsy.
“Everyone
who comes to DCH for a screening or diagnostic mammogram utilizes the Breast
Care Center,”
continued
Mrs. Ferreira. “While our emphasis is on total breast health, the vast majority
of individuals who
come
to the Breast Care Center will visit for a clinical breast exam and/or a
screening mammogram. For
those
individuals who require additional care, the Center is able to offer a full
complement of services.”
The
Center offers comprehensive breast care ranging from screening and diagnostic
mammography to the
coordination
of advanced diagnostic, therapeutic, surgical and/or reconstructive procedures
and related
support
services. In cooperation with the individual’s personal physician, advanced
care is provided under
the
direction of General Surgeons Dr. Shannon Davis, Dr. Mark McAndrew and Dr.
Michael McAndrew,
who
are members of the American Society of Breast Surgeons.
Procedures
performed in the DCH Breast Care Center include clinical breast exams;
screening and
diagnostic
digital mammography; pre-operative needle localizations; cyst aspirations and
stereotactic core
biopsies.
Physician consultations with General Surgeons, a Plastic-Reconstructive
Surgeon, Oncologists and
Radiologists
are also available in the Center, as is coordination for in-hospital procedures
such as breast
MRI
or diagnostic ultrasound.
“As
the Center’s Nurse Navigator/Family Nurse Practitioner, my job is to answer
questions and provide
breast
health information to all individuals, however, my primary function is to
assist patients who have an
abnormal
mammogram or those who have been diagnosed with breast cancer.
“Under
the direction of their surgeon, I work with the patient as requested, to help
coordinate specific
portions
or all aspects of their continuing care. My work may be as simple as scheduling
an appointment for
a breast MRI or
as detailed as helping to coordinate the ongoing plan of care for a person
newly diagnosed
with
breast cancer. It all depends upon the clinical needs of the patient and the
type and degree of assistance
the
individual desires,” she explained.
“While
much of my work deals with the patient’s immediate clinical issues, I am also
available to assist with
non-medical
problems which could impede proper or timely treatment. Sometimes issues such
as
transportation
or lack of financial resources cause patients to delay follow-up diagnostic
procedures or even
treatment.”
The
Breast Care Center is also available to assist breast cancer patients and
breast cancer survivors with
other
services including the acquisition of wigs and headwear; breast prostheses;
lymphedema compression
garments
and personal care products.
“In
my position as the Center’s Nurse Navigator, my focus is to offer support to
the individual and to help
guide them
through their diagnostic testing and when necessary, their treatment and
recovery,” Mrs. Ferreira
added.
“A
diagnosis of cancer or a potential diagnosis of cancer is very frightening. It
not only affects an individual’s
immediate
plans but can have an effect on how they view life. My job is to help alleviate
some of their
anxiety,
fears or stress and to assist them in maintaining a positive outlook. I let
them know that they are not
alone
in dealing with their illness and I help to serve as their advocate. Together
we can sort out the
complexities
of their clinical care so they can devote more of their time and energy to
getting well.”
Physicians
and physician practices working in coordination with the DCH Breast Care Center
include Dr.
Shannon
Davis, Dr. Mark McAndrew and Dr. Michael McAndrew of Dearborn County Surgery;
Dr. Mary
Albers,
Dr. Kurt Leuenberger, Dr. John Sacco and Dr. Louis Schroder of
Oncology/Hematology Care; Dr.
Thomas
Jackson of Southern Indiana Aesthetic and Plastic Surgery and Dr. John
Botsford, Dr. James Cole,
Dr.
William Drew and Dr. Kyung Noh of River Valley Imaging.
March
20, 2011 - Celebrating a 9-Year Cancerversary From Breast Cancer - About - News
& Issues –
By
Pam Stephan –
Today
is my 9-year Cancerversary! On March 20, 2002 I was diagnosed with ductal
carcinoma in situ, and
one
year to the day later, I was given the all-clear. That diagnosis and the year
in treatment for breast cancer
changed
me in many ways. The whole experience was a very hard teacher - but the lessons
have stuck with
me.
For the last 5 years through this site, I've had the chance to pass along many
of the things I've learned
during
treatment and survival. I've continued learning about dealing with breast
cancer - and many of my
readers
have taught me from their own wisdom. The more we know, the better we can fight
this cancer, and
perhaps
someday, it will be totally preventable.
At
first, I did not expect to survive breast cancer - everyone I had known with
that diagnosis had suffered
and
died. My husband's mother Nancy had fought it - twice - for 6 years, but we
eventually lost her, in
1980.
Treatments have improved since then, as have diagnostic procedures and imaging
technology.
Patients
have become more empowered - we get to choose between a mastectomy and a
lumpectomy -
instead
of leaving that up our surgeons. In the past, many women went in for a breast
biopsy and didn't
know
if they would wake up with, or without breasts! Before the widespread adoption
of sentinel node
biopsy,
many women endured a full axillary dissection (nasty term!) and then suffered a
lifetime of arm
lymphedema.
Now the practice of having almost all your lymph nodes removed to be tested for
metastasis is
fading
- thank goodness!
Best
of all, more and more of us are becoming breast cancer survivors. In fact, the
National Cancer Institute
says
that there are about 2.5 million of us living 5 or more years after being
diagnosed with breast cancer. In
addition,
we survive longer than previous generations did.
So
how did I celebrate? Just by doing normal things - went to church, made lunch
at home, did some
yardwork,
and played with our little dogs. All of these things are nice, everyday
occupations - and I am so
happy
to still be around to enjoy them! I had my 85-year old father and my wonderful
husband to spend the
day
with, and then had internet time with my sister. Such moments I no longer take
for granted. I am not
grateful
that I had breast cancer - so that's not what I celebrate. It is survival and
endurance I enjoy, and
that's
what I am thankful for today.
March
20, 2011 - Study supports less-aggressive lymph node surgery for some breast
cancer patients - By
Jan
Jarvis –
For
women with small breast cancer tumors, removing just a few lymph nodes from
under the arm instead of
several
could be just as effective as more extensive surgery, a recent study has
found.
If
the data hold up, the less-invasive approach could spare some women from
further surgery to remove
lymph
nodes and the problems that sometimes go with it, such as lymphedema, which
causes fluid retention
and
tissue swelling.
Numbness,
a decrease in the range motion and pain can also occur.
"Most
women are pretty happy when I can tell them that we don't have to do as
extensive auxiliary surgery,"
said
Dr. Mary Brian, a breast surgeon with Texas Oncology.
But
it's not that simple.
"The
less you do the better it is for the patient," she said. "But you don't want to
do the wrong thing and
leave
cancer behind."
The
study, published in the February issue of the Journal of the American Medical
Association, found that
for
women with breast tumors less than 2 inches in diameter the survival rate was
the same whether only two
lymph
nodes were removed or multiple nodes were taken out.
All
891 women in the study had small tumors and cancer cells in no more than two
lymph nodes. A sentinel
lymph
node biopsy was used to detect any cancer cells. The procedure involves
injecting dye in the tumor to
see
which lymph nodes it travels to.
After
the surgery, the pathologist examined the lymph nodes over multiple days. The
study helps address the
question
of what to do if there's a very small amount of cancer found after the patient
has left the hospital.
"If
there's a tiny drop of cancer in the lymph nodes, no more surgery is
acceptable," Brian said. "The study
showed that
there is no improvement in survival by doing more."
The
study flies in the face of the longtime practice of aggressively treating
cancer by removing at least 10
lymph
nodes.
But
the trend has been shifting toward performing less surgery, and the study may
prompt more doctors to
follow
suit.
Going
into surgery last fall, Kathy Reich, 49, knew a sentinel node biopsy would be
performed, and she
hoped
she would be spared more aggressive surgery.
"If
it had been negative, my doctor would have made the decision at that time never
to take out any lymph
nodes,"
she said. "But I did have more nodes involved."
She
underwent a more aggressive surgery.
March
20, 2011 - The PINK Album – A Musical Celebration of Courage and Hope To
Benefit The Maine
Breast
Cancer Coalition - PR Web –
PATCO
Construction, Inc. of Sanford Maine to serve as Executive Producer on an
unprecedented CD
featuring
Maine's most talented female singer songwriters. Veteran performers, Grammy
nominees, and
rising
stars unite to make life a little easier for Maine women (and men) battling
breast cancer.
PATCO
Construction, Inc. of Sanford, Maine, will serve as Executive Producer on an
unprecedented CD
featuring
Maine's most talented female singer songwriters. Veteran performers, Grammy
nominees, and
rising
stars unite to make life a little easier for Maine women (and men) battling
breast cancer.
PATCO
Construction, Inc of Sanford, Maine is a company on a mission. Family owned for
over 26 years,
and
a leader in the States residential and commercial building industry, PATCO
understands that they have a
responsibility
to give back to the community. Because so many families – including those of
PATCO
employees
– are touched by breast cancer, they chose to help provide financial support to
The Maine
Breast Cancer
Coalition Support Service Fund (MBCC).
Mark
and Greg Patterson, co-owners of PATCO, like the fact that the Fund provides
assistance directly to
Maine
residents. “It helps cover the costs of items not taken care of by insurance
companies”, said Mark.
“It’s
also used to help defray costs for individuals who may be under insured.”
According to MBCC
President
Pam Sirois, the fund has covered mammograms and ultrasound, hospital bills,
physician bills, bras
and
prostheses, wigs, prescriptions, lymphedema therapy and compression garments,
genetic testing,
transportation
costs, as well as temporary living expenses for people in active breast cancer
treatment.
In
2008 PATCO launched the first in a series of campaigns on behalf of the MBCC.
"The Pink Key
Project"
pledged a donation for every contract, residential or commercial, signed that
year. This campaign
was
just the beginning of PATCO’s passionate commitment to the cause. To date PATCO
has contributed
nearly
$20,000 to the Support Service Fund.
This
year, PATCO is serving as Executive Producer on "The Pink Album," scheduled for
release October 1
to
coincide with National Breast Cancer Awareness Month. An unprecedented two CD
collection, the
project
will bring together, for the very first time, over two dozen of Maine’s most
talented female
performers.
Among those participating are artists such as Cindy Bullens, Kate Schrock, Anne
Clark, Sara
Cox,
and Women In Harmony. These veteran performers, rising stars, and Grammy
nominees – some of
whom
have shared the stage with such legends as Elton John and Johnny Cash - will be
contributing tracks
they’ve
selected specifically for this musical tribute. The album's producer, Con
Fullam, has a long history in
the
music business and is perhaps best known locally as the composer of "The Maine
Christmas Song" and
the
driving force behind "The Amazing Music of Mainers," a fundraiser to help end
hunger in Maine.
The
official kick-off for "The Pink Album" will be held on Wednesday, March 23 at
SPACE Gallery, 538
Congress
Street, Portland, Maine from 12:30 to 2:00 PM. Members of the public are
welcome. During this
event
proceeds from the 2010 PATCO and New England Building Materials "Kitchens That
Care"
promotion,
will be presented to representatives of The Maine Breast Cancer Coalition by
Mark Patterson of
PATCO
and Joy Martel of NEMB.
March
21, 2011 - This Way Up: Breast cancer survivors pull together on a boat - By
Art Carey –
In
his new book, The Social Animal, David Brooks makes a strong case for
connection, community, and
group
participation. According to one study he cites, joining a group that meets even
just once a month
produces
the same happiness gain as doubling your income.
That
assertion came to mind the other night as I listened to Tobi Goldberg Maguire
give an impromptu thank-
you
speech to the women on her dragon boat team.
It
was 10 years to the day since her mastectomy, Maguire announced. Seven years
ago, she joined the
team,
and six weeks after that, her sister died.
Maguire,
of Melrose Park, recalled the consoling words of a teammate: "I'm sorry to hear
about your sister,
but
you have a whole boatload of new sisters here."
They
call themselves Hope Afloat, a name both inspired and inspiring because the 40
or so women who
paddle
for the team are all breast-cancer survivors. This is the team's 10th
anniversary, and over the years it
has
included women ranging in age from the late 20s to mid-70s, of all shapes and
sizes, all levels of physical
condition
and athletic ability.
That
was evident on a recent evening as a couple of dozen members of the team
practiced in the new paddle
pool
at Main Line Health & Fitness in Bryn Mawr.
"Push
with the legs, pull with the core!" exhorted their coach, Robin Parker, 57, of
Plymouth Meeting.
"Crunch
down and remember your exit. It's just as important as the catch."
The
women plunged their paddles into the churning water and pulled hard, seeking to
move in unison as they
increased
power and pace. Some looked fierce and seemed fueled by anger. A few vocalized
each stroke
with
a grunt, like a pro tennis player swatting a tremendous forehand.
"They're
tough broads," said Meg Fasy, 46, of Society Hill, a three-time cancer survivor
who recently joined
the
team. "Everybody is really welcoming, but at the same time, very competitive.
These women have been
through
a lot, and nothing stops them."
Dragon
boat racing, with roots in ancient China, is increasingly popular in the United
States. Philadelphia
hosts
two big events, the Independence Dragon Boat Regatta in June and the
International Dragon Boat
Festival
in October.
Breast-cancer
survivors began flocking to the sport after Don McKenzie, a Canadian physician
and exercise
scientist,
proved in the '90s that it was not only unharmful but also beneficial.
Previously, such women had
been
told to avoid strenuous upper-body exercise, for fear it might cause or
aggravate lymphedema, a
painful
swelling of the limbs.
In
Vancouver in 2005, at the first regatta exclusively for breast-cancer
survivors, Hope Afloat beat all the U.
S.
teams and placed second overall.
Hope
Afloat has traveled also to Italy and Australia and will take part this summer
in the Pan Am Games in
Florida.
Practice
on the Schuylkill begins in April, and before the season ends in November, the
team typically vies in
four
to six regattas. This year, the paddle pool, which opened in January and is
billed as unique in the United
States,
has given the team a jump.
March
23, 2011 - Integrating Bevacizumab, Everolimus, and Lapatinib into Current … –
Medscape
A
pilot study of vascular endothelial growth factor inhibition with bevacizumab
in patients with lymphedema
following
breast cancer treatment. ...
Sorry
Tina, this one you need to be a member of something to access it
March
25, 2011 - Elizabeth Taylor: Beautiful Mutant - Slate Magazine – By Roxanne
Palmer –
The
late Elizabeth Taylor was widely known for her violet eyes—so much so that she
named her newest
fragrance
after them. I was slightly crushed, then, to discover that, by most official
accounts, Taylor's eyes
were
actually a deep blue that appeared purple when enhanced by lighting and makeup.
(Truly violet eyes
occur
only in albinos.)
While
she might not have had bona fide purple eyes, as anyone who saw Elizabeth
Taylor onscreen knows,
they
were still arresting: large, liquid, and framed by a thick fringe of eyelashes.
With respect to those
eyelashes,
Taylor apparently hit the jackpot, genetically. According to biographer J.
Randy Tarborelli, just
after
her birth, Taylor's parents were ushered into the doctor's office and told that
their newborn daughter
had
a mutation:
"Well,
that sounded just awful," the girl's mother later recall[ed], "a mutation. But,
when he explained that her
eyes
had double rows of eyelashes, I thought, well, now, that doesn't sound so
terrible at all."
Double
rows of eyelashes are usually the result of a mutation at FOXC2, a gene that
influences all kinds of
tissue
development in embryos. FOXC2 mutations are thought to be responsible for,
among other things,
lymphedema-distichiasis
syndrome, a hereditary disease that can cause disorders of the lymphatic system
in
addition
to double eyelashes.
The
eyelash mutation isn't always as cosmetically enhancing as Taylor's turned out
to be—the extra
eyelashes
can sometimes grow inward and damage the cornea. And it turns out that 7
percent of people
with
lymphedema-distichiasis syndrome also suffer from congenital heart disease.
Taylor herself had a
history
of heart problems—in 2009, Taylor underwent surgery to repair a "leaky valve",
and her death on
Wednesday
was attributed to congestive heart failure.
The
late actor Richard Burton, who accounted for two of Taylor's eight marriages,
was oddly dismissiveof
her
beauty, saying that she had a double chin, an overdeveloped chest, and short
legs. But, he conceded,
"she
has wonderful eyes."
Special
thanks to Dr. Janet Sparrow and Dr. Stephen Tsang from the Ophthalmology
Department at
Columbia
University, and to makeup artist Elias Gutierrez.
Photograph
of Elizabeth Taylor courtesy of Getty Images.
March
25, 2011 - New Technology at NewYork-Presbyterian/Columbia Aids Surgeons With
Early
Detection
of Lymphedemain Breast Cancer Patients – Newswise –
Early
Detection and Intervention May Prevent Disabling Complication of Breast Cancer
Surgery
Newswise
— NEW YORK (March 24, 2011) -- Breast cancer specialists at
NewYork-Presbyterian
Hospital/Columbia
University Medical Center are offering patients new ways to detect early signs
of
lymphedema,
a common side effect of breast cancer surgery that causes painful, debilitating
and disfiguring
swelling
in the arms following removal of lymph nodes.
As
many as 30 percent of women who have breast cancer surgery with lymph node
removal will develop
lymphedema.
Radiation treatment increases this risk to as high as 50 percent. While it is
possible to arrest
the
condition through physical therapy and bandaging, there is no cure.
"Just
as we've used early detection to improve breast cancer survival, we are using
early detection to reduce
women's
risk for developing lymphedema,"says
Dr.
Sheldon Feldman, the Vivian L. Milstein Associate Professor of Clinical Surgery
at Columbia University
College
of Physicians and Surgeons and chief of breast surgery at NewYork-Presbyterian
Hospital/Columbia
University Medical Center.
Dr.
Feldman and his colleagues at NewYork-Presbyterian/Columbia are employing a
technique called
bioimpedence
spectroscopy to help them identify the earliest onset of lymphedema. An
FDA-approved
device
called L-DEX (ImpediMed Inc.) uses a mild electrical current to measure minute
changes in
extracellular
fluid, allowing for a diagnosis of lymphedema by the physician well before any
swelling is
noticeable.
"By catching it early, we can reverse the process and prevent unnecessary pain,
embarrassment,
debilitation
and risk of infection,"says Dr. Feldman.
Alongside
its clinical use, the bioimpedence technique is also being used in research to
better understand
which
patients are most at risk for lymphedema and whether the condition always
progressively worsens, or
if
it can naturally correct itself over time. Other studies will investigate the
common belief that lymphedema is
negatively
affected by air travel and weight training.
Another
method of reducing risk for lymphedema is a technique called "reverse arm
mapping.""The lymph
nodes
that drain the arm are sometimes removed during breast cancer surgery because
they're situated
within
the armpit (axilla) in the same area as the lymph nodes that relate to the
breast. With reverse arm
mapping,
we inject dye into the patient's arm to differentiate the two kinds of lymph
nodes. This allows the
surgeon
to avoid removing any nodes related to arm drainage while still accurately
identifying the sentinel
nodes,
which are important for breast cancer evaluation and treatment,"says Dr.
Feldman. "This should
reduce
the risk of developing lymphedema.”
Arm
mapping is part of a larger trend toward reducing or eliminating the need to
remove a woman's lymph
nodes
-- thereby reducing the incidence of lymphedema. Beginning in the 1990s,
sentinel node biopsy used
dye
injected into the breast to target the sentinel lymph node, the gatekeeper to
the axilla and the one most
at
risk for cancer spread. Today, the latest research indicates that fewer
patients need any lymph nodes
removed
than previously thought. Even if the sentinel node is shown to be positive,
patients with early-stage
breast
cancer who are treated with lumpectomy, chemotherapy and radiation may not need
to have any
further
lymph nodes removed.
For
more information, patients may call (866) NYP-NEWS.
Columbia
University Medical Center
Columbia
University Medical Center provides international leadership in basic,
pre-clinical and clinical
research,
in medical and health sciences education, and in patient care. The Medical
Center trains future
leaders
and includes the dedicated work of many physicians, scientists, public health
professionals, dentists,
and
nurses at the College of Physicians & Surgeons, the Mailman School of
Public Health, the College of
Dental
Medicine, the School of Nursing, the biomedical departments of the Graduate
School of Arts and
Sciences,
and allied research centers and institutions. Established in 1767, Columbia's
College of Physicians
and
Surgeons was the first institution in the country to grant the M.D. degree and
is now among the most
selective
medical schools in the country. Columbia University Medical Center is home to
the largest medical
research
enterprise in New York City and state and one of the largest in the United
States. For more
information,
please visit www.cumc.columbia.edu.
NewYork-Presbyterian
Hospital
NewYork-Presbyterian
Hospital, based in New York City, is the nation's largest not-for-profit,
non-
sectarian
hospital, with 2,353 beds. The Hospital has more than 2 million inpatient and
outpatient visits in a
year,
including more than 220,000 visits to its emergency departments -- more than
any other area hospital.
NewYork-Presbyterian
provides state-of-the-art inpatient, ambulatory and preventive care in all
areas of
medicine
at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical
Center, NewYork-
Presbyterian
Hospital/Columbia University Medical Center, NewYork-Presbyterian/Morgan
Stanley
Children's
Hospital, NewYork-Presbyterian/The Allen Hospital and NewYork-Presbyterian
Hospital/Westchester
Division. One of the most comprehensive health care institutions in the world,
the
Hospital
is committed to excellence in patient care, research, education and community
service. NewYork-
Presbyterian
is the #1 hospital in the New York metropolitan area and is consistently ranked
among the best
academic
medical institutions in the nation, according to U.S.News & World Report.
The Hospital has
academic
affiliations with two of the nation's leading medical colleges: Weill Cornell
Medical College and
Columbia
University College of Physicians and Surgeons. For more information, visit
www.nyp.org.
March
25, 2011 - The Benefits Of Liposuction On Breast Cancer Patients - Bay Net
–
The
Benefits Of Liposuction On Breast Cancer Patients
Reconstructive
plastic surgery is often a necessity for breast cancer survivors. Insurance
companies will
normally
pay for reconstructive plastic surgery procedures that have been linked to a
medical illness but will
not
cover certain procedures that are still considered cosmetic. One such procedure
is liposuction.
Insurance
companies view liposuction as a strictly elective procedure that is used to
remove fat deposits for
cosmetic
improvement. New research is starting to discover that liposuction can offer
help for breast cancer
patients
that have developed secondary medical conditions from their cancer treatments.
The most
prominent
illness that is linked to breast cancer treatment is Lymphedema.
Lymphedema
occurs when the lymph nodes near the breasts and upper arms are removed due to
the
presence
of cancerous cells. Once the lymph nodes are removed from the upper arms, the
lymphatic fluid is
trapped
with no way to be purged from the body. The excess lymphatic fluid is absorbed
into the
surrounding
fat cells. This process results in the painful condition called Lymphedema.
Symptoms of
Lymphedema
include: severely swollen arms, numbness of the arms, heaviness and poor
mobility.
Both
traditional liposuction and
smart
liposuction have proven to be very effective treatments in reducing the effects
of Lymphedema.
Removing
excess fat cells in the upper arm region decreases the amount of swelling that
is associated with
this
medical condition. Currently Insurance companies refuse to acknowledge the
benefits of liposuction as a
treatment
to Lymphedema.
Liposuction
cost can range anywhere from $12,000 to $17,000. Without insurance coverage,
patients are
often
left to pay for these procedures out of pocket. The medical community is
currently doing case studies
to
prove that both regular and laser liposuction can help improve the quality of
life in breast cancer survivors.
However,
these medical case studies can take several years to complete. Patients who are
currently
suffering
from Lymphedema have no other options to cover the liposuction cost other than
paying the entire
fee
upfront or borrowing in the form of a medical loan.
The
health benefits associated with liposuction in regards to Lymphedema are worth
the costs of the
procedure.
Many patients have reported relief of the swelling and regained use of the
affected limbs. Until
the
medical community can prove to the insurance companies that liposuction can be
a medical necessity,
there
are other financial options available to patients who wish to use liposuction
as a means to relieve
Lymphedema.
www.liposuctioncost.com/smart-liposuction
www.liposuctioncost.com/
March
27, 2011 - Good Deeds, March 27 - Omaha World-Herald –
The
following are fundraisers, donations and other charitable events or
opportunities happening in the
Midlands.
E-mail your information about good deeds to [email protected] or call
402-444-1040.
Help
for colleague, wife, mother: The Immanuel Medical Center community has
organized a Saturday
fundraiser
for the family of one of its own. Rachel Stotler Clasemann, a lymphedema
therapist at Immanuel,
sustained
a severe brain injury in a Jan. 10 traffic accident and is at Immanuel
Rehabilitation Center. Her
husband,
Jon Clasemann, and their sons, Jacob and Nathan, live in Papillion. The pancake
breakfast and
silent
auction will be from 7:30 a.m. to 12:30 p.m. Saturday at St. Columbkille
Catholic Church, 200 E.
Sixth
St. in Papillion. The cost is $6 for adults and $4 for children ages 2 to 12.
T-shirts also will be sold for
$10
each. Jacob and Nathan designed the shirts.
TeamMates:
Tuesday will be TeamMates Day at Runza. All 75 Runza restaurants will donate 10
percent of
Tuesday’s
proceeds to benefit local TeamMates chapters.
Bowling
for Recovery: Community Alliance will host a Bowling for Recovery fundraiser
Thursday at
Sempeck’s
Bowling and Entertainment, 20902 Cumberland Drive in the Elkhorn area. Form a
team, join a
team
or sponsor a bowler in support of those with mental illness. Visit
www.community-alliance.org and
click
on the events tab to learn more, register or donate. The first bowling session
will start at 5 p.m. For
$15,
you get two hours of bowling, pizza and pop.
Reaching
out: Creighton University social work students will offer information at the
Heart Ministry Center,
2222
Binney St., to help attendees connect with Nebraska services. The students will
be there from 10 a.m.
to
noon Friday. Among the topics to be addressed are applying for Medicaid, Title
XX and other state
programs;
healthy eating and good nutrition; budget matters; and information to help in
applying for jobs and
services.
Grease
the griddle: The Waffle Man will be in action Friday to raise funds for the
American Cancer Society’
s
Relay For Life of Cass County. Kris’ Krew is putting on the all-you-can-eat
Belgian waffle event from 5 p.
m.
to 7:30 p.m. at Conestoga Elementary School in Murray, Neb. Cost: $6 per person
but free for ages 4
and
younger.
Kicking
cancer: Zeta Tau Alpha, a sorority at the University of Nebraska at Omaha, will
host its annual
Kick
Out Cancer kickball tournament beginning at 10 a.m. Saturday in Elmwood Park.
Proceeds go for
breast
cancer education and awareness. Teams of eight to 10 members each can register
with Sarahbeth
Averill
at 402-201-5734 or [email protected]. Registration costs $65. Watching the
tournament is free
and
open to the public.
Polka
time: The Polka America Corp. has organized a Saturday and April 3 fundraiser
to benefit polka
music
promotions and college scholarships. Four bands will perform. Concessions will
be available for
purchase.
Doors will open at 11:30 a.m. both days at the Starlite Ballroom in Wahoo, Neb.
Admission is
$10
Saturday and $8 April 3. Tickets available at the door only.
Just
a reminder: Boy Scouts will attach door hangers Saturday to alert residents
that Scouting for Food’s
pickup
of nonperishable items will be April 9.
Benefit
for Campfire USA: A tailgating event before the April 3 Creighton University
versus University of
Portland
baseball game will raise money for the Midlands Council of Campfire USA, a
nonprofit that works
with
children. The fundraiser will be from 11 a.m. to 2 p.m. at the McGloin parking
lot in front of the
stadium.
A “Wing Fling” lunch will include wings, vegetables, chips, desserts and soda
for $5. Sponsoring
the
lunch is the CU chapter of Gamma Phi Beta Sorority.
Dodgeball:
Sigma Kappa Sorority at the University of Nebraska at Omaha will host a
dodgeball tournament
to
raise money for Alzheimer’s research. The tournament will begin at noon April 9
at UNO’s pep bowl and
the
Health Physical Education and Recreation Building. Teams of six to eight
players will play 20-minute
games.
Teams must have two women on the court during play time. Registration is $5 per
player. E-mail
Samantha
Mancuso at [email protected] to register.
There
he is: The Fremont (Neb.) Area Habitat for Humanity Mr. Habitat Pageant 2011
will be April 16 at
Midland
University’s Hopkins Arena in Fremont. Five men will compete in several
categories, including
fundraising.
The event is open to the public. Visit www.fremonthabitat.org to purchase
tickets, $45, or to
make
a donation.
Prosthetics:
Step Global, a Nebraska-based charity, refits unneeded prosthetics for its
charity therapy work
in
Nicaragua. Both monetary donations and prosthetics that are no longer needed
are accepted. Step Global’
s
website, www.stepglobal.org, has information about donating. For more
information, call Jacob Keough at
402-614-7321.
Biking
for housing: Anne Troyer — a native of Shickley, Neb., and a student at Goshen
College in Indiana
—
will pedal 3,600 miles from Seattle to Washington, D.C., to raise awareness and
support for the Fuller
Center
for Housing, a nonprofit Christian housing ministry. The ride will start June
10 and end Aug. 14. Her
fundraising
goal is $3,600. To help sponsor her ride, e-mail her at [email protected] or
visit www.
fullercenter.org/bikeadventure.
Still
time to give: The Twin Rivers YMCA in Valley, Neb., has surpassed previous
years’ fundraising efforts
and
added more than $70,000 to its Strong Kids Campaign funding for the next year.
The fundraising effort
will
end Thursday for the entire YMCA of Greater Omaha Area locations. Additional
donations are
welcome
through the Twin Rivers YMCA or online at www.metroymca.org, click on
Opportunities.
Helping
the sisters: A week ago, 264 guests joined the Notre Dame Sisters at Omaha
Roncalli High School
to
celebrate their 100-year ministry in the United States and to honor Sister
Marilyn Ross, executive director
of
Holy Name Housing. The fundraiser grossed $40,000 for the ministries of the
Notre Dame Sisters and
featured
a silent auction and raffle.
Compiled
by Sue Story Truax
March
27, 2011 - Breast biopsy may be first step in cancer battle - Pueblo Chieftain
– By DR. CARL
BARTECCHI
–
Q:
I just found out that I have an abnormal mammogram, and a biopsy is
recommended. What will happen
to
me?
A:
For help with this sensitive question, I consulted Louis Balizet, M.D., a
medical oncologist at the Rocky
Mountain
Cancer Center. Here is his answer:
When
radiologists read mammograms, they place the results in one of five categories
ranging from totally
normal
to very suspicious for cancer. Your mammogram is abnormal enough that biopsy is
recommended
(Category
4 or 5).
Breast
biopsies are usually done using a special type of mammogram, which allows the
radiologist to see the
abnormality
—frequently only a tiny cluster of white dots, or microcalcifications — in three
dimensions.
After
local anesthesia, he places a small needle in the middle of the abnormality and
takes one or several
samples.
These samples are then reviewed by a pathologist, who determines if cancer is
present. If he finds
cancer,
he then performs a number of other studies on the biopsy specimen to determine
how aggressive it
might
be, and what medicines might be helpful in treatment. Approximately 20 percent
of Category 4
mammograms
come back positive on biopsy; almost all Category 5 ones do.
Obviously
this is a scary time for any woman; it is very upsetting to go from feeling
perfectly normal one day
to
worrying about harboring a potentially fatal cancer the next. If your biopsy
comes back positive, it is
important
to remember three things: (1) Most women with breast cancer are cured; (2) the
overwhelming
majority
of women whose breast cancer is discovered by mammogram, without a lump that
they can feel,
are
cured; and (3) mastectomy is rarely needed in the treatment of breast
cancer.
If
the biopsy does come back positive, your primary care provider will refer you
to a surgeon, who will
perform
a lumpectomy —removal of a relatively small portion of the breast surrounding
the original biopsy
site.
This will be sent to the pathologist, who will determine the size of the cancer
(usually a fraction of an
inch)
and whether a rim of normal tissue surrounds the cancer (in medical terms,
whether the “margins are
clear.”)
The surgeon may also suggest removing a “sentinel node” — a lymph node under the
armpit that is
first
in line to collect cancer cells if any decide to migrate in that direction. The
incisions for these procedures
are
usually only a few inches in length.
These
days we rarely proceed to remove any more lymph nodes under the armpit, even if
the sentinel node
is
positive — research has shown that next to nothing is gained by doing any more.
The value of finding out if
the
sentinel node is positive is to guide subsequent use of medical therapy; it is
done more to get information
about
the way the cancer is likely to behave than to treat it. These and other
discoveries have virtually
eliminated
the “fat arm” (lymphedema) that women experienced in the past as a consequence
of surgery to
remove
lymph nodes under the armpit.
At
this point we are about halfway through treatment for the breast cancer. Even
if all the cancer seen on the
mammogram has
been removed, with negative margins, there is still a good chance that there is
(invisible)
cancer
left in the breast. Eradicating this, while still keeping the breast intact and
looking as close to normal
as
possible, is the job of the next specialist you will see— the radiation
oncologist. He will use X-rays —
invisible
but deadly to any remaining cancer — delivered in small daily doses for three
to five weeks to the
entire
breast. This treatment is painless but, toward the end, you might develop a
“sunburn” on the breast
that usually
goes away in one to two weeks. Radiation therapy after lumpectomy virtually
guarantees that
cancer
will not return in the breast. It is natural at this stage for you to feel that
therapy should be done —
the
cancer in the breast has been removed, and, for good measure, the entire breast
has been irradiated.
However,
there remains one critical element of therapy— medical or “systemic” therapy.
In fact, it is this
portion
of therapy which has made the treatment of breast cancer more likely to be
curative than in the past.
We
know that women who die from breast cancer die from cancer cells that have
escaped beyond the
breast
before the diagnosis is made, then grow months to years later in other parts of
the body (metastatic
cancer).
All the treatment in the world, if directed only at the breast, will not touch
these cells. Fortunately,
there
is a large selection of medicines that do attack these cells, wherever they may
be. To decide about
whether
they are needed, and if so, which ones, you will meet yet another member of the
breast cancer
treatment
team — a medical oncologist. To guide his decision the medical oncologist turns
to the information
given
by the pathologist: How big is the tumor? Is it influenced by female hormones?
Is it driven by other
growth
factors? Is the sentinel node positive? Sometimes, to further refine the
selection of anti-cancer
medicines,
he will order an additional study on the biopsy material that can actually
measure the activity of
16
cancer-promoting genes. Armed with this information, the medical oncologist can
recommend a regimen
of
medical treatment tailored to the characteristics of your individual cancer, as
well as to your individual
overall
health status. This regimen could be as simple as a once-daily pill for five
years, or as complicated as
a
five-drug cocktail including intravenous chemotherapy.
Chemotherapy,
when needed, is by far the most difficult part of breast cancer treatment. It
can entail the
placement
(by a surgeon or radiologist) of a “port” to facilitate frequent intravenous
injections; it usually
causes
hair loss that is temporary but still distressing; it rarely causes nausea but
almost always causes
fatigue.
It is recommended only when it gives a woman a significant boost in her chances
of cure beyond
what
they would be without it. It is the medical oncologist’s job to explain to you
why additional medical
therapy
might be needed, and if so, what medicines would be best and why. The medical
oncologist also will
describe
the possible side effects of the proposed regimen, and what steps can be taken
to lessen or
eliminate
them.
Breast
cancer is common and the treatment is complex. But thanks to reduced use of
hormone replacement
treatment
and to mammograms, it is being diagnosed less frequently, and in earlier
stages. Thanks to
improvement
in surgical and radiation therapy techniques, disfiguring consequences of
treatment are rare.
Thanks
to early application of a variety of drugs, treatment is more likely to be
curative.
An
American woman’s chance of dying from breast cancer is 20 percent less now than
it was 20 years ago,
with
even more improvements likely on the horizon. If your biopsy does come back
positive for breast
cancer, you
will likely be cured of your disease, and your appearance should remain
essentially the same.
Dr.
Carl Bartecchi is an internal medicine specialist. Please submit general health
questions to him via e-mail
at
[email protected].
March
28, 2011 - Breast cancer specialists offer new technology for patients to
detect early-stage
lymphedema
–
Breast
cancer specialists at NewYork-Presbyterian Hospital/Columbia University Medical
Center are
offering
patients new ways to detect early signs of lymphedema, a common side effect of
breast cancer
surgery
that causes painful, debilitating and disfiguring swelling in the arms
following removal of lymph nodes.
As
many as 30 percent of women who have breast cancer surgery with lymph node
removal will develop
lymphedema.
Radiation treatment increases this risk to as high as 50 percent. While it is
possible to arrest
the
condition through physical therapy and bandaging, there is no cure.
"Just
as we've used early detection to improve breast cancer survival, we are using
early detection to reduce
women's
risk for developing lymphedema,"says Dr. Sheldon Feldman, the Vivian L.
Milstein Associate
Professor
of Clinical Surgery at Columbia University College of Physicians and Surgeons
and chief of breast
surgery
at NewYork-Presbyterian Hospital/Columbia University Medical Center.
Dr.
Feldman and his colleagues at NewYork-Presbyterian/Columbia are employing a
technique called
bioimpedence
spectroscopy to help them identify the earliest onset of lymphedema. An
FDA-approved
device
called L-DEX (ImpediMed Inc.) uses a mild electrical current to measure minute
changes in
extracellular
fluid, allowing for a diagnosis of lymphedema by the physician well before any
swelling is
noticeable.
"By catching it early, we can reverse the process and prevent unnecessary pain,
embarrassment,
debilitation
and risk of infection,"says Dr. Feldman.
Alongside
its clinical use, the bioimpedence technique is also being used in research to
better understand
which
patients are most at risk for lymphedema and whether the condition always
progressively worsens, or
if
it can naturally correct itself over time. Other studies will investigate the
common belief that lymphedema is
negatively
affected by air travel and weight training.
Another
method of reducing risk for lymphedema is a technique called "reverse arm
mapping.""The lymph
nodes
that drain the arm are sometimes removed during breast cancer surgery because
they're situated
within
the armpit (axilla) in the same area as the lymph nodes that relate to the
breast. With reverse arm
mapping,
we inject dye into the patient's arm to differentiate the two kinds of lymph
nodes. This allows the
surgeon
to avoid removing any nodes related to arm drainage while still accurately
identifying the sentinel
nodes,
which are important for breast cancer evaluation and treatment,"says Dr.
Feldman. "This should
reduce
the risk of developing lymphedema."
Arm
mapping is part of a larger trend toward reducing or eliminating the need to
remove a woman's lymph
nodes
-- thereby reducing the incidence of lymphedema. Beginning in the 1990s,
sentinel node biopsy used
dye
injected into the breast to target the sentinel lymph node, the gatekeeper to
the axilla and the one most
at
risk for cancer spread. Today, the latest research indicates that fewer
patients need any lymph nodes
removed
than previously thought. Even if the sentinel node is shown to be positive,
patients with early-stage
breast
cancer who are treated with lumpectomy, chemotherapy and radiation may not need
to have any
further
lymph nodes removed.
Source:
NewYork-Presbyterian Hospital
March
28, 2011 - $356K in grants for local breast cancer programs - Fresno Business
Journal –
The
Central Valley affiliate of Susan G. Komen for the Cure has announced its award
of 10 grants totaling
$356,216
to programs providing breast cancer services in the Fresno County
area.
The
awards will be presented in a press conference at ValleyPBS on April 1, which
begins the Susan G.
Komen
for the Cure fiscal year that concludes on March 31, 2012, said Sharon Johnson,
executive director
of
the Central Valley affiliate.
“We
have identified specific, unmet breast health needs within our community and
‘filled in the gaps,’
delivering
the life-saving message of early detection and providing assistance to
medically-underserved
breast
cancer patients and their families," Johnson said in a statement.
Susan
G. Komen for the Cure is a network of 125 affiliates that bills itself as "the
world's largest and most
progressive
grassroots network fighting to end breast cancer forever."
The
grantees include:
Association
for Community Enhancement: Breast Cancer Awareness Project - $10,000
?
B-CAP
will provide the nutrition education and portable exercise program in the
Hispanic and Lao
communities.
Designed to implement a series of discussion programs regarding risk reduction,
early
detection,
and treatment of breast cancers.
Centro
la Familia Advocacy Services, Inc.: Cancer del Seno - $50,000
Offers
a culturally and linguistically appropriate program specifically for Latinas
with bilingual education,
awareness
and advocacy on their behalf and screening referral resources. There are plans
to reach 500
women
in the following areas: Huron, Parlier, Sanger, Selma, and Reedley.
Children's
Hospital Central California: Children’s Hospital Central California Breast
Cancer Awareness and
Education
Project - $10,143
Research
indicates that young women who have received radiation as part of chemotherapy
have a higher
incidence
of breast cancer than the general population and need to be screened for
secondary recurrences
starting
as early as age 25. As a result, breast cancer awareness and education is vital
to early detection of
secondary
cancer conditions.
Clovis
Community Medical Center-Lymphedema Clinic :Effective and Timely Treatment of
Lymphedema,
Axillary
Web Syndrome and Related Conditions Regardless of the Ability to Pay for
Services or of Cultural
Barrier
- $50,000
Program
will provide treatment to underserved breast cancer survivors who have been
diagnosed with
lymphedema.
Deaf
and Hard of Hearing Service Center, Inc. (DHHSC): Cancer, Awareness, Recovery,
and Education
(CARE)
- $33,206
Provide
culturally and linguistically appropriate breast cancer education to the deaf
and hard of hearing.
Disability
Legal Rights Center – Cancer Legal Resource Center : Guide to Navigating Breast
Health Care
Options
in Fresno County - $10,000
Educate
those who do not have adequate information about their legal rights and
options. These groups are
less
likely to receive optimum health care and are more prone to experience
increased stress and less
positive
survivorship outcomes.
Fresno
Health Consumer Center, a project of Central California Legal Services, Inc.:
Breast Cancer
Education
Project - $50,000
The
culturally diverse staff is trained to assist families with health care access
issues in their own language.
Individuals
served represent an ethnically diverse clientele, with an increasing number of
residents for whom
English
is a second language. Will provide advocacy and educational breast cancer
awareness services and
offer
free mammograms for men and women in Fresno County through the administration
of the $200
Challenge,
funds raised from Komen Central Valley Race for the Cure.
Hinds
Hospice: Palliative Care/Hospice for Breast Cancer Patients - $43,900
Financial
assistance to help offset the un-reimbursed cost of care provided to the
uninsured or underinsured
terminally
ill breast cancer patients who are in need of Hospice Care in Fresno
County.
Valley
Public Television, Inc. DBA ValleyPBS : Multi-media Educational Outreach
Project-$50,000
Multi-media
educational outreach project for the Central Valley Affiliate of Susan G. Komen
for the Cure
focused
on developing culturally appropriate breast health education materials for
Central Valley residents.
West
Fresno Health Care Coalition, Inc.: Body and Soul United - $48,967
Community-based
and faith-based partnership project working with predominately
African-American
churches
for increasing awareness on breast health education
Thirteen
specialists in Hanford recently earned accreditation for their Adventist
Health/Central Valley
Network
surgery center.
The
Accreditation Association for Ambulatory Health Care denoted the Kings River
Surgical Center as
officially
certified, recognizing the outfit at the Hanford Medical Pavilion for its
quality of services and its
performance
based on a national standard.
“I’m
very excited we received the maximum accreditation available,” said Dr. Jeffrey
Csiszar, the center’s
medical
director. “It reflects our commitment to the quality of care our patients
receive.”
Ambulatory
means “able to walk” and refers to outpatient services, or those that don’t
require a hospital
stay.
Surgeons at the center specialize in gastroenterology, orthopedics, podiatry,
urology, gynecology,
general
surgery and ear, nose and throat operations.
The
surgeries are performed in a 7,000 square-foot center on the first floor of the
pavilion, next to Adventist
Medical
Center. The Kings River Surgical Center was designed to emphasize personalized
care and faster
surgeries
and recoveries.
March
28, 2011 – Sentinel Lymph Node Dissection – openPR –
openPR)
- Health care professionals at the King Hussein Cancer Center (KHCC) work
tirelessly not only
to
treat cancer, but to treat the patient with cancer. Doctors are trained in the
latest available techniques and
findings;
employ the most recent proven methods of diagnosis, procedures and treatment;
and utilize state-of-
the-art
medical equipment. KHCC care is patient centric, focusing on the best interests
of the patient-
aggressively
attacking cancer while working to minimize side effects for the patient.
Sentinel Lymph Node
Dissection
(SLND) is one example of the many highly-advanced techniques offered to KHCC
patients.
SLND
is an effective surgical procedure for multiple types of cancer. According to
Dr. Mahmoud Al
Masari,
Department Chairman of Surgery at KHCC, “SLND has been the standard of patient
care at the
Center
in determining the spread of disease for breast cancer since 2003.” Doctors
began using this
procedure
because of its extreme benefits to patients, offering a much less invasive
alternative, quick
recovery
and fewer post-operative complications than the traditional staging method of
Auxiliary Lymph
Node
Dissection (ALND).
Lymph
nodes are small organs grouped in the neck, underarms, chest, abdomen and groin
that help the
body
fight infection, clean and filter foreign cells. Although not all cancers
spread in an orderly progression,
the
flow of fluid from a breast tumor is predictable; it will first drain into
lymph nodes under the arm. If cells
from
a malignant breast tumor begin to spread, they are found trapped in an underarm
lymph node closest to
the
tumor before potentially spreading to other areas of the body. Doctors refer to
the sentinel lymph node
as
being the first lymph node fed directly from the tumor.
Years
ago, breast cancer patients would undergo conventional ALND where surgeons
remove most
(approximately
10-30) nodes in the armpit area to determine if cancer has spread. This
intrusive procedure
has
post-operative risks such as lymphedema (permanent, life-long swelling of the
arm). In contrast, SLND
involves
the removal of only 3-4 nodes, those suspected to be the sentinel lymph node.
If the nodes are
found
to be cancer-free after careful analysis, doctors determine that cancer from
the breast tumor has been
contained
and not spread to create any secondary tumors.
A
middle-aged woman, Rania, detected her breast cancer through screening from a
Jordan Breast Cancer
Program
(JBCP)-sponsored campaign. Upon being diagnosed, she immediately sought
treatment at KHCC,
where
she underwent a concurrent lumpectomy and SLND procedure. Like countless other
KHCC
patients,
she is grateful that Dr. Al Masari used this method which not only assured that
all cancer had been
removed,
but allowed “excellent mobility” within days of the operation. She quickly
resumed daily activities
with
her three active children, relieved to have not endured the possible nerve
damage or potential
lymphedema
commonly associated with ALND. Rania credits the excellent medical care she
received at
KHCC
- accuracy in diagnosis, advanced procedures, cutting edge technology, and
highly-skilled doctors-
for
being “a cancer-free survivor” today.
Procedure
When
a patient is diagnosed in the early stages of breast cancer and presents only a
small malignant mass,
doctors
determine in pre-operative exams if the patient is a likely candidate for SLND.
If a patient meets
required
prerequisites for SLND, surgeons perform the SLND procedure before beginning
the patient's
lumpectomy
or mastectomy to access if cancer has spread beyond the breast.
For
KHCC surgeons to accurately locate the specific sentinel lymph node(s)
requiring removal, patients are
injected
near the tumor site with two tracers- blue dye for visual identification and a
low-level radioactive
material
detected via a Gamma Probe machine. With the help of the dual tracers, a
specially-trained surgeon
identifies
the sentinel lymph nodes. Only dye-stained nodes, nodes detected with any
radioactive activity,
and
any other suspicious nodes are removed for comprehensive analysis.
KHCC
pathologists analyze the excised sentinel lymph nodes while surgeons
concurrently perform their
patient’s
lumpectomy or mastectomy. The KHCC pathology lab tests nodes by varied methods
in order to
provide
the most accurate results. Initially, a portion of the nodes are immediately
examined during surgery
to
give doctors a preliminary indication if cancer is detected. If cancer is
found, an ALND is performed to
determine
the extent of the cancer's spread. However, if preliminary pathology results
show that cancer is
not
present, it is likely that cancer has not metastasized. Pathologists perform
additional laboratory tests for
verification
which provide more reliable accuracy in detection but take longer to analyze.
For this reason,
there
is a possibility that cancer could be detected days after SLND from one of the
other methods of
analysis.
If cancer is identified, patients return to undergo the ALND procedure for
deeper analysis.
At
KHCC
The
Center's overall SLND success rate is an amazing 98%, exceeding the
international average. A
relentless
commitment to the success of SNLD is evident in rigorous training and
unparalleled,
uncompromising
quality at KHCC.
Training
Standard learning protocol requires SLND surgeons to perform at least 20-30
procedures where
sentinel
nodes have been correctly identified in over 90% of cases. All KHCC surgeons,
residents and
fellows
are thoroughly trained under the watchful eye of Dr. Al Masari, an expert in
the procedure, who
helped
pioneer this technique in Jordan as one of the first surgeons in the region to
employ SLND. Since
SLND
is regularly performed at the Center, KHCC provides a learning platform for
doctors in Jordan (and
the
region), to gain invaluable experience by receiving significant hands-on
observational training from
KHCC
experienced surgeons.
Quality
KHCC has always provided quality cancer care, utilizing only the latest and
greatest tools and
techniques
for its patients. The Center's commitment to quality has been recognized
nationally and
internationally.
Among the honors, the Center received accreditation from the Joint Commission
on
Accreditation
of Healthcare Organizations (JCAHO) as both a general hospital in 2006 (renewed
in 2009)
and
a disease-specific cancer center in 2007. Additionally, in 2009, the Department
of Pathology and
Laboratory
Medicine of KHCC was awarded an accreditation from the College of American
Pathologists
(CAP),
testifying to the exceptional high quality of KHCC’s pathology and laboratory
services. KHCC's lab
is
the first and only lab in Jordan to achieve the high criterion set by
CAP.
Statistics
since 2005 indicate 335 procedures of SLND performed at KHCC. A staggering 90
of these 335
procedures
were performed between 1/1/2010 to 8/2010. Dr. Al Masari credits increased
public
awareness
and advocacy of regular breast examinations through the JBCP, with more
incidences of breast
cancer
being detected at early stages. At these early stages of detection, SLND is
most likely to be
performed
to detect any potential spread of cancer, thereby reducing mortality.
References
Dr.
Mahmoud Al-Masri, KHCC Department Chairman of Surgery
Mrs.
Rania Odeh, KHCC patient
www.breastcancer.org/treatment/surgery/lymph_node_removal...
www.cancer.gov/cancertopics/factsheet/therapy/sentinel-no...
www.cancernews.com/data/Article/202.asp
www.emedicinehealth.com/sentinel_node_biopsy/article_em.htm
www.gammaprobe.com/clinical/lymphnodes
www.imaginis.com/breast-health/sentinel-lymph-node-biopsy-2
www.wikipedia.org/wiki/Sentinel_lymph_node
The
King Hussein Cancer Center (KHCC) is the only specialized cancer center in the
Middle East that
treats
both adult and pediatric patients. Founded in 1997, KHCC is a non-governmental,
not-for-profit
comprehensive
center dedicated entirely to cancer care. It has achieved several international
and national
P.O.Box
1269 Al Jubeiha Amman 11941 Jordan, Tel.5300460
Monday,
March 28, 2011 - Boscov's Berks Jazz Fest: Sharon Bailey battles back to the
jazz limelight – By
Susan
Shelly –
After
a two-year battle with breast cancer and melanoma, the Bethlehem resident and
Berks native reunites
with
the Ladies of Jazz for a Saturday Berks Jazz Fest concert.
After
nearly two years of battling breast cancer and melanoma, singer Sharon L.
Bailey will return to the
stage
with the Ladies of Jazz during a Boscov's Berks Jazz Fest performance Saturday
in the Abraham
Lincoln
Hotel.
Her
return to singing is a triumph, both of the medical professionals who cared for
her and Bailey's spirit,
which
wavered during the intensive cancer treatments but wouldn't be
broken.
"There
were times when I didn't know what would happen to me," said Bailey, 54, a
Berks County native
who
lives in Bethlehem. "The radiation affected my throat, and I wasn't sure about
being able to sing. But, I
tried
to stay positive through it all. At the worst times, I would imagine myself
being on stage, singing."
Singing
is what Bailey does, and has done since she was 4 years old. She has been a
part of the area music
scene
for years, and in 2003 left her nursing job to pursue singing full time.
Audiences embraced her, and
she
was hired to perform at venues including the Berks Jazz Fest, Bethlehem's
Musikfest, the Hotel
Bethlehem
and Philadelphia clubs.
She
was preparing for a show in Jenkintown, just outside of Philadelphia, in June
2009 when she discovered
a
lump in her breast and was diagnosed with an aggressive form of
cancer.
"I
am one who has had mammograms faithfully, and I'd had one just six months
before the diagnosis," Bailey
said.
"They did another mammogram and, when the doctor called me on the same day, I
knew the news
was
not good."
She
began extensive treatment, including surgeries, chemotherapy and radiation, at
Lehigh Valley Hospital,
where
she had worked as a nurse five years earlier. While she was being treated for
breast cancer, doctors
removed
some moles from Bailey's leg and discovered that she also had melanoma, a
serious form of skin
cancer.
"I
always say that things happen for a reason," Bailey said. "If it hadn't been
for the breast cancer, we might
not
have discovered the melanoma."
Today,
Bailey is in complete remission from both cancers, and ecstatic to finally be
getting back to her life.
She
recently returned from a trip to the West Coast, where she attended her
grandson's one-year birthday
party.
Bailey was still undergoing chemotherapy when Steven Xavier Bailey was born
prematurely on March
11,
2010, weighing a little more than 3 pounds.
"It was
difficult to be so far away from my son (Erik Bailey) and his wife at the time,
but I just wasn't able to
travel,"
Bailey said. "I was recently able to visit them in their new home and take part
in his first birthday
celebration."
Feeling
that she can provide valuable support and help to other women, she is looking
to shift her career
focus
to working with women suffering from lymphedema, a condition involving swelling
of the arm or arms
that occurs in
10 to 15 percent of breast-cancer patients. And she is anticipating her return
to the stage with
the
Ladies of Jazz and The Last Big Band.
"I
feel like it's going to be wonderful to be up there and see all those faces and
have the band behind me
again,"
Bailey said. "There's no other feeling like that."
Suzie
Ernesto and Toni Lynne, the other ladies of the group, are thrilled to have
Bailey back.
"Sharon
is a tough lady, and I really admire her stamina," Ernesto said. "We're happy
to get together again
and
offer up this performance as a tribute to a lady who's winning the
fight."
Lynne,
who said she and Ernesto kept in touch with Sharon via e-mail during her cancer
treatments, said the
fact
that Bailey is not only well again, but able to sing and perform with the
group, is overwhelming.
"Just
to see her strong and alive is one thing," Lynne said. "But she still sings.
She can still sing. And, that is
just
awesome."
Bailey
is philosophical about her ordeal with cancer, and grateful to the medical
staff and advancements that
enabled
her recovery. While she dealt with her illness in a somewhat private manner,
she feels it is important
to
share her story to bring additional awareness about breast cancer and melanoma,
and to serve as a
source
of hope and inspiration to people who are in treatment for cancer.
"I
just feel so blessed," Bailey said. "My cancer is gone, and I'm thrilled to be
able to do what I can do now.
I
want other people to know there's hope. I can't do everything I'd like to, but
I can sing again, and I'm just
thrilled
about that."
Contact
Susan Shelly: [email protected].
March
28, 2011 - Local Soldiers, Girl Scouts Display Best of Americans - Patch.com –
ByAnna Renault –
Witnessing
acts of bravery, generosity highlight columnist's week 'around town.'
Traveling
around town is always an interesting experience.
Last
Thursday, I had mixed emotions as I attended the deployment for a unit from the
175th Infantry
Regiment
of Maryland’s National Guard. Eric Friesl, an usher at Our Lady of Mt. Carmel
Parish, is a
member
of the Towson unit that deployed 88 men. This is Friesl’s fourth
deployment.
Family,
friends and parishioners are wishing him all the best.
“I’m
glad I have the special skills and training needed that keeps my name on the
‘available for deployment’
list,”
Friesl said.
His
unit left from the Towson Armory, bound for six weeks of focused training at
Fort Atterbury, IN. The
training
will be followed by a 12-month assignment in Egypt.
The
Armory was abuzz with dignitaries, family and friends, all there to say
farewell as the men departed on
their
dangerous mission. It seemed a bit strange seeing the men carrying their
machine guns on their shoulder,
across
their back, or along their front. While it is recognized that soldiers deploy
to a war zone and must use
heavy
weapons, it isn’t every day you see them carrying the weapon like a backpack or
a baby. The guys
admit
they quickly learn that it is necessary to have hands on your weapon at all
times—it becomes second
nature
when in a war zone.
Days
after watching soldiers ship out for an unknown mission, I had the chance to
see another great group
of
Americans display what makes this country great. On Saturday night, I was on
hand as 16 Girl Scout
Troops
came together for one of their community events at St. Clements in
Rosedale.
Their
focus was Kami’s Jammies, a nonprofit organization that collects new pajamas
that are distributed to
children
who must spend time in hospitals. Watch for more details on this type of
fundraising projects.
Congrats
to Girl Scout Troop #1081 for hosting the event and for collecting 112 pairs of
pajamas.
At
the event was Laila Lowery representing Kami’s Jammies, a program of the Casey
Cares Foundation.
Laila
is a second grader who attends the Friends School. Laila has Sickle-Cell
Anemia, a chronic condition,
which
causes severe pain when her blood cells form crescents in the blood or “sickle
shapes” that cause
pain
as these clumps pass through her veins and arteries.
Many
other symptoms impede normal childhood activity and development. As a frequent
visitor to
University
Hospital, Laila understands the importance and influence receiving a gift of
new jammies has for
young
children who face unpleasant hospital stays.
along
with book signings has made my face more recognizable.
Thank
you to all who have taken the time to speak with me about my journey through
both domestic
violence
and cancer. Yes, there have been tough times, but know that many positive
things have happened
along
my life’s journey—perhaps that will have to be another book … something like
Anna’s Journey: The
Rest
of the Story! Would anyone be interested in things that are rather ordinary,
fun, exciting, weird and
otherwise
filling in the blanks of my life?
And
yes, the journey is continuing as I live through cancer reactions like
Lymphedema on top of a
rollercoaster
ride as a newly published author.
March
29, 2011 - NewYork-Presbyterian/Columbia Uses Latest Technology for Early
Detection of
Lymphedema
in Breast Cancer Patients - By Jyothi Shanbhag –
To
offer a quick relief for Breast Cancer Patients, specialists at
NewYork-Presbyterian Hospital/Columbia
University
Medical Center are using new methods and technology to detect early signs of
lymphedema, a
common
side effect of breast cancer surgery that causes painful, debilitating and
disfiguring swelling in the
arms
following removal of lymph nodes.
A
new technique called bioimpedence spectroscopy has been implemented by Dr.
Sheldon Feldman, the
Vivian
L. Milstein Associate Professor of Clinical Surgery at Columbia University
College of Physicians and
Surgeons
and chief of breast surgery at NewYork-Presbyterian Hospital/Columbia
University Medical
Center,
and his colleagues at NewYork-Presbyterian/Columbia to help identify the
earliest onset of
lymphedema.
“Just
as we've used early detection to improve breast cancer survival, we are using
early detection to reduce
women's risk
for developing lymphedema,"says Feldman.
An
FDA-approved device called L-DEX (ImpediMed Inc.) uses a mild electrical
current to measure minute
changes
in extracellular fluid, allowing for a diagnosis of lymphedema by the physician
well before any
swelling
is noticeable. "By catching it early, we can reverse the process and prevent
unnecessary pain,
embarrassment,
debilitation and risk of infection,"says Dr. Feldman.
Along
with this clinical use, the bioimpedence technique is also being used in
research to better understand
which
patients are most at risk for lymphedema and whether the condition always
progressively worsens, or
if
it can naturally correct itself over time.
Other
studies will investigate the common belief that lymphedema is negatively
affected by air travel and
weight
training. Even other methods like reverse arm mapping are used to reduce the
risk of developing
lymphedema.
NewYork-Presbyterian
Hospital, based in New York City, is the nation's largest not-for-profit,
non-
sectarian
hospital, with more than 2 million inpatient and outpatient visits in a year,
including more than
220,000
visits to its emergency departments.
March
29, 2011 - EMMC's motion for new trial in miscarriage case denied - Bangor
Daily News – By
Nok-Noi
Ricker –
BANGOR,
Maine — U.S. District Judge John Woodcock on Monday upheld a jury’s October
decision
that
awarded a Millinocket woman $200,000 in a civil lawsuit against Eastern Maine
Medical Center, and
he
also denied the hospital’s motion for a new trial.
The
decision is just another step in the appeal process, EMMC’s lawyer said in
response to Woodcock’s
ruling.
Lorraine Morin’s lawyer said it affirms the jury’s decision that the hospital
violated the law and in so
doing
directly caused her to suffer personal harm.
Morin,
who was having contractions when she was discharged from EMMC on July 1, 2007,
after finding
out
the 16-week-old fetus she was carrying had no heartbeat, went home and
delivered her dead son in the
bathroom
of her Millinocket home.
She
sued the hospital in U.S. District Court in Bangor, claiming that doctors
violated the Emergency Medical
Treatment
and Active Labor Act when they sent her home. The law prohibits a hospital from
discharging a
patient
who is in an emergency medical condition, which includes being pregnant and
having contractions.
A
jury of six women and two men issued their verdict in October after
deliberating for nearly seven hours.
They
awarded Morin $50,000 in compensatory damages and $150,000 in punitive
damages.
Woodcock’s
decision, which was filed Monday, means “the jury got it absolutely right,”
said A.J. Greif,
Morin’s
attorney, “and that he wasn’t going to undo seven hours of hard work by this
very bright jury.”
George
Schelling, EMMC’s attorney, said in an email that he was not surprised by
Woodcock’s decision.
“The
judgment released today in the Morin case is as expected,” he said. “The ruling
clears the way for
EMMC
to appeal the jury’s October 20, 2010, verdict to the federal appeals court.
While EMMC’s
profound
sympathies are with the Morin family, EMMC is confident the appellate court
will find that EMMC
treated
Mrs. Morin in keeping with national standards of care in cases of miscarriage,
and that EMMC is in
full
compliance with EMTALA.”
EMMC
had filed a renewed motion for judgment and a motion for a new trial more than
a month ago based
on
three claims.
The
Bangor hospital “attacks the verdict, claiming that EMTALA distinguishes
between viable and non-
viable
pregnancies, that the Court erred in allowing a nurse to testify as an expert,
and that the trial evidence
did
not sustain the verdict,” Woodcock said in his decision denying EMMC’s
post-verdict motions.
The
hospital asked for a new trial “because the Court did not instruct the jury
that the ‘may pose a threat’
language
of EMTALA depends on whether the woman in labor has any medical condition that
could
interfere
with the normal, natural delivery of her healthy child,” Woodcock
said.
The
judge responded by saying he rejected the same motion during the trial because
Morin did not deliver a
healthy
child, but a dead fetus, and therefore the language did not apply. He again
denied the motion.
The
issue about whether a veteran nurse called as a witness by the defense should
have been allowed to
testify
also was dealt with during the three-day trial in October, the judge said in
rejecting the hospital’s
second
reason for a new trial. The final assertion, that the evidence didn’t support
the verdict, also was
denied
by Woodcock.
The
judge also denied a motion by Morin, which she filed after the October verdict,
for the hospital to
change
its policies regarding the discharge of women going through
miscarriages.
“The
Court declines to issue such an injunction because the law does not authorize
it and the facts do not
support
it,” Woodcock said.
Greif
said his client filed the motion because “she would never want another woman to
go through what she
went
through. This has never been about Lorraine, and this has never been about
money.”
March
30, 2011 - Uterine Cancer Treatments: Success Without Side Effects - SYS-CON
Media –
SARASOTA,
Fla., March 30, 2011 /PRNewswire/ --
Regina
Baldwin was 57 and post-menopausal when she started spotting and experiencing
pain during
intercourse.
She was shocked when her gynecologist told her she had endometrial cancer. And
she shocked
her
family when she announced that she was going to a treatment center in Mexico.
According to TMD, a
medical
tourism research company, Baldwin was one of half a million US citizens going
out of the country
for
medical treatment each year.
An
aerobics instructor and avid jogger, Baldwin maintained a healthy weight, had
never taken estrogen or
Tamoxifen
or had radiation to the pelvis. She had 3 children, and her periods had always
been normal, so
she
had none of the risk factors associated with endometrial cancer.
Endometrial
cancer is the most common cancer of the female reproductive system. Ninety-five
per cent of
uterine
cancers, like Baldwin's, develop in the lining of the uterus. Sarcomas that
develop in the muscle of the
uterus
are very rare. In 2010, there were 43,470 new cases in the USA, most in women
over 55. There
were
7,950 deaths due to endometrial cancer in that same year.
The
uterus is pear shaped and located in the pelvis between the bladder and rectum.
During childbearing
years,
the uterine lining grows thicker each month to prepare for pregnancy. When
pregnancy does not
occur,
the thick bloody lining is shed through the vagina. This cycle occurs regularly
until menopause.
When
normal cells in the uterus begin to change and grow uncontrollably, tumors may
form. The most
common
symptoms of endometrial cancer are abnormal bleeding or discharge, difficulty
emptying the
bladder,
pain in the pelvic area, or pain during sex or urination.
Diagnosis
is done by pelvic exam, ultrasound, biopsy, a pap test to see if the cancer has
spread to the cervix
and
labs to measure kidney function and tumor markers. Other tests may include
chest X-ray, CT scans and
MRIs.
When
Baldwin was presented with conventional medicine's standard treatment -
surgery, chemotherapy and
radiation
and hormone therapy - she began to research side effects.
Surgery usually
involves removing the ovaries, fallopian tubes, part of the vagina, lymph nodes
and the uterus
itself.
Side effects include nausea and vomiting, loss of bladder control,
constipation, loss of desire, hot
flashes,
vaginal dryness and night sweats. Removing lymph nodes may cause lymphedema, a
painful swelling
in
the legs.
Radiation
and chemotherapy causes hair loss, skin tenderness, diarrhea, vomiting, vaginal
burns, infections,
exhaustion,
low blood counts, mouth and lip sores, numbness in extremities, hearing loss,
joint pain and
swelling.
Further
research told her that when caught early, about 84% of patients live up to 5
years. The survival rate
for
late stage endometrial cancer is only 10%. Faced with these dismal statistics,
Baldwin told her doctor
she
wanted to get a second opinion before deciding on a course of treatment. And
she began to look into
alternative
clinics located both in and outside of the US.
"I
found many clinics in the states that offered excellent programs for detox and
immun
e
support, but none could offer the aggressive natural therapies that are only
legal outside of the US,"
Baldwin
explained.
"I
learned that the cancer had been in my uterus for a long time before symptoms
appeared, so I felt
comfortable
taking a few weeks to look at all my options. I was not going to be rushed into
a treatment that
had
so many side effects. I wanted to live, and I wanted to be able to enjoy life
with my children and
grandchildren."
Baldwin
faxed her medical records to several clinics in Baja California, Mexico, just
across the border from
San
Diego, California. "I talked to the head doctor at each clinic, and they
answered my questions,
suggested
treatment plans and told me what I could expect. And they all told me there
would be no side
effects,"
Baldwin said.
Eventually,
Baldwin was admitted to Hope4Cancer Institute, near Rosarito Beach in Baja. "I
chose this
small
private clinic because they have 8 physicians on staff and they take only 10
patients at a time. And they
were
the only clinic I interviewed that did not offer any chemotherapy, not even low
dose chemo. The warm,
personal
attention and caring staff made my stay a pleasure. The clinic is small enough
that you really bond
with
the other patients and their families, and I made some lifelong friends," she
said.
According
to Baldwin, it was her research findings on local and whole body hyperthermia
treatments that
made
her choose Hope4Cancer.
Dr.
Antonio Jimenez, founder and medical director of Hope4Cancer Institute, uses
both local and whole
body
hyperthermia. "It has been scientifically proven that if you can sustain a
temperature of 106 degrees
inside
a tumor for one hour, the cancer cells will be destroyed," Jimenez explained.
"Because malignant
tumors
have poor circulation, they are more sensitive to temperature changes, and
normal cells are not
affected,
so the treatment has no side effects. We attribute our success to the way we
combine a variety of
therapies,
with an individual treatment plan for each patient. And we educate our
patients, so they
understand
what they need to do to regain their health and then stay healthy."
Hyperthermia
has been used in Germany for over two decades. Recently the FDA approved
microwave
hyperthermia
for medical use in the US, but microwaves can only be used on a small area at a
time, and only
penetrates
a short way beneath the skin. Sound wave or radio wave hyperthermia can be used
as a whole
body
treatment to find and destroy cancer cells throughout the body. This type of
treatment also kills
parasites,
virus and fungi while stimulating the immune system. Baldwin's research
confirmed that this
treatment would
be safe and effective in fighting her cancer.
"My
treatment was pretty intense - I was in therapy from after breakfast until
dinner time, seven days a
week
for two weeks," said Baldwin. "I had local and whole body hyperthermia,
SonoPhoto Dynamic
Therapy,
several different IVs, a vaccine, lots of detox, counseling and nutrition
classes. The food was all
organic
and I've learned why I need to change my eating habits. My husband was able to
come with me - he
stayed
in my room and attended classes and learned how to help with home
therapies."
According
to Baldwin, making this decision was not easy. "My parents were appalled that I
was traveling to
Mexico
for treatment. My kids were very supportive. My gynecologist thought I was
crazy. My best friend
said
she was 100% behind whatever decision I would make and that was the best thing
anyone could have
said
to me. I needed the people around me to respect my decision as the right one
for me."
"It's
been 4 years since my treatment at the clinic, and I feel confident I will
remain cancer free. My test
results
are still clean. I maintain a healthy diet, and stay on a maintenance program
from the clinic. I think I
made
the right decision."
Author
Marla Manhart is a health writer affiliated with TMD Limited and is a patient
advocate. She can be
reached
at: [email protected]
SOURCE
TMD Limited
March
30, 2011 - Lesser-known illness comes to light – StarPhoenix – By Hannah
Scissons –
Having a
medical condition that most people have never heard of can be frustrating —
especially when one
of
those people who has never heard of it is you.
Angela
Connell-Furi started experiencing severe swelling in her ankles when she was
21.
"When
I went to doctors and showed them, they would just say, 'Oh, yeah, there's
something going on. Put
your
feet up. Lose a little weight, it'll go away,' " said Connell-Furi, now 30
years old.
Working as a
home-care aid made the directive to put her feet up a difficult one to follow,
but she did her
best.
As the years progressed, however, the swelling only got worse. Connell-Furi's
legs and ankles
ballooned
to such a point that she had trouble finding shoes that fit, let alone
assisting her home-care clients.
Six
years on, suffering from a toe infection, Connell-Furi visited a doctor who
took one look at her legs, told
her
it looked like primary lymphedema and referred her to a vascular specialist who
confirmed that diagnosis.
"He
just lifted so much weight off my shoulders when he said, 'I'm going to send
you to someone who
knows,'
" Connell-Furi said about the family doctor who gave her the
referral.
WHAT
IS LYMPHEDEMA?
Lymphedema
occurs when the lymphatic vessels -part of the immune system -don't perform
properly,
causing
a buildup of lymph fluid.
Primary
lymphedema is a rare, hereditary condition. Secondary lymphedema occurs when
the lymph nodes
or
vessels are damaged by things such as surgery, cancer, radiation treatment for
cancer or an infection that
invades
the lymph vessels.
It's
a chronic condition and treatment can only slow its progression. There is no
cure.
Treatment
includes reducing the swelling through a process called manual lymph drainage
-a massage
technique
also known as complex decongestive therapy -and the use of compression garments
that are
specially
fitted to the patient.
Patients
who are diagnosed with lymphedema in Saskatoon are referred to the outpatient
physical therapy
department
at Royal University Hospital to be fitted with the compression garments. Janice
Block, a senior
physical
therapist, said the department gets between 60 and 70 referrals every
year.
"The
vast majority of clients we see are people who develop lymphedema after surgery
for cancer,
particularly
breast cancer," Block said.
Clients
who are interested in manual lymph drainage and who are approved by their
doctor to get it can be
referred
to therapists in the city who offer it. Evelyn Tucker receivied training in
manual lymph drainage in
1993
and many of her clients have lymphedema.
"The
goal of the treatment is to arrest the progression of the condition and then I
would be teaching the
clients
how to do selfbandaging and self-massage, making sure they're taking really
good care of the skin in
that
area, because it's so susceptible to infection," Tucker said.
Similar
to Block, Tucker also sees many breast cancer patients who are post-mastectomy
and who
developed
secondary lymphedema.
"They've
had treatment for cancer and now, much to their chagrin, they've developed
lymphedema and . . . I
think
the hardest thing for them is they dealt with the cancer and now, life-long
likely, they have this," said
Tucker.
BORN
WITH IT
In
Connell-Furi's case, the lymphedema is primary, meaning she was born with the
susceptibility to the
condition.
After her
diagnosis, she was sent to Royal University Hospital to be fitted for
compression garments to keep
the
swelling down. It was a difficult fitting process and Connell-Furi ended up
with compression garments
for
her lower legs -not ideal, because her upper legs would also swell, but better
than it was before.
Two
years after that, her arms also started swelling. Connell-Furi now had
lymphedema in all four limbs.
When
she was 28, Connell-Furi reached a point where she had to face the fact that
her condition made
continuing
as a home-care aide impossible. She went on disability. She said it's still
hard to talk about the
day
she had to leave her job.
"I
had to wear sunglasses because I was just bawling," she said.
Later
that year, she was referred to the Foeldi Clinic in Germany, where she finally
was treated by lymphatic
specialists
-there are none in Canada. During her five weeks there, she received manual
lymph drainage
massage
twice a day and was fitted for compression garments that reached from just
under her breasts
down
her legs and ones for her arms that reached down to her fingertips.
She
was also in exercise classes every day and her husband Trevor received massage
training.
PUSHES
HERSELF
Back
home in Saskatoon, Connell-Furi found it very difficult to learn more about her
condition, even in the
years
after she finally knew what it was. Tucker, her massage therapist, told her
about the Saskatchewan
Lymphovenous
Learning Association (SLLA), a group that was created in 2004. ConnellFuri is
now a
board
member with the association.
One
of the goals of the association is to increase awareness of lymphedema among
both the general public
and
health-care professionals. Connell-Furi tells the story of when she was in the
emergency room and the
struggle
she had communicating to the nurse about her condition.
"With
lymphedema in your arms, you're not supposed to have a blood pressure cuff.
It's like blunt trauma, it
can
make your arm blow up, I'm exaggerating a bit, to six times its size. It can
really make it worse," she
said.
"Nurses
have fought with me. I'll explain to them why, and they just don't listen. . .
. Now I have a note from
(my
doctor) that I'm not to get lab work, blood pressure or an IV unless it's
life-threatening. The health-care
system
definitely needs more education on it."
One
of the goals the SLLA had was to establish a website with links and other
information on lymphedema.
Connell-Furi
volunteered to do that.
"I
thought, 'how hard can it be?' " she said. "It took me a good five months. I
would just do a little bit every
few
days, because I can only sit for so long and type for so long too."
The
site went live earlier this month. It can be found at
www.sasklymph.ca.
March
30, 2011 - A Regional Leader in Orthopedic Care - MD News –
The
Tahoe Center for Orthopedics — with offices located in beautiful Lake Tahoe and
the surrounding
areas
— provides an integrated care approach in treating a wide range of orthopedic
conditions. A resource
for
physicians and patients, it is a regional destination for exceptional
orthopedic care.
Focusing
on quality and personalized care that covers the full spectrum of
musculoskeletal injury and disease
states,
the Tahoe Center for Orthopedics provides preventive care and wellness,
surgical and nonsurgical
services
and a rehabilitation program in a world-class destination.
“At the Tahoe
Center for Orthopedics, our goal is to provide exceptional patient care while
ensuring an
excellent
patient experience,” says Michael Lewis, M.D., M.B.A., Director of the Tahoe
Center for
Orthopedics.
“Our top-level health care providers, including dedicated physicians, nurses and
physical
therapists,
exercise an integrated care approach that allows us to deliver high-quality
clinical care as well as
maximize
patient outcomes.”
Service
lines provided to patients through the Tahoe Center for Orthopedics include,
sports medicine, joint
replacement
and reconstruction, spine care, hand and upper extremity care, medical imaging
and
rehabilitation.
Providing a true continuum of care, staff from home health and case management
also work
closely
with the treatment team, patients and their caregivers, creating the smoothest
possible transition from
hospital
to home.
“When
patients are in need of musculoskeletal care, they benefit from seeing our
staff of dedicated and
experienced
medical professionals, including fellowship-trained orthopedic surgeons and
radiologists,” says
Dr.
Lewis. “Other services provided to patients include care for metabolic bone
disease, osteoporosis and
rheumatology.”
Advanced
Medical Imaging
Radiologists
at Barton Health routinely collaborate with orthopedic surgeons and
physiatrists at the Tahoe
Center
for Orthopedics, providing medical imaging services through a 1.5T MRI, a
64-slice CT scanner and
X-rays.
“As
radiologists, we work closely with orthopedists to quickly and efficiently
obtain images of the injured
body
parts,” says Leonard Holmgren, M.D., radiologist on staff at Barton Health.
“Primarily, we do sports
imaging,
as injuries of the knee and shoulder are the most commonly seen conditions due
to the popularity of
recreational
sports activities such as mountain biking, skiing and rock climbing. Our goal
is to provide
enhanced
access to imaging and help return people to an active lifestyle as soon as
possible.”
Radiologists
also work with physiatrists and spine surgeons through the spine program at the
Tahoe Center
for
Orthopedics to help address concerns, including back pain, neck pain and other
spinal conditions.
“Part
of the care that we provide to spinal patients is MRI services,” says Dr.
Holmgren. “However, we are
also
involved in nonsurgical management of spinal pain, including epidural steroid
injections and nerve root
blocks.
We also perform percutaneous kyphoplasty for patients who have spinal
compression fractures or
osteoporosis.”
During
a percutaneous kyphoplasty procedure, a needle is injected into the damaged
vertebral body. An
inflatable
balloon is used to restore the vertebral body to its normal height and cement
is then injected into
the
space to maintain proper spine alignment.
Ensuring
the Best Possible Outcome
To
ensure a patient’s recovery to optimal functionality following care,
rehabilitative services, including
physical,
occupational, speech and aquatic therapy, are provided through Barton’s
Rehabilitation Services, a
division
of the Tahoe Center for Orthopedics.
“Orthopedists
at the Tahoe Center for Orthopedics will refer patients who need nonoperative
injury
management or
rehabilitation after surgical care,” says Alan Barichievich, P.T., Director of
Rehabilitation at
Barton
Memorial Hospital. “Once referred, we perform a complete musculoskeletal
evaluation to design a
customized
treatment plan that is then communicated back to the orthopedist to enhance
collaboration.”
Additional
services offered through Barton’s Rehabilitation Services include a running
program, mechanical
traction
and aquatic therapy, hand therapy and lymphedema management. Barton Memorial
Hospital
employs
the only certified hand therapist on the South Shore.
The
runner’s program provides footwear, orthotic assessment and video analysis to
evaluate runners to help
prevent
injury and help them get back into shape after injury. Many therapists employed
at Barton Memorial
Hospital
are avid runners themselves, so patients and physicians can rest assured that
the program was
developed
by trail runners and racers who understand runners’ specific needs.
“Each
therapy protocol is individually customized,” says Barichievich. “We see
patients of all ages from
pediatric
to geriatric patients, and depending on each individual’s injury and
rehabilitation goal, we develop
individualized,
hands-on care.”
Enhancing
the Education ?of Other Medical Professionals
For
the past 20 years, the Lake Tahoe Sports Medicine fellowship, part of the Tahoe
Center for
Orthopedics,
has provided a sports medicine fellowship program for physicians who have
completed a
residency in
orthopedic surgery and are seeking additional training in the area of sports
medicine. Because
Lake
Tahoe is home to an array of outdoor activities, fellows are exposed to a high
level of sports medicine
cases
during their fellowship training. Additionally, fellows gain experience in both
academic and private
practice
settings.
Lake
Tahoe’s Sports Medicine Fellowship Program is one of 95 programs accredited
through the
Accreditation
Council for Graduate Medical Education. This year-long program allows
orthopedic surgeons
to
gain subspecialty expertise in the area of sports medicine. Specific areas of
focus include musculoskeletal
trauma
of the ligaments, bones and joints.
“Through
the fellowship program, training physicians become part of our orthopedic
sports team and take
care
of everything from evaluating patients to participating in treatment, including
surgery,” says Keith
Swanson,
M.D., Program Director of the Lake Tahoe Sports Medicine Fellowship Program.
“Not only
does
this allow us to participate in the training of another generation of
physicians, but it also enhances the
care
provided to our patients.”
Because
the program is accredited, the Tahoe Center for Orthopedics is held to a higher
standard in regards
to
the level of research and care provided to patients. Active research programs
are in place, and training
physicians
can expect to complete more than 500 surgeries throughout the duration of the
fellowship
program.
Located in beautiful Lake Tahoe, the location of the center can be a draw as
well. A wide variety
of
recreational sports are available, and the Tahoe Center for Orthopedics is also
proud to be the official
medical
provider of the United States Ski and Snowboard teams.
A
Community Resource
The
Tahoe Center for Orthopedics strives to be a resource for patients and
community physicians. Staff
work
closely with referring physicians who often know their patients best,
especially at the onset of care.
Referrals
are accommodated in a timely fashion, and inpatient and outpatient treatments
are facilitated by
staff
to enhance patient convenience.
Weekly
educational conferences are open to community physicians and the Tahoe Center
for Orthopedics’
medical
staff. Orthopedic surgeons, primary care physicians, physical therapists and
radiologists generally
attend
the conference, which is held at 7 a.m. on the Barton Hospital campus. At this
conference, topics in
sports
medicine are discussed and difficult orthopedic cases are presented, which
allows for education as
well
as increased collaboration among the treatment team.
Seminars
for community members are also routinely held. Each program features a specific
musculoskeletal
condition and
includes educational information, such as wellness, treatments and symptoms.
The Tahoe
Center
for Orthopedics’ sports medicine staff is very involved with high school sports
programs as well.
Through
the Center’s preventive care and treatment, local high school sports teams have
increased access to
a
wide variety of medical providers, including physicians, athletic trainers and
physical therapists.
“Aside
from the high-quality clinical care provided, the commitment we have to our
patients and our
community
is what makes the Tahoe Center for Orthopedics unique,” says ?Dr. Lewis. “We
are
knowledgeable
and respectful of each patient’s goals and abilities and strive to
individualize treatment plans
to
provide ideal outcomes for every patient.”
For
more information about the Tahoe Center for Orthopedics or to refer your
patient, please call (877)
543-5554
or visit tahoeorthopedics.com.
March
31, 2011 - Area breast health organizations get grants - ConnectAmarillo.com
powered by KVII –
by
Nastassia Tamari –
AMARILLO,
TEXAS -- In order to address the specific unmet breast cancer needs of the
panhandle
community,
the Susan G. Komen Greater Amarillo Affiliate works has handed out grants to a
tune of
$285,000
dollars.
The
four programs all provide breast cancer services to the panhandle area, with
the goal of saving lives. "It
will
provide mammograms for women who don't have insurance or who don't have the
means to pay for the
deductibles.
Women will put it off because there's other things in life that they put first
you know as mom as
a
woman," said Julie Evenson, the Radiology Director at the Moore County
Hospital. "I have friends that
came
in for their first screening mammogram and found cancer," continued Evenson.
The Moore County
Hospital
District will use the funds to provide breast cancer screening, diagnostic
follow-up and surgical
treatment
as well as community outreach and education to underserved women in Moore
County and the
surrounding
communities.
That
funding will help them reach the community. "We cover the Texas and Oklahoma
panhandle and it lets
us
to reach all those ladies," said Terri Prescott, the Community Manager of
Health Initiatives for the
Amarillo
Cancer Society, a division of the American Cancer Society. It will use the
funds for the Amarillo
Breast
Prosthesis and Lymphedema Accessory Program. It will give the patient emotional
support, a kit
containing
a leisure bra, a lightweight temporary breast form, and rehabilitative exercise
educational
information.
These
grants will provide that detection for free. The money will go specifically to
address women in the
panhandle
by providing education, support, and services, even properly fitted
prosthesis.
"Early
detection has you know, if you can detect breast cancer early, the chances of
you surviving are much
longer,
it's when we don't detect breast cancer early is that the chance for cure is
much less," said Aneta
Younger,
the Director Diagnostics and Therapeutics at Don Harrington Cancer Center. The
funds will be
used
to help cover screening and diagnostic mammography, breast biopsy, breast MRI,
and some treatment
regimens
for medically underserved women of all ages who are not covered by other
funding.
So
that's why these programs are so important for those unmet needs.
"This
reaches women who might never have mammogram, they will get mammograms through
the grant, free
of
charge," said Leticia Goodrich, Executive Director of the Amarillo Area Breast
Health Coalition and
Project
Director of WISE Woman. The WISE program is a "train the trainer" concept. It
selects and trains
women
in basic breast health practices that stress the value of screening and early
detection.
To
date, the Susan G. Komen organization has invested $1.3 million in the
panhandle's 26 counties.
Here
are the 2011-2012 Grant Programs:
American
Cancer Society: $10,000
Amarillo
Area Breast Health Coalition (WISE Woman): $12,000
Moore
County Hospital District: $43,000
The
Don & Sybil Harrington Cancer Center: $220,000
March
29, 2011 - Peterson Chiropractic introduces Power Plate technology - Ridgefield
Press -
Peterson
Chiropractic has incorporated advanced technology known as “vibrational
therapy” to increase
circulation
and rehabilitate patients quickly. Power Plates are three-dimensional vibration
technology that
transmits
waves of energy, activating muscle contractions between 25 and 50 times per
second.
“Good
for patients with osteoporosis and lymphedema, as well people looking for a
challenging but painless
abdominal
workout, it works so quickly that most people only spend five to 10 minutes on
the machine,”
said
Dr. Nick Peterson. “Patients can be treated for lower extremity rehabilitation
just standing on the
Power
Plate.”
Power
Plate exercise improves ROM, increase bone density as well as reduces the
appearance of cellulite,
Dr.
Peterson said. “This type of a workout is also known as acceleration training.
It was first introduced by
Russian
cosmonauts to reduce the effects of zero gravity in space.”
Owner
Nick Peterson, D.C. was introduced to this new machine by his son Nicholas A.
Peterson, D.C.,
who
attended the sports centric Life University in Atlanta where the machines were
used by all athletes as
well
as the coaches who wanted to stay fit without the high impact of most training
regiments.
“After
our patients are out of acute pain we start then on more active treatments like
the Power Plate,” said
Dr.
Nicholas Peterson. “It only takes a few minutes to feel the benefits of the
vibrations and circulation
immediately
increases into muscles and joints.”
“Many of our
patients only have a few precious minutes to get a stretch and the vibration
speeds a warm-up
by
involving 100%o of muscle fibers.
For
a free demonstration, call 203-438-9609.
April
1, 2011 - Charity's dedicated helpers improve the lives of cancer victims and
their families –
MANY
lives are affected by cancer. One in three of us will get the disease and
countless more will feel its
impact
indirectly through the suffering of loved ones.
Beyond
the diagnosis and treatment at hospitals such as Good Hope, one Sutton charity
has dedicated itself
to
improve the lives of those affected by cancer – whether they are patients or
their family and friends.
Set
up a little over ten years ago, The Cancer Support Centre's (CSC) goal is to
provide a haven away from
the
physical and psychological effects of the disease.
When
CSC started in 2000 it offered alternative therapies one day a week, as well as
support for cancer
sufferers.
In the first year 145 treatments were carried out at its Farthing Lane site.
Last year that number
rose
to 2,900, including one-to-one sessions and group therapies, everything from
acupuncture to yoga, art
classes
to aromatherapy, counselling and meditation.
CSC
provides complementary therapies free of charge to its clients and to
accommodate the expanding
need,
it has recently moved to the St Giles site in Lindridge Road, on the edge of
Sutton's leafy suburbs.
Here
it will be open five days a week, Monday to Friday, helping thousands of people
cope with the rigours
of
dealing with cancer.
I
met CSC's chief fund-raiser, Pat Brighton and trustee, Alan Bunn, whose wife
Denise used the service for
three
years before succumbing to lymphoma.
The
pair were delighted to have completed the move from the charity's former site
in Midland Drive in the
town
centre to the St Giles' building, which St Giles uses to help people with
illnesses including multiple
sclerosis,
Parkinson's, lymphodema and bereavement counselling.
"With
the services that St Giles offers and what we offer for cancer patients, the
two organisations
complement
each other," Pat said. "Anyone who has cancer can come here. Once they have
been
diagnosed
they are sent on their way from hospital which deals with the medical side but
we offer support
beyond
that. The management at St Giles has been terrific in helping us," Pat said.
"St Giles contacted us
about
having a supportive care centre for Sutton Coldfield last year. The more we
talked about it, the more
we
realised how good it would be for the local community."
Another
advantage of the new venue is ground floor treatment rooms and lifts to the
upper level.
"At
the other place the treatment rooms were upstairs," Alan said. "Anyone who came
in a wheelchair had
to
make do but here it is a lot easier."
The
new site is indeed in a stunning location.
Homely
touches have been brought to the inside of St Giles' building.
In
the talking therapy room comfy chairs are in place and pictures are ready to
hang on the walls.
Sofas
replace hard chairs in the main meet and greet area, which has now become CSC's
library. Therapy
rooms
are called Sunflower, Lavender and Poppy, the latter decked out with children's
characters and soft
toys,
for young clients use St Giles' children's lymphedema clinic.
A
more controversial change took place at the site's entrance. "People from CSC
were sensitive about "St
Giles
Hospice" and we asked them to remove hospice from the sign," Alan
said.
At
the centre of the building is The Sanctuary room, with pictures of woodland
surrounding you, chairs
carved
from logs and subtle lights changing colour, creating a calming
escape.
"My
wife was here three years and tried everything," Alan explained. "We used to
travel to Solihull for
meetings
every other week as we didn't know this place existed.
"Two
years after losing my wife I became involved with the charity. It has provided
me with something to
give
back.
"I
had an email about a meeting "to discuss the future of the CSC". That was when
I came on board. I didn't
know
if it was going to close but in fact it was to discuss the move."
Alan
has been a director for blue chip companies and his business acumen has been an
important element
for
the charity. The cost of providing free treatments to clients, running the
building and paying for a full time
finance
manager means CSC must raise £100,000 a year -or £2,000 a week.
By
expanding its service from four to five days a week, the pressure on costs can
only go higher.
"At
the end of the day you have got to run it like a business," Alan said. "If you
haven't got the funds to pay
for
the services that the therapists provide, you can't do it."
By
moving to St Giles site, the two charities are sharing the costs of the
building but the way to pay for all
the
costs is "lots of hard work".
"The
Great Midlands Fun Run is our biggest fund-raiser," Pat said. "We were the
second most supported
charity
last year and we need lots of people to run in the Fun Run this year for
us.
"We
raised £10,000 last year, with £8,700 in sponsorship and the rest with Gift
Aid. Anyone who runs for
us
can get a free t-shirt to run in."
CSC
has just recruited 20 new volunteers, bringing its total to 35. With trustees
and other helpers it has
nearer
to 50 unpaid staff. It has no guaranteed funding.
"We
apply for grants and we have to be able to prove the benefits," Alan said. "We
measure the results of
treatments
here from the feedback."
Demand
is ever increasing and Pat is always on the look out for more help.
"We
are open five days a week and the need is there," Pat said. "This is the
problem. We want to give as
many
treatments as needed and since we have moved we have been pretty well fully
booked. The more
treatments
the more money we need."
The
Cancer Support Centre is open Monday to Friday from 9.30am to 4.30pm and can be
contacted by
calling
0300 012 0245
May 2, 2011
Complementary
Treatments for Cancer: The Role Reiki And Massage Can Play in Treatment -
Huffington Post – by Joseph Nowinski, Ph.D. –
Modern
medicine has transformed death and dying. Whereas a "terminal" diagnosis once
meant that
death was more or less imminent, increasingly "terminal" illness
refers to a chronic and potentially fatal
disease. It begins with a
diagnosis. That can lead to a protracted process that includes treatment,
remission, possible relapse, treatment again and so on. In this way, death
has become a process for
millions of us, as opposed to the sudden event it
once typically was.
In the course of writing "Saying Goodbye:
How Families Can Find Renewal through Loss," we
interviewed a great many
patients, caregivers and family members. We were looking for common
themes
and experiences in an effort to draw a rudimentary "road map" of what families
can expect --
and what they can do to make this process more manageable.
One of the themes that emerged was
the increasing use of alternative and
complementary treatments (ACT's) conjointly with treatments
such as
chemotherapy, radiation therapy and surgery, all of which can have pernicious
side effects.
As I did in my first blog on complementary
treatments, I have tried to base this material as much as
possible on
objective evidence that can be found through the National Institutes of Health,
the
National Cancer Institute and the National Center for Complementary and
Alternative Medicine
(NCCAM). Recognizing that there are many advocates for
various kinds of complementary
therapies, I should make it clear that I am
a clinical psychologist, not a massage therapist or Reiki
practitioner. As
a psychologist, however, I am well aware that it is possible to obtain
testimonials
attesting to the effectiveness of virtually any treatment. That is not to say that those treatments did not
help those individuals.
But that is not the same as controlled clinical research. I carry no brief for
any
complementary treatment, and I am open to the possibility of their
effectiveness.
My previous blog looked at acupuncture. This one
focuses on two additional therapies: Massage and
Reiki. Conceptually, they
are thought to work in somewhat opposite, yet perhaps complementary
ways.
Massage is a hands-on therapy that is based on manipulating tissue. Reiki, in
contrast, is a
hands-off (or light touch) therapy that seeks to free up
innate bodily energy (ki) that is believed to
have healing
power.
Reiki
Reiki, in its original form, is a
self-administered treatment; however, it cannot be self-taught. One must
learn Reiki from an experienced practitioner and it involves three levels
of learning. As a
complementary treatment, it has been used to treat many
conditions. Although Reiki can theoretically
be performed at a distance, in
the cancer treatment centers where it is used, it is often applied
in-
person at one-to-one sessions lasting anywhere from 30 to 90 minutes. In
these sessions the Reiki
practitioner places his or her hands close to or
lightly touching the patient's body, using as many as 15
different hand
positions. The idea behind Reiki is that the practitioner is able to feel the
flow (or lack
of flow) of the body's energy (ki) and to free it up so as to
facilitate the patient's overall health. Reiki
can be a very calming and
reassuring therapy for the patient who receives it.
Is Reiki
Effective?
The Journal of Alternate and Complementary Medicine
recently published a review of 12 clinical trials
of Reiki. While nine of
these investigators reported positive effects for Reiki, 11 of the 12 studies
had
serious methodological flaws, such as the lack of a control group
and/or a comparison treatment. It is
therefore impossible to say whether
the reported effects were due to patients' expectations of benefit
-- the
placebo effect. In another review of research published in the International
Journal of Clinical
Practice, 205 studies were evaluated and boiled down to
nine that were scientifically sound. The most
common benefits of Reiki that
were reported in these studies was in the area of relieving depression
and
anxiety. There were no substantiated results for pain relief. Finally, none of
these studies has been
replicated to show that the results can be reliably
repeated.
If Reiki is effective, then, it is most likely to be
with respect to patients' overall emotional state. That,
of course, matters:
Depression and anxiety are two side effects of medical treatments for cancer
that
are often overlooked.
Massage
According to
NCCAM, the leading reason why Americans turn to massage therapy as an adjunct
to
cancer treatment is to help relieve pain. To the extent that massage is
effective in relieving the physical
aspects of stress (tight muscles,
etc.), we could say that massage is also used to relieve stress. And
surely
treatment for cancer is stressful, for the patient as well as loved
ones!
There are a variety of "schools" of massage therapy, but
all of them involve the direct manipulation of
bodily tissue in one way or
another. In addition, the majority of massage therapists I spoke with said
they incorporate a variety of techniques in their practice, including the
use of pressure, deep muscle
massage, body alignment and so
on.
Is Massage Therapy Effective?
Keep in mind that
we are talking specifically about the use of massage as a complement to cancer
treatment, not its effectiveness in general. In a study funded in part by
NCCAM, 380 participants
were randomly assigned to receive either six
30-minute sessions of actual massage therapy or six
three-minute sessions
of simple touch therapy that did not include the kinds of methods cited above.
Both groups showed significant reductions in reported pain, physical and
emotional distress and
overall mood. However, these effects were greater
for the group that received actual massage
therapy.
Two
things strike me as important about the above findings. The first is that touch
-- any kind of touch
-- appears to be beneficial when you are fighting
cancer, including the side effects of medical
treatments. Second, the fact
that these beneficial effects were not sustained after the massage therapy
ended suggests that this form of complementary treatment needs to be
ongoing as opposed to a one-
time intervention.
One final
note on massage: A treatment known as manual lymphatic drainage, in which
massage is
used to move fluid away from areas where lymph vessels are
blocked, appears to be effective in
reducing lymphedema associated with
surgery for breast cancer.
Both Reiki and massage therapy are
available to patients who reside (for free) at the Hope Lodge in
Boston
while they undergo treatment in one of that city's several major cancer
centers. However, as
people have commented in response to my earlier blog,
it is a mistake to assume that a cancer
treatment center -- even an
expensive or well-known one -- will offer such services. Their availability
may reflect in part the bias of the center's administration regarding the
effectiveness of complementary
treatments. So the best advice I can offer
to these patients and their families is to pursue these options
on your own
if you think they might be worth a try.
Insurance may not cover
complementary treatments; on the other hand, they are much less costly than
any medical treatment, such as chemotherapy. And some have commented that
it may be possible to
negotiate rates, especially if several patients get
together and seek a discount.
Perhaps as more rigorous research is
conducted and reported we will learn more about which
complementary
treatments do what, and for whom. Surely all of the above symptoms -- anxiety,
depression, pain -- complicate cancer treatment. To the extent they can be
ameliorated, it makes
sense to include them in a comprehensive treatment
plan.
The "new grief" that is the result of the transformation
of death and dying will affect every one of us
eventually, if it hasn't
already. Families do best when they approach terminal illness by learning about
primary treatment as well as complementary treatment, and bringing both to
bear.
May 3, 2011
Hawthorn Medical Associates in
Dartmouth hires new full-time physical therapist - Fall River Herald
News
–
DARTMOUTH --
The Hawthorn Medical Associates’
Physical and Occupational Therapy Department announces that
Sherry
Spencer-Brown has become a full-time member of the staff. Spencer-Brown is an
experienced physical therapist and a nationally certified lymphedema
therapist. She specializes in the
care of oncology patients and vascular
patients who have symptoms of lymphedema.
With the addition of
Spencer-Brown, the Physical and Occupational Therapy Department is able to
offer its patients a progressive and comprehensive approach to oncology
rehabilitation. Spencer-
Brown’s expertise will ensure that cancer patients
have access to rehabilitation that will assist them in
their recovery.
Patients who will benefit include those with symptoms of lymphedema, joint
pain,
limited range of motion, loss of function, decreased independence in
home and work activities and
deconditioning.
A graduate of
Northeastern University, Spencer-Brown was most recently employed at St. Anne’s
Hospital in Fall River as a lymphedema specialist. She has also been in
private physical therapy
practice and is a past manager of the
rehabilitation department at Morton Hospital and Medical
Center in
Taunton.
May 4, 2011
Thursday's Pink Fair emphasizes
women's health and wellness - TheDay.com –
Norwich — Enhancements
to the Breast Health Patient Navigator program at The William W.
Backus
Hospital will be featured during the third annual Pink Fair from 3 to 6 p.m.
Thursday at the
hospital.
The fair focuses on women’s health
and wellness, and includes free screenings such as bone
densitometry and
blood pressure. Admission is free. This year, special attention is being given
to the
services available through the navigator program. It has been at
Backus since 2008 but has recently
been enhanced, James O’Dea, assistant
vice president at the hospital, said Wednesday. The program
helps guide
women through the healthcare system after a suspicious
mammogram.
Offices for the navigator program have moved to a
more prominent location in the hospital so the
services are more easily
accessible, O’Dea said. One area contains resources for breast cancer
patients including wigs, garments and an information library. O’Dea said
other recent enhancements
include prompter follow-up imaging for women who
have had an “inconclusive” mammogram finding,
so that instead of waiting 20
days they are now have a diagnostic mammogram or ultrasound within
six
days.
The hospital is also starting a lymphedema screening
program to track women for up to three years
who have had breast surgery
for signs of this painful, disfiguring condition that can become a chronic
condition, O’Dea said. If detected early, there are effective treatments,
he said. Thanks to donations
to the navigator program, the hospital was
able to purchase lymphedema screening equipment.
May 5,
2011
BrightLife Direct Introduces 3 New Lymphedema Product Lines
- PR Newswire –
Washington, DC-based medical compression garment
distributor adds several lymphedema products
to its
inventory.
WASHINGTON, May 5, 2011 /PRNewswire/ -- BrightLife Direct, a
compression clothing
distributor, recently added three new lymphedema
products to its inventory. Products by Farrow
Medical, Solaris and
Gottfried are now available online through the Washington, DC-based
company.
These compression garments are used in lymphedema
treatment. Lymphedema is a medical condition
that involves swelling of the
arms, legs or hands. Although it can be caused by a genetic condition, it is
often caused by lymph node removal after breast cancer surgery. Statistics
show that up to 50
percent of breast cancer survivors develop lymphedema.
About 32 percent have persistent swelling
three years after surgery. While
there is no cure for this condition, lymphedema can be managed with
the use
of compression sleeves, gloves, stockings and wraps.
"We have received
requests from therapists for hard-to-find products, so we are trying to address
that need," said Kip Bright, president of BrightLife Direct. "We want to be
a resource for patients and
therapists who need these compression
garments."
BrightLife Direct will begin carrying jobst bandages
over the next few months. These are long-stretch
and short-stretch bandages
which accommodate patients during different stages of their treatment.
The
FarrowWrap resembles a sports brace and has adjustable hook and loop closures.
The Farrow
Microfine glove is another new addition to BrightLifeDirect's
inventory. It is made of more lightweight
material than other types of
compression gloves, allowing for more hand
flexibility.
BrightLife Direct also carries Swell Spots,
manufactured by Solaris, Inc. Swell Spot is typically
placed under
clothing, bandaging, or a compression garment to gently massage the underlying
tissue
and break up problem areas of swelling.
Gottfried Medical
makes custom compression garments for all parts of the body. These reasonably
priced garments are custom ordered to meet the specific needs of the
patient, making them more
comfortable to wear.
About
BrightLife Direct, Inc.: BrightLife Direct (http://www.brightlifedirect.com/)
has been serving
those who wear compression garments for more than 10
years. The Washington, DC-based
company offers name brand products at
discounted prices. This includes compression stockings from
Jobst, Mediven,
Sigvaris and Juzo. The company features a private label brand, Allegro
stockings,
which meets all rigorous testing standards and is available at
50% to 60% less than name brands.
SOURCE BrightLife Direct,
Inc.
Activcare Physical Therapy Combines with Wellness One -
dBusinessNews Triangle –
Triangle - RALEIGH, NC – Effective May
9, Activcare Physical Therapy and Wellness One, two of
Raleigh’s most
respected private physical therapy practices have combined their physical
therapy and
support teams. The entire staff, including physical therapists
from Wellness One, will become
employees of and operate under the name of
Activcare Physical Therapy.
Wellness One patients will continue to see
their same Wellness One therapist at Activcare Physical
Therapy’s
state-of-the-art facility, just down the road at 3100 Blue Ridge Road, Suite
204. Patients
should not experience any gap of service, and their same
insurance will continue to cover their
physical therapy treatments. The
current Wellness One phone and fax numbers will also remain in
service.
Wellness One patients will have access to more credentialed insurance companies
and
additional hours of service — from 7am – 7pm Monday through Friday and
8am – 12pm on
Saturdays.
“By joining forces with Wellness One,
Activcare Physical Therapy has created what we believe to be
the most
extensive physical therapy resource in the Triangle area,” said Brad Hancock,
MPT and
owner of Activcare Physical Therapy. “We have worked diligently to
make this transition as seamless
as possible for all the Wellness One
patients and we’re happy to be able to continue to offer them the
very best
possible physical therapy services and care.”
Activcare Physical Therapy
is a privately held physical therapy practice with three current locations:
two in Raleigh on Blue Ridge Road, and one in Fayetteville. With the
combined capabilities of
Activcare Physical Therapy and Wellness One,
patients can now access a multitude of treatment
options under one roof,
including: Orthopedic Therapy, Neck and Back Therapy, Neurological
Rehabilitation, Incontinence, Vestibular and Balance, Women’s Health,
Sports Medicine, Oncology,
Geriatric Therapy, Pain Management, Cardio
Conditioning, TMJ Disorder and Lymphedema.
For more information about
Activcare Physical Therapy, visit www.activcarept.com.
Backus
health fair especially 'pink' this year - Norwich Bulletin – by JAMES MOSHER
–
Norwich, Conn. --
Breast cancer survivors were in an
especially festive mood Thursday as The William W. Backus
Hospital
celebrated moving a key program to a larger space in addition to its annual
women’s health
fair.
The Breast Health Patient Navigator
Program officially took up its quarters in three refurbished offices
as the
program’s leader, nurse Joyce Kuusela, cut pink ribbons on two of the
second-floor offices
including her own.
“It’s a great day,” said
Kuusela, who lives in Lisbon and is a breast cancer survivor. “We’re going to
be able to better direct people and help a lot more.”
Before
joining colleagues on the first floor for the 3rd annual Pink Fair, hospital
workers reflected on
the program’s milestone and looked forward to
more.
James O’Dea, the administrator who oversees the navigator
program, described himself as “giddy”
over the establishment of a
lymphedema screening program. Lymphedema is a painful condition that
can
result from mastectomy surgery.
“All of this reflects a real commitment
to women’s health in this community,” he said.
The program has
strong support at the hospital’s top echelon.
“It’s nice to see
all this come together,” President and CEO David Whitehead said. “It’s just the
beginning. We’re looking for opportunities to expand health care in this
regard.”
During the Pink Fair, cancer survivors raised money for
an Oct. 20 fashion show planned for
Foxwoods Resort Casino. About 20 models
are expected to participate. At last year’s show,
organizers sold out of
all 60 pink boas. They will bring 200 this year, said Barbara Chiangi, a
Norwich resident who is director and co-producer of the show and a two-time
cancer survivor.
“It all goes back into the Backus community,”
said Donna Palumbo of Niantic, the show’s co-
producer and also a survivor.
“We’re building up women’s health through all this.”
The fair
featured 17 stations of information and therapies including facial massage and
harp music.
Nurse Elizabeth Fracchia and social worker Wendy Heilweil
strengthened the theme of looking ahead
by discussing medical directives,
also known as living wills.
Visitors praised the
offerings.
“It’s great,” said Yvonne Wright of Norwich, while
walking the fair with daughter Michele Bilodeau
of Preston. “Lots of useful
information. And free chocolates don’t hurt.”
May 6,
2011
Tai chi offers special benefits for cancer survivors - News
Record and Sentinel –
Every Thursday morning, a group of women
who share a common bond gather at Mission Hospital's
Wellness Resource
Center at 50 Doctors Drive on the Memorial Campus.
The bond we
share? We're all Cancer Thrivers and Survivors. Why do we gather? Mainly
because of
the camaraderie. And because tai chi is relaxing and good for
the soul.
We continue because tai chi is a great motivator to
help slow aging, and regain strength, energy and
range of
motion.
Our tai chi class has been offered for just over a year, and is
sponsored by the resource center. It
meets 10:30-11:30 a.m. every
Thursday.
Nancy Chatham, our instructor and a breast cancer
survivor herself, has taught exercise classes for
10 years and is certified
as a tai chi for arthritis instructor. We are fortunate that she now brings
that
program to us, for cancer survivors.
Tai chi, often described
as “meditation in motion,” can also be described as “medication in motion.”
Good body alignment and slow, flowing moves increase flexibility and
strengthen muscles weakened
by surgery.
The emphasis on
relaxed breathing and gentle moves enhances the lymphatic system, adding to the
benefits for women at risk of lymphedema following
surgery.
As we focus on balance and weight transference and move
with intent, we improve our mental focus
and internal strength. The flowing
motion relaxes the body and fosters a sense of peace and calm. Did
I
mention that it's fun, too?
I have attended this class since its
inception in August 2008, just 2 weeks after my own double
mastectomy. In
addition to the benefits from exercise and movement, there's the ever-present
friendship and support among the women in our class. Together, we've been
through surgery,
reconstruction, and many other challenges of
life.
And that, my friends, is priceless.
Women
dealing with cancer or other chronic illness who are interested in this journey
are welcome to
join our class. The health benefits are for
everyone!
For more information, or to register for the class,
call Mission Hospital's Wellness Resource Center at
213-8246.
Scabies Outbreak Linked to Nurse's Dirty
Compression Glove - Infection Control Today –
A dirty
compression glove worn by a healthcare worker is implicated in a scabies
outbreak among
newborns. In a study appearing in Infection Control and
Hospital Epidemiology, Barbara G. Ross, of
the Department of Infection
Prevention and Control at New York-Presbyterian Hospital, and
colleagues,
report that after three cases of scabies in infants were identified by a
pediatric
dermatologist during a three-month period, an intensive
investigation was launched to find additional
cases by contacting local
pediatric dermatologists and hospital-affiliated
pediatricians.
Scabies is a contagious infestation of the skin
caused by the mite Sarcoptes scabiei; it is transmitted
through close
personal contact with infested individuals or their personal items and can live
on
inanimate items for up to two days.
The researchers report that
seven additional case patients, including three neonatal intensive care unit
patients, were identified. Cases were diagnosed both by microscopic
examination of skin scraping
specimens and clinically. They add that
environmental rounds were conducted in the newborn
nursery, postpartum
rooms, nursing stations and patient and staff lounges, and no cloth furniture
or
grossly contaminated fomites were found. The researchers then looked for
a healthcare worker index
case patient; six employees were identified as
having contributed to the electronic medical record for
three or more case
patients; five were found to be without symptoms and they accepted
prophylaxis.
Ross, et al. (2011) report further that a per diem
nurse had contributed to 10 of 10 electronic medical
records examined:
“When evaluated, she was noted to have a rash and wore a noticeably dirty
compression glove for lymphedema while on duty, making it impossible for
her to clean her hands
effectively. This nurse reported that she had been
treated for scabies by a private dermatologist at
least five times in the
previous year, although she had not reported this
treatment.”
The researchers hypothesize that the dirty
compression glove that the nurse wore at work contributed
to her
re-infestation or was a means for transmission to patients and add, “Staff who
require hand or
wrist braces or compression gloves or sleeves must be
evaluated and reasonable accommodations
considered by hospitals so that
infection prevention policies can be followed. A single case of scabies
in
a newborn should be considered a sentinel event of a nursery
outbreak.”
Reference: Ross BG, Wright-McCarthy JK, DeLaMora PA and
Graham PL. Transmission of
Scabies in a Newborn Nursery. Infection Control
and Hospital Epidemiol. Vol. 32, No. 5.
May
2011
Stillwater team goes to nationals: Rutherford Elementary
Lego League Robotics Team heads to
national competition, hopes to make a
difference - Stillwater Gazette - By HANNAH JOHNSON
It's not
just a competition. It's personal.
In its third year competing, a
sixth-grade Lego League Robotics Team from Rutherford Elementary
School is
going on to the First Lego League (FLL) national competition at the end of the
month.
Every September FLL releases a themed challenge based on a
real-world scientific topic. Each
challenge has two parts: the Robot Game
and the Project. Each team with one adult coach
participates in the
challenge by programming an autonomous robot to score points on a themed
playing field (Robot Game) and developing a solution to a problem they have
identified (Project).
The seven-student team placed first in the
regionals and qualified as "Champions" at the state
competition. Now the
team will be heading to Lego League Nationals near San Diego, California
May 20-22.
This year's theme was Biomedical Sciences and
Engineering. The Rutherford team chose to research
lymphedema, which is a
condition that causes chronic swelling from the build-up of tissue fluid in an
area of the body. Normally lymph vessels transport protein-rich lymph fluid
into the circulatory
system, but if it can't transport the fluids then
swelling and skin thickening occurs. If it's left untreated it
can harden
the tissues, cause infections and even cancer.
The students didn't
randomly select its research topic. The team decided to study lymphedema
because one of the team's coaches was recently diagnosed with the disease.
The project then became
more than constructing an award-winning piece - it
also became an opportunity to make a difference.
"This year has been
exciting for (the students) because as they studied the topic they discovered
each
(student) has a connection with someone suffering from lymphedema,"
said Teresa Cook, one of the
team's coaches. "They had no idea they had
these connections so it became a real topic to them."
While conducting
their research the students met with doctors and researchers, learning that
lymphedema affects people young and old. People can be born with it or
receive the disease from
cancer treatment. As a result, the students
designed The LymphESocc, a compression garment that
combines electric
stimulation and channel foam to alleviate pressure on the
limbs.
Normally patients wear a knee or thigh-high stocking that puts
pressure on the limb and then patients
see therapists for individual
therapies. This garment brings together all therapeutic aspects, eliminating
the need to see a therapist and alleviate relieve their pain at any
time.
The students' product has been recognized by more than the Lego
League judges. The students were
recently recognized by the research
department at the Sister Kenny Institute in Minneapolis.
"In coming up
with the garment they didn't know where it was headed, but we've been told this
is a
viable garment that could be put to use in the next few years," Cook
said. "For them to come up with
something really innovative that could
possibly better the lives of someone with lymphedema was neat
for
them."
In addition to attending the Lego League Nationals, the students
will also compete in the Global
Innovations competition that awards a paten
process to an innovative and viable product.
The students will be
hosting three fundraisers in the next couple of weeks to raise the necessary
funds
to pay for their trip to Nationals. On Wednesday, May 11 the students
will host a fundraiser at
Buffalo Wild Wings in Oak Park Heights. For every
diner who joins the students and turns in a ticket,
BWW will donate 10
percent of the person's meal spent.
If people also choose to do their
garden shopping and turn in a team voucher at Linder Mart, Linder
will
donate 15 percent of the sale to the team.
To print vouchers and tickets
or to learn more information visit www.twizbots.webs.com.
May 8,
2011
Pregnant with cancer, mom makes gut-wrenching decision -
GoErie.com - By LINDY
WASHBURN –
HACKENSACK, N.J. -- Sheri
Quattrocchi was just 13 weeks pregnant when the cancer she
thought she'd
beaten two years earlier surged back.
A swollen lymph node
beneath her rounded belly turned out to be metastatic melanoma, an advanced
form of the deadliest type of skin cancer.
This was to be
her first child, the happy outcome of in-vitro fertilization after two
heartbreaking
miscarriages.
But now her choice was stark.
Doctors said she had two options: terminate her pregnancy and begin
treatment immediately, or carry her pregnancy as close to full term as
possible and begin treatment
after the baby was born.
"They
said it really had to be my decision," recalls the 33-year-old, who lives in
Lodi, N.J. with her
husband, Michael Quattrocchi.
But the
physicians' preference was clear: Termination.
"It was not my
recommendation that she continue (the pregnancy)," said Dr. Anna C. Pavlick, a
specialist in melanoma at New York University Medical Center. "I think it
was not anybody's medical
advice that she
continue."
Melanoma can spread to the brain and lungs; when it
reaches that advanced stage, few treatments are
available. It is also one
of very few cancers that can cross the placenta and affect the fetus: The
longer
she carried the pregnancy, the greater the risk that the baby would
be born with cancer.
Cancer occurs in about one in 1,000
pregnancies. It's rare, but becoming more common as women
wait until they
are older to bear children, when the risk of cancer is
higher.
Metastatic melanoma, though, is even more unusual. "You
don't see too many of them," said Dr.
Abdulla Al-Khan, Sheri Quattrocchi's
high-risk pregnancy specialist at Hackensack University
Medical Center. "We
didn't have a lot of data out there to tell us the best thing to
do."
Pavlick and Quattrocchi's obstetrician laid out the risks
and benefits of each course for the couple.
"She needed to know
that her life, and possibly even the baby's life, may have been in jeopardy by
continuing," Pavlick said.
But doctors make recommendations;
patients are supposed to make the decisions.
The doctors saw a
pregnant woman with melanoma. Sheri Quattrocchi knew there was more to the
story than that.
For the couple, the melanoma's recurrence
began another harrowing chapter in several years of
hardship.
In 2007, a month after her 30th birthday, Sheri
Quattrocchi learned she had multiple sclerosis.
"I had some
weird sensations in the legs, and thought nothing of them," she said. She went
to the
doctor for something else, received a referral to a neurologist and
had a battery of tests.
In December 2007, an internist treating
her for a virus noticed a mole on Sheri Quattrocchi's
abdomen and told her
to get it checked out. Surgery took place the following June. The mole was
removed with a wide excision and the lymph nodes in the groin nearby
dissected.
When it turned out to be melanoma, Sheri Quattrocchi
was shocked: there'd been no blistering
sunburn, there was no family
history. She was glad that the lymph nodes were deemed
"clear."
"Life was getting too short," though, she said. She and
Michael Quattrocchi became engaged five
days after the cancer
diagnosis.
The couple, who had been together since they were 14
and 15, decided to start a family right away.
Then, six months
after the wedding, Michael Quattrocchi was diagnosed with testicular cancer.
Two
operations followed.
Once he got better, they turned to
in-vitro fertilization.
Their first two cycles, undertaken at
great expense, resulted in two failed pregnancies.
Then they
made a third and final attempt. It succeeded.
Although wary at
first, Sheri Quattrocchi had made it through her first trimester and was
entering her
second when the lymph node started to swell.
A
Hackensack, N.J., surgeon, Dr. Donald McCain, removed it while Sheri
Quattrocchi was under
local anesthesia. She and her husband were watching
television in the recovery room when they
learned the devastating news: The
melanoma had come back.
"I was in shellshock," she
said.
The doctors presented her choices a few days
later.
She didn't hesitate.
"I'd heard the
heartbeat already," she said. "I had seen the baby move on the ultrasound
screen."
She couldn't wait to meet this new member of the
family. "There was no question I was going to take
my chances," she said.
"God was not going to finally give me this gift and then, you know, take it
away, or make her (the baby) sick."
"She thinks the baby is
more important, and I think the mother is more important," said Al-Khan, a
director in Hackensack's division of maternal-fetal medicine, recalling
their early discussions. "These
are the difficult dilemmas that physicians
face."
Should he do everything for Sheri Quattrocchi --
diagnostic imaging with CT and PET scans, careful
staging of the cancer,
followed by aggressive treatment? "Or do we buckle our seat belts and take it
day by day?"
He talked with the couple, talked with
colleagues, reached out for second, third and fourth
opinions.
The combination of pregnancy, multiple sclerosis and
melanoma was a "perfect storm," said Pavlick,
each condition affecting or
affected by her immune system. "These are the cases that make me stay up
at
night."
There was little record of previous cases to guide
them.
"No one can really say with certainty that waiting three
to six months is going to be the difference
between long-term living or
dying" with most cancers, said Dr. Andrew Pecora, vice president for
cancer
services at Hackensack. "Lots of times you can stall and not adversely affect
the outcome."
"You do your best," Pecora said. "You share all
that and give their options and then respect their
choice."
Sheri Quattrocchi chose. The waiting and watching
began.
Sheri Quattrocchi's plastic surgeon, Dr. David Byckoff,
removed a small melanoma from her
abdomen under local anesthesia. It had
not gone deeply into the skin and was not a major worry.
Then,
at the end of February, Sheri Quattrocchi felt something new where her
lymph-node surgery
had been. "My scar was getting lumpy," she said. "It was
starting to hurt. I was getting concerned."
She was 30 weeks
pregnant. The doctors' goal for her pregnancy: 36 weeks.
Her
pregnancy crowded the other organs and made it hard to see what was going on
with ultrasound
imagery. But something was clearly
growing.
Al-Khan spoke with Sheri Quattrocchi after the
ultrasound, on a Friday afternoon. Get ready, Al-
Khan told her. The baby
would be delivered at 32 weeks.
On March 21, her baby was
born.
It was an emotional scene in the delivery room, but the
birth itself "was uneventful, thank God," said
Sheri Quattrocchi. She cried
as the baby was held to her face. So did her husband.
The
incision was stitched up -- a vertical rather than a lateral scar, because of
the additional
abdominal surgery that was sure to be
needed.
Baby Mikayla weighed 4 pounds, 14 ounces -- big for a
premature baby.
Meanwhile, the cancer was getting hotter and
hurting more each day.
When doctors saw the results of the CT
scan, they changed their minds about waiting to let the C-
section scar
heal. Two days after Mikayla's birth, Sheri Quattrocchi returned to the
operating room.
The mass the surgeon removed was "the size of an
Idaho potato," she said. The contents of the node
had spilled into the
surrounding tissue. But it could have been worse: There were no signs of
melanoma in other organs of her body.
Afterward, Sheri
Quattrocchi rested in her hospital bed, and wore pressure sleeves on her legs
intermittently to treat the lymphedema, or swollen legs, that had
developed. As often as she could, she
visited Mikayla in the intensive-care
nursery.
The placenta was analyzed: no signs of cancer. The
melanoma had not spread to the baby.
They are at home now. The
baby -- 5 pounds of tiny perfection in a green sleeper with matching cap
and booties -- sucks from a bottle as she nestles on a cushion on Sheri
Quattrocchi's lap.
Michael Quattrocchi takes the overnight shift
with Mikayla, then goes to his job at a group home for
developmentally
disabled adults.
He admits he's scared. "I just pray. I pray
every night. I put it in God's hands," he says.
"We got our
miracle -- Mikayla," he adds. "I don't feel that God is going to give us this
wonderful little
girl and take her mother away. I'm scared, but I'm staying
positive."
Sheri Quattrocchi needs radiation therapy to target
the area where the lymph node was removed with
51/2 to 6 weeks of daily
treatments. She'll also get chemotherapy, in pill form, to prevent future
cancer spread.
Pavlick says she is "cautiously
optimistic."
"The fact is, she made it through the whole
pregnancy without (the cancer) going to other parts of
body," Pavlick said.
"Now her immune system may be going back to normal," although with MS, it
won't ever be entirely normal.
Al-Khan agrees. "I think she
will do well -- my mouth to God's ears," he said.
"People say
I'm very unlucky," Sheri Quattrocchi said. "I feel like I'm lucky. I survived
it. My husband
survived it. I have this awesome, feisty little baby girl.
... I have great friends, great family. I have
awesome
co-workers.
"This is my light at the end of the tunnel: having
my baby," she said.
May 9, 2011
Hospital
hosts clinical trials - Cookeville Herald Citizen – by Liz Engel Clark
–
COOKEVILLE -- Cancer patients participating in clinical trials
could be laying the groundwork for
future care, say health care officials
at Cookeville Regional Medical Center.
The hospital offers a wide
variety of trials for patients with prostate, colon, breast and lung cancer,
among others. And although only a small percentage can actually participate
in such research studies,
the information gathered could have a lasting
impact down the road.
"The majority of patients that we approach about a
clinical trial, most of them want to do something to
help somebody else,"
said Joy Hilliker, RN, certified clinical trials coordinator at Cookeville
Regional.
"Time after time I have women who say, 'If this is something that
will help my daughters or
granddaughters, then I'm going to do it, even if
it doesn't help me.' And obviously that philosophy is
huge, because the
treatments we use today are those things that have been tested in the
past."
All trials offered at the hospital are phase two or higher. Phase
one trials, for example, test an
experimental drug or treatment in a small
group of people for the first time to evaluate safety,
determine safe
dosage ranges and identify side effects. Trials in phase two and three would be
given
to larger groups to further test a drug's effectiveness and evaluate
its safety.
"Phase two is more researchy from the standpoint that you
might be using a drug that's less
established, but it's still gone through
a phase one, which means there's some track record there," said
CRMC Dr.
Paul Jacquin. "Phase one is really the first human testing of a drug, and I
don't really think
that community hospitals should do a phase one or even
pre-clinical drugs, particularly. Because then
you're truly experimenting
on your population base."
The hospital, he said, offers a wide variety
of trials for prostate, colon, breast and lung cancer. Many
are currently
active or enrolling patients.
There's one new trial, for example, for
advanced lung cancer patients. It utilizes a drug recently
approved in
melanoma treatment, and participants should have never had chemotherapy
before.
There's also a lung trial that utilizes a vaccine, which attacks
the cells that these cancers produce.
"Probably almost 50 percent of our
cases are lung cancer in this community," Jacquin said. "There's
different
kinds of lung cancer, and we kind of like to hit all of them. We're trying to
get a number of
different protocols for that."
CRMC also offers a
myeloma trial and is in the process of opening a radiation therapy trial.
Another
trial is testing a new drug that could help prevent mouth sores, a
common side effect from radiation
therapy in head and neck cancers. The
hospital has also started a lymphedema prevention trial for
breast cancer
patients. Hilliker says participants should enroll before they have
surgery.
"That's actually a real interesting trial, and it was
originally funded with (Susan G.) Komen and Lance
Armstrong," Hilliker
said. "It's studying an exercise program in hopes of preventing lymphedema in
women after they've had breast surgery, and specifically, lymph node
surgery related to breast
cancer."
The trials offered are a
combination of observation and controlled. They are either
pharmaceutical-
sponsored or cooperative group trials, like those offered
through SWOG, or the Southwest
Oncology Group, one of the nation's largest
clinical trial networks. A cooperative group membership
allows the hospital
access to trials being conducted nationwide, which means patients don't always
have to go elsewhere for treatment.
There are risks with trials, of
course, but Hilliker said SWOG audits are conducted every couple of
years.
Pharmaceutical companies are also active in the monitoring process.
"The
only resistance you get sometimes is people say, 'Gee, I don't want to be a
guinea pig,' but we're
only doing trials in phase twos and threes," Jacquin
said. "There's only a small percentage of people
nationwide that go through
trials, so we're basing our standard of care on minority population of
people who volunteer for this.
"They're really getting the
best-known treatment," he said.
May 10,
2011
Class helps women with exercise after breast cancer surgery
- Ventura County Star - By Alicia Doyle
–
Some women may be
reluctant to get involved in an exercise class right after breast cancer
surgery.
"They have questions about what they can and cannot
do," said Sara David-Feyh, who leads women
who have undergone breast
surgery related to cancer during a free class, "Exercise is Wise After
Breast Cancer Surgery." It meets at St. John's Outpatient Therapy Center in
Oxnard.
"The goal is to provide a relaxed, supportive setting
where the women can see themselves as the
women they used to be or want to
become as they go through the cancer experience together," said
David-Feyh,
57, of Ventura, who has been leading the class since 2005.
A
physical therapist assistant for 15 years, she was mentored by Claudia
Steele-Major, who
launched the program in 2001.
The class
incorporates low-impact stretching and strengthening, with an emphasis on the
upper body.
Exercises are designed to improve range of motion in the
shoulders, upper back and neck, as well as
improve posture. A
cardiovascular component to improve endurance and general mobility is included
and adjusted to each individual. Breathing and relaxation techniques are
integrated to enhance well-
being and reduce stress.
Class
participants also have access to information about lymphedema, which is
swelling in the arms
and legs. A participant may be referred to a physical
or occupational therapist if their physical needs
exceed the scope of the
class.
"Initially after surgery, reaching overhead or lying on the
affected side is difficult due to pain and scar
tissue formation. Exercise
should be designed to regain flexibility in the arms, and prevent poor
posture," said Steele-Major of Ventura, a physical therapist for 23 years.
She also is a lymphedema
therapist with a background in orthopedics and
women's health and has worked with breast cancer
patients and their
rehabilitation for more than a decade.
"Pain must be respected,
and as the healing process advances, so will the activity tolerance,"
Steele-
Major said. "The goal for each woman should be to return to her
prior level of function. As a
minimum, that should include activities such
as reaching overhead, driving, light housework and
carrying her purse on
the affected side."
A common misunderstanding is that
weightlifting and carrying objects are no longer permitted.
"The
reality is that limitations are dictated by the type of surgery or
reconstruction, prior medical
conditions, as well as level of function
before surgery," Steele-Major said. "As women undergo
chemotherapy and
radiation, their energy levels will greatly fluctuate. Fatigue is a common side
effect
that can be managed better with exercise. Each patient should be
cleared by her physician before
starting an exercise
program."
The physical benefits are evident not only in the
increasing activity tolerance but also in the
management of
fatigue.
Women who participate in the class often bond with one another
and develop friendships that reach
beyond the scope of the class,
Steele-Major said.
Rose Martinez, 85, has been taking the class
since 2000.
"I was fortunate that I did not have chemo, which is
almost as bad, or worse, as hearing the dreaded
word 'cancer,' " said
Martinez of Ventura. "I am fortunate that I have made so many friends. One
makes friends and acquaintances during our lifetime, but they are not like
cancer survivors."
Ventura resident Eileen Kanatzar, 77, started
attending in 2003.
"It's a great group of people," she said. "I
go for the exercise and the wonderful camaraderie. We're
all in the same
boat, so it's a great support group."
The class is offered from
4 to 5 p.m. Wednesdays at St. John's Outpatient Therapy Center, 961 N.
Rice
Ave., Suite 3, in Oxnard. For more information, call
988-2641.
Remembering all the victims of the Vietnam War - Ct
Post –
Unlike today, the troops that returned home from Vietnam
were regarded with indifference. Thanks
to the Vietnam Veterans Memorial
Fund, honor and appreciation is bestowed on them through the "In
Memory
Honor Roll."
On April 18, I attended a ceremony in Washington,
D.C., in which my brother, Gregory Patrick
Russell, was inducted, along
with 92 others, into the "In Memory Honor Roll." To be an honoree, one
must
have served in the military in Vietnam. The veteran must have died of a disease
or committed
suicide that was traceable to the time spent there and his or
her death does not meet the Department
of Defense's criteria for being
added to the Vietnam Veterans Memorial ("The Wall"). There are
approximately 2,100 people on the honor roll and 58,000-plus names etched
into the black granite
wall.
Greg's disease was prostate cancer that
was traced to exposure to Agent Orange. He enlisted in the
United States
Marine Corps in Bennington, Vt. He served in Vietnam in 1970-1971; he hadn't
yet
reached his 20th birthday. Greg was diagnosed in 1997 after complaints
to his doctor two years
earlier were dismissed as "something that happens
to men over 40." By the time the diagnosis came,
the cancer had already
spread outside of the prostate gland. He was in excellent physical condition
and very active in both work and play -- a blessing and a curse since his
cancer was also active and
aggressive in his healthy body. Over the next 14
years, the disease painfully manifested itself in his
back, skin, lungs and
hips. He and his wife made countless visits to Mass General for chemo,
radiation and pain management. Some of these treatments caused serious
problems including
lymphedema, blood clots and incontinence, to name a few.
The last several years his pain was
lessened by a methadone pump which
administered pain medication 24/7. Greg never complained
and enjoyed life
to the fullest. He lost the battle on Thanksgiving Day 2010, when his body
could no
longer overcome pneumonia and kidney problems.
If
you have a loved one who was in Vietnam and died due to complications from
exposure to Agent
Orange or other causes attributed to being in Vietnam,
fill out an application to have him or her added
to the "In Memory Honor
Roll." The ceremony gave my siblings, my sister-in-law and me yet another
chance to grieve the life of this remarkable man and allowed us to meet
other families who lost their
loved ones, too. A description of the program
and the application are on this website:
http://www.
vvmf.org/InMemoryProgram. I thank all the veterans for their
service to our country and salute them
this Memorial Day and every
day.
How Meditation Can Support Cancer Treatment - Huffington
Post - Joseph Nowinski, Ph.D. –
My two previous blogs in this
series have focused on several different treatments that are used as
adjuncts or complements to contemporary medical treatments for cancer
(chemotherapy, surgery and
radiation therapy). While some people advocate
for these treatments as alternatives to such medical
treatment for cancer,
to this point I have found testimonial data to support that position, but no
convincing research. In this blog we'll look at a very popular
complementary treatment: meditation.
Meditation as a Complement
to Cancer Treatment
Let's begin by acknowledging that millions
of people have used meditation for general health and
mental health
benefits for centuries. When I was a graduate student in clinical psychology,
my wife,
who was then suffering from frequent head and neck aches, tried
everything from massage (delivered
by me in a less than expert manner) to
medications to the original "earth shoes" in an effort to find
relief, with
little effect. Then one day she told me that she'd signed up for a class in
Transcendental
Meditation (TM). All I knew about TM was that it was
something The Beatles were into, and I was
skeptical. Nevertheless, my wife
took the day-long class, returned home with her secret mantra, and
proceeded to practice TM twice a day. Three weeks later she told me that
she'd had only one brief
headache, whereas she was used to having two or
three serious ones a week. So there you go --
some testimonial data from
your blogger!
The two primary modalities of meditation that are
practiced here are:
Concentrative Meditation (CM)
This
describes TM and similar meditation practices that teach individuals to focus
on a single image,
sound or mantra, or even on their own
breathing.
Mindful Meditation (MM)
In mindful meditation,
individuals are taught not to focus their attention in a singular way, but
rather to
be aware of any and all thoughts, feelings, sounds and images
that may pass through their mind. And
that is the key to MM: Letting them
pass through your mind, as opposed to trying to hold on to any
one of
them.
Is Meditation Effective?
There is good news when it
comes to meditation as a complementary treatment, and that is that a
number
of rigorous clinical trials are underway. Using controlled clinical trials,
these investigators are
studying the effects of both types of meditation on
health issues such as hypertension, cardiovascular
disease and the side
effects of cancer treatment. The common denominator driving this research is a
general recognition that chronic stress is linked to a variety of health
problems, such as increased
heart disease, compromised immune system
functioning and premature cellular and cognitive aging. It
makes sense,
then, to take a closer look at how meditation can help. Here is a sample of
what
researchers have discovered and verified so far:
· In a
study of 60 breast cancer survivors, women who practiced meditation reduced the
number and
severity of hot flashes and also reported improvements in mood
and sleep.
· A study of 63 people with rheumatoid arthritis found
that mindfulness meditation helped to improve
quality of life and reduce
psychological distress.
· A study of 298 college students found that
transcendental meditation helped students reduce stress
and improve coping
strategies.
· A "meta-analysis" of 10 studies found that mindfulness
meditation improves the overall mental health
of cancer
patients.
The above should be encouraging to those who are facing cancer
and contemplating a comprehensive
treatment plan. As with the other
complementary treatments looked at in this series, there is no
evidence as
yet that meditation arrests or cures cancer. That said, comprehensive treatment
should
include mental health as well as reductions in the pernicious side
effects of cancer treatment.
Looking Beyond What
Works
Clinical research (including research in psychology) often
seeks to ask a simple question: Does a
treatment work? That is an important
question. But an equally important question is: What works for
whom, and
when? Consider the following email message I received from a woman who has been
working with her doctors to confront metastatic cancer
("mets"):
"This recent cancer treatment is very hard on me ... and I
don't suspect the remaining chemos will be
much different. I want to spend
the years I have left on a healing spiritual quest ... for me.
I
have bone mets and massage is not advised due to pressure on the bones that are
already
weakened. I have lymphedema in my arms and chest, leaving just my
legs, feet, back, face and ears
for acupuncture needles. In the earlier
stages, I did get relief from acupuncture, but not so much
now.
I am a big time meditator and do lots of energy work.
Frankly I think that has had some impact on my
being alive eight-plus years
with mets. We all have to die of something. I am not afraid to die, but am
afraid to die before I am able to fully accept myself with no judgments.
That is what I am devoting my
remaining time to."
For this
woman, as for many women (and men) who are faced with cancer, the issue becomes
not
just "what works" but "what works and when." Clearly, what worked
before does not necessarily
work now for this woman -- but that does not
mean that the various complementary treatments she
tried were not
worthwhile at the times she turned to them
Health calendar:
Weekly events in Brevard County - Florida Today
–
SEMINARS/WORKSHOPS
Aches and pains: The free
lecture will focus on aching joints, fibromyalgia and other pain at 7:30 p.m.
today at CARE Chiropractic and Wellness Center, 1938 Dairy Road, West
Melbourne. Registration
is required. Call 321-728-1387 or visit
drwalshcares.com. Acupressure workshop: Lama David Bole
will host an "Art
of Living" acupressure workshop from 12:30 to 3:30 p.m. Sunday at Aquarian
Dreams, 414 N. Miramar Ave., Indialantic. The cost is $30. Registration is
required. Call 321-729-
9495. AIDS/HIV: Brevard Community College offers
online mandatory HIV/AIDS courses for
health care professionals. The cost
is $40. Call 321-433-7535 or visit brevard.edu/ice. Balance
workshop:
Parrish Medical Center will offer "A Matter of Balance" workshop from 1 to 3
p.m.
Mondays through May 23 at Parrish Health & Fitness Center, 2210
Cheney Highway, Titusville.
Participants will learn to view falls and fear
of falling as controllable and set goals for increasing
activity. Call
321-268-6596. Better health lecture: Dr. Joe Strater will give a free talk on
"5 Facets of
Health" at 12:30 p.m. May 17 at Freedom 7 Senior Community
Center, 5000 Tom Warriner Blvd.,
Cocoa Beach. Call 321-783-9505.
Breastfeeding: Classes for beginners are from 6:30 to 9 p.m.
every third
Monday at Children's Center, 5650 S. Washington Ave., Titusville. Admission is
free. To
register, call 321-268-6682. Cancer center lecture: Dr. Richard
Levine, a medical oncologist with
Space Coast Cancer Center, will host a
free lecture on the medical services and resources at Space
Coast Cancer
Center at Viera Health Park at 10:30 a.m. Thursday at One Senior Place, 8085
Spyglass Hill Road, Viera. A complimentary lunch will be served.
Registration is required. Call 321-
268-4200, ext. 3500. Caregiver education
classes: Caregiver Education and Resources Program at
Hospice of St.
Francis will host free classes starting from 2 to 3:30 p.m. Monday at Merritt
Island
Public Library, 1195 N. Courtenay Parkway. Classes will be Mondays
and Wednesdays through
May 30. Registration is required. Call 321-269-4240,
ext. 330, or e-mail
[email protected]. Childbirth: Parrish
Medical Center, 951 N. Washington Ave.,
Titusville, offers "Moments to
Miracles: Childbirth Education" classes. The cost is $50 per couple.
For
times, dates and registration, call 321-268-6110. Childbirth: Birth Resources
of Brevard offers
classes in several locations. The cost is $50 per family.
To register, call 321-252-4573 or visit
birthresoucesofbrevard.com. CPR
classes: American Red Cross instructors make house calls for
"Safe Baby
Presentation," an orientation to infant CPR. Sessions last about two hours. The
cost is
$25 for each person, with a minimum of eight people. Call
321-890-1002 or visit redcross.
org/fl/brevard. CPR course: American Heart
Association will offer instruction from 9 a.m. to noon
May 21 at Satellite
Beach Fire Department, 1390 South Patrick Drive. The cost is $35 and includes
certification card. Books are available for $15. To register, call
321-773-4405. Dementia tutorials:
The Brevard Alzheimer's Foundation hosts
free dementia tutorials from 1 to 3 p.m. every third
Thursday at Joe's Club
Central, 4676 N. Wickham Road, Melbourne. Call 321-253-4430.
Dementia
presentation: East Central Florida Memory Disorder Clinic will offer a
presentation on the
Lewy Body Dementia Association from 1:30 to 3 p.m. May
25 at Sunflower House, Merritt Square
Mall, 777 E. Merritt Island Causeway.
Call 321-452-4341. Domestic violence: A free class to
educate participants
about emotional and physical abuse in relationships meets from noon to 1:30
p.
m. on the second Friday of each month at the Women's Center, 1425 Aurora
Road, Melbourne.
Classes are offered in Spanish. Call 321-242-3110. Family
memories: A free scrapbooking class to
build memory books for caregivers
and loved ones dealing with memory loss meets from 1:30 to 3:30
p.m.
Thursdays at Health First Leeza's Place, 3661 S. Babcock St., Melbourne. Call
321-951-
7118. Hormone lecture: Dr. Sal Martingano will present "How to
Balance a Woman's Hormones
Naturally" at 10:30 a.m. May 24 at the Family
Center for Chiropractic, 1320 Palm Bay Road NE.
Call 321-729-9430. Free
health lecture: Beachside Physical Therapy, 2030 South Patrick Drive,
Indian Harbour Beach, hosts free lectures at 6:30 p.m. on the last Tuesday
of the month. Learn about
back pain, triathlon training, golf fitness and
more. To register, call 321-725-2267. Free health
lecture: Dr. Sal
Martingano will present "The Three Solutions to Your Health Problems" at 10:30
a.m.
today at the Family Center for Chiropractic, 1320 Palm Bay Road NE,
Palm Bay. Admission is free.
Call 321-729-9430. Free Medicaid seminar: Free
lecture from 10 to 11 a.m. May 17 at One Senior
Place, 8085 Spyglass Hill
Road, Viera. Call 321-253-1667. Health awareness: Joseph Eplett will
discuss strategies for how to get well and stay well and how to deal with
stress, among other things, at
6:15 p.m. Mondays and 12:45 p.m. Fridays at
The Eplett Chiropractic Life Center, 429 Fifth Ave.,
Indialantic. Call
321-733-4434. Health classes: Free health awareness classes covering
meditation,
exercise, posture awareness, spinomics and nutrition, meet from
3 to 4 p.m. last Saturdays at
Aquarian Dreams, 414 N. Miramar Ave.,
Indialantic. Call 321-733-4434. Health lecture: Charlie
Mora will lecture
on health, nutrition and weight loss at 1 p.m. every second Tuesday at Cocoa
Beach Public Library, 550 N. Brevard Ave. Admission is free. Call
321-868-1104. Healthy Living
workshops: Parrish Medical Center, 951 N.
Washington Ave., Titusville, will host workshops for
people with chronic
conditions to help improve health and reduce hospitalizations from 9:30 a.m. to
noon Tuesdays, May 17 through June 21. Call 321-268-6596. Hip replacement
lecture: Orthopedic
surgeon Dr. John Perry will present a free lecture on
the anterior approach hip replacement from 11 a.
m. to noon today at Holmes
Regional Medical Center, 1350 S. Hickory St., Melbourne. Call 321-
434-4359.
Injury protection lecture: Registered nurse Tammy Clemens will host a free
lecture on
senior lifestyle and injury protection from 10 to 11 a.m. May 18
at Holmes Regional Medical Center,
Auditorium A, 1350 S. Hickory St.,
Melbourne. Call 321-434-4359.
Lymphedema lecture: Lecture starts at 6:30
p.m. June 6 at Beachside Physical Therapy, 4270 Minton
Road, Suite 120,
Palm Bay. Registration is required. Refreshments will be provided. Call
321-777-
4033. Life management: Metabolic Research Center of Merritt Island
offers a free course at 5:30 p.
m. Wednesdays at 255 Fortenberry Road,
Merritt Island. Also, at 5:30 p.m. Mondays at 1966 Dairy
Road, West
Melbourne. To reserve a space on Merritt Island, call 321-452-3355; for
Melbourne,
call 321-953-0203. Look Good, Feel Better: American Cancer
Society teaches beauty techniques to
Palm Bay residents/patients who are
battling cancer. Sessions are on the first Tuesday of the month.
For
information and registration, call 800-227-9954. Marital/sex therapy: Florida
Tech's Community
Psychological Services Clinic offers a marital and sex
therapy/counseling service for adult couples in
committed relationships who
are experiencing relationship conflict or sexual difficulty. For
appointments, call 321-727-9956. Meditation class: Learn Eastern meditation
techniques with Ellen
Cameron from 7 to 7:45 p.m. Tuesdays at Aquarian
Dreams, 414 N. Miramar Ave., Indialantic. The
cost is $7. Call
321-729-9495. Memory loss lecture: Learn tips and strategies for coping with
memory loss at 2 p.m. May 24 at One Senior Place, 8085 Spyglass Hill Road,
Viera. Call 321-751-
6771. Natural approaches to illness: Sylvie Morin,
doctor of Oriental medicine, will discuss natural
approaches to illness at
1 p.m. every third Friday at Cocoa Beach Public Library, 550 N. Brevard
Ave. Call 321-868-1104. Osteoporosis lecture: CARE Chiropractic and
Wellness Center, 1938
Dairy Road, West Melbourne, will host a free lecture
on osteopenia/osteoporosis at 7 p.m. May 23.
Call 321-728-1387 or go to
drwalshcares.com. Parenting and life skills: Classes are from 6 to 7:30
p.
m. Wednesdays at the Alternative Pregnancy Center, 205 Magnolia Ave.,
Merritt Island. Child care
provided. Call 321-454-9853. Postpartum
adjustment: Learn skills to regain control of your life,
decrease symptoms
of stress and depression and get support from other moms. Classes are from
10:
30 to 11:30 a.m. Tuesdays at Girlfriends Health, 503 5th Ave., Suite
103, Indialantic. The cost is
$30. Registration is required. Call
321-536-1724. Prenatal classes: Pediatrics in Brevard physicians
Dr. Tara
Forcier and Dr. Jan Borowski will offer free classes at 6 p.m. Tuesdays at
Pediatrics in
Brevard, 134 S. Woods Drive, Rockledge. Call 321-636-3066,
ext. 206. Restless leg syndrome
lecture: Learn the causes and cures at 1
p.m. May 27 at Cocoa Beach Public Library, 550 N.
Brevard Ave. Call
321-868-1104. Smoking cessation: Classes are offered from noon to 1 p.m. or
from 5 to 6 p.m. Wednesdays at Patrick Air Force Base Health and Wellness
Center, 1223 Atlas
Ave. You must have base access to attend. To register,
call 321-494-2660. Smoking cessation: Quit
Smoking Tobacco Cessation
program will be from 3:30 to 4:30 p.m. Tuesdays, now through May
31, at One
Senior Place, 8085 Spyglass Hill Road, Viera. The program will feature support,
educational information, handouts and a free, six-week supply of nicotine
replacement. Registration is
required. Call 1-877-252-6094. Stroke
prevention lecture: Dr Jill Miller will present the free lecture
from 11
a.m. to noon May 25 at Holmes Regional Medical Center, Auditorium A, 1350 S.
Hickory
St., Melbourne. Call 321-434-4359. Free Secrets to Weight Loss: The
lecture begins at 7 p.m. May
19 at CARE Chiropractic and Wellness Center,
1938 Dairy Road, West Melbourne. Call 321-728-
1387 or visit
drwalshcares.com. Spanish health care phraseology course: Brevard Community
College offers online courses that teach Spanish health care phraseology to
help nurses, doctors and
patients understand each other clearly. The cost
is $99. To register, call 321-433-7535 or visit
brevard.edu/ice.
"Superfoods II: Health and Nutrition": The Space Coast Cancer Center, 490 N.
Washington Ave., Titusville, presents the workshop for cancer survivors and
their families from 4 to 5:
30 p.m. the first Tuesday of each month. Call
321-269-4200, ext. 3500, or visit
spacecoastmedicalassociates.com. Violence
prevention: "Family Violence Prevention" is a 12-week
course for adults
that will be taught in 90-minute sessions at 4680 Lipscomb St., Suite 10H, Palm
Bay. The cost is $90 per person. Call 321-394-7179. Water rescue:
Pro-Health & Fitness Center
offers an American Red Cross Basic Water
Rescue Course on a monthly rotational basis at 255
Borman Drive, Merritt
Island. The cost is $25, $40 per family. Call 321-434-5816 or 321-409-
8215.
Youth anger management: The 10-week course offers youths ages 10 to 16 insights
into
causes of personal anger and provides effective techniques for
managing stress and anger. Weekly
classes meet juvenile justice
court-ordered requirements, 4680 Lipscomb St., No. 10H, Palm Bay.
The cost
is $50. Call 321-394-7179.
May 12, 2011
Roanoke
Wounded Warrior "accidentally" meets President Obama - Lynchburg News and
Advance
- By Jarett Henshaw –
ROANOKE, VA
–
30-year-old veteran Sarah Bonner walks pretty well, but is
otherwise limited physically.
"I took a fall in basic training
and had problems with my back,” said Bonner.
She was never able
to serve her deployment to Germany, and was medically discharged. From her
injury, she developed Lymphedema, causing painful swelling in her lower
legs.
"It's very hard. I don't wear shorts anymore, because I'm
very embarrassed,” said Bonner.
But Sarah tries to be as active
as she can. Last week she participated in the Soldier Ride, as part of
the
wounded warriors program in Washington, D.C. Organizers fitted Sarah with a
special
recumbent bicycle that allowed her to pedal more
comfortably.
"I felt free again. I felt like a kid. I had more
fun than I ever had a Christmas. On the bike, my back
didn't hurt. My
feet didn't hurt,” said Bonner.
She and 29 other vets got to
ride on the White House grounds. President Obama even came out to
watch.
But when Sarah got close to the President, the unthinkable
happened.
"The next thing I know, the chain is off the gears and
that bike, as hard as I'm trying to pedal, it wasn't
moving,” said
Bonner.
Other members of the ride rushed over to help, and they
weren't the only ones.
"The President walks over, and I didn't
know what was going to happen, and was just like 'Come on,
fix the bike
guys.' And he (President Obama) goes with his hands (gesturing) 'I thought
these things
only happened to me,'” said Bonner.
They eventually got
the chain back on track.
"He shook my hand and he goes, 'It
looks like you're getting taken care of' and I said yeah and he
kind of
patted me on my back,” said Bonner.
It was an unlikely meeting
that Sarah says she'll never forget. Later that day she received a
Presidential coin to remember her special encounter with the Commander in
Chief.
May 13, 2011
National African American
Breast Cancer Conference starts today – WBXH - by mmccalope
–
Sisters Network Incorporated, the only national African
American breast cancer survivorship
organization in the United States, will
host its 12th Annual National African American Breast Cancer
conference on
May 13 through May 15 at the Crowne Plaza Hotel in Baton Rouge. The three-day
conference is generously underwritten by the Centers for Disease Control
and Prevention.
Breast cancer is the most common cancer among
African American women. Research shows nearly
20,000 newly diagnosed cases
of breast cancer are expected to occur among African American
women, and
5,640 are expected to die from the disease.
The incidence rate
of breast cancer is higher among younger African-American women (under age
40); than among white women. The incidence rate of breast cancer is 12%
lower in African-
American women; however, the mortality rate is higher
compared to white women.
During the conference, Sisters Network
will launch a new national program, Young Sisters Initiative
(YSI). In
response to the alarming mortality rate in African
American
women under the age of 45. Over 40 partial scholarships were given to Young
Survivors
from across the United States.
A pioneer in the
African American breast cancer awareness movement, Sisters Network hosts the
only national conference specifically addressing the devastating impact of
breast cancer among
African American women. The conference attracts over
400 participants, including breast cancer
survivors and non-survivors from
around the United States, nationally recognized medical experts,
elected
officials and the general community.
"Sisters Network is honored
to bring the national conference to our affiliate chapter city of Baton
Rouge, Louisiana. It is important that we host our national conference in
our affiliate chapter cities to
increase African American breast cancer
awareness, reinforce the great outreach efforts of the local
chapter and
celebrate survivorship with our members and the communities in which they serve
on
behalf of the National office," said Karen Jackson, Founder/CEO Sisters
Network Inc." We
welcome everyone from around the nation to attend the
national conference to be educated,
empowered and energized to join Sisters
Network's African American breast health movement,"
added
Jackson.
The Honorary Conference Chair is Congresswoman Sheila
Jackson Lee, 18th Congressional District
State of Texas. Conference Chair
is Lisa A. Newman, MD, MPH, F.A.C.S., and Professor of
Surgery &
Director of Breast Cancer Care Center, University of Michigan and C. Kent
Osborne,
MD, Director, Dan L. Duncan Cancer Center, Baylor College of
Medicine. Conference Co-Chair is
Edie Staples, President, Sisters Network
Baton Rouge.
Conference highlights include the State of Sisters
Network Address by Karen E. Jackson, General
Session on Exploring Triple
Negative Breast Cancer, Lymphedema Management, Clinical Trials; the
Renewing Hope Series; Genetics & Heredity; Treatment Update on
Metastatic Breast Cancer and
Young Survivors Focus Groups; Spirituality and
Fear of Recurrence will be offered. Celgene Day of
Wellness Luncheon,
Annual Awards Signature Luncheon, Gospel Prayer Breakfast and Remberance
Celebration Ceremony are also included in the national conference
agenda.
Sponsors include Avon Foundation for Women,
sanofi-aventis, Genentech,GlaxoSmithKline
Oncology, Celgene; Cancer
Treatment Centers of America; Baton Rouge General; Mary Bird
Perkins Cancer
Center and the Breast Cancer Wellness Magazine.
National
organization partners include Alpha Kappa Alpha Sorority, Delta Sigma Theta
Sorority, the
Cancer Support Community and the Center for Research on
Minority Health at The University of
Texas M. D. Anderson Cancer
Center
May 22, 2011
Health Collaborative obtains grant for
another year of services - Enterprise-Record –
CHICO — California Health
Collaborative is seeking low income, under or uninsured people in
Butte,
Colusa, Glenn, Plumas and Tehama counties to help them overcome barriers to
breast care
services through the Clinical Education, Coordination and Nurse
Navigation Program.
Funding for the second year of this program, through
March 31, 2012, has been secured by a grant
received from the Sacramento
Affiliate of Susan G. Komen for the Cure.
Services provided to those
eligible include assistance getting through the health care system, education
regarding medical options, referral to local resources and financial
assistance with medical costs.
Financial assistance may include help with
transportation, child/elder care, food vouchers, utility bills,
housekeeping, post-mastectomy products, wigs/head coverings, lymphedema
garments and overnight
accommodations necessary to comply with treatment
recommendations.
During its first year, California Health Collaborative
worked with volunteers around the community to
accomplish its services to
175 women in need.
The collaborative reports that some 100 residents
were helped through the processes of screening,
diagnosis, treatment and
follow up from April 1, 2010 to March 31, 2011. That included more than
$14,000 in claims reimbursement for diagnostic medical services and
associated needs for 44 women
in need of breast care in Chico, Forest
Ranch, Gridley, Magalia, Oroville and Paradise.
CHARITY NOTEBOOK: Race
for hope cyclists raise money for medical research - Syracuse.com
–
Syracuse.com
Bicyclists will take to the rolling hills above Skaneateles
Lake in the fifth annual Race For Hope that
starts 8:30 a.m. May 29 at the
intersection of East Lake Road (Route 41) and Rose Hill Road in
Borodino.
The 24-mile timed race was inspired by Dick Shaffer, a
Borodino resident and triathlete, who died of
cancer in 2006. Proceeds from
the race support research at Upstate Golisano Children's
Hospital.
Riders can register online until noon May 27 at
www.SkanRaces.com for $30. Race day registration
is $35. Riders can
register from 7:30 a.m. to 8 a.m.. Parking and check-in will be at Midlakes
Club
Golf Course, Bockes Road.
The race is open to riders 15 and
older. Awards will be given to the top three male and female overall
finishers. Age group awards will be given to the top three finishers in
each category.
Results
Owasco Reformed Church raised $3,000 in a
chili cook-off that raised money to help pay for beam
restoration in its
200-year-old church.
The Syracuse University Sport Management Club, a
student-run organization in the College of
Human Ecology, donated $24,000
to the Central New York SPCA.
Village of Cleveland Spirit Committee
raised $600 from an Easter bunny breakfast and $440 from a
raffle to help
pay for a 9/11 Memorial Gazebo.
Scholastic rowers from the Cascadilla
Boat Club of Ithaca earned more than $5,300 in pledges in an
"Erg A Thon"
at Ithaca Mall.
Upstate Medical University employees raised more than
$609,270 for the United Way of Central
New York and the State Employees
Federated Appeal.
Grants
The Allen Speiser Memorial Fund for
Vocational Rehabilitation, a fund of the Central New York
Community
Foundation, awarded $4,770 in grants to CNY Works, Oswego Industries, Enable,
Unity House of Cayuga County and ARC of Onondaga.
The Central New
York affiliate of Susan G. Komen for the Cure awarded an $18,260 grant to St.
Joseph's Hospital Health Center Foundation to support lymphedema education
and prevention.
Donations
Metro Mattress is donating new beds to
21 charitable organizations in the Syracuse/Southern Tier
region.
Alternatives, a nonprofit bakery operated by Madison
Cortland ARC, donated 252 pies to the
Rescue Mission for its Easter
dinner.
Kidney Foundation seeks cars
The Kidney Foundation of
Central New York is seeking donations of old cars, boats, recreation
vehicles, campers, motorcycles, riding lawn mowers and tractors. To donate
an item call the
foundation at 800-488-2277.
May 23,
2011
Jennifer Tull named Exceptional Therapist – Crookston Daily Times
–
Crookston, Minn. --
Jennifer Tull, PT was awarded the Benedictine
Health System’s Exceptional Therapist for the second
quarter of 2011. The
exceptional therapist award was initiated in May of 2006. This award was
created to recognize the extraordinary efforts and contributions from
therapists throughout the
Benedictine Health System (BHS).
Jennie
“Coauette” Tull graduated from Crookston High School in 1995 and then went on to
the
University of North Dakota where she received her Bachelor’s and
Master’s degrees of Physical
Therapy with a minor in Psychology in 2001.
She has worked at the Villa St. Vincent since
December of 2009 and became a
lymphedema certified therapist in November of 2010.
Jennie is known for
providing outstanding patient care and consistently meeting the needs of her
patients. She is an excellent clinician and member of the Villa therapy
team. Quality and evidenced
based care is always provided by Jennie. By
working closely with the interdisciplinary team, she
ensures a holistic
approach to her patients. She has offerred continuing education to the therapy
department, the skilled nursing facility staff and community members.
Jennie demonstrates the BHS
core values of hospitality, respect, justice,
and stewardship everyday in her practice. She exhibits
moral and ethical
standards that exemplify the BHS Mission and Values.
In addition to
providing outpatient therapy to members of the Crookston community, Jennie
works
with the residents of the Villa St. Vincent and the Summit. Please
feel free to stop in to the Villa
Therapy Department and congratulate
Jennie on her accomplishment.
May 24, 2011
Your Hero: Local woman
helps breast cancer patients - FOX43.com – by Jaime Garland
Bonnie
Julius is helping women across the country in honor of her late
daughter
YORK COUNTY--
A local woman, who lost her daughter to
breast cancer, is now helping all women battling the disease.
From her
computer, Bonnie Julius is giving the ladies their identity back; that makes
her this week's
FOX43 "Your Hero."
From wigs to massages,
Bonnie Julius is taking care of breast cancer patients across the country. She
operates an online non-profit organization that connects women with the
products they need to
restore their self confidence. She started
'Crickett's Answer For Cancer' in 2008, in honor of her
daughter, Crickett
Julius.
Julius earns no paycheck, she only the satisfaction she feels
from above.
"I know that Crickett is smiling, smiling, smiling down on
us all the time," Bonnie says.
Crickett was just 39-years old when
doctors diagnosed her with breast cancer.
"I said what is Stage 4?
Because I never had anything to do with it, didn't know people who had
breast cancer and before he (the doctor) could answer, she said 'Mama, that
means I'm terminal," she
says.
Bonnie was by her daughter's side
through chemotherapy, but her fight ended just four months later.
After
Crickett's death, all Bonnie could do was wonder how it could
happen.
Bonnie says, "she was vivacious, she was energetic, she had a
personal trainer, she kept herself in
good shape, she did self breast exams
and all the sorts of things that you're supposed to do."
Through her
fight, Crickett had strength. Bonnie decided to carry that torch and help women
nationwide who are battling the same disease.
Through her website,
CrickettsAnswerForCancer.org Bonnie provides wigs, mastectomy and
lymphedema products, as well as pampering services to female breast cancer
patients across the
country.
It's all for free for patients; paid
for solely by donations and fundraisers.
But, the products come with a
price; one that Bonnie hopes to be able to pay for many years to keep
her
daughter's memory alive.
"I'm having the time of my life and I hope to
help many, many more," Bonnie says.
Bonnie operates the website with
help from her niece. Since they started it in 2008, they have helped
265
women.
Lymphedema support group helps educate those suffering -
Villages Daily Sun – By APRIL TOLER
–
THE VILLAGES — When Phyllis
Campbell first began experiencing swelling in her legs she wasn’t
sure what
to do.
She sifted through the advice of others — keep your legs up, wear
support hose — but nothing
worked eventually making it difficult for
Campbell to even get around.
“It effected my mobility and it also
depressed me,” the Spruce Creek South resident said. “When you
are heavy
and you keep gaining, and gaining and gaining because of fluid and you’re not
eating hardly
anything you begin to think what’s happening? Depression is
big.”
What was happening was lymphedema — a condition with which local
doctors say few people seem
to be aware.
Lymphatic obstruction is a
blockage of the lymph vessels that drain fluid from tissues in the body and
allow immune cells to travel throughout the body.
This causes
lymphedema, which is swelling due to the blockage of lymph
passages.
Primary lymphedema happens either at birth or develops at the
onset of puberty. Reasons for primary
lymphedema are
unknown.
Secondary lymphedema, the most common type, can be caused by
surgery, particularly the removal
of lymph nodes, infections, injury and
radiation therapy.
For Campbell, she believes it developed after she had
open heart surgery where veins were removed
from her left leg.
Like
most people suffering from lymphedema, she had no previous knowledge of the
condition.
“I never knew about this,” she said. “I suffered all these
years and knew nothing.”
That also was the case for area resident Regina
Browne, whose case was so bad it confined her to a
wheelchair the few times
she was able to travel outside her home.
“I had this condition for over
a year before I could find help for it,” she said. “No one knew.”
Meenu
Jethwani, certified lymphedema therapist and occupational therapist at Therapy
For You, said
a lack of knowledge about the condition, and how to treat it,
is common.
“The challenges are a lot of time they don’t know what is
happening,” Jethwani said. “The physicians
are not able to catch
it…”
Although lymphedema itself is not painful, it can cause discomfort,
Jethwani said, and make it difficult
to maneuver limbs due to the heaviness
of the collected fluid.
There is no cure for lymphedema, she said, but
there are ways to manage it.
“It is not a disease, it is a condition,”
she said. “It’s a compromised system so when we open these
lymphatic
channels we are not curing them of lymphedema we are just controlling the
condition.”
Jethwani treats patients with manual drainage using the
Vodder techniques and compression
bandages. How long a person is in
treatment, she said, depends on the severity of the condition.
It is
important, she said, for patients to continue their part of the treatment once
they leave a therapist’
s care.
“It’s important that once patients
get discharged from here, we put them on compression garments,
they
continue wearing those compression garments,” she said. “It’s very important
because that
compression garment is what’s going to keep the extremity
contained in a position.”
Other measures those dealing with lymphedema
can do is educate themselves.
Scottie Bull, a certified lymphology
association of North America therapists, started a lymphedema
support group
some 10 years ago to help educate people on the condition and possible
treatments.
“I started it simply because there wasn’t a support group
around and I thought it would be good to
educate people …,” said Bull, of
Physio Med Outpatient Rehab.
When seeking treatment it is important,
Bull said, to find a therapist certified in treating lymphedema
especially
since being certified it is not mandated in the state of
Florida.
Because there are few people who are well educated about the
condition, Bull said it is important for
each patient to do their own
research and make sure they are receiving proper treatment.
“There’s not
very many therapists that are technically certified and that is extremely
important,” she
said. “If a patient is being treated by a therapist not
trained in proper technique they can get worst or
can waste the number of
treatments (covered by their insurance).”
As for Browne, as the swelling
in her leg continues to shrink, she continues to follow her therapist’s
orders and is thrilled each time she sees a change in her
swelling.
“I’m going to be patient and do whatever I need to do,” she
said.“It took a long time to get that way;
it’s not going to go away over
night. You have to be patient, you have to think ‘I’m going to see this
thing through.’”
May 25, 2011
BioCis Pharma and Lx Therapies
Combine to Create Laurantis Pharma Oy - Genetic Engineering
News
–
BioCis Pharma Oy and Oy Lx Therapies Ltd. announced today that the
companies have combined to
create Laurantis Pharma Oy (“Laurantis Pharma”),
a clinical-stage specialty pharmaceutical
development company. The new
entity has a broad portfolio of first-in-class products based on two
proprietary technologies. The Company’s lead products target the treatment
of a variety of
inflammatory diseases and conditions including atopic
dermatitis, dry eye syndrome, interstitial cystitis,
and lymphatic
disorders, as well as the treatment of bladder cancer. In connection with the
creation of
the new Company, Riku Rautsola, PhD, was appointed as President
and CEO of Laurantis Pharma.
In addition, Inveni Capital and Helsinki
University Funds made an investment in Laurantis Pharma.
“We are excited
about the potential created by forming this new company. We have a broad
portfolio, cost-efficient operation model, and several upcoming clinical
milestones in the next couple
of years,” said Dr. Rautsola. “This provides
the unique opportunity to build Laurantis Pharma from an
early clinical
development company to a successful specialty pharmaceutical company in the
coming
years.”
Riku Rautsola has more than 25 years of international
biopharmaceutical experience, most recently as
President and CEO of VIRxSYS
Corporation in the United States. Previously, Dr. Rautsola held
various
senior executive positions, among others, at Boehringer Ingelheim, Beiersdorf
and Fresenius
and served on the board of directors of the Finnish drug
development company Biotie Therapies.
“We are very excited about having
the capacity to a build a competitive specialty pharmaceutical
company with
a strong technology base. Laurantis Pharma is well positioned to reach several
significant clinical milestones for its lead products in the next two to
three years,” said Lasse Leino,
COO of Laurantis Pharma and previously CEO
of BioCis Pharma.
Laurantis Pharma’s pipeline includes proprietary and
patent-protected formulations and applications
of cis-urocanicacid
(cis-UCA), a locally acting anti-inflammatory and anti-proliferative agent.
Clinical
candidates include an emulsion cream for atopic dermatitis (human
and veterinary use), an intravesical
product for the treatment of
non-muscle invasive bladder cancer and inflammatory conditions of the
bladder such as interstitialcystitis, and an eye drop product for dry eye
syndrome. The Company is
also developing Lymfactin™, a vascular endothelial
growth factor C (VEGF-C) in an adenoviral
vector, for the treatment of
secondary lymphedema. The first indication will be breast cancer-
associated
lymphedema.
About Laurantis Pharma
Laurantis Pharma Oy is a
privately held specialty pharmaceutical company based in Finland. Laurantis
Pharma Oy was formed in 2010 through the merger of two independent
companies, BioCis Pharma
Oy and Oy Lx Therapies Ltd. More information can
be found at www.laurantis.com.
Kenilworth's David Brearley students
collect thousands of pennies for patients - Suburban News –
KENILWORTH —
The 2010-11 “Pennies for Patients” fundraiser was just completed. The David
Brearley Middle and High School raised a total of $5,654 this year. In
memory of Jeffrey Bubnowski,
the money was donated to the Leukemia and
Lymphoma Society’s School and Youth Program.
Bubnowski is the younger
brother of Brearley’s Assistant Principal Ronald Bubnowski. Jeffrey died
of
leukemia in August of 2010.
The Brearley students were extremely
committed to this very worthy cause. Since 2004, David
Brearley Middle and
High School has raised $27,710.09 for the Leukemia and Lymphoma Society’s
School and Youth Program through the “Pennies for Patients”
fundraiser.
In the high school, the individual class that raised the most
money this year was Mrs. Greten’s
homeroom class. These first place winners
raised $291.79 and won a pizza party.
In the high school, the individual
class that raised the second greatest amount of money this year was
Ms.
Spampinato’s homeroom class. These second place winners raised $174.70 and won
an ice
cream party.
In another very charitable action, these winning
high school homeroom classes have decided to
donate the money for their
pizza and ice cream parties ($70 total) to the Michael N. Bibbo Surgery
Fund (thebibbofund.com). Michael Bibbo is a junior at David Brearley High
School. He has been
diagnosed with Primary Lymphedema and is in need of
major surgery.
In the middle school, the homeroom class that raised the
most money was Mr. Shapiro’s homeroom
class. These first place winners
raised $356.16 and won a pizza party.
In the middle school, the homeroom
class that raised the second greatest amount of money was Mrs.
Alvarez’s
homeroom class. These second place winners raised $188.84 and won an ice cream
party.
The “Pennies for Patients” committee this year was chaired by
David Brearley High School senior
Amy Roman. Assisting with the fundraiser
were Brearley seniors James Hannon, Megan Gilligan and
Jaclynn Vaughn. The
generosity of the David Brearley Middle and High School students, faculty, and
staff during this charitable fundraiser is a fine example of true
volunteerism. It is also proof of their
commitment to helping
others.
May 26, 2011
Spa Treatments During Cancer? Visit a
Certified Oncology Esthetician - Opposing Views – by Cinco
Vidas
–
Research has shown that massage, facials, reflexology, and other spa
treatments can all help reduce
stress, nurture the skin, slow the
appearance of aging, and even reduce side effects from cancer
therapies and
medications.
Because so many people are now turning to spa treatments
for health reasons, today’s therapists
need to know a lot more than just
how to make you feel good. I was fortunate enough to meet one
spa owner and
esthetician who is taking her responsibilities very seriously. Beverly Miller
owns and
operates Tranquility Spa & Wellness in St. Charles, Illinois.
We attended a training course together
on oncology esthetics (given by
Morag Currin, pioneer of the Clinical Oncology Esthetics (COE)
certification for licensed estheticians), and I was so impressed that she
paid for most of her staff to
take the course with her. They’re all
committed to making a difference in the lives of cancer patients
and wanted
to gain certification before promoting themselves as a spa that works with
fighters and
survivors.
“We have five estheticians working at the
spa,” Beverly said, “and I wanted all of us to have this
knowledge. We’re
very involved in a center in Geneva called the Living Well Cancer Resource
Center, and we would like to be able to donate our services
there.”
Beverly says that her personal experience with cancer made her
want to do more: “Over the last
several years, I’ve had many of my clients
come in and say, ‘I’ve just been diagnosed with breast
cancer,’ or ‘I just
found out I have ovarian cancer.’ I’ve seen friends and clients go through
chemotherapy and radiation and I’ve seen what it does to their skin. The
treatments, medications, and
surgeries create unique situations that you
have to know how to deal with so you don’t cause any
injuries.”
When
talking with Beverly about the need for additional education, she pointed out
that there have
been a lot of changes in the industry that require it.
“Back when I started, spa treatments were mainly
a ‘fluff and puff’ sort of
thing you did to pamper yourself on a special occasion,” she says. “Since
then, science has learned a lot more about the skin and body, and we now
have more beneficial
ingredients in our skin care products like
antioxidants and peptides. More likely than not, one of us
will detect a
suspicious mole or dark spot on the skin before anyone else does, making us the
first line
of defense against skin cancer. And our spas aren’t just about
looking pretty anymore—we’re
catering to people’s health and well being
with things like acupuncture, reflexology, and yoga classes,
in addition to
the standard massage and facial treatments. So we have to be a lot more
educated to
fulfill that role.”
After the course was finished,
Beverly said the most important thing she learned was to be extra
careful
with people who’ve had lymph nodes removed. “It’s very important to know how
not to
massage, because you could cause lymphedema [long-term swelling],”
she said. “I want to create a
safe haven for my clients. No matter what
they’re going through, I want them to feel comfortable in
my spa, and know
that they’re putting their bodies in the hands of someone who knows what
they’re
doing.”
When asked what advice she would give people living
with cancer when looking for the right
esthetician, Beverly said, “Call the
spa or wellness center. Check their certifications. They should
have their
basic training, plus additional training from the International Dermal
Institute (for
estheticians), or from a course like this one. When you go
in, observe how they react. Do they have
you fill out an extensive
questionnaire? They need to know if your blood count is low, for example, so
that they’re extra cautious about risk of infection. Finally, if I were
going through cancer, I would call
and say, ‘Do your estheticians know how
to treat someone going through cancer?’ And I would
make sure to tell them
everything about my condition.”
Today, armed with her new knowledge,
Beverly is excited about expanding her services. “A spa
treatment is
soothing, relaxing, and truly healing. It can definitely help you deal with the
side effects so
you feel more confident and refreshed.”
Lymphedema
Depot Adds New Solaris Caresia Arm Sleeve - Wire Service Canada
–
Lymphedema Depot presents the new Caresia arm sleeve from
Solaris.
Lymphedema Depot is happy to announce that Solaris has
introduced a new model of the Caresia
Bandage Liner arm sleeve. The new
sleeve is called a Wrist to Axilla (armpit) Caresia Bandage Liner
and it
does not cover the hand but starts at the wrist and goes up to the shoulder. It
can be worn with
the Caresia glove or gauntlet if hand compression is
needed or desired. The new Wrist to Axilla
garment can also be paired with
the Caresia Glove or Gauntlet in order to provide individualized full
arm
coverage.
The Wrist to Axilla Caresia does not replace the regular
Caresia Bandage Liner arm sleeve, which is
a one-piece, MCP’s to Axilla
style with a thumb hole and coverage over the dorsum of the hand to
the
knuckles, but it does add another option to the line of Caresia arm
garments.
Like all of the Caresia products, the new design helps
simplify the active phase of therapy; clients
simply don their Caresia and
wrap over it with short-stretch bandages to achieve the desired
compression.
Come and visit us at the Solaris booth at the 3rd
International Lymphedema Framework Conference
and Lymphedema Association of
Ontario Conference in Toronto June 16- 18. For more information
on this
combined conference, visit our events page here!
http://www.lymphedemadepot.com/events.
About Caresia
Caresia
Bandage Liners are standard-sized bandage liners which simplify complex
multi-layered
bandaging protocols while enhancing therapeutic outcomes in
the active phase of therapy. Caresia
Bandage Liners replace stockinette and
multiple layers of padding or foam. Patients simply don the
Caresia and
then, using a spiral or figure-eight wrapping style with 50% overlap, wrap over
top of
their Caresia with short-stretch bandages. The short-stretch
bandages should be applied to provide a
snug fit, but not tight.
The
unique foam chips used in every Caresia will help resolve tissue induration,
stimulate interstitial
fluid movement, and diffuse irregular wrapping
pressures. Solaris manipulates the insertion of foam
chips to create a
medial to lateral pressure differential to encourage interstitial fluid
movement toward
the collateral pathways.
Caresia with over-wrapping
is much more comfortable and effective than standard bandaging for
patients
during the active phase of therapy. Caresia decreases the level of time and
effort commitment
required for self-care, thus increasing compliance with
the vital bandaging routine
About Solaris
With over a decade
of manufacturing experience, Solaris has become a leader in nighttime
lymphedema management and is quickly developing a reputation in venous
edema and wound care
treatment. Solaris prides itself on its products,
customer service, and involvement in their local and
lymphedema
communities. For more information on Solaris, please visit
About
Lymphedema Depot
Lymphedema Depot is a Canadian company dedicated to
bringing new options in lymphedema care
products to Canada. We are the
exclusive Canadian distributor of the Solaris line of medical
compression
garments for the management of lymphatic and venous edemas.
Lymphedema
Depot and Solaris both strive for continuous improvement to make the management
of
lymphedema and related conditions less complex, more effective, and
ultimately easier for patients.
Learn more about Lymphedema Depot, and
the Solaris products we offer in Canada by visiting us
online at
http://www.lymphedemadepot.com.
Understanding Lymphedema - NBC2 News
–
FORT MYERS, FL -
Lymphedema is extreme swelling of an arm or
leg, that often occurs after surgery in many cases for
breast cancer. Once
the lymph nodes are removed it leaves lymphatic fluid with nowhere to
go.
"You end up breaking the lymphatic channels, they don't have a way
of getting back to the heart,"
says Dr. Frank Rodriguez. "When that happens
it pools up and you can have a lot of swelling of the
hand, or of the
arm."
Patient's limbs can swell up to 2 or 3 times their normal size.
There's no cure for lymphedema, people
are left managing their symptoms.
Starting with understanding the condition.
Lymphedema therapist Jackie
Speas teaches patients how to ease the constant swelling.
"We'll teach
them manual lymph drainage which is a massage technique to redirect the fluid
to parts of
the body that do not have edema," she says. "Then we'll also do
compressive wrapping."
It's important to understand the condition
because it can lead to bigger health consequences.
"You can have all
sorts of problems with infection and you really, really want to keep it under
control
because you don't want to get into one of these higher-level
problems."
More than a lifestyle issue, managing lymphedema is accepting
it is a lifelong process
Main Named Chattanooga Area Manager of the Year
– WTVC –
Robert P. Main, President and Chief Executive Officer of Siskin
Hospital for Physical Rehabilitation,
is the recipient of the Chattanooga
Chamber of Commerce’s Chattanooga Area Manager of the Year
Award for
2011.
The Manager of the Year Award is made annually by member
organizations of Chattanooga Area
Manager of the Year (CAMOY). Now in its
24th year, the award recognizes an executive manager
who has made a
significant contribution to the Hamilton County area.
Robert Main is
serving in his 23rd year as President and Chief Executive Officer of Siskin
Hospital
for Physical Rehabilitation. He was instrumental in the
development of the hospital and officially
became the first employee in
1987. He has remained steadfast in his leadership for the past 23 years,
providing paramount insight and direction in establishing Siskin Hospital’s
presence as one of the most
successful regional rehabilitation hospitals in
the country. Mr. Main remains the longest tenured
healthcare Chief
Executive Officer in the Chattanooga area.
The Chattanooga community has
directly benefited from Mr. Main’s vision of providing specialized
programs
such as the Brain Injury Unit, the Lymphedema program, the Balance and
Dizziness
program, and the Driving Evaluation program. These programs
provide the Chattanooga community
with localized specialty care that would
otherwise be unavailable in this area. Mr. Main and his team
continue to
search for new ways to better serve patients with special needs.
As a
way to continue serving the disabled population, Mr. Main has worked diligently
with staff to
develop the Fitness Center at Siskin Hospital. The focus of
the Fitness Center is to provide a place
where disabled and able-bodied
people, whether former patients or not, can exercise side-by-side
with the
benefit of using specially designed equipment developed to accommodate their
needs. The
Chattanooga community directly benefits from the Fitness Center,
since it is the only full-service
adaptive exercise facility in the
region.
Mr. Main is an active member of the boards of directors of
United Way, Blood Assurance, Hospice
of Chattanooga, and The Jordan Thomas
Foundation. He is also a member of the Rotary Club of
Chattanooga, and a
past board member of the Chamber of Commerce and Notre Dame High
School. In
his professional life, he has served as Chairman of the Chattanooga Area
Hospital District.
He has also served as Chairman and is currently a board
member for the Tennessee Hospital
Association.
Mr. Main is past
Chairman and a member of the American Hospital Association Governing Council
for Rehabilitation, and is the past Chairman and current board member of
the American Medical
Rehabilitation Providers Association. He also serves
on the Regional Policy Board of the American
Hospital Association. He was
the founding Chairman of the Southeast Rehabilitation Network. Mr.
Main is
a past member of the Professional and Technical Advisory Committee of the Joint
Commission on Accreditation of Healthcare Organizations, as well as
continuing to chair a number of
other committees and task forces on a
national level.
Robert Main’s community service also includes past board
membership on the Chattanooga
Symphony and Opera Association and membership
on the University of Tennessee at Chattanooga
Chancellor’s
Roundtable.
Locally, Mr. Main’s leadership was essential in enhancing
the field of rehabilitation education. Under
his direction, Siskin Hospital
joined in a three-way partnership with the University of Tennessee
Health
Science Center in Memphis and the University of Tennessee at Chattanooga to
offer a Master’
s Degree program in Occupational Therapy on the UTC
campus.
Mr. Main has also been very active on a state and federal level
with lobbying efforts for the disabled
to ensure their access to
rehabilitation care. On a federal level, Mr. Main was a founding member of
the FAIR Fund, a common legal fund formed to preserve access to inpatient
rehabilitation care. The
members of the FAIR Fund pursue test cases across
the country challenging inappropriate medical
necessity denials of
Medicare/Medicaid.
In his professional and personal life, Robert Main
values and rewards hard work, encouraging growth
and promotion within his
organization. He worked his way through his own schooling to earn a
Bachelor of Science in Education from State University of New York (SUNY)
at Buffalo and a
Masters of the Arts in Hospital and Health Administration
from the University of Iowa. He has a
special fondness for those who are
willing to work hard and have the motivation to excel in their field.
He is
a great teacher and mentor, as witnessed by a large number of Siskin Hospital’s
staff members
who were recently honored for their longstanding employment
terms ranging from five to 20-plus
years.
Siskin Hospital is the
only freestanding, not-for-profit rehabilitation hospital in Tennessee,
employing
nearly 400 people. Mr. Main’s primary objective for Siskin
Hospital is to provide services that will
enable patients to return to an
active lifestyle within the community. For many Siskin Hospital patients,
this includes returning to work and volunteer activities, allowing them to
discontinue disability benefits,
and ultimately saving taxpayer
dollars.
Paddling in the pink - Woodstock Sentinel Review – By Heather
Rivers –
WOODSTOCK — There may be plenty of stories of duels against the
deadly disease, but these
breast cancer survivors have picked another
fight.
"We don't go as breast cancer survivors," explained Hooters
member Alice Parsons. "We're dragon
boaters."
The Woodstock dragon
boat team, comprised of breast cancer survivors, is currently looking for new
members.
Joining the team is free of charge, and participants are
provided with free coaching, T-shirts, a pink
life jacket and
paddle.
The team of paddlers aged 30 to 70 years of age includes one
male breast cancer survivor and meets
every Monday night at the boat launch
at Roth Park, starting on May 30.
Paddlers compete against other breast
cancer survivor teams at the annual Caressant Care
Woodstock Rotary Dragon
Boat Festival.
"The good thing about Hooters is you don't need any
experience," Hooters member Laurel Gillespie
said.
Gillespie said
medical research was the instigation for the formation of a wave of breast
cancer
survivor dragon boat teams.
"Prior to 1995, upper body
exercises were believed to be a cause of lymphedema in people who had
their
lymph nodes removed," she explained. Lymphedema, which commonly occurs in
people who
have had breast cancer, is a painful chronic swelling of the
tissue due to a blockage of the lymph
vessels. However, Dr. Don McKenzie, a
sports medicine physician at the University of British
Columbia, believed
that following a specialized exercise and training program could help prevent
lymphedema.
"He started the first breast cancer dragon boat team in
Canada," Gillespie said. "He chose dragon
boating because it increased
upper body flexibility and strength, and aerobic output."
As it turned
out, McKenzie's theories rang true and a new dragon boat movement was born. But
Hooters paddlers said their team is about much more than activity and
exercise, providing members
with "uplifted spirits, companionship and
support."
"It's about the power of these women going through something
together and coming out at the other
end," Gillespie said. "It's
reaffirming the positive side of life after cancer — life goes
on."
Hooters member Deb Daub said each member of the group has their own
story to tell about their
struggles with disease.
"We're all able to
get together and support each other," she said.
Gillespie said being a
member of the team is also a way to make life a more joyful
experience.
"It's about mostly having fun," she said.
Parsons
said members of Hooters often meet socially outside of dragon boat
activities.
"There are so many opportunities beyond Hooters," she
said.
Hooters is sponsored by the Woodstock Rotary Club, the Zonta Club
of Woodstock and Shoppers
Drug Mart.
For more information on
Hooters, contact Donna Stewartsmith at 519-539-4134.
May 27,
2011
MU hospital expansion nears halfway mark - Columbia Business Times
–
Ellis Fischel Cancer Center will have a new home in early 2013. The
center, which has been located
on Business Loop 70 since it was established
in 1940, will move into University of Missouri Health
Care’s new $203
million patient care tower that’s under construction.
Preparation for
the patient care tower began in August 2009, and ground was broken nearly a
year
and a half ago. Workers are completing internal concrete framing on
the seven-level structure and will
put up external panels next.
The
tower is on the north side of University Hospital and will provide 300,000
total square feet for
Ellis Fischel Cancer Center along with additional
operating rooms, pre- and post-procedure rooms
and 90 private patient rooms
for University Hospital.
Ellis Fischel will occupy the first and second
floors of the patient care tower, where personnel will
provide outpatient
services and clinical services such as chemotherapy treatment, radiation
therapy
and cancer screening. There will also be space for the Margaret
Proctor Mulligan Breast Health and
Research Center, Cancer Screening
Services, Missouri’s only lymphedema center and a variety of
cancer
survivor and quality-of-life services such as a resource center, family support
services, a
boutique and an outdoor “healing” garden.
Construction
of the Ellis Fischel portion of the tower is funded through $30 million in
revenue bonds
that the MU Board of Curators approved in May 2010 and $22
million in operating revenue from
MU Health Care.
The third and
fourth floors of the patient care tower will house surgical services, including
six
operating rooms, with enough space for six more operating rooms in the
future. The new tower will
also include 25 new pre- and post-operating
rooms — all private — with expansion space for 26
more rooms. The tower
also will offer an expanded surgery waiting room.
The fifth, seventh and
eighth floors will house inpatient units with 90 private patient rooms for
patient-
centered care, visitor lounges and facilities for physicians,
nurses and other health care providers to
treat patients. Because of the
alignment of the new tower with University Hospital’s critical care
tower,
there is no sixth floor.
MU Health Care is seeking Leadership in Energy
and Environmental Design certification of the patient
care tower with these
green features:
• The landscaping plan will feature water-efficient
plants to reduce the demand for irrigation.
• Thirty percent efficiency
of sinks, toilets and shower fixtures will reduce water use.
• The
building will be 16 percent more energy efficient than the ASHRAE 90.1 energy
standard.
• Monitoring systems will confirm that the building is
performing as designed.
• Fifty percent of construction waste is
scheduled to be recycled.
• At least 20 percent of construction
materials are scheduled to come from within a 500-radius of
Columbia.
• The building materials will have at least 20 percent
recycled content.
• Surgery spaces will “power down” when not in
use.
Ellis Fischel Cancer Center will have a new home in early 2013. The
center, which has been located
on Business Loop 70 since it was established
in 1940, will move into University of Missouri Health
Care’s new $203
million patient care tower that’s under construction.
Preparation for
the patient care tower began in August 2009, and ground was broken nearly a
year
and a half ago. Workers are completing internal concrete framing on
the seven-level structure and will
put up external panels next.
The
tower is on the north side of University Hospital and will provide 300,000
total square feet for
Ellis Fischel Cancer Center along with additional
operating rooms, pre- and post-procedure rooms
and 90 private patient rooms
for University Hospital.
Ellis Fischel will occupy the first and second
floors of the patient care tower, where personnel will
provide outpatient
services and clinical services such as chemotherapy treatment, radiation
therapy
and cancer screening. There will also be space for the Margaret
Proctor Mulligan Breast Health and
Research Center, Cancer Screening
Services, Missouri’s only lymphedema center and a variety of
cancer
survivor and quality-of-life services such as a resource center, family support
services, a
boutique and an outdoor “healing” garden.
Construction
of the Ellis Fischel portion of the tower is funded through $30 million in
revenue bonds
that the MU Board of Curators approved in May 2010 and $22
million in operating revenue from
MU Health Care.
The third and
fourth floors of the patient care tower will house surgical services, including
six
operating rooms, with enough space for six more operating rooms in the
future. The new tower will
also include 25 new pre- and post-operating
rooms — all private — with expansion space for 26
more rooms. The tower
also will offer an expanded surgery waiting room.
The fifth, seventh and
eighth floors will house inpatient units with 90 private patient rooms for
patient-
centered care, visitor lounges and facilities for physicians,
nurses and other health care providers to
treat patients. Because of the
alignment of the new tower with University Hospital’s critical care
tower,
there is no sixth floor.
MU Health Care is seeking Leadership in Energy
and Environmental Design certification of the patient
care tower with these
green features:
• The landscaping plan will feature water-efficient
plants to reduce the demand for irrigation.
• Thirty percent efficiency
of sinks, toilets and shower fixtures will reduce water use.
• The
building will be 16 percent more energy efficient than the ASHRAE 90.1 energy
standard.
• Monitoring systems will confirm that the building is
performing as designed.
• Fifty percent of construction waste is
scheduled to be recycled.
• At least 20 percent of construction
materials are scheduled to come from within a 500-radius of
Columbia.
• The building materials will have at least 20 percent
recycled content.
• Surgery spaces will “power down” when not in
use.
May 29, 2011
Lymphedema patient seeks a home - News Chief –
By CHASE PURDY –
LAKELAND -- Sitting in a hospital bed on the third
floor of Lakeland Regional Medical Center on
Friday, Yvonne Gallimore, 51,
dabbed her eyes and shook her head.
A 17-year battle against lymphedema
has left the Lakeland woman weighing 770 pounds, limiting her
mobility and
banishing her to a life confined to her apartment.
Despite treatment
surgeries, her condition escalated and prevented her from moving freely through
the
front door of her home, she said.
On May 19, medical crews tore
through a wall of the apartment to transport her to the hospital. An
infection in one of her legs needed immediate medical treatment, she
said.
About a week after doctors admitted her to the hospital, they
deemed Gallimore ready for release.
But extrication damage to her Section 8
apartment in the 1100 block of Martin Luther King Avenue
left her homeless.
Because she doesn't face a life-threatening condition, Gallimore said she
doesn't
qualify for admittance to area bariatric facilities for
treatment.
"But I'm not going to let anybody break my spirit," she said
"I've come too far. I have grandchildren
and I want to spend time with my
grandchildren."
Visiting with Gallimore on Friday afternoon was Chaundra
Greer, a private healthcare nurse, who
said her patient and friend is now
stuck between a rock and a hard place.
Because of her weight, Gallimore
can't live with Lakeland family members, not without significant
modifications to their homes.
Greer said Gallimore needs an
apartment where she won't be confined to a bed, with access to fresh
air
outside the house
Information published by the Mayo Clinic states that
lymphedema creates blockage in a person's
body that prevents fluids from
draining well. As a result, Gallimore's legs swelled significantly and her
chances for infection enhanced.
There is no cure for the condition,
but it can be controlled.
Ashley Link, a spokeswoman for the hospital,
said doctors would not discharge the woman if she had
no place to
go.
Aware of the predicament, officials with the Lakeland Housing
Authority said they led Greer and
Gallimore's family through a handicapped
accessible apartment to replace the previous apartment.
"We did offer
her what we had available ... that we would be willing to modify," said John
Calcagni,
senior director of housing. "It was not accepted. And we've
spoken with her and the family this week
about half-a-dozen
times."
The substitute apartment didn't appeal to Gallimore's family,
particularly Alnieta McKenzie, her sister.
McKenzie said the housing
authority conceded to make some modifications, but not enough to give
her
sister access to all the rooms. Not the kitchen. Not the living room. Just the
back door and the
bedroom, she said.
Housing Authority Administrator
Herbert Hernandez said he could not confirm that claim because the
man who
led the family through the apartment was not in the office Friday.
"We
attempted to meet all of our obligations," Hernandez said. "We made an offer
and it wasn't
accepted, and at this point we are going to be talking to our
consultants."
The family sought help at area nursing homes, but said
they were turned away for lack of adequate
accommodations. Now they're
appealing to the community.
"The place she was in, she wasn't getting
proper care," McKenzie said. "What we're trying to do is
get her somewhere
here in Lakeland where somebody from our family can get there every day to
check on her."
Weepy about her misfortunes, Gallimore cried into her
hospital gown, little gold earrings swaying
back and forth. She said she
hopes somebody in Lakeland can help her find a place to live. A place
to be
a grandmother again.
"I don't just want to give up my life," she said.
"I ain't trying to say I'd like to run a marathon, but I
want quality of
life."
May 30, 2011
Complementary Cancer Treatments: Which Is For
You? - Huffington Post – Joseph Nowinski, Ph.D.
–
This series has
looked at a variety of complementary therapies that are often used by cancer
patients.
They include: Acupuncture, Reiki, Therapeutic Massage,
Meditation, Tai Chi and Yoga.
Although the effectiveness of these
treatments on physical symptoms such as nausea and pain vary, all
of them
appear to have one thing in common: They have the potential to reduce chronic
stress in many
of the people who use them. Which raises the question: Is
stress related to cancer, and if so, how?
Linking Stress, Depression and
Cancer
According to a study conducted at Stanford University School of
Medicine, women with breast
cancer who are also clinically depressed are at
higher risk for a recurrence of cancer than are women
who have only the
cancer but not the depression. The reason could possibly have to do with the
way
depression affects the immune system. This was a study of women with
metastatic breast cancer --
cancer that has spread from the breast to other
organs. There is little doubt that these women were
under chronic stress,
even if they were able to continue functioning in their daily lives. It was
found
that the more symptoms of depression these women had, the less their
immune systems were able to
respond to a variety of bacteria, fungi and
yeasts.
Some researchers have suggested that there is a difference
between how acute versus chronic stress
may affect the immune system.
Acute, relatively brief stress may actually enhance the effectiveness of
our immune system, at least for a short period of time. Depression,
however, is most often the result
of chronic stress that wears us down.
Researchers at the Health Sciences Center at the State
University of
Londrina in Brazil, in a review published in The Lancet of many studies on the
immune
system concluded that "chronic stress impairs the immune response
and contributes to the
development and progression of some types of
cancer." Chronic stress causes the body to produce
more cortisol, a hormone
that suppresses the immune system. This could potentially be one of several
biochemical mechanisms through which chronic stress and depression
contribute to cancer.
Janice Kiecolt-Glaser, Ph.D., a psychologist and
researcher at Ohio State University, has also studied
the relationship
between chronic stress, depression and the immune system. She looked at a
sample
of 47 men and women who were all caregivers to patients with
Alzheimer's and found that all were
experiencing moderate levels of
depression -- not serious enough to prevent them from functioning,
but
enough to affect their mood and their sleep. Again, you could reasonably argue
that these people
were experiencing chronic, not acute stress. When this
group was given a standard flu shot (which
triggers an immune response)
their bodies over-reacted, producing much higher than normal amounts
of the
chemical interleukin-6, which can cause inflammation in various organs. Such
chronic
inflammation is associated with cardiovascular disease, diabetes
and other disorders. In effect, these
persons' immune systems were
overworking, to their detriment. It makes sense that a chemical that
can
contribute to something like cardiovascular disease or diabetes can also
complicate cancer and its
treatment.
Readers who have been following
this series may have noticed one other finding that stuck out for me:
Complementary treatments reduce stress more effectively when they are
followed consistently over a
long period of time. As an example, women who
had been practicing yoga consistently for at least
two years had
significantly lower heart rates and better overall mental health than a group
who had
been practicing yoga for only a short time. Similarly, the
beneficial effects of massage on stress levels
soon dissipate if massage
was discontinued.
Which Complementary Treatment To
Choose?
Studies such as the above raise another important question: If
the kinds of complementary therapies
we have been looking at in this series
all have the power to reduce chronic stress and depression,
could they not
-- in combination with medical treatment -- potentially improve the prognosis
and
extend the lives of cancer patients?
In turn, the fact that what
complementary treatments seem to have in common is the ability to reduce
chronic stress leads to an interesting hypothesis:
Which
complementary treatment a patient chooses may be somewhat less important than
the fact that
they choose one or more and follow through. In other words:
Find something you like and stick with it.
Consider the way one woman
who has been living with Stage 4 cancer for many years wrote about
her use
of meditation:
"I am a huge fan of meditation and would be a mess
without my practice. It has centered me and
brought to my awareness when I
am the cause of my own suffering, and then I need to let it go as a
cloud
just passing by. Pain is a part of life ... but suffering is optional.
Frequently in the world of
cancer treatment, prescriptions for
tranquilizers or antidepressants are given out. While at times this is
a
valid and needed approach, there are many people who don't know what to do with
their fear and
anxiety, and rather than dealing with it through something
like meditation, they pop a pill for a quick
fix."
This woman wrote
to me that she had also made use of massage and acupuncture as part of her
holistic approach to dealing with her cancer, and that these had been
useful at different times, but that
her overall health (weakened bones,
lymphedema, etc.) had led her to turn to meditation. In each
case, however,
this woman followed through with the complementary treatment, as opposed to
merely dabbling in it.
What About Caregivers?
As a corollary
to the above, it is reasonable to argue that complementary therapies can be
helpful to
the caregivers of cancer patients, as well as to the patients
themselves. Numerous studies have
documented the deleterious effects that
long-term caretaking can have, especially if that caretaking
falls
primarily on the shoulders of one or two people (as it typically does). My blog
on disabled
veterans, for example, cited research on the negative effects
on the mental and physical health of the
wives who care for them -- often
for years and years. These findings were strongly supported in
interviews
Dr. Barbara Okun and I conducted in preparation for writing our book, "Saying
Goodbye:
How Families Can Find Renewal through Loss," which is a guide for
helping patients as well as their
families cope with a terminal illness.
Does it not make sense, then, to encourage (and even facilitate)
access to
complementary therapies to caregivers?
Want More Information?
To
join the conversation about how medicine has transformed death and dying, and
how to help a
loved one who is facing cancer, visit
www.newgrief.com.
Links to more information on complementary treatments
can also be found by visiting the Annie
Appleseed Project at www.annieappleseedproject.org
May 13, 2011
Ann Hildebrand earns
hospital award for excellence - Ventura County Star - By Alicia Doyle
–
For Ann Hildebrand, earning the Core Value Award for Excellence for her
work with cancer patients
is not just about her.
"It brings
awareness to the Cancer Center, highlighting the importance of all that is
offered here," said
Hildebrand, of Ventura, who was recognized for her role
as supervisor of the Cancer Center at St.
John's Regional Medical Center in
Oxnard. "It is affirmation that I am able to make a difference."
At the
Cancer Center, Hildebrand's responsibilities include collecting cancer data,
meeting numerous
quality standards, scheduling weekly tumor boards and
maintaining services. A certified tumor
registrar by profession, she is
responsible for reporting all cancer cases as required by law.
Tumor
board is a weekly multidisciplinary conference where all the medical
professionals in different
specialties gather for an hour to discuss
interesting or difficult cancer cases.
"The patient benefits by a
coordinated, multidisciplinary team approach to the best available
diagnostic and treatment options," Hildebrand said. "The physicians benefit
from the shared
knowledge and experience of the peers."
She also has
volunteered with the American Cancer Society for more than 25 years. She said
she
consistently promotes its activities and services.
"We have
similar missions. ... They are the only other organization I will fundraise
for, as they have
funded 42 Nobel Prize-winning cancer researchers," she
said.
Hildebrand's role on the community council for the American Cancer
Society requires a deep
personal commitment of time and energy, said Ray
Vasquez, administrative assistant at the Cancer
Center.
"This is a
group which meets to plan and strategize priorities and fundraisers Relay for
Life, the Gala
and Cancer Survivors Day are just a few of the events
sponsored by the American Cancer Society,"
Vasquez said.
The work of
the Cancer Center, which offers support and resources to cancer patients and
their
caregivers, is made possible through more than 20 volunteers who
together donate more than 100
hours a month. Free services include support
groups for colon cancer, prostate cancer and Latinos
with cancer, as well
as art classes, yoga, lymphedema education courses and exercise classes for
patients after breast cancer surgery.
"Ann goes beyond the call
of duty for patient advocacy. We see new patients on a daily basis, and
she
demonstrates her commitment to these persons without fail," Vasquez
said.
Inspired by her efforts to make the world a better place, Vasquez
nominated Hildebrand for the Core
Value Award for Excellence. She was
recognized with the honor in April at St. John's.
"I have 30 years of
experience working with severely injured accident victims and very ill persons,
and being there for them and their families," said Vasquez, a retired
firefighter. "Here at the Cancer
Center, I have had the extraordinary
experience of watching Ann do what she does, and that is to
bring some
comfort to persons in their darkest moments. I have seen many people come in
frightened
and leave comforted, some with a smile, knowing someone cares so
much as Ann."
For Hildebrand, the desire to help others began with her
parents.
"They taught me a strong work ethic and the importance of
making a difference and giving back to
society," she said.
She also
credits her grandfather, who died in 1956 of pancreatic cancer when she was
2.
"I never got to know him. It sparked something in me that still burns
to this day," she said.
May 14, 2011
A chronic disease? -
Malaysia Star - By Dr YIP CHENG HAR –
Can breast cancer be considered a
chronic disease, and, what are the support systems available to
women with
breast cancer?
A CHRONIC disease is a disease that persists for a long
time. The US National Centre for Health
Statistics defines chronic disease
is one lasting three months or more.
Traditionally, diseases like
hypertension or diabetes are considered chronic diseases, while cancers
are
generally not, as they usually present as a life-threatening condition,
requiring urgent attention.
In cancers where treatment options are
limited, and diagnosis is usually made at a late stage, such as
seen in the
majority of lung, gastric, and liver cancer, survival is poor. Hence, such
cancers are not
likely to be considered as a chronic
condition.
Redefining breast cancer
However, survival rates for
certain cancers, notably breast, colorectal and prostate, have risen
steadily over the past 10 years. Because survival rates for breast cancer
have improved so much,
there are now more than four million women worldwide
who have been diagnosed and treated for
breast cancer over the past five
years, compared to an incidence of slightly more than a million new
cases
per year.
Survival rates of breast cancer has increased to more than 80%
in some of the more developed
countries. Hence, there are more breast
cancer survivors than any other cancer survivors.
It is no surprise that
there are so many breast cancer support groups all over the country, while
there
is not a single lung cancer support group. Because of the large
numbers of women living with breast
cancer, the Institute of Medicine in
the US now recognise breast cancer as a chronic disease, bringing
greater
focus to this area of research.
After the cancer
After being
treated for breast cancer, there are still a few remaining issues. Chemotherapy
can lead to
an early menopause. With early menopause, women have to face
problems with decreased libido, dry
skin, earlier onset of osteoporosis
(where the bones become brittle and prone to fracture), hot
flushes, and
depression.
While the majority of women deal with menopause well, there
is a small proportion where
menopausal symptoms persist, hence interfering
with quality of life. For oestrogen-receptor positive
breast cancer (which
occurs in up to 60% of women with breast cancer in Malaysia), an
anti-
oestrogen drug called tamoxifen is prescribed for five
years.
In premenopausal women (more than 60% of women with breast cancer
in Malaysia are in the
premenopausal age group), this may cause menopausal
symptoms, such as hot flushes, dry skin, sleep
disturbances, and
genitourinary symptoms. Hence, these women experience a poorer quality of
life.
Side effects of surgery may persist, such as numbness and pain of
the upper limb, problems with
shoulder movement, and lymphedema. Pain over
the chest wall is also a common symptom.
These women also have to deal
with discrimination at the workplace. Indeed it is not uncommon for
women
to be coerced into resigning from their jobs. Insurance companies will also not
insure women
with a “history of breast cancer”. Because of the stigma that a
diagnosis of breast cancer brings, some
women do not even tell their family
members about their condition.
Quality of life
CanSORT (Cancer
Surveillance and Outcomes Research Team) is a multidisciplinary group of
investigators based at the University of Michigan and the Ann Arbor VA
Centre for Clinical
Management Research in the US, and studies the quality
of cancer care across a continuum of care,
from prevention to
survivorship.
CanSORT studies the impact of cancer and its treatment on
the quality of life, especially in breast
cancer, to understand the unique
issues that breast cancer survivors face.
In a study carried out by this
group, women interviewed eight months after completion of breast
cancer
treatment report ongoing symptoms – fatigue, sleep disturbances, breast and arm
discomfort,
and reduced emotional well-being.
Younger women and
women with a poorer health status at the time of diagnosis reported more
symptoms, and younger women tended to report a lower quality of life
overall.
Apart from discrimination, fear of recurrence persists, even in
women with early-stage breast cancer,
where the prognosis is
excellent.
The slightest twinge of pain, even in their big toe, can send
women into a panic and running to their
doctors.
This fear of
recurrence is difficult to cope with for some women, while others accept it
pragmatically
and move on with their lives, living every day to the
fullest.
The breast cancer experience differs with each women, as coping
mechanisms differ widely between
women, based on their previous life
experiences, educational level, socio-economic status, and
degree of family
support.
However, “benefit-finding” is a new concept where a woman,
after experiencing a life threatening
event, goes on to live life more
fully, taking part in activities such as mountain-climbing or
trekking.
A family affair
What about the role of the family in
women surviving after a diagnosis of breast cancer?
One of a woman’s
greatest fear is that her husband may leave her because of cancer, and
certainly,
among the less educated, there are myths that cancer can spread
to the spouse and that sexual
intercourse will bring on a
relapse.
Some women are told by their family members that they cannot
eat chicken and a whole host of other
types of food, so social life which
revolves around eating out, can be severely curtailed.
This is unlike
other chronic diseases like hypertension and diabetes, where there are less
superstitions
and taboos.
In metastatic breast cancer, where the
cancer has spread beyond the breast into areas like the bones,
liver and
lungs, it meant that it was time to write your will and get your affairs into
order, because in
the early years, only 10% of women were alive five years
after a diagnosis of metastatic breast cancer.
However because of
improved treatment, women are living longer with metastatic breast cancer and
it is common now to see as many as 40% of women with metastatic breast
cancer surviving five years
or more. Hence, even metastatic breast cancer,
which used to have such a bleak outlook, is being
viewed as a chronic
disease.
Ultimately, it is important to develop interventions and
programmes to meet the needs of the breast
cancer survivor. Interventions
include decision making tools to assist women to make good decision
about
surgery, chemotherapy, and their treatment options, including breast
reconstruction.
Interventions to help women to better manage their
condition is also required so that a woman, after
being treated for breast
cancer, can move on and live a normal life, somewhat like a woman who has
a
chronic disease like hypertension, which is so common.
This article is
contributed by The Star Health & Ageing Panel, which comprises a group of
panellists
who are not just opinion leaders in their respective fields of
medical expertise, but have wide
experience in medical health education for
the public. The members of the panel include: Datuk Prof
Dr Tan Hui Meng,
consultant urologist; Dr Yap Piang Kian, consultant endocrinologist; Datuk Dr
Azhari Rosman, consultant cardiologist; A/Prof Dr Philip Poi, consultant
geriatrician; Dr Hew Fen
Lee, consultant endocrinologist; Prof Dr Low Wah
Yun, psychologist; Datuk Dr Nor Ashikin
Mokhtar, consultant obstetrician
and gynaecologist; Dr Lee Moon Keen, consultant neurologist; Dr
Ting Hoon
Chin, consultant dermatologist; Prof Khoo Ee Ming, primary care physician; Dr
Ng Soo
Chin, consultant haematologist. For more information, e-mail
[email protected]. The Star
Health & Ageing Advisory Panel
provides this information for educational and communication
purposes only
and it should not be construed as personal medical advice. Information
published in this
article is not intended to replace, supplant or augment a
consultation with a health professional
regarding the reader’s own medical
care. The Star Health & Ageing Advisory Panel disclaims any
and all
liability for injury or other damages that could result from use of the
information obtained from
this article.
Women's Health: Significant
Developments Regarding Breast Surgery - MD News – by : Barbara D.
Goldberg
-
Two recent studies involving breast surgery will likely have an impact
on cases in which a patient
requires a breast biopsy following a suspicious
mammogram, or where cancer has been found in the
lymph nodes.
A
study of breast biopsies found that many women who undergo surgical biopsies do
not need them
and should be having needle biopsies instead. As reported in
The New York Times, a study of
172,342 biopsies in Florida found that 30%
of the biopsies from 2003 to 2008 were surgical, while
the rate should have
been only 10% or less, according to medical guidelines. Assuming that the
figures
for the rest of the country are similar, this would mean that more
than 300,000 women a year are
having unnecessary surgeries.
This is
significant because a surgical or open biopsy typically requires an inch-long
incision, sedation
or general anesthesia, and carries the risk of scarring
and infection. A needle biopsy, by contrast,
requires only a local
anesthetic and involves a minimal risk of scarring and infection. Moreover, in
those women who are found to have cancer, a surgical biopsy may make a
subsequent mastectomy
more difficult than it would otherwise have
been.
The other study indicates that dissection of axillary lymph nodes
may often be unnecessary — even in
women who have residual disease in the
remaining nodes — and that surgeons may safely remove
only the sentinel
lymph nodes. In the study, which was conducted at 115 sites and enrolled
patients
from 1999 to 2004, women who had invasive tumors that were less
than 5 cm and one to two
positive sentinel nodes were randomized into two
groups. The 445 women randomized to axillary
node dissection underwent
removal of 10 or more nodes, compared to two nodes for the 446
women in the
other group. Women in both groups underwent lumpectomies and whole-breast
radiation. Whether they would also have chemotherapy was decided by their
treating physicians.
The study measured both overall and “disease-free”
survival rates, and, significantly, these were found
to be almost identical
for the two groups. For the women who had axillary lymph nodes removed, the
five-year overall survival rate was 91.8%, compared to 92.5% for those with
only the sentinel nodes
removed. Similarly, the five-year, disease-free
survival rate was 82.2% for the women who had
axillary nodes removed and
83.9% for those with only the sentinel nodes removed.
The study thus
demonstrates that for women who qualify, not removing the axillary nodes has
minimal,
if any, effect on overall survival and disease-free survival
rates. The significance for patients is that, by
not having their axillary
lymph nodes removed, they can avoid potentially serious sequelae, such as
arm stiffness, pain, lymphedema and numbness.
Of course, the results
of a single study can never substitute for a surgeon’s best judgment in a
particular case. Nevertheless, surgeons would be well advised to proceed
cautiously in light of these
two studies and carefully document the reasons
for deciding on an open biopsy or axillary node
dissection instead of the
less invasive procedures. A surgeon who performs an open biopsy when a
needle biopsy would have sufficed may find himself or herself facing a
lawsuit if the patient’s breast is
scarred or deformed as a result of the
procedure. Likewise, a surgeon who unnecessarily removes
axillary nodes in
a patient who would have qualified for sentinel node dissection may face
litigation if
the patient develops lymphedema or other serious
complications as a result.
Barbara D. Goldberg is a partner and Head of
Martin Clearwater & Bell LLP’s appellate
department. Goldberg is well
known for her appellate expertise in high exposure and complex cases
and
has handled hundreds of significant motions and appeals in state and federal
courts.
References
i See Grady, Denise, “Study of Breast Biopsies
Finds Surgery Used Too Extensively,” The New
York Times, February 18,
2011.
ii Giuliano, A.E., et al., “Axillary Dissection vs no Axillary
Dissection in Women with Invasive Breast
Cancer and Sentinel Node
Metastasis,” JAMA 2011:305(6): 569-575
Race for the Cure: Enhancing
lives - Columbus Dispatch - By Misti Crane –
A cancer diagnosis is never
welcome news. But for the more than 207,000 women and men who
learn they
have breast cancer each year, there are reasons to be hopeful.
Nine of
10 people with early-stage breast cancers will live at least five
years.
Treatment advances not only are keeping people alive longer, but
they increasingly are improving
quality of life, too.
Researchers
are searching for ways to further tailor care to the individual. And they
continue to
pursue work that not only will tackle the disease, but also
circumvent it.
"The real thing I hope for is prevention, and we're
putting more dollars into research looking for ways
to prevent breast
cancer from ever occurring," said Dr. Mark Cripe, a breast surgeon at Grant
Medical Center and Doctors Hospital.
Some women are doing that by
taking preventive medications or undergoing surgery because of
elevated
risk. Everyone can benefit from healthy-lifestyle choices, including shunning
cigarettes,
limiting alcohol consumption and staying fit, he
said.
"And hopefully we can find a vaccine to prevent patients at high
risk from developing a breast
cancer," Cripe said.
At Ohio State
University Medical Center, researcher Pravin Kaumaya is working on just that,
an
experimental vaccine that targets a molecule that occurs in abnormally
high levels in about one-third of
breast cancers and another molecule that
is overexpressed in many other tumors.
"We've always been looking for
vaccines. That would be a huge way of preventing cancer," said Dr.
William
Farrar, a surgical oncologist and director of Ohio State's JamesCare
Comprehensive Breast
Center.
Farrar said that one of the most
exciting recent developments in the field - and one that already is
changing patients' lives - is the discovery that surgeons don't have to
remove all the lymph nodes in
some patients whose nodes test positive for
the disease.
Women who have their lymph nodes taken out suffer from
varying degrees of lymphedema, a
condition in which excess fluid builds up
in the arm and causes swelling.
"It can be anything from very mild
swelling where they can't get their rings on to tremendous arm
swelling
that truly limits what they can do," Cripe said.
Dr. Deb Norris, a
surgical oncologist at Mount Carmel West hospital, recently returned from a
medical conference and said there was a lot of buzz about new agents that
offer promise in attacking
specific kinds of tumors in specific
patients.
The recognition that one approach doesn't work for all
patients and that some do especially well on
certain drug regimens is
revolutionizing cancer care.
"Breast cancer is not one disease," Farrar
said. "As we learn more and more about the biologic
parameters of breast
cancer, it really separates how one breast cancer is going to behave over
another."
A lot of work is being done on what are known as
triple-negative breast cancers, which tend to be
more aggressive, have
genetic links and occur in younger women, Farrar said.
Medha Sutliff of
Granville is especially interested in work that will help both the treatment
and
identification of disease in young women.
Sutliff, 44, has had
breast cancer twice. She was 27 the first time. The second was diagnosed 10
years later, after the birth of her four children.
"It can many
times be more aggressive. It can be different biologically, and there isn't
really any
effective screening tool," because mammograms aren't routinely
recommended for women younger
than 40, she said.
Sutliff is the
educational-programming chairwoman for the Young Survival Coalition and works
with
breast-cancer patients through a program at the Licking County Health
Department that is funded by
Susan G. Komen for the Cure.
She was
fortunate, she said, because she found the original lump and opted for removing
it even
though a needle biopsy didn't reveal cancer. As it turned out,
there were cancer cells around the
margins of the lump.
After that,
she had yearly mammograms, which detected the second cancer.Both were found
early,
vastly improving Sutliff's chances for survival.
"If I had
waited and watched (the original lump), we really don't know."
Screening
has improved drastically in recent years for those who do get mammograms, but
there is
much room for improvement on the detection front, Farrar said. A
blood test, for example, could
make it easier to find hard-to-detect
cancers.
Even as they cheer advances in surgical techniques and therapy
for breast cancer, doctors say they
remain frustrated by a very old
problem: Women with advanced cancer that could have been stopped
through
early detection, either because the woman noted an early change in her own
breast or it was
detected through mammography.
"I still have women
coming in with advanced-stage cancer, and it's just so hard and you know at one
point it was less than the size of a dime and it could have been a simple
lumpectomy for her," Norris
said.
"This is 2011: Why are we still
seeing this? It's just terrible."
May 16, 2011
Local health
happenings - Daytona Beach News-Journal –
Breast Cancer/Lymphedema
Networking Group meets from 6:30 to 8 p.m. the third Monday of each
month
at Halifax Health Medical Center Meeting Room F, 1st Floor, France Tower, 303
N. Clyde
Morris Blvd., Daytona Beach. First time attendees, should arrive
at 6:15 pm. For more information,
call Catherine McQuade at 386-238-2219.
5K RUN FOR MISSIONS
Komen Foundation Donates $1M To Sharp Healthcare -
KGTV San Diego –
Donation Aims To Help Woman Get Access To Breast Cancer
Care
SAN DIEGO -- The Susan G. Komen Foundation's San Diego chapter
donated $1 million to Sharp
Healthcare programs to help women with little
or no insurance coverage gain access to breast cancer
care, the hospital
system announced Monday.
Among the awards were $335,000 to Sharp Chula
Vista Medical Center to increase access to
diagnostic services to
low-income, uninsured women at-risk for breast cancer in the South Bay;
$152,800 to Sharp Memorial Hospital to help women afflicted by lymphedema,
a chronic and
debilitating condition that causes swelling after surgery or
radiation treatment; and $140,000 to Sharp
Grossmont Hospital to provide
financial assistance to uninsured, or under-insured, women in the East
County.
"Since 2004, thousands of patients at Sharp have benefited
from the vision and generosity of the San
Diego affiliate of the Susan G.
Komen for the Cure," said Bill Littlejohn, chief executive officer of the
Sharp Healthcare Foundation.
"We are proud to be the beneficiary of
their dedication to helping medically uninsured and under-
insured women
fight breast cancer and are honored to partner with such a pioneering
institution," he
said.
Sharp Healthcare is the first San Diego
organization to receive $1 million from the Komen
Foundation, famous for
its "Race for the Cure" and outfitting athletes in pink to raise breast cancer
awareness.
The San Diego chapter also granted money toMama's
Kitchen, the Council of Community Clinics,
San Ysidro Health Center and
Vista Community Clinic, among others, to provide assistance for
women with
little or no medical coverage.
May 18, 2011
Breast cancer support
group hears from medical equipment providers - Scottsboro Daily Sentinel -
By Charlene Larson –
MMI Breast Center celebrated Mother's Day for
the breast cancer support group recently with
representatives from Kerley
Medical Equipment as the guests. The 11-year old privately owned
company is
located in Huntsville.
Brenda Kerley, owner, brought a van full of
merchandise so the women could go home with their new
garments. Other fit
specialists, Barbara Garrison, Sharon Jones and Ashlea Redard, worked with
each woman fitting foundation garments and other merchandise that help
“reclaim a positive body
image and healthy lifestyle during and after breast
cancer.”
The representatives brought brochures that covered products
which are available from Amoena, a
company that specializes in “recovery
care products”; exercises for after breast cancer surgery and
how to deal
with lymphedema.
MMI staff not only supplied the main dish for the meal
but also had a pink Gerber daisy, a token
imprinted with “strength, hope,
faith and courage” and a card that read, “May this token be a
reminder for
you that support and awareness will see us through.” One of the door prizes was
in
memory of Jerry Varnedoe, donated by her family.
Each person
bought a loaf of Robin Taylor's famous banana nut bread to support Relay for
Life.
Early detection is the key to successful breast cancer treatment
and yearly mammography is still the
best way of detecting a malignancy. MMI
Breast Center will direct uninsured and underinsured
women in the correct
procedures to obtain financial help. Just call 256-574-2883 for this
information.
The next meeting will be at 5:15 p. m., Tuesday, June 14 at
the MMI Breast Center on South Broad
Street in Scottsboro. Teresa Alley of
New Beacon Hospice will the guest.
Day Break Massage Reflects Expansion
with Launch of Re-Designed Website
Online PR News – Web development and
SEO client of Web Full Circle, launches newly enhanced
website
-
Online PR News – 18-May-2011 –CHARLOTTE, NC — Website Design and SEO
Company,
Web Full Circle, is pleased to announce the launch of Day Break
Massage’s re-designed website
www.dbmassage.com. Web Full Circle provided
the company with an improved website that reflects
their expansion of new
product lines, additional therapists, and continual expertise.
Day Break
Massage is a Charlotte massage center that enables clients to affordably
receive the best
therapeutic massage possible in a comfortable and relaxing
setting. Their services include therapeutic
(Swedish and deep tissue),
sports, hot stone, pregnancy, and couples massage as well as massage
instruction for couples to learn basic massage techniques for use in their
own home. Additionally, Day
Break offers Medical Massage that complements
mainstream western practices for those who suffer
from a wide array of
maladies such as Fibromyalgia, Carpal Tunnel Syndrome, headaches,
sprain/strains, and chronic pain associated with numerous neurological
disorders. Day Break has on
staff a Certified Lymphedema Therapist (CLT)
that specializes in the treatment and management of
those suffering from
excessive swelling in the body, primarily the arms and legs, as a result of
cancer
treatment.
The spa services also include the slim and detox
body treatment from their newly introduced
Eminence Organics line.
Alongside establishments such as the Ritz Carlton, and the Ballantyne, Day
Break Massage is proud to be the only massage therapy center in Charlotte
that features this award-
winning provider of the most effective skin care
products in the natural & organic skin care industry.
The
re-designed site reflects the growth of Day Break Massage by providing a
plethora of
information for potential clients. Therapist profiles are
showcased as well as benefits of massage
therapy, and FAQs to answer
questions and ease any concerns a client may have but may not feel
comfortable asking. Specials and rewards are also provided to site visitors
such as the current “Refer
four people and receive a free 60 minute
massage” promotion. The new website also offers the ability
for a client to
book an appointment online after reading extensively about each of the services
Day
Break provides.
“Web Full Circle shares similar interest in Day
Break’s core values of building relationships with
clients and community
partners” said Josh Astete, President of Web Full Circle. “We are happy to
aid Day Break Massage with this newly enhanced website so they are able to
showcase themselves
to their fullest potential.”
For more
information about Web Full Circle, please visit www.WebFullCircle.com or call
(980) 322-
0518.
About Web Full Circle:
Web Full Circle is Website
Design and SEO Company that specializes in developing websites that
generate leads for companies. Our team of Internet consultants and SEO
experts develop solutions
that are customized around companies’ online
marketing goals. Web Full Circle is located at 207
Regency Executive Park
Dr., Suite #150, Charlotte, NC 28217.
About Day Break Massage:
Day
Break Massage requires therapists to hold an associate’s degree, and/or a
minimum of two years
of licensed massage therapy experience. Day Break
values vigorous qualifications and believes
demonstrated excellence among
their therapists is the only way to properly care for their clients. For
more information about Day Break Massage and the services they offer please
visit: www.dbmassage.
com.
Solaris Simplifies Upper Extremity
Lymphedema Management - PR-USA.net –
WEST ALLIS, WI - People living with
lymphedema have another management option during the
active phase of CDT
therapy: the Caresia Wrist to Axilla arm garment. Solaris is proud to introduce
this new design and offer their customers a full range of upper extremity
solutions. The new Wrist to
Axilla garment can also be paired with the
Caresia Glove or Gauntlet in order to provide
individualized full arm
coverage.
Caresia bandage liners were designed to increase therapeutic
results and improve compliance by
simplifying the active phase of therapy,
and have been a popular choice among clients and
professionals for years.
Therapists like Caresia's unique foam particles which help open initial
lymphatic gaps and soften indurated tissue, while patients love Caresia's
comfortable and breathable
materials and the simplicity that Caresia brings
to their therapy. Caresia is designed to replace all of
the under layers of
traditional bandaging, such as stockinet, gauze, and foam or cotton padding;
patients simply donn their Caresia and wrap over the top with short-stretch
bandages.
Other designs in the Caresia product line include the Foot,
Below Knee, Thigh, Glove, Gauntlet, and
MCPs to Axilla garments. The MCPs
to Axilla garment has also been recently redesigned to increase
comfort
based on user feedback. To learn more about Caresia and other Solaris products,
please
visit www.solarismed.com.
About Solaris
With over a decade
of manufacturing experience, Solaris has become a leader in nighttime
lymphedema management and is quickly developing a reputation in venous
edema and wound care
treatment. Solaris prides itself on its products,
customer service, and involvement in their local and
lymphedema
communities. For more information on Solaris, please visit
www.solarismed.com.
May 19, 2011
Breast Cancer Survivors Go Pink!
DC Find Meaning at the Dragon Boat Festival - Washingtonian.
com - By Debra
Bruno –
It’ll be hard to miss the breast-cancer survivors at Saturday’s
Dragon Boat Festival in Georgetown--
just look for the pink
Update (2
PM): The Dragon Boat Festival has been canceled this weekend due to high river
waters.
Organizers are working to plan a make-up date.
If you go
to the Washington DC Dragon Boat Festival in Georgetown on Saturday morning,
don’t be
surprised if you see lots of pink. Those pink-and-purple-clad
paddlers on the Potomac are breast-
cancer survivors.
“Breast cancer
made me think, ‘I gotta do something different in my life,’ ” says Brigid
Krizek, 63, a
breast-cancer survivor and dragon-boat paddler. “I had never
been an athlete, never been on a
sports team. But I called and went down
there, and I was hooked.”
The connection between breast-cancer survivors
and dragon-boat paddling started in 1996 with a
Canadian sports-medicine
physician named Don McKenzie, who wanted to do research on whether
lymphedema, the swelling that often results from surgery for breast cancer,
gets better or worse with
upper-body exercise. He formed a group, Abreast
in a Boat, and coached the women through
exercises and training. While his
research couldn’t quite prove that it helped with lymphedema, he did
determine that the swelling didn’t get worse. McKenzie had set in motion a
group of women who
suddenly had a positive way to deal with a breast-cancer
diagnosis.
Since then, interest in the sport has blossomed throughout
the world, and there are dragon-boat races
specifically for breast-cancer
survivors around the country. At the DC festival, which is in its tenth
year, five boats of breast-cancer survivors will join roughly 70 other
boats from around the world in
an event that combines Chinese folklore, a
competitive spirit, and a lot of colorful outfits.
Dragon boats are
long, narrow vessels with a dragon head on the front and a wooden tail in
back.
Paddlers face forward—don’t confuse them with rowers on crew
teams—and are guided by a
drummer who faces the paddlers and bangs a drum
to keep the rowing rhythm. Saturday’s race will
begin with a traditional
“eye-dotting ceremony,” in which the eyes in the dragon heads are painted.
The goal, say organizers, is to wake the sleeping dragon.
The
breast-cancer survivors will have their own ceremony: Those boats will raft out
together, the
paddlers will hold hands, a poem will be read, and every
paddler will throw a pink carnation into the
water in what participants
call a gesture of “hope and remembrance.”
But this is not all about
cancer, say members of Go Pink! DC, a local dragon-boat team made up of
breast-cancer survivors. Team member Mary McComb, 62, says, “When we’re
preparing and
practicing and competing, it’s not ‘Oh, you poor cancer
survivor,’ it’s ‘Oh, look what you can do
today that you couldn’t do four
weeks ago.’ ”
Jane Crawford, a Go Pink! DC board member and paddler,
says that the topic of cancer does come
up, “but it’s not something we
dwell on. It’s all about celebrating life and putting cancer behind
us.”
Leslie Caplan joined the group several years ago when she had just
finished chemotherapy and
radiation; she was nearly bald. What she
discovered was a sense of empowerment. “When you’ve
been a patient for a
long time and people are doing things to you, you don’t have a lot of control,”
she
says. “In a dragon boat, it’s all about what you can do, and that’s a
very freeing, liberating experience
for someone who has been in the
health-care system for a while.”
Being out on the water is another plus.
“If I could paddle seven days a week, I would,” says member
Diana
Dean.
“I’ve never been an athlete,” says Krizek, who now rows with a
coed team called the DC Dragons.
“And yet it’s Saturday morning and it’s
raining and we’re sitting out there in a boat. Every time I put
my paddle
in the water for the first time, I’m like, ‘This is so neat.’ ”
KEYWORD
NEWS – YAHOO! ALERTS FORMATTED DOCUMENT:
May 16, 2011
Lymphedema
takes toll emotionally, physically - Pittsburgh Post-Gazette - By Pohla Smith
–
Kim Marmarosa says she wishes she could have her body back, but she
knows that's not going to
happen.
Because of breast cancer, she had
a double mastectomy, removal of lymph nodes and radiation about
four years
ago. She wasn't a candidate for breast reconstruction, but she was a for
lymphedema, an
incurable but controllable condition marked by swelling.
Found usually in an arm or a leg, it's a
buildup of fluid caused by a
blockage in the lymphatic system.
A year after her cancer treatment, Ms.
Marmarosa, 49, who owns an insurance agency and lives in
Brighton Heights,
developed a less common variety of the condition called torso, or truncal,
lymphedema.
The swelling affects her "torso and back, basically, and
the arms are included. It's kind of
proportional," she said.
It also
has affected her emotionally and psychologically.
"It really plays havoc
with your body image, to want your body back, the body you're used to," Ms.
Marmarosa said. "For a woman, it's not the easiest thing to deal with. When
you end up in a different
body, it's hard; it's difficult. I think I'm less
social."
The lymph system, says Atilla Soran, the surgeon who serves as
director of UPMC's Lymphedema
Screening, Early Detection and Prevention
Program, is "the cleaning lady of the body."
Lymph is the name of the
fluid that circulates through the body via lymph vessels, picking up bacteria,
viruses and waste products to be filtered through the lymph nodes; the
fluid is then returned to the
bloodstream.
Either cancer, surgery,
radiation or infection in any area of the body near the lymph system can cause
the blockage that results in lymphedema. In Ms. Marmarosa's case, she said,
it's "chicken or the egg.
It's probably from the surgery and the radiation.
That's pretty much the thought of it."
There also are several inherited,
rarer types of lymphedema known as primary lymphedema, but, Dr.
Soran said,
the genes that cause them aren't yet known.
He said the highest
incidence of lymphedema in the United States, however, occurs in women who
have had breast cancer surgery with lymph node dissection and mostly
affects the arm. The rate of
occurrence is about 25 percent for those who
have had surgery; "radiation adds 5 to 10 percent
more," he said.
It
is treated by various methods collectively called "complete decongestive
therapy," says certified
lymphedema therapist Suzanne Cavanaugh. All of
them have to do with pushing the lymph fluid
through the system.
One
technique is manual lymph drainage, or massage; others include compression
bandaging,
compression garments and therapeutic exercises. Certified
lymphedema therapists can do the
massage and teach the patient how to do it
at home. There also are pumps, Dr. Soran said, in which
the patient puts
her limb and body in a garment, pushes a button and lets the machine do the
massaging.
Ms. Marmarosa recently got a machine called a Flexitouch,
which simulates the massaging drainage
technique. She spends one hour on it
twice a day.
Dr. Soran's clinic is designed to help women catch
lymphedema before it becomes a life-altering
complication. Using a machine
that measures extracellular fluid, he takes a baseline measurement
before
the breast cancer patient's surgery and again afterward. Yearly assessments
then are taken for
five years, and if there is any change in fluid volume,
treatment is started.
"If you can start the whole complement of
lymphatic treatment you may never get big swelling," he
said. "It won't
affect your social life, psychology or quality of life."
Dr. Soran said
the clinic sees about 1,200 breast cancer patients per year, 40 percent of whom
have
the presurgical assessment. The clinic was the first in the world to
perform the presurgery
measurements, he said, but New York Presbyterian
Hospital has recently started a similar program.
The first symptom of
lymphedema is a feeling that one arm is heavier than the other. "Then the
swelling starts, and if it's not treated, they get an arm infection and
also it gets hard, tough," he said.
"Then if it's not treated, it gets
bigger and bigger."
Ms. Marmarosa has only been using the Flexitouch for
several weeks, so it hasn't done much to
reduce her swelling. "But, I feel
better because the fluid is moving" through the lymphatic system, she
said.
Meanwhile, she also expects to feel better psychologically
when the Cancer Caring Center joins with
Allegheny Chesapeake Physical
Therapy to start a lymphedema social support group on May 24.
Free to
patients, friends, family and caregivers, it will be held at the Cancer Caring
Center, 4117
Liberty Ave., Bloomfield, from 6:30 to 7:30 p.m.
"I'm
really looking forward to [it]," Ms. Marmarosa said. "I think I'll find out I'm
not the only one and
find healthy ways of coping ... ways to better explain
it to people and my family, ideas I don't have
now."
Ms. Cavanaugh
will be the facilitator for the sessions, which also will be held at the Cancer
Caring
Center on June 28 and July 26.
"I've been treating the
[lymphedema] population almost 81/2 years; this is a group that really has no
support as of yet," Ms. Cavanaugh said. "Our goal is to bring the community
together and give
educational components, as well as a networking group for
those who are touched with lymphedema."
Until then, Ms. Marmarosa has a
message for other people with cancer-related lymphedema: "Just
don't give
up, and realize you're just as lovable in the body you're in.
"All of us
are grateful to be alive. Cancer costs all of us something. Sometimes you think
you paid the
ultimate price -- both breasts, things I can't get back. It
sneaks up on you like that. You think, 'I want
my body back.'
"
Reservations are necessary for the support group sessions
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 [email protected]
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
[email protected].
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 [email protected].
More
information about WeCanRow can be found here.
Amy
Laskowski can be reached at [email protected].
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
July 1, 2011
National
Alliance of Wound Care® Announces a New Advanced Certification in the Specialty
of
Lymphedema
Lower Extremity Management – RedOrbit –
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).
Glendale
WI (PRWEB) June 30, 2011
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.
For
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Antimicrobial
Prophylaxis in Adults - Dentistry IQ –
Antimicrobial
prophylaxis is commonly used by clinicians for the prevention of numerous
Infectious
diseases,
Including herpes simplex infection, rheumatic fever, recurrent cellulitis,
meningococcal
disease,
recurrent uncomplicated urinary tract infections in women, spontaneous
bacterial peritonitis
in
patients with cirrhosis, influenza, infective endocarditis, pertussis, and
acute necrotizing pancreatitis,
as
well as infections associated with open fractures, recent prosthetic joint
placement, and bite
wounds.
Perioperative antimicrobial prophylaxis is recommended for various surgical
procedures to
prevent
surgical site infections. Optimal antimicrobial agents for prophylaxis should
be bactericidal,
nontoxic,
inexpensive, and active against the typical pathogens that can cause surgical
site infection
postoperatively.
To maximize its effectiveness, intravenous perioperative prophylaxis should be
administered
within 30 to 60 minutes before the surgical incision. Antimicrobial prophylaxis
should be
of
short duration to decrease toxicity and antimicrobial resistance and to reduce
cost.
Mayo
Clin Proc. 2011;86(7):686-701
AAOS
= American Association of Orthopedic Surgeons; ADA = American Dental
Association;
ANP
= acute necrotizing pancreatitis; AP = antimicrobial prophylaxis; AUA =
American Urological
Association;
CP = chemoprophylaxis; FDA = US Food and Drug Administration; HlV = human
immunodeficiency
virus; IDSA = Infectious Diseases Society of America; IE = infective
endocarditis;
IS
= Information Statement; MRSA = methicillin-resistant Staphylococcus aureus;
PJl = prosthetic
Joint
Infection; PJR = prosthetic Joint replacement; RF = rheumatic fever; SBP =
spontaneous
bacterial
peritonitis; SCIP = Surgical Care Improvement Project; Tdap = tetanus toxoid,
reduced
diphtheria
toxoid, and acellular pertussis vaccine, adsorbed; UGI = upper
gastrointestinal; UTI =
urinary
tract infection
On
completion of this article, readers should be able to: (I) identify common
surgical and nonsurgical
indications
for the use of antimicrobial prophylaxis in adults, (2) formulate selected
surgical and
nonsurgical
antimicrobial prophylaxis regimens for adults, and (3) summarize the arguments
for and
against
the use of antimicrobial prophylaxis in adults.
Antimicrobial
prophylaxis (AP) can be used effectively to prevent infection, but its use
should be
limited
to specific, well-accepted indications to avoid excess cost, toxicity, and
antimicrobial
resistance.
Antimicrobial prophylaxis may be considered primary (prevention of an initial
infection) or
secondary
(prevention of the recurrence or reactivation of an infection), or it may also
be
administered
to prevent infection by eliminating a colonizing organism. This article reviews
widely
accepted
indications for AP in nonsurgical and surgical patients and is an update of a
previously
published
review of this topic.1 In selected situations, vaccination may be recommended
as part of a
prophylaxis
regimen. This article is meant to be a point-ofcare overview topic for the busy
clinician.
Many
of these recommendations are based on expert opinion rather than on prospective
clinical
trials.
Most of the recommended antimicrobial agents are not approved by the US Food
and Drug
Administration
(FDA) for prophylaxis. Current full prescribing information available in the
package
insert
of each drug should be consulted before prescribing any product. Detailed
information on
individual
topics can be found in the cited references.
The
potential risks and benefits of AP should be discussed in detail with the
patient. Potential risks
include
allergic reactions that may be severe or life-threatening as well as
Clostridium difficile colitis
with
the use of antibacterial agents.2 Patients taking fluoroquinolones should be
warned of the risk of
developing
tendinitis, including Achilles tendon rupture.3 For all antibiotic dosing
recommended in this
article,
normal hepatic and renal function are assumed.
NONSURGICAL
AP
RHEUMATIC
FEVER
Rheumatic
fever (RF), which is associated with tonsillopharyngitis caused by the group A
?-hemolytic
streptococci,
may result in carditis with or without valvulopathy. Primary prevention of RF
involves
prompt
and appropriate antibiotic treatment of group A ?-hemolytic streptococcal
pharyngitis with a
penicillin
(drug of choice) or alternative antibiotic.4 Continuous secondary AP prevents
recurrent
episodes
of RF, which could otherwise lead to worsening of the severity of rheumatic
heart disease
that
developed after the initial attack or the development of rheumatic carditis in
those who did not
develop
carditis with the initial RF episode. Guidelines for secondary AP of RF have
recently been
updated
(recommendations for AP regimens are summarized in Table I).4 Penicillins are
the
antibiotics
of choice for secondary prophylaxis for RF, and intramuscular penicillin is
superior to oral
penicillins.25
Macrolides (eg, erythromycin, clarithromycin, azithromycin) should be reserved
for
patients
who are allergic to both penicillin and sulfa antibiotics. The duration of
secondary prophylaxis
for
RF is reviewed in detail elsewhere and is summarized in Table 2.4 Physicians
should tailor the
duration
of secondary prophylaxis to the individual patient, taking into account the
patient's risk
factors
for RF recurrence, such as exposure to young children and the presence of
carditis with or
without
underlying valvular disease. Antimicrobial prophylaxis should be considered for
at least 10
years
or until age 40 years (whichever is longer) for patients with carditis with
persistent valvular
disease.
Prophylaxis should be continued in patients even after prosthetic valve
replacement surgery.
Antibiotic
suppression for the prevention of RF is not adequate for infective endocarditis
(IE)
prophylaxis
before dental procedures.
RECURRENT
CELLULITIS
Patients
with lymphedema or severe venous insufficiency of their extremities are at
increased risk of
recurring
?-streptococcal cellulitis. Common scenarios for recurrent cellulitis of the
lower extremity
include
patients with venous insufficiency after saphenous vein graft harvesting or
pelvic
lymphadenectomy.
Recurrent cellulitis has been observed in the upper extremity after
lymphadenectomy
performed at the time of mastectomy for breast cancer. Antimicrobial
prophylaxis
may
be a useful addition to the control of lymphedema with local measures and
treatment of
concurrent
tinea pedis in the prevention of recurrent cellulitis. However, this
recommendation is based
on
small, uncontrolled studies.26"28 Typically, more than 2 or 3 episodes per year
should occur
before
AP is initiated. Recommended prophylactic antibiotics for recurrent cellulitis
are summarized in
Table
1. Oral penicillin V (Phenoxymethylpenicillin) is a reasonable first choice,
but optimal dosing of
this
agent is not well established.5"7 Although monthly administration of 1.2 MU of
intramuscular
benzathine
penicillin is recommended as an alternative to oral penicillin V, this dosing
regimen was
shown
to be effective only in those patients not at risk of cellulitis recurrence.28
Some experts
recommend
intramuscular administration of benzathine penicillin every 2 to 3 weeks for
individuals
who
break through once-monthly intramuscular benzathine penicillin
regimens.5
Recurrent
pyogenic skin infections caused by Staphylococcus aureus, including
methicillin-resistant S
aureus
(MRSA), may be managed by encouraging good personal hygiene, the avoidance of
shared
personal
items, and the diligent cleaning of high-touch environmental surfaces. If a
patient is found to
be
colonized by S aureus , nasal decolonization with mupirocin for 5 to 10 days
with or without a
topical
body decolonization with a skin antiseptic solution such as 4% Chlorhexidine
for 5 to 14 days
may
be reasonable in an attempt to decolonize the patient.8 Antimicrobial
prophylaxis options are
listed
in Table 1 for recurrent methicillin-susceptible S aureus skin
infections.9,29Long-term oral AP
of
recurrent MRSA skin infections is not well studied, and formal recommendations
for this situation
were
not included in recently published MRSA treatment guidelines.8
MENINGOCOCCAL
DISEASE
Antimicrobial
prophylaxis for meningococcal diseases should be offered to close contacts of
sporadic
cases
of Neisseria meningitidis infection (Table 1). Close contacts include household
members, day
care
center staff, and any person directly exposed to an infected person's oral
secretions (for
example,
through kissing, mouth-to-mouth resuscitation, endotracheal intubation, or
endotracheal
tube
management).11 Public health authorities may recommend population-based
prophylaxis in the
event
of an outbreak. Prophylaxis should be offered as soon as possible. Close
contacts should be
offered
meningococcal vaccination if the outbreak strain is one that is contained in
the currently
available
meningococcal tetravalent conjugate vaccine.30
ASPLENIC
PATIENTS
Penicillin
prophylaxis is recommended in children during the first few years after
splenectomy to
prevent
overwhelming Streptococcus pneumoniae sepsis.31 French and American authorities
have
advocated
this form of prophylaxis (eg, 250 mg of oral penicillin V or amoxicillin twice
daily) in adults
for
1 to 2 years after splenectomy, although data showing the efficacy of this
approach are lacking.
3133
Haemophilus influenzae type B, meningococcal, and pneumococcal vaccinations
should be
current
in asplenic adults.
URINARY
TRACT INFECTION
Several
prophylactic antibiotic options are available to nonpregnant women with
recurrent (?3 per
year),
uncomplicated urinary tract infections (TJTIs)13 (Table 1). Continuous low-dose
AP and
patient-initiated
treatment after onset of symptoms are both effective.13?14 During AP, monthly
urine
cultures
should be performed to monitor for bacteriuria and the development of
antibiotic resistance.
34
Structural abnormality of the urinary tract, renal involvement with infection,
or chronic prostatitis
(in
men) should be considered in the setting of recurrent VTIs. Methenamine
hippurate (dosage, 1 g
twice
daily) has been approved by the FDA for UTI prophylaxis. A recent Cochrane
review
concluded that
methenamine hippurate may be effective for short-term prophylaxis (^l week) in
patients
without known renal tract abnormalities.35 The typical duration of an initial
trial of continuous
AP
is 6 months. Patients with prolonged exposure to nitrofurantoin should be
counseled about the
rare
but serious complications associated with this agent, including hepatitis,
pulmonary reactions, and
neuropathy.
Cranberries contain 2 substances that prevent fimbriated Escherichia coli from
adhering
to
uroepithelial cells.36 Clinical studies have shown that cranberry juice and
cranberry products may
reduce
the recurrence of UTIs in women. A recent Cochrane review noted limitations in
these
studies,
including variable cranberry products and dosing used in the various studies,
as well as high
study
participant dropout rates.37 Other patients who may be considered for
prophylaxis of frequent
UTIs
include pregnant women, persons with spinal cord injuries, persons with
neurogenic bladders,
renal
transplant recipients, and men with chronic bacterial prostatitis.13?34
Postcoital regimens may
be
appropriate for female patients with UTIs temporally related to sexual
intercourse.15?38 Patients
who
use postcoital regimens should be informed that only 1 dose per day is
recommended,
regardless
of the frequency of intercourse. Postcoital AP in pregnancy can be managed with
a single
dose
of either cephalexin (250 mg) or nitrofurantoin (50 mg).34 Tetracyclines and
fluoroquinolones
should
be avoided during pregnancy, and sulfonamides should be avoided during the last
weeks of
gestation
to minimize the risk of hyperbilirubinemia and kernicterus in the newborn.
Topical vaginal
estrogen
therapy has been shown to reduce the risk of recurrent UTIs in postmenopausal
women; it
may
be a consideration for postmenopausal women who are not receiving estrogen
replacement
therapy
and who have no contraindications to estrogen therapy.39
SPONTANEOUS
BACTERIAL PERITONITIS
Spontaneous
bacterial peritonitis (SBP) in patients with cirrhosis is associated with
increased
morbidity
and mortality. Aerobic gram-negative organisms and streptococci are the most
frequent
causes
of this infection. In a recent Cochrane review of 12 treatment trials,
empirical oral or
parenteral
antimicrobial treatment of patients with cirrhosis and upper gastrointestinal
(UGI) bleeding
reduced
the incidence of bacterial infections and was associated with shortened
hospital stays and
reduced
rates of overall mortality, mortality from bacterial infections, and
rebleeding.40 No one
antibiotic
regimen or route of administration was found to be superior. On the basis of
these data, 7
days
of empirical antibiotics are recommended for patients with ascites and UGI
bleeding16 (Table
1).
In prospective randomized clinical trials, primary prophylaxis in high-risk
patients and secondary
prophylaxis
after an initial episode of SBP have been shown to be effective in preventing
SBP.41"44
A
recent Cochrane review of 7 trials of empirical AP to prevent SBP in cirrhotic
patients with ascites
without
UGI bleeding revealed a pooled reduction in SBP and mortality but noted issues
with trial
methodology
and findings suggestive of systematic bias in publication and design.45 A 1998
analysis
concluded
that prophylaxis in high-risk patients (serum bilirubin level 2.5 mg/dL [to
convert to
umol/L,
multiply by 17.104]; ascitic fluid protein level, 1 g/dL) is cost-effective.46
The American
Association
for the Study of Liver Diseases has published guidelines that recommend
long-term daily
AP
for patients with previous SBP and for primary prophylaxis in those with an
ascitic fluid protein
level
of less than 1 .5 g/dL and at least 1 of the following criteria: a serum
creatinine level of 1.2
mg/dL
or higher (to convert to ?p???/L, multiply by 88.4), a blood urea nitrogen
level of 25 mg/dL or
higher
(to convert to mmol/L, multiply by 0.357), a serum sodium level of 130 mEq/L or
less (to
convert
to mmol/L, multiply by 1), or a Child-Pugh score of 9 points or higher with a
bilirubin level of
3
mg/dL or higher16 (Table 1). Before initiation of AP, SBP should be ruled out
in all patients with
ascites
at hospital admission and in cirrhotic patients with ascites with signs,
symptoms, or laboratory
abnormalities
suggestive of infection.16
ACUTE
NECROTIZING PANCREATITIS
Severe
pancreatitis with necrosis is associated with an overall mortality rate of 17%
and a mortality
rate
of 25% to 30% with infected necrosis. Debate is ongoing as to whether AP in the
setting of
acute
necrotizing pancreatitis (ANP) leads to improved outcomes (some consider the
use of
antibiotics
in this setting preemptive).47 A recent Cochrane database review of 7
randomized studies
concluded
that patients randomized to receive AP for ANP had no statistically significant
reduction in
infections.48
Recent practice guidelines published by the American College of
Gastroenterology do
not
recommend AP for ANP.49 If AP is initiated, a broadspectrum ?-lactam such as
imipenem-
cilastatin
is often recommended and should be limited to computed tomographydocumented
pancreatic
necrosis involving 30% or more of the pancreas for 14 days or less.50
BITE
WOUND INFECTION
Five
percent of dog bites and 30% of cat bites become secondarily infected because
these wounds
are
highly contaminated by microorganisms present in the oral cavity of these
animals. These
infections
can lead to septic arthritis, tenosynovitis, severe soft tissue infection, or
sepsis.51 The
microbiology
of dog and cat bite infections is typically polymicrobial and includes
Pasteurella species
as
the most common isolate, followed by staphylococci, streptococci, and
anaerobes.52 Although
AP
for animal bites remains controversial, a meta-analysis of 8 clinical trials by
Cummings53 found
that
AP significantly protects against subsequent wound infection. Antimicrobial
prophylaxis of a
contaminated
wound may be more accurately considered expectant therapy to prevent the
development
of a wound infection in a contaminated but not yet infected wound. No clinical
trials
have
shown superiority of one antibiotic regimen over another; choices should be
based on the likely
microbiology
of dog and cat bite infections.54 Antimicrobial prophylaxis for bite wounds has
recently
been
reviewed and should be offered to all patients who are thought to have an
increased risk of
infection17
(Table 1). High-risk situations include, but are not limited to, bites to body
areas where
deeper
structures (tendons and bones) can become easily injured, bites to the hand(s)
or close to a
bone
or joint, crush injuries, puncture wounds (difficult to clean), bites in which
treatment is delayed
more
than 8 to 10 hours, wounds requiring closure, bites in compromised persons
(diabetic patients,
persons
with no spleen, immunocompromised patients), bites in persons with indwelling
prosthetic
devices,
and all cat bites.17?18 Consideration for hospitalization and intravenous
antibiotics may be
reasonable
for patients in the setting of fever, sepsis, spread of cellulitis, significant
edema or crush
injury,
loss of function, compromised immunity, or patient nonadherence to treatment.19
All dog and
cat
bites should be appropriately irrigated and d?brided, and rabies prophylaxis
should be
administered,
if indicated. Delayed primary closure of heavily contaminated wounds should be
considered
to decrease the risk of wound infection.
Human
bite wounds, including clenched fist injuries, are considered to be at
high-risk of infection with
organisms
such as Streptococcus anginosus, S aureus, Eikenella corrodens, and anaerobes.
Recommended
AP is similar to that for animal bite wounds17?55 (Table 1). Patients who have
sustained
human bites should be assessed for human immunodeficiency virus (HTV) and
hepatitis B
infection
risk, and prophylaxis should be offered as indicated according to published
guidelines.
Tetanus
immune globulin and tetanus toxoid should be administered to patients who have
not been
immunized
or tetanus toxoid alone to any patient who has not received a tetanus booster
within the
past
5 years.
PERTUSSIS
Pertussis
(whooping cough), an upper respiratory tract infection caused by Bordetella
pertussis, is
associated
with prolonged bouts of coughing that may last 1 to 6 weeks. Numerous
pertussis
outbreaks
have occurred in the United States during the past 6 years among adolescents
and adults
as
immunity from childhood vaccination has waned. Because pertussis is spread by
aerosolized
respiratory
droplets, it is recommended that all household and other close contacts of
infected
patients
who did not use respiratory precautions while in contact with an infected
patient receive AP,
regardless
of age or immunization status20 (Table 1).
The
first tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis
vaccine, adsorbed (Tdap)
licensed
for adults was approved by the FDA in 2005 (ADACEL; Sanofi Pasteur; Swiftwater,
PA
[US
Headquarters]; Lyon, France [Global Headquarters]) as a single-dose booster
vaccine for
persons
aged 1 1 to 64 years to provide protection against tetanus, diphtheria, and
pertussis. Tdap
was
initially recommended to replace the next adult booster dose of tetanus- and
diphtheria-toxoid
vaccines
in patients whose last tetanus booster was 10 years or more earlier. The
interval between
the
most recent tetanus vaccination and Tdap for persons with contact with infants,
child care
providers, or
health care professionals with direct patient contact could be as short as 2
years or less.
56
Given the poor adult pertussis vaccine coverage (5.9% in 200857), and in the
setting of increasing
numbers
of pertussis cases in the United States (16,858 cases in 2009, including 14
infant deaths58),
the
Pertussis Vaccine Working Group of the Advisory Committee on Immunization
Practices59
recommends
the administration of a single Tdap (either ADACEL or BOOSTRTX
[GlaxoSmithKline
Biologicals;
Morrisville, NC]), when indicated, for any adult, at any interval since the
previous
tetanus-diphtheria
vaccination. A single Tdap should be considered for adults 65 years or older
who
have
or anticipate having close contact with an infant younger than 12 months as
well as for children
aged
7 through 10 years who are not fully vaccinated against pertussis. Tdap is not
licensed for
revaccination.
A provisional recommendation from the Advisory Committee on Immunization
Practices
(February 23, 2011) states that the data on the need for postexposure AP for
Tdap-
vaccinated
health care professionals are inconclusive.60 In view of this, Tdap-vaccinated
health care
professionals
may still be at risk of acquiring pertussis and should be considered for
chemoprophylaxis
(CP) after a significant pertussis exposure, particularly if they are likely to
be
exposed
to a patient at risk of severe pertussis, such as hospitalized neonates and
pregnant women.
INFECTIVE
ENDOCARDITIS
Infective
endocarditis is a relatively rare endocardial infection that can lead to
catastrophic
complications
and death. Guidelines for the prevention of LE have been published by the
American
Heart
Association for more than 50 years. The first 9 guidelines (1955-1997) were
based on low-
level
evidence; more recently, guidelines have been stratified according to the
lifetime risk of LE. The
recommendations
of the most recent (2007) guidelines reflected a new reticence about using AP
for
LE
based on the following premises: (1) cumulative bacteremia risk is much greater
with daily
activities
than dental procedures; (2) antibiotics do not eliminate bacteremia or clearly
reduce IE risk;
(3)
there are no prospective, placebo-controlled AP trials; and (4) even if 100%
effective, antibiotics
would
prevent only rare cases of TE.61 The 2007 AP guidelines for LE from the
American Heart
Association
and the Infectious Diseases Society of America (LDSA) recommend AP only for
patients
at highest risk of complications of LE (Table 3) and only for selected dental
procedures
(Table
4). Administration of prophylactic antibiotics is no longer stratified
according to lifetime LE
risk.
The antibiotics that are recommended for TE prophylaxis before dental
procedures are fisted in
Table
5. Patients receiving a penicillin for RF prophylaxis should not receive a
penicillin for LE dental
prophylaxis.
Prophylaxis
is no longer recommended for uncomplicated gastrointestinal bronchoscopy
without
incision
of the respiratory mucosa and for urinary procedures. If the urine is colonized
or infected
before
an elective cystoscopy, antibiotic therapy to eradicate the infection before
the urologie
manipulation
is recommended. If an urgent cystoscopy is to be performed in the setting of
colonized
or
infected urine, then an antibiotic with activity against enterococci should be
administered.
Ampicillin
or amoxicillin are the preferred agents in this setting; vancomycin should be
used in the
setting
of severe penicillin intolerance. Urinary tract colonization or infection with
enterococci known
or
suspected to be resistant (including those resistant to vancomycin) may require
a consultation with
an
infectious diseases expert.61
Although
many respiratory tract procedures reportedly cause bacteremia involving a wide
variety of
microorganisms,
no published data conclusively demonstrate a link between these procedures and
LE.
Antimicrobial prophylaxis (for regimens, see Table 5) is thought to be
reasonable for patients at
highest
risk of complications from LE (Table 3) who undergo invasive procedures of the
respiratory
tract
that involve incision or biopsy of the respiratory mucosa (eg, tonsillectomy,
adenoidectomy).
Patients
at highest risk of complications from TE who undergo an invasive respiratory
tract procedure
to treat an
established infection, such as drainage of an abscess or empyema, should
receive an
antibiotic
that is active against the viridans group streptococci. If an infection is
known or suspected
to
be caused by S aureus, the antibiotic regimen should contain an
antistaphylococcal penicillin or a
cephalosporin
for patients who are unable to tolerate a penicillin. Vancomycin should be used
in
those
in whom an infection is known or suspected to be caused by a
metWcilfin-resistant strain of S
aureus
or in those who have a history of a severe reaction to ?-lactam
antibiotics.61
PROSTHETIC
JOINT INFECTIONS
By
2030, an estimated 4 million total knee or hip arthroplasties will be performed
annually in the
United
States.62 Prosthetic joint infections (PJIs), which are rare but serious
complications of
prosthetic
joint replacements (PJRs), occur in 0.3% to 1.0% of patients after primary
total hip
replacement
and 1.0% to 2.0% of patients after primary total knee replacements, with the
greatest
risk
occurring during the first 2 postoperative years (6.5, 3.2, and 1.4 infections
per 1000 patient-
years
during the first year, second year, and after the second year,
respectively).63,64 These
infections
may be associated with devastating financial and personal consequences. Most
PJIs are
acquired
in the operating room as a result of colonization of the prosthesis at the time
of implantation
or
airborne contamination of the wound.63 Infection of a prosthesis via
hematogenous seeding is a
less
common cause of PJI. Among PJIs occurring via the hematogenous route, most are
the result of
S
aureus bacteremia, skin infections, or urosepsis.65"67 The development of a PJI
due to
hematogenous
seeding after dental procedures is thought to be a rare event. According to a
recent
literature
review, this occurred in 0.04% to 0.20% of reported PJR case series; many of
these
infections
were seen in patients with dental disease.68 Pins, plates, and screws not
within the synovial
joint
are not thought to be at increased risk of hematogenous seeding by
microorganisms. No studies
have
shown that AP before dental procedures prevents PJI.69 A recently published
prospective
case-control
study concluded that dental procedures were not risk factors for subsequent
total hip or
knee
infection. Additionally, the use of AP before dental procedures did not
decrease the risk of
subsequent
total hip or knee infection.70
Despite
the lack of data supporting AP before dental procedures, many surveys of health
care
professionals
have shown that a substantial number of them recommend AP before dental
procedures
in patients
with a PJR.71?72 Antimicrobial prophylaxis for patients with a prosthetic joint
undergoing
a
dental procedure or other invasive medical procedure has been controversial for
decades.67?71?
73"75
Consensus guidelines for this practice were initially published in 1997 and
affirmed in 2003 by
the
American Dental Association (ADA) and the American Association of Orthopedic
Surgeons
(AAOS)
on the basis of low-level evidence.69?76 It was proposed that AP be
administered before
dental
procedures thought most likely to be associated with bacteremia for patients
who were
considered
to be at highest risk of bacteremia-associated PJI. High-risk patients are
thought to
include
all patients during the first 2 years after joint replacement,
immunocompromised or
immunosuppressed
patients, patients with comorbid conditions (eg, diabetes, obesity, HTV
infection,
smoking),
and patients with inflammatory arthropathies (eg, rheumatoid arthritis),
systemic lupus
erythematosus,
medication- or radiation-induced immunosuppression, previous PJI,
malnourishment,
hemophilia,
HTV infection, insulin-dependent (type 1) diabetes, megaprosthesis, or
malignancy.
More
recently (February 2009), the Patient Safety Committee of the AAOS posted an
Information
Statement
(IS) advising that "clinicians consider antibiotic prophylaxis for... all total
joint replacement
patients
prior to any invasive procedure that may cause bacteremia."77 The ADA no longer
supports
the
2003 AAOS/ADA Guidelines and refers patients and health care professionals to
the AAOS IS
(Karen
London, American Dental Association, written communication, March 28, 201
1).77
Although
specific dental procedures that may cause bacteremia are not listed in the AAOS
IS, the
ADA
lists the dental procedures that may cause bacteremia in the AAOS/ ADA 2003
guidelines.76?
77
The antibiotics recommended in the AAOS IS to be administered to patients with
PJR before
dental
procedures include 2 g of oral cephalexin, cephradine, or amoxicillin 1 hour
before dental
procedures.
The AAOS IS makes no mention of parenteral antibiotic options or antibiotic
alternatives
for penicillin-allergic patients. The 2003 AAOS/ADA advisory statement
recommended
1
g of intravenous cefazolin or ampicillin as parenteral antibiotic alternatives
or 600 mg of clindamycin
(intravenous
or oral) for penicillin-allergic patients, to be administered 1 hour before the
dental
procedure;
in our opinion, these remain valid antibiotic alternatives.76
A
panel that included representatives from the ADA, AAOS, and LDSA was recently
convened with
the
goal of producing an evidence-based antimicrobial guideline for patients with
PJR before dental
procedures
(D.R.O. is a member of the working group). It is hoped that this will lead to a
simpler
consensus
guideline for patients and health care professionals. Good dental health before
and after
total
joint replacement and prompt treatment of active oral infection should be
encouraged for all
patients
with PJR.
Antimicrobial
prophylaxis in patients undergoing invasive gastrointestinal procedures is not
recommended
by the American Society of Colon and Rectal Surgeons78 or the American Society
for
Gastrointestinal Endoscopy.79 If clinicians elect to recommend AP for the
prevention of
hematogenous
PJI in these patients, they should discuss with them the possibility of
life-threatening
adverse
reactions (rare) and the more common drug toxicities. If used, antimicrobial
agents should be
chosen
on the basis of the expected flora at the site of the procedure.
The
American Urological Association (AUA) and the AAOS first published consensus-
and expert
opinion-based
AP guidelines in 2003 for patients with total joint replacement who were
undergoing
urologie
procedures.80 Antimicrobial prophylaxis is recommended for patients at
increased risk of
hematogenous
PJI who undergo urologie procedures associated with an increased risk of
bacteremia.
The
details of these recommendations can be found in the 2007 AUA Best Practice
Policy Statement
on
Urologie Surgery Antimicrobial Prophylaxis, which is available on the AUA Web
site.80?81 The
guidelines
assume that the urine is sterile preoperatively. If bacteriuria is present, it
should be treated
with
appropriate antibacterial agents before manipulation of the urinary
tract.
TRAVELERS'
DIARRHEA
Antibacterial
agents have been shown to decrease the risk of travelers' diarrhea by up to
84%.8284
Antimicrobial
agents are not routinely recommended for the prevention of travelers' diarrhea
because
antibiotic
self-treatment is so rapidly effective. The traveler may be instructed to carry
a supply of an
antibiotic
(often a 1- to 3-day course of a fluoroquinolone for travel to Central or South
America or
Africa
or of azithromycin when traveling to Asia or the Indian subcontinent) to be
taken on an as-
needed
basis.12 In certain circumstances (riskaverse travelers, athletes, persons
taking antacids, or
persons
with diabetes, an elevated gastric pH, or inflammatory bowel disease), a daily
oral antibiotic
regimen
may be considered on a short-term basis (ideally 2-3 weeks) to prevent
travelers' diarrhea.
Fluoroquinolones
may be less effective in areas with quinolone-resistant Campylobacter species
infections
(eg, India, Southeast Asia), so an agent such as azithromycin (250 mg once
daily) may be
considered,
although this has not been studied. In a 14-day study among travelers to
Mexico,
rifaxirnin
(200 mg 1-3 times daily) was 72% effective in preventing travelers' diarrhea.23
Bismuth
subsalicylate
prophylaxis (Pepto-Bismol [Proctor & Gamble; Cincinnati, OH]: two 262-mg
chewable
tablets
4 times daily, with meals and once in the evening) is less effective (62%-65%
effective) than
antibiotics,
is inconvenient to take, contains a salicylate (to be avoided if receiving
anticoagulant
therapy
or high-dose salicylates), causes a black tongue, and may interfere with the
absorption of
medications
such as doxycycline.12 Probiotics containing Lactobacillus GG or Saccharomyces
boulardii
are of limited efficacy (0%-60% effective) in the prevention of travelers'
diarrhea and
generally
are not recommended for this purpose.85,86
OPEN
FRACTURES
Open
fractures, particularly Gustilo grade 3 fractures, are at an increased risk of
infection.87 The key
to
infection avoidance of open class LTJ fractures is wound irrigation, surgical
debridement of
devitalized
tissue, and delayed wound closure. A recent Surgical Infection Society
Guideline
recommended
AP with a first-generation cephalosporin after open fracture until 24 to 48
hours after
wound
closure.88 Some groups recommend adding gram-negative coverage for class UI
open
fractures.89
HERPES
SIMPLEX VIRAL INFECTION
Frequent
recurrent genital herpes simplex viral infections (5-6 episodes per year) are
amenable to
prophylaxis
with continuous acyclovir (400 mg twice daily), famciclovir (250 mg twice
daily), or
valacyclovir
(500-1000 mg once daily).90?91 Famciclovir may be less effective for
suppression of
viral
shedding, and 500 mg of valacyclovir once daily might be less effective than
other valacyclovir
or
acyclovir dosing regimens in patients who have very frequent recurrences (ie,
?10 episodes per
year).91
Patients should be counseled regarding consistent condom use and avoidance of
sexual
activity
during recurrences in addition to suppressive antiviral therapy.
INFLUENZA
Chemoprophylaxis
of influenza A and B infection with a neuraminidase inhibitor (zanamivir
[inhaled]
or
oseltamivir [oral]) is 70% to 90% effective92?93 (Table 1). These agents are
particularly useful
for
prophylaxis after exposure in unvaccinated high-risk patients and unvaccinated
health care
professionals
in an outbreak setting in a medical institution or community. Chemoprophylaxis
is
recommended
for persons who are at high risk of influenza complications (Table 6) and those
who
are
hospitalized or have severe, complicated, or progressive illness.94 Lowrisk,
healthy persons who
are
not in contact with high-risk patients do not typically require CP. Adults for
whom antiviral CP
should be
considered during periods of increased influenza activity in the community are
listed in
Table
7. Zanamivir and oseltamivir are classified as category C (risk cannot be ruled
out) for use
during
pregnancy. Influenza CP should be considered as an adjunct to influenza
vaccination.
Chemoprophylaxis
should not be administered 48 hours before or 2 weeks after administration of
the
intranasal
live-attenuated FluMist influenza vaccine (Medlmmune, Gaithersburg, MD); CP has
no
effect
on the inactivated influenza vaccine.21 Chemoprophylaxis may be stopped 10 days
after
exposure
for household contacts and 7 days after other exposures.94 For control of
outbreaks in
long-term
care facilities and hospitals, the Centers for Disease Control and Prevention
recommends
CP
for a minimum of 2 weeks, even for vaccinated persons, up to 1 week after the
last known case
was
identified.22?94 In patients who are unable to receive influenza vaccination
and who are at high
risk
of complications, treatment should be continued for the duration of the
influenza season in the
community.
Oseltamivir- and zanamivir-resistant influenza A strains have been reported;
one should
monitor
the Centers for Disease Control and Prevention influenza Web site (http://
www.cdc.gov/flu)
for
seasonal updates. The adamantanes (amantadine and rimantadine) are active only
against influenza
A;
with the emergence of adamantane resistance in most seasonal A H3N2 and
pandemic 2009-
2010
A HlNl strains, these agents are no longer recommended for CP.
SURGICAL
AP
Surgical
site infections account for 14% to 18% of all health care infections and are
the third most
frequently
reported nosocomial infection.96?97 Factors that may increase the risk of
surgical site
infection
include those related to the patient (age, nutritional status, diabetes,
smoking status, obesity,
coexisting
infections at a remote site, colonization with a pathogenic microorganism,
altered immune
response,
and length of preoperative stay) and the operative procedure (duration of
surgical scrub,
skin
antisepsis, preoperative shaving, preoperative skin preparation, duration of
operation, AP,
operating
room ventilation, inadequate sterilization of instruments, foreign material at
the surgical site,
surgical
drains, and surgical technique).98 The risk of surgical site infection also
depends on whether
the
surgical procedure is clean, clean-contaminated, contaminated, or
dirty-infected based on
standard
definitions of these terms.98 Improvements in operating room ventilation,
sterilization
methods,
barriers, and surgical technique as well as the use of perioperative topical,
oral, and
intravenous
AP have been important in decreasing the incidence of surgical site
infection.98,99
Perioperative
antimicrobial surgical prophylaxis is recommended for operative procedures that
have a
high
rate of postoperative wound infection, when foreign material is implanted, or
when the wound
infection
rate is low but the development of a wound infection results in a disastrous
event.98100
Prophylactic
antimicrobial agents should be bactericidal, nontoxic, and inexpensive and have
in vitro
activity
against the common organisms that cause postoperative wound infection after a
specific
surgical
procedure. Consensus panels most often recommend cefazolin and other
cephalosporins
because
they meet the aforementioned criteria.98?100 Broad-spectrum antibiotics (eg,
ertapenem)
should
be avoided for surgical prophylaxis.100,101 Perioperative antimicrobial
surgical prophylaxis
regimens
for various surgical procedures adapted from the published recommendations of
2
consensus
panels are summarized in Table 8.99,100,102 The use of vancomycin for
prophylaxis is
appropriate
in the event of true type I hypersensitivity or other serious reaction to
penicillin or when
the
incidence of surgical site infection is high due to methicillin-resistant
staphylococci.132 Adherence
to
this practice will help to avoid the emergence of vancomycinresistant organisms
and vancomycin-
related
toxicity.133136 Prophylactic antimicrobial agents should be administered not
more than 30 to
60
minutes before surgery, including cesar?an sections.100?112?137?138 Exceptions
to this include
oral
administration of antimicrobial agents before colonic and urologie procedures
(Table 8).
Infusions
should be completed before the tourniquet is placed with orthopedic surgeries.
Vancomycin
and
fluoroquinolone infusions should be started 90 to 120 minutes before surgical
incision because
these
require at least 1 hour to infuse. Therapeutic concentrations of antimicrobial
agents should be
present
in the tissue throughout the period that the wound is open. Additional
antibiotic doses may
need
to be administered intraoperatively for prolonged procedures or with
antimicrobial agents with
short
half-lives.102?139 Initiating intravenous antimicrobial therapy before the
perioperative period
provides
no benefit. Prolonged postoperative AP should be discouraged because of the
possibility of
added
antimicrobial toxicity, selection of resistant organisms, and unnecessary
expense. The duration
of
AP for most procedures should not exceed 24 hours, with the exception of
cardiac surgeries, in
which
antibiotics may be continued for up to 48 hours.99?100?102?103?140 The duration
of
antibiotic
therapy for ophthalmic procedures has not been established. An advisory
statement for AP
in
dermatologie surgery has been published recently.141 The LDSA, American Society
of Health-
System
Pharmacists (ASHP), Society for Healthcare Epidemiology of America, and
Surgical
Infection
Society are currently in the process of revising the 1999 ASHP Antimicrobial
Prophylaxis in
Surgery
Guideline.99
In
2002, the Center for Medicaid and Medicare Services implemented a quality
initiative project,
currently
entitled the Surgical Care Improvement Project (SCLP), in an attempt to
decrease
postoperative
surgical site infections.140 As part of the SCLP, medical institutions are
being graded
on
3 surgical AP performance measures with cardiothoracic, vascular, colon,
hip/knee, and vaginal or
abdominal
hysterectomy surgeries: (1) the proportion of patients who have parenteral AP
initiated
within
1 hour before surgical incision, (2) the proportion of patients who are
provided an antibiotic
agent
that is consistent with currently published guidelines, and (3) the proportion
of patients whose
prophylactic
antibiotic is discontinued within 24 hours after the end of the operation (48
hours for
cardiothoracic
surgery). The most up-to-date list of approved antibiotics for various
surgeries is
posted
on the SCLP Web site.140
CONCLUSION
The
use of AP has led to the prevention of a large number and variety of infections
and to substantial
declines
in surgical site infections. Antimicrobial prophylaxis should be limited to
specific, well-
accepted
indications to avoid excess cost, toxicity, and antimicrobial resistance.
Patients should
understand
the potential risks and benefits of any AP regimen. Although some AP practices
are
evidence-based,
many are based on low-level evidence or expert opinion. More studies in the
area
of
AP are needed.
Mark
J. Enzler, MD; Elie Berbari, MD; and Douglas R. Osmon, MD, MPH
From
the Division of Infectious Diseases, Mayo Clinic, Rochester, MN.
Address
correspondence to Mark J. Enzler, MD, Division of Infectious Diseases, Mayo
Clinic, 200
First
St SW, Rochester, MN 55905 ([email protected]). Individual reprints of this
article and
a
bound reprint of the entire Symposium on Antimicrobial Therapy will be
available for purchase from
our
Web site www.mayoclinicproceedings.com.
©
2011 Mayo Foundation for Medical Education and Research
Copyright
2011 ProQuest Information and LearningAll Rights ReservedCopyright 2011 Mayo
Foundation
for Medical Education and Research
Mayo
Clinic Proceedings
July
2, 2011
Woman
Remains Hospitalized at LRMC - The Ledger – By CHASE PURDY –
LAKELAND
| A Lakeland woman opened her eyes this morning to the monotonous sight of
same
old
room.
Yvonne
Gallimore, after 46 days in Lakeland Regional Medical Center, will remain at
the hospital this
Fourth
of July weekend, her infection long healed and her anticipation
mounting.
Deemed
ready for release by doctors more than a month ago, the Lakeland woman said
she's waiting
for
a temporary home to become available before moving into a brand new house
scheduled for
construction
later this month. The new house will be tailored especially for her, using
$100,000 from
an
anonymous donor, said Claire Twomey, chief executive officer of Lakeland
Habitat for Humanity.
The
generous donation came after Gallimore pleaded to her community for help
following her
hospitalization.
A longtime sufferer of lymphedema, a disease that makes her lower body to
become
extremely
large, she was admitted to the facility May 19 for a leg infection. The
770-pound woman
said
rescue crews had to rip a wall from her home to remove her from the house,
which left her
homeless.
Sitting
in her hospital room last week, Gallimore said she's ready for the day she can
leave the
Lakeland
Hills Boulevard facility.
"I
tell you, I'm bored with it, because when I'm at home I can look at different
things and see my
grandchildren,"
Gallimore said. "I miss that, definitely miss that. Ain't no place like
home."
She
said being in the hospital for so long has her missing the mundane routines she
used to enjoy.
Twomey
said she anticipates Gallimore will remain in the hospital for five to six more
weeks, or until
temporary
housing can be arranged. Construction on the new house could take four to six
more
months,
she said.
Gallimore
said she did feel some relief last week when she learned the check from the
anonymous
donor
transferred successfully to Habitat for Humanity.
"There
is an end to this," Twomey said. "The place where we picked to build her a
house was the
place
where she was living. We're going to sit and talk with her about the
plans."
In
the meantime, Gallimore said she looks forward to visits by her family and
friends at the hospital.
[
Chase Purdy can be reached at [email protected] or 802-7516.
]
Early
Physiotherapy of the Arm After Breast Cancer Surgery Reduces Lymphedema
-
MedIndia
–
Present
statistics indicate that women with breast cancer have a 77% chances of
survival for at least
10
years; therefore it is important to effectively prevent and manage
complications after treatment of
the
cancer.
Any
node excision can lead to stasis of lymph in the area and it is no different
when it comes to breast
cancer
surgical treatment. The axillary lymph nodes drain from breast tissue and are
responsible for
spread
of the cancer to other parts of the body, hence their removal is indicated when
doing curative
surgery
in breast cancer. A randomized, single- blinded, clinical trial of women after
unilateral breast
cancer
surgery with axillary lymph node dissection was carried out at the Pr�ncipe de
Asturias
Hospital
in Madrid between May 2005 and June 2007 by Maria Torres et al and their
findings were
published
recently in British Medical Journal.
The
study strived to analyze the unaddressed needs of women, in whom symptoms and
signs indicate
the
presence of lymphoedema, post breast cancer treatment.
The
study tried to determine the efficacy of an early physiotherapy programme in
reducing the risk of
lymphoedema
in women after breast cancer surgery involving dissection of axillary lymph
nodes.
Subjects-
237 women with signs and symptoms of lymphoedema formed the subject of
study.
Women
without axillary lymph node dissection or with bilateral breast cancer,
systemic disease, loco-
regional
recurrence, or any contraindication to physiotherapy were excluded from the
study.
About
Lymphedema
An
acquired interruption or damage to the axillary lymphatic system after breast
cancer surgery, or
after
radiotherapy for breast cancer, may result in generalized or regional
accumulation of lymph fluid
in
the interstitial space. This condition, known as secondary lymphoedema, is the
most important
chronic
complication after axillary lymph node dissection. It has a tendency to
progress.
Secondary
lymphoedema can cause physical discomfort, disfigurement, and functional
impairment.
Other
factors seen in patients with secondary lymphoedema include anxiety,
depression, and
emotional
distress.
The
condition can badly undermine self esteem and can affect social relationships.
It can aggravate
cellulitis,
erysipelas, lymphangitis, and can occasionally cause lymphangiosarcoma ( a form
of cancer).
The
factors that influence secondary lymphoedema development after
surgery:
•
Number of lymph nodes removed
•
Radiotherapy to the axilla
•
Post -surgery wound infection,
•
Post-surgical drainage time
•
Lack of mobility,
•
Obesity.
The
incidence rates for secondary lymphoedema, ranges from 5% to 56%, two years
post- surgery.
Method
- Each subject was evaluated pre-operatively and also between days 3 and 5 after
hospital
discharge.
Equal numbers of participants were then randomly assigned to either:
•
The early physiotherapy and an educational strategy (early physiotherapy group)
or
•
The educational strategy only (control group).
The
incidence of secondary lymphedema was the main outcome.
Management/
Interventions - Early physiotherapy group and control group would receive the
same
educational
intervention.
a)
Early physiotherapy group - In this group, manual lymph drainage technique was
used to treat post-
operative
oedema. This group also did shoulder exercises and stretching in their homes,
once daily
during
the three -week intervention period.
b)
Educational strategy (both groups)- Here, printed materials with instructions
about the lymphatic
system,
concepts of normal load versus overload, the factors leading to secondary
lymphoedema,
identification
of potential precipitating factors, and the four categories of interventions to
prevent
secondary
lymphoedema were given to the patients.
Follow-up
- Four follow-up visits were to be carried out. They were four weeks three
months, six
months,
and 12 months after surgery. These dates were flexible, depending on the
availability of the
participant.
If patients experienced pain, discomfort, or any other symptoms a
physiotherapist was
asked
to visit them.
If
secondary lymphoedema developed, complex decongestive physiotherapy was carried
out on
those
patients.
Results
and Conclusion - Of 120 women studied, 60 were slotted in the early
physiotherapy and an
educational
strategy group and 60 to the educational strategy only group.
It
was discovered through the study that early physiotherapy along with an
educational strategy
helped
to lower the risk of secondary lymph edema in women post breast cancer surgery
involving
dissection
of axillary lymph nodes, in comparison to the educational strategy only
(control group).
Secondary
lymphoedema developed from six to 12 months post surgery. The authors suggest
that the
manual
lymph drainage after breast cancer surgery in the early physiotherapy group
could be one of
the
contributing factor towards better results in that group.
The
study concludes that early physiotherapy couldplay a role in preventing and
reducing secondary
lymphoedema
in post- breast cancer surgery patients involving dissection of axillary lymph
nodes, at
least
for one year following surgery.As for understanding its role long-term, more
work is required.
The
researchers also stress upon the positive role of physiotherapy in creating
awareness, prevention,
early
diagnosis, and management of secondary lymphoedema.
Source:
Priorities for women with lymphoedema after treatment for breast cancer:
population based
cohort
study; Maria Torres et al; BMJ 2010; 340:b5396
*
http://www.bmj.com/content/342/bmj.d3442
Source-Medindia
July
5, 2011
Hormone-blocking
drug reduces breast cancer risk - Nevada Appeal –
CHICAGO
(AP) — 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 suggested 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.
Still,
it could be a tough sell. These women have only about a 2 percent to 3 percent
risk, individually,
of
being diagnosed with breast cancer in the next five years. A prevention pill
that cuts that chance by
65
percent means they'll have about a 1 percent risk, said Dr. Eric Winer, breast
cancer chief at
Dana-Farber
Cancer Institute in Boston.
“Many
women are not willing to take a daily medicine” for such a small risk, he
said.
Brand-name
aromatase inhibitors cost $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.
Results
of the study were published online by the New England Journal of Medicine. The
Canadian
Cancer
Society, Pfizer 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.
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 received standard treatment with radiation to the breast, and half
also had radiation
in
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.
The
National Cancer Institute and Canadian Cancer Society paid for the
study.
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.
July
5, 2011
#78-
Take a Walk for a Cause - Patch.com –
Join
the National Walk for Lymphedema and Lymphatic Disease.
We're
frequently encouraged to walk for different causes, but not everyone
understands the
significance.
The
very act of walking, jogging or running around these tracks and arenas
certainly promotes a
healthy
lifestyle, but it also serves as a way to raise funds for those suffering from
various life-
threatening
ailments. Teams have already started registering for the Sept. 24 National walk
for
Lymphedema
and Lymphatic Diseases, so join a team, donate or register your own group at
the
National
Walk for Lymphedema and Lymphatic Diseases web site.
While
problems with the lymphatic system are related to a number of different
possible conditions,
some
of the diseases walkers help to fight against include cancer, arthritis,
systemic lupus and AIDs,
according
to the Lymphatic Research Foundation.
This
year's walk will take place at Eisenhower Park, and it will begin at the
Merrick Avenue
entrance.
Registration begins at 1 p.m., and the walk starts at 2 p.m. The distance of
the walk is three
miles
(5K), but the site cheerily states to complete whatever you are able to
accomplish. The walk
will be held
rain or shine, so get your rain boots and umbrellas ready in case drops decide
to fall.
Even
if you are unable to physically attend the walk, consider setting up a
Fundraising Page to show
your
support.
July
6, 2011
'Zumbathon'
benefits Ross Jewish Community Center's Wellness Club - Sun-Sentinel – |By
Shani
McManus
-
Latin
music blared from a loudspeaker. The music was so deafening that conversation
was
impossible,
but no one seemed to mind. They were there to dance — and sweat — to help make
a
difference.
"I
like to dance and I wanted to support a good cause," said Sara
Ingles.
Ingles
was one of more than 150 enthusiasts who turned out for the Ross Jewish
Community Center's
first
"Zumbathon" in Boynton Beach. The event was a fundraiser for the JCC's Pink
Ribbon Wellness
Club,
a program designed for cancer survivors and patients to add physical activity
to their lives.
The
program includes dieticians, social workers, healing touch therapists,
lymphedema specialists and
JCC
fitness professionals who design a program to improve the physical and
emotional condition of
those
dealing with breast cancer.
July
7, 2011
Hospital
purchases cancer center to give patients more comprehensive care - Carroll
County Times –
By
Alisha George –
When
Wendy Garver was diagnosed with Stage III breast cancer in 2003, she started
visiting Dr.
Flavio
Kruter.
"I'm
here today because of Dr. Kruter and my husband," Garver said during her yearly
exam with
Kruter
in Westminster Thursday.
Kruter
gave the Littlestown, Pa., resident a hug and asked about her summer plans and
how she
feels,
and Garver had only good things to report.
"Life
is good," said Garver, now cancer-free.
At
the start of the month, Carroll Hospital Center expanded its cancer services by
purchasing Carroll
Hematology
Oncology from US Oncology and renaming it the Carroll Regional Cancer Center.
The
center,
a separate building beside the hospital, has kept the majority of its staff
members and is set to
provide
a more holistic approach to serving patients.
"What's
exciting about this is now we can take cancer care to the next level," said the
hospital's Chief
Operating
Officer, Leslie Simmons.
Both
the hospital and center offer various cancer care services, but right now they
are fragmented,
she
said. Rather than a patient bouncing between the hospital, center and
specialists, the hospital
hopes
to expand and open a larger center where all cancer services can be packaged
together to
better
serve more patients.Garver said she utilized the hospital and center for cancer
treatments and
lymphedema
specialists in different locations in Carroll and Pennsylvania. Lymphedema is a
condition
that
resulted from her surgery after surgeons removed her arm's lymph nodes because
her cancer
spread.
Now, the hospital provides services for that condition.
She also
struggled with knowing where to find things such as a wig when she was going
through
chemotherapy.
But Garver likes the idea of having everything under one roof at the
center.
"I
think it's great because you'll have everything you need right there," she
said.
Some
additional services the hospital plans to add to the center include more
coordinated care,
remission
support and genetic testing, Simmons said.
"With
the hospital owning it, we can invest more in the growth of that center," she
said.
Simmons
said patients should not have to leave the community to receive cancer
care.
"With
the new name, we are trying to communicate that we want to branch out to not
only
Westminster,
but all of Carroll County and beyond," she said.
Kruter,
who will remain the center's medical director, said incorporating all the
services under one
roof
will be a significant benefit for patients. Now, the goal is to offer more
emotional and
psychological
support and specialized services.
The
center wishes to get input from groups like cancer coalitions to better
incorporate community
needs,
he said.
The
hospital is going to launch a major campaign to raise money for the new
comprehensive cancer
center.
The vision is to open the new center in two years, Kruter said.
Kruter
said the hospital and the center have always had a strong relationship and he
has always been
involved
with the hospital's cancer programs. It doesn't really matter what name is on
the door as
long
as patients are getting the best care possible, he said.
"If
this association can help me do a better job, then it's a good deal for
everyone," Kruter said.
Reach
staff writer Alisha George at 410-857-7876
[email protected].
Find
Promotions Galore and Discount Compression Stockings at - Online PR News
–
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Many
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Cancer
patients take part in restorative yoga - The Daily Advance – By Anna Goodwin
Mccarthy –
"Allow
your eyes to shut,” Tami Richards says to a group of cancer patients. “Quiet
your mind.”
Richards
commences the Restorative Yoga for Cancer Patients class in a dimly lit room at
the
Albemarle
Health Education Center on the first floor of the hospital. She places a chair
in front of
each
of the participants, elevating their legs into the seat.
Their
backs remain on their yoga mats on the carpeted floor, as their arms extend to
their sides,
fingertips
loosely dangling in a graceful position. Richards supports their head and neck
with soft
blankets,
asking each if they are comfortable and adding more blankets where they are
needed.
In
a relaxed, supported savasana pose, participants begin to experience the
benefits of the calming
atmosphere.
“Let
your inhalation be nice and full,” Richards says softly. “Connect with the
breath.”
Tension
lifted from their limbs, they start to breath easily. Holding each pose for 10
to 12 minutes is
essential
to gaining the maximum advantages of the yoga exercise, said
Richards.
At
the end of the allotted time for the pose, Richards says, “Take some nice long
healing breaths,
exhale
your tension and worries.”
She
advises the participants to slowly move their fingers and toes, open their eyes
and bring their legs
down
to floor when they are ready to begin the next exercise.
Richards
moves a long table with its legs folded so that it lays flat on the floor
beside each person.
“Sometimes
you need a lot of props,” to achieve the correct poses, said the yoga
instructor. She
helps
adjust each person’s body so a hip leans against the table as their torso and
head is twisted on
its
surface, supported by numerous blankets.
“Bring
lightness and healing energy into the body.” The supported twist pose is
helpful for “massaging
the
organs” within the body, Richards explains.
Richards
culminates the session with the supported modified inversion pose. The regular
class
attendees
begin to laugh with pleasant familiarity as they slide their mats against the
wall for what most
consider
their favorite pose.
With
their backs on the mat, they lift their legs against the wall. Richards places
a strap around each
person’s
legs to keep them together and supported.
In
her closing comments, Richards asks the participants to “notice how you feel
prior to the class and
now.”
Martha
Jackson, who was first diagnosed with cancer 32 years ago, said “My back feels
strengthened.”
The cancer survivor said several surgeries left her with scar tissue.
“I
feel better,” said Jackson after attending the class.
“It
is not hard to do,” said Alean Holden, referring to the yoga positions. Holden
who was diagnosed
with
cancer a couple of years ago said she feels “relaxed” after completing the
exercises.
Richards
provides individualized attention to each participant in the class. Helping
each person find
the
most support in every exercise is integral to a successful outcome. “Every pose
can be modified”
to
maintain the comfort of the participant.
After
receiving training in Los Angeles, Calif., Richards taught yoga classes for
almost a decade. A
physical
therapy assistant and certified lymphedema therapist at the hospital, Richards
realized her
knowledge
of yoga could help cancer patients.
She
began instructing the Restorative Yoga for Cancer Patients class at Albemarle
Health in April.
Decreasing
stress through the breathing exercises helps participants “get rejuvenated” and
“emotionally
heal.”
Specifically
tailored for cancer patients, the exercises produce “restorative poses to
stretch tissue and
get
motion back.” However, Richards said the free class is open to any person who
wants to
experience
the restorative effects of the exercises.
Richards
encouraged her mother, Marti Jones, to attend the class. Jones remarked on her
increased
“flexibility”
and limberness after just one session.
Yoga
assists people with having a “little more balance in life,” said Richards. “The
beauty of yoga is
the
benefit to psychological well being.”
Richards
recommends class participants practice the poses they have learned at home on a
daily
basis.
Energized
by the positive comments she has received from class participants, Richards
said many
people
have a “peaceful feeling at the end of class.”
Richards
smiles, remembering a totally relaxed person telling her at the end of the
instruction, “This is
so
wonderful. Do I have to get up now?”
While
some people arrive at the class with high stress levels, pain and anxiety, they
leave finally able
to
“exhale.”
The
Restorative Yoga Class for Cancer Patients is held the last Wednesday of each
month from 6:30
p.m.
to 7:30 p.m. at the Albemarle Health Education Center. For more information or
to register for
the
free class, call Tami Richards at 384-4632.
Anna
Goodwin Mccarthy is a correspondent for The Daily Advance
July
8, 2011
St.
Catharines, Ontario
In
the last week of June, 2011, St. Catharines based John Mulligan, a Registered
Massage Therapist
and
Certified Lymphedema Therapist, as well as Clinical Specialist for Lymphedema
Depot Ltd.,
spent
5 days at the Foldi Specialist Clinic for Lymphology, the European Centre for
Lymphology in
the
Black Forest of southern Germany.
The
training took place entirely in English as part of the Klose Training and
Consulting English
language
series of classes given annually at the Foldi Clinic.
The
classes consisted of lectures, hands-on demonstrations, case studies and manual
therapy and
bandaging
workshops. The students were also able to observe treatments given by members
of the
Foldi
Clinic therapist staff. “It was great to have the opportunity to observe such
skilled manual
therapists.
Each one of them has such a deep understanding of the lymphatic system, manual
lymph
drainage
and multi-layer lymphedema bandaging that it was a privilege to observe them as
they
worked,”
said Mulligan.
Physicians
at the Foldi Clinic also delivered in-depth lectures on lipedema, infections in
lymphedema
and
the relationship between chronic venous insufficiency and lymphedema.
Students
also had a chance to empathize with patients by experiencing the rigours of
multi-layer
lymphedema
bandaging.
“All
of the therapists that were attending as students bandaged each another one
morning and we
went
through our whole morning wearing our bandages. We even had to eat lunch while
wearing the
bandages.
It gave us a better insight into what lymphedema patients go through, even if
it was only a
small
taste of what they have to put up with” said Mulligan.
“The
Foldi Clinic in many ways represents the model for what a lymphedema facility
can be and what
lymphedema
treatment can be,” said Mulligan. “There are other similar clinics in Europe,
such as the
Wittlinger
Clinic and the Asdonk Clinics, but I feel a special kinship with the Foldi
Clinic. The
European
approach to lymphology has a lot to offer to North Americans, where lymphology
is an
obscure
and little understood field and patients have a hard time finding
treatment.”
“I
feel refreshed and inspired and ready to return to my own work in a renewed
frame of mind,”
Mulligan
stated. Mulligan is also involved the Canadian Lymphedema Framework as a member
of the
Education
Committee. In addition to his work with as in-house Clinical Specialist with
Lymphedema
Depot,
Mulligan also teaches classes in multi-layer lymphedema bandaging and manual
lymph
drainage.
He
can be contacted [email protected].
His
website is http://www.LymphedemaTherapist.com
The
Lymphedema Depot website is http://www.LymphedemaDepot.com
His
blog is at http://www.LymphedemaDepot.com/blog
July
11, 2011
Docs
discovering breast cancer earlier - Columbia Daily Herald –
A
new study may bring welcome news to many women diagnosed with early stage
breast cancer,
according
to John P.W. Brown, M.D., a surgeon on the medical staff at Maury Regional
Medical
Center.
With
improvements in technology such as digital mammography, Brown indicates that
clinicians are
able
to detect cancers in much earlier stages than in years past. Women diagnosed
with early stage
breast
cancer often choose breast conservation surgery known as a lumpectomy, local
removal of the
cancerous
mass and a margin of tissue surrounding the site. During the lumpectomy, the
sentinel
lymph
node — the first lymph node in the series of those located underneath the arm —
is removed
for
testing. The procedure is commonly referred to as a sentinel node biopsy and is
a key indicator to
determine
if the cancer has spread beyond the breast.
In
the past, any positive sentinel lymph node was followed by a complete removal
of all of the lymph
nodes
from under the arm, known as axillary dissection. The lymph nodes would then be
tested for
the
presence of cancer. This operation was associated with a significant risk of
arm lymphedema, a
condition
in which the arm retains fluid and the tissue swells as a result of the
compromised lymphatic
system.
A new clinical trial demonstrates that some women with two or fewer positive
sentinel lymph
nodes
do not need further lymph node removal, according to Brown.
“The
results of this long-awaited six-year clinical trial were presented at the
American Society of
Clinical
Oncology last summer. Many found the results surprising and practice-changing.
Women
who
are found to have only two or three minimally involved nodes at the time of the
sentinel node
biopsy
are no longer recommended to have the remaining lymph nodes removed,
eliminating the need
for
invasive surgery and greatly decreasing the side effect of lymphedema,” said
Brown.
Gardening
for health - Columbus Telegram – by Julie Blum –
COLUMBUS
- Gardening isn't just a hobby. For some, it is a way to better their
health.
That
is the idea behind the OT Garden Club.
Occupational
therapists from Columbus Community Hospital started the club last year with
the
opening
of the Columbus Community Garden. Two plots are used by occupational therapists
Megan
Freier
and Liz Gonka.
They
invite patients to garden, which can help them in their recovery.
"It's
kind of like free therapy," Gonka said.
Patients
like Wilda Buckle have been coming to the garden for several weeks, helping
with planting,
weeding
and harvesting vegetables. Buckle suffered a broken left wrist in a January
fall and has
incorporated
gardening into her therapy.
"Any
little thing you do helps," Buckle said of activity she has done to help her
wrist heal.
As
a natural right-hander, Buckle said it was easy to use her dominate hand for
most everything, but
in
order to get strength and movement back in her left wrist, she had to do
exercises to move the
process
along. She went to occupational therapy, but also found gardening
helped.
Gardening
is especially good for those recuperating from injuries like Buckle had, Freier
said.
"When
people have a hand injury, they are hesitant to do activities that involve
their hands. With
gardening,
you have to use your hands," Freier said.
A
variety of people have volunteered to work in the garden including stroke
victims and lymphedema
patients.
Special
tools that have been supplied by master gardeners are used by the patients. The
tools have
been
extended and adapted with ergonomically angled handles to keep the wrist in a
more natural
position.
Gonka
said the garden has been a great way to get patients to transition into daily
activities. She
hopes
in the future the hospital will have its own garden where patients could work
in raised beds,
which
could be utilized by those who are in wheelchairs.
Working
in the garden is optional and patients can volunteer as many hours as they
choose. This
year,
about five patients have regularly been tending to the plots. The garden has
become self-
sufficient.
Much of the vegetables grown last year were sold and some of the profits were
used to
purchase
seeds for this year's crops. The group also gave a donation of money from the
sale to the
Columbus
Area United Way.
The
OT Club isn't the only one from the hospital that has been taking advantage of
the Community
Garden.
Another plot is being used by Deb Moore, a registered dietitian. She hopes by
next year to
get
families, students or children involved in raising vegetables in order to learn
about healthy eating
and
fighting obesity.
Most
of those who have plots at the garden are couples and families. For some, like
Jenny Sylvester,
this
is her first experience growing vegetables.
Sylvester
is often at the site with her children, Jackson, 9, and Jaylynn, 5. As a first
time gardener, it
has
taken Sylvester some trial and error to get vegetables sprouting and producing,
but now she has
rows
of radishes, carrots, cucumbers, tomatoes and jalapeno peppers.
The
veggies that have been harvested have been shared with other family members
including her
husband's
uncle and grandmother. One of Sylvester's sisters is going to use the
vegetables to can
salsa
and spaghetti sauce.
Gina
Matson started gardening last year with her two boys, Alex and Erik. She said
gardening has
helped
save on her grocery bill. Matson is able to freeze some of the vegetables like
squash and use
long-lasting
potatoes throughout the fall and winter months instead of having to buy
more.
The
experience has also made her children, age 13 and 9, more apt to eating
vegetables.
"We
grew it so they want to try it. They have that ownership of growing it
themselves," she said.
As
members of 4-H, the kids have also used what they have grown in as entries in
the Platte County
Fair.
July
12, 2011
Methodist
opens one-of-a-kind triple negative breast cancer clinic - Your Houston News
–
For
a woman with no family history of cancer, 60-year-old Brenda Sorrells was
shocked to discover
that
a lump on her sternum was later diagnosed as triple negative breast cancer, a
rare form of cancer
that
can be highly aggressive and is only present in about 15 percent of breast
cancer patients.
Breast
cancer is usually diagnosed based on three common receptors known to help the
cancer
develop.
The cells in triple negative breast cancer do not express any of these
receptors, making
them
generally unresponsive to standard treatments.
This
type of cancer can be especially aggressive and there is a greater chance of
recurrence. To help
patients
with this particular type of cancer, The Methodist Cancer Center recently
opened a triple
negative
breast cancer clinic, the first of its kind in the nation. It is located at
6445 Main St., with
imaging
services at 2615 Southwest Freeway, Suite 110.
Patients
have access to services including genetic counseling, psychosocial support,
nutritional
counseling,
lymphedema management and even massage therapy, said Dr. Angel Rodriguez, the
clinic’
s
director and a breast medical oncologist. “This clinic focuses efforts on a
type of breast cancer that
is
very difficult to treat, giving women convenient access to these
services.”
Research
shows this highly aggressive form of cancer accounts for half of all breast
cancer deaths.
The
only method for treating it right now is chemotherapy, but current therapies
most effectively
target
only the three common receptors.
“The
support I have received from the entire Methodist team has given me the
confidence to get back
into
my daily routine and continue living my life,” said Sorrells, who recently
began participating in
clinical
trials in hopes of enhancing her treatment along with chemotherapy.
“We’re
always looking for better and more promising treatments that might increase our
chances of
finding
a cure,” Rodriguez said. Through clinical trials, patients have the opportunity
to explore other
options
that could be beneficial toward their treatment, he said.
For
information, call 713-790-2700 or visitwww.methodisthealth.com.
Young
Gymnast Tumbles on One Leg after Overcoming Cancer - KGO-AM –
NORTHFIELD,
Minn.) -- Adam Starr stepped into the Northfield Gymnastics Club last week; it
had
been two years since he last tumbled. Gymnastics skills aren't like riding a
bike.
Any
gymnast would be rusty after two years of no physical preparation. It takes
enhanced muscle
memory,
daily practice and sheer mental strength to convince the mind to
tumble.
It
takes courage for any gymnast to jump into the air and flip the human body
backward in unnatural
ways,
fully knowing the danger that waits on the ground if one small mistake is
made.
But
Starr's situation was different. This time he was attempting his first
gymnastics trick with only his
left
leg.
Starr
started gymnastics at the age of three and continued practicing as a teenager.
His mother, Leslie
Starr,
said he was always a "monkey" climbing around their home. His father, Garrett
Starr, said that
his
son was always an acrobat.
The
21-year-old senior at St. Olaf College in Northfield, Minn,. lost his leg to
cancer in 2009. Being
a
lifelong gymnast, captain of his high school track team and an All-American
diver, losing one a leg
was
devastating.
Starr
was born with a rare condition called Lymphedema, which causes swelling in
limbs. In this case,
Starr
always had swelling issues with his leg that would come and go, but he was
still able to compete
in
athletics.
During
his freshman year, Starr went to the doctor for swelling and a bruise on his
foot that would not
go
away. The doctor called him on Valentine's Day in his college dorm room and
told him he had a
form
of low-grade cancer, but it still required amputation of his leg.
The
doctor gave Starr two choices for his surgery: either to have his
below-the-knee amputation in
just
one month over spring break or to wait until his summer break. Starr chose to
go ahead and have
his
surgery over spring break -- a decision his parents agreed with, but they were
worried for their
son.
Once
the doctors did the surgery, they found that Starr actually had a very
aggressive and rapidly
growing
cancer that had spread -- stage four angiosarcoma, which has a very high
mortality rate.
His
mother said they were shocked by the news, but her multi-talented son, who is
also a guitarist,
kept
them grounded after the devastating diagnosis.
Two
days later, Starr went through another amputation, this time above the knee to
remove the
aggressive
cancer that had spread. He said it was odd to see where his leg should have
been after the
amputation.
Starr
took the spring semester off from college and for the next seven months he
endured a rigorous
schedule
of chemotherapy.
Starr
was fitted with a prosthetic leg and learned to walk with his new body. He said
the most difficult
part
was building up his endurance to walk long distances.
Starr
said one thing that pulled him through his cancer was his desire to become a
doctor. He is a pre-
med
student and will be applying to medical school after he graduates next year. He
is considering the
field
of physical medicine and rehabilitation after going through his
illness.
Starr
spent the last two years rehabilitating, and just last week he decided to go
back to the gym to
see
if he could still tumble.
Starr
walked into the gym with a couple of friends and a camera, with a goal in mind
of completing a
back
tuck.
To
Starr's surprise, he could still land a back tuck and began attempting other
gymnastics tricks that
were
also successful.
Starr
posted the tumbling video online for his family and friends to see. The video
became a viral
sensation
online with hundreds of thousands views. Messages came pouring into Starr's
inbox from all
over
the country, some from amputees who were inspired by what Starr could
do.
Starr
says his return to the gym serves as an affirmation that he can achieve his
goals and be
successful.
Copyright
2011 ABC News Radio
July
22, 2011
HBO's
Potential Anti-Cancer Effects on Breast Cancer Cells - MD News – By: James
Slaby, MD -
James
Slaby, MD, discusses hyperbaric oxygen therapy's (HBO's) effect on breast
cancer cells.
The
total metastatic load in the lung is reduced after HBO --— that’s one of the
most significant new
findings
from a 2007 study. Despite the misconception that HBO could actually have
cancer-
enhancing
effect, HBO is frequently administered to cancer patients.
In
the 2007 study, Haroon, Patel, and Al-Mehdi decided to evaluate the growth of
murine breast
cancer
cells in the lung after hyperbaric oxygen treatment in an experimental
metastasis assay. To do
this,
young nu/nu mice were injected intravenously with 3x 10(3) 4T1-GFP tumor cells
per g body
weight
followed by lung isolation, perfusion, and intact organ epifluorescence
microscopy 1 to 37
days
after injection. A group of animals (n=32) was exposed once daily for five days
a week to 45
minutes
of 2.8 ATA hyperbaric oxygen in a research animal chamber.
Control
animals (n=31) were not subjected to HBO, but received similar intravenous
administration
of
3x 10(3) 4T 1- GFP tumor cells. Single tumor cells and colonies were counted in
the subpleural
vessels
in areas of about 0.5 cm2 of lung surface [Haroon et al]. What Haroon et al
found was that
HBO
treatment did not lead to an increase in the number of the large colonies or
small colonies in the
lungs.
Instead, there was a significant reduction in the number of the large colonies
when observed at
varying
periods of the time after hyperbaric treatment.
Most
importantly, there was a significant decrease in large colony size in the HBO
group during all
periods
of observation. The results indicate that HBO is not prometastatic for breast
cancer cells,
but,
instead restricts the growth of large tumor cell colonies [Haroon et al]. One
of the most
significant
new findings from the study was that the total metastic load (the combined mass
of large
colonies,
small colonies, and the single cell colonies in the target organ) in the lung
is reduced after
HBO.
What’s more, HBO treatment did not lead to an increase in the combined number
of metastic
foci
in the lung. The load reduction was accomplished because the size of the
colonies was limited
states
Haroon et al.
Studies
reveal that there is no adverse effect of HBO on tumor growth. In fact, the
research suggests
that
HBO may have an anti-cancer effect with breast cancer cells. Use of HBO in
human breast
cancer
patients did not have any adverse effects in a recent long-term follow up study
and is even
considered
for treating lymphedema associated with breast cancer surgery.
These
findings represent good news for patients that have cancer and other issues
that would benefit
from
HBO therapy. In the past we were hesitant to use HBO on patients with cancer
for fear of
encouraging
tumor growth. Now, for example, a patient with breast cancer that needed
radiation
therapy
and developed soft tissues radiation neurosis would benefit from HBO therapy.
As a result,
her
healing ability after breast reconstruction would improve.
Dr.
James Slaby is a plastic surgeon specializing in wound care and a panel
physician at the Wound
Healing
& Hyperbaric Oxygen Center at Wooster Community Hospital
July
23, 2011
Cabrini
receives Komen grant - Alexandria Town Talk –
The
Christus St. Frances Cabrini Hospital's Cancer Center has received a grant from
the Northeast-
Central
Louisiana Affiliate of Susan G. Komen for the Cure to help the Breast Cancer
Rehabilitation
Program
provide free initial and ongoing lymphedema screenings for breast cancer
survivors.
The
grant also will help pay for bandages for those undergoing treatment for breast
cancer-related
lymphedema
and provide compression garments for breast cancer lymphedema
patients.
Cabrini's
group for breast cancer survivors, the Pink Ribbon Club, meets monthly on the
third
Thursday
of each month at 5:30 p.m. in the Women's Life Center.
July
24, 2011
Cuts
for a cause - Slidell Sentry News – By Erik Sanzenbach –
If
your hair is getting a little shaggy and unkempt, and you need a haircut, wait
about a week, and
then
go get a haircut that will not only make you look good again, but you will be
helping out a good
cause.
Kirsten
O’Shaughnessy and Rebecca Peters, owners of the Simply You Salon in Slidell
are
organizing
a unique fundraiser to help cancer victims.
If
you get your hair cut July 31 from 3 – 6 p.m. at the salon, all haircuts will
cost $10 and all the
money
will go to the Pink Hearts Funds. The Pink Heart Funds is a non-profit that
operates out of
Long
Beach, Miss., and they provide free wigs to adults and children who have lost
their hair due to
chemotherapy
or other medical causes. The organization also provides free breast prostheses
for
breast cancer
victims and free lymphedema sleeves.
Lymphedema
is a disease that affects a lot of breast cancer victims.
It
is the overproduction of lymph node fluid and causes arms, legs, hands and feet
to swell painfully.
The
sleeves help to keep the swelling down.
O’Shaughnessy
said that not only will they be raising money for The Pink Heart Funds, but
they will
also
be collecting hair for the wigs. If your hair is 8 inches or longer and you
want to donate it, O’
Shaughnessy
and her crew will cut your hair for free.
“We just want
to do a good thing and bring the community together,” O’Shaughnessy
said.
She
and Peters did a similar event last year. That was to help one of Peters’
cousins that had fallen
off
a horse and was in a coma. This year, the two stylists decided to expand their
generosity and raise
money
others.
O’Shaughnessy,
was raised in Slidell, and Peters is a Slidell transplant from Picayune,
Miss.
They
met six years ago when they were in school learning to be hair stylists. Since
then, they have
been
best friends and business partners. They bought the Simply You Salon last
December.
We
want this to be more than just a haircut,” O’Shaughnessy said. To that end, the
two women have
gotten
inflatable bounce house for the children that will be set up in the parking
lot. There will also be
face
painting There will also be live entertainment with DJ David Storm spinning the
tunes. There will
also
be a karaoke competition.
The
Simply Cakes Bakery next door to the salon will be serving up baked goodies and
there will also
be
cotton candy, nachos and hot dogs.
O’Shaughnessy
said she is still looking for other businesses to help out with prizes for
raffles, and she
said
she could always use as many volunteers as she can get to help out.
“We
want the whole community to come out, have fun, get a haircut and help out a
good cause,” she
said.
O’Shaughnessy
said that July 31 is a good time for the event because it is a week away from
school
opening.
“Come
get your back-to-school haircut and donate to a good cause,” she
said.
July
26, 2011
First-Class
Bariatric Surgical Care - MD News –
The
bariatric surgery program at Princeton Baptist Medical Center is one of a few
programs in the
state
accredited by the American College of Surgeons, verifying the high level of
services provided.
At
Princeton Baptist Medical Center, patients undergoing bariatric surgery benefit
from
comprehensive
care. A Bariatric Center of Excellence through the American College of
Surgeons,
Princeton
Baptist Medical Center has met and exceeded standards set forth to ensure
high-quality
care.
“To
receive certification as a Bariatric Center of Excellence, Princeton underwent
a retrospective
analysis
of cases spanning the last three years,” says John Mathews, D.M.D., M.D., FACS,
bariatric
surgeon
at Princeton Baptist Medical Center. “A site visit was also conducted by a
bariatric surgeon
who
inspected the operating rooms, emergency department and intensive care units,
and also
interviewed
members of the medical staff, including our bariatric surgical team and other
specialists.
The
American College of Surgeons sets benchmarks that facilities must meet, and we
surpassed each
of
the requirements.”
Enhancing
Quality of Life Through Bariatric Surgery
Patients
who undergo bariatric surgery experience significant improvements in quality of
life.
Treatment
of comorbidities, including high blood pressure, high cholesterol, lymphedema,
infertility,
degenerative
joint disease and diabetes, is also greatly enhanced.
“Management
of comorbidities associated with morbid obesity — defined as a body mass index
of
40
or higher — is one of the most common reasons that patients are referred for
bariatric surgery,”
says
Andrew DeWitt, M.D., FACS, bariatric and minimally invasive surgeon at
Princeton Baptist
Medical
Center. “However, patients also experience improvements in lifestyle, as things
that we take
for
granted — such as sitting in an airplane or tying your shoes — are a challenge
for this patient
demographic.
Following bariatric surgery, patients are able to care for themselves and
participate in
activities
without feeling restricted because of their weight.”
At
Princeton Baptist Medical Center, patients have access to laparoscopic
adjustable banding using
either
the Realize Band or LAP-BAND, laparoscopic roux-en-Y gastric bypass, and
laparoscopic
sleeve
gastrectomy. Utilizing various factors, including overall medical condition,
patient age, weight-
loss
goals and the presence of comorbidities, physicians work closely with patients
to help determine
the
option that will provide the best possible outcome.
Future
Growth
A
$60-million expansion is currently underway at Princeton Baptist Medical
Center. Bariatric
surgeons
and patients will benefit from this expansion through renovated operating rooms
that will
feature
the most up-to-date laparoscopic equipment. In the future, a physical center of
excellence, a
Bariatric
Care Center, is planned, and will provide physicians with a one-stop, dedicated
space
where
patients can undergo laboratory work, pre-admissions testing, psychiatric
evaluations,
nutritional
counseling and exercise therapy, as well as attend educational seminars,
perioperative and
postoperative
classes, a “back on track” recovery program for patients who have gained weight
back
postoperatively
and support group meetings — services that were always available through the
bariatric
surgery program but were previously held at various locations throughout the
hospital.
For
more information about the bariatric surgery program at Princeton Baptist
Medical Center, call
(205)
783-7991 or visit www.bhsala.com.
New
Continuing Education Video Courses from HomeCEUConnection.com – Benzinga
–
HomeCEUConnection.com
is excited to announce the release of two new Seminars on Demand
(video)
continuing education courses designed for rehabilitation professionals -
Sensory Impairments
Across
the Lifespan, by Heather Vasilopoulos, MT, OT/L, and Practical Applications of
Manual
Lymphatic
Therapy by Carmen Thompson, BS, LPTA, CMT, CLT.
Plano,
TX (PRWEB) July 26, 2011
HomeCEUConnection.com
is excited to announce the release of two new Seminars on Demand
(video)
continuing education courses designed for rehabilitation professionals -
Sensory Impairments
Across
the Lifespan, by Heather Vasilopoulos, MT, OT/L, and Practical Applications of
Manual
Lymphatic
Therapy by Carmen Thompson, BS, LPTA, CMT, CLT.
Both
of these continuing education courses use of demonstrative video, slides,
graphs, and other
visual
aids, in combination with professional lectures create a virtual classroom
setting. As fully-
interactive,
continuing education courses, the user has complete control of the course and
is able to
navigate
between various segments. As with all HomeCEUConnection.com continuing
education
courses,
"Sensory Impairments Across the Lifespan", and "Practical Applications of
Manual
Lymphatic
Therapy" both provide students with the opportunity to interact with the
author.
Sensory
Impairments Across the Lifespan
"Sensory
Impairments Across the Lifespan" is a two contact hour continuing education
course
available
to Physical Therapists, Physical Therapist Assistants, Occupational Therapists,
and
Occupational
Therapist Assistants. "Sensory Impairments across the Lifespan" focuses on
neurology,
etiology,
techniques, and clinical applications of sensory impairments.
Heather
Vasilopoulos, MS, OT/L, is a licensed Occupational Therapist with more than ten
years of
experience
specializing in dementia care. She is the CEO and founder of Vital Spark LLC,
an
occupational
therapy and life coaching company, where she provides therapy consulting
services and
clinical
education for health care practitioners on dementia care. She also works
clinically as an
Occupational
Therapist in Home Care and Sub Acute Rehab/Long-Term Care.
Practical
Applications of Manual Lymphatic Therapy
"Practical
Applications of Manual Lymphatic Therapy" is a four contact hour continuing
education
course
available to Physical Therapists, Physical Therapist Assistants, Occupational
Therapists,
Occupational
Therapist Assistants, and Athletic Trainers. "Practical Applications of Manual
Lymphatic
Therapy" focuses on the basic uses of manual lymphatic therapy.
Carmen
Thompson, BS, LPTA, CMT, CLT 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 sub-acute
care.
All
available Seminars-On-Demand online continuing education courses have been
approved by the
Athletic
Trainers' Board Of Certification (BOC) and 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
in applicable 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.
Specializing
in quality online continuing education courses, HomeCEUConnection.com offers
CEUs
for
physical therapists, occupational therapists, speech language pathologists,
athletic trainers and
certified
strength and conditioning specialists that are convenient, affordable and
user-friendly.
Advertorial-Living
with lymphedema ‑‑ understanding & managing your symptoms -
StarNewsOnline.com
– By Amanda Hromadka, DPT, CLT –
Did
you know the human body has one system that regulates immunity, digestion, and
the balance of
fluids
and proteins? The lymphatic system is complex, and serves a vital role in human
health,
circulating
lymph fluid, which is made up of proteins, fats and other cells, from the skin
to the blood
system.
The
lymphatic system requires healthy lymph nodes and vessels to function
efficiently. The most
common
lymphatic system disorder is called lymphedema. Lymphedema is the accumulation
of lymph
fluid
and most commonly shows up as swelling in the arms or legs, but it can also be
present in other
areas
of the body.
There
are two types of lymphedema: primary and secondary. Primary lymphedema means a
person is
born
with abnormal or missing lymph nodes. Secondary lymphedema is caused from
trauma or
surgically
removing lymph nodes. (ie: following surgery for breast or uterine cancer).
Either way,
typical
lymphedema symptoms can include: decreased flexibility in the affected arms or
legs,
increased
size of the arms or legs, prolonged infections, feelings of heaviness and/or
discomfort, and
possibly
malignancy.
While
there is currently no cure for lymphedema, physical therapy can greatly assist
with ideal
management.
Lymphedema can be treated through the use of Complete Decongestive Therapy
(CDT).CDT
has four components: skin care, manual lymphatic drainage (MLD), compression,
and
specifically
designed exercise programs.
For
skin care, it is important to protect the involved area of the body against any
signs of infection or
trauma.
Lotion is recommended to prevent any cracking of the skin that could eventually
lead to
infections.
MLD is the hands-on process of re-routing the lymph fluid from unhealthy to
healthy lymph
nodes.
This light and gentle massage technique has been proven to reduce the amount of
swelling,
decrease
discomfort, regenerate tissue, and improve venous conditions. MLD helps reduce
the size
of
the swollen area, and the compression garments help maintain the size of the
affected area.
Compression
garments can be ordered in a variety of different pressure amounts, sizes,
colors, and
textures.
These compression garments are to be worn during the day and during exercises.
Additional
methods
of compression may be recommended for nighttime wear. Exercise programs are
designed
for
each individual and can include movements to increase flexibility, strength,
stabilization,
endurance,
etc.
A
good CDT program of skin care, MLD, compression, and exercise helps manage
lymphedema.
Prevention
and early intervention are important parts of the success of managing
lymphedema. It is
recommended
to avoid extreme temperatures, infections, and/or trauma to the involved area
of the
body
to significantly decrease the risk for developing lymphedema
symptoms.
Physical
Therapy for Women offers Complete Decongestive Therapy (CDT) by Certified
Lymphedema
Therapists (CLT). If you, or someone you know, could benefit from lymphedema
management,
please call Physical Therapy for Women for more information.
Risk
for Melanoma in Kids Not Clear Cut - Skin and Allergy News Digital Network –
By:
SHARON
WORCESTER –
BOCA
RATON, FLA. – The risk factors for melanoma are well established in adults, as
is the well-
known
ABCD method for self-evaluation for the disease, but assessing risk and
recognizing
melanoma
in children are far less clear cut.
The
typical risk factors, such as a history of changing moles, white race, and sun
sensitivity, don't
seem
to apply in children to the degree they do in adults, and although the ABCDs
(asymmetry,
border
irregularity, color variations, diameter over 6 mm) have withstood the test of
time in adults, for
whom
they were developed, they don’t necessarily apply in children, Dr. Seth J.
Orlow said at the
meeting
of the Florida Society of Dermatology and Dermatologic Surgery.
The
relatively recent addition of an E to the ABCD method adds an element that is
applicable to
assessment
of suspected melanoma in children, noted Dr. Orlow, chair of dermatology and
the
Samuel
Weinberg professor of pediatric dermatology at New York University.
The
E stands for evolving, and it refers to any unexpected change in a mole. It is
the word
"unexpected"
that is important when it comes to moles in children, because in many cases –
such as
with
Spitz nevi – some change is normal, he noted.
Adding
to the challenge of predicting and diagnosing melanoma in children is the fact
that the disease
is
very rare in this population, he said.
Based
on information from the National Cancer Institute's Surveillance, Epidemiology
and End
Results
(SEER) Program database from 1973 to 2001, only 95 of 140,206 cases of melanoma
were
in
children under age 10 years. Compared with older children with melanoma, those
in this age group
who
had melanoma were more likely to be nonwhite; have metastatic disease; show
nodular
histology;
have primary tumors on the head, face, and neck; and have a history of other
cancer (J.
Clin.
Oncol. 2005;23:4735-41).
Among
the melanoma patients younger than 10 years old, survival was about 90%, which
was
comparable
to that in individuals aged 10-19 years and 20-24 years. Among those under age
20,
survival
was 100% if the melanoma was in situ, and 96%, 77%, and 57% if it was
localized, regional,
or
distant, respectively.
Dr.
Orlow noted that findings from other series over the years have also
underscored the rarity of
pediatric
melanomas: Children's Hospital of Boston reported only 23 cases over 36 years,
a
Montreal
hospital reported only 13 cases over 22 years, and Istituto Nazionale Tumor
reported only
33
cases over 25 years. Many of the cases included nodular or amelanotic disease,
reinforcing other
data
suggesting that children tend to have a different presentation than adults. For
example, studies
have
shown that about 20% of melanomas are nodular in adults, compared with 30%-40%
in
children,
and about 10%-20% of melanomas in adults are amelanotic, compared with about
30% in
children.
Dr.
Orlow noted that his own experience over 21 years underscores the rarity and
differences of
melanoma
in children, compared with adults.
He
has encountered only five authentic cases (excluding giant congenital
melanocytic nevi), including
one
that he said "made the most sense" because it involved a 12-year-old boy from
Chernobyl, the
site
of a 1986 large-scale explosion at a nuclear power plant in Ukraine. Radiation
levels at that site
remain
high to this day. The child had a lesion on his lower back and innumerable
dysplastic nevi. The
boy's
mother also had a history of melanoma as a child.
The
other cases included one involving a 12-year old Ashkenazic Jewish girl with a
less than 1-mm-
thick
lesion on her shoulder, one involving a 14-year-old Peruvian Indian girl with
deeply pigmented
skin
and a 1-mm-thick lesion on her fingertip, one involving a 15-year old
Ashkenazic/Sephardic boy
with
xeroderma pigmentosum C and two melanomas in situ, and one involving a
16-year-old
Jamaican
girl with very deeply pigmented skin who had an 8-mm-deep lesion on her
posterior thigh
and
who died of her disease within 3 months.
"I
think this list is typical in that it shows you that these are not people you
would necessarily predict
to
have a problem," he said.
Children
seem to differ from adults not only in terms of who gets melanoma, but also in
terms of how
they
develop the disease.
Molecular
alterations appear to differ in children, Dr. Orlow noted. While BRAF/NRAS
pathway
genetic
mutations are present in 50%-70% of adults with superficial spreading
melanomas, and
mutations
in the c-KIT gene are present in acral lentiginous and mucosal melanomas in
adults, in
children
melanomas appear to have an increased incidence of deletion of c-KIT as well as
mutations
in
the CDKN2A gene, according to one study (J. Invest. Dermatol.
2009;129:1759-68).
The
workup and treatment of children with pediatric melanoma are well established.
The prognostic
value
of sentinel lymph node biopsy – which is well established in adults – is also
believed to apply in
children.
There is no evidence regarding lymph node dissection in either adults or
children, although it
is
used frequently. Risks of lymph node dissection include infection and
lymphedema, he noted.
As
for treatment, adjuvant therapy includes high-dose interferon-alpha, which is
approved for use in
adults
but not children. It has been used in several case series in children. Risks
include fever,
malaise,
neutropenia, and abnormal liver function tests.
While
there remains a great deal to learn about melanoma in children, there are
several fallacies about
the
disease that dermatologists should know. The top five falacies, according to
Dr. Orlow, are:
•
Any new mole that appears suddenly in a child, or a mole that has grown over the
past 6 months,
should
prompt concern about melanoma just as it does in adults. Reality: The
appearance of new nevi
in
children is normal, and it is also normal for nevi to grow and evolve until
they reach their zenith.
•
Nevi on the scalp are particularly worrisome and should be removed because they
are difficult to
follow.
Reality: The scalp is a common site for nevi to arise in white children. Such
nevi will often
have
a targetlike appearance or resemble a fried egg. Many resolve by
adulthood.
•
All atypical/dysplastic nevi must be removed. Reality: Even in patients with the
highest risk, such as
those
with familial atypical mole melanoma syndrome, more than 50% of melanomas will
not have
any
evidence of a preexisting nevus.
•
If melanocytic cells are found in a sentinel lymph node biopsy, it must be
melanoma. Reality: Such
cells
can be found in the lymph nodes of children with Spitz nevi, atypical spitzoid
melanocytic
tumors,
and blue nevi.
•
We can prevent most prepubertal melanomas by applying our experience with
melanoma and
melanoma
risk in adults. Reality: Such melanomas are unusual both clinically and with
respect to the
patients
in whom they arise.
Dr.
Orlow had no disclosures relevant to his presentation.
'Hidden'
cancer cells not a factor in early-stage breast cancer survival rates –
EurekAlert – Contact:
Sandy
Van -
Study
reported in Journal of the American Medical Association
LOS
ANGELES (EMBARGOED UNTIL 3 P.M. CT ON TUESDAY, JULY 26, 2011) –A new
study
shows that removing lymph nodes due to the presence of occult, or microscopic,
cancer cells
found
in the sentinel lymph node – the one closest to the tumor -- has no impact on
survival outcomes
of
women with early-stage breast cancer. The principal investigator of the study
is Armando E.
Giuliano,
MD, of Cedars-Sinai, who already is renowned for his clinical expertise and for
his seminal
research
on lymph node removal in women with early-stage breast cancer.
The
latest study, conducted by the American College of Surgeons Oncology Group
(ACOSOG) and
supported
by the National Cancer Institute, was published in the July 27 issue of the
Journal of the
American
Medical Association. Giuliano is the executive vice chair of surgery for
surgical oncology
and
holds several leadership positions at Cedars-Sinai's Samuel Oschin
Comprehensive Cancer
Institute.
His
previous findings related to sentinel lymph node biopsy and cancer diagnosis
revolutionized the
accepted
approach to treating early-stage breast cancer. His groundbreaking research,
published
earlier
this year in the Journal of the American Medical Association, challenged the
commonly held
belief
that removing all lymph nodes– not just the sentinel nodes closest to the
tumors – was key to
improving
survival rates.
The
ACOSOG research showed the opposite: Survival outcomes were no different
between women
undergoing
total lymph node removal and those only having the sentinel lymph node removed.
This
finding
dramatically changed the surgical approach for these patients. Women now can be
spared the
pain
and side effects of comprehensive lymph node removal.
In
this new study, Giuliano and colleagues sought to determine whether there is an
association
between
patient survival rates and the presence of microscopic cancer cells that have
spread from an
early-stage
tumor to nearby lymph nodes.
Occult
metastases usually cannot be seen in routine pathological or clinical
examination. The tiny cells
were
detected with immunochemical staining of sentinel lymph nodes and bone marrow
specimens
from
patients with early-stage breast cancer.
Some
5,210 women with breast cancer enrolled in the American College of Surgeons
Oncology
Group
trial at 126 sites nationwide from May 1999 to May 2003. All subjects underwent
breast-
conserving
surgery and sentinel lymph node dissection.
"This
study shows that the presence of tiny sentinel lymph node metastases has no
bearing on survival
outcomes,"
said Giuliano, co-director of the Saul and Joyce Brandman Breast Center – a
Project of
the
Women's Guild.
According
to Giuliano, removing lymph nodes can cause complications such as lymphedema,
a
chronic
and often painful swelling in the arm that can be debilitating. "Treating the
patient doesn't end
with
stopping the cancer," he says. "We want to make sure we maximize the patient's
quality of life
even
after cancer treatment is completed."
Lymph
Node Test Doesnt Improve Breast Cancer Care, Study Finds - U.S. News &
World Report
–
By Maureen Salamon -
Tiny
cancer cells found in first node to which disease typically spreads did not
affect survival
TUESDAY,
July 26 (HealthDay News) -- A lymph node-sparing test hailed as revolutionary
for its
conservative
approach does not lead to longer survival times for women undergoing
lumpectomies
whose
early-stage breast cancer has spread microscopically, a large, new study
suggests.
Examining
the medical records of more than 5,200 patients who underwent
breast-conserving
surgery
for early, invasive breast cancer, researchers found that tiny cancer cells in
the sentinel lymph
node
-- the first node to which malignant cells are likely to spread from a primary
tumor -- detected
with
a diagnostic procedure called immunohistochemical (IHC) staining had no effect
on overall
survival.
The
biopsy procedure known as sentinel lymph node (SLN) dissection has been praised
for averting
the
removal of large numbers of armpit lymph nodes during breast cancer surgery,
which can lead to
a
painful buildup of fluid called lymphedema.
"I
think I'd have to say it was highly controversial whether these occult [hidden]
metastases would be
clinically
relevant," said study author Dr. Armando Giuliano, chief of surgical oncology
at Cedars-
Sinai
Medical Center in Los Angeles. "If it's not going to affect mortality, it
shouldn't affect treatment."
The
study is published in the July 27 issue of the Journal of the American Medical
Association.
The
observational study included data from women included in the American College
of Surgeons
Oncology
Group trial at 126 sites from May 1999 to May 2003, and all patients were
followed until
April
2010. Results were blinded to treating physicians to avoid the bias of
overtreatment, Giuliano
said.
At
a midpoint follow-up of 6.3 years, 435 women had died and 376 experienced
recurrence of their
cancer.
Based on IHC staining, five-year overall survival rates of those whose samples
tested positive
for
node involvement were 95.1 percent, compared to 95.7 percent for those whose
SLN biopsies
tested
negative. Corresponding five-year rates of disease-free survival were 90.4
percent and 92.2
percent,
respectively.
Giuliano
said the research, when adopted clinically, can save patients several hundred
dollars or more
in
unnecessary tests. Women with microscopic metastases in their SLNs can also be
spared from
certain
more aggressive treatments that were thought to increase their survival rates,
he said.
Dr.
Lora Weiselberg, chief of breast cancer service at the Monter Cancer Center of
North Shore-
LIJ
Health System in Lake Success, N.Y., said many physicians have questioned the
significance of
the
SLN biopsies evaluated in the study.
"In
certain cases . . . we would want to do them anyway, but otherwise I think this
is very strong
evidence,"
Weiselberg said. "I think more and more pathology laboratories are going to go
in that
direction
[of fewer tests] because adding another costly test, if it's not going to help
the patient, is
unnecessary."
More
information
The
U.S. National Cancer Institute has more on sentinel lymph node
biopsies.
Copyright
© 2011 HealthDay. All rights reserved.
July
27, 2011
Expert
Panel Issues Lymphedema White Paper: Calls for Early Detection and and
Intervention to
Reduce
Lymphedema Progression - PR Newswire (press release) –
Avon
Foundation for Women-sponsored white paper reports latest lymphedema clinical
advances
that
could benefit many of the 2.3 million U.S. breast cancer survivors
NEW
YORK, July 27, 2011 /PRNewswire-USNewswire/ -- An expert panel issued a white
paper
examining
new evidence that shows early detection and intervention hold the greatest
promise for
reducing
breast cancer-related lymphedema, which affects up to one-third of the 180,000
newly
diagnosed
breast cancer patients annually and 2.3 million breast cancer survivors in the
United States.
The
Avon Foundation for Women, in partnership with the Lymphatic Research
Foundation and the
National
Lymphedema Network, convened a group of leading scientists, clinicians and
advocates in
April
2011 to discuss recent advances in the early detection and early intervention
of upper extremity
lymphedema.
The expert panel produced several recommendations, which are shared in a white
paper
released today, Recent Advances in Breast Cancer-Related Lymphedema Detection
and
Treatment.
Breast
cancer-related lymphedema is a chronic, debilitating disorder following
surgery, chemotherapy
or
radiation therapy that causes limb swelling and chronic inflammation. According
to the white
paper,
monitoring for lymphedema onset in breast cancer patients is essential—and
medically
necessary—and
should include capturing baseline arm volume measurements prior to treatment
and
follow-up
measurements at regular intervals once breast cancer treatment is completed. By
the time
lymphedema
is visually detectable, it has already progressed to advanced stages. Regular
surveillance,
using tools such as perometry or bioimpedance spectroscopy (BIS), in the years
following
breast cancer treatment can reduce the development of irreversible lymphedema
and
improve
quality of life.
"Lymphedema
can have devastating physical and emotional consequences for breast cancer
survivors,"
said Marc Hurlbert, executive director of the Avon Foundation for Women Breast
Cancer
Crusade.
"The expert panel's recommendations for lymphedema care can dramatically change
the
lives
of breast cancer patients. Early detection of lymphedema can identify
sub-clinical lymphedema
at
a time when simple, cost-effective interventions can be used to prevent it from
evolving into
advanced
stages of lymphedema and reduce the condition's severity."
The
white paper recommends that breast cancer survivors be closely monitored for
the development
of
lymphedema and learn how to reduce their risk of developing the disorder, such
as by recognizing
the
physical triggers (e.g. cuts or burns on the fingers) that may transform the
disease from latent to
active
and by maintaining meticulous skin care hygiene and a healthy body weight.
Recent studies in
weight
lifting, exercise and weight loss also have demonstrated a benefit in
preventing lymphedema:
stretching,
aerobics and arm and leg weight lifting resulted in fewer flare-ups among
patients with
lymphedema
and reduced the chance of developing the condition among at-risk patients by
70%.
"The
Lymphatic Research Foundation (LRF) and our National Lymphatic Disease and
Lymphedema
Registry
(NLDLR) were pleased to partner with the Avon Foundation for Women in
co-sponsoring
this
important conference," said Jacqueline Reinhard, executive director of the
Lymphatic Research
Foundation.
"Publication of the resulting White Paper – Recent Advances in Breast
Cancer-Related
Lymphedema
Detection and Treatment – provides a much-needed resource for the many
patients
living
with lymphedema, as well as the researchers and treatment professionals
involved in this field."
At
the Avon Foundation symposium, the National Lymphedema Network (NLN) also
shared its
recent
position paper on lymphedema screening and treatment. The NLN's position paper
recommends
all breast cancer patients receive pre- and post-treatment measurements on both
arms,
as
well as consistent measurements throughout their treatment, and use
bioimpedance spectroscopy
(BIS)
or infrared perometry as alternatives to a tape measure. These precautions have
proven to
reduce
the occurrence of false negative and false positive results which could be
obtained by using a
tape
measure.
For
more information about lymphedema or to download Recent Advances in Breast
Cancer-
Related
Lymphedema Detection and Treatment or the National Lymphedema Network's recent
white
paper, please visit
www.avonfoundation.org/programs-and-events/lymphedema-information.
html.
Avon
Foundation for Women
The
Avon Foundation for Women, the world's largest corporate-affiliated
philanthropy focused on
issues
that matter most to women, was founded in 1955 to improve the lives of women.
Through
2010,
Avon global philanthropy has donated more than $800 million in more than 50
countries for
causes most
important to women. Today, Avon philanthropy focuses its funding on breast
cancer
research
and access to care through the Avon Breast Cancer Crusade, and efforts to
reduce
domestic
and gender violence through its Speak Out Against Domestic Violence program.
Avon also
responds
generously to provide support for relief and recovery efforts in times of major
natural
disasters
and emergencies.
Avon
Breast Cancer Crusade
Since
the Avon Breast Cancer Crusade launched in 1992, Avon breast cancer programs in
more
than
50 countries have raised almost $700 million for research and advancing access
to care,
regardless
of a person's ability to pay. The Avon Foundation for Women awards funding to
beneficiaries
ranging from leading cancer centers to community-based grassroots breast
health
programs
to support breast cancer research and access to care. In addition to receiving
generous
support
from Avon Products, Inc., and its sale of Avon "pink ribbon" products, the
Foundation raises
funds
through a variety of events, such as the U.S. Avon Walk for Breast Cancer
series, which is the
Foundation's
largest fund-raising source.
Available
Topic Expert(s): For information on the listed expert(s), click appropriate
link.
Marc
Hurlbert, Ph.D.
https://profnet.prnewswire.com/Subscriber/ExpertProfile.aspx?ei=95833
SOURCE
The Avon Foundation for Women
July
29, 2011
770
lb. Lakeland woman learns help is close by - WTSP 10 News – by Tammie Fields
–
Lakeland,
Florida - For a little more than two months, a hospital room has been home for
Yvonne
Gallimore.
She even celebrated her 52nd birthday in the hospital. Balloons and flowers
decorated her
room
Friday morning.
For
the past 17 years, Gallimore has battled a medical condition called Lymphedema.
It's caused by
a
blockage that allows fluids to build up in the body, causing excessive
swelling.
Gallimore
weighs 770 pounds.
After
a recent infection in her leg, she was transported to Lakeland Regional Medical
Center. While
the
infection was cleared up in about a week, she couldn't go home because her
Section 8 apartment
was
badly damaged during the process of removing her to get her to the
hospital.
Gallimore's
sister, Alnieta McKenzie, was moved to tears recently when she stumbled across
the
hospital's
website for Lakeland Regional Rehabilitation and Sports Medicine Clinic, which
is located
about
four miles away from the hospital. She says her family didn't know about the
clinic.
The
website shows it has therapists on staff specially trained in
Lymphedema.
With
tears streaming down her face, McKenzie says, "We've seen her get mistreated so
many times
because
of her size and people passing the buck like the doctor could have said, 'OK,
you have
Lymphedema.
Let's do something while you're here in the hospital. We don't have anything
else to
treat.'"
10
News spoke with Cindy Sternlicht, the director of Public Relations and
Marketing
Communications
for Lakeland Regional Medical Center. While privacy laws prohibit her from
talking
about
Gallimore's case, she explained how the clinic operates.
Sternlicht
says, "Lakeland Regional has an outpatient rehabilitation clinic. We do have
certified
Lymphedema
therapists."
But
she says patients have to be able to get to the facility on their own, which is
something that
Gallimore
can't do because she can't walk.
Sternlicht
adds, "You have to be able to get out of the vehicle, get into the facility,
and get yourself
onto
the patient bed."
McKenzie
says while they appreciate the care Gallimore has received at Lakeland Regional
Medical
Center,
they just can't understand why the inpatient hospital and the outpatient clinic
couldn't work
together
to offer some type of solution to help her sister.
McKenzie
broke down and put her hand over her eyes to cry and said, "Excuse me. I'm
sorry. It's
just
because we love her and we want what's best for her."
On
Friday evening, Gallimore was slated to be released from the hospital. She's
staying at a different
Section
8 apartment for now that is specially equipped so she can be transported inside
through two
french
doors.
Gallimore
has both Medicaid and Medicare and says her coverage for her hospital stay
ended on
July
11th. She says she doesn't know how much the hospital stay will cost.
Her housing
there is temporary, however, because an anonymous donor has volunteered to
build her
and
her family a free home that will accommodate her special needs.
Meanwhile,
Gallimore's family says neither her doctor nor her nurse practitioner have
written
Gallimore
an order that would allow her to seek treatment at the Lakeland Regional
Rehabilitation
and
Sports Medicine Clinic.
September 2, 2011
Healthy
Living: TruJoy promotes breast cancer education – YNN – by Web Staff
-
If
you were told your chance of getting cancer was 90% - what would do? How would
you change your
life?
Marcie Fraser shares one woman's inspirational story.
When
Trudie Kelly's mom lost the battle from both ovarian cancer and breast cancer,
genetically, she knew
the
odds were against her.
"I
carry the genetic mutation. I decided at that point and time to have a complete
hysterectomy so that would
alleviate
the ovarian risk," said Trudie Kelly, TruJoy Founder.
Two
years after her hysterectomy, she found a cancerous tumor in her left breast.
Trudie decided to have a
double
mastectomy.
"I
ended up had a routine MRI before the surgery and found I had it in my right
side also that didn't show up
in
the mammogram," said Trudie.
It's
been a year after surgery and treatment, her prognosis is excellent. After
experiencing cancer, Trudie
Kelly
was on a mission.
"Once
you have been through it, I knew what was missing, I knew the pieces that were
missing for women
and
that is what I wanted to address," said Trudie.
She
created TruJoy.Inc, an organization to hold breast cancer educational forums,
support, and a tool kit for
comfort.
"We
have included a reacher, a mastectomy pillow, a stress ball to alleviate any
kind of swelling that may
lead
to lymphedema down the road," said Trudie.
One
of TruJoy’s objectives is community education, targeting young women and
teaching them about the
risk
factors for breast cancer.
In
an effort to raise money for the tool kits and the education forums, a
motorcycle poker run is being held.
For
more information, visit www.trujoy.org.
September
4, 2011 –
Gene
Defect Predisposes People to Leukemia - Science Daily –
A
new genetic defect that predisposes people to acute myeloid leukemia and
myelodysplasia has been
discovered.
The mutations were found in the GATA2 gene. Among its several regulatory roles,
the gene acts
as
a master control during the transition of primitive blood-forming cells into
white blood cells.
The
researchers started by studying four unrelated families who, over generations,
have had several relatives
with
acute myeloid leukemia, a type of blood cancer. Their disease onset occurred
from the teens to the
early
40s. The course was rapid.
The
findings will be reported Sept. 4 in Nature Genetics. The results come from an
international
collaboration
of scientists and the participation of families from Australia, Canada, and the
United States.
In
collaboration with Dr. Hamish Scott and Dr. Richard J. D'Andrea at the Centre
for Cancer Biology,
University
of Australia, Adelaide, the U.S. portion of the study was conducted by Dr.
Marshall Horwitz,
University
of Washington (UW) professor of pathology. Horwitz practices genetic medicine
at UW Medical
Center
and the UW Center for Human Development and Disability, both in
Seattle.
The
genetic mutation was first discovered in a patient from central Washington. The
research participant had
been
successfully treated for leukemia in 1992 through a bone marrow transplant at
UW Medical Center. At
that
time, Horwitz decided to seek a possible genetic reason after learning his
patient had several family
members
with myelodysplastic syndrome, myeloid leukemia, and intractable mycobacteria
infections.
Myelodysplastic
syndrome is a difficulty in producing certain kinds of blood cells. The problem
originates in
the
bone marrow with a decline in the number and quality of blood-forming cells.
Patients often have severe
anemia and need
frequent blood transfusions. The disease generally worsens due to bone marrow
failure and
low
blood counts. About one- third of those with the syndrome soon develop acute
myeloid leukemia, in
which
abnormal white cells build up in the bone marrow and interfere with normal
blood production.
Horwitz's
Australian colleagues had described a family with a similarly inherited blood
disorder. Eighteen
years
later, after rifling through many candidate genes, the researchers on both
continents were relieved
finally
to have hit upon the mutated gene responsible for the leukemia that affect
these families. They have
gone
on to identify abnormal GATA2 genes in more than 20 families and
individuals.
"It's
likely that this inherited error is more common than we had thought," the
researchers noted. In some
families
with a GATA2 mutation, the over-riding concern has been leukemia, while others
suffer dangerous
infections
from bacteria, viruses and fungi because of a lack of white blood cells to
fight off germs.
The
lab of Dr. Dennis Hickstein, formerly of the UW School of Medicine and the
Puget Sound Veterans
Affairs
Health System and now at the National Institute of Health, in collaboration
with NIH colleague Dr.
Steven
Holland, associated the mutation with mycobacteria infections. Those results
were reported in
separate
study appearing in the journal Blood.
Activcare
Physical Therapy Announces Executive Drive Office Grand Opening On September 12
-
dBusinessNews
Triangle –
Triangle
- Activcare Physical Therapy, Raleigh NC’s premiere physical therapy practice,
has expanded
operations
to serve the community around Duke Raleigh Hospital with the opening of a new
clinic on
Executive
Drive.
RALEIGH,
NC: Brad Hancock, MPT, of Activcare Physical Therapy, is pleased to announce
the opening
of
their newest clinic at 3410 Executive Drive, Suite 205 in Raleigh, adjacent to
Duke Raleigh Hospital,
formerly
Raleigh Community Hospital. Opening day will be celebrated at the new clinic on
Monday,
September
12 with lunch from 11:30am to 2:00pm and wine and cheese at 5:00pm.
Visitors
will be able to tour the new facilities as well as meet the knowledgeable and
experienced therapists
at this state-of-the-art clinic. Services offered at this facility include: orthopedic therapy, sports related
injuries,
neck and back pain and injuries, pain management, neurological rehabilitation,
geriatrics, oncology-
related
and lymphedema therapy and cardiovascular conditioning therapy, as well as
balance and vestibular
dysfunctions.
“It is our
mission to not only provide the highest quality physical therapy services, but
to provide a friendly
and
supportive atmosphere to our patients,” said Hancock. “This patient-centric
approach helps ensure that
patients
will reach their goals through continued treatment, and it is the key to our
continued growth in the
Triangle
market.”
For
more information about Activcare Physical Therapy, visit www.activcarept.com or
call 919-786-7434.
About
Activcare Physical Therapy
Activcare
Physical Therapy, with convenient locations in Raleigh and Fayetteville, NC
provides physical
therapy
services with a strong emphasis on orthopedic injuries, geriatrics, women’s
health, neurological,
incontinence,
general conditioning/cardiovascular, balance and vestibular disorders, foot and
ankle
biomechanics,
spine treatments including cervical decompression therapy and oncology-related
and
lymphedema
therapies. Our quality therapy services provide continuity of health services
and positively
influence
their patient outcomes. Activcare provides patients from all walks of life with
world-class,
comprehensive
physical and occupational therapy services that improve function, encourage
independence,
and
enhance quality of life. For more information, visit www.activcarept.com or
call 919-786-7434.
Media
Contact:
Charlie
Caserta
Activcare
Physical Therapy
[email protected]
919-786-7434
www.activcarept.com
September
5, 2011
Swollen
ankles have several possible causes - The Detroit News – Dr. Paul Donohue
–
Dear
Dr. Donohue: I am a diabetic male, age 96, with many aches and pains but no
high blood pressure. I
have
low cholesterol and am in control of my diabetes. In the past few weeks, I've
noticed swelling of my
ankles and feet. I have been taking two water pills a day for it. I never use salt or eat salty foods. What can
you
suggest for me?
Dear
S.S.: That swelling is edema, and it has many causes. One is sitting for long
periods with the legs
dangling
down. With the legs in that position, gravity pulls fluid from the legs' blood
vessels. Treatment for
this
kind of edema consists in elevating the legs. Every hour, lie down for 10
minutes with pillows under your
legs
and feet so that they are above heart level. When sitting, squeeze the leg
muscles over and over. Muscle
contractions
stop the oozing of fluids from the blood vessels. And take a morning and
afternoon walk.
Elastic
hose can keep fluid in blood vessels and out of the surrounding
tissues.
Dilated
leg veins — varicose veins — promote edema. A clot in a leg vein is another
cause. That's usually
quite
painful, and you'd be aware that something is going on if you had a clot. Liver
ailments can lead to
edema.
The liver makes a blood protein, albumin, that keeps fluid in circulation. With
a low production of
this
protein, fluid leaks out of vessels. Kidney failure is another reason why edema
occurs. Medicines can
lead
to it.
The
booklet on edema and lymphedema explains this kind of swelling. Readers can
obtain a copy by writing:
Dr.
Donohue — No. 106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money
order (no
cash)
for $4.75 U.S./$6 Can. with the recipient's printed name and address.
Write
to Dr. Donohue at P.O. Box 536475, Orlando, FL 32853-6475.
Another
paper appearing Sept. 4 in Nature Genetics from a London group found similar
mutations of
GATA2
in leukemia patients with lymphedema and, in some cases, deafnesss. By blocking
the vessels that
drain
fluid from the body's tissues, lympedema causes swelling of the arms or
legs.
Ongoing
work in Seattle and Adelaide has identified a congenital syndrome associated
with developmental
delay
and a risk of myelodysplasia. This syndrome results from chromosomal loss of
GATA2 and adjacent
genes.
Comparable
GATA2 mutations also have been found in people with the more common,
non-inherited
leukemias.
Scientists
are trying to figure out why apparently similar gene mutations in GATA 2 cause
such assorted
health
problems. Also perplexing is how hard it has been to find genetic errors
underlying blood cancers,
compared with
other cancers.
"While
several genes have been discovered and linked to solid, malignant tumors such
as breast cancer in
families
susceptible to those types of cancer, so far very few inherited mutations have
been uncovered for
blood
cancers," Horwitz said.
Previously,
other scientists linked mutations in two other genes -- RUNX1 and CEBPA -- to
injerited forms
of
myelodysplastic syndrome and acute myeloid leukemia. These genes bind to DNA
and control the
copying
of information encoded in this molecule.
Keeping
this in mind, researchers looked for mutations in similar genes in families who
did not have the
RUNX1
and CEBPA mutations and who had no other explanations for their inherited blood
cancer. In so
doing,
the researchers identified the GATA2 mutations. They also observed that these
mutations relate to
loss
of function by making the gene unable to perform the molecular duties necessary
to manufacture healthy
white
blood cells.
According
to Horwitz, the GATA2 mutations in DNA occur adjacent to an amino acid mutated
in some
patients
with terminal chronic myeloid leukemia. This proximity suggests a common
pathway may be critical
for
several types of myeloid malignancies, he said.
People
at risk because of their pedigree eventually may obtain tests to detect this
genetic error before
symptoms
emerge. Learning that they have the gene mutation might help patients and their
doctors decide on
appropriate
follow-up for early diagnosis and treatment of problems that might
arise.
Additional
knowledge about how the GATA2 gene and its mutations operate may foster the
development of
new
therapeutic agents.
A
clinical trial under way in the United States may point to specific treatment
recommendations for persons
with
a GATA2 genetic mutation.
The
research for "Heritable GATA2 Mutations Associated with Familial
Myelodysplastic Syndrome and
Acute
Myeloid Leukemia," was supported by grants from the National Health and Medical
Research
Council
of Australia, a Dora Lush Postgraduate Award, Leukaemia Foundation of
Australia, the Cancer
Council
of South Australia, MedVet Pty Ltd., and the U.S. National Institutes of
Health.
The
researchers extend their gratitude to the families and individuals who
participated in this project.
Horwitz
has been invited to speak on the role of GATA2 in myelodysplastic syndromes at
a National
Institutes
of Health conference Sept. 7-8 in Bethesda, Md.
September
15, 2011
National
Walk For Lymphedema And Lymphatic Diseases – Garden City News –
As
Executive Director of the Lymphatic Research Foundation, Garden City resident
Jacqueline Reinhard
coordinated
the organization’s first walkathon last September at Belmont Lake State Park.
“It was a
resounding
success,” says Reinhard, “and the idea has clearly caught on with lymphatic
disease patients
around
the country. In the coming weeks the National Walk for Lymphedema and Lymphatic
Diseases will
take
place in Texas, New York, and Massachusetts!”
Founded
in 1998 by Roslyn resident Wendy Chaite, LRF has become a leader in patient
advocacy and a
primary
force behind advancements in lymphatic science worldwide. LRF’s advocacy
programs have been
effective
in gaining Congressional and National Institutes of Health (NIH) support for
lymphatic research at
the
National Institutes of Health and at major academic research centers, elevating
lymphatic diseases from
relative
obscurity to a position on par with other national health priorities. The
organization directly funds
cutting-edge
lymphatic research by funding Postdoctoral Research Fellowship Grants, a
National Lymphatic
Disease
Patient Registry and Tissue Bank, a peer-review biomedical journal in
lymphatics, and the first-ever
endowed
academic Professorship in Lymphatic Research and Medicine (Stanford University
Medical
School,
2008). Reinhard became the Foundation’s first executive director in July
2008.
The
New York Walk will be at Eisenhower Park in East Meadow on September 24th.
Registration begins
at
1:00 p.m. “I’m inviting all our Garden City neighbors to join this effort, said
Reinhard, “ . . . and promising
a
fun afternoon of live entertainment, refreshments, and the great feeling you
get in supporting an important
and
meaningful cause.” To learn more about the Walk, to register or donate, go to
www.walklrf.org.
The
Skin IQ™ Mattress Cover Does More to Lower Costs of Pressure Ulcers - Online PR
News (press
release)
–
With
the current economic climate, hospitals and long-term care facilities are
looking to find innovative ways
to
cut costs. Vascular PRN™ provides compression therapy equipment to treat
ulcers, deep vein
thrombosis,
and lymphedema, so they uniquely know the pressures that nurses, hospital
directors, and
nursing
home administrators are under to save money.
Online
PR News – 15-September-2011 –With the current economic climate, hospitals and
long-term care
facilities
are looking to find innovative ways to cut costs. It is not every day that new
products make their
way
into a patient’s room that cut down health care costs, workload, and the cost
of medical treatment.
“We
were floored when we found the Skin IQ™ Microclimate Manager,” said Vascular
PRN’s president
Greg
Grambor. “This KCI coverlet costs $6 a day versus low air loss mattresses that
usually cost our clients
$30
a day.”
Vascular
PRN™ provides compression therapy equipment to treat ulcers, deep vein
thrombosis, and
lymphedema,
so they uniquely know the pressures that nurses, hospital directors, and
nursing home
administrators
are under to save money. Every day they help specialists in long-term and
critical care centers
to
find the right products at the best value.
“Pressure
ulcers are a major cost and cause more treatment, regulatory fines, and the
potential for a lawsuit
in
health care settings every day,” said Grambor. “For KCI to address this big
need is huge to prevent and
manage
a patient’s skin breakdown and pressure ulcers.”
The
National Pressure Ulcer Advisory Panel says that, “Support surfaces are an
integral part of any plan of
care
for the prevention and treatment of pressure ulcers.” The Skin IQ™ waterproof
mattress cover
promotes
healing and addresses the variety of challenges an immobile person has. It
reduces moisture from
the
skin’s surface, reduces skin temperature while maintaining a patient’s comfort,
and has powerful odor
control
features. KCI’s case studies show that patients with stool incontinence, skin
breakdown, bariatric
concerns,
and associated issues can greatly benefit from using the Skin IQ™ within days
or a few weeks.
“The
Skin IQ™ is 30 percent better than the average healthcare facility mattress
cover,” said Grambor. “It
is
easy to use and fits over any pressure re-distribution mattress.”
The
Skin IQ™ pulls air down through the mattress cover and cools a patient’s
contact points while pulling
moisture
away. This is more effective than low air loss, which blows warmed room air up
through the
mattress.
A Skin IQ™ mattress cover prevents new pressure ulcers and better treats
existing ones, thus
helping
the health care field to lower their overall costs on the non-reimbursable,
"never events" of decubitus
ulcers.
To
learn more, visit www.vascularprn.com or call 800-886-4331. Vascular PRN’s
website at www.
vascularprn.com
is the go-to site for directors of nursing, nursing home administrators, and
medical
professionals
to find out more about the Skin IQ™ MCM and compression therapy. The site
spotlights
industry
news, frequently asked questions, and director of nursing and healthcare
jobs.
September
14, 2011
Pink
Ribbon Program at Avon Rec Center Friday, Saturday - Vail Daily News
–
AVON
— The Pink Ribbon Program is an exercise program designed specifically for
post-operative breast
cancer
survivors. Program founder and director of the Pink Ribbon Program, Doreen
Puglisi, became aware
of
the need as she herself was diagnosed with breast cancer. She used the Pink
Ribbon Program to regain
her
range of motion, as well as strength in her affected arm.
The
Avon Recreation Center will be hosting a two-day workshop on Friday and
Saturday for individuals
who
come in contact with breast cancer survivors through physical therapy,
occupational therapy, massage
therapy,
personal trainers, nurses, group exercise instructors, lymphedema treatment
specialists and spa
services
such as facials, manicures, etc. The goal of this interactive two-day course is
to provide the
participants
with a knowledge base that is essential to the successful evaluation of the
breast cancer survivor,
from
diagnosis to treatments, recovery, preventions of lymphedema and proper
exercise guidelines and
protocols.
Evidence based practice and integration of material from the areas of
functional exercise, shoulder
rehabilitation
and Pilates exercise will be the emphasis of the course sessions.
The
Pink Ribbon Program is offered on Friday starting from 2 to 8 p.m. and Saturday
from 9 a.m. to 3 p.m.
Workshop
cost is $425 per person, plus $35 for course materials. Space is still
available for this two day
workshop.
Visit www.pinkribbonprogram.com or call 888-445-3089.
September
12, 2011
Komen
QC Affiliate and Gilds's Club to hold educational symposium - Quad-Cities
Online –
Susan
G. Komen for the Cure-Quad Cities affiliate to hold 2nd annual educational
symposium
September
12th, 2011---DAVENPORT, IA—Breast cancer survivors and their supporters are
invited to
launch
breast cancer awareness month in the Quad Cities on October 1st at the 2nd
annual Educational
Symposium
sponsored by the Komen Quad Cities Affiliate and Gilda's Club Quad
Cities.
The
Symposium is an effort to connect survivors to others that share a common
journey and offer discussion
about
topics of interest to survivors, such as lymphedema and breast
reconstruction.
"We
hope that breast cancer survivors take advantage of this opportunity to learn
and heal," said event
organizer
Sheila Soltow. .
The
October 1st event runs from 8 a.m.-1:30 p.m. at the Isle of Capri in
Bettendorf, and includes a lunch
and
panel discussion about the pros and cons of breast reconstruction.
The
cost to attend the event is $15 for survivors and $20 for others. To register
for the Symposium, call
Mackenzie
Batterbee at 563-421-1905. Early registration is encouraged as space is
limited.
The
Susan G. Komen for the Cure-Quad Cities Affiliate was formed in 1999, after the
Komen Quad Cities
Race
for the Cure® began in 1990. Over the past 22 years, the Affiliate has raised
nearly $5 million in the
fight
against breast cancer. For more information on the Affiliate or the Komen Quad
Cities Race for the
Cure,
please visit www.komenquadcities.org
Once-Homeless
Lakeland Woman Awaits Construction of House - The Ledger – By Chase
Purdy
LAKELAND
| Echoing from another room in the house, Yvonne Gallimore's grandchildren
squealed with
delight.
After more than two months in the hospital, it's a sound to which she's still
getting accustomed.
Michael
Wilson | THE LEDGER
Cooped
up in Lakeland Regional Medical Center for longer than she liked, Gallimore
smiled from the
bedroom
of her temporary home in North Lakeland. She pointed to her view of the
backyard.
In
June, an anonymous donor stepped forward with an offer to build Gallimore a new
house. She recently
looked
over the blueprints, she said, but continues to wait for Habitat for Humanity
construction crews to
break
ground.
"There's
no place like home," she said. "There's no place like home."
For
more than a decade she's suffered from a severe case of lymphedema, a condition
that led to an
infection
that left her hospitalized in May. Her medical issues left her weight at about
750 pounds.
On
May 19, medical crews were forced to tear through a wall of her apartment so
she could be transported
to
the hospital. An infection in one of her legs needed immediate medical
treatment, she said.
But
that left her homeless, necessitating a longer stay at LRMC.
"I
was miserable because I didn't have anywhere to go," she said. "It was a
situation that I had no say-so
about."
Lymphedema,
a condition that can be controlled but not cured, creates blockage that
prevents bodily fluids
from
draining well. As a result, Gallimore's legs swelled significantly, preventing
her from moving freely.
With
her weight, Gallimore still cannot move from room to room in her home. Claire
Twomey, the chief
executive
officer of Lakeland Habitat for Humanity, said the new home will be designed to
offer plenty of
room
for mobility.
September
9, 2011
Coping
with breast cancer pain - Baltimore Sun –
This
has passed on Septbember 13 sorry
September
6, 2011
Mammography:
More is not necessarily better - Kansas.com – By Abigail Trafford
Mom
— what are you talking about?" My friend was on a family vacation when her
mother mentioned she
had
to get her annual mammogram. My friend continued: "You don't need a mammogram!
You're 88!"
Her
mother gave her a withering look: "What? I'm so old at 88, you want me to die
of breast cancer?"
So
ingrained is the annual mammogram habit in this country that any challenge to
it is met with a combination
of
scorn and outrage.
We
belong to the pink ribbon sisterhood that worked hard to strike down the stigma
of breast cancer and
get
better care. We walk for the cure. We lobby Congress for research funds. We
demand coverage of
screening,
including high-tech digital mammography. In the past 20 years, deaths from
breast cancer have
gone
down by about 30 percent.
But
what role has screening played in this decline?
At
a forum in March at the Harvard School of Public Health in Boston, physicians
and policy officials
debated
the question "Mammograms: Who in the world are they good for?"
Mette
Kalager, a surgeon at Oslo University Hospital and a visiting scientist at the
Harvard School of Public
Health,
told the forum about a study she had led in Norway.
The
researchers looked at the records of 40,075 women who received diagnoses of
breast cancer between
1986
and 2005. Some had been screened every two years. Others had not been screened;
their cancers
had
been detected by physical examination. Both groups were treated by teams of
specialists. Over the 20-
year
period of the study, both groups saw a decline in death rates from the
disease.
By
comparing the groups, researchers determined that only about a third of this
decline was due to
screening.
Most of it was due to state-of-the art treatment and comprehensive care.
Previous studies had
suggested
a greater impact from screening, and the study, published in the New England
Journal of
Medicine,
caused a stir in the breast cancer community.
A
little history is in order.
When
mammography screening got under way in the United States 40 years ago, it put
breast cancer on the
public
agenda. Catch-it-early-when-it's-curable became a mantra of hope. Since then,
treatments have
improved,
and the understanding of breast cancer has changed. Perhaps more important than
the timing of
detection
is the biology of the cells.
"There
are some very tiny cancers that are just bad biology and are destined to
relapse, no matter how early
you
find them," Julie Gralow, a professor of oncology at the University of
Washington Medical School, told
the
Harvard forum.
And
some cancers don't progress even when they are found late.
"I've
had patients who have had very aggressive, large cancers, which, for one reason
or another, they have
ignored,"
continued Gralow. "And still years later, it never spreads. It doesn't come
back. . . . We're
struggling
to understand the biology."
Diagnosing
a cancer early often leads to more-conservative treatment (such as lumpectomy
instead of
mastectomy),
a great advantage to patients. But the annual mammogram may not be as important
as it once
was
in stemming the death toll.
"The
evidence seems to be that mammography screening plays less and less of a role
in reducing mortality in
countries
of the Western world," Kalager said.
That
may be true for older women in particular. In Europe, mammography screening is
recommended only
for
women ages 50 to 69. Yet when Kalager and her colleagues studied breast cancer
patients ages 70 to
84,
they saw a reduction in mortality that "was largely the same" as in younger
women who were screened.
The
key for both groups was access to good care.
But
Felicia Knaul, director of the Harvard Global Equity Initiative, offered a
different view: "I was diagnosed
with
a breast cancer 3 1/2 years ago in my first baseline mammogram at age 41," she
said. "If anything saved
my
life, in addition to expert care, it is that mammogram."
The
room went quiet. How to resolve the experience of Knaul with the findings of a
study based on more
than
40,000 women? Furthermore, as Knaul pointed out, many women, especially in
developing countries,
do
not have access to the state-of-the art care.
Such
is the conundrum for policymakers in setting health guidelines: Personal
anecdote often clashes with
wider
research. But screening policies should be based on evidence from large-scale
population studies: the
greatest
good for the greatest number.
The
United States has the most expansive mammography screening standards in the
world, starting at age
40
and continuing every year. But more is not necessarily better in health
care.
Wide-net
screening can cause harm, leading to over-detection, over-diagnosis and
unnecessary treatment,
according
to Kalager and other researchers. Once a woman has a suspicious mammogram, she
gets on a
medical
train and can't get off until the doctor-conductor gives the all-clear
signal.
Often
that requires just a repeat test. But some women are treated for cancers that
are not invasive or are
too
slow-growing to endanger their health. They undergo surgery or drugs or
radiation with side effects such
as
blood clots, breathing problems, lymphedema and high blood pressure.
"I
don't know how to weigh the over-detection piece," said Gralow. "We clearly
have to sort that one out."
Yes,
there's a lot of sorting out to do. My friend's mother, who believed in annual
screening, obviously
managed
her health pretty well. She never got breast cancer and lived to age 94. But my
friend was also
right:
Research is on her side.
More
coverage
Today's
story is the first in a series dealing with breast cancer. Find more in next
week's Healthy Living.
If
you go
2011
Komen Wichita Race for the Cure
What:
More than 10,000 people are expected to participate in the local benefit for
Susan G. Komen.
When:
Sept. 24. Registration begins at 6:45 a.m., followed later in the morning by
activities, including a
breakfast
and celebration for survivors. The competitive timed 5K is at 8 a.m., and the
non-competitive 5K
is
at 8:15 a.m.
Where:
At Douglas and Armour near Towne East Square
How
much: Advance registration before Sept. 24 is $30 for the competitive and $25
for noncompetitive
races.
Registrants receive a T-shirt.
To
register or learn about the complete schedule and additional related special
events — including Sleep-in
for
the Cure and Kids for the Cure — visit www.komenmidks.org or call
316-440-7033.
Breast
cancer in Kansas by the numbers
*
1,780: The approximate number of women diagnosed with breast cancer in Kansas
last year.
*
370: The estimated number of women who died from breast cancer in Kansas last
year.
September
20, 2011
NARH
Offers Q&A Session on Hyperbaric Wound Care - iBerkshires.com –
NORTH
ADAMS, Mass. — North Adams Regional Hospital will host a question-and-answer
session with
the
wound-care experts from the Wound Healing Center of the Berkshires on Tuesday,
Oct. 4, from 6:30 to
8
p.m.
The
free event takes place at the VNA & Hospice of Northern Berkshire Community
Room. Pie and coffee
will
be served. Registration is requested by calling 413-664-5142.
Dr.
Fred Landes, center Director Kelly Morse and hyperbaric oxygen technician
Gladys Conklin will take
questions
on wounds resulting from radiation side effects, lymphedema, diabetes,
peripheral vascular
disease,
and injuryThey will also discuss new state-of-the-art techniques used to heal
wounds including
hyperbaric
oxygen therapy.
The
Wound Healing Center opened in 2009 and has been recognized as a top-performing
center among all
those
operated in collaboration with National Healing Corp. The Wound Center boasts a
“heal rate” of 96
percent,
meaning that 96 percent of patients’ wounds are healed within nine
visits.
Landes
is a board-certified emergency medical physician and is the Wound Healing
Center’s medical
director.
He received his training from the New York Presbyterian Hospital, Cornell
University, in New
York
City.
Morse
is a registered nurse and has worked in the health-care field for 32 years.
Conklin is a licensed
practical
nurse.
September
20, 2011
Breast
Surgeon Addresses the Worries, the Wonders and the What-to-dos of Breast Health
– TribLocal –
Join
Breast Surgeon Jennifer Gambla, M.D., of Palos Community Hospital, as she
discusses the latest
mammogram
recommendations, measures to prevent breast cancer and the multiple steps
involved in
diagnosing
breast health concerns. This free event will be held on Monday, Oct. 3 from
6:30 p.m. to 7:30 p.
m.
at Palos Health & Fitness Center, 15430 West Avenue in Orland Park. Call
708-226-2300 to register.
Palos
Community Hospital's Comprehensive Breast Program combines the technological
capabilities of
digital
mammography, ultrasound and magnetic resonance imaging with a highly skilled
and compassionate
staff.
You benefit from the talents of radiologists who are fellowship-trained in the
field of mammography.
Breast
exams and procedures under all imaging modalities, as well as breast surgery,
are performed at Palos
Community
Hospital. Whether you need a routine exam or have a more serious breast
concern, you can
trust
Palos Community Hospital.
The
breast care treatment team at Palos Community Hospital provides a
multidisciplinary, integrated and
comprehensive
approach to screening, diagnosis and treatment. Our complete continuum of
services include:
Digital
Mammography, Breast Ultrasound, Stereotactic & Ultrasound Guided Needle
Biopsy, Excisional
Breast
Biopsy, Breast MRI and MRI Guided Needle Biopsy, Ultrasound Guided Cyst
Aspirations, Surgical
Treatment for
Breast Cancer, Breast Reconstruction and Lymphedema Program and Support
Group.
To
schedule a digital mammogram or other Breast Imaging service, call (708)
827-2030.
September
20, 2011
Hospital
celebrates National Rehab Week - Journal-Advocate –
Sterling
Regional MedCenter Rehabilitation department is celebrating National
Rehabilitation Awareness the
week
of Sept. 18-24. The mission of National Rehabilitation Awareness Week is to
educate people about
the
benefits and impact of rehabilitation and give credit to those who help people
with disabilities live up to
their
fullest potential through rehabilitation.
Sterling
Regional MedCenter's rehab department offers comprehensive therapy services
including physical
therapy,
occupational therapy, speech therapy, cardiac rehab, and the new oncology rehab
program.
Patients
receive individualized therapy programs that address a wide variety of patient
needs. The goal of
therapy
is to return patients to their highest level of function as quickly and safely
as possible.
The
oncology rehab program was created to assist individuals with cancer move past
the challenges of their
diagnosis.
Cancer treatment can be both physically and mentally challenging. Each
patient's experience is
different
and each patient faces unique side effects.
The
oncology rehab program provides specialized treatments to cancer patients
including a thorough
evaluation
to access baseline values (endurance, strength, flexibility and range of
motion) which lets the
rehab
providers create a specialized treatment program for each patient's unique
needs. Each session is
designed
to address the individual's needs and provides extensive education to assist in
recovery.
"The
physical therapy program for cancer patients is very good. I think the support
you receive helps
patients
to have a positive attitude," said Henry Littler, program
participant.
"It
is easy to be inactive during this time due to the side effects most patients
experience," notes Littler. "The
program
and the therapist offer a challenge to get stronger physically as well as
mentally because of the
weight
loss and other effects that one experiences from treatment. I would recommend
this program for
patients
going through treatment!"
The
program also offers lymphedema services provided by an occupational therapist
certified in upper
extremity
lymphedema therapy. These treatment options include manual lymph drainage,
bandaging,
exercise,
and skin care to assist in the effective management of this
condition.
Chemotherapy,
radiation, and surgical patients can all benefit from this exercise program, no
matter what
stage
of their diagnosis.
"We
are excited to offer a program that can help people through all stages of
recovery - from the initial
diagnosis
to possible side effects felt years after," said Amy Baseggio, occupational
therapist and certified
lymphedema
therapist at Sterling Regional MedCenter. "This is a unique program that is
meant to give those
with
a cancer diagnosis one more way to regain their health and live their lives to
the fullest. "
The
therapists at SRM are dedicated to making a difference in people's lives by
providing excellent patient
care
in a caring and friendly environment. For more information regarding
rehabilitation services at SRM,
please
contact us at (970) 521-3138
September
20, 2011
Pink
Ribbon Program Coming To New Orleans, LA - October 14 & 15, 2011 - PR Web
–
Become
a Post-Rehabilitative Breast Cancer Exercise Specialist
The
Pink Ribbon Program is an exercise program designed specifically for
post-operative breast cancer
survivors.
Program founder and director of the Pink Ribbon Program, Doreen Puglisi M.S.,
became aware
of
the need as she herself was diagnosed with breast cancer. She used the Pink
Ribbon Program to regain
the
range of motion as well as strength in her affected arm.
Xtend
Barre New Orleans will be hosting a two day workshop on Friday, October 14 and
Saturday,
October
15, 2011 for individuals who come in contact with breast cancer survivors
through Pilates, physical
therapy,
occupational therapy, massage therapy, personal trainers, nurses, group
exercise instructors and
lymphedema
treatment specialists. The goal of this interactive two day course is to
provide the participants
with
a knowledge base that is essential to the successful evaluation of the breast
cancer survivor, from
diagnosis
to treatment, recovery, prevention of lymphedema and proper exercise guidelines
and protocols.
Evidence
based practice and integration of material from the areas of functional
exercise, shoulder
rehabilitation
and Pilates exercise will be the emphasis of the course sessions.
The
Pink Ribbon Program is offered on Friday, October 14 starting at 3:00 p.m. to
8:00 p.m. and Saturday,
October
15 starting at 8:00 a.m. to 2:00 p.m. Workshop cost is $425 per person plus $35
for course
materials.
Space is still available for this two day workshop. Please visit
http://www.pinkribbonprogram.com
or
call 888-445-3089
September
7, 2011
Incredible
New Plastic Surgery Product Helps Accelerate Healing After Popular Armlift
Procedure
(Brachioplasty)
- DigitalJournal.com –
An
exciting new product to help speed up healing following arm lift surgery is the
latest addition to Nouvelle’
s
premier compression wear line. Convertible compression arm sleeves provide
lightweight, yet powerful
healing
compression and support for the arms. A key feature of the product is the ease
with which patients
can
adjust the bodice for a precise fit.
“Proper
care of the arms is critical to a successful surgical result,” said Dawn Cover,
president of Nouvelle.
“We’ve
fine-tuned our arm care line to include products that help patients get the
maximum care and best
outcomes
from surgeries involving the arms,” she said.
Key
uses of arm sleeves:
1.
Care following arm lift surgery (brachioplasty) and liposuction.
2.
Prevention of extreme, hypertrophic scarring from severe, skin-damaging
burns.
3.
Relief for symptoms associated with lymphedema, such as fluid retention and
tissue swelling.
Also
important to proper care of the arms following surgery is scar prevention.
Nouvelle carries the
internationally-recognized
ScarHeal product line, which features an outstanding combination of
ingredients
designed
to help calm inflammation and tame overactive collagen production in scars
resulting from surgery,
burns,
wounds, and keloids. The line features four proven products for treating scars
resulting from any
trauma
to the skin.
Additional
Resources
Web
site
The
newly-designed Nouvelle Inc. Web site includes comprehensive product details,
company history and
and
more.
Healing
Transformations
An
online forum dedicated to patients, physicians and families of anyone
recovering from the myriad of
emotional
and physical health issues surrounding aesthetic and reconstructive
surgery.
Facebook
Page
Look
for new products, stories from customers, and helpful recovery tips on
Nouvelle’s Facebook page.
One
of the first 100 people to “like” the page will be entered into a special
drawing to win a free
compression
or shapewear product.
About
Nouvelle
Nouvelle
manufactures and distributes post-surgical compression wear, body shaping
garments, and scar
care
products worldwide from its facility in Virginia Beach, Va. Its
internationally-recognized products are
available
through approved distributors and online at
http://www.nouvelleinc.com.
International
Distribution Opportunities
For
more information about purchasing or distributing the company’s products,
please contact Dawn Cover
via
email or telephone: dawn(at)nouvelleinc(dot)com or
888-653-0113/757.965.3767.
September
9, 2011
Why
Knees Fail in 2011: Patient, Surgeon, or Device? - Ortho SuperSite – by Steven
J. Fitzgerald, MD;
Robert
T. Trousdale, MD
Abstract
The
outcome of total knee arthroplasty (TKA) is influenced by multiple
interconnected factors, including
patient
selection, implant design, and surgical technique. Total knee arthroplasty has
been shown to be highly
successful,
with patient satisfaction rates reported from 85% to 95% with low rates of
failure, but if failure
occurs,
its impact is significant. In 2003, 402,000 primary TKAs and 32,000 revision
TKAs were
performed
in the United States, and the number of TKAs is expected to double by 2015.
Recent data on
modern
implant designs and techniques have demonstrated a surprising number of early
failures, although the
true
number of early failures is unknown. Patient medical comorbidities should be
optimized preoperatively,
while
psychosocial issues and workers compensation are more nebulous yet contribute
greatly to patient
perceived
outcomes. Understanding current failure mechanisms of primary TKA and how to
prevent
complications
will be critical to help manage a potentially overwhelming TKA revision burden.
This article
discusses
failure rates as well as factors from the patient, surgeon, and device, that
contribute to TKA failure.
Dr
Fitzgerald is from Department of Orthopedic Surgery, University Hospitals Case
Medical Center,
Cleveland,
Ohio; and Dr Trousdale is from the Mayo Clinic, Rochester, Minnesota.
Dr
Fitzgerald has no relevant financial relationships to disclose. Dr Trousdale
receives royalties from DePuy,
Wright
Medical Technology, and MAKO.
Presented
at Current Concepts in Joint Replacement 2010 Winter Meeting; December 8–11,
2010;
Orlando,
Florida.
Correspondence
should be addressed to: Robert T. Trousdale, MD, Mayo Clinic, 200 First St SW,
Rochester,
MN 55905 ([email protected]).
Posted
Online: September 09, 2011
The
outcome of total knee arthroplasty (TKA) is affected by patient selection,
implant design, and surgical
technique
( Figure). Total knee arthroplasty has been shown to be highly successful with
patient satisfaction
rates
reported from 85% to 95% with low failure rates, but if failure occurs, its
impact is significant. 1,2 In
2003,
402,000 primary total knee and 32,000 revision TKAs were performed in the
United States. The
number
of total knee revisions is expected to double by 2015. 3 Understanding current
failure mechanisms
of
primary TKA, and how to prevent complications will be critical to help manage a
potentially
overwhelming
TKA revision burden. This article will discuss failure rates as well as factors
from the patient,
surgeon,
and device, which all contribute to the TKA failure.
Rates
of Failure
Long-term
studies have demonstrated excellent survivorship rates for TKA. 4–6 Rand and
Bryan 7
reported
failure rates of condylar total knee prostheses implanted at the Mayo Clinic
over a 20-year period
and
demonstrated 91% survivorship at 10 years, and 78% at 20 years. These rates
improved for patients
who
were women, older at the time of surgery, and had not undergone previous knee
surgery. Survivorship
of
patients older than 70 years at the time of surgery also increased to 94% at 10
years. Other factors that
were
attributed to increased survivorship were cruciate retaining and non-modular
tibial designs, although
these
factors may be related to prosthesis design issues that have been improved with
modern designs in
2011.
We currently advise our patients that they have approximately a 1% cumulative
chance per year of
their
total knee failing.
Why
and When do Knees Fail?
Historically,
reasons for TKA failure have been attributed to infection, loosening,
instability, and
patellofemoral
complications. 7 Surprisingly, data detailing failure mechanisms of modern TKA
is relatively
scant.
Sharkey et al 2 retrospectively reviewed reasons for 212 revisions over a
3-year period from 1997 to
2000
at a tertiary referral center. Failures were subdivided into early (<2
years) and late (>2 years), with
55%
falling into the early group. Overall, the most common reasons for revision
were polyethylene failure,
aseptic
loosening, instability, and infection. Not surprisingly, polyethylene wear and
aseptic loosening were
more
common in the late group comprising >70% of all late revisions combined. The
most common reason
for
failure in the early group was infection, comprising 25%. The early group also
demonstrated a
surprisingly
high rate of aseptic loosening of 16.9%, which points to surgical technique as
a major
contributing
factor to early revision since early loosening cannot be attributed to
polyethylene wear.
Fehring
et al 8 retrospectively reported reasons for revision of 440 total knees at a
tertiary referral center.
They
specifically looked at reasons for early failure, which they defined as
revision within 5 years from the
index
arthroplasty. An alarming 64% of revisions fell into this early failure group
over a 10-year period.
Infection
(38%) was the most common reason for early revision, followed by instability
(26%), and failure of
cementless
fixation (13%). Both of these studies are limited by data from tertiary
referral centers, clouding
the
true incidence of the mechanisms of TKA failure. They, however, demonstrate an
alarming number of
early
failures, and indicate room for improvement in surgical technique.
Patient
Factors
Patient
factors significantly contribute to the TKA failure. Medical comorbidities such
as obesity, diabetes,
inflammatory
arthropathy, tobacco use, lymphedema, immunosuppressive medications, and
depression can
all
contribute to early postoperative complications as well as long-term outcomes.
9–13 Kang et al 12
recently
suggested HbA1C >8% as an independent risk factor for postoperative wound
complications.
Foran
et al 11 demonstrated a significantly higher revision rate in morbidly obese
patients undergoing TKA
compared
to non-obese patients. Other patient factors, such as patient-surgeon
relationship, patient
expectations,
psychosocial issues, and workers compensation add an additional layer of
complexity to TKA
outcomes.
14 While not all patient factors are correctable in patients undergoing TKA;
medical optimization
of
diabetes, cardiopulmonary disease, smoking cessation programs, weight control,
and treatment of
lymphedema
should be pursued preoperatively to help mitigate the risk of complications
following TKA.
Patient,
Surgeon, or Device?
Failure
of TKA is multifactorial with combined contributions attributable to the
patient, surgeon, and device.
Medical
optimization of patient comorbidities such as cardiorespiratory disease,
obesity, diabetes, and
venostasis
should be attempted to help mitigate the risk of perioperative
complications.
Current
implant design has improved greatly over the past 2 decades, but the rate of
developing technology
is
largely uncontrollable by both patient and surgeon. Most TKA designs today, if
implanted correctly, will
have
excellent long-term outcomes. Surgeons should choose an implant design that
they are comfortable
with
putting in well that has a proven track record. Implant design and improved
materials in the future
should
lead to further decreases in failure rates. However, surgeons should be
cautioned against early
adoption
of new technologies that have not been proven over time.
Surgeons
can do the most to limit factors that lead to early failure. Judicious use of
perioperative antibiotics,
good
soft tissue handling techniques, and safe and efficient operative times can all
help to decrease chances
of
early postoperative infection. Early loosening and instability, also directly
attributable to surgical technique,
can
be limited with good cement technique and adherence to traditional arthroplasty
balancing and alignment
principles.
Continued professional education through national meetings and literature
review can also keep
surgical
technique up to date and help prevent the surgeon from repeating previous
failures.
References
Noble
PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: Patient expectations
affect
satisfaction
with total knee arthroplasty. Clin Orthop Relat Res. 2006; (452):35–43. doi:
10.1097/01.blo.
0000238825.63648.1e
[CrossRef]
Sharkey PF,
Hozack WJ, Rothman RH, Shastri S, Jacoby SM. Insall Award paper. Why are total
knee
arthroplasties
failing today? Clin Orthop Relat Res. 2002; (404):7–13. doi:
10.1097/00003086-
200211000-00003
[CrossRef]
Kurtz
S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip
and knee
arthroplasty
in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;
89(4):780–785. doi:
10.2106/JBJS.F.00222
[CrossRef]
Ranawat
CS, Padgett DE, Ohashi Y. Total knee arthroplasty for patients younger than 55
years. Clin
Orthop
Relat Res. 1989; (248):27–33.
Rand
JA, Trousdale RT, Ilstrup DM, Harmsen WH. Factors affecting the durability of
primary total knee
prostheses.
J Bone Joint Surg Am. 2003; 85(2):259–265.
Scuderi
GR, Insall JN, Windsor RE, Moran MC. Survivorship of cemented knee
replacements. J Bone
Joint
Surg Br. 1989; 71(5):798–803.
Rand
JA, Bryan RS. Revision after total knee arthroplasty. Orthop Clin North Am.
1982; 13(1):201–212.
Fehring
TK, Odum S, Griffin WL, Mason JB, Nadaud M. Early failures in total knee
arthroplasty. Clin
Orthop
Relat Res. 2001; (392):315–318. doi: 10.1097/00003086-200111000-00041
[CrossRef]
Peersman
G, Laskin R, Davis J, Peterson M. Infection in total knee replacement: A
retrospective review of
6489
total knee replacements. Clin Orthop Relat Res. 2001; (392):15–23. doi:
10.1097/00003086-
200111000-00003
[CrossRef]
Namba
RS, Paxton L, Fithian DC, Stone ML. Obesity and perioperative morbidity in
total hip and total
knee
arthroplasty patients. J Arthroplasty. 2005; 20(7 suppl 3):46–50. doi:
10.1016/j.arth.2005.04.023
[CrossRef]
Foran
JR, Mont MA, Etienne G, Jones LC, Hungerford DS. The outcome of total knee
arthroplasty in
obese
patients. J Bone Joint Surg Am. 2004. 86(8):1609–1615.
Kang
S, Han H, Yoon KS. Preoperative HBA1C is a good marker for predicting wound
complications
after
TKA in diabetics. J Bone Joint Surg Br. 2010; 92(suppl):135.
Shrader
MW, Morrey BF. Insall Award paper. Primary TKA in patients with lymphedema.
Clin Orthop
Relat
Res. 2003; (416):22–26. doi: 10.1097/01.blo.0000092985.12414.6e
[CrossRef]
Mont
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Compensation. J Bone Joint Surg Am. 1998; 80(9):1285–1290.
September
8, 2011
Lymphedema
From Breast Cancer May Respond To Weightlifting – EmpowHer – By Jody
Smith
Treatment
for breast cancer can lead to an unpleasant condition called lymphedema which
causes the arms
to
swell. Research from the University of Pennsylvania School of Medicine
indicated that weightlifting may
prevent
the development of lymphedema. Previous research by the same team found that
when women with
lymphedema
lift weights, they can prevent the condition from becoming worse.
This
Article
·
VoteImproved My Health
·
VoteChanged My Life
·
VoteSaved My Life
The
results were presented on December 8, 2010 at the San Antonio Breast Cancer
Symposium. It was
published
at that time in the Journal of the American Medical Association as
well.
According
to a Eurekalert also released on December 8, 2010, lymphedema is most likely to
occur after
surgery
removing multiple lymph nodes in the area of the breast that had cancer. Up to
47 percent of women
who
have had this type of surgery can experience lymphedema.
Women
in the study took part in a membership at a fitness center for 13 weeks where
they used free
weights
and machines under the watchful eyes of certified fitness professionals. They
worked out twice a
week
for 90 minutes at a time. For the rest of a year, the women exercised on their
own, monitored monthly.
The
women with lymphedema who participated in this routine had fewer setbacks and
fewer symptoms than
women
who did not take part in weightlifting.
It
is important for a woman who has or may develop lymphedema to be in touch with
her doctor, and a
certified
fitness professional for safety's sake.
According
to the New England Journal of Medicine's website Nejm.org, more than 2.4
million American
women
are survivors of breast cancer. Depending on the type of treatment received, a
woman may run a 6
percent
to 70 percent chance of developing lymphedema.
Many
of these survivors have been trying to restrict the use of their affected arms
under the impression that
this
will help. However advice along these lines is counterproductive. Instead,
lymphedema responds best to
a
carefully controlled increase in activity, including weightlifting.
Nejm.org
concurred with the results referred to in the eurekalert, that weightlifting
had an effect on hand and
arm
symptoms, decreasing both severity and frequency.
Apparently
exercise enhanced the flow of lymph and enhanced protein reabsorption. The
effects of regular
exercise
on the lungs seemed to boost lymph flow as well. It is speculated that the
increase in muscle
strength
may have reduced the effects of stress on the arm in daily
activities.
This
Article
·
VoteImproved My Health
·
VoteChanged My Life
·
VoteSaved My Life
This
research was funded by grants from the National Cancer Institute and the
National Center for Research
Resources.
Sources:
Weightlifting
slashes lymphedema risk after breast cancer treatment. Eurekalert.org. Web.
September 5,
2011.
http://www.eurekalert.org/pub_releases/2010-12/uops-wsl120610.php
Weight
Lifting in Women with Breast-Cancer-Related Lymphedema. Nejm.org. Web.
September 5, 2011.
http://www.nejm.org/doi/full/10.1056/NEJMoa0810118#t=articleTop
Visit
Jody's website and blog at http://www.ncubator.ca and
http://ncubator.ca/blogger
Reviewed
September 6, 2011
by
Michele Blacksberg R.N.
September
8, 2011
New
tool may help predict breast-cancer-associated lymphedema – HemOncToday
–
ASCO
2011 Breast Cancer Symposium
SAN
FRANCISCO — A set of statistical models have demonstrated more than 70%
accuracy for
predicting
the 5-year risk for developing lymphedema after lymph node removal during
breast cancer
surgery.
New
tool may help predict breast-cancer-associated lymphedema
ASCO
2011 Breast Cancer Symposium
SAN
FRANCISCO — A set of statistical models have demonstrated more than 70%
accuracy for
predicting
the 5-year risk for developing lymphedema after lymph node removal during
breast cancer
surgery.
Jose
Bevilacqua, MD, PhD, a surgical oncologist at the Hospital Sirio Libanes in Sao
Paulo, Brazil, and
colleagues
studied 1,054 women with breast cancer who underwent axillary dissection in
2001 and 2002.
They
used clinical factors such as age, BMI, ipsilateral arm chemotherapy infusions,
level of axillary
dissection
and others to develop three models and nomograms to predict the risk for
developing
lymphedema.
The
first model predicted lymphedema in advance of surgery and considered age, BMI
and number of
chemotherapy
cycles before surgery. The concordance index for this model was 0.706. The
second model
used
the same predictors within 6 months surgery, as well as the extent of axillary
dissection and the location
of
the radiotherapy field. The concordance index for this model was 0.729. The
third model predicted
lymphedema
6 months or more after surgery. It considered the same predictors, as well as
the development
of
fluid buildup and swelling. The concordance index for this model was
0.736.
“The
statistical models and the corresponding nomograms use readily available
clinical factors and allow for
quick
and easy estimation of individual risks of developing lymphedema after axillary
lymph node surgery in
women
with breast cancer,” Bevilacqua said. “For the sake of comparison, these
modeling tools are as
accurate
for predicting a woman’s risk of developing lymphedema as mammography is for
the detection of
breast
cancer.”
September
7, 2011
2011
Breast Cancer Symposium Research Reveals Trends in Survival, Treatment -
-Newswise
Newswise
— ALEXANDRIA, Va. – New studies on breast cancer screening, treatment, and
survival were
released
today in advance of the 2011 Breast Cancer Symposium. The symposium is being
held September
8-10,
2011, at the San Francisco Marriott Marquis in San Francisco.
Four
major studies were highlighted in today’s presscast:
-
Two Studies Report Similar Recurrence, Survival Rates for Breast Conservation
and Mastectomy among
Younger
Women with Breast Cancer: A pair of studies indicates comparable outcomes – in
local recurrence
and
survival rates – for lumpectomy (breast conservation surgery) or mastectomy
(entire breast removal)
among women
with breast cancer age 40 and younger.
a)
Study Finds Recurrence Rates are Similar in Younger Women Who Have Either
Breast Conservation
Surgery
or Mastectomy: A retrospective study of medical records of more than 600 women
aged 40 and
younger
who were diagnosed with up to stage III breast cancer, analyzed according to
the type of surgery
(lumpectomy
versus mastectomy) the women had, found no statistically significant difference
in local cancer
recurrence
risk.
b)
Large Analysis Shows Breast Conservation and Mastectomy Result in Similar
Survival Among Younger
Women
With Early Stage Breast Cancer: Using the National Cancer Institute’s SEER
(Surveillance,
Epidemiology,
and End Results) database, investigators compared overall survival and breast
cancer-
specific
survival among nearly 15,000 women age 40 and younger, finding no significant
differences between
the
two groups.
-
New Statistical Tool May Predict Risk of Common Debilitating Side Effect –
Lymphedema – Associated
with
Breast Cancer Surgery: Researchers have created a set of statistical models
that are more than 70
percent
accurate for predicting the five-year risk of developing lymphedema
(debilitating swelling) after
lymph
node removal during breast cancer surgery.
-
Large Michigan Study Suggests Continued Importance of Self-Exams, Annual
Mammography in Breast
Cancer
Detection, Even in Younger Women: An analysis of breast cancer diagnosis data
from nearly 6,000
women
in Michigan suggests that mammography and self-breast exams remain important
tools for detecting
breast
cancer, even among women aged 40 to 49 for whom routine mammography has been
questioned by
the
U.S. Preventive Services Task Force (USPSTF).
“Improvements
in detection, as well as insights into surgical treatment options and their
outcomes, have
increasingly
led to longer, improved lives for women with breast cancer,” said Andrew
Seidman, MD,
American
Society of Clinical Oncology Cancer Communications Committee member. “The
studies
presented
today reflect the impact of these advances in treatment approaches on patient
outcomes and
treatment
decision-making.”
In
2011, an estimated 230,480 new cases of invasive breast cancer are expected to
occur in women in the
United
States, and another 2,140 cases are expected in U.S. men. An additional 57,650
cases of in situ
(non-invasive)
breast cancer are expected to occur in U.S. women as well, totaling more than
290,000 new
cases.* This
year’s Breast Cancer Symposium will include more than 300 abstracts and focus
on a range of
breast
cancer topics that range from prevention and screening to treatment and
survivor care.
*Source:
Cancer Facts & Figures 2011. Atlanta, GA; American Cancer Society:
2011.
The
full release is available at the following link:
http://www.asco.org/ASCOv2/Department
Content/Communications/Downloads/BCS11 Research Release
Final.pdf
About
the 2011 Breast Cancer Symposium
The
fifth annual Breast Cancer Symposium is co-sponsored American Society of Breast
Disease, the
American
Society of Breast Surgeons, the American Society of Clinical Oncology, the
American Society for
Radiation
Oncology, the National Consortium of Breast Centers and the Society of Surgical
Oncology.
Susan
G. Komen for the Cure®, the world's largest grassroots network of breast cancer
survivors and
advocates,
is the primary supporter of the Symposium.
Information
for Media: www.asco.org/BCSpresskit
Relevant
Links on ASCO’s CancerProgress.Net Website:
http://cancerprogress.net/breast
Relevant
Links on ASCO’s Cancer.Net:
•
Guide to Breast Cancer
•
Cancer Screening
•
Mammography – What to Expect
•
Expert Perspective from ASCO on Mammography Screening for Breast
Cancer
•
Understanding Cancer Surgery
•
Talking With the Doctor About Breast Surgery Options
•
After Treatment for Breast Cancer: Preventing Lymphedema
•
Coping With Fear of Recurrence
ATTRIBUTION
TO THE 2011 BREAST CANCER SYMPOSIUM IS REQUESTED IN ALL NEWS
COVERAGE
September
7, 2011
New
Nomograms Predict Lymphedema After Axillary Lymph Node Dissection - Internal
Medicine News
Digital
Network – By: SUSAN LONDON
A
new set of nomograms based on easily assessed risk factors accurately predicts
a woman’s likelihood of
developing
lymphedema after axillary lymph node dissection for breast cancer, researchers
are reporting at a
breast
cancer symposium sponsored by the American Society of Clinical
Oncology.
The
nomograms, which enable risk assessment throughout the course of treatment
using data available at the
time,
had accuracy exceeding 70%, according to results presented in a press briefing
before the meeting.
"The
accuracy is the same as mammography to detect breast cancer. ... So that’s a
very good statistical
tool,"
said lead author Dr. Jose Bevilacqua, a surgical oncologist at the Hospital
Sirio-Libanês in São Paulo,
Brazil.
Being
able to identify high-risk patients has several potential applications, he
added. They could be
monitored
more closely and offered interventions that might prevent or reduce the
severity of lymphedema,
such
as use of compression sleeves. "The earlier you detect [it], the better is the
outcome," Dr. Bevilacqua
said.
Additionally,
high-risk patients with a positive sentinel lymph node could be counseled about
the risk of
further
surgery. Thus, "you have physicians who make closer follow-up and [have] a
better discussion with
the
patients."
Finally,
the nomograms could be applied in clinical research. "These tools might help
[ongoing] or new
studies
to select high-risk patients in order to avoid exposing the low-risk patients
to unproven therapies," he
explained.
Dr.
Andrew Seidman, moderator of the press briefing and a medical oncologist at the
Memorial Sloan-
Kettering
Cancer Center in New York, commended the investigators for a study that "has
real practical
implications
for patients."
"It
allows us to identify patients who then can be appropriately triaged for early
intervention and perhaps for
clinical
trials aimed at preventing what many consider inevitable, and that is the
development of lymphedema."
The
effectiveness of early interventions is controversial, according to Dr.
Seidman, who did not report any
relevant
conflicts of interest. "There are believers and there are nonbelievers," he
commented. "What I think
this
nomogram does is [allow] us in a scientific way to segregate out patients in
terms of their risk, and by
doing
that, we can have more uniform cohorts for which early intervention can be
studied more rigorously."
The
researchers prospectively followed 1,054 women with unilateral breast cancer
who underwent breast-
conserving
surgery or mastectomy with an axillary lymph node dissection in 2001-2002.
Median follow-up
was
41 months.
"As
far as we know, we have established the largest prospective cohort specifically
established to study the
incidence
and factors associated with lymphedema after axillary node dissection for
breast cancer,"
commented
Dr. Bevilacqua.
Using
Data to Predict Lymphedema
The
women had serial arm volume measurements starting before surgery. To facilitate
this process, the
researchers
created a tool that is now available free online (www.armvolume.com).
They
then developed and internally validated three multivariate nomograms (or
statistical models) for
predicting
lymphedema using data available at various time points.
The
first model, to be used preoperatively, incorporated age, body mass index, and
number of cycles of
neoadjuvant
chemotherapy infusions in the ipsilateral arm.
The
second model, to be used within the first 6 months after surgery, incorporated
all the factors from the
first
plus the extent of axillary dissection, the location of radiation therapy
field, and the number of cycles of
adjuvant
chemotherapy infusions in the ipsilateral arm.
The
third model, to be used 6 months or later after surgery, incorporated all the
factors from the second,
plus
the development of postoperative seroma and development of early
edema.
Study
results showed that within 5 years of axillary lymph node dissection, 30.3% of
the women developed
lymphedema
(defined as a difference in volume of at least 200 mL between arms at 6 months
or later after
surgery).
All
of the risk factors used in the models were significantly associated with the
development of lymphedema,
Dr.
Bevilacqua reported.
"One
of the novelties of our study is the [finding] that ipsilateral neoadjuvant
chemotherapy infusion is as
morbid
as adjuvant chemotherapy infusion to increase the risk of lymphedema," he
pointed out. "This is
somewhat
intuitive, but it has never been described, and the great majority of clinical
oncologists are not
aware
of this fact."
For
predicting the 5-year risk of lymphedema, the first, second, and third models
had accuracy of 70.6%,
72.9%,
and 73.6%, respectively. The investigators have converted the models into free,
user-friendly
calculators
that are available online (www.lymphedemarisk.com) during the ASCO Breast
Cancer
Symposium
(Sept. 8-10), but will be taken off line until the manuscript is published,
after which they are to
become
available again.
Dr.
Bevilacqua reported that he had no relevant conflicts of interest.
September
8, 2011
New
Research: Acupuncture treats Breast Cancer Lymphedema – HealthCMI –
Recent
Memorial Sloan-Kettering Cancer Center research demonstrates that acupuncture
significantly
reduces
lymphoedema related arm swelling in women after breast cancer surgery.
Lymphoedema is a when
there
is fluid retention and tissue swelling in the body due to disorders of the
lymphatic system. The
lymphatic
system controls the return of interstitial fluid to the bloodstream. After
breast cancer surgery, the
lymphatic
system can be damaged by lymph node surgery or radiation therapy. Symptoms may
appear
quickly
or take several months or years to become apparent. Swelling of the arms and
sides of the body is
most
common after lymphatic system damage due to breast cancer procedures.
The
researchers at Sloan-Kettering in New York note that existing conventional
treatments for
lymphoedema
are only “marginally beneficial, rarely reducing arm swelling in any meaningful
way.” The new
study
concludes that acupuncture is safe and that some of the women in the study
showed a 30 percent or
better
reduction of lymphoedema related arm swelling.
Acupuncture
Results
In
this study, lymphoedema was diagnosed when the affected arm was greater than
2cm in circumference
than
the unaffected arm. Participants received acupuncture at a rate of 2 times per
week for a total of four
weeks.
Results were tabulated after a six month follow-up. No serious events were
reported and the study
concludes
that “acupuncture appears safe and may reduce lymphoedema associated with
breast cancer
surgery.”
Acupunct
Med. doi:10.1136/aim.2011.004069. A safety and efficacy pilot study of
acupuncture for the
treatment
of chronic lymphedema. Barrie R Cassileth, Kimberly J Van Zee, Yi Chan, Marci I
Coleton,
Clifford
A Hudis, Sara Cohen, James Lozada, Andrew J Vickers.
Author
Affiliations:
Integrative
Medicine Service, Memorial Sloan-Kettering Cancer Center, New York.
Department
of Surgery, Memorial Sloan-Kettering Cancer Center, New York.
Breast
Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New
York.
Integrative
Medicine
September
8, 2011
New
Research: Acupuncture treats Breast Cancer Lymphedema – HealthCMI –
Recent
Memorial Sloan-Kettering Cancer Center research demonstrates that acupuncture
significantly
reduces
lymphoedema related arm swelling in women after breast cancer surgery.
Lymphoedema is a when
there
is fluid retention and tissue swelling in the body due to disorders of the
lymphatic system. The
lymphatic
system controls the return of interstitial fluid to the bloodstream. After
breast cancer surgery, the
lymphatic
system can be damaged by lymph node surgery or radiation therapy. Symptoms may
appear
quickly
or take several months or years to become apparent. Swelling of the arms and
sides of the body is
most
common after lymphatic system damage due to breast cancer procedures.
The
researchers at Sloan-Kettering in New York note that existing conventional
treatments for
lymphoedema
are only “marginally beneficial, rarely reducing arm swelling in any meaningful
way.” The new
study
concludes that acupuncture is safe and that some of the women in the study
showed a 30 percent or
better
reduction of lymphoedema related arm swelling.
Acupuncture
Results
In
this study, lymphoedema was diagnosed when the affected arm was greater than
2cm in circumference
than
the unaffected arm. Participants received acupuncture at a rate of 2 times per
week for a total of four
weeks.
Results were tabulated after a six month follow-up. No serious events were
reported and the study
concludes
that “acupuncture appears safe and may reduce lymphoedema associated with
breast cancer
surgery.”
Acupunct
Med. doi:10.1136/aim.2011.004069. A safety and efficacy pilot study of
acupuncture for the
treatment
of chronic lymphedema. Barrie R Cassileth, Kimberly J Van Zee, Yi Chan, Marci I
Coleton,
Clifford
A Hudis, Sara Cohen, James Lozada, Andrew J Vickers.
Author
Affiliations:
Integrative
Medicine Service, Memorial Sloan-Kettering Cancer Center, New York.
Department
of Surgery, Memorial Sloan-Kettering Cancer Center, New York.
Breast
Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New
York.
Integrative
Medicine Service and Department of Epidemiology and Biostatistics, Memorial
Sloan-Kettering
Cancer
Center, New York.
September
7, 2011
Software
Predicts Lymphedema Risk After Axillary Dissection – Medscape –
Sorry
have to be a member of something to access this article.
September
8, 2011
MBCS:
Tool Predicts Arm Swelling in Breast Cancer - MedPage Today – By Crystal
Phend
SAN
FRANCISCO -- Five-year risk of lymphedema can be predicted with at least 70%
accuracy using a
free
online statistical tool, researchers found.
Concordance
of predicted risk with actual outcomes was 70.6% when calculated
preoperatively, 72.9%
when
calculated within the first six months after surgery, and 73.6% when calculated
further along in the
postop
course, Jose Bevilacqua, MD, PhD, of Hospital Sirio Libanes in Sao Paulo,
Brazil, and colleagues
reported.
Although
some high-risk patients might be missed by the tool, this level of accuracy is
similar to what has
been
seen with mammography, according to Bevilacqua.
He
reported the results at a press telebriefing in advance of presentation at the
Multidisciplinary Breast
Cancer
Symposium here.
This
kind of risk prediction is an important step forward that could have real
practical implications for
patients,
commented telebriefing moderator Andrew D. Seidman, MD, of Memorial
Sloan-Kettering
Cancer
Center in New York City.
"It
allows us to identify patients who can then be appropriately triaged for early
intervention and perhaps for
clinical
trials aimed at preventing what many consider inevitable [lymphedema]," he told
reporters.
Bevilacqua
suggested a strategy of close follow-up for patients identified as high risk by
the lymphedema
prediction
tool.
Currently,
"patients are often referred when lymphedema is already very significant, where
it begins to
interfere
with function," Seidman noted at the briefing.
There's
debate about whether any prevention strategies are actually effective, but,
Seidman said, catching
the
complication at an early stage can delay progression to the later debilitating
stages.
Those
early stage patients can be referred for physical therapy, and given
compression sleeves and standard
instructions
on prevention, such as avoidance of heat and heavy lifting with the affected
arm, Bevilacqua
added.
His
study used a prospective cohort of 1,054 women followed for lymphedema after
axillary lymph node
dissection
as part of surgery for breast cancer done at the Brazilian National Cancer
Institute from Aug.
2001
to Nov. 2002.
The
five-year cumulative incidence of lymphedema was 30.3%.
Significant
independent predictors in the statistical models included:
For
preoperative prediction, age, body mass index (BMI), and number of cycles of
neoadjuvant
chemotherapy
For
prediction within six months of surgery, age, BMI, number of cycles of
neoadjuvant or adjuvant
chemotherapy,
level of axillary lymph node dissection, and extent of radiotherapy
field
For
prediction beyond six months after surgery, all the earlier factors as well as
development of seroma and
evidence
of early edema
The
researchers cautioned that their nomograms have yet to be validated on an
independent cohort of
patients.
The
online tool, found at lymphedemarisk.com, is hosted by the Cleveland Clinic,
which collaborated on the
project.
The Web site will be available temporarily during the conference (from
September 8 through 10)
and
permanently accessible after planned publication of the study.
The
researchers reported having no conflicts of interest to disclose.
Seidman
reported having served as consultant or advisor to Enzon and Wyeth and having
received
honoraria
from Celgene, Genentech, and Genomic Health.
Primary
source: Multidisciplinary Breast Cancer Symposium
Source
reference:
Bevilacqua
JLB "Nomograms for predicting the risk of arm lymphedema after axillary
dissection in breast
cancer"
MBCS 2011; Abstract 8.
September
7, 2011
Hampton
community events - Daily Press –
L.E.A.P-
Lymphedma, Education, Advocacy, Program Support Group Meeting. 6 p.m. Sept. 15,
Sentara
Hampton
Careplex first floor conference room C. All are welcome to attend. L.E.A.P. is
for patients, family
members,
and/or friends suffering from lymphedema. Also, come hear about how you can
make a difference
and
learn more about the Lymphedema Treatment Act. Contact Tiffany at
[email protected] for
more
information or visit http://www.wix.com/leapdirector/lymphedema.
This
one has passed but sounds like it might be a regular meeting on
Thursdays
September
7, 2011
Software
Predicts Lymphedema Risk After Axillary Dissection – Medscape –
You
have to be a member to access this article sorry
September
24, 2011
Telemedicine
Service Launched at Shirgaon through Spanco's Maha E Seva Kendra - Business
Wire India -
The
telemedicine service for Filarias (Lymphedema) disease was launched in Maha
e-Seva Kendra at
Shirgoan,
under the National e-Governance Plan. Government of Maharashtra has implemented
a National
e-Governance
Plan (NeGP) to provide government services to the rural population at their
doorstep at an
affordable
cost .The telemedicine project is a part of the Common Services Centers scheme,
and has been
implemented
by Spanco through the CSC centre at Shirgoan.
The
Telemedicine service was inaugurated, by the hands of Honorable Dr.Shashi
Bhushan Gogia Director
SAATHI
(NGO). Mr.Ravindra Jogal member of Zillah Parishad and Mr.Mangesh Dhopate
Shirgaon
Sarpanch were
also apart of the telemedicine launch event.
The
Shirgoan Maha E Seva Kendra will facilitate Lymphedema Patient to get a check
up done with a
nominal
consultancy fee ranging between Rs.30-50/-in their village. For this activity
Spanco Limited has
provided
the facility to install the necessary equipments costing Rs.1.5 lacs in the
Maha E Seva Kendra
center.
Beside this Spanco has also made 10 special medical kits available each costing
Rs.2000/- for
Lymphedema
patients through this Center.
Spanco
has taken this initiative in Sindhudurg as villagers are affected by this
disease and along with local
social
activist & health department Spanco intends to eradicate this disease from
Sindhudurg district. During
the
launch camp, 2 patients were methodically examined by Dr.Gogia as apart of the
launch program.
“Detailed
information about the disease is available in Spanco’s Maha e Seva Kendra and
those people who
are
suffering in the district are advised to take the benefit of this Telemedicine
service by visiting the centre
“said
Mr.Dhananjay Vartak- Head citizen Service Group, Spanco Limited.
For
this Inauguration Honorable Dr.Mrs. Arunarekha Gogia, Dr.Ashish Keche Shiragon
Primary Medical
officer,
Ms.Sugandha Satam Zila Bank Vice President, Ms.Archana Kalra Spanco’s General
Manager, Mr.
Sagar
Tope Asst. General Manager Spanco, Mr.Sandeep Uttekar Area Manager Spanco and
Mrs. Harsha
Ajit
Chahan representative of Maha E Seva Kendra, Shirgaon were present at this
function.
About
Spanco
Spanco
is in the business of creating Technology Infrastructure to help drive
governance efficiency across
key
sectors.Spanco is SEI CMM Level 3 and ISO 9001:2008 certified. We have more
than 12,000
employees
working across 4 continents.
Spanco
caters to large complex Technology Infrastructure projects across Government,
Power, Transport
and
Telecom Service Provider’s space. We also have a formidable presence in the BPO
space catering to
India,
US/Europe, Middle East and African markets
September
23
Pink
Ribbon Produce Launching at Price Chopper to Support Susan G Komen for the Cure
– WBGH
From
Price Chopper:
Pink
Ribbon Produce, a unique retail program committed to raising breast cancer
awareness, will return to
Price
Chopper stores for its fourth year from October 2 through October 29. The
educational fundraising
program
partners the grocery retailer with produce suppliers in an effort to raise
money for local Susan G.
Komen
for the Cure® Affiliates.
“Price
Chopper is proud to participate in the Pink Ribbon Produce program again this
year as part of our
multifaceted
year-round initiative to raise funds for breast cancer research and support
services,” said Mona
Golub,
vice president of public relations, consumer and marketing services for Price
Chopper
Supermarkets.
“During October, our customers can show their support for Susan G. Komen for the
Cure
by
buying healthy fruits and vegetables from the branded partners that are
participating in the program.”
Barbara
Connolly, who once worked at Price Chopper, is a courageous mother of five who
was diagnosed
with
breast cancer at just 29 years old. Connolly was passionate in her personal
fight against breast cancer.
She
drew inspiration from support groups led by Komen for the Cure and benefitted
from grants to receive
treatment
and supplies for Lymphedema, which developed after her breast cancer treatment.
Connolly now
gives
back to Komen by volunteering for the Northeast Pennsylvania (NEPA) Affiliate
of Susan G. Komen
for
the Cure. Connolly was awarded the Spirit of Hope Award by NEPA in 2011 and has
inspired many by
her
participation in “Pink in the Park,” a Northeast Pennsylvania Affiliate walking
program. In addition to
walking,
Connolly participated in Team Survivor and with just six weeks of training, ran
a 5k during the
Susan
G. Komen Race for the Cure®. She took third place in the survivor division in
September 2010.
Through
various fundraising activities, including Pink Ribbon Produce and the Race for
the Cure series,
Komen
has invested more than $1.9 billion in research and lifesaving community
programs.
By
bringing together Price Chopper, Komen and produce suppliers, Pink Ribbon
Produce provides
shoppers
with an easy way to give back to their communities and support efforts to find
cures for breast
cancer.
The money raised goes to local Komen Affiliates. Stores will direct shoppers to
the participating
produce
suppliers with a Pink Ribbon Produce program icon on posters and point-of-sale
signs at the
product.
Produce
partners supporting this year’s Pink Ribbon campaign include:
·
Calavo
·
Custom Pak
·
Del Monte Fresh Produce
·
Dole
·
Earthbound Farm
·
Fowler Packing
·
Mastronardi
·
POM Wonderful
·
Santa Sweets
September
23, 2011
A
Walk and a Wedding for Westbury's Nancy Safran - Westbury Times –
Westbury
resident Nancy Safran never suspected retirement would be so
frenzied.
Recently
retired from Nassau BOCES after a 34-year teaching career – the past 24 years
of which have
been
“extremely rewarding” as a speech teacher for the hearing impaired – Nancy is
now focusing on a
speech
of a quite different kind.
On
Oct. 1, Nancy and her husband, Howard, will proudly deliver some very special
words at the wedding
of
their daughter, Marnie.
“Helping
Marnie to plan her wedding has been a joy,” said Nancy recently. “I miss
teaching and the kids
and
my colleagues so much, but this year – with the wedding and with Lymphatic
Research Foundation’s
(LRF)
New York Walk right on top of one another, I’m almost too busy to feel that
September back-to-
school
pull on the heartstrings.”
In
addition to preparing for the wedding and volunteering with LRF, Nancy is
finding that retirement gives
her
time to pursue long-held interests and reconnect with friends.
She
is taking golf lessons, has joined a book club and a canasta club, and tries to
find time for frequent
walks
on the Jones Beach Boardwalk. Over the summer she has been working extra
volunteer hours with
the
Glen Cove-based Lymphatic Research Foundation (LRF) to help garner support for
their National Walk
for
Lymphedema and Lymphatic Diseases at Eisenhower Park on Saturday, Sept.
24.
“As
a family we have journeyed with lymphedema since Marnie was a little girl. We
have faced serious
health
issues, a frustrating lack of knowledge about lymphatic diseases, and a medical
system that offers few
treatment
options and little hope for reversing the sometimes devastating effects of
lymphedema and other
lymphatic
disorders,” Nancy explained. “Now I do what I can to inform and support other
families facing a
similar
situation; and I help LRF because I know that more scientific and medical
research offers the best
hope
for finding better treatments and cures.”
Born
with congenital lymphedema, Marnie Safran, a 1999 graduate of W. Tresper Clarke
High School and
now
an early childhood special educator with the NYL Gramercy Pre-School in
Manhattan, will be married
to
Scott Lesser at Temple Chaverim in Plainview on Oct. 1
“Everything
is finally all set,” said Marnie. “It’s going to be a great wedding. I’m still
working on getting the
right
shoes, but I know I’ve got the right life partner – and that’s what’s
important,” Marnie added.
In
honor of their wedding, Marnie and Scott are making a generous donation to
support the work of the
Lymphatic
Research Foundation. Founded in 1998 by Roslyn resident Wendy Chaite, LRF has
become a
leader
in patient advocacy and a primary force behind advancements in lymphatic
science worldwide.
LRF’s
advocacy programs have been effective in gaining Congressional and National
Institutes of Health
(NIH)
support for lymphatic research at the National Institutes of Health and at
major academic research
centers,
elevating lymphatic diseases from relative obscurity to a position on a par
with other national health
priorities.
The organization directly funds cutting edge lymphatic research by funding
Postdoctoral Research
Fellowship
Grants, a National Lymphatic Disease Patient Registry and Tissue Bank, a
peer-review
biomedical
journal in lymphatics, and the first-ever endowed academic Professorship in
Lymphatic Research
and
Medicine (Stanford University Medical School, 2008).
“I’m
glad to be walking for LRF and walking for Marnie the week before the wedding,”
said Nancy. “That’
s
going to be a great day, too, with all of our friends coming out to support
us.”
Visit
www.walklrf.org for details and to support Team Safran.
September
22, 2011
Tennis
Rally for the Cure, October 2, at the Mountain Home Tennis Center - Baxter
Bulletin –
The
Third Annual Tennis "Rally for the Cure" will be held Sunday, October 2, at the
Mountain Home Tennis
Center.
The Tennis Rally is open to women and men who want to help win the fight
against breast cancer.
Rally
for the Cure is the largest grassroots world-wide network of breast cancer
survivors and activists
hosting
a Rally that include tennis, golf, running and dining events created to support
the promise of Susan G.
Komen
for the Cure and spread the message that early detection saves lives. More than
1.3 million people
have
participated in Rally for the Cure events across the nation since its inception
in 1996. The program was
started
by the sister of Susan G. Komen, who died at only 36 of breast
cancer.
The
Mountain Home Tennis Center Rally will begin at 11:00 a.m. at the Tennis
Center. A complimentary
luncheon
will be served for all participants and donors, followed by more tennis in the
afternoon.. The cost
for
the day is $25.00 a person ($20.00 for full-time college students) with checks
made out to Rally for the
Cure
and all proceeds going to the Foundation.
Each
participant will receive a goody bag with Komen breast health information, an
exclusive Rally bandana,
a
pink ribbon pin, a Rally towel, a Rally Charm, Cards for the Cure from Hallmark
and a one-year
subscription
to a selection of Condi Nast magazines, including SELF, Bon Appetit,
Architectural Digest and
other
choices. Participants are encouraged to wear pink, the signature color of Rally
for the Cure.
"We
are proud and happy to again open the Mountain Home Tennis Center for the Cure
event which is a
fun
way to give our members and people from the area a chance to come together to
support an important
cause
while playing a sport they love", states Mark Klingelhoets, owner of the Tennis
Center.
On
October 2, Lisa McBrayer, Flippin, and Debbie Voss, ellvillle, will represent
women like them in our
community
who have battled breast cancer and survived. Lisa has been a local Ambassador
for this cause
and
instrumental in organizing the October Tennis Rallys the past two years, along
with Maria Acree, Cindy
Holeyfield,
Roberta Heldenbrand and Charlotte and Al Wynne. Lisa is grateful to the Komen
foundation,
which
provided her with a free wig and also a free massage every week while she was
undergoing radiation
therapy
at Carti.
Up
to 75% of the net income from each Rally or Race stays in that local community
" The Komen Grant
touches
us personally in Mountain Home because of this", states Karyn Klingelhoets, one
of the Rally
organizers.
"Here is some of what comes home to us from the Komen Grant":
CARTI
radiation treatment regardless of income, ability to pay or distance from a
CARTI facility.
Treatments
typically last 4-6 weeks.
Baxter
Regional Medical Center provides schools with a "TELL YOUR MOM, SAVE A LIFE"
outreach
program
aimed at education and prevention at all ages.
BRMC
Mobile Mammography Unit which travels to provide easy access to remote areas
and workplaces
to
provide reduced cost mammography.
Lymphedema
Outreach VI to provide compression garments to survivors after
surgery.
The
mission of Rally for the Cure has been to emphasize the vital importance of
early detection in the
successful
treatment of breast cancer and to someday eradicate this life-threatening
disease. According to
Komen
for the Cure, each year breast cancer is the leading cause of death for women
ages 35-54 and
accounts
for more then 75% of all cancer deaths in women 55 years of age and older.
Since 1996, Komen
has
received over $46 million from Rally events nationwide to support their
mission.
Rally
for the Cure is based in Wilton, Connecticut. They can be reached at
800.327.6811 or at their
website:
www.rallyforthecure.com.
To
register for the October 2 Rally in Mountain Home, call the Tennis Center at
425-5009 or stop in at the
Tennis
Center at 111 CR 27.
Take
Hwy 5 No. to Roller Funeral Home. Turn right just past the cemetery onto Canne
Baker (Hwy 27).
The
Center is located on the immediate right. Donations should be made out to Rally
for the Cure and sent
to
the Tennis Center, or call to have a Rally organizer pick up your
contribution.
September
22, 2011
Doctors'
Choice earns accreditation - Daytona Beach News-Journal – by Peggy
Ellis
SOUTH
DAYTONA -- Doctors' Choice, a home health service, has earned accreditation by
the
Accreditation
Commission for Health Care Inc. (ACHC) for the services of skilled nursing,
home health
aide,
therapy and social work.
Doctors'
Choice Home Health provides skilled nursing, therapy, medical social work and
home health aide
services
to clients in Volusia and Flagler counties. The company also offers psychiatric
and wound certified
nurses,
lymphedema treatment, intravenous therapy administration, cardiac care, balance
and low vision
programs,
diabetic education and pulmonary rehabilitation.
ACHC,
a private, not-for-profit corporation, was developed by home care and
community-based providers
to
help companies improve business operations and quality of patient care.
Accreditation is a voluntary
activity
where healthcare organizations submit to peer review for their internal
policies, processes and patient
care
delivery against national standards.
September
22, 2011
Laurantis
Pharma Release: New Treatment for Lymphedema Could Mean Breakthrough for Breast
Cancer
Patients
- PipelineReview.com
Laurantis
Pharma announced that LymfactinTM, adenoviral VEGF-C growth factor therapy, was
successful
in
rebuilding lymphatic vessels in pre-clinical animal models
STOCKHOLM,
Sweden | September 21, 2011 | Laurantis Pharma, a privately held biotechnology
company
based in Finland, today announced that LymfactinTM, adenoviral VEGF-C growth
factor therapy,
was
successful in rebuilding lymphatic vessels in pre-clinical animal models. The
use of VEGF-C growth
therapy to
regenerate lymphatic vessels over time may be used to assist lymph node
transfer surgery as a
technique
to treat secondary lymphedema.
The
results were presented at the 23rd International Congress of Lymphology in
Malmö, Sweden by Kari
Alitalo,
MD, PhD, Academy Professor, Molecular Cancer Biology Program
Biomedicum
Helsinki, University of Helsinki, and Anne Saaristo, MD, PhD, Consultant
Plastic Surgeon,
Turku
University Central Hospital, Turku, Finland. The researchers were able to
demonstrate VEGF-C’s
ability
to induce the spontaneous growth of lymphatic vessels during the first two
weeks of treatment, which
then
stabilized and matured over the course of the next six months.
The
ability of VEGF-C to regulate the growth of lymphatic vessels presents an
advantage for the use of
lymph
node transfer as a way of treating lymphedema. Currently lymph node transfer is
being tested as a
way
to rebuild the lymphatic vascular anatomy but no treatment currently helps to
assist the spontaneous
growth
of lymphatic vessels.
“Breast
cancer patients have an urgent need for better treatments for lymphedma,” said
Dr. Saaristo. “With
Lymfactin,
we see the potential to increase the impact of the operation and reduce the
amount of lymphoid
tissue
that needs to be removed from other parts of the body. Ideally Lymfactin will
result in more durable
lymph
node transplants, reducing the need for painful pressure bandages.”
Lymphedema
Lymphedema,
localized swelling due to fluid accumulation, is caused by the disruption in
the flow of
lymphatic
fluid, usually associated with the removal of lymph nodes as treatment for
breast cancer. About 20
to
30 percent of patients who have had lymph nodes removed as a part of treatment
for breast cancer will
develop
chronic lymphedema. Currently, there is no cure for the condition, and
treatments are limited in their
ability
to reduce swelling and reduce the risk of infection.
About
Laurantis Pharma
Laurantis
Pharma is a clinical-stage specialty pharmaceutical development company with a
broad portfolio
of
first-in-class products based on two proprietary technologies. The Company’s
lead products target the
treatment
of a variety of inflammatory diseases and conditions including atopic
dermatitis, dry eye syndrome,
interstitial
cystitis, and lymphatic disorders, as well as the treatment of bladder
cancer.
The
Company’s pipeline includes proprietary and patent-protected formulations and
applications of cis-uroc
anic
acid (cis-UCA), a locally acting anti-inflammatory and anti-proliferative
agent. Laurantis Pharma is also
developing
Lymfactin™, a vascular endothelial growth factor C (VEGF-C) in an adenoviral
vector, for the
treatment
of secondary lymphedema. Laurantis Pharma is located in Turku, Finland. More
information can
be
found at www.laurantis.com
SOURCE:
Laurantis Pharma
September
22, 2011
in,
Fatigue, Cognitive Deficits in Breast Cancer Survivors – Medscape –
Sorry
you have to be a member of something to get this article
September
25, 2011
Dighton
family seeks to raise awareness, a cure for lymphatic diseases - Taunton Daily
Gazette – By Joan
Psotto
–
Dighton
--
With
the exception of lymphoma – a cancer of the lymphatic system – most people have
never heard of
lymphatic
disease. That changed four years ago for one Dighton couple when their
daughter, Giana, was
born
with a lymphatic malformation of the head and neck.
Initially
diagnosed at birth with a bronchial cyst, a fairly common congenital anomaly,
little Giana was sent
home
at one week of age. But with a mother's instinct, Wendy Richard knew something
more serious was
interfering
with Giana's breathing. When she was two weeks old Giana was admitted to
Children's Hospital
Boston
where specialists diagnosed the lymphatic malformation.
“It
was a nightmare,” says Wendy now. “My son was 21 months old and my infant
daughter had a life-
threatening
condition that was preventing her from breathing normally.”
Giana
underwent schlerotherapy (injections to break down the cystic mass); and at one
month old was sent
home
with a tracheotomy to open her airway. “At first they told us the trach would
be removed by her
second
birthday; but she's 4 now, and now we're hoping that it will come out next
summer,” said her mother.
Wendy
recalls the first few difficult months at home: “It was terrifying ... not only
did Giana have special
medical
needs and infection risks because of the tracheotomy and breathing
difficulties, (but) she could not
make
any sound. You had to be looking at her to know she was crying. Someone had to
be with her all the
time,
even when she slept.”
The
family had home nursing assistance for Giana's first three years.
The
family struggled — and continues to struggle — with the difficulties of having
a child with a rare disease.
“Giana's
first year was a very difficult time, a terrible strain on our family —
emotionally and financially,”
recalls
Wendy. “I wasn't able to go back to work. There was so much to learn about and
so much to worry
about.
And no one could tell us what kind of future our little girl would have. We
felt like pioneers, but we
also
felt guilty thinking that — as parents — it was somehow our fault. That was the
hardest thing. There is
just
no way to know why this happened to Giana and still happens to other children.
At this point there isn't
enough
known about lymphatic diseases and malformations to know what causes them or
what will cure
them.”
Giana's
father Chris agrees, but says that their daughter's condition has also been a
blessing to the family.
“Giana's
struggle with this lymphatic malformation has helped our family grow closer
together and closer to
God,”
he said. “We just keep believing that God will help us to work it all
out.”
Now
4 years old, Giana runs and plays with other children, but doesn't understand
why she cannot romp in
the
waves at the beach or play in the pool with her brother and cousins. She began
pre-K this September,
and
her brother Zachary is in kindergarten.
Her
parents and grandmother, Taunton resident Karen Castro, have become advocates
for lymphatic
disease
awareness. They have reached out to the Lymphatic Research Foundation, a
non-profit organization
supporting
biomedical research of the lymphatic system and advocacy for lymphatic disease
patients.
“It's
amazing to me that no one has heard of this,” says Castro, Wendy’s mom. “They
ask why Giana has
the
tracheotomy ... and no one's ever heard of lymphatic malformations or even
knows what the lymphatic
system
is. Aside from worrying about Giana, that's the most frustrating thing ... no
one has even heard of
what
she has!”
The
family will be walking with Giana to raise awareness of lymphatic diseases and
to raise funding for
lymphatic
research at the Oct. 2 National Walk for Lymphedema and Lymphatic Diseases in
Melrose.
“Giana's
Dream Team will be out there walking for our girl,” says Castro.
To
learn more about the Walk, and to support the Richard family's efforts, visit
www.walklrf.org or www.
lymphaticresearch.org.
Joan
Psotto is affiliated with the Lymphatic Research Foundation.
Copyright
2011 The Taunton Gazette. Some rights reserved
September
25, 2011
Telemedicine
Service Launched at Shirgaon through Spanco's Maha E ... - IT News
Online
This
is a duplicate article see above September 24, 2011
September
25, 2011
Andrew
set for gruelling fundraiser - NW Evening Mail –
A
SEVERELY disabled man will complete a gruelling solo wheelchair push to raise
money for other people
affected
by his condition.
Double
amputee Andrew Stevens, who has spina bifida and hydrocephalous, will push
himself on a six-mile
route
around Barrow on October 15.
The
40-year-old, who lost both legs to lymphedema in 2005, will set off from The
Forum, in Duke Street,
and
travel around Holbeck, Roose and town centre streets.
His
friend Bryn Tyson, 17, will be accompanying him to provide moral
support.
Mr
Stevens completed a five-mile push last year in memory of a friend who died 20
years ago. This year he
was
determined to do it to raise money and awareness for people with spina
bifida.
It
took him around three hours to complete the task last year, and Mr Stevens has
a similar target for when
he
does it this time round.
Mr
Stevens, of Ewan Close, Barrow, is now drumming up support for the challenge,
which will raise money
for
the Association for Spina Bifida and Hydrocephalus.
He
said: “Last time, I did it in memory of a friend, but as spina bifida affects
people around the world, I
wanted
to do something for that.
“ASBAH
has helped so many people in my situation with help and advice, I think it’s
important to give
something
back so they can continue helping people.
“I
got a real sense of achievement from it last time, but this time it has been a
real struggle getting people to
sponsor me.
Everybody has got financial problems or worries.
“I
have been in a wheelchair all my life. I was born with spina bifida and because
there was a hole in my
spine,
my mother was told they could either operate to close it, which would paralyse
me, or I would not
survive.
“I’ve
been training for a few months for it. I try and get out and do a couple of
miles in my chair whenever I
can
motivate myself, because you need a lot of strength in your arms. I just keep
pushing until I’m tired.”
To
sponsor Mr Stevens, visit www.justgiving.com/Andrew-Stevens0.
September
26, 2011
Traveling?
Veterans share the lowdown on flying after cancer treatment - MLive.com – by
Sue Schroder
Karen
Hogan puts it well: You decide how much risk you let into your life.
Hogan,
a breast cancer survivor who has been cancer-free for three years, is no
stranger to risk, but there’s
one
she won’t take: air travel.
She
had 18 lymph nodes removed following breast cancer surgery, and two more nodes
five months later.
As
a result of that and radiation, she says air travel, with its changes in air
pressure, would increase her risk
of
developing lymphedema.
For
her, that would be a painful and debilitating swelling of her right arm and
hand, which could be, she says,
even
disfiguring.
“I
don’t know what percentage of risk that could be, but I have met too many women
with lymphedema,
and
when I ask them if they have traveled via an airplane, they have all said yes.
So, I am very scared to
potentially
trigger this lifetime side effect for me.
“I
treat my arm like having a special needs child with me,” said Hogan, who calls
it a small price to pay for
being
alive. She took part in a one-year clinical trial designed to prevent
lymphedema through the Lemmen-
Holton
Cancer Pavilion, Spectrum Health and Mary Free Bed Rehabilitation
Hospital.
“Maybe
I know too much now. But I follow the instructions/tips to a T — carrying my
purse on my
nonaffected
side, not carrying anything (that weighs more than) a gallon of milk, no
manicures on my right
side
— wearing my (compression) sleeve when I exercise, etc.”
She’s
given up air travel, but she’s still on the go on her terms: She drives, or in
the case of a cross-country
business
trip, takes a train.
“I
guess I would love to know — now, three years later — if those restrictions on
travel have changed? And
am
I being too overkill on this or not?”
The
risk has not gone away.
“Lymphedema
can flair up on airplanes, so the National Lymphedema Network has some
precautions,” said
Deb
Bisel, oncology nurse and manager of Cancer Program Compliance for Spectrum
Health Cancer
Services.
“There
are many considerations (about traveling and cancer),” Bisel wrote in an email.
“We have a fair
amount
of people who winter in warmer climates, and have part of their treatment here
and part elsewhere.
Due
to our electronic environment, it is becoming easier for physicians to
communicate and set up treatment
plans.
“If
(a patient is) under active treatment, there should be some pre-planning to
know where the hospitals and
local
resources are for your destination.
“I’ve
personally contacted an oncology nurse in the area where a patient is
traveling, if I have concerns that
they
could get in trouble while away. The patient then has a local contact number to
seek help or advice for
an
unplanned side effect, for example.”
Advice
which takes on extra significance for those of us who have experienced blood
clots: On long flights,
wear
compression hose. I just traded up to full foot-to-knee compression socks by
Zensa.
Sue Schroder,
former features editor for The Grand Rapids Press, was diagnosed with
non-Hodgkin’s
lymphoma
in late 2009. Email her at [email protected].
September
25, 2011
Cancer
survivor joins CIBC Run for the Cure - Calgary Herald –
CALGARY
— Active, healthy and a hard-working career woman in her late 40s, Diane Martin
had always
avoided
mammograms, figuring she was too young to worry about breast cancer.
In
May 2000, her doctor finally convinced her to go for a routine ultrasound as
part of her annual physical,
which
revealed swollen lymph nodes under her arm, near her left breast.
A
biopsy soon after confirmed stage 3 breast cancer, and Martin’s breath was
taken away.
“I
remember my doctor came into the room and sat down, pulling her chair very
close to me,” she said.
“I
knew something was up. But you can never prepare yourself.
“When
she said the two words ‘breast cancer,’ I lost my breath. I didn’t hear much of
anything else she said
after
that.”
About
two months before her diagnosis, Martin had lost her own father to lung cancer.
He died just two
weeks
after checking into the hospital, worried about pneumonia-like
symptoms.
“I
thought I would end up the same. I thought, that’s it, I have two weeks left to
live. What am I going to
do?”
But
the next few weeks brought on what Martin likes to call her “warrior face” and
she took her battle head
on,
realizing she had too much to live for.
“I
thought, ‘I want to live, I want to meet more people. And I want people to meet
me, because I’m a pretty
special
person,’” she said.
A
lumpectomy, followed by six weeks of chemotherapy and one month of radiation
left her exhausted,
shaken
and plagued by constant nausea.
But
a life once devoted to career, collecting money and material wealth, changed
completely for Martin.
She
still remembers one night during her recovery “I was sitting outside one summer
night. It was 4 a.m. and
I
couldn’t sleep. I looked around at the trees and the flowers and I thought,
‘have these always been here?
Because
I’d never really noticed them before.’”
She
quickly became involved in volunteer work, the CIBC Run for the Cure, and
helping other women
battling
breast cancer.
But
her difficult road wasn’t over.
A
year later, a small cut on her left hand led to massive, painful swelling all
along her left arm.
Because
lymph nodes had been damaged during her surgery, lymphatic fluid was building
up as it reacted to
infection
in her hand.
It
wasn’t cancer, but a case of lymphedema few doctors were able to help her
with.
After
hundreds of phone calls, Martin was able to finally find a lymphedema therapist
that was able to
massage
the fluid out of her arm and into the rest of her body.
Although
the ailment is typical in breast cancer survivors, help is hard to find. So
Martin and her therapist
created
the Alberta Lymphedema Association to provide support for sufferers and better
education and
awareness
within the medical community.
Over
the next several years, Martin continued her volunteer work and also helped her
sister battle kidney
cancer.
But,
by 2007, Martin found another lump near her left breast as she lathered up in
the shower.
It
was only days before her annual check up.
A
mammogram, followed up by another biopsy confirmed, again, stage 3
cancer.
And
while Martin, “warrior-face” on was ready to fight once more, it was her
husband Doug, that found the
news
really hard to take.
“I
could tell it was really hurting him this time.”
Her
second bout of chemotherapy was much more difficult than the first, forcing her
to lay in bed for up to
eight
hours at a time, connected to an IV, being fed an even harsher concoction this
time.“The pain was like
my bones were
being squeezed together, three or four days at a time,” she said. “It was
terrible. Every time
I
came back for the next round, I knew how bad it was going to be.”
After
her final round in late 2007, Martin found yet another lump in the same area
and was sent straight to
surgery.
But
this time doctors confirmed it was benign.
The
good news and her clean bill of health since has Martin now working as co-run
director for the CIBC
Run
for the Cure for the Prairies and NWT region.
Up
to 5,300 runners are already registered for this year’s run, eager to beat last
year’s fundraising total of
$1.7
million.
Martin
looks forward will be run alongside other survivors like her, ready to lend a
helping hand, and a
supportive
ear.
“When
you go you have to just stop and look around. It’s a sea of pink,” she said.
“And everyone is there
to
support each other.
“It’s
a wonderful feeling.”
September
24, 2011
Lymfactin™
Found To Significantly Increase Growth Of Lymphatic Vessels In Animal Study
–
Laurantis
Pharma, a privately held biotechnology company based in Finland, announced that
LymfactinTM,
adenoviral
VEGF-C growth factor therapy, was successful in rebuilding lymphatic vessels in
pre-clinical
animal
models. The use of VEGF-C growth therapy to regenerate lymphatic vessels over
time may be used
to
assist lymph node transfer surgery as a technique to treat secondary
lymphedema.
The
results were presented at the 23rd International Congress of Lymphology in
Malmö, Sweden by Kari
Alitalo,
MD, PhD, Academy Professor, Molecular Cancer Biology Program Biomedicum
Helsinki,
University
of Helsinki, and Anne Saaristo, MD, PhD, Consultant Plastic Surgeon, Turku
University Central
Hospital,
Turku, Finland. The researchers were able to demonstrate VEGF-C's ability to
induce the
spontaneous
growth of lymphatic vessels during the first two weeks of treatment, which then
stabilized and
matured
over the course of the next six months.
The
ability of VEGF-C to regulate the growth of lymphatic vessels presents an
advantage for the use of
lymph
node transfer as a way of treating lymphedema. Currently lymph node transfer is
being tested as a
way
to rebuild the lymphatic vascular anatomy but no treatment currently helps to
assist the spontaneous
growth
of lymphatic vessels.
"Breast
cancer patients have an urgent need for better treatments for lymphedma," said
Dr. Saaristo. "With
Lymfactin,
we see the potential to increase the impact of the operation and reduce the
amount of lymphoid
tissue
that needs to be removed from other parts of the body. Ideally Lymfactin will
result in more durable
lymph
node transplants, reducing the need for painful pressure bandages."
Lymphedema
Lymphedema,
localized swelling due to fluid accumulation, is caused by the disruption in
the flow of
lymphatic
fluid, usually associated with the removal of lymph nodes as treatment for
breast cancer. About 20
to
30 percent of patients who have had lymph nodes removed as a part of treatment
for breast cancer will
develop
chronic lymphedema. Currently, there is no cure for the condition, and
treatments are limited in their
ability
to reduce swelling and reduce the risk of infection
September
26, 2011
Lymphedema
Depot Fundraising for Lymphedema Association of Ontario - Wire Service Canada
–
It’s
that time of year again! It's time for Team Niagara to put on their walking
shoes to support the
Lymphedema
Association of Ontario in their annual fundraising 5K walk/run.
On
October 16, 2011, Lymphedema Depot and Team Niagara will be participating in a
local fundraising
event.
This local event in St. Catharines, Ontario, is a satellite event to the annual
Scotiabank Toronto
Waterfront
5k Run/Walk.
Lymphedema
Depot will be raising funds for The Lymphedema Association of Ontario (LAO) as
we take a
5K
walk (you can run if you like) along the scenic Welland Canal in St.
Catharines, Ontario.
The
work of the LAO supports the lymphedema community in Ontario and
beyond.
According
to John Mulligan, a registered massage therapist and certified lymphedema
therapist, and Clinical
Specialist
with Lymphedema Depot, "The LAO gives a voice to lymphedema patients and
connects them
with
therapists, goods and services and, most importantly, connects them with one
another. The LAO has
been
putting on conferences and publishing a newsletter for 15 years now, and they
need our support to
continue.The
LAO gives a voice to lymphedema patients and connects them with therapists,
goods and
services
and, most importantly, connects them with one another. The LAO has been putting
on conferences
and
publishing a newsletter for 15 years now, and they need our support to
continue."
"Not
only does the LAO support lymphedema patients and therapists but their work
crosses over into
helping
patients with lipedema, venous insufficiency and other related conditions. Not
only do they support
lymphedema
patients and therapists but their work crosses over into helping patients with
lipedema, venous
insufficiency
and other related conditions."
Mulligan
states, "If you are in the Niagara region and you would like to come out on
October 16 and join
Team
Lymphedema Niagara in this awareness and fundraising event for the Lymphedema
Association of
Ontario,
the Team would love to hear from you!"
Contact
team captain, John Mulligan
at
[email protected] or (905) 687-1828.
If
you can’t make it, please consider making a donation online in support of the
LAO using the link provided
here:
http://my.e2rm.com/TeamPage.aspx?teamID=259759&langPref=en-CA.
You
can learn more about the Lymphedema Association of Ontario here:
http://www.torontowaterfrontmarathon.com/en/charity/lao.htm.
"I
can’t overstate the importance of the Lymphedema Association of Ontario and the
work they do, and
have
done for the past 15 years," Mulligan continued. "Through their persistent
efforts they have made the
general
public and the medical profession more aware of lymphedema."
"No
donation is too small and every dollar helps this wonderful non-profit
organization to accomplish their
important
objectives. Any donation cheque must be made out to the Lymphedema Association
of Ontario,
or
simply LAO."
All
pledges will receive an official tax receipt.
September
27, 2011
Cancer
Patient Carrying Out Voluntary Work to Help Other Patients - French Tribune
–
Most
of the women do not go for mammograms and end up with cancer diagnosed at
advanced stages, this
is
what happened with Diane Martin who did not underwent mammograms thinking that
it was too early to
get
the check-up done.
But
finally in 2000, she underwent ultrasound where swollen lymph nodes under her
arm besides her breast
were
discovered, which was later identified as stage-three breast cancer.
Her
doctor had many a times asked her to go for the check-up but she delayed the
issue which resulted in
breast
cancer at advanced stage. If she would not have been thinking much, she would
have got her cancer
detected
timely. Similar is the case with lot of women who due to some reasons do not
consider it as
necessary
and end up in screwing up their lives.
After
undergoing treatment, she is now working as volunteer at the Canadian Breast
Cancer Foundation
CIBC
Run for Cure and has been providing help to women in need.
Even
after the surgery, lymphatic fluid was building up in her arm, so she finally
found a lymphedema
therapist
who helped her take the fluid out.
Now,
she and her therapists have joined hands with Alberta Lymphedema Association
that make the
women
aware about the early diagnosis and help them in related problems.
inful
surgery to remove the lymph nodes is not necessary for some women – Ocala – By
Molly Larmie -
For
more than 100 years, standard treatment for breast cancer has included a
painful surgery: the removal of
lymph
nodes under the armpit. But a new study finds that for 20 percent of invasive
breast cancer patients
—
around 40,000 women in the U.S. each year — radiation and chemotherapy treat the
cancer just as
effectively
as removing the nodes.
The
study, conducted by the American College of Surgeons Oncology Group, throws the
traditional view of
breast
cancer treatment "out the window," said Dr. Uma Swamy, a radiation oncologist
at North Florida
Regional
Medical Center.
Once
breast cancer reaches the lymph nodes, it has the potential to spread to other
vital organs. If cancer is
detected
in the armpit, wary surgeons typically remove about 10 nodes.
"The
thought with cancer has usually been ‘Cut, cut, cut — take as much out as
possible,'" Swamy said.
Painful
complications can accompany node removal surgery, including infection,
limitation of motion and
lymphedema,
a chronic swelling in the arm. These side effects have long been considered
necessary evils in
the
successful treatment of breast cancer.
But
the study, published in The Journal of the American Medical Association, finds
there is no difference in
overall
survival rate between women who had 10 or more lymph nodes removed and those
who had only
one
or two removed for testing.
The
findings turn over a new leaf in the much-evolved history of breast cancer
treatment.
Forty
years ago, the standard of treatment for breast cancer was the Halsted radical
mastectomy, in which
surgeons
removed the whole breast and surrounding muscles. Lymph nodes in the armpit
were removed in a
procedure
called axillary lymph node dissection, or ALND.
Over
time, as research shed new light on the disease, rates of mastectomy declined.
Most breast cancer
patients
today undergo a lumpectomy, in which doctors remove large tumors in the breast
and treat
microscopic
disease with radiation and chemotherapy.
A
technique called sentinel lymph node dissection, or SLND, is commonly used to
detect cancer in the
lymph
nodes. Using SLND, physicians inject dye into the breast and observe the path
the dye takes to the
lymph
nodes. If cancer has spread from the breast to the lymph nodes, this is the
route it would have taken.
The
illuminated or "sentinel" lymph nodes are removed and tested for cancer. If the
nodes test negative, the
patient
will not require further surgery in the armpit. If a positive result comes
back, surgeons usually remove
eight
to 10 additional nodes.
After
armpit surgery, some women experience numbness, limited range of motion or
lymphedema, a painful
swelling
in the arm that occurs when scar tissue blocks the flow of fluid. Radiation
increases the risk for
lymphedema,
which has no cure.
The
lead author of the study, Dr. Armando Giuliano, and his team worried that
physicians were ordering
painful
surgeries for patients with no proof that removing the lymph nodes actually
increases the chance of
survival.
With funding
from The National Cancer Institute, the researchers enrolled 891 patients at
115 medical
centers
into the study. All patients had early invasive breast cancer with tumors less
than 2 inches across and
no
more than two cancerous sentinel lymph nodes.
After
undergoing lumpectomies and whole-breast radiation, the women were randomly
assigned to either
undergo
ALND, with 10 or more lymph nodes taken out, or no further surgery.
The
reduced risk of complications could help sway their decision. With radiation
and SLND alone, patients
have
a less than 5 percent risk of lymphedema, Swamy said.
"As
a patient, you must be careful and talk to your physicians to make sure the
study applies to you,"
Swamy
said. "And it is the physician's responsibility to make sure patients
understand as much as they need
to
make an informed decision."
Marshall
Browning & SIH Reach Affiliation Agreement - Du Quoin Evening Call
–
Du
Quoin, Ill. --
Marshall
Browning Hospital (MBH) in Du Quoin and Southern Illinois Healthcare (SIH) in
Carbondale
today
announced a formal affiliation between the two facilities.
Under
the affiliation, patients of Marshall Browning Hospital will continue to
receive high-quality care from
the
providers they know and trust at the hospital they have long relied upon. MBH
will remain as a separate
entity
with its own Board of Directors, identity and endowment.
"Marshall
Browning Hospital is pleased to partner with a highly regarded organization
such as SIH to
enhance
services for the residents of Perry County through outreach, development and
clinical integration,"
says
William Huff, CEO, Marshall Browning Hospital. Huff emphasized that “this is
not a merger or
acquisition
and that Marshall Browning Hospital would retain its own identity. The
affiliation will provide a
rich
spectrum of educational, administrative, and clinical opportunities in the
healthcare professions, meet
community
needs for high quality, cost-effective healthcare and develop new regional
linkages among
healthcare
providers.”
A
significant benefit of the affiliation is for patients with complex medical
needs who require tertiary care or
specialty
services unavailable at MBH. The affiliation will offer better coordination of
care and services
through
such means as an expanded pool of consulting subspecialists. In addition, SIH
will work closely with
the
hospital to identify opportunities to enhance the services available at
MBH.
"The
Marshall Browning Hospital Board took extensive steps to consider the
affiliation prior to formal
adoption
and feels confident that the alignment is proper and in the best interest of
the hospital and the
patients
it serves," stated Harold Rice, President of the Marshall Browning Hospital
Board. William Huff,
CEO,
added that a key benefit of the affiliation is allowing the hospital to remain
a local facility with "local
citizens
serving on the Board to work to provide services for the citizens in its
service area."
The
affiliation builds on and expands the various collaborations that already exist
between SIH and MBH
such
as its partnership with SIH and Prairie Cardiovascular through its Prairie
STATHeart program.
STATHeart
identifies, treats, and transfers acute heart attack patients to a cardiac cath
lab within 90 minutes
of
arriving in Marshall Browning Hospital’s emergency room. The STATHeart program
melds cooperation
and
collaboration between the community hospital emergency department, EMS ground
and air transport,
Memorial
Hospital of Carbondale and cardiologists of Prairie Cardiovascular.
In
addition, SIH physicians have long consulted at MBH, seeing patients in such
specialties as cardiology,
oncology/hematology,
and pulmonology.
“The
affiliation is not meant to be disruptive of pre-existing clinical
relationships or referral patterns. Rather
we
want to work closely with the hospital to identify gaps in care and determine
how SIH can help fill in
those
gaps as well as reinforce or add services that will be helpful to Perry County”
said SIH President and
CEO
Rex Budde.
Marshall
Browning Hospital is a not-for-profit Critical Access Hospital providing a
broad range of services
to
citizens of Perry County and the surrounding communities. Founded in 1919, the
25-bed hospital
maintains
a deep tradition of providing high-quality care to a service area of over
20,000.
The
hospital also includes Marshall Browning Therapy Center, located on the
hospital campus. Services
offered
at the center include Physical Therapy, Occupational Therapy, Speech Therapy,
Athletic Training,
ImPACT
Concussion Testing, Aquatic Therapy, Lymphedema Therapy, Vestibular Therapy,
Hand
Therapy,
Pediatrics and Hippotherapy. Marshall Browning Therapy Center also has become
the only facility
in
southern Illinois to have certified instructors to offer the highly acclaimed
Sportsmetrics™ Training
Program,
effective in reducing the risk of knee injuries in female athletes.
The
campus also includes a 22-unit Independent Living Center and Marshall Browning
Medical Clinic that
includes
the practices of Dr. Gladstone Tucker, Dr. Terrence Hall, Dr. Beth Bigham, and
Family Nurse
Practitioner,
Felicia Kimbrough. Marshall Browning Hospital is fully accredited by The Joint
Commission.
The
hospital has in excess of 43,000 patient visits which include inpatient,
outpatient and ER visits per year.
Southern
Illinois Healthcare includes Memorial Hospital of Carbondale, Herrin Hospital,
St. Joseph
Memorial
Hospital, the SIH Cancer Institute and Miners Memorial Health Center.
Copyright
2011 Du Quoin Evening Call. Some rights reserved
September
28, 2011,
Life
After Breast Cancer Can Be Difficult: Dr. Pearman - MyFox Chicago -
Chicago
- More women than ever before are surviving breast cancer, but some still
struggle to feel normal
and
healthy after beating their disease. Dr. Timothy Pearman, a clinical
psychologist and director of the
supportive
oncology program at Northwestern Medicine and the Robert H. Lurie Comprehensive
Cancer
Center,
joined us.
Pearman
said after battling breast cancer, woman may struggle with fatigue, cognitive
problems (sometimes
known
as chemobrain), nutrition, depression and side effects that may present
themselves years after
treatment.
Quality of life for breast cancer survivors, in particular, is often affected
by lymphedema,
premature
menopause and concerns about their risk of recurrence and libido.
A
lot of these issues, which may be either disease related or treatment related,
tend to revolve around
emotional
support. Anywhere from 30 to 50 percent of patients will be clinically
depressed or experience
clinical
anxiety at some point during their treatment, Pearman said.
To
make the transition to life after breast cancer easier, woman can take care of
their mental and physical
health,
Pearman said. Specialists like social workers, cancer rehabilitation
therapists, nutritionists and health
educators
can be a big help in helping women striving to live healthy lives after
cancer.
The
free Lynn Sage Breast Cancer Town Hall Meeting on Sunday, Oct. 2 is open to the
public from 1 p.m.
until
4 p.m. in the Arthur Rubloff Building’s Thorne Auditorium, 375 East Chicago
Avenue, on
Northwestern
University’s Chicago Campus. Exhibits and registration start at noon.
Recovery
Club: Pro-Level Training Tools for Weekend Warriors - Wired News – By Joe
Lindsey -
I
lean back in a chaise lounge while what look like the world’s largest blood
pressure cuffs slowly inflate
around
my legs. But this is no medical test: This is the future of active recovery for
amateur athletes.
Professional
athletes have for years had access to better training tools and techniques than
us workaday
amateurs.
They benefit from more sophisticated approaches because the price, complexity,
or simple rarity
of
many of these modalities puts them out of reach of the rest of us.
Josh
Shadle hopes to change all that. A longtime massage therapist, Shadle earlier
this year opened
AllSports
Recovery Club, which he believes is the first open-to-the-public recovery
center in the world.
And
while his clientele includes pro athletes, he’s targeting amateurs, giving them
access to the same tools as
elite
competitors.
“I’ve
been doing massage for five years,” he says, “and the next step, to me, was a
walk-in recovery center
where
people could go and use these tools themselves, without anyone having to do it
for them.”
AllSports
is focused on FDA-approved products that you can use without medical
supervision. The suite of
tools
runs a broad range, from cold lasers to a custom temperature-controlled ice
bath that circulates
saltwater
at a constant 50 degrees. One ingenious hack is a $25 Ryobi six-inch orbital
buffer, perfect for
self-massage.
But
the star of the show is clearly the NormaTec MVP boots, a compression therapy
that Shadle likens to
an
extremely effective massage. You can buy static compression clothing, but the
research on its
effectiveness
is mixed.
The
NormaTec system, by contrast, uses dynamic sequential gradient compression,
which is a fancy way of
saying
it pressurizes five separate chambers in sequence; you can control intensity
and duration to match
your
needs.
Clinical
research in sports recovery hasn’t caught up to use yet, but the system —
invented for hospital
patients
— has been shown effective in medical settings at counteracting lymphedema, the
painful and
dangerous
pooling of lymphatic fluid in tissues.
Dynamic
compression’s action mechanism for sports recovery is unclear. It may help
speed toxins and
promote
circulation; it may enhance muscles’ thixotropic properties — their ability to
become more flexible
when
used.
Mesa
State University’s Bill Sands, a physiologist who formerly ran the United
States Olympic Training
Center’s
recovery facility, says compression — particularly dynamic compression like the
NormaTec
system
— is one of the few recovery modalities he’s studied that show clinical promise
for producing an
actual
performance benefit.
Anecdotally,
results are more emphatic. Mirinda Carfrae, the reigning Ironman World
Triathlon Champion,
and
an AllSports client, says that ice baths AND NormaTec boots are her top choices
for post-workout
recovery.
So
what’s to stop you from getting this stuff yourself? Well, a pair of boots is
$5,000, for one. An ice bath
from
iCool, one of the cheapest available, will set you back another $4,990 or more.
Cold lasers are cheap
by
comparison, starting around $300 for a basic model.
Shadle’s
club offers unlimited walk-in access to all that for $60 a month, plus
discounted à la carte services
like
chiropractic, massage and Graston technique. “I’ve been to the USOC’s recovery
room,” says
NormaTec
vice-president Gilad Jacobs, “and what Josh has going is every bit as good as
that.”
For
a retail model, Shadle is less focused on the gym or yoga studio model and more
on an icon from the
tech
industry: Apple. “I envision it like the Genius Bar,” Shadle says. “You come in
and tell us what
problems
you’re having and we set you up with the tools and a recovery protocol to help.
It’s free advice,
so
that we can help educate people to get the kind of help they need to be healthy
and improve their
performance.”
That’s
great, I think, but I still have two questions.
First,
do amateur athletes really need all that? After all, we don’t work out as hard
as pros.
Sure,
replies Shadle. “In fact, we think amateur athletes have more to gain here.
Pros are already focused on
recovery
and are looking at single-percent performance gains. But amateurs often don’t
have time for
recovery
workouts; when they work out they go hard every time. So muscles get tight from
all that
metabolic
waste, and it builds up and people never really recover. With amateurs, the
room for improvement
is
so much bigger.”
Second,
right now the only location is in Boulder, Colorado, a town known for being
packed wall-to-wall
with
endurance athletes at 4 percent body fat. Will it play, as they say, in
Peoria?
Shadle
hopes so. He realizes not every city could support an AllSports, but that’s
part of why the price is
set
where it is. “This is the same price as a one-hour massage,” he points out,
“but you can come here every
day
if you like.”
And
because everything is in one place, AllSports might be all you need. Carfrae
has a set of NormaTec
boots
at home, but comes in anyway, she says, because of what else AllSports offers.
“I can go in for a
massage,
do some Graston, or jump in the ice bath and use the boots,” she says of the
range. “It’s a one-
stop
shop.”
Carfrae
defends her title on Oct. 8. You can bet Shadle will be watching
closely.
September
28, 2011
Nomograms
can predict 5-year lymphedema risk - Oncology Nurse Advisor –
Estimating
the risk of lymphedema after axillary dissection for breast cancer is
difficult, but a group of
researchers
has used a large data set to develop graphical statistical tools known as
nomograms to help
predict
5-year probability.
Jose
L. Bevilacqua, MD, PhD, a surgical oncologist at Hospital Sírio-Libanês in São
Paulo, Brazil, and
colleagues
collected clinicopathologic features from a prospective cohort study of 1,054
women with
unilateral
breast cancer. All subjects had undergone axillary dissection, between August
2001 and
November
2002, as part of their surgical treatment
The
investigators determined the cumulative incidence of lymphedema and predicted
the risk of developing
the
condition based on the available data at each of three timepoints:
preoperatively, within 6 months
postoperatively,
and 6 months or more postoperatively. They defined lymphedema as a volume
difference of
at
least 200 mL between arms at 6 months or more after surgery.
As
reported at the American Society of Clinical Oncology 2011 Breast Cancer
Symposium, held
September
8-10, 2011, in San Francisco, California, Bevilacqua and associates found the
5-year cumulative
incidence
of lymphedema to be 30.3% (www.asco.org/ASCOv2/Meetings/Abstracts?
&vmview=abst_detail_view&confID=111&abstractID=86647).
Independent risk factors for the condition
were
age, body mass index (BMI), ipsilateral arm chemotherapy infusions, level of
axillary dissection,
location
of radiotherapy field, development of postoperative seroma, infection, and
early edema.
The
predicted 5-year risks calculated by the nomograms were more than 70% accurate
for all three
timepoints
assessed—70.6% for the preoperative model, 72.9% for the
within-6-months-postoperatively
model,
and 73.6% for the 6-months-or-more-postoperatively model.
The
investigators concluded that the proposed nomograms can help clinicians and
patients predict the 5-year
probability
of lymphedema after axillary dissection for breast cancer, knowledge that could
identify patients
who
may benefit from early intervention.
September
29, 2011
QH
Medical Supply Joins G'Town Chamber – Memphis Daily News – By JOHN
LINTNER
QH
Medical Supply hasn’t moved to a new location, but the company will celebrate
its membership into the
Germantown
Chamber of Commerce with a ribbon-cutting ceremony Tuesday, Oct. 4.
That
event will be followed by an open house at QH Medical Supply’s headquarters,
2965 N. Germantown
Road
in Bartlett.
QH
Medical is a durable medical equipment company specializing in mastectomy
products and pain
management.
It also carries a host of other items such as lymphedema sleeves, compression
hose, adult
diapers
and wheelchair cushions.
All
employees are certified to fit mastectomy products such as bras and
forms.
The
company, which works directly with patients, providing them with much-needed
supplies that are
ordered
by a physician, also has a retail location.
“I
have 25 years’ experience doing medical billing and medical software,” said
Patricia Barnett, co-owner of
QH
Medical Supply. “So, I’m a certified vendor – not QH – but I’m a certified
vendor with Medicare as far
as
medical software. (Co-owner) Jan (Freudenberg) and I both have been in the
(durable medical
equipment)
business with another company. We have extensive backgrounds in DME as well as
medical
billing.”
The
medical supply company now offers Freedom Alert, which is a two-way emergency
pendant
communicator
that allows wearers to call 911, family members or remotely answer incoming
calls. It carries
no
monthly maintenance fee.
QH
is Medicare-accredited and carries most insurance. It is also a member of the
Bartlett Chamber of
Commerce.
September
30, 2011
NJ
med firm, office manager admit fraud charges - Houston Chronicle –
TRENTON,
N.J. (AP) — State authorities say a southern New Jersey medical firm and its
office manager
have
admitted defrauding Medicaid and Medicare of $3 million.
Attorney
General Paula Dow announced the guilty pleas Friday, one day after The Center
for Lymphatic
Disorders,
based in Egg Harbor Township, and 54-year-old Farah Iranipour Houtan appeared
in state
Superior
Court in Atlantic County. Houtan admitted that between 2004 and 2007, she
billed the health care
programs
for treatment that wasn't provided.
In
a related matter, 45-year-old Khashayar Salartash of Linwood, a surgeon and
company owner, agreed
Thursday
to repay the $3 million as part of a separate consent agreement with the
state.
The
company treated patients with lymphedema, a disorder that causes fluid
accumulation and swelling of
the
arms and legs.
St.
John's Cancer Center of Ventura County Offers Several Free Classes and Support
Groups Each Month
-
Ventura County Star -
St.
John’s Cancer Center of Ventura County offers various free classes and support
groups to help those
affected
by cancer. For more information or to register for a class, please call (805)
988-2641.
The
following classes are offered at St. John’s Cancer Center of Ventura County,
located at 1700 North
Rose
Avenue, Suite 145 in Oxnard, unless otherwise indicated:
Colorectal
Cancer Support Group: second and fourth Thursdays of each month from 6 to 7:30
p.m. Co-
sponsored
by the American Cancer Society. Facilitated by MaryAnna Palmer, MS, MFT from
The
Wellness
Community.
The
Color of Love Group: first and third Thursdays of each month from 7 to 8:30
p.m. This group is
designed
to allow cancer patients and their families to express themselves through art.
Facilitated by local
artist
Kathleen Hagen, who has over eight years of experience in leading this
group.
Exercise
is Wise—an After Breast Cancer Surgery Exercise Class: Wednesdays from 4 to 5
p.m. Classes
are
held at St. John’s Outpatient Therapy Center, 961 N. Rice Avenue, #3,
Oxnard.
Free
Wigs, Hats and Scarves
Individual
Bilingual Counseling for Patients and Caregivers: By appointment only. Call
(805) 988-2641.
Kids
with Relatives with Cancer Support Group: Tuesdays from 6:30 to 8 p.m.
Facilitated by Diane Martell,
LMFT.
Co-sponsored by The Wellness Community.
Latina
Breast Cancer Support Group: first and third Thursdays of each month from 12 to
1 p.m. Facilitated
by
Rosie Hernandez, MSW.
Latina
Women’s Support Group: second and fourth Mondays of each month from 10 to
11:3-0 a.m. for
Latina
women with any kind of cancer. Facilitated by Diane Martell, LMFT. Co-sponsored
by The
Wellness
Community.
Latino
Cancer Support Group: fourth Thursday of each month from 6:30 to 8 p.m. for
patients and family
members.
Facilitated by Mario Cepeda, MA. Co-sponsored by The Wellness
Community.
Latino
Men’s Support Group: first and third Mondays of each month from 10 to 11:30
a.m. Facilitated by
Diane
Martell, LMFT. Cosponsored by The Wellness Community.
Lymphedema
Education and Screening Clinic: third Friday of each month from 2 to 3 p.m.
Individual risk
assessments
and valuable information for the prevention of chronic lymphedema will be
provided by
Cassandra
Norton, PT.
Nutrition
Counseling: Thursdays from 9 a.m. to 3 p.m. Individual one-hour sessions with
Susan J. Speer,
MS,
RD, FADA, CSO a certified nutritionist specializing in diets for cancer
patients that can help you eat
better
and feel better. She can explain problems related to your individual condition
and develop a dietary
plan
to meet your special needs.
Prostate
Cancer Support Group: third Tuesday of each month from 10 to 11:30 a.m.
Facilitated by Helmut
K.
Hoenigsberg, a volunteer with the American Cancer Society. Co-sponsored by the
American Cancer
Society.
Relaxation
Therapy in the Reiki Tradition: see the Cancer Center calendar for days and
times. Practitioners
strategically
place their hands on various positions of the body so Reiki Energy can begin to
flow. Patients
often
report they have less pain and nausea and are able to sleep better and think
more clearly.
Reinhabiting
You Yoga Classes: Gentle Yoga for Your Journey with Cancer—Thursdays from 1:45
to 3 p.
m.;
Feeling Better and Stronger with Yoga—Thursdays from 3 to 4:30 p.m. Taught by
Audrey Waltzer,
owner
and director of the Camarillo Yoga Center.
Women
with Cancer Support Group: Tuesdays from 1 to 2:30 p.m. Facilitated by Joyce
Boucher, LCSW,
MFT.
Co-sponsored by The Wellness Community.
October
1, 2011
Occupational
Therapist - Minot Daily News –
MEDICAL
HELP WANTED
OCCUPATIONAL
THERAPIST
Full-time
position. Mon.- Fri. day shift with some weekend coverage required. Job duties
include but not
limited
to: Orthopaedics, Vestibular, Incontinence, Fibromyalgia, Lymphedema, Pool
Therapy, Skilled,
Home
Health and Care Center. Occupational Therapy License required. Sign-on bonus
and paid CEU's.
HOSPITAL
PHARMACIST
Full-time
position. Mon.- Fri. 9:00 a.m. - 5:30 p.m. but will require flexibility. Job
will primarily be in the
hospital
pharmacy at both Wright Medical Center and Belmond Medical Center and will
float as needed in
the
retail pharmacy at Wright Medical Center. Position will be required to be on a
call rotation and work
every
fourth Saturday morning. Hospital pharmacy experience preferred.
Positions
offer outstanding wages & fringe benefits. Please stop by and pick up an
application, apply on-line
at
www.wrightmed.com or contact the Human Resouces Department at 515-602 9801 to
receive an
application
by mail. All positions are subject to criminal/department adult abuse
background checks, pre-
employment
physical and drug testing.
WRIGHT
MEDICAL CENTER
1316
S. MAIN STREET
CLARION,
IA 50525
Wright
Medical CENTER
Breast
cancer 'not a death sentence' - Taunton Daily Gazette – By Deborah Allard
–
FALL
RIVER --
In
the waiting room of Charlton Memorial Hospital’s Southcoast Center for Cancer
Care, Juanita
Thompson
sang softly to a tune that she alone could hear from her iPod.
Thompson,
a breast cancer survivor, had a mastectomy about a year ago and several rounds
of
chemotherapy.
Despite losing her hair and a breast, the spiritual woman has found a renewed
sense of joy.
“I’ve
come out of this with a brand new mind, body and spirit,” Thompson said. “It’s
really not a death
sentence.
It’s made me think about life and make every minute of it count.”
Thompson,
like most who suffer from breast cancer, has gone on to live a long and healthy
life — a far cry
from
what women endured not so many years ago when little was known about breast
cancer.
Today,
there are some 50 forms of chemotherapy, hormonal agents and targeted therapies
that work
together
to kill breast cancer cells, not to mention surgical options, radiation therapy
and clinical trials,
according
to materials from Saint Anne’s Hospital’s Regional Cancer Care
center.
Susan
O’Brien, an oncology nurse practitioner at Saint Anne’s Hospital, said breast
cancer has become
more
chronic than fatal.
“Once
a woman is diagnosed, it’s a journey that she undertakes,” O’Brien said. “It’s
so wonderful that these
women
with breast cancer are living so long.”
O’Brien
said breast cancer survival rates have been incredibly improved even since she
started at Saint
Anne’s
Hospital 25 years ago. Because of advances made in drugs and in education, more
women are
diagnosed
with curable Stage I and II cancers, rather than at more advanced
stages.
The
five-year survival rates for Stage I and II breast cancer now ranges from 74 to
88 percent, according to
the
American Cancer Society. The survival rates for stage III and IV breast cancer
are as high as 67 percent.
Until
the 1960s — and later, in some cases — survival rates were very low, and the
disease often resulted in
death.
People thought breast cancer was embarrassing, and it was a hushed topic that
often resulted in a
late,
if any, diagnosis.
Dr.
William Stewart Halsted is credited with being one of the fathers of modern
American surgery at Johns
Hopkins
University Hospital in the late 1800s. He developed the radical mastectomy,
which consisted of
removing
the entire breast, the underlying chest wall muscles and all lymph nodes in the
armpit, according to
the
National Surgical Adjuvant Breast and Bowel Project.
The
deforming operation resulted in a concave appearance, O’Brien explained. Women
who underwent the
procedure
often sought to wear a heavy prosthetic breast afterward.
This
procedure was the standard breast cancer surgery for decades, until brothers
Drs. Bernard and Edwin
Fisher
challenged the radical mastectomy in the 1960s.
Today,
doctors know that mastectomy has the same end result as lumpectomy plus
radiation for most
women.
Those undergoing mastectomy do not lose as much tissue as in decades
past.
Until
25 years ago, women also underwent 14 cycles of chemotherapy lasting for 14
months, as opposed to
today’s
roughly four months of chemotherapy.
“I
never thought I would die,” said Margaret McCaffrey, who had breast cancer in
1995. Now retired, she
is
a greeter at the Hudner Oncology Center at Saint Anne’s Hospital.
Because
most women live with breast cancer, there is a whole new population of women in
follow-up care
for
years after their surgery or treatments. For them, living with breast cancer is
the new normal.
For
Thompson, follow-up care has included doctor’s visits every three months and
monthly blood work.
Breast
cancer can also result in complications. Thompson experienced lymphedema in her
arm, a swelling of
the
tissue, due to the surgery.
O’Brien
said there are many “immediate and long-term effects.”
Besides
lymphedema, patients can suffer from cognitive difficulties, low energy and
depression. They may
also
suffer effects to the heart and lungs, or go into early menopause, which can
lead to osteoporosis.
Follow-up
care generally consists of following any side effects, and includes hormone
therapy for some.
Support
groups, yoga, meditation and spiritual retreats are also part of what is
offered at local hospitals.
Thompson
attends a monthly support group where she is free to talk about her experience
with breast
cancer
and other topics.
“I
love it,” Thompson said. “Talking about it helps other women through it. We
lift each other up.”
Thompson
plans to have reconstructive surgery in the near future, and is also planning
on getting gastric
bypass surgery to lose weight. Now 51, she
has begun computer programming classes at Bristol Community
College,
something the mother of five has wanted to do for decades.
“I
want to live,” Thompson said. “I want to enjoy the rest of my life. I feel
wonderful.”
ctober 30, 2011 – St. Mary opens new physical therapy center - phillyBurbs.com -
By Jo Ciavaglia -
MIDDLETOWN — St. Mary Medical Center has opened a new 2,500
square-foot physical therapy
center in Middletown and expanded its nearby
wound healing and hyperbaric medicine center to include
lymphedema therapy
for the head, neck and lower body.
Physical Therapy services at the Cornerstone Executive Suites will focus on orthopedic and muscular
rehabilitation for injury or troublesome conditions of the hip, knee,
shoulder and back. The new center also
will offer an amputation therapy program designed to help a patient re-learn skills and improve mobility to
attain the highest level of independence following the amputation of a
limb.
The lymphedema therapy program will focus on treating swelling of the
lower extremities as a result of
certain medical conditions, including
chronic venous insufficiency, as well as swelling of the head and neck,
typically occurring as a result of cancer treatment.
Lymphedema is an
abnormal swelling of a body part caused by an excessive buildup of fluid.
Lymphedema
most often occurs after a lymph node dissection, surgery or
radiation, all of which can damage the lymphatic
system during the treatment
of cancer.
October 30, 2011 - Secondary Lymphedema in the cancer patient -
WHIO Radio – By Steve Wilson -
The Dayton Daily News spent the entire month
of October giving our readers special and in-depth coverage
for National
Breast Cancer Awareness Month.
In today's story they look at a painful
limb-swelling condition known as lymphedema.
A study by the University of
Dayton confirm a common side effect of breast cancer treatment is
lymphedema.
Lymphedema is a condition characterized by swelling in one or
more extremities that results from impaired
flow of the lymphatic
system.
There's no cure for lymphedema, but it can be controlled.
November 3, 2011
Taking
steps to better health - Omaha World-Herald – By Katy Healey –
Joan
Fredrickson presses a miniature beach ball between her hands and the sage-green
wall. A handful of
others do the same as the sound track to "Grease" plays in the background. Then the group begins to do a
series
of standing push-ups.
The exercise is part of Healthy Steps, a therapeutic exercise program at Bergan Mercy Medical Center that
was
originally created for breast cancer survivors in the 1980s.
"Since
then, they've done research and have found out everyone benefits from this
program," said class
instructor
Michaela Fornoff.
Those
with other forms of cancer, Parkinson's disease, arthritis, chronic fatigue,
fibromyalgia and multiple
sclerosis,
among other illnesses, can also enroll.
Fornoff
said the exercises promote balance, muscle strength and perhaps most
importantly, prevent or
manage
lymphedema. Lymphedema is severe swelling that results from blocked lymph
passages. It inhibits
movement.
The swelling can make it difficult or even impossible to do everyday tasks like
reaching
something
on a shelf or brushing your teeth.
"You
don't hear about it very much so it gets missed, but your lymphatics can back
up with any cancer
treatment
or trauma to your limbs," said Fornoff, a certified lymphedema
therapist.
About
half a dozen regulars attend the class every Tuesday afternoon. Fredrickson, a
breast cancer
survivor,
first joined Healthy Steps in 2004. "This class helps keep the fluid moving and
the lymphedema
down,"
she said. "I want to keep it that way. That's why I keep coming."
During
the one-hour class, the group used miniature beach balls, chairs for balance,
resistance bands and
poles
roughly three feet long to improve their range of motion. They also used their
own body weight during
lunges
and dance numbers. The room was full of smiles and laughter during the dancing
portion of class.
"It's
not hard. Anybody could do it," said Connie Czaplewski of Omaha. Czaplewski
joined Healthy Steps a
year
ago. She is also a breast cancer survivor who attends class to manage
lymphedema.
"I
like the people there," she said. "You feel relaxed there, a little more
limber, a little more energetic, a little
more
flexible."
None
of the exercises are too difficult, she said. "We don't do anything on the
floor, which is good because
we'd
probably need a couple squads to help us back up," Czaplewski joked.
The
first six-week session is free. Additional sessions cost $36. The next session
begins Nov. 15. Contact
Alegent
Health for more information by calling 1-800-ALEGENT.
November
5, 2011
Hometown
briefs - Glens Falls Post-Star –
Cancer
center hosts benefit fashion show
The
C.R. Wood Cancer Center and The Rehabilitation Center at Glens Falls Hospital
will hold the third
annual
Lymphedema Awareness Fashion Show from 6 to 7:30 p.m. Friday at Glens Falls
Hospital Bistro on
the
first floor of the hospital's Northwest Tower, 100 Park St.
Supplies
needed to treat lymphedema are not always covered by insurance companies. All
proceeds from
the
event will be placed in a special fund to help individuals who are unable to
afford the costly supplies.
The
show will feature fall fashions from Finders Keepers Consignments in Glens
Falls and formal wear
supplied
by Jacqueline's Bridal Shoppe in Glens Falls.
Hair
and makeup for the models will be provided by Adonis Hair Design in
Queensbury.
A
silent auction also will be held that will include items donated by a number of
local businesses and artisans.
The
cost to attend the event is a donation. For more information, contact Vickie
Yattaw at 926-6639 or
Lisa
Mallette at 926-2067.
November
6, 2011
What
Your Feet Say About Your Health - Myjoyonline.com –
If
your toes are always cold, one reason could be poor blood flow -- a circulatory
problem sometimes
linked
to smoking, high blood pressure, or heart disease. The nerve damage of
uncontrolled diabetes can
also
make your feet feel cold to you. Other possible causes include hypothyroidism
and anemia. A doctor
can
look for any underlying problems -- or let you know that you simply have cold
feet.
Foot
Pain
When
your feet ache after a long day, you might just curse your shoes. After all,
eight out of 10 women say
their
shoes hurt. But pain that’s not due to sky-high heels may come from a stress
fracture, a small crack in a
bone.
One possible cause: Exercise that was too intense, particularly high-impact
sports like basketball and
distance
running. The weakened bones of osteoporosis increase your risk.
Red,
White, and Blue Toes
Raynaud’s
disease can cause your toes to turn white, then bluish, and then redden again
and return to their
natural
tone. The cause is a sudden narrowing of the arteries, called vasospasms.
Stress or changes in
temperature
can trigger vasospasms, which usually don’t lead to other health concerns.
Raynaud’s may also
be
related to rheumatoid arthritis, Sjögren’s disease, or thyroid
problems.
Heel
Pain
The
most common cause of heel pain is plantar fasciitis, inflammation where this
long ligament attaches to the
heel
bone. The pain may be sharpest when you first wake up and put pressure on the
foot. Arthritis,
excessive
exercise, and poorly fitting shoes also can cause heel pain, as can tendonitis.
Less common causes
include
a bone spur on the bottom of the heel, a bone infection, tumor, or
fracture.
Dragging
Your Feet
Sometimes the
first sign of a problem is a change in the way you walk -- a wider gait or
slight foot dragging.
The
cause may be the slow loss of normal sensation in your feet, brought on by
peripheral nerve damage.
About
30% of these cases are linked to diabetes. Nerve damage also can be due to
infection, vitamin
deficiency,
and alcoholism. In many cases, no one knows what caused the nerve
damage.
Clubbed
Toes
In
clubbing, the shape of the toes (and often the fingers) changes. The nails are
more rounded on top and
curve
downward. Lung disease is the most common underlying cause, but it also can be
caused by heart
disease,
liver and digestive disorders, or certain infections. Sometimes, clubbing runs
in families without any
underlying
disease.
Swollen
Feet
This
is usually a temporary nuisance caused by standing too long or a long flight --
especially if you are
pregnant.
In contrast, feet that stay swollen can be a sign of a serious medical
condition. The cause may be
poor
circulation, a problem with the lymphatic system, or a blood clot. A kidney
disorder or underactive
thyroid
can also cause swelling. If you have persistent swelling of your feet, see a
physician.
Burning
Feet
A
burning sensation in the feet is common among diabetics with peripheral nerve
damage. It can also be
caused
by a vitamin B deficiency, athlete’s foot, chronic kidney disease, poor
circulation in the legs and feet
(peripheral
arterial disease), or hypothyroidism.
Sores
That Don't Heal
Foot
sores that will not heal are a major warning sign for diabetes. Diabetes can
impair sensation in the feet,
circulation,
and normal wound healing, so even a blister can become a troublesome wound.
Those sores
also
are prone to infection. Diabetics should wash and dry their feet and check them
for any wounds every
day.
Slow-healing of sores also can be caused by poor circulation from conditions
such as peripheral artery
disease.
Pain
in the Big Toe
Gout
is a notorious cause of sudden pain in the big toe joint, along with redness
and swelling (seen here).
Osteoarthritis
is another culprit that causes pain and swelling. If the joint is rigid, it may
be hallux rigidus, a
complication
of arthritis where a bone spur develops. Finally, turf toe is an ailment of
athletes, particularly
those
who play on hard surfaces. It's caused by an injury to ligaments surrounding
the joint.
Pain
in the Smaller Toes
If
you feel like you're walking on a marble, or if pain burns in the ball of your
foot and radiates to the toes,
you may have
Morton’s neuroma, a thickening of tissue around a nerve, usually between the
third and fourth
toes.
It is eight to 10 times more common in women than in men. It is caused by
injury or too much pressure
on
the toes.
Itchy
Feet
Itchy,
scaly skin may be athlete’s foot, a fungal infection that's common in men
between the ages of 20 and
40.
A reaction to chemicals or skin care products -- called contact dermatitis --
can cause itching, too,
along
with redness and dry patches. If the skin on your itchy feet is thick and
pimple-like, it may be
psoriasis,
an over-reaction of the immune system. Medicated creams can relieve the
symptoms.
Claw
Toe
This
foot deformity can be caused by shoes that are tight and pinch your toes or by
a disease that damages
nerves,
such as diabetes, alcoholism, or other neurological disorder. Your toes will be
bent upward as they
extend
from the ball of the foot, then downward from the middle joint, resembling a
claw. They may respond
to
stretching and exercises of the toes or you may need special shoes or even
surgery.
Foot
Spasms
A
sudden, sharp pain in the foot is the hallmark of a muscle spasm or cramp,
which can last many minutes.
Overwork
and muscle fatigue are common causes. Other causes include poor circulation,
dehydration, or
imbalances
in potassium, magnesium, calcium, or vitamin D levels in the body. The changing
hormone levels
of
pregnancy or thyroid disorders may play a role. If spasms are frequent or
severe, see a doctor.
Strengthening
exercises can help.
Dark
Spot on the Foot
We
associate skin cancer with the sun, so we’re not as likely to check our feet
for unusual spots. However,
a
melanoma, the most dangerous form of skin cancer, can develop even in areas
that are not regularly
exposed
to the sun. Melanoma can even appear beneath the nail, where it might look like
a black spot.
Yellow
Toenails
Your
toenails tell a lot about your overall health. A fungal infection often causes
thickened yellow toenails.
Thick,
yellow nails also can be a sign of an underlying disease, including lymphedema
(swelling related to the
lymphatic
system), lung problems, or rheumatoid arthritis.
Spoon-shaped
Toenails
Sometimes
an injury to the nail or frequent exposure to petroleum-based solvents can
create a concave,
spoon-like
shape. However, iron deficiency also can cause this unusual shape.
White
Nails
Injury
to the nail or illness anywhere in the body can cause white areas in the nails.
If part or all of a nail
separates
from the nail bed (shown here), it can appear white -- and may be due to an
injury, nail infection,
or
psoriasis. If the nail is intact and most of it is white, it can sometimes be a
sign of a more serious condition
including
liver disease, congestive heart failure, or diabetes. Talk with your health
care team about any
concerns.
Pitting
of the Nails
Pitting,
or punctured-looking depressions in the surface of the nail, is caused by a
disruption in the growth of
the
nail at the nail plate. It affects as many as half of people with
psoriasis.
November
7, 2011
Indian
River Health Listings Updated updated Nov. 7 – TCPalm –
ONGOING
Lymphedema
Therapy Center: Vodder Technique to reduce swelling. 787 37th St., Ste. E-100,
Vero
Beach,
8:30 am-5 pm, Mon-Fri.
Kitsap
Physical Therapy and Silverdale Fitness celebrate remodel with open house -
Kitsap Peninsula
Business
Journal -
Come
and see the newly remodeled Kitsap Physical Therapy and Silverdale Fitness at
an open house on
Nov.
10 from 5 to 7 p.m.
Kitsap
Physical Therapy and Silverdale Fitness are a ‘whole body’ wellness facility
that helps its patients get
well
and stay fit.
Some
of the areas of specialty offered at the Silverdale office are: cardiac
rehabilitation phase 3 & 4,
amputee
prosthetic limb gait training and conditioning, vestibular/balance
rehabilitation, Bike Fit,
computerized,
fitness testing, myofascial/trigger release work, SportsMetrics/sports
performance programs,
industrial
injury and wellness programs, aquatic therapy, breast cancer lymphedema
management, senior
fitness/SilverSneakers
programs, weight loss programs, personal training and much more. For more
information,
call (360) 613-1834
Melrose
Pusey's Dilemma:Light at the end of the tunnel - Jamaica Gleaner –
Last
Wednesday, a kind reader, Violet Mahfood, donated $10,000 and local medical
expert, Patrice
Dwyer,
certified lymphedema therapist, met Mrs Pusey and after a consultation, she
told Flair that Pusey's
case
is treatable. She placed the order for the materials needed for the treatment.
So we are moving closer
to
getting Mrs Pusey some relief! With some help from Mrs Pusey's daughter and a
donation from The
Gleaner's
editorial department, we will be able to pay for the items needed to treat
her.
Flair
says a big thank you to Nadeen Matthews who pledged US$100 towards the cost.
Coincidentally, she
was
in a meeting with Dwyer last week and handed over the money. Both are sorority
sisters in the
Jamaican
chapter of Delta Sigma Theta Sorority, and Matthews said, based on their
conversation, there is
an
educational opportunity here for the Jamaican public, as well, beyond the care
for Mrs Pusey. Dwyer
ordered
the items from her own credit card.
Meanwhile,
Mrs Pusey comes close to tears when she speaks about the help she has been
receiving since
Flair
first aired her story. She is full of gratitude and prayers for everyone who
has called, written and sent
help
for her.
Materials
Needed
2
Double Arm Kits @ US$94 each
4
10cm Rosidol Soft Padding Bandages at US$5.94 each
1
Lymphoderm US$17.50
1
Eucerin Cream US$14.90
4
10cm Cellona Padding Bandages US$2.94 each
The
total is US$288.92 and an additional sum for shipping and customs costs. The
order was placed at the
Academy
of Lymphatic Studies http://www.acols.com.
Lymphedema
After Breast Cancer Surgery
The
term lymphedema comes from the lymphatic system, which helps coordinate the
immune system's
function
to protect the body from foreign substances and includes an extensive network
of lymph vessels and
lymph
nodes. Here's how the lymphatic system works:
Excess
fluid is collected from the space between tissues in the body and moves through
the lymph vessels.
The
fluid (now called lymph) isn't pumped through the body like blood, but instead
is 'pushed' through the
lymph
system as the vessels are compressed by surrounding muscles. Filters called
lymph nodes remove
certain
harmful substances from the lymph fluid, such as bacteria and debris. The fluid
from most tissues or
organs
is filtered through one or more lymph nodes before draining into the
bloodstream.
What
is Lymphedema?
Lymphedema
is an abnormal build-up of fluid that causes swelling, most often in the arms
or legs. The
condition
develops when lymph vessels or lymph nodes are missing, impaired, damaged, or
removed.
Two
Types
There
are two types of lymphedema: primary and secondary.
Primary
lymphedema is rare and is caused by the absence of, or abnormalities in,
certain lymph vessels at
birth.
Secondary lymphedema occurs as a result of a blockage or interruption that
alters the flow of lymph
through
the lymphatic system and can develop from an infection, cancer, surgery,
scar-tissue formation,
trauma,
deep vein thrombosis (a blood clot in a vein), radiation, or other cancer
treatment.
Reasons
for it
1.
Simple mastectomy in combination with axillary (arm pit) lymph-node
removal.
2.
Lumpectomy in combination with axillary lymph-node removal.
3.
Modified radical mastectomy in combination with axillary lymph-node
removal.
4.
Combined cancer surgery and radiation therapy to a lymph-node region (such as
the neck, armpit, groin,
pelvis,
or abdomen).
5.
Radiation therapy to a lymph-node region.
Lymphedema
develops after breast surgery because there is an alteration in the pathway
that drains the
fluids
involved in the immune system. It can occur at any time after the surgery. If
untreated, it can become
worse.
Following
breast-cancer surgery, a doctor will examine you and take arm measurements.
Sometimes, there
may
be redness or pain in the arm, which may be a sign of inflammation. Depending
on your symptoms, your
physician
will then consider the best treatment options for you.
Source:
webmd.com.
Powerful
combo: Reducing lymphedema - WFTV 9 Orlando –
Between
5 percent and 40 percent of women are estimated to experience some form of
lymphedema after
breast
cancer surgery; however, the condition is often overlooked or misdiagnosed.
Lymphedema occurs
when
the lymph system is damaged or blocked. It can cause fluid buildup and swelling
and usually affects an
arm
or a leg, but it can affect other parts of the body. Lymph fluid, tumors, lymph
vessels and lymph nodes
all
can play a part in lymphedema.
(SOURCES:
www.breastcancer.org, www.cancer.gov)
CAUSES
AND SYMPTOMS: Lymphedema can be either primary or secondary. Primary lymphedema
is
caused
by abnormal development and can occur at birth or develop later in life.
Secondary lymphedema is
caused
by damage to the lymph system due to infection, injury, cancer, scar tissue, or
radiation therapy.
People
can be at risk of developing lymphedema if they are obese, smoke heavily, have
diabetes or have
had
a mastectomy or previous surgery to the armpit area. Along with swelling,
people with lymphedema may
experience
a feeling of heaviness or tightness in the arm or leg. They may also feel
aching or discomfort and
possibly
hardening of the skin around the affected area.
(SOURCES:
www.cancer.gov, www.breastcancer.org and Mayo Clinic)
NEW
PREVENTION TECHNIQUES: Using single photon emission computed tomography
(SPECT)
along
with computerized tomography (CT) scans, doctors may be able to offer
substantial protection against
lymphedema.
Although a person may have as many as 62 lymph nodes under the arm, only a few
are
responsible
for the removal of fluids from the arm. The SPECT-CT technique works best for
patients who
do
not require radiation targeting any remaining lymph nodes. The risk of
developing lymphedema may be as
much
as 50 percent without taking measures to preserve the function of a person’s
lymphatic system.
Because
lymphedema can occur years after a surgery, patients will continue to be
monitored by their
physicians
for signs of lymphedema. Currently, there are two treatment plans for each
patient: a standard
plan
and one adapted for lymph node sparing based on the SPECT-CT scans.
(SOURCE:
Mayo Clinic)
Nevada
Man Wants Surgery For His 100 Pound Scrotum –
The
rare but incredible case of Wesley Warren Jr. puts our daily burdens into
perspective as the Nevada
resident
says he needs around a million dollars to pay for an operation to remove his
100 pound scrotum.
He
has a hugely enlarged scrotum, the sack that protects the testicles and its
size and weight causes him
discomfort,
pain and makes it incredibly difficult to get out and about.
"It's
not easy to get around... It makes me stay
in
most of the time."
Warren
told the Las Vegas Review-Journal of his 100-pound scrotum.
Warren
says the problems started in 2008 when he rolled over in bed and caught his
scrotum with his leg,
causing
him a terrible pain. As the pain subsided his scrotum swelled to the size of a
football and has been
getting
larger since.
Doctors
say that Warren's condition is extremely rare and although more common in
tropical Africa and
Asia,
in these cases the problem is usually put down to a mosquito spread parasitic
infection where thread
like
worms block the lymphatic drainage and fluids collect, that cause huge swelling
known as lymphedema.
However
physicians that have examined Warren's case say there is no sign of this kind
of infection and living
close
to downtown Las Vegas he's hardly at risk of these kinds of tropical
diseases.
Initially,
he sought basic medical treatment, being given antibiotics for what doctors
thought was a local
infection.
Slowly the swelling became so large he could no longer work, so he signed on
for disability
benefits.
In 2010 he tried medical treatment again at the University Medical Center in
Las Vegas. Doctors
classified
and reclassified his condition as scrotal elephantiasis, scrotal lymphedema or
scrotal edema, a
condition
characterized by an excess of watery fluid collecting in tissues of the
body.
Doctors
at UMC thought they might be unable to save Warren's penis and testicles, which
was a shock to
him
:
"Basically,
he was telling me there was a good chance that I would be castrated and have to
go to the
bathroom
through a tube for the rest of my life ... I really would like to have a
relationship with a woman. I
should
be in the prime of my life right now."
Doctors
at UCLA were more hopeful, but then money issues kicked in; even if Nevada
Medicaid would
cover
an out of state procedure, they wouldn't pay enough for what looks to be a
seven figure operation.
Warren
said after he came back from LA :
"I
really don't think people know what I have ... It's not something people have
seen before, I'm sure of that.
I
doubt if they can even imagine it."
November
14, 2011 –
Healthy
Dates - Macon Telegraph –
Lymphedema
Therapy
Women
who have had many lymph nodes removed or have had radiation therapy may
develop
lymphedema.
Ask physician to refer you to a lymphedema specialist by calling (478) 201-6748
or faxing a
referral
to (478) 757-0884.
November
10, 2011
Devon
Medical Products to Feature Compression Therapy Pumps, Secure European
Distributors at 2011
MEDICA
World Fair - MarketWatch
Devon
Medical Products, a global designer, manufacturer, and distributor of creative,
safe, and cost-
effective
medical devices, today announced it will present its featured product line on
the world stage at the
2011
MEDICA World Fair in Dusseldorf, Germany from November 16-19. The company will
be in the U.
S.
Pavilion in Hall 16/Booth D40-5MEDICA is the world's largest event for the
medical sector and has
operated
for over 40 years. Over 4,300 exhibitors, from small innovators to global
health giants, will present
services
and products in 17 halls totaling nearly 400,000 square feet of exhibition
space.
Devon
Medical Products will present its line of U.S. Food and Drug Administration
(FDA) 510(k)- cleared
CircuFlow(TM)
compression therapy pumps and its 510(k)-cleared ArterioFlow(TM) 7500 arterial
pump.
The
company's goal is to secure distributors in the European markets, including the
United Kingdom,
Germany,
France, Italy, and the Netherlands.
"We
are ecstatic to begin our expansion into Europe, and MEDICA is the ideal place
to launch our product
lines
and begin securing distributors," says Dr. John A. Bennett, CEO of Devon
Medical Products. "Our
research
indicates that the European medical device market continues to grow, and that
there is a constant
search for
devices that reduce swelling and improve quality of life for diabetics and
patients battling
lymphedema.
We look forward to sharing information with the world's top medical
professionals in
Dusseldorf."
Devon
Medical Products' CircuFlow(TM) compression therapy pumps and sleeves use
gradient pressure to
increase
the flow of lymphatic fluid, reduce swelling, and increase mobility for
patients suffering from
lymphedema
and venous insufficiencies. The ArterioFlow(TM) 7500 arterial pump and sleeves
apply
pressure
that increases blood flow to the legs of diabetics and patients with poor blood
circulation to help
treat
diabetic foot ulcers and prevent amputation.
Global
medical device distributors and the media can schedule private demos with Devon
Medical Products.
Email
[email protected] to schedule an appointment, or visit the company
in Hall 16/Booth
D40-5
at MEDICA.
About
Devon Medical Products
Devon
Medical Products ( www.devonmedicalproducts.com ) is a global medical device
designer,
manufacturer,
and distributor that provides the medical community with innovative, safe, and
cost-effective
medical
products. The company has cultivated an exclusive line of medical devices
designed to advance
healthcare
treatments and maximize safety for healthcare workers and patients worldwide,
and works with
various
healthcare entities including durable medical equipment providers (DMEs),
hospitals, physician
offices,
nursing homes, physical therapy companies, and more. The company is
headquartered in King of
Prussia,
Pennsylvania, and has offices in China and other countries staffed with
bilingual engineers, product
developers,
and FDA-regulatory experts.
SOURCE:
Devon Medical Products
November
4, 2011
New
Study Reveals Concerns About Lymphedema and Other Complications as Cancer
Survivors Increase
–
Emailwire –
Some
cancer patients deal with lymphedema as a result of surgery or radiation
therapy that causes a
mechanical
alteration of the lymphatic system. It is critical that treatment for
lymphedema occurs early on, as
the
disorder can worsen over time. Compress
(EMAILWIRE.COM,
November 04, 2011 ) Tampa, FL -- A new study in the journal Cancer
Epidemiology,
Biomarkers & Prevention shows that during the next 10 years there will be a
42 percent
increase
of cancer survivors who are older than 65 years old. Health care professionals
will need to become
aware
of some of the distinct challenges these types of patients face to give them
high-quality care.
In
particular, some cancer patients deal with lymphedema as a result of surgery or
radiation therapy that
causes
a mechanical alteration of the lymphatic system. This chronic disorder can
greatly affect an individual’
s
quality of life. It is critical that treatment for lymphedema occurs early on,
as the disorder can worsen over
time.
“Health
care professionals need to do everything possible to keep the skin integrity
and prevent further
infection,”
said Greg Grambor, president of Vascular PRN, a company that helps healthcare
professionals
nationwide
with lymphedema pumps and lymphedema boots. “Compression therapy can keep fluid
from
repooling
so that other complications do not occur.”
Over
time, lymphedema can lead to cellulitis, disability, and psychosocial issues.
Swollen tissues can create
an
environment where infections can reappear and cause irreversible damage to the
tissues. Pain and
difficulty
moving can lead to a diminished quality of life, and affect other areas of a
person’s social and
intimate
relations.
“With a
doctor’s guidance, extremity pump systems and physical therapy can do a lot of
good to regain
comfort
and lessen the issues that can ensue,” said Grambor.
Vascular
PRN has decades of experience helping nursing homes, surgery centers and
hospitals, managed
care
organizations, and other institutions with their lymphedema product needs. To
learn more about
lymphedema
boots, lymphedema pumps, and Vascular PRN’s other products for rent or for sale
such as
sequential
compression devices or SCD boots, visit http://www.vascularprn.com/ or call
800.886.4331.
Press
Release Courtesy of Online PR Media: http://bit.ly/tzc2y6
Contact
Information:
Vascular
PRN
Vascular
PRN
Tel:
800-886-4331
Email
us
This
is a press release. Press release distribution and press release services by
EmailWire.Com: http://www.
emailwire.com/us-press-release-distribution.php.
November
15, 2011
All
in the same boat - Irish Independent –
Dragon-boat
racing is putting breast cancer survivors back on the road to
recovery
A
GROUP of Irish cancer sufferers and survivors recently returned from a
12,000-mile round-trip to Kuala
Lumpur
where they competed for Ireland in dragon-boat racing. There they beat off
competition from 14
countries
to win silver and bronze in their two races.
The
Plurabelle Paddlers are our first dragon-boat team and were in Malaysia to
represent Ireland in the
inaugural
Cancer Survivors World Cup 2011. Before they hit our shores the only place
dragon boats were
regularly
seen was in 'Hawaii-Five-O's title sequence. Now they are being used to help
cancer sufferers to
rehabilitate
as they offer a safe way of doing upper body exercise.
The
Plurabelle Paddlers were set up last year by cancer survivor Fiona
Tiernan.
"I
had a recurrence of breast cancer two years ago and wanted to manage my health.
I had been reading
about
the benefits of exercise and came across dragon-boat racing and got stuck into
getting it set up. I had
an
open day when more than 100 people turned up. After that we started
fundraising."
The
Plurabelle Paddlers started with two members last year and now have more than
70 and two dragon
boats.
"We
had no money and no boats a year ago. Each boat costs €8,000. We fundraised and
got money from
the
HSE. To get to Malaysia we got support from companies like Etihad, who
sponsored our flights," she
says.
"Each
boat holds 22 people. There are 20 paddlers and the two others are steering and
beating a drum. We
don't
talk about cancer when we're out in the boats. You're focused on paddling,"
adds Fiona.
There
were 60 teams at the Malaysian event, made up of 1,500 competitors from 14
countries.
One
of the Irish dragon-boat competitors was mother-of-three Fiona Slevin. Fiona's
sister Jenny was
diagnosed
with breast cancer in August 2004. Jenny recovered but suffered a recurrence in
autumn 2007
and
died in 2009.
Fiona
was also diagnosed with breast cancer the week before Christmas in 2004 when
her youngest child
was
just one year old.
"I
left the meeting in the hospital that day, went to Smyth's toys and bought the
children the best Christmas
presents
ever." Fiona went on to have a lumpectomy, chemotherapy and radiotherapy and
has now
recovered.
Fiona
got into dragon-boat racing following a chance encounter with Plurabelle
Paddlers' founder Fiona
Tiernan
at a cancer conference in August 2010.
"When
you get cancer you are just getting through it. You are dealing with GPs,
oncologists, the hospital and
you
feel helpless in the whole process.
Easiness"Dragon-boat
racing is something you can do for yourself. We also just understand where we
have
been.
With friends and family, it can be a bit difficult as they sometimes don't know
how to deal with you,
but
there's an easiness with the team because we've all gone through the same
thing," adds Fiona Slevin.
One
of the main benefits of dragon boating is to reduce the occurrence of
lymphedema, a swelling of the
arms
and chest area caused by surgery, often to remove lymph nodes.
The
upper body exercise involved in the paddling helps manage lymphedema and has
also been shown to
aid
recovery from cancer.
Another
member of the Plurabelle Paddlers is Margy Fitzsimons from Clondalkin, who was
diagnosed with
breast
cancer in 2003 at the age of 43.
Cancer
has been ever present in Margy's life. "My mum died of a brain tumour, leaving
eight children behind
when
I was only 17. Dad died in 2000 from lung cancer. My youngest son got leukaemia
when he was five
--
he recovered -- and I was diagnosed in 2003.
"I
said to myself if my son can beat cancer I am going to beat it. He inspired
me."
Seven
years on and after a successful recovery Margy decided she had to get
fit.
"I
saw Fiona on the telly. They had an open day. Normally I wouldn't go along to
something like this but it
sounded
so different. It's hard getting fit when you're on your own. It's easier when
you're part of a team,"
she
says.
"When
I was diagnosed I was told 'don't do this' and 'don't do that' -- that's very
negative. If you're active
and
physical you're more likely to stay fit. I'd say to anyone -- come
along!
"The
nature of the illness is such that it knocks your confidence. You can't drive,
you can't do a lot of things.
Give
dragon-boat racing a go. You might just enjoy it!"
?Dragon
Boating -- www.plurabellepaddlers.com
?The
National Cancer Helpline -- 1 800 200 700
November
15, 2011
Helping
lymphedema sufferers - Brantford Expositor –
Soon
after her treatment for breast cancer, Pat Perkins began to notice persistent
swelling in her left arm.
In
June of 2004, the Brantford woman had a lumpectomy followed by chemotherapy and
radiation. By
October,
the swelling began and she was diagnosed with lymphedema.
The
condition is an accumulation of lymphatic fluids that occurs when there is
removal of, or disruption or
damage
to lymph nodes or vessels, usually following surgery or radiation treatment for
cancer.
"I
had never heard of it," said Perkins. "I wasn't really warned about it prior to
my surgery."
Trauma
caused by an accident, injury or a burn can also cause secondary lymphedema
like that suffered by
Perkins.
Some
people are born with a faulty lymphatic system. It may be present at birth,
develop when puberty
begins
or in adulthood. That condition is known as primary lymphedema.
A
2009 study by the Canadian Lymphedema Framework found a lack of standardized
care for patients in
Canada,
no provincial health coverage, a lack of resources for assessment, and a need
to teach lymphedema
prevention
and self-management.
Tissues
with lymphedema are at risk of infection.
Beverley
Speechley, a registered massage therapist who runs a practice from her Erie
Avenue home, said
that
while there is no cure for lymphedema, there is relief available. Pamela
Monarch, another registered
massage
therapist in the city, also provides treatment.
"A
lot of what I do is take away people's fears," said Speechley.
Treatment
includes not only massage therapy, but also compression therapy involving the
use of elastic
bandages,
sleeves, gauntlets or tights to control swelling.
"(With
lymphedema) it's hard to move the limb," said Speechley. "There is pain because
of the stretched
skin.
The muscles need to work harder to lift."
During
massage, the soft tissues of the body are lightly rubbed, tapped and stroked.
It is a very light touch,
almost
like brushing.
"It's
very gentle movement of the fluid from an impaired area to one that isn't,"
said Speechley.
She
also educates her clients about how to best manage lymphedema using exercises
that promote lymphatic
flow
and about skin care to prevent infection.
Perkins
said her arm can be painful, particularly in the summer when it's hot and
humid. Doctors have told
her
she carries about a litre of fluid in her arm. She needs to wear clothing that
will accommodate the
swelling.
She
wears a compressive sleeve and glove during the day and, at night, a special
sleeve that channels the
fluid
up her arm.
Perkins
said none of cost of the sleeves is covered by OHIP, nor are the massage
treatments. She is able to
have
some of the costs picked up by her insurance, but says others are not. She said
the massage treatments
provide
effective temporary relief but she is has the treatments less frequently than
she'd like because of the
cost.
"This
is a medical condition and it should be covered."
November
16, 2011
Hospital
to coordinate, improve cancer-care programs - Outer Banks Sentinel –
Hospital
to coordinate, improve cancer-care programs
Outer
Banks Sentinel
The
hospital added Digital Stereotactic Biopsy and Lymphedema Therapy services in
2011, also introducing
the
Breast Health Program to provide mammograms for ...
SORRY
TINA, THIS ONE NEEDS TO HAVE A USER ACCOUNT WITH THEM
November
14, 2011
Villagers
recruiting members for first all-women's and breast cancer survivor dragon boat
teams - Villages
Daily
Sun – By ASHLEY SLOTA –
THE
VILLAGES — Breast cancer survivor teams are not uncommon in the world of dragon
boating. When
Marguerite
Muller saw these teams at other competitions, she thought it would be a great
idea to start a
team
in The Villages, but she went one step further.
She
decided that it was time The Villages also had an all-women’s team.
“I’ve
seen other women’s teams at races and I thought it would be a fun thing to do.
It’s a challenge; I like a
challenge.
Since I went to my first race and saw breast cancer survivor teams there, I
said‘I’m going to start
one
of those in The Villages’. I’d love to be a part of something like that,”
Muller said.
Muller
is now in the process of recruiting at least 40 members for the two teams. The
all-women’s team will
be
called Dragon Sisters and the team comprised of breast cancer survivors will
tentatively be named Hope
for
the Breast.
On
Nov. 5, the current members of the team gathered with potential members to
teach them a little about
dragon
boating and to let them try it out for themselves. Unfortunately, the water was
too unstable, so
everyone
was landlocked for the day.
However,
the potential members did get a chance to try out paddling on dry land to get a
feel for what it
was
like. Village of Caroline resident Bonnie Blate was one of the women interested
in joining the team.
“I’m
from Key Largo so I’m a water person. I love the water. That’s the only thing I
miss about living in The
Villages
is being on the water,” Blate said.
Blate
had never done any paddling before but she was willing to give it a
shot.
“The
thing about being in The Villages is just connecting with other people with
similar interests. This could
maybe
be my thing,”she said.
Also
present during the informational session were members of the breast cancer
survivor team from Tampa
called
The Pink Dragon Ladies. They explained the benefits that paddling can offer to
those who have had
breast
cancer.
“There’s
a marriage between dragon boating and breast cancer survivors,” said Connie
Bainbridge.
“It’s
a great support network, but it’s also great physical fitness. You’re typically
weak after breast cancer
surgery
so it’s great to build up your upper body strength. One of the goals of the
organization really is to
promote
physical fitness,” added Elaine Emmanuel.
Women
who have had breast cancer also have a higher risk of getting lymphedema, which
causes a woman’
s
arms to swell up. Studies have shown, however, that the motions of paddle
boating can actual help
decrease
a woman’s chances of getting lymphedema.
In
addition to the physical benefits that come with dragon boating, there is also
a connection for those who
had
breast cancer.
“The
mission is ‘Sport and Support’ for women, so while they want to win, their
first mission is support,”
explained
Bainbridge.
“We
all got cancer. Then I went to a conference and there were fliers about dragon
boating and I went
down
and tried it and fell in love with it,” said Sylvia Moss. “For me, soon after I
joined the team my
husband
died and they became my family sort of. It was very good for me and it helped
me over my initial
loneliness.”
Muller wants
every woman in The Villages to be able to reap these benefits if they are
interested in dragon
boating.
“It’s
just a wonderful activity. It’s so healthy and so good for you and it’s so much
fun,” she said. At 3 p.m.
every
Wednesday, members of the Dragon Sisters set out at Lake Miona to practice and
Muller invited
anyone
who is interested to come and join them or just come and watch.
“Come
and try it. There’s no obligation. If you don’t try it, you’ll never know. It’s
like anything else, you’ve
got
to try it then make your decision,” Muller said.
For
more information, call Muller at 259-2175.
Ashley
Slota is a reporter with the Daily Sun. She can be reached at 753-1119, ext.
9303, or ashley.
[email protected]
November
14, 2011
Husband
uses photos, blog to tell story of wife's struggle with cancer - Plain Dealer –
By Angela Townsend
–
At
just 39, Jennifer Merendino uses a walker and cane to get around. Special daily
exercises ward against
swelling
in her arms -- the consequence of lymphedema, a condition she developed after
surgeons removed
cancerous
lymph nodes following a double mastectomy.
Jennifer
is no longer able to work as assistant to the vice president of marketing and
product development at
a
cosmetics company in New York. Jennifer and her husband, Angelo -- Ohio natives
who moved to New
York
several years ago -- initially received a lot of support from family and
friends following Jennifer's breast
cancer
diagnosis in February 2008. As time went on, however, they didn't think many
people fully
appreciated
the drastic changes in their lives.
"We
had a hard time getting people to understand how serious things had become,"
said Angelo, 38.
"They're
not around day-to-day to see the fatigue, the exhaustion."
About
a year ago, Angelo began documenting Jennifer's experience through photos, a
way to express
themselves
to their families without words, he says.
"It
started making a difference," said Angelo, who estimates that he has taken
"tens of thousands" of photos
since
his wife's cancer diagnosis.
Angelo
Merendino has documented his wife's nearly four-year struggle with breast
cancer in a 35-piece
photo
exhibit that is on display at the 78th Street Studios in Ohio City, beginning
Friday.
Being
the center of attention isn't an issue for Jennifer.
"Since
I met him, he'd had that camera in my face," said Jennifer, who recently came
home from a 21-day
stay
in the hospital to manage her pain. "It's something I'm used to. It wasn't 'Now
all of a sudden I have
cancer
and suddenly you're taking my picture.' "
The
two met in Cleveland in August 2005. Jennifer, from Bath Township, was manager
of the former Fulton
Bar
& Grill Restaurant (now Momocho) in Ohio City. Angelo, originally from
Akron, was living in Ohio City
at
the time. He went to the restaurant to interview for a bartending
gig.
While
waiting on the restaurant's stoop for someone to open up the building, Angelo
saw Jennifer pull up in
her
black Volkswagen Beetle.
For
him, it was love at first sight. For her, not so much.
Angelo
got the job. The two became friends.
A
month later, Jennifer moved to New York to start a new job. They kept in touch
and eventually began a
long-distance
romance.
Angelo
moved to New York to be with Jennifer. The two married in Central Park in
September 2007.
The
following February, Jennifer was diagnosed with Stage 3 breast cancer that had
spread to her lymph
nodes.
The
news wasn't completely out of the blue. For more than a decade Jennifer had
felt a lump in her breast.
Yet
since her first mammogram and biopsy -- when she discovered that first lump --
all of the subsequent
tests
were always "inconclusive." Until it wasn't.
Nearly
four years later, Jennifer is living with what physicians have labeled chronic
cancer. The cancer has
metastasized
to her liver, hip and sacrum, and her brain. She continues to be treated at
Memorial Sloan-
Kettering
Cancer Center in New York.
As
time progressed, and as people from around the world emailed in response to the
nearly 200 images on
Angelo's
Facebook page and through an online photo contest that Angelo had entered, the
couple began
talking
about a photo exhibit.
"Being
from Akron and spending important time here, I wanted this to first happen [in
Cleveland]," said
Angelo,
who studied documentary photography at Cuyahoga Community College's Western
Campus in
Parma.
Angelo
emailed Matthew Fehrmann, a photographer and custom printer he had met several
years ago while
living
in Cleveland.
It
didn't take long for Fehrmann, whose own studio is housed in the same building
as the gallery, to respond.
"The
photo community is pretty tight in Cleveland," said Fehrmann, who found out
about Angelo's photos
from
the Facebook link sent by a mutual friend.
"I
had actually considered contacting him to see if he was working on a show, but
he beat me to it," he said.
"What
drew me to his work in the first place was the beauty of his images. Everyone
who encounters his
work
is touched in one way or another."
While
some of the couple's family will be at the exhibit opening, Jennifer won't be
able to travel for the event.
What
does she think of the photographs?
"I
think they're ridiculous," she said, adding, "I'm so proud, so
impressed.
"I
know that's not my normal body in those pictures. I think he's done an amazing
job. They take my breath
away."
November
14, 2011
Story
of lymphatic system expands to include chapter on valve formation – EurekAlert
–
St.
Jude Children's Research Hospital scientists show that a gene essential for
normal development of the
lymphatic
system also plays a critical role in forming the valves that help maintain the
body's normal fluid
balance
A
century after the valves that link the lymphatic and blood systems were first
described, St. Jude Children's
Research
Hospital scientists have detailed how those valves form and identified a gene
that is critical to the
process.
The
gene is Prox1. Earlier work led by Guillermo Oliver, Ph.D., a member of the St.
Jude Department of
Genetics,
showed Prox1 was essential for formation and maintenance of the entire
lymphatic vasculature.
The
lymphatic vasculature is the network of vessels and ducts that help maintain
the body's fluid balance and
serves as a
highway along which everything from cancer cells to disease-fighting immune
components
moves.
Oliver is senior author of the new study, which appeared in the October 15
edition of the scientific
journal
Genes & Development.
The
new research suggests that Prox1 is also essential for proper formation of the
one-way valves that
control
movement of fluid and nutrients from the lymphatic system into the blood
stream. Researchers found
evidence
that the Prox1 protein also has a role in formation of the venous
valves.
"Understanding
how valves form is crucial to efforts to develop treatments for valve defects
that affect both
children
and adults," said the paper's first author, R. Sathish Srinivasan, Ph.D., a
research associate in the St.
Jude
Department of Genetics. Those defects are linked to a variety of problems
including lymphedema and
deep
vein thrombosis, which are blood clots that form deep in veins and have the
potential for causing life-
threatening
complications. Lymphedema is the painful and sometimes disfiguring swelling
that can occur
when
lymph flow is disrupted.
For
more than a decade, the lymphatic system has been a focus of Oliver's
laboratory. The laboratory's
contributions
through the years include evidence that leaky lymphatic vessels might
contribute to obesity.
Oliver
and his colleagues also demonstrated how the lymphatic system forms from
Prox1-producing cells
destined
to become lymphatic endothelial cells (LECs) when they leave the developing
veins and migrate
throughout
the body.
The
investigators also showed the Coup-TFII gene is essential to the process. The
Coup-TFII protein binds
to
the promoter region of the Prox1 gene. The binding switches on production of
the Prox1 protein that is
required
to create and maintain the lymphatic system. The newer research builds on that
earlier work from
Oliver's
laboratory. The latest study focused on the lymphovenous valves. These valves
are found at just two
locations
in the body, on either side of the chest just under the clavicle bone where the
lymphatic vessels
intersect
with the subclavian and internal jugular veins.
Working
in mice, investigators discovered that these lymphovenous valves form from a
newly identified
subtype
of endothelial cell found in developing veins. Like the LECs that form the
lymphatic system, the
newly
identified endothelial cells make Prox1. But while the LECs leave the veins and
migrate throughout the
body,
these endothelial cells stay put to form the lymphovenous valves.
Researchers
demonstrated the process requires two copies of the Prox1 gene. That ensures
adequate levels
of
the Coup-TFII-Prox1 complex and with it enough Prox1 to build and maintain the
lymphatic system.
Mice
engineered to carry a single copy of Prox1 either did not survive or were born
without lymphovenous
and
venous valves.
"If
you have only one copy of Prox1 you are going to have a reduction in the
Coup-TFII – Prox1 complex
and
so a dramatic reduction in the number of cells available to build the lymphatic
system. That explains the
defects
we see," Srinivasan said.
###
The
study was supported in part by a grant from the National Institutes of Health
and ALSAC.
St.
Jude Children's Research Hospital
St.
Jude Children's Research Hospital is internationally recognized for its
pioneering research and treatment
of
children with cancer and other life-threatening diseases. The hospital's
research has helped push overall
survival
rates for childhood cancer from less than 20 percent when the institution
opened to almost 80
percent
today. It is the first and only National Cancer Institute-designated
Comprehensive Cancer Center
devoted
solely to children, and no family ever pays St. Jude for care. For more
information, visit www.
stjude.org.
November
16, 2011
3-D
body scans could ease pain for cancer survivors - Minnesota Daily – ByRachel
Raveling - The
technology
may help with clothing designs.
A
17-year breast cancer survivor and professor in the University of Minnesota
College of Design is striving
to
find ways to make the lives of fellow survivors’ less painful by using 3-D
imaging technology.
Karen
LaBat and a team of researchers from the school are using 3-D body scans in the
Human
Dimensioning
Lab to aid breast cancer survivors with body asymmetries, or figure
disproportionalities,
brought
on by surgery and radiation therapy. These often cause the survivors pain and
discomfort.
Last
fall, the group reached out to several breast cancer support groups in hopes of
finding volunteers for the
study,
said Karen Ryan, a fellow researcher on the project.
Twenty-five
breast cancer survivors volunteered to travel to the Twin Cities campus for the
3-D full-body
scans
and interviews about their apparel concerns and discomforts, Ryan
said.
She
said some volunteers come from hundreds of miles away to help in the research.
They bared nearly
everything
for the cause, allowing the group to scan them in little more than their
underwear.
The
project is funded by a grant from the Minnesota Agricultural Experiment
Station, which provides money
for
a number of research projects in the Human Dimensioning Lab.
LaBat
said the idea for the project came from her personal experience with breast
cancer and through
experiences
she read about other survivors.
Part
of their project focuses on developing apparel needs for survivors based on the
asymmetries, primarily
in
the arms, she said.
One
common irregularity in survivors is lymphedema, or swelling of the arms or legs
caused by lymph node
removal
during cancer treatments.
Ryan
said survivors experience a feeling of heaviness from the swelling and it is
important to control it
because
it can make them more prone to infection.
In
an attempt to control the swelling (there is no cure), some survivors use
lymphedema “sleeves,” or
compression
garments, LaBat said. But the sleeves can be difficult to get on, are usually
unattractive and can
be
uncomfortable.
Sherry
Sanden Will, undergraduate research assistant and apparel design student, said
women who have
overcome
cancer often complained about bra discomfort and the compression garments
irritating their skin
which
is already sensitive due to radiation therapy.
The
scans will hopefully shed light on ways to design apparel such as bras and
shirts, as well as compression
sleeves.
Using
the scans, the team will evaluate the effectiveness of current sleeve designs
and help shape future ones,
Labat
added.
The
scans were completed last spring, and now the group is focusing on data
analysis.
Chad
Sowers, a graduate research assistant, is working to gather information from
each set of arms.
They are trying
to compare the volume of one arm to the other. To do that they take a
paper-thin extract of
the
arm scan and match it to the same spot on the other arm, he said. They are
still trying new techniques to
make
this more accurate.
Once
the results are published, they will be open for use by students at the
University, as well as designers,
medical
researchers and doctors.
In
the future, Ryan said they hope the technique becomes exact enough so it may be
used for diagnosis and
rehabilitation.
Ryan
said the scans and analysis technique could document body changes with other
treatments like weight
training.
She
said the scan will hopefully be a scientific, documented way to prove what
works and what doesn’t so
survivors
can live without discomfort.
November
7, 2011
Disabled
teacher in tenure case fight - NorthJersey.com – BY LESLIE BRODY –
Paterson
officials are trying to fire a disabled teacher accused of making his young
students carry a plastic
bottle
of his urine to the bathroom to flush it away, legal papers say.
The
School 13 second-grade teacher, Ron S. Tuitt, said Friday the allegations were
completely false. The
district
suspended him without pay on Oct. 17 while it seeks to revoke his
tenure.
An
investigation into the teacher’s behavior began in September 2010 when a
custodian saw Tuitt urinate
into
a garbage can in his classroom. Tuitt, who uses a wheelchair due to severe leg
swelling from
lymphedema,
said that was a one-time incident and no students were present. He said he was
removed from
the
classroom that November, but continued to get his $63,375 yearly
salary.
The
district’s legal papers said that when an investigator interviewed Tuitt’s past
students, one 12-year-old
boy
said that when he was 8, the teacher had students close their eyes once a day
for a minute. Then the
boy
and a friend would take a partly full bottle to the bathroom to dump it out,
the papers said. The friend
also
described that practice in an affidavit, saying the stuff smelled “horrible”
and he thought it was “pee.”
A
woman who worked at School 13 until 2009 also said in an affidavit that Tuitt
gave her cash to buy him a
hand-held
plastic urinal at a nearby Walgreens pharmacy. She said that two or three times
a week for about
a
year, she saw students carrying the urinal to and from the bathroom.
Tuitt,
54, said the boys lied in the interviews and their answers were steered by the
investigator. “I had
hundreds
of other children – how come nobody else said it?” he asked. Tuitt said any
students spotted with
bottles
of liquid were carrying cleaning supplies used to wash the blackboard and
desks.
The
teacher, who joined the district in 1996, was profiled in the Herald News in a
2007 article that quoted
children
saying it made them feel good to help him. He often taught while sitting on the
floor, and the kids
liked
to sit in his wheelchair.
Tuitt,
of North Brunswick, said the district filed tenure charges in retaliation
because last summer he filed suit
in
Passaic County Superior Court, alleging they were discriminating against him
due to his medical condition.
He
said administrators refused to transfer him to a classroom closer to the
handicapped bathroom.
“There
is absolutely no merit to his claim that any action is being taken in
retaliation,’’ said the district’s
lawyer,
Joanne Butler. “We cannot and will not speak about ongoing litigation. However
the situation is such
that
the school district felt that action had to be taken … Districts don’t pursue
tenure charges lightly.”
An
administrative law judge who hears the case will make recommendations to the
education commissioner,
who
will decide the matter.
November
11, 2011
About
136 former cheerleaders got together to do a dance routine to benefit "Susan G.
Komen for the
Cure"
(Breast Cancer). Each time someone views the video, United Healthcare will make
a $.10 donation
to
the Komen organization. Their goal is to get a million hits, which will lead to
$100K raised.
Please,
can you take a moment to watch the video, and just as important, pass this link
on to your network
of
friends, family, and colleagues? It benefits a very important cause!
www.KomenPhiladelphia.org/Video
November
2, 2011
Lymphedema
Bandaging Class to Be Held in Kitchner, Ontario - Wire Service Canada (press
release) –
Mulligan,
a registered massage therapist and a lymphedema therapist, educator and
consultant, will be
teaching
a lymphedema bandaging class in Kitchener, Ontario on Saturday February
26th.
Lymphedema
therapist and educator John Mulligan will present an Advanced Lymphedema
Bandaging
Workshopon
Saturday, November 26th at Motion Specialties in Kitchener, Ontario. The
workshop is co-
sponsored
by Motion Specialties Kitchener and BSN Medical.
The
workshop will focus on the role of multi-layer lymphedema bandaging as a part
of the overall treatment
of
lymphedema, and how to introduce advanced and creative bandaging concepts into
the therapy regimen
to
use as needed.
“Lymphedema
is a complex condition, and therapists must be resourceful. A comprehensive
approach to
bandaging
should include a wide variety of materials and techniques so the therapist can
meet any challenges
that
arise in the treatment of patients with lymphedema and related disorders,” said
John Mulligan, workshop
leader.
“Lymphedema bandaging is a creative effort based in science.”
To
register for the workshop, visit the Lymphedema Depot web site
(www.LymphedemaDepot.com ) and
click
on the Events tab. Scroll down to the November listings and click on the
Advanced Lymphedema
Bandaging
Workshop and click on the registration form.
Lymphedema
is a condition of chronic swelling. It is a treatable and manageable condition.
The most
effective
treatment is Complete Decongestive Therapy, known as CDT.
Complete
Decongestive Therapy consists of :
·
Manual lymph drainage, a massage-like technique that facilitates movement of
congested fluids in a
saturated
or swollen areas of the body;
·
Multi Layer Lymphedema Bandaging (MLLB) to compress the limb, reduce swelling
and prevent further
swelling;
·
Decongestive Exercise; a series of exercises that helps to mobilize fluid in
the body;
·
Meticulous Skin Care, especially of the affected area. This is done to prevent
or minimize the occurrence
of
infection.
John
Mulligan has been a lymphedema therapist since September of 1998 and has worked
as a therapist,
educator
and consultant in the lymphedema field for the past 13 years. He is currently
serving as Clinical
Specialist
for Lymphedema Depot, importer of Solaris lymphedema products. He also sees
patients and
presents
classes.
For
further information contact [email protected].
To
learn more about lymphedema and lymphedema therapy visit
www.LymphedemaTherapist.com.
November
21, 2011
Compression
therapy firm Wright Therapy raises $1M - MedCity News –
Compression
device maker Wright Therapy Products has raised about $1.1 million of what the
company
hopes
is a $2 million fundraise, according to a regulatory document.
The
Pittsburgh-area company develops compression pumps and other accessories for
patients suffering
from
poor circulation or swelling in their limbs. Wright Therapy also markets its
pumps for the treatment of
sports
injuries that result in swelling.
Chief
Technology Officer Carol Wright didn’t return a call
Compression
therapy can be used to treat venous ulcers and lymphedema, swelling in the
limbs caused by a
blockage
in the lymphatic system. A compression pump inflates a sleeve that’s placed on
a patient’s limb
and
the inflated sleeve moves lymphatic fluid away from the limbs and
reducesswelling.
Wright
Therapy’s latest funding was sourced from 13 investors, with the first sale
happening in December
2010.
As of May 2011, the company had raised $565,000 of the investment, according to
an earlier
regulatory
filing.
Economic
development group Pittsburgh Life Sciences Greenhouse had previously invested
in Wright
Therapy.
Wright
Therapy got its start in the 1980s when Carol Wright’s father, Edward, created
a compression pump
for
a child suffering from chronic lymphedema.
November
28, 2011
Prisoner
in her own bed - Wigan Today –
A
WIGAN cancer sufferer has described the nightmare of becoming a prisoner in her
own bed after her
weight
ballooned to 40 stone.
Marjorie
Jones, of St Patrick’s Way, Scholes is bedridden and has to call emergency
services if she needs
to
move, because of a series of medical conditions.
The
61-year-old suffers with lymphedema, which causes her legs to swell from fluid
retention, along with
cervical
cancer and heart problems.
Up
until last year, the mum-of-four was mobile and was able to move around the
house unaided.
As
her cancer has got worse, Marjorie’s weight has increased, making it
increasingly difficult to get out of
bed
to go to the toilet, or even have a wash.
But
now Marjorie, who regularly has to call out the emergency services to help move
her, says she has been
denied
home care to help get her washed, and a suitable bed.
Marjorie
said: “I just feel abandoned and upset at being told I can’t have home help. I
was given a bariatric
bed
but it wasn’t suitable for me, I kept cutting my legs on the side every time I
tried to get out of bed.
“My legs are so
big because of lymphedema, and because I can’t move often, my skin is very
delicate and
sore,
so it cuts easily.
“I
was told I couldn’t have anything else and there was no home care available for
me because I have my
children
to help me. But they need help to look after me.
“I
can lie here for up to five days and not be moved and have, at times, had to
soil the bed and sit in it for
hours
until somebody came to help me.”
The
emergency services were called to Marjorie’s home up to six times in one week
but the last time she
needed
help, fire services refused to attend.
The
Ince woman also says she has not been able to have a recent cancer screening to
see if the disease has
spread,
due to her weight issues.
Marjorie
added: “If I had some help I wouldn’t have to keep ringing the emergency
services. I know they
are
busy and I don’t like troubling anybody but I need some assistance – I’m just
trapped in my own bed.
“I
know what people will think when they look at me and see my size, but it is
down to my illness.
“I
feel my treatment is less than that of somebody who would be an average weight
because I am so heavy.”
A
spokesman on behalf of Bridgewater Community Healthcare NHS Trust, Ashton,
Leigh and Wigan
Primary
Care Trust and Wigan Council, said: “We cannot comment on individual cases for
reasons of
patient
confidentiality, but we can give a reassurance that all the agencies involved
have been working
closely
together for a number of years and continue to do so.
“With
regards to the process, health and social care workers work together to carry
out regular assessments
of
both an individual’s and their carer’s needs.
“These
assessments will involve discussions with individuals, their carers and will
often recommend a variety
of
aids, equipment and care packages to ensure that care can be provided safely in
an individual’s own
home.
“Individuals
and carers are free to decline any equipment which is offered as a result, but
are advised that
this
is likely to impact on the package of care that can be provided.
“Any
decisions made will consider whether providing any element of care will be safe
for the individual, their
carer
and our staff.”
November
28, 2011
$8.3M
supports breast cancer research - Laboratory Products News –
Saskatoon,
SK - $8.3 million in funding has been announced by Canadian Breast Cancer
Foundation to
support
24 research projects in Alberta, Saskatchewan, Manitoba and the Northwest
Territories.
"We
want our stakeholders and everyone touched by the breast cancer cause to be
confident in the work
that
the region methodically selects to support, because the foundation is investing
in innovative research and
creative
education and awareness programs that are taking us one step closer to our
vision of a future
without
breast cancer," says Trish Bronsch, CEO Canadian Breast Cancer Foundation -
Prairies/NWT
Region.
The
following projects received 2011 research grants with funding provided from
2011 to 2014.
University
of Saskatchewan & Saskatchewan Cancer Agency; Dr Deborah Anderson. Project
title: Role of
p85
in EGFR-expressing triple negative breast cancer.
University
of Alberta; Dr Shairaz Baksh. Project title: The role of pro-apoptotic protein,
MOAP-1, in triple
negative
breast cancer.
University
of Saskatchewan & Saskatchewan Cancer Agency; Dr Keith Bonham. Project
title: Epigenetic
reprogramming
of transcription in breast cancer cells by HDAC inhibitors.
University
of Alberta; Dr David Brindley. Project title: Novel mechanisms of tamoxifen
resistance in breast
cancer.
University
of Alberta; Dr Sambasivarao Damaraju. Project title: Mechanisms underlying
postchemotherapy
outcomes
in early stage breast cancer treated with adjuvant docetaxel, doxorubicin and
cyclophosphamide:
Identification
and validation of predictive biomarkers.
CancerCare
Manitoba; Dr James Davie. Project title: Role of peroxiredoxin phosphorylation
in estrogen
receptor
negative breast cancer.
University
of Alberta; Dr Richard Fahlman. Project title: Alternative mechanisms of BRCA1
protein turnover
and
apoptosis.
University
of Alberta; Dr Larry Fliegel. Project title: Role and regulation of the Na+/H+
exchanger in
proliferation
of breast cancer cells.
University
of Calgary; Dr Don Fujita. Project title: Steps in the Src signaling pathway
that are important
mediators
in breast cancer metastasis and critical targets for targeted
therapeutics.
University
of Saskatchewan; Dr Ron Geyer. Project title: Antibodies targeting the
ErbB2/ErbB3/ IGF-1R
complex
as therapeutics for ErbB2 positive breast cancer.
University
of Alberta; Dr Roseline Godbout. Project title: Investigating the mechanism
underlying retinoic
acid
resistance in triplenegative breast cancer.
University
of Saskatchewan; Dr Troy Harkness. Project title: The antiproliferative effects
of insulin sensitizing
drugs
on multiple drug resistant breast cancer cells.
University
of Alberta; Dr Roger Leng. Project title: Mechanisms of inactivation of the p53
pathway in breast
cancer.
University
of Alberta; Dr Margaret McNeely. Project title: Feasibility of night-time
compression systems for
breast
cancer related Lymphedema.
University
of Calgary; Don Morris. Oncolytic Project title: Viral Immunotherapy for breast
cancer. (Funding
is
for 2011-2012 only.).
University
of Alberta; Dr David Murray. Project title: Targeting the apoptotic threshold
for improving breast
cancer
therapy.
University
of Alberta; Dr Manijeh Pasdar. Project title: The role of plakoglobin in the
p53 pathway in breast
normal
and carcinoma cell lines.
University
of Calgary; Dr Karl Riabowol. Project title: Can ING epigenetic regulators
predict response to
epigenetic
cancer drugs?.
Cross
Cancer Institute/University of Alberta; Dr Wilson Roa. Project title: Targeted
paramagnetic gold
nanoparticles
in the treatment of breast cancer.
University
of Saskatchewan; Dr David Sanders. Project title: Design of B-glucuronidase for
use in antibody-
directed
enzyme prodrug therapy (ADEPT).
University
of Saskatchewan; Dr Rajendra Sharma. Project title: Role of
N-myristoyltransferase in
modulating
breast cancer.
University
of Alberta; Dr Andrew Simmonds. Project title: Defining the role of
post-transcriptional regulation
for
the Wnt1 breast cancer associated oncogene.
University
of Alberta; Dr Jack Tuszynski. Project title: Towards individualized Tubulin
targeting
chemotherapy
for breast cancer.
University
of Saskatchewan & Saskatchewan Cancer Agency; Dr Jim Xiang. Project title:
A combinatorial
immunotherapy
of anti-HER-2 antibody and HER-2 specific adenoviral vector vaccine for
advanced HER-2
positive
breast cancer.
November
28, 2011
International
leader in lipedema management stresses need for greater awareness –
ModernMedicine – By:
Cheryl
Guttman Krader –
•Women
are affected by lipedema, which most often develops in the upper legs
•Abnormal
fat that accumulates in lipedema is resistant to conventional weight-loss
measures
•Early
intervention can help to prevent progression
Liposuction
using super tumescent local anesthesia is an important advance for the safe and
effective
treatment
of lipedema, but appropriate diagnosis is the first step to successful
management of this disorder,
which
causes significant morbidity and is more common than generally recognized, says
Louis Habbema, M.
D.,
Ph.D.
In
lipedema, there is abnormal accumulation of subcutaneous fat that can be
accompanied by mild edema in
the
extremities. Women, almost exclusively, are affected by the condition, which
occurs bilaterally and
symmetrically,
and most often develops in the upper legs. The lower legs and upper arms may be
involved,
but
lipedema rarely affects the lower arms, and fat accumulation in lipedema never
occurs in the trunk or
face.
Some
patients develop lymphedema as well, probably due to compression of the lymph
vessels. Lipedema
patients
also may show anatomically abnormal lymph vessels, Dr. Habbema says.
Due
to a low awareness of the condition among physicians, patients seeking help may
simply be counseled
to
lose weight and/or offered liposuction using conventional techniques. Although
women with lipedema may
also
suffer from obesity, the abnormal fat that accumulates in lipedema is very
resistant to conventional
weight-loss
measures, and it is destined to accumulate again after removal with
conventional liposuction,
says
Dr. Habbema, who has been at the forefront of developing treatment for lipedema
and efforts to
increase
awareness about the condition.
"Fat
accumulation in lipedema cannot be controlled or eliminated through diet, and
the swelling and aching
associated
with the condition are worsened by exercise. Women attempting to lose weight by
these methods
will
simply lose fat from areas of the body that are not affected by lipedema,
including the face, the breasts
and
the trunk, while the lipedema gets progressively worse," says Dr. Habbema, a
dermatologist specializing
in
cosmetic medicine and founder, Medical Centre 't Gooi, Amsterdam.
"Our
experience with around 800 women shows that lipedema treatment with
circumferential liposuction
performed
using a large volume of tumescent anesthesia safely and effectively removes the
fat and improves
patient
symptoms," he says. "Early intervention is desired to hopefully prevent
progression and improve
quality
of life. However, the doctor must first recognize the problem in order to offer
the correct treatment."
ASSOCIATED
MORBIDITY The morbidity associated with lipedema includes physical,
psychosocial and
functional
consequences. In addition to having low self-esteem because of their
appearance, affected women
become
frustrated and discouraged by the failure of their weight-loss efforts, and the
psychological burden
may
be compounded for those who go from physician to physician seeking help, only
to receive the same
advice
about diet and exercise that they have already tried and know doesn't
work.
In
severe cases, the enlarged extremities can cause mechanical sequelae, including
mobility issues and
friction-induced
skin breakdown. Expansion of the subcutaneous compartment with fat also causes
discomfort,
tenderness or even severe pain, and the affected areas may be prone to easy
bruising.
"Women
who've enjoyed long walks may find they must stop after just 10 minutes because
of their pain, and
merely
touching the surface of the skin can cause distress," Dr. Habbema
says.
"In
addition, the pain may be misdiagnosed as originating from some other
musculoskeletal condition and
lead
women to undergo unnecessary diagnostic and surgical procedures that will have
no benefit on their
chief
complaint."
SUPER
TUMESCENT SUCCESS Liposuction using massive amounts of tumescent anesthetic
solution
allows
safe and effective removal of the accumulated abnormal fat in patients with
lipedema because the
infiltrated
solution is sufficient to surround all of the fat cells, facilitating fat
removal while protecting other
tissues,
Dr. Habbema says.
"The
super tumescent technique minimizes the risk of injury to lymph vessels, which
would result in
worsening
of the lymphedema component, and to a delicate network of fibrous septae that
is present in
patients
with lipedema," he says.
Depending
on the area being treated, as much as 10 L to 12 L of tumescent anesthetic
solution is instilled.
The
solution is delivered very slowly to facilitate uniform distribution around all
of the fat cells.
Since
the liposuction needs to be performed circumferentially in one or multiple
procedures and patients
must
cooperate in altering their body position, only local anesthesia is
administered. Traditional power-
assisted
liposuction is used with a blunt cannula usually 3.0 mm in diameter that is
moved from the back to
the
front.
"Initially,
it was thought that a smaller-gauge cannula might be safer, but even though the
tip is blunt, a
cannula
with a small diameter has a knifelike quality and can damage the fibrous
network," Dr. Habbema
says.
NUMBER
OF SESSIONS Depending on the volume of fat that must be removed, two or three
sessions
done
at monthly intervals may be necessary to address circumferential treatment of
the upper legs. Usually,
the
maximum volume of supernatant fat removed per session is 5 L to 5.5 L; however,
the ultimate goal is to
remove as much fat as possible in the
treated area, because it appears that minimizing the amount of fat that
is
left behind will lower the risk of recurrence.
Post-liposuction
care is routine per other liposuction procedures, and post-procedure sequelae
are also the
same,
except that bruising and pain are more significant after treatment for lipedema
because of the greater
volume
of fat removed.
"However,
there is not any significant downtime, and women can expect to be mobile on the
first day after
the
procedure," Dr. Habbema says.
Dr.
Habbema is working on a paper about treatment of lipedema that will include
data from his clinical
experience.
He also co-authored a review article on the topic (Langendoen SI, Habbema L,
Nijsten TEC,
Neumann
HAM. Br J Dermatol. 2009;161(5):980-986).
December 1, 2011
Lymphatic Health And
The Importance Of Good Hydration - Healthy Wealthy n Wise – By: Karen L Davis
–
What is the correlation between proper hydration and the maintenance
of lymphatic health? To better
understand this point, let us take a look at
how the lymphatic system works. The lymphatic system is a
network of lymph
vessels carrying lymph fluid throughout the body in the direction of the heart.
The lymph
fluid is filtered through lymph nodes to trap and remove toxins
and bacteria that could cause disease. The
lymph nodes can be found
throughout the body but most prominently, in the armpit and stomach and are
filled with lymphocytes - white blood cells that help protect the body
against the disease by killing pathogens.
When the flow of lymph through
the lymph vessels is sluggish, the lymphatic system develops disorders such
as lymphedema or swelling in the arms and legs due to the buildup of lymph
fluid. As a result, auto-immune
diseases such as rheumatoid arthritis may
proliferate and even contribute to the spread of cancer cells
throughout
the body, as your lymphatic health collapses and no longer protects
you.
When you are poorly hydrated, the lymph fluid can become thick and
viscous, making it more difficult to
flow through the lymph vessels and
impairing the efficient functioning of your immune system. Poor hydration
can also cause other health disorders that affect the operative functioning
of the lymphatic system. One such
disorder is sluggishness, which makes it
more difficult for you to remain physically active, and causes the
lymph to
move more slowly through your body.
Experts recommend that you drink at
least eight to ten glasses (8 oz) of water a day to help remove the
toxins
from your body when they are filtered through the lymph nodes. How do you
maintain proper
hydration so that you can improve your lymphatic health?
Here are some tips:
1. Have a two liter bottle of water on your desk to
help you keep track of how much water you need to
drink.
2. Instead of drinking fruit juices, coffee and soft drinks to make up your fluid intake requirement, add some
flavor to your water with lime juice or fresh lemon.
Alternately, you can take herbal teas instead of water.
3. When you wake
up in the morning, take a drink of water to help energize you and flush your
system. Try
making some sole (pronounced so-lay) and adding it to that
first drink of water in the morning.
4. When you feel hungry, take some
water instead of a snack. This will help you address hunger pangs and
keep
your weight down since some snacks increase the strain on the lymphatic system,
and increases the
amount of toxins that have to be filtered from the
body.
5. Mix up your water consumption by taking water in various ways
such as teas, soup, plain and flavored
waters, fruits, and
vegetables.
Having a regular exercise program can also help improve your
lymphatic health since staying active can help
the lymph move more easily
through the body. However, the body loses more water during exercise, making
proper hydration more important. To ensure that you stay hydrated after
your workout, as well as
replenishing important electrolytes such as
potassium, sodium and chloride, take a mixture of fruit juice
diluted 50/50
with water and mixed with a half-teaspoon of unrefined sea salt per quart of
the mixture. Also
make sure to drink one glass of water thirty minutes
before exercising, and another glass for every additional
15 minutes of
exercise. Drink 12oz of the fruit juice mixture if you exercise for more than
one hour.
Everyone's water intake needs may not be the same. Please
approach any information you receive with
common sense and an informed
opinion. You can overdue anything, even those things that are good for you.
If you are unsure, some due diligence will give you the basis for any
questions you need to formulate.
Notice:
The article you are
reading is for your personal edification. The information contained therein is
for
educational purposes only and is not to be used in place of proper
medical advice, nor is it intended to treat,
diagnose or cure any ailments.
One should always seek out a properly licensed professional to answer any
questions or render treatment. As always check with your doctor before
engaging in any new activity.
December 2, 2011
Long Term Care Symposium
Attracts 500 Medical Pros - Space Coast Medicine and Healthy Living - By
CENTRALFLORIDAMEDICINE.COM –
CENTRAL FLORIDA, USA – The 2011 Long Term
Care Symposium, presented by the Brevard County
Medical Directors
Association (BCMDA), attracted more than 500 health care providers and enjoyed
great
support from the health and medical marketplace.Long-Term Care
Symposium founder, John H. Potomski,
Jr., D.O., CMD, is president of the
BCMDA and has been a medical provider for residents in area
rehabilitation
and nursing centers, as well as assisted living facilities, for more than 28
years.
Dr. Potomski, who serves as the medical director of Osler Geriatrics,
now part of Osler HMA Medical
Group, has always been an advocate for the
most vulnerable elders. As the chairman of the Brevard County
Commission on
Aging, he has advocated at the national, state and local legislative
levels.
Attendees included medical directors, physicians, nurse
practitioners, physician assistants, nurses, nursing
directors,
administrators, pharmacy consultants, hospice and home health care
representatives and facility
department heads.
“This program was started
as an educational dinner meeting for approximately 80 health care professional
in
long term care and has now grown to a spectacular educational event for
approximately 500 health care
providers,” said BCMDA Executive Director Jo
Ann Fisher.
The symposium, held Nov. 30 in Melbourne, Florida, was organized
by Fisher with support from the staff of
Osler Geriatrics and Brevard
Geriatric Assessment Services, who managed the registration process and
supplied the CEU credit.
This year’s nationally known speakers included
Norman Silverman, MD, of Rely Radiology Group on the
topic of “Bedside
Imaging Examinations: Indications and Results;” Robyn Bjork, MPT, WCC, CLT, on
the
topic of “Differential Diagnosis of Lymphedema and Treatment Options;”
and Kevin O’Neil, M., CMD,
chief medical officer of Brookdale Senior Living
on the topic of “Cross Train Your Brain.” The speakers
were supported by an
educational grant from Osler Geriatrics.
Boyle Wins Long Term Care
AwardAmong the highlights of the event was the presentation of the 2011
Long Term Care Award to Joyce Boyle, LPN, for her more than 25 years of
service to the older adults
residing in nursing facilities. Boyle is
currently a unit manager at Melbourne (Florida) Terrace Rehabilitation
Center.
The keynote address was delivered by DiAnn Barnes, RN, with
Hospice of St Francis; Father Robert
Bruckart of Health First Pastoral Care
gave the invocation; and the Pledge of Allegiance was led by Capt.
Jessica
Pabon form Patrick AFB.
“I have always felt that it is important to give
back to the community,” said Dr. Potomski. “This event not
only shows our
appreciation to the professionals in long term care, but also provides them
with education in
the field of geriatrics at no cost.”
For more
information log on to www.bcmda.comDecember 2, 2011
Exercise Benefits Breast
Cancer Survivors, Patients With Lymphedema, Say Researchers - Medical News
Today –
After reviewing published evidence, University of Missouri
researchers conclude the benefits of exercise
outweigh the risks for breast
cancer survivors, including those who develop lymphedema, a chronic swelling
that commonly occurs after breast cancer treatment. Co-author Jane Armer,
professor in the University's
Sinclair School of Nursing, and colleagues,
write about their findings in the December 2011 issue of the
Journal of
Cancer Survivorship.
Armer told the media, "exercise can be beneficial
and not harmful for breast cancer survivors," and patients
at risk for
lymphedema, a condition that affects around 3 million people in the US, can
exercise if they are
careful and watch what they are doing:
"Each
individual should balance the pros and cons of the activity she chooses, but
keep in mind that being
sedentary has risks and being active is beneficial
in many ways, including possibly reducing the risk of cancer
recurrence,"
she added.
Lymphedema usually results when lymph nodes are removed or
treated with radiation as part of cancer
treatment. It can develop any time
after treatment, and traditional thinking was that patients should avoid
exercise in case it prompted development of the condition.
But Amer
and colleagues found patients who exercise were at no greater risk of
developing lymphedema
than those who do not exercise. Furthermore,
exercising once lymphedema has developed does not make it
worse.
"Breast cancer survivors do not need to restrict their
activity as we once thought," said Amer.
"If patients want to be active,
they should carefully condition their bodies by increasing repetitions of
resistance exercises under proper supervision," she added.
However,
Amer said more studies would be needed to establish whether exercise actually
prevents
lymphedema.
For their review, Amer and colleagues searched
the available literature and found 19 studies out of over
1,000 potential
articles met their stringent inclusion criteria.
Seven of the studies
covered resistance exercise, another seven covered aerobic and resistance
exercise,
and five studies covered other forms of exercise.
"Studies
concluded that slowly progressive exercise of varying modalities is not
associated with the
development or exacerbation of breast cancer-related
lymphedema and can be safely pursued with proper
supervision. Combined
aerobic and resistance exercise appear safe, but confirmation requires larger
and
more rigorous studies," write the authors.
Written by Catharine
Paddock PhD
Copyright: Medical News Today
December 2, 2011
Exercise
does not worsen lymphedema - UPI.com –
COLUMBIA, Mo., Dec. 2 (UPI) -- The
benefits of exercise outweigh the risks for breast cancer survivors
and
patients with lymphedema, a chronic swelling, U.S. researchers say.
Jane
Armer, a professor in the Sinclair School of Nursing at the University of
Missouri, said patients at risk
for lymphedema can exercise if they closely
monitor their activities.
"Exercise can be beneficial and not harmful for
breast cancer survivors," Armer said in a statement. "Each
individual
should balance the pros and cons of the activity she chooses, but keep in mind
that being
sedentary has risks and being active is beneficial in many ways,
including possibly reducing the risk of cancer
recurrence."
Lymphedema
can occur any time after cancer treatment and is usually caused by the removal
or radiation of
lymph nodes as part of the treatment process, Armer
said.
Armer found patients who exercise had no greater risk for developing
lymphedema than those who do not
exercise, and patients with lymphedema did
not worsen their condition by exercising.
Future research is needed to
determine whether exercise prevents the condition, Armer said.
"Breast
cancer survivors do not need to restrict their activity as we once thought,"
Armer said. "If patients
want to be active, they should carefully condition
their bodies by increasing repetitions of resistance
exercises under proper
supervision."
The findings were published in the Journal of Cancer
Survivorship and the Annals of Surgical Oncology.
December 4,
2011
Manitowoc-Two Rivers Y program helps cancer survivors stay strong -
Herald Times Reporter –
MANITOWOC — Mary Kay Johns of Manitowoc was very
active before she was diagnosed with breast
cancer in 1993.
After
recovering from a mastectomy and reconstruction surgery, she was ready to get
back to exercising,
but didn't know how to go about it.
"Because of the
changes in my body, I had no idea where to begin or how to adapt myself to get
back to the
physical fitness level I had prior to my diagnosis," said
Johns, 55, who returned to the Manitowoc-Two
Rivers Y where she had worked
out before her illness.
Removal of her breast affected her balance. Johns
suffered neuropathy or nerve damage resulting in
numbness and tingling in
her hands. This condition is sometimes a side effect of chemotherapy in cancer
patients. Surgery also destroyed what Johns calls her "sit-up" muscles, so
she had to find new ways to do
that simple exercise.
"Because of
reconstructive surgery, I can't do sit-ups and abdominal exercises like other
people do … I do
them sitting on a ball," she said.
Johns learned what
she could and could not do by trial and error.
"I made a lot of mistakes
along the way, but I was able to get far beyond my expectations ... to the
point I
was doing half-marathons and triathlons," she said.
Program
introduced this year
Johns eventually became a staff member at the Y, which
last year received a grant to offer LIVESTRONG,
a free 12-week fitness
program for adult cancer survivors. The program eliminates the guesswork that
she
faced in her battle to regain her fitness.
Johns underwent extensive
training to become the program facilitator and is one of four instructors
knowledgeable in the limitations of cancer survivors and techniques that
can positively affect their lives, both
physically and
emotionally.
Through the program, which kicked off earlier this year, Johns
is now helping other cancer survivors
overcome their challenges. Having
first-hand experience gives her a better understanding of what they're
going through.
"We have to find a new normal for ourselves because our
bodies are no longer the same. We are forever
changed by our diagnosis and
the treatment we have gone through," she said.
The group, for survivors of
all different cancers, provides individually structured exercise programs that
focus on aerobic endurance and strength conditioning, Johns said.
In a
way, she is starting all over again. In January, a lump was found in her other
breast. Although it turned
out to be noncancerous, she decided to have
another mastectomy as a preventive measure, she said.
Retiree wanted to
regain lost energy
When Sandra Fraize, 70, moved from Boston to Manitowoc to
retire in 2007, she didn't envision a battle
with colon cancer as part of
that retirement.
After surgery and six months of chemotherapy, Fraize was
tired and weak, with neuropathy of the feet
affecting her
balance.
Cancer patients often experience balance issues, which the program
helps combat through simple exercises
on unstable surfaces and balance
equipment, said instructor Candy Ruffolo.
Exercise also can build up the
muscle tissue that has broken down through chemotherapy and inactivity
during the illness and treatment, Johns said.
"I wanted to regain the
way I had planned on living retirement. I wanted to be an energetic and vibrant
person," said Fraize, who found renewed stamina thanks to the
program.
When she started exercising, she could only tolerate a cardio
workout for two to three minutes. Now she is
up to 20 minutes, said the
recent LIVESTRONG graduate.
"It gave me hope and belief in the human spirit
and body," Fraize said of the program.
Exercises tailored to individual
needs
Breast cancer survivor Ann Wind, 58, of Manitowoc endured a
mastectomy, three months of chemotherapy
and 6½ weeks of radiation after
she was diagnosed with breast cancer in November 2010.
She's been
cancer-free since April but wears a compression sleeve on her left arm to help
control
lymphedema, which causes chronic swelling.
Survivors of breast
cancer, colon cancer and any cancer in which the lymph nodes have been removed
are
more susceptible to the condition; breast cancer patients like Wind,
who have lymphedema in the arm,
typically start out lifting lighter weights
so as not to aggravate the condition, Johns said.
"I feel much better
physically," said Wind, who recently completed the program and regained her
strength
and energy. "I've improved a lot."
And because Wind felt so
isolated during her cancer treatment, when her immune system was down and she
had to stay away from people, she welcomed the social aspects of the class
as well, she said.
In fact, the members of the group got along so well that
they plan to continue meeting.
Colon cancer survivor Joanne Vogds, 51, of
Manitowoc, found that the class improved her gait and her
balance.
"I'm
disabled to begin with and I got cancer and it just compounded things," she
said. "I can't walk as good
and I can't talk as good and cancer made the
condition worse."
The class customized some of her exercises so they could
be done while she was sitting in a chair, Vogds
said.
Program targets
emotional and physical health
It's common for cancer patients to suffer from
depression, said breast cancer survivor Connie Peterson, 49,
of
Manitowoc.
"Your whole life is turned upside down. Some of your treatments
make you feel worse," Peterson said.
"Now I feel a sense of hope. I have
new friends who are supportive, and that's a plus."
As Mary Nix, 63, of Two
Rivers put it: "No one else understands where you've been, and people can't
truly
identify with you unless they've walked the walk."
Nix said the
relaxation portion of the program helped her combat the anxiety of her battle
with breast cancer
in 2009, the death of her husband in 2010 and her
diagnosis of colon cancer this year.
LIVESTRONG is designed to improve
energy levels and self-esteem, build muscle mass and strength,
increase
flexibility and endurance, improve the ability to perform everyday tasks and
develop an ongoing
fitness plan, Johns said.
Not only can exercise help
you bounce back after cancer treatment, studies have shown that physical
fitness
and having a support system and a positive outlook will lessen your
risk of recurrence for cancer, she said.
Classes offered again in
January
LIVESTRONG classes will again be offered at the Y starting on Jan.
9, Johns said.
In addition to Johns and Ruffolo, instructors are Amy Tisol
Retzinger and Craig Pautz.
Participants are assessed and their progress is
charted. Each participant receives a free 12-week
membership to the Y for
the duration of the program. The class also is free to caretakers and spouses
as
well as cancer survivors. Guest speakers on topics of interest to cancer
patients are part of the program.
To register or for information, contact
Michelle Kernz at (920) 682-0341, [email protected] or visit
www.
mtrymca.org.
December 4, 2011
Cancer survivors step up therapy -
Dailyrecord.com –
On any given Monday morning, the sounds of “New York, New
York,” “Boogie Woogie Bugle Boy of
Company B” and “Mambo No. 5” waft
through the speakers of the Accents on Dance studio in
Ledgewood.
The
three women on the studio floor were not previously acquainted, but after being
classmates for nearly a
year, share a generous amount of laughter and
encouragement.
They are not, however, rehearsing for any dance competitions
or ballroom appearances.
Instead, the women are a close-knit sisterhood of
breast cancer survivors who have found beneficial therapy
— and an
unexpected support system — through a weekly exercise program rooted in
dance.
“Before the class, I found that it was harder for me to reach up and
stretch,” said Penny Johansen, a retired
retail sales associate from
Succasunna. “It has helped my balance tremendously.”
Johansen underwent a
double mastectomy and reconstruction surgery in 2008, and says she then
developed
neuropathy in her feet and hands following chemotherapy.
Prior
to the chance spotting of a newspaper ad for a class called “Focus on Healing
Through Movement and
Dance” that was starting up at the studio this past
January, Johansen said she had difficulty finding an
exercise regimen
tailored to her recovery.
“I found, with a lot of gyms, it just hasn’t been
for me,” Johansen said.
“Focus on Healing” is a gentle, therapeutic exercise
program geared specially to the needs of women in
recovery from breast
cancer surgery and related treatment.
Among other reported benefits, the
program helps women regain their range of motion and balance, and
counteract such conditions as lymphedema, frozen shoulder, neuropathy and
fibromyalgia.
The dance-oriented class uses what has come to be known as the
Lebed method, in honor of namesake
Sherry Lebed Davis.
Davis, a
professional dancer, dance teacher and breast cancer survivor devised the
program in the early
1980s with her two physician brothers, after the
siblings’ mother had a difficult recovery from breast cancer.
Accents on
Dance instructor Sherrin Claesson – a veteran jazz, ballet and tap dance
teacher who is also
Lebed-certified – is a proud cheerleader for her
students, to whom she endearingly refers as “my ladies.”
“These women are
wonderful,” Claesson said. “What my ladies love about this class is not how well
they do
it. It’s the fact that they’re moving.”
Eliminating any
intimidation is essential to the program, which calls for the placement of
chairs next to each
participant.
“Everything that we do you can do
sitting down or standing up,”
Claesson said. The chairs can be used for
extra balance and support or taking a break.
Between 8 and 12 songs of
varying tempo comprise the soundtrack for each class.
“We start with
soothing music for our lymphatic opening,” Claesson said. “We do breathing
exercises, head
movements, shoulder shrugs and rolls, and isolating and
moving the rib area.”
Before long, the women segue to knee bends, lunges,
arm movements and step touches, and are ready to
tackle something
Latin-flavored and upbeat along the lines of Ricky Martin’s "Livin' La Vida
Loca."
Karen Bonte, a former co-owner of Solar Living, Inc. in Budd Lake,
remembers having difficulty opening
her mailbox after undergoing a left
side mastectomy and radiation last year.
“I can now lift my left arm as high
as my right arm,” Bonte said. “My range of motion has come back with
the
exercise program.”
Breaks are taken for sips of water, and to allow the
women to chat — a part of the class that is arguably as
important as the
exercise.
“If one of us has a question, we can ask one of the others who
might have already been through something
we’re going through,” Bonte
said.
“It’s a nice little bond we have.”
Elaine Nader, a retired
bookkeeper from Succasunna, rounds out the class, and appreciates the
camaraderie with her exercise mates.
“We get along fabulously,” Nader
said. “There’s nothing that we don’t discuss before class and after class. I
do miss it when I go to Florida.”
Nader says she finds the routines
particularly helpful in combating arm swelling from lymphedema and
neuropathy in her feet — conditions that developed after a 2007
mastectomy.
Especially appealing, the women say, is the fact the class does
not have the rigid, impersonal feel of other
exercise and rehab
programs.
“It’s very relaxing because you’re dancing to the music,” Bonte
said.
“If you can’t keep up, Sherrin will slow it down. We laugh about it
when we do something wrong, but
nobody cares.”
At the nominal charge of
$10 per session, the program has not been a moneymaker, despite the
testimonials
and fierce loyalty of its three participants — who have even
shown up for class on Monday holidays.
“We're keeping it going because it’s
a great class for these women,” Claesson said. “As long as people are
coming and (Accents on Dance owner/manager) Lou Cordileone provides the
space, I'm willing to teach it.”
Claesson said the Monday morning class has
room for more people, and that the studio is willing to start
additional
classes if demand exists.
“One of my ladies asks every doctor she goes to if
she can put brochures (about the “Focus on Healing”
class) in the waiting
rooms,” Claesson said, noting there is still resistance from some doctors to
recommend
alternative therapy.
Although originally designed for breast
cancer survivors, the dance-infused exercises may also be beneficial
for
people with Parkinson's disease, multiple sclerosis, arthritis and
osteoporosis, Claesson says, as well as
"senior citizens in
general."
Finding a bit of irony that it took recovery from breast cancer to
finally get her to join a dance class,
Johansen says she looks forward to
the classes every week – and is passionate about wanting the program
to
continue.
“I can’t tell you how much I’ve enjoyed it – mentally and
physically,”
Johansen said. “As long as we don’t have to wear tutus and be
in dance recitals.”
December 5, 2011
Mohawk College Offers Lymphedema
Program - Wire Service Canada –
Lymphdema is one of the most feared and least
understood complications of breast cancer treatment.
Mohawk College in
Hamilton, Ontario, is offering a day-long overview that will prepare the
student to
understand the causes of lymphedema as well as its treatment and
management.
John Mulligan, RMT/CLT-LANA will present an Overview of
Lymphology and Lymphedema Management
at Mohawk College at the
Mohawk/McMaster Institute of Applied Health Sciences Hamilton Campus in
the
Applied Health Sciences building, on Saturday February 4th, 2012, 9:00 a.m. to
4:30 p.m.
This unique one day workshop will explore the different types and
stages of lymphedema, clinical pathways
for treatment and the need for
skilled care. Topics include basic lymphology, differentiating among different
types of edema, the role and mechanics of compression, manual lymph
drainage and complex decongestive
therapy. We will also discuss the
International Lymphedema Framework Movement, research resources
and
educational opportunities in the field of lymphology.
This one-day
introduction to the basics of lymphedema and lymphedema management will
immediately give
the attendees a solid base of knowledge of the lymphatic
system and disorders of the lymphatic system.
For more information
visitwww.LymphedemaDepot.com and click on EVENTS in the left-side menu. This
will bring you to the Mohawk online course catalogue where register for the
daylong overview. To locate the
course listing, simply go to page 53 of the
catalogue. To register, click on Registration Information.
For further
assistance contact John Mulligan directly at
[email protected].
For more information about Mr. Mulligan and
his practice, please visit www.LymphedemaTherapist.com.
December 5,
2011
ArjoHuntleigh Forms New Division to Enhance the Quality Home Medical
Care- PR Newswire –
ADDISON, Ill., Dec. 5, 2011 /PRNewswire/ --
ArjoHuntleigh Inc., a global leader of integrated solutions
for the care of
people with reduced mobility and related conditions, announced today the launch
of a new
division and product portfolio focused exclusively on developing
and distributing medical equipment to
people in home care settings.
The
new division, ArjoHuntleigh Home Care, will offer a broad range of product
solutions that aid in the
caring of individuals at home including patient
handling systems, hygiene systems, therapeutic surfaces,
medical beds,
treatment of lymphedema, and bariatric care.
"We are excited to announce the
formation of ArjoHuntleigh Home Care," said Phil Croxford, President and
CEO ArjoHuntleigh North America.
"The new Home Care division will
provide world-class solutions for the care of people with reduced
mobility
and related conditions that are specific to home care environments.
ArjoHuntleigh Home Care will
provide an enhanced sales and service network
that will enable our distribution partners to deliver high
quality and
cost-effective healthcare to people who have mobility challenges," continued
Croxford.
ArjoHuntleigh offers a broad range of integrated solutions for the
care of people with reduced mobility and
related conditions, with the aim
to enhance the quality of care in long-term care, acute-care and home care
environments. The company is known for high-quality and state-of-the-art
solutions including the Sara®
product line of standing-and-raising aides,
the Voyager and Maxi-Sky® ceiling lifts, the Freedom bathing
system,
Minuet® bed and the Nimbus®/DFS range of Therapeutic Surfaces.
Products are
currently available through a wide range of dealers located throughout the US
and Canada.
The new Home Care division will be based out of the
organization's North American Headquarters in
Addison, IL.
About
ArjoHuntleigh ArjoHuntleigh Inc. is a global medical technology company
providing a broad range of
integrated solutions for the care of people with
reduced mobility and related conditions. We aim to enhance
the quality of
care of people with reduced mobility and related solutions by providing medical
equipment and
integrated solutions for patient handling and hygiene,
medical beds and therapeutic surfaces, wound healing,
DVT prevention,
disinfection and diagnostics. With more than 4,400 dedicated employees
worldwide,
ArjoHuntleigh serves the needs of patients and healthcare
professionals in more than 100 countries. For
more information about
ArjoHuntleigh, visit our website at www.ArjoHuntleigh.com.
December 6,
2011
Exercise 'can be good for lymphedema patients' - International
Federation of Gynecology and Obstetrics –
Breast cancer survivors with
lymphadema are not putting themselves in danger by exercising, women's health
researchers have stated, saying physical activity could be good for these
patients.
Scientists at the University of Missouri in the US reviewed
the literature about this chronic inflammation
condition, which it was
previously thought could be caused or aggravated by fitness
pursuits.
The researchers said the evidence suggests the benefits of
exercise actually outweigh the potential risks, with
Sinclair School of
Nursing professor Jane Armer, who was involved in the study, reporting breast
cancer
survivors are not at a significantly higher threat of lymphadema if
they keep physically active.
Additionally, those who already had the
condition did not seem to get worse if they kept fit, but the expert
said
people in danger of developing the swelling should monitor their
pursuits.
"Breast cancer survivors do not need to restrict their
activity as we once thought," professor Armer said.
"If patients want to
be active, they should carefully condition their bodies by increasing
repetitions of
resistance exercises under proper supervision," she
added.
Dartmouth Institute for Health Policy and Clinical Practice
researchers in Hanover in the US recently
developed a model that can be
used to determine the survival rates of those who go through breast cancer
screenings.
December 6, 2011
Mom's illness sparks desire to fight the
fat - Stockton Record –
STOCKTON - With her own Web design business and a
job working with Spanish-speaking students in a
Lodi school, Lodi resident
Alejandrina Britschgi didn't need a new career.
Then her mom got
sick.
Britschgi, 27, said her mother, Lucresia Duran, was on a visit from
her home in Puerto Rico when
lymphedema - severe fluid retention in her
legs - made it painful to walk.
"I put her on a diet," Britschgi said. That
didn't work. A doctor warned that Duran was in danger of losing a
leg.
Finally, Britschgi found Amanda McCann, a personal health coach
based in Sacramento. McCann helped
Duran lose 47 pounds over five months.
Duran saved her leg.
But Britschgi was deeply involved in the entire effort.
McCann doesn't speak Spanish. By translating for her
mother, Britschgi
learned about nutrition, exercise and coaching.
Britschgi said she then
tried the system for herself, basically eating small, nutritious meals six
times a day and
avoiding junk food. It worked, and she, like her mom, felt
stronger and no longer suffered weight
fluctuations.
That was in 2009.
Two years later, Britschgi is a certified health coach and has won an award
from San
Joaquin County's Obesity and Chronic Disease Prevention Taskforce
for her efforts to combat obesity and
other health ills.
"In my family,
I thought being obese was something you inherited," Britschgi said.
In part,
that may have been because she was fond of the food in her native Puerto Rico,
much of which is
fried. She said she's retrained herself to cook with less
oil. Now, when she makes mafongo - a garlic-
flavored, mashed-plantain dish
- she boils the plantain instead of frying it.
One way she earns money as a
health coach is with a consulting contract at Jose Serna Charter School in
Lodi. There, she teaches cooking and offers children tips like this:
"Instead of white sugar, why don't you do
raw sugar or brown sugar?"
Britschgi said people can be healthy and still enjoy treats, but that it helps
to
substitute better ingredients and control portion sizes.
Britschgi's
other source of income as a health coach is through commissions on
meal-replacement products
sold by Medifast.
People using the Medifast
program can get her coaching services for free through a related program
called
Take Shape for Life. In addition, she offers free weekly classes on
various health topics.
McCann said that Britschgi has played a huge role in
bringing health-coaching services and meal-
replacement products to Spanish
speakers. And not just in Lodi and Stockton.
About four times a year,
Britschgi travels to Puerto Rico to coach clients there. When she is at home
in
Lodi, she keeps up with them through Skype.
"A lot of people think
you cannot change your habits," Britschgi said. "But yes, you can."
Contact
reporter Dana M. Nichols at (209) 607-1361 or [email protected]. Visit his
blog at
recordnet.com/calaverasblog.
December 5, 2011
Taking control
of the fear with breast cancer - MiamiHerald.com –
Andrea Torres is an
editor at The Miami Herald. Follow her breast cancer journey at
miamiherald.
com/health.
Narcotics detectives hunt addicts and
traffickers for the sort of painkillers that are prescribed to breast
cancer patients after a bilateral mastectomy. Oxycodone can destroy a
life.
I decided to stay away from it on the fifth day after the surgery.
That was a big mistake. It was torture. I felt
like there were little
creatures with sharp objects poking and tearing me from within. The pain was so
excruciating it made me weep.
“Why are you crying? That’s not going to
solve anything,” said my mom. “That’s enough. Just take it.”
She is a
believer in homeopathic remedies, and taught me how to use prana yoga and
breathing exercises to
deal with headaches when I was 8. She is the person
least likely to push pharmaceuticals, yet she was
standing in front of me
with a glass of water and a container full of white pills. I laughed and
swallowed one.
Within 40 minutes, I found peace.
The pills couldn’t
vanish the gray cloud floating over my head. The body image I had been used to
seeing in
the mirror after showering was no longer there. I felt deformed,
and still I had to find the courage to be
topless in front of two men at
the University of Miami’s Sylvester Comprehensive Cancer Center.
After
careful examination, Dr. Marc Lippman, chairman of the University of Miami’s
department of
medicine, said the outcome of the surgery was “great.” I told
him I disagreed. My doctors had done an
amazing job, and I had not had any
complications while healing. All was well. I just didn’t like the “under
construction” sign that was hanging over my chest.
“You could have come
out of this surgery a lot worse,” he said. “You are not going to have the
breasts you
used to have but it will come close.”
He was right. Vanity
twists perspective and makes one ungrateful.
“We are still aiming for a
cure? Aren’t we?” he asked.
“Yes, absolutely,” I said.
I wasn’t as
enthusiastic. The surgery had added the risk of developing lymphedema, which
causes painful
and chronic swelling of the arm due to fluid
retention.
The medical director of the Baptist Health Breast Center, Dr.
Robert DerHagopian, said the pain in my left
arm was going to
subside.
“Damage to the intercostobrachial nerve causes numbness on the
upper inner arm,” said DerHagopian, while
pointing to the back of my
arm.
The damage happened during the axillary lymph node dissection. This
procedure and another one — the
sentinel lymph node biopsy — were done to
examine whether the pea-sized filters under the arm had
collected cancer
cells that may have spread. The pathology report said DerHagopian had removed
“one
sentinel lymph node and 16 random lymph nodes” and that doctors had
found two with “macrometastases.”
The good news was that doctors did not
believe the cancer cells had spread to other parts.
“Your prognosis is good,
but there is no guarantee that a recurrence won’t happen,” DerHagopian
said.
To reduce the risk of a recurrence, both DerHagopian and Lippman
recommended that I undergo radiation
and referred me to UM Sylvester
Comprehensive Cancer Center’s radiation oncologist, Dr. Cristiane
Takita.
During my meeting with Takita, who specializes in using radiation to kill or
shrink cancer cells, I
learned that the therapy would reduce the risk of
recurrence from about 30 to 10 percent. Although when
used on children,
Takita said, radiation can become a cancer risk.
“We are going to use
radiation as a preventive measure,” said Takita. “That means that we are going
to
radiate the clavicular area.”
The chest wall was also a very common
area of recurrence, Takita said. She recommended I undergo six
weeks of
treatment Monday through Friday.
“The treatment is painless when
administered, but your skin becomes more sensitive. It will feel like you had
a sunburn,” said Takita. “Some patients experience tiredness … lowered
white cell counts and
inflammation.”
I had fears. What if the radiation
damaged my tissue so severely that it would cause my body to reject the
implant? “I am concerned about it affecting my reconstruction,” I
said.
Fear has taken different forms through my experience with breast
cancer treatment. The steps the doctors
have recommended are simple, and
I’m going to continue them despite Lady Terror’s creative mirage
December 6,
2011 –
Exercise for Breast Cancer Survivors - Biomed Middle East –
Jane
Armer says patients at risk for lymphedema can exercise if they closely monitor
their activities.
“Exercise can be beneficial and not harmful for breast
cancer survivors,” he said. “Each individual should
balance the pros and
cons of the activity she chooses, but keep in mind that being sedentary has
risks and
being active is beneficial in many ways, including possibly
reducing the risk of cancer recurrence.”
Lymphedema can occur any time after
cancer treatment and is usually caused by the removal or radiation of
lymph
nodes as part of the treatment process. Armer found that patients who exercise
had no greater risk
for developing lymphedema than those who do not
exercise. In addition, patients with lymphedema did not
worsen their
condition by exercising. She says future research is needed to determine
whether exercise
prevents the condition.
“Breast cancer survivors do not
need to restrict their activity as we once thought,” Armer said. “If patients
want to be active, they should carefully condition their bodies by
increasing repetitions of resistance
exercises under proper
supervision.”
“Many people think surgery will correct the underlying
lymphatic problem, but that is not correct,” Armer
said. “There are several
surgical techniques that may reduce the swelling associated with lymphedema. In
most cases, it is recommended that patients undergo traditional therapy
using specialised massage and
compression garments and bandages to reduce
fluid and swelling before considering surgery.”
Established in 2008, the
American Lymphedema Framework Project (ALFP) aims to increase awareness of
lymphedema, improve patient care and enhance training for professionals
caring for persons at risk or with
cancer-related lymphedema. The ALFP has
two main goals: maintain up-to-date best practices supported
with
evidence-based lymphedema treatment guidelines for health practitioners, and
create a minimum data
set of all available lymphedema research and clinical
data.
MEDICA.de; Source: University of MissouriDecember 6,
2011
Lymphedema 'is not caused by exercise' - Private Healthcare UK
–
Patients who have received breast cancer treatment have been told that
exercise will not instigate the onset
of lymphedema.
There had been some
controversy about advising people recovering from the illness to participate in
physical
activity, but scientists at the University of Missouri analysed
medical records and found that the benefits of
exercise were more
significant than the risks.
Lymphedema is caused by the removal or radiation
of lymph nodes in breast cancer treatment and can
cause a painful chronic
swelling in some patients.
"Breast cancer survivors do not need to restrict
their activity as we once thought," said Jane Armer, from the
Sinclair
School of Nursing at the university.
She explained that patients should
choose their physical activities carefully as being active has many health
benefits, including possibly reducing the risk of the tumours
reoccurring.
According to Cancer Research, it is in the second stage of
breast cancer when the disease first affects the
lymph nodes.
December
7, 2011
Comprehensive Lymphedema Patient Resource and Education Site to
Launch this Month - MarketWatch
(press release) –
LOS ANGELES, Dec 07,
2011 (BUSINESS WIRE) -- Emphasizing the notion that "Lymphedema doesn't
have to be a secret," a new online resource site, www.lymphconnect.com ,
has been developed to spread
the word about the largely misunderstood
condition suffered by hundreds of thousands of women. The site is
designed
to provide a comprehensive informational resource and support network for women
living with
lymphedema and their loved ones and families, as well as anyone
faced with breast cancer in general.
After the physical and emotional rigors
of a mastectomy or lumpectomy as part of the fight against breast
cancer,
patients often need to undergo extensive radiation or chemotherapy treatments
as well.
Unfortunately, for many of those who successfully beat breast
cancer, there is a chance they could face the
potentially debilitating
post-breast cancer condition called lymphedema.
Largely under diagnosed and
misunderstood, lymphedema is a condition resulting from damage to the lymph
nodes that causes swelling in the limbs. Early detection is critical for
survivors of breast cancer to manage
and control the condition. However,
the majority of women are unaware that lymphedema is a risk
associated with
breast cancer treatments. Too often, the condition is not diagnosed until after
swelling is
visible, the point at which the progression of the disease is
often irreversible.
The hope of LymphConnect.com is to create a community of
breast cancer patients and survivors, friends
and family, who support the
education, prevention, early detection, intervention and treatment of
lymphedema. The site creates a forum that offers women the opportunity to
get proactive about the
condition by sharing their stories and learning
those of others via the site's built-in online support community.
The site
also contains regularly updated news and information about the condition and
related research,
question and answer opportunities with medical
professionals, and information empowering readers to
spread the word about
the condition.
The ultimate goal of LymphConnect.com is to generate
increased awareness and knowledge of
lymphedema, as well as a support
network so that more breast cancer survivors will have the resources
necessary to be informed and to become advocates for early detection and
awareness. The easy-to-
navigate and interactive site goes live this
month.
SOURCE: LymphConnect.com
December 12, 2011Monday Medical:
Lymphedema treatment is vital - The Steamboat Pilot & Today – By
Christine McKelvie - Almost 12 years after being diagnosed with stage 3
breast cancer, Craig resident
Bonnie Curtis is beaming. The cause of her
celebratory smile is something most of us take for granted. She
can reach
above her shoulder and bend her right arm.
“I’ve got elbow!” Curtis
triumphantly says, flexing her arm to prove it.
With the help of two
specialist therapists at Yampa Valley Medical Center, Curtis has overcome the
worst
symptoms of her lymphedema. This nasty side effect of some cancer
treatments can create serious swelling,
discomfort and disability.
“The
lymphatic system transports and filters vital fluids throughout the body,”
explains Jodi Bringuel, physical
therapist and certified lymphedema
therapist at YVMC.
“Lymphedema is an accumulation of lymphatic fluid that is
not draining properly. It can be caused by
removal of lymph nodes or damage
to the lymphatic system,” she said.
Curtis’ breast cancer surgery in 2000
involved removal of 18 lymph nodes. About a year later, she noticed
that
her arm “started poofing up.” Although she sought treatment, the swelling kept
creeping up toward her
shoulder.
In 2004, Curtis began working at YVMC
as a housekeeper. Noticing Curtis’ badly swollen arm, one of her
new
co-workers suggested that she see Susan Ring, certified lymphedema therapist,
physical therapist and
director of SportsMed at YVMC.
“Susan and Jodi
have been my angels ever since,” Curtis said.
Bringuel has a passion for her
work, in part because of her own family history of cancer.
“In the United
States, lymphedema is most often a result from cancer surgery or treatments,”
Bringuel said.
“The main groups of lymph nodes are found in the armpit and
groin areas,” she explains. “These are often
the site of biopsies when
determining if cancer has spread to the lymphatic system. Sometimes lymph nodes
are removed in surgery or are damaged by radiation treatment.
“The key
thing we want people to know is that once lymphedema starts, it’s a matter of
managing it for the
rest of your life,” Bringuel said. “There is no cure.
But there are things people can do and avoid doing to
reduce their
risk.”
Warning signs can be subtle. Typically lymphedema can cause some
minor discomfort, but it is not painful,
Bringuel said. One arm or leg may
seem heavier. Clothing or jewelry may feel a little tighter.
Bringuel said
early intervention is vital to keep swelling to a minimum. That is why she
attempts to visit with
everyone who has cancer surgery at YVMC, either
before or soon after his or her surgery.
“We offer a free consultation,”
Bringuel said. “This education is available to all residents of the Yampa
Valley, regardless of where they have their surgery.”
Lymphedema
treatment has three components — education, manual lymphatic drainage and
bandaging or
compression garments.
Curtis credits her recent dramatic
improvement to the newest technique of manual lymphatic drainage, a
relaxing whole-body experience that “opens up” the entire lymphatic
system.
“Just this year, we started manual drainage,” she said. “Up until
then, it was just arm massage and wrapping.
My arm is so much smaller and
lighter now. I can see my wrist bone for the first time in years.”
At a
recent check-in with Bringuel and Ring, Curtis learned that she is eligible for
a new, smaller arm
compression “sleeve.” She wears one type of sleeve during
the day and a different one at night.
Lymphedema treatment at YVMC also
includes education about skin care. Because lymphedema increases
the risk
of infections, something as simple as a hangnail or scratch can cause an
infection.
Curtis spent years coping with her swollen arm, aching shoulder
and limited movement.
“I didn’t let it get me down, but my life is
definitely better now,” she said. “Jodi and Susan are always
learning about
new treatments and techniques, and they gave me back my arm.”
Christine
McKelvie is the public relations director of Yampa Valley Medical
Center.
December 12, 2011
Lymphedema After Breast Cancer Surgery:
Pain, Swelling May Occur Years Later - Patch.com –
There is no rhyme,
reason, or way to predict if a woman will experience lymphedema following
surgery or
radiation to treat breast cancer. Swelling of the arm, breast,
or chest may begin shortly after breast cancer
surgery or radiation, but
some women experience lymphedema months—or even years—later. According to
the American Cancer Society, most women who have had breast cancer do not
develop lymphedema, but
the many who do can take steps to manage the
swelling and pain, which can range from mild to severe.
Lymphedema results
when lymph nodes and vessels are removed or scarred during breast cancer
surgery.
With fewer lymph nodes and vessels, it is more difficult for the
upper body to drain lymph fluid. When
excess lymph fluid builds up, pain
and swelling occurs. Radiation for breast cancer also affects the flow of
lymph fluid in the arm, chest, and breast area, and can cause
lymphedema.
“Lymphedema is always a risk when a woman has had any lymph
nodes removed or radiation for breast
cancer,” says Monique Tiffany, R.N.,
nurse navigator at the Total Care Breast Center at Los Alamitos
Medical
Center. Tiffany advises women about lymphedema not only as a breast cancer care
nurse, but also
as a breast cancer survivor. She celebrated being
cancer-free for 10 years this month.
Tiffany says she remains aware that
lymphedema can still occur, even after a decade. “I still have to think
about it if I’m going to get on a plane,” she says. Air travel can cause
lymphedema to flare up.
January 12, 2012
This one has tables and a
lot of stuff in the full article, but I also found the abstract to use if the
formatting is
unusable Tina
Newswise — Articles featured in this issue
include— - Newswise
Abstract—Lymphedema is a debilitating complication
following mastectomy, affecting the arm functions and
quality of life (QOL)
effects of upper-limb exercises on lymphedema in clinical settings. However,
there is a
dearth of evidence regarding the effect of home-based exercises
on lymphedema; therefore, we examined
the effect of a home-based exercise
program on lymphedema and QOL in postmastectomy patients. Thirty-
two female
postmastectomy lymphedema patients participated in an individualized home-based
exercise
program for 8 weeks. Arm circumference, arm volume, and QOL
(36-Item Short Form Health Survey)
were measured before and after the
program. Data were analyzed with the use of paired t-tests for
circumferential and volumetric measures and Wilcoxon signed ranks tests for
QOL. Significance level was
set at p < 0.01 with Bonferroni correction
(alpha/n = 0.05/5 = 0.01). Analysis showed a statistically
significant
improvement in the affected upper-limb circumference and volume (~122 mL
reduction, p <
0.001) and in the QOL scores (p < 0.001) at the end of
the home-based exercise program. The
individualized home-based exercise
program led to improvement in affected upper-limb volume and
circumference
and QOL of postmastectomy lymphedema patients.
INTRODUCTIONLymphedema is a
chronic, debilitating complication that breast cancer survivors face
after
breast cancer treatment [1–8]. Incidence of secondary arm lymphedema varies
from 5 to 56 percent
[4,7–12]. About 60 percent of patients who undergo
axillary lymph node resection and irradiation will
eventually develop
lymphedema [13].
Lymphedema develops when the lymphatic flow is impaired and
excess fluid and protein accumulate in the
interstitial space. The
hemodynamic factors at the site oflymphedema may also play a role in its
development
[1]. Affected women can experience pain, swelling, arm
tightness, heaviness of the arm, and recurrent skin
infections. If left
untreated, lymphedema may predispose the affected limb to the development of
other
secondary complications like recurrent bouts of cellulitis or
lymphangitis, axillary vein thrombosis, severe
functional impairment,
cosmetic embracement, and lymphangiosarcoma [9]. Breast cancer survivors may
find lymphedema more distressing than mastectomy, because hiding the
physiological manifestations and loss
of function of lymphedema is harder.
Overall, these factors lead to decreased quality of life (QOL) for
breast
cancer survivors [14–15]. Rehabilitative interventions are considered the
mainstay for the treatment of
lymphedema, and exercises form an integral
component of such rehabilitation [16].
For decades, any kind of strenuous
activity has been feared to exacerbate the lymphedema. Current clinical
guidelines indicate that women with and at risk for lymphedema should
protect the affected arm from
overuse [17–18]. For this reason, patients
with lymphedema avoid using the affected limb, leading to
weakness and,
hence, predisposing the limb to injury even from small household tasks.
Further, such fear
poses an additional barrier to patients staying
physically active, potentially translating to weight gain, which
has been
shown to be associated with a worse clinical course for women with lymphedema
[5]. However,
the evidence shows no association between lymphedema and
strenuous activity; hence, upper-limb
resistance exercises can help in
recovery [19–26]. Previous studies support the view that upper-limb
exercises may decrease lymphedema risk by improving the lymphatic return
and lymphangiogenesis, i.e.,
regeneration of new collaterals [27–31]. On
the other hand, avoiding activity of the affected limb may lead
to poor
lymphatic clearance and, hence, stasis of the lymphatic fluid in the affected
limb [32]. During the
early 6 to 12 months after mastectomy, pain and
decreased shoulder movements are more common than
lymphedema [33]; these
can also be prevented by upper-limb exercises [34]. Particularly, strength
training
will help not only in recovering arm strength but also in
recovering bone mineral loss due to cancer treatment.
Inactivity of the
affected limb may lead to prolonged arm weakness, poor scapulohumeral function,
bone
mineral loss and, finally, lymphedema [35–36].
Since the 1990s,
efforts have been made by McKenzie and other researchers to disprove the
concept that
strenuous exercise of the affected upper limb may lead to or
worsen lymphedema [19–22]. A few recent
clinical trials [19–29], including
a well-controlled trial by Schmitz et al. [26], have proved that upper-limb
exercises have beneficial effects for lymphedema without exacerbating it.
Most of the exercise interventions
were provided in hospitals, clinics, or
fitness centers. These interventions may not be helpful for those
patients
who cannot afford the cost of or who lack transportation to institution-based
rehabilitation. So, a
need existed for the development of an exercise
program that these patients could easily follow and perform
at their
homes.
Evidence is lacking regarding the effect of home-based exercise
programs on lymphedema and QOL of
breast cancer patients. So, this study
was carried out to evaluate the effects of a home-based exercise
program on
lymphedema and QOL of breast cancer patients. We hypothesized that a structured
home-
based program of progressive resistance exercises of the upper limbs
combined with deep breathing and
self-care would help relieve the symptoms
of lymphedema and improve the QOL of breast cancer patients.
Hence, this
study may give valuable evidence supporting the importance of home-based
exercise programs
in the reduction of postmastectomy lymphedema symptoms
and thereby improve the QOL of breast cancer
patients.
METHODSThis study
was a pre-post intervention study in which measurements were taken before and
after the 8-week home-based exercise program. Convenience sampling was used
to select the participants.
The contralateral upper limb was used as the
control so that any physiological change happening would
happen equally on
both the limbs.
SubjectsBreast cancer patients who had undergone mastectomy
surgery and had completed neoadjuvant
chemo- and radiation therapy from
March 2006 to February 2008 were referred to the study by the
concerned
oncologist and oncology surgeon. We screened 137 patients for the inclusion and
exclusion
criteria given subsequently; of these, 38 met the ideal inclusion
criteria. Six were lost to follow up. Therefore,
a total of 32 patients
(all women) completed the exercise program. The flow of participants through
the
study is shown in the Figure.
Figure. Flow of participants through
study.
Inclusion and Exclusion CriteriaPatients were included if they had
undergone unilateral mastectomy and
completed chemo- and radiation therapy
for stage I or II breast cancer 1.5 years or more before
participating in
the study. Also, the patients must have subsequently developed ipsilateral
upper-limb
lymphedema with a difference of 2 cm or more at any one
measurement point or 200 mL or more compared
with the contralateral upper
limb. Patients were excluded if they had primary lymphedema, secondary
lymphedema due to other system pathology, stage III lymphedema, bilateral
disease, diagnosed cancer
recurrence, and any contraindication to the
affected upper-limb exercises (e.g., venous thrombosis).
MeasurementsAll the
measurements were taken at baseline and at the completion of 8 weeks of the
home-
based exercise program.
Lymphedema MeasurementLymphedema was
measured two ways: using circumferential measurements and
a volumetric
method. Patients using compression sleeves were advised to remove them 3 to 4
hours before
the following measurements were taken:
1. Upper-limb
circumference was taken using cloth measuring tape on bilateral upper-limbs at
four levels, i.
e., at the metacarpophalangeal joints, wrist joint, 15 cm
distal to the lateral epicondyle, and 10 cm proximal
to the lateral
epicondyle. Patients were positioned prone with their upper limbs at their
sides and their
elbows straight while the circumference measurements were
taken [20–21]. Two measurements were taken
and their mean was used. The
calculated difference between each circumference (in centimeters) at all four
levels between the affected and contralateral upper limbs was taken as
outcome.
2. Volumetric measurements were taken by the water displacement
method, which is based on
Archimedes’ Principle. Two readings were taken:
(1) at the ulnar styloid process level and (2) 45 cm
proximal to the ulnar
styloid process level for each upper limb. During measurement, patients were
advised
to keep their upper limb straight and immerse it slowly by sliding
their fingers straight down inside the wall of
the volumeter, which was
filled with water. Water displaced was collected from the point of immersion of
upper limb until the marked level was reached and no further dripping of
water was observed. The collected
water was transferred into a graduated
cylinder and the volumetric reading was taken to the nearest 5 mL
level.
This method of volumetric measurement has been used previously by McKenzie and
Kalda [22]. The
outcome measure was the calculated difference in volume (in
milliliters) displaced between the affected and
contralateral upper
limbs.
Quality of LifeQOL was measured by using the 36-Item Short Form
Health Survey (SF-36) QOL
questionnaire. The SF-36 has been widely used as
a reliable and valid tool to measure general QOL of
patients with various
medical conditions, including cancer. It is a 36-item scale with 8 major
components that
cover physical, social, and emotional functioning as well
as vitality, bodily pain, mental health, and general
health. Completely
filled questionnaires were scored using the SF-36 Health Survey Manual and
Interpretation Guide [37].
Home-Based Exercise ProgramEducation about
postmastectomy lymphedema and the home-based
exercise program (Table 1) was
given before the initiation of the exercise program. A qualified
physiotherapist gave the initial sessions of exercise prescription and
training. Patients practiced the exercise
sequence three to four times;
once their performance was found satisfactory, the exercise program (handout)
along with logbook were given to the patient. Patients were advised to
increase the weight only when 2 sets
of 15 repetitions became easy to
perform. Patients were monitored telephonically every week and at a
fourth-week follow up in the hospital or at home for those patients who
were not able (30%) to come in for
follow
up.
--------------------------------------------------------------------------------
Table
1.
Progressive resistance exercise program to enhance muscle strength and
endurance of upper limb and
scapular muscles (modified from Franklin et al.
and Harris et al. [1–2]). Participants used household items (e.
g., water
bottle, salt packets).
Parameter Description
Warm Up Active range of
motion exercises for glenohumeral joint for 5 min.
Muscle Groups Rhomboids,
middle trapezius (scapular retraction), latissimus dorsi (shoulder extension),
serratus anterior (scapular protraction), lower trapezius (scapular
depression), biceps (elbow flexion),
triceps (elbow extension), forearm
muscles (wrist flexion, extension), hand muscles (ball squeeze).
Frequency 5
d/wk.
Intensity Start with light resistance 50%–60% of 10 repetition maximum
weight progress within tolerance.
Repetitions 1 set of 8–10, increase
gradually to 10–15.
Sets 1 set, progress to 2 sets; at 2 sets of 12–15
repetitions, increase resistance weight by 5%–10%.
Stretching Exercises
Pectoralis major and minor, latissimus dorsi.
Deep Breathing Exercises Deep
breathing exercises between each set.
Indication to Reduce Workload
Excessive fatigue, postexercise muscle soreness >48 h, slight increase in
arm edema lasting <1 h, pain during or following exercise.
Indication
to Terminate Pain, discomfort, marked increase in arm edema, dizziness,
general malaise.
Self-Care Advice Daily monitoring of affected arm for any
injury or redness, gentle distal to proximal self-
massage, wearing of
compression garment, avoid insect bites, avoid sleeping on affected side, limb
elevation, etc.
1. Franklin BA, Whaley MH, Howley ET, Balady GJ. ACSM’s
guidelines for exercise testing and
prescription. 6th ed. Philadelphia
(PA): Lippincott Williams and Wilkins; 2000.
2. Harris SR, Hugi MR, Olivotto
IA, Levine M; Steering Committee for Clinical Practice Guidelines for the
Care and Treatment of Breast Cancer. Clinical practice guidelines for the
care and treatment of breast
cancer: 11. Lymphedema. CMAJ.
2001;164(2):191–99. [PMID: 11332311]
Statistical AnalysisData were
analyzed using SPSS version 16 (SPSS Inc; Chicago, Illinois) and Microsoft
Excel 2007 (Microsoft Corp.; Redmond, Washington).
Descriptive analysis
was done for patient age and time since mastectomy. Paired t-tests were used
for
comparison of mean values of the pre- and postexercise circumferential
and volumetric measurements and
the Wilcoxon signed ranks test was used for
SF-36 QOL scores. The significance level was set at p < 0.01
using
Bonferroni correction (α /n = 0.05/5 = 0.01).
RESULTSThe mean ± standard
deviation age of the postmastectomy lymphedema patients was 46.56 ±
6.98
years and time since mastectomy was 2.08 ± 0.65 years. A statistically
significant reduction in affected
upper-limb circumference was found at
three levels of measurement (p < 0.001), except at the
metacarpophalangeal joint level (p = 0.04) and in the affected upper-limb
volume (p < 0.001) (Table 2)
following the 8-week home-based exercise
program. Also, a statistically significant difference was found for
QOL
scores in all SF-36 domains postintervention (Table 3). Result analysis of the
data is shown in Tables
2 and
3.
--------------------------------------------------------------------------------
Table
2.
Pre-post exercise program changes in affected upper-limb circumference
and volume. Data presented as
mean ± standard deviation.
Measurement
Preexercise Postexercise Pre-Post Change
MCP Joints (cm) 19.17 ± 1.46 19.03 ±
1.37 0.14 ± 0.9
Wrist Joint (cm) 16.45 ± 2.09 16.20 ± 1.96 0.25 ± 0.13
15
cm DLE (cm) 22.16 ± 3.11 21.47 ± 2.83 0.69 ± 0.28
10 cm PLE (cm) 31.02 ±
4.38 30.06 ± 4.44 0.96 ± 0.06
Volume (mL) 2306.32 ± 627.82 2183.49 ± 597.45
122.83 ± 30.37
DLE = distal to lateral epicondyle, MCP =
metacarpophalangeal, PLE = proximal to lateral
epicondyle.
--------------------------------------------------------------------------------
Table
3.
Pre-post exercise program changes in 36-Item Short Form Health Survey
quality of life scores.
Parameter Preexercise Postexercise Change in
Score
Physical Function 33.90 44.40 10.50
Role Physical 37.30 43.40
6.10
Bodily Pain 37.60 46.10 8.50
General Health 42.20 44.60
2.40
Vitality 45.80 52.10 6.30
Social Function 37.75 45.90 8.15
Role
Emotional 32.60 44.20 11.60
Mental Health 37.30 44.40 7.10
Physical
Component Summary 41.25 46.30 5.05
Mental Component Summary 38.55 48.30
9.75
DISCUSSIONLymphedema is a chronic, progressive, long-term adverse
effect of breast cancer treatment
resulting in affected upper-limb
swelling, pain, heaviness, and discomfort. This not only affects the normal
functional use of the affected upper limb but also causes psychological
distress by altering the patient’s body
image because of visible swelling
of the arm. Together, these symptoms greatly reduce QOL [14–15].
Several
therapies have been used to treat lymphedema, but rehabilitative interventions
remain the treatment
mainstay and exercises play an important role in such
rehabilitation.
Therefore, we carried out this study to evaluate the effect
of an 8-week home-based exercise program of
progressive resistance
exercises, deep breathing, and self-care on the lymphedema and QOL of
postmastectomy patients. The results of our study showed that the
home-based exercise program led to
statistically significant reductions in
the circumference and volume (Table 2) of the affected upper limb and
improved QOL scores (Table 3) of breast cancer patients. Providing a
logbook and continuous monitoring
resulted in good adherence to the
exercise program (89% as per logbook records). Mean change in arm
volume
was 122 mL. In fact, in our study, exercise acted as a therapeutic intervention
instead of worsening
the lymphedema symptoms.
Many justifications can be
given regarding the use of gradual, progressive upper-limb exercise training
along
with deep breathing in the rehabilitation of lymphedema [19].
Gradually increasing the physiological stress to
the affected upper limb
through flexibility, resistance, and aerobic exercises will be better than
inactivity in
postmastectomy patients. Possible mechanisms by which
affected upper-limb exercise improves or helps
prevent lymphedema symptoms
include that such exercise not only enhances lymphatic flow [38–41] but
also improves protein resorption [42]. Lymphatic flow increases as a result
of decreased intrathoracic
pressure during inspiration phase [43]; this
leads to speculation that increased pulmonary work during
exercise may help
in decreasing the lymphedema [44]. Also, affected upper-limb venous drainage
has been
found to be compromised most frequently in lymphedema patients
[45]. Stretching exercises may help
reduce the soft tissue contractures
and, hence, decrease the blood and lymphatic obstruction [44].
Progressive
resistance exercises may also cause self-contraction of the lymphatic vessels
by regulating
sympathetic nerves innervating these vessels. Hence, the
exercises enhance control over the internal
contraction of these vessels by
resetting their sympathetic drive, which in turn is important for the
long-term
management of lymphedema [38–39]. Because skeletal muscle
contraction is a primary force in propelling
lymph fluid throughout the
lymphatic system, it can enhance lymphatic clearance. Lane et al. injected an
isotope into the hands of nondisabled women and determined that 5 minutes
of exercises using an arm
ergometer enhanced lymphatic clearance in the
hand [30].
In addition, deep breathing while performing any exercise for
lymphedema is doubly important. First, deep
breathing is vital to ensure an
adequate supply of oxygen to the tissues when the body is undergoing greater
than usual exertion. Second, deep breathing creates pressure change in the
abdomen, which acts like a
vacuum in the thoracic cavity, helping to drain
lymphatic vessels [44]. Moseley et al. reported that 38
women with
secondary arm lymphedema who performed 10 minutes of gentle arm exercises
combined with
deep breathing everyday for 1 month achieved a statistically
significant reduction in arm volume of 101 mL
(9.0%) [31]. In our study, we
found a similar reduction in arm volume of 122 mL, which might be due to
longer duration of the exercise program compared with Moseley et al.’s
study.
The contralateral upper limb was used as the control so that any
physiological change in arm composition
due to exercise would happen
equally on both limbs. This method is similar to previous studies [20,22]. The
outcome measures we used did not give accurate information regarding
changes at the tissue level, but
regular exercises cause hypertrophy of
muscles and adipose tissue loss. Not much change was seen in arm
circumference clinically, so any effect of exercise on lymphedema is
unknown to us; other tissue changes
may have occurred that masked any
positive change regarding accumulation of lymphatic fluid.
The participants
also reported improvement in their affected upper-limb health (i.e., decreased
pain,
heaviness, and discomfort along with softening of fibrotic areas
during daily household work) due to the
exercise program. Many participants
continued doing the exercises even after completion of the study
period.
Results showed a trend toward improved QOL scores in all aspects, including
physical, social, and
emotional well-being as well as general and mental
health and vitality scores after the completion of the
prescribed
home-based exercise program (Table 3). Increase in physical functioning scores
proved the fact
that affected upper-limb progressive resistance exercises
had a beneficial effect on postmastectomy
lymphedema. Participants reported
more confidence in using the affected upper limb during regular
household
work and were even able to lift groceries with ease. Due to this, they were
less often reminded of
having lymphedema, which may have improved vitality
and general health scores. These results are similar to
the study by
McKenzie and Kalda, which was also an 8-week exercise program [22]. Recent
studies by
Ahmed et al. and Schmitz et al. reported 80 and 88 percent
adherence rates to twice a week supervised
exercise programs for 6 months
and 1 year, respectively [23,25]; in our study, adherence was found to be
89 percent. Reason for this may be that the self- directed exercise program
for a short period of 8 weeks
included many features thought to comprise
effective home training, including baseline evaluation, written
guidelines
for home exercise, education about the exercise monitoring and self-care, daily
activities log, once
weekly telephonic monitoring by the therapist, and
interim evaluation (fourth week). It may also be the fact
that
self-directed exercises performed in the home and community facilities are more
convenient, and
therefore, participants adhered more to the prescribed
exercise program. In our study, none of the
participants reported increased
lymphedema symptoms as a result of the exercise program.
The prescribed
8-week home-based exercise program improved the affected upper-limb symptoms
and
also led to improved QOL. Home-based exercise programs should be
considered for improving the
symptoms of lymphedema resulting from breast
cancer treatments.
Lack of an appropriate control group and a small sample
size were two important limitations of our study.
Also, we did not follow
the patients to determine the long-term effects of the exercise program.
Long-term
studies with larger sample sizes and appropriate control groups
should be undertaken. Studies should also
be done comparing effects of
home-based versus institution-based exercise programs.
CONCLUSIONSA
home-based exercise program was found to effectively improve affected
upper-limb
symptoms and led to improved QOL of breast cancer patients.
Hence, this home-based exercise program
should be considered for improving
the secondary lymphedema and associated symptoms resulting from
breast
cancer treatments.
ACKNOWLEDGMENTSAuthor Contributions:Study concept and
design: A. P. Gautam, A. G. Maiya.
Acquisition of data: A. P.
Gautam.
Analysis and interpretation of data: A. P. Gautam.
Drafting of
manuscript: A. P. Gautam.
Critical revision of manuscript for important
intellectual content: A. G. Maiya, M. S. Vidyasagar.
Statistical analysis:
A. P. Gautam.
Administrative, technical, or material support: M. S.
Vidyasagar.
Study supervision: A. G. Maiya, M. S. Vidyasagar.
Financial
Disclosures: The authors have declared that no competing interests
exist.
Funding/Support: This material was unfunded at the time of manuscript
preparation.
Institutional Review: Ethical clearance for the study was
approved by the hospital ethical committee. A
written consent for willing
participation in the home-based exercise program was taken from all the
patients
before the baseline measures.
Participant Follow-Up: The
authors do not plan to inform participants of the publication of this study.
However, participants for whom contact information is available have been
encouraged to check the study
Web site for updated
publications.
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Submitted for
publication May 17, 2010. Accepted in revised form January 20, 2011.
This
article and any supplementary material should be cited as follows:
Gautam
AP, Maiya AG, Vidyasagar MS. Effect of home-based exercise program on
lymphedema and
quality of life in female postmastectomy patients: Pre-post
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DOI:10.1682/JRRD.2010.05.0089
January 12,
2012
The Benefits of Healing Touch - Huffington Post – by Julie Chen
Many
of my patients express their frustration that massage therapy generally is not
covered by their health
insurance, yet the health benefits seem tremendous
for them. I believe that the growing trend of discontent
with lack of
coverage for massage therapy is not just limited to patients, but from health
practitioners as well.
What is even more unfortunate is that sometimes
health care practitioners rarely fully lay hands on patients
even for
office visits and evaluations anymore. As a part of most healing modalities in
the past, the simple
touch therapy of examining and treating the patient
imparts a level of healing that is now becoming lost in
modern day
medicine.
Many of my patients joke that doctors these days don't even put
their hands on the patient anymore except
for a cursory exam at the first
visit or unless absolutely necessary. It is unfortunate that along with
declining
time allowed with each patient, even the simple but effective
practice of laying of hands on patients is slowly
becoming lost as
well.
Even as recent as just a few decades ago, the laying of hands and
massage therapy or manual therapy was
considered a normal natural part of
medicine. In more recent times, massage and manual therapy is seen as
more
of a luxury rather than a necessary part of healing and wellness.
This
is an unfortunate change in Western healing philosophy since studies show that
massage and manual
therapy are beneficial for many medical conditions and
health concerns, which is likely the reason why
manual therapy is still
considered an important part of healing in most other parts of the
world.
Based on numerous studies as listed below, massage and manual therapy
is in my opinion an essential part of
health and healing based on
improvement of circulation, muscle function and stress reduction, just to name
a
few.
Nowadays in medicine, we are all well aware of how stress affects
our body negatively. We see time and
time again that patients who are
stressed, anxious or depressed tend toward more negative health outcomes
than those who are feeling balanced, calm and positive.
Studies indicate
that manual therapy likely helps with stress reduction as well as other aspects
of physiology.
But even taking those other physiological benefits aside,
the reduction of stress alone has tremendous health
benefits to patients,
as related to more positive outcomes to overall health and daily
functioning.
So, my recommendation to everyone reading this article is to
stop thinking of massage or manual therapy as
a luxury. It is well worth
the investment on a regular basis if you can afford it. It is likely worthwhile
to
double check with your insurance company and ask whether you have some
coverage within your physical
therapy coverage, which many of my patients
were not aware of and were pleasantly surprised.
My second recommendation is
to find a physician who still uses the healing modality of touch in the clinic.
Frequently, just simply laying hands on a patient during an exam allows the
physician to both heal and
diagnose all in one motion.
I am a firm
believer that the therapeutic alliance between a patient and a health care
practitioner is stronger
when there is a respectful level of healing touch
involved in treatment and diagnosis. In order to achieve an
accurate level
of diagnosis, we were taught in medical school to obtain at least 90 percent of
the diagnosis
from the patient. In order to do that, we would need to lay
our hands on our patients to fully evaluate and
diagnose them... and that
is what I would recommend that you look for in your physician.
Overall, I
agree with my patients that insurance companies do not cover for this vastly
beneficial healing
modality enough. Not only do they not allow physicians
more time with patients for visits (short visits are
necessary in order to
keep a clinic financially afloat based on the current system), but frequently
they do not
cover for hands-on therapy such as massage or manual therapy.
Unfortunately then, it is left to us to pursue
this topic with our
physicians and our insurance companies and see if there is coverage hidden in
the fine
print of the physical therapy coverage.
If there is, I highly
recommend that you utilize the services and not wait until you have
longstanding chronic
pain, insomnia, irritable bowel syndrome or
hypertension, just to name a few adverse consequences of
longstanding
stress and discomfort.
I like to frequently remind my patients that our body
is not cut off at the neck; such that what is in our mind
does affect our
body, and what is happening in our body does affect our mind. So, why not make
use of a
healing modality that seems to treat both our mind and
body?
Ultimately, if you have to put in some leg work on your end to figure
out an affordable way to achieve
regular manual or massage therapy, either
through your physical therapy coverage or an affordable massage
clinic in
your neighborhood, in the long run, your mind and body will both be better off
for it.
For more by Julie Chen, M.D., click here.For more on personal
health, click here.
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Orem
Rehabilitation & Skilled Nursing - Daily Herald –
State-of-the-Art
Therapy A Passion for the Art of Caring The Orem Rehabilitation & Skilled
Nursing
therapy team is passionate about bringing the latest techniques and
programs to our patients. Through
continuing education, our physical and
occupational therapists apply the latest research to improve balance
and
reduce fall-risk. They also utilize therapeutic modalities combined with a
comprehensive therapy
program for strengthening, balance training, pain
reduction, wound-healing, urinary incontinence, and
increasing range of
motion. In addition, we have therapists certified in specialty areas of
practice such as: •
Wound Care • Neurological Conditions • Electrical
Stimulation For Swallowing Dysfunction • Lymphedema
• Pulmonary Programs Our
speech-language pathologists incorporate research-based swallowing, language
and cognitive procedures to address the needs of our patients. At the heart
of our therapy programs is a
deep appreciation for, and understanding of,
the special needs of our more mature patients. This goes
beyond the science
and research in order to tap into the art of caring for these unique
needs.
January 14, 2012
Nursing with empathy: Childhood cancer survivor
beats odds, helps others - Glens Falls Post-Star – by
Meg
Hargarty
Although the odds were stacked against her that she would survive
cancer as a 3-year-old, Joanna Burgess
never let her illness stand in the
way of realizing her dream of helping others.
Now, at 49, the former South
Glens Falls resident is a wound, ostomy and continence nurse in North
Carolina.
Joanna recently received the Great Comebacks Regional Award
for rebounding from her bladder cancer
and making a difference in the lives
of her patients.
"Seeing the transformation when a patient goes from being
withdrawn to, ‘OK, I can learn to take care of
(an ostomy bag),' is
rewarding," she said. "(Winning the award) will globally and extensively get my
story
out."
Great Comebacks is sponsored by ConvaTec, a developer and
marketer of medical technologies for
community and hospital care, in
partnership with the Crohn's and Colitis Foundation; the United Ostomy
Associations of America; the Intestinal Disease Education and Awareness
Society; the Wound, Ostomy and
Continence Nurses Society; and the American
Society of Colon and Rectal Surgeons.
Joanna developed rhabdomyosarcoma, a
type of bladder cancer, when she was little more than a toddler.
Her
father, South Glens Falls retired pastor Clayton Burgess, recalled local
surgeon Harry "Mac" DePan
delivering the grim diagnosis to him and Joanna's
mother, Shirley.
"He didn't hide anything. He came out and said, ‘Children
don't survive this cancer," Clayton said.
Given a 10 percent chance of
survival, Joanna was immediately transferred to a Boston hospital, where she
underwent a urostomy to replace her bladder. Ironically, the massive doses
of chemotherapy and cobalt
radiation meant to spare her life would cause
her body to break down in the future.
The most outward effects of the harsh
treatment are Joanna's small stature - she never grew past 4 feet 11
inches
- and a noticeable limp.
The 1981 graduate of South High said she was
thought of as the "mystery girl" at school.
"I walked a little differently.
I think a lot of kids thought I had polio," she recalled. "I didn't know they
thought that. Later on my friends told me."
Joanna graduated from
college and was a nurse for five years when her body began to show signs of the
damaging effects of the cobalt radiation treatments given to her as a
child. She endured a series of
operations, including plastic surgery for
burns on her back, two hip replacements, bypass grafts on her legs
to
improve circulation and an elective colostomy to eliminate the pain of
radiation-induced colitis.
Her life was put on hold for about 20
years.
"Basically they had to re-create my body," Joanna said.
Today she
still wears the colostomy and ostomy bags, uses support hose for lymphedema and
has limited
mobility. The hip replacements won't last forever, she said,
and she thinks she'll need more surgery in the
future.
Despite
everything Joanna endured, she remained grateful to be alive and made the most
of the years spent
recovering from her operations. She volunteered at a
clinic in Honduras, explored the field of holistic nursing
and aided in the
launch of a clinic devoted to those suffering from lymphedema.
Joanna loved
pediatrics and wanted to work with ostomy patients. She had a "synchronistic
opportunity" to
work with a 3-year-old boy diagnosed with rhabdomyosarcoma
and decided to begin coursework to
become a WOCN.
"Now I was able to
witness what a parent goes through when their child gets this diagnosis. It's
still a terrible
diagnosis and still very life threatening," she
said.
At the point when Joanna was finding the most fulfillment both in her
personal life - she met the man who
would become her husband- and
professionally by pursuing her WOCN certification, her doctors advised
her
not to go back to work, fearing her physical condition was too
"fragile."
Joanna decided to follow her own path and has been a WOCN at
WakeMed Cary Hospital in North
Carolina for three years. She brings a type
of empathy to her patients other nurses who haven't walked her
path can't
provide.
"When a person has to have an ostomy, people cannot imagine what it
is going to be like and there is a lot of
shame associated with it. People
don't talk about it because it has to do with something you don't talk about
in society," Joanna said. "I tell them I have an ostomy, and they can't
believe it. They immediately feel hope,
and if I can teach them a way to
change their perception, it can make all the difference."
As the southeast
regional winner of the Great Comebacks award, Joanna said she is now able to
raise
awareness of ostomy issues on a broader level through
workshops
and conferences and by telling her own journey through
illness.
She hopes to help start an outpatient ostomy clinic at WakeMed, but
most importantly, she wants to
continue to be an empathetic resource to her
patients and their families.
"Your story touches something in someone else
whether they have the same thing or not. We're all dealing
with something
difficult, and it's a way to connect with each other," she said.
January 15,
2012
This next one is some kind of blog about printers, I never found
anything referencing lympheema there:
hp photosmart c4280 all-in-one driver
download - Kashmir Observer –
mphedema, a frequent cause of leg edema and
often included in the differential diagnosis of venous disease,
is also
discussed. ...
December 16, 2011
Mohawk College Offers Lymphedema
Program - Wire Service Canada (press release) –
Hamilton, Ontario -
Lymphedema is one of the most feared and least understood complications of
breast
cancer treatment. Mohawk College in Hamilton, Ontario, is offering a
day-long overview that will prepare
the student to understand the causes of
lymphedema as well as receive an introduction to its treatment and
management.
John Mulligan, RMT/CLT-LANA will present an Overview of
Lymphology and Lymphedema Management
at Mohawk College at the
Mohawk/McMaster Institute of Applied Health Sciences Hamilton Campus in
the
Applied Health Sciences building, on Saturday February 4th, 2012, 9:00 a.m. to
4:30 p.m.
This unique one day workshop will explore the different types and
stages of lymphedema, clinical pathways
for treatment and the need for
skilled care. Topics include basic lymphology, differentiating among different
types of edema, the role and mechanics of compression, manual lymph
drainage and complex decongestive
therapy. We will also discuss the
International Lymphedema Framework Movement, research resources
and
educational opportunities in the field of lymphology.
This one-day
introduction to the basics of lymphedema and lymphedema management will
immediately give
the attendees a solid base of knowledge of the lymphatic
system and disorders of the lymphatic system.
For more information visit
www.LymphedemaDepot.comand click on EVENTS in the left-side menu. This
will
bring you to the Mohawk online course catalogue where you can register for the
daylong overview. To
locate the course listing, simply go to page 53 of the
catalogue. To register, click on Registration Information.
For further
assistance contact John Mulligan directly at
[email protected].
Contact Mohawk College here:
http://www.mohawkcollege.ca/continuing-education.
For more information about
Mr. Mulligan and his practice, please visit
www.LymphedemaTherapist.com.
December 17, 2011
New registry will
track lymphedema among breast cancer patients - HealthCanal.com - BY TRACIE
WHITE
More and more woman are surviving breast cancer, but
lifesaving surgical and radiation therapies can cause
a grave side effect:
an incurable chronic condition called lymphedema that involves swelling of the
arms and
often debilitating pain and discomfort.
While this disorder
frequently has been ignored, misdiagnosed and untreated in breast-cancer
survivors, that’
s beginning to change.
In an effort to find better
treatment and preventive strategies for lymphedema, researchers at the
Stanford
University School of Medicine are launching a patient registry to
study breast-cancer-related lymphedema.
The information and records of
breast cancer survivors gathered in the registry will be used in a study to
determine whether early diagnosis of lymphedema can help treat and,
possibly, prevent it.
“There is early evidence to suggest that prompt
diagnosis may reduce the severity or eliminate this problem,”
said Stanley
Rockson, MD, the Allan and Tina Neill Professor of Lymphatic Research and
Medicine, the
lead investigator of the study. “If you take a wait-and-see
treatment approach, by the time the lymphedema
becomes noticeable, it can
be quite advanced. Caught earlier, it may be more manageable, or even
reversible.
“Oncologists and surgeons are becoming more aware of the
need, and there are new technologies that help
with early diagnosis.”
A
leading expert in lymphatic diseases, Rockson, who directs the Center for
Lymphatic and Venous
Disorders at Stanford, helped establish the first
patient registry and tissue bank for patients with lymphatic
disorders in
2009.
For this new study, Stanford researchers hope to recruit an estimated
1,000 breast-cancer survivors for the
Stanford National Breast Cancer
Lymphedema Registry.
“Members of the American Society of Breast Surgeons
will have the opportunity to collaborate in this
project,” according to a
statement from the society. “Member surgeons can choose to help Stanford in
the
identification of patients to be enrolled in the registry and will
facilitate participation through the society's
web-based quality reporting
initiative.”
Participants will periodically update information about any
symptoms, test results or treatments in 15-minute
online sessions. They’ll
give approval for their surgeons to provide their treatment information to the
registry.
Identifying information will be removed.
Currently, there is
no cure for lymphedema, a disorder that arises in 15-60 percent of breast
cancer
survivors. A lifelong problem of disrupted lymph circulation
characterized by fatigue, limb swelling and loss
of the integrity of the
skin, the condition’s severity can range from mild discomfort to disabling
disfigurement,
pain and loss of function.
When lymph circulation is
delayed or interrupted, swelling and inflammation can result from a traffic jam
of
lymph that builds up in the limbs. There are multiple sources of
blockages but often they are caused by
tumor removal surgery, radiation
treatment or lymph node biopsy. The only available treatments are physical
therapies, including skin massage, drainage and pressure bandages, though
the long-term effectiveness of
these therapies has not been carefully
studied.
Patients interested in enrolling can log into the Stanford National
Breast Cancer Lymphedema Registry
website at: http://breastcancer-lymphedema.stanford.edu.
For more information, patients can call (650) 723-
1396 or email [email protected].
Stanford
University Medical Center integrates research, medical education and patient
care at its three
institutions - Stanford University School of Medicine,
Stanford Hospital & Clinics and Lucile Packard
Children's Hospital. For
more information, please visit the Office of Communication & Public Affairs
site at
January 16, 2012
i earns highest level certification -
bcrnews.com –
PERU — Sonnie (Ryba) Blocki, PT, MS and certified lymphedema
therapist of United Physical Therapy
LLC in Peru, attended a three-day
continuing education training in Estes Park, Colo. The conference was
hosted by Klose Training and Consulting LLC.
The conference brought
together lymphedema therapists, physicians, researchers, and world-renowned
experts to share research, experiences, and resources in order to advance
the treatment of lymphedema and
improve the quality of life of cancer
survivors.
Lymphedema is a condition that is most associated with the
swelling of a limb following breast cancer.
However, it can also occur due
to a condition from birth, cancer treatment, or other injury. It is estimated
there are currently 5 million people in the U.S. who suffer with
lymphedema, and they often go undiagnosed,
untreated and mistreated.
As
a LANA-certified therapist, Blocki consults with physicians in the diagnosis
and treatment of
lymphedema.
Big Spike in Knee Surgeries Calls for
Compression Therapy Devices to Lessen Risk of Blood Clots –
SBWire
–
Tampa, FL -- (SBWIRE) -- 01/16/2012 -- New statistics show a big increase
in knee replacement surgery
since the late 1990s. From 1997 to 2009, knee
surgery increased for women ages 45 to 64 by 157 percent
and men in the
same range by 144 percent. The Agency for Healthcare Research and Quality
attributes this
to advances in knee surgery, better implants, and obesity
that can cause the joints to be more compromised.
Right after knee surgery,
patients must be mindful of preventing blood clots as they are immobile while
they
initially heal.
“Sequential compression devices can be great
for many patients who cannot walk or get around much in the
first few
weeks,” said Greg Grambor, president of Vascular PRN, which helps healthcare
professionals
nationwide fill prescriptions for SCDs and IPCs. “Patients
should talk to their doctor about their risk for a
blood clot, find out if
mechanical compression is good for them, and be proactive before the day of
the
surgery.”
The American Journal of Surgery notes that compression
therapy devices can lessen the chances of DVT
post-surgery by 60 percent.
Many patients get mechanical compression therapy devices along with medicine
to help prevent blood clots. Knee and hip surgery carry a higher risk of
blood clots, so patients should be
prepared when they have these types of
surgeries to address any concerns ahead of time.
“Blood vessels can get
damaged during surgery and when you are restricted to bed rest, SCDs can help
blood flow from the superficial veins to the deep veins,” said Grambor. “The
devices are comfortable and
there are some choices depending on how
portable you want the compression therapy system to be.”
Vascular PRN is
known for its full line of sequential mechanical compression devices for the
full leg, calf,
and foot. To learn more about renting or buying a
Sequential Compression Device, SCD boots, or
Lymphedema boots visit
http://www.vascularprn.com/ or call 800.886.4331.
January 16,
2012
Visiting Sloth City? Exercise your options - The Grand Rapids Press -
MLive.com – by Sue Schroder
My inner sloth has been having its way with
me.
My recent failure to exercise is a combination of my own inertia coupled
with bronchitis followed by the cold
from hell. My maintenance therapy gets
only minuscule blame.
Those in active chemo may face limited exercise
options as I did when the chemical warfare did heavy
collateral damage to
my energy and strength, drastically lowered my white blood count and left me
susceptible to infection.
Once outside the treatment-dictated shalt-nots
of human contact, is exercise really worth the effort we’d
have to put into
it?
If you care about reducing the risk and/or recurrence of some cancers
and actually increasing the energy
levels chemo knocks out of us, the
answer is a resounding yes.
Reduce your riskThe National Cancer Institute
reports “strong evidence” that physical activity is associated
with reduced
risk of colon and breast cancers. It also cites several studies reporting links
between physical
activity and reduced risk of endometrial, lung and
prostate cancers.
So how do those of us with a near-mortal fear of Spandex
go about rebuilding our bodies and regaining our
strength?
Consider
exercise programs designed specifically for cancer survivors.
One of the
longest-running is Cancer Well-fit. The program has been offered for more than
10 years at the
Michigan Athletic Club (the MAC) and the East Hills
Athletic Club through the Lacks Cancer Center of
Saint Mary’s Health
Care.
“We don’t have much control over cancer, and people who’ve gone
through our program tell us they feel
they gain some control in their
lives. We know the classes actually reduce fatigue and increase energy
levels,” said Kristi Tuck, fitness director of the MAC and East Hills, and
the woman in charge of the Cancer
Well-fit program.
Certified
programCancer Well-fit is a 14-week program that includes 10 weeks of sessions
conducted by
the only nationally recognized certified cancer exercise
trainers in Michigan, according to the Lacks Cancer
Center website. It also
includes an additional four weeks of open membership.
Classes for 8-10
people are focused on strength training through weight training, Tuck said.
Balance and
stability, flexibility and core strength training are part of
the program.
Open to patients who have recently been or are currently being
treated for cancer and are referred by their
doctors, classes are geared to
people dealing with the effects of treatment, whatever the cancer.
Cost: $50
for patients of The Lacks Cancer Center (support partner included) or $150 for
participants who
are not patients at the Lacks Cancer Center (support
partner included.)
For more information, visit lackscancercenter.org; to
register, call the Lacks Cancer at Saint Mary’s, 685-
5222.
Gilda’s Club
Grand Rapids and Gilda’s Club Lowell both offer fitness and wellness classes
free to Gilda’s
members and open to supporting family and friends.
“In
most cases, the type and level of exercise for someone on a cancer journey will
be dependent on their
current health status and/or treatment plan,” said
Wendy Wigger, vice president of community relations and
program
development.
Here is a small sample of Gilda’s monthly classes:
(Visit
gildasclubgr.org for information on all classes and membership
information.)
Fitness & Movement Taught by a certified physical
therapist, this variety fitness class offers a combined
exercise of core
strength, Tai Chi, meditation and gentle strength training.
Movement &
LymphedemaThis program combines dance with gentle exercise and lymphedema
awareness,
and is designed to increase range of motion and to decrease
lymphedema.
A brochure from the University of Colorado Cancer Center also
can help with planning and monitoring post-
cancer exercise.
Cancer
survivors can download the brochure.
Editor’s note: Sue Schroder, former
features editor for The Grand Rapids Press, was diagnosed with
non-
Hodgkin’s lymphoma in late 2009. Email her at
[email protected].
January 17, 2012
Sports Medicine, Life Therapies
opens in Dickson - The Tennessean –
Baptist Sports Medicine and Life
Therapies recently opened a new outpatient rehabilitation clinic at 10250
Ramsey Way in Dickson.
The clinic offers orthopedic physical therapy,
sports medicine and lymphedema therapy and is led by
physical therapists
Bill Rion and Celeste Crider.
“We are pleased to now have a presence here,
as well as a facility to offer our services to the Dickson
community,” said
Rion in a press release. “We are so grateful for the outreach and support we
have
received thus far and are excited to establish lasting relationships
with the people of Dickson.”
The opening of this clinic marks the 20th
Baptist Sports Medicine and Life Therapies facility in Middle
Tennessee and
the first in Dickson. The clinic is located in the Crestview Office Park
directly across from
Dickson Medical Associates.
For more information,
call (615) 441-2707.
SJH Sports RebahCare debuts Harrison Township location
- Gloucester County Times - NJ.com – By
John Barna -
HARRISON TWP. — SJH
Sports RehabCare has opened its newest location in Mullica Hill at SJH
Tomlin Station Park.
Located at 201 Tomlin Station Road, Suite D, the
facility offers sports and orthopedic physical therapy,
occupational
therapy, spine care, worker's compensation services including FCE and Pre-Work
Screens
and lymphedema services.
In highlighting the opening of this new
location, SJH Sports RehabCare Tomlin Station Park would like to
introduce
two new staff members to the Gloucester County community.
Kristy Meade, who
has over 10 years clinical experience, will oversee SJH Sports RehabCare at
Tomlin
Station Park site. Meade graduated with a Masters Degree in Physical
Therapy from Sacred Heart
University in Fairfield, Conn. She is also a
Certified Athletic Trainer. Kristy's special interests include
post-
surgical patients, athletic injuries, body mechanics and postural
education with a specialty focus on trends in
ACL
rehabilitation.
Victoria Rink, is the OT clinical coordinator for all SJH
RehabCare inpatient and outpatient facilities and
SJH Sports RehabCare
locations. Rink is a Certified Hand Therapist with over 17 years of experience
treating upper extremity disorders. She is a graduate of Thomas Jefferson
University's Honors Program. Her
specialty is in treating complex
post-surgical cases and trauma, including nerve injury, hand replant and hand
transplantation rehabilitation.
For more information, call 856-241-2533
or by email [email protected].
January 17, 2012
Breast Cancer Survivor from
Cortlandt Publishes Book on Mastectomy - Patch.com – ByJessie Jafet –
The
authors provide comprehensive information on mastectomy and breast
reconstruction surgery in their
book released today.
Though there is
plenty of information online about mastectomy, Amy Curran Baker thought it
would be
helpful to many women if she wrote a single-resource guide that
explains the recovery process from
beginning to end.
A breast cancer
survivor herself, the 43-year-old Baker has authored “Now What? A Guide to
Recovery
After Mastectomy,” officially released today, Jan. 17 (the book
has been available online since Dec. 31).
She hopes that women who are
searching for answers about their own journey with mastectomy will find
them in her book.
Baker, a Cortlandt resident, was 39 years old with two
young daughters when she was diagnosed with the
disease in 2008. Even with
significant family experience with breast cancer—her mother, maternal
grandmother, and her maternal aunt had all been diagnosed—she still had
many questions about the
procedure she opted for: bilateral mastectomy with
“direct to implant reconstruction.”
Copious research, along with her daily
work as an occupational therapist, gave her an unique perspective to
write
the book.
“Being an OT I realized that there were a lot of basic recovery
and rehabilitation issues that women might
never be told about after
mastectomy,” Baker said.
“Things like how to manage activities such as
dressing and bathing, getting a good night’s sleep, caring for
children,
home management, and returning to work.” She added that the book is full of
suggestions from
other women who have “been there” and who offer their
advice on what works and what doesn’t in the
recovery process.
The book
is geared toward anyone who has been diagnosed with breast cancer and is
contemplating
mastectomy with or without breast reconstruction—in addition
to those with a hereditary predisposition to
breast cancer who may be
contemplating prophylactic mastectomy. Reconstruction, she emphasized, should
be a personal choice.
“Sometimes I hear people say that women need
breast reconstruction after a mastectomy in order to feel
“whole again” and
that bothers me a little bit,” Baker said—explaining that it was her personal
decision to
reconstruct. She does not like to think of a particular part of
the body as defining the “wholeness” of a
person or a woman.
With her
co-authors, who are her sisters (nurses themselves), she covers other topics
including range of
motion exercises, post-surgical drain care, lymphedema
prevention, breast prostheses, and what to look for
in terms of
complications with healing, wound management, scar massage, emotional recovery,
and more.
Baker also wants readers to know that mastectomy is not what it
used to be. “Techniques for breast
reconstruction have come a long way in
recent years and options are available,” she said.
“And many women don’t
know that there is a federal law called the Women’s Health and Cancer Rights
Act that requires group health insurers that cover mastectomy to also cover
breast reconstruction, breast
prostheses, and treatment for physical
complications like lymphedema that may result from mastectomy.”
This
comprehensive book not only benefits those looking for information: portions of
the proceeds will go to
two breast cancer support organizations that have
been “near and dear” to Baker: Support Connection in
Yorktown and FORCE
(Facing Our Risk of Cancer Empowered) a national hereditary cancer support
organization.
Baker said she is happy to share all that she has learned.
“I feel fortunate that I had access to really great
physicians who were
doing cutting edge work in the areas of mastectomy and breast
reconstruction.”
January 19, 2012
Health Calendar - Santa Maria Times
–
Lymphedema Prevention Exercise Class: 9 a.m. Tuesdays, Marian Health and
Wellness Center, 1207 E.
Main St., Santa Maria. This is a fun, therapeutic
program for cancer survivors and others with chronic
conditions of all ages
and fitness levels to increase range of motion and reduce the risk of
lymphedema. Info
and to make a reservation: 739-3780.
January 20,
2012
Health Matters: Flying with a medical condition - WZVN-TV –
FORT
MYERS, FL -
Every year is a victory for breast cancer survivor Carol
Thisted.
"I just turned 71 and I'm so happy I had another birthday."
She
enjoys life, family and traveling despite suffering from lymphedema. An after
effect from her cancer
surgery, the removal of lymph nodes led to chronic
fluid retention and swelling. It first appeared after a flight
last
year.
"I went on vacation in August and flew in an airplane and came home
and I said to my doctor ‘my ankles are
rather swollen and my arm is a
little swollen too'," says Thisted.
Carol manages her condition with daily
wraps and compression garments, something she has to consider
when taking
flight. Health conditions can spike at 30,000 feet.
"The pressures when
you're flying are less, atmospheric pressure is less so you tend to swell more
when
you're flying," says Jackie Speas, a lymphedema therapist with Lee
Memorial Health System.
"I'd be sure to wear my arm compression stocking and
I would probably even wear some compression
socks on my ankles and my feet
cause they do swell also," says Thisted.
People with vascular conditions
also need to consider their medical condition, especially when you consider
sitting in cramped quarters for long stretches of time.
"I'm on blood
thinners because of blood clots and we want to avoid those so when I fly I make
sure that I
have a layover to get off of the plane after two or three
hours," says Pamela Cupp, a frequent flyer.
Travelers who take long flights,
more than four hours, face a two to three fold risk of developing a clot. So
it's important to move around even in a tight space.
"You have the
change of getting blood clots because of lack of circulation. So you do want to
move your
legs and pump your ankles up and down, so you get that blood flow
back up," says Heather Parker, an
exercise specialist with Lee Memorial
Health System.
Before any trip, confer with your doctor about any medical
conditions, because keeping up with your health
doesn't take a
vacation.
December 20, 2011
Exercise Benefits Breast
Cancer Survivors: Research – EmpowHer - By Mamta Singh
Researchers at
the University of Missouri suggest that exercises will not aggravate the
condition of breast
cancer survivors who suffer from post-treatment
lymphedema. Lymphedema is a condition where the
breasts of the person
undergo swelling because of the removal or radiation of lymph nodes as part of
the
treatment process. It is estimated that more than 6.8 million Americans
either suffer from lymphedema or are
at a risk of developing it.
(1)
This Article
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The study reviewed some older
literature on breast cancer survivors that suggested that exercise could
worsen the lymphedema patient’s agony and that they are recommended to lead
a sedate life. After the
review the researchers say that the benefits to be
had by both the breast cancer survivors and those with
lymphedema are far
more than the risks of aggravating their condition especially if they are
closely
monitored. (2)
As per the author of the study, Jane Armer, PhD,
RN, FAAN at the University of Missouri, “Exercise can
be beneficial and not
harmful for breast cancer survivors. Each individual should balance the pros
and cons
of the activity she chooses, but keep in mind that being sedentary
has risks and being active is beneficial in
many ways, including possibly
reducing the risk of cancer recurrence.” (3)
The researchers after executing
a systematic review of contemporary literature said that of specific benefit
would be doing weight workouts or any other workouts that provided
resistance to the patient’s musculature
and skeletal system. Advantages are
to be had through carefully increasing the number of repetitions done in
such exercise programs. However, what needed t be seen is whether such a
program will altogether prevent
the breast cancer condition from
occurring.
As was the cases earlier, patients of lymphedema were recommended
to undergo surgery to ‘fix’ the
swelling yet the swelling at best, could
only be reduced and not done away with. For this reason, a lot of
patients
took to wearing traditional compression garments. Other patients undergo
traditional therapy using
specialized massage and compression garments and
bandages to reduce fluid and swelling before
considering surgery
Update
on Lymphedema: Exercise After Breast Cancer Treatment Is OK - hcp.obgyn.net
–
Lymphedema, swelling caused by a blockage in the lymphatic system, can
occur as a result of surgical or
radiation therapy associated with breast
cancer treatment. Since some research has shown that exercise
after breast
cancer treatment has been associated with developing lymphedema, clinicians
often advise
patients to avoid exercising. But is this truly
necessary?
To better understand the actual risk, Dr Marilyn L. Kwan,
research scientist at the Kaiser Permanente
Northern California Division of
Research, and colleagues conducted a systematic literature review of
contemporary studies. After applying exclusion criteria, Kwan et al.
identified 19 articles for review and
synthesis. The researchers rated the
evidence in the studies utilizing the Oncology Nursing Society Putting
Evidence into Practice Weight-of-Evidence Classification.
Of the
included studies, seven examined the effects of resistance exercises, seven
examined regimens
including aerobic and resistance exercises, and the
remaining five studies looked at other exercise modalities.
Kwan et al.
found that slowly progressive exercise of varying modalities was not associated
either
developing or exacerbating lymphedema associated with breast cancer.
Further, the studies indicated that,
with careful supervision, patients
should be allowed to participate in such exercise regimens. However, data
from the studies examining combined aerobic and resistance exercise did not
yield as conclusive results or
recommendations. While the studies showed
that these exercise regimens appeared to be safe, confirmation
of their
safety requires larger and more rigorous studies.
“Strong evidence is
now available on the safety of resistance exercise without an increase in risk
of
lymphedema for breast cancer patients,” Kwan and colleagues concluded.
“With reasonable precautions, it
is safe for breast cancer survivors to
exercise throughout the trajectory of their cancer experience, including
during treatment.”
“Exercise can be beneficial and not harmful for
breast cancer survivors,” Dr Jane Armer, one of the study’s
co-authors and
director of nursing research at the Ellis Fischel Cancer Center at Sinclair
School of Nursing,
explained in a statement to the press. “Each individual
should balance the pros and cons of the activity she
chooses, but keep in
mind that being sedentary has risks and being active is beneficial in many
ways,
including possibly reducing the risk of cancer
recurrence.”
Mohawk College considers program for condition short of
specialists - Hamilton Spectator –
Mohawk College is considering a program
to train health-care workers how to treat a chronic swelling
condition that
suffers from a shortage of certified therapists.
The college is holding a
one-day workshop in February to gauge interest in learning about lymphedema —
the chronic swelling of limbs or others parts of the body that can be
genetic or caused by trauma or cancer
treatment.
“It could evolve into a
program but we’ve got to see if there’s an interest,” said Donna Dunlop,
program
manager for part-time and graduate studies health sciences. “This
is, from my perspective, one of the cutting
edges that’s emerging as far as
health sciences is concerned.”
There are currently just more than 100
certified lymphedema therapists in Ontario and more than 63,000
patients
with the condition. The Lymphedema Association of Ontario reports some parts of
the province
have little or no access to a therapist.
“I think
health-care practitioners really don’t have a strong knowledge base about
lymphedema and how to
manage it,” said Margaret Forbes, a nurse
practitioner at the Juravinski Cancer Centre who specializes in
lymphedema.
“It’s something that’s under-reported by patients themselves.”
The $95
workshop on Feb. 4 is aimed at health-care workers and students to give them a
background on
the condition that is caused when lymph fluid, which the body
uses to defend against infection, accumulates
because it can’t drain back
into the blood stream. One of the common causes is radiation and surgery for
cancer treatment.
There is no cure, but there are treatments — involving
massage, exercise and compression garments — to
help manage it. The
treatments aren’t covered by OHIP and can cost thousands of dollars.
“It’s
limiting in terms of your activities of daily living to have one limb that’s
quite a bit larger than the other
and it’s also so visible,” said John
Mulligan, a certified therapist who is teaching the workshop. “A lot of
people have had cancer and they’ve been all through the cancer route and
they’ve come out the other side
and then they get stricken with this
lymphedema and they find it difficult to deal with.”
Donna Reise has lived
with lymphedema in her left arm and chest wall for 14 years. She got it one
year after
she was first diagnosed with breast cancer.
“I felt a little
bit like a fullback playing football,” she said. “My arms stood away from my
chest wall. It was
like I was carrying a roll of cotton underneath my
arms.”
Reise, a 62-year-old nurse who lives on the west Mountain, became a
therapist herself after experiencing
firsthand how much the treatment
helped. She now runs a practice on Locke Street.
“It can be quite painful
because of the aching, the swelling causes extra weight and your clothes pinch
because nothing fits properly,” she says. In addition, “it’s a very visual
reminder that you’ve had breast
cancer.”
She feels a workshop such as
the one being held at Mohawk is badly needed.
“There is such a gap in the
training for nurses and physicians,” she says. “Historically, there hasn’t been
a lot
available.”
[email protected] | @JfrketichDecember
21, 2011
Research and Markets: Lymphedema Global Clinical Trials
Review, H2, 2011 - Business Wire (press
release) –
DUBLIN--(BUSINESS
WIRE)--Research and
Markets(http://www.researchandmarkets.
com/research/78850f/lymphedema_global)
has announced the addition of GlobalData 's new report
"Lymphedema Global
Clinical Trials Review, H2, 2011" to their offering.
“Lymphedema Global
Clinical Trials Review, H2, 2011”
GlobalData's clinical trial report,
Lymphedema Global Clinical Trials Review, H2, 2011" provides data on
the
Lymphedema clinical trial scenario. This report provides elemental information
and data relating to the
clinical trials on Lymphedema. It includes an
overview of the trial numbers and their recruitment status as per
the site
of trial conduction across the globe. The databook offers a preliminary
coverage of disease clinical
trials by their phase, trial status,
prominence of the sponsors and also provides briefing pertaining to the
number of trials for the key drugs for treating Lymphedema. This report is
built using data and information
sourced from proprietary databases,
primary and secondary research and in-house analysis by GlobalData's
team
of industry experts.
Scope
•Data on the number of clinical trials
conducted in North America, South and Central America, Europe,
Middle-East
and Africa and Asia-pacific and top five national contributions in each, along
with the clinical
trial scenario in BRIC nations
•Clinical trial
(complete and in progress) data by phase, trial status, subjects recruited and
sponsor type
•Listings of discontinued trials (suspended, withdrawn and
terminated)
Key Topics Covered:•Introduction
•Lymphedema
•Report
Guidance
•Clinical Trials by Region
•Clinical Trials by Country
•Top
Countries Contributing to Clinical Trials in Asia-Pacific
•Top Countries
Contributing to Clinical Trials in Europe
•Top Countries Contributing to
Clinical Trials in North America
•Top Countries Contributing to Clinical
Trials in Central and South America
•Clinical Trials by G7
Nations
•Clinical Trials in G7 Nations by Trial Status
•Clinical Trials
by E7 Nations
•Clinical Trials in E7 Nations by Trial Status
•Clinical
Trials by Phase
•In Progress Trials by Phase
•Clinical Trials by Trial
Status
•Unaccomplished Trials of Lymphedema
•Subjects Recruited Over a
Period of Time
•Prominent Sponsors
•Top Companies Participating in
Lymphedema Therapeutics Clinical Trials
•Clinical Trial
Profiles
•Clinical Trial Overview of Top Companies
•Five Key Clinical
Profiles
•Appendix
•Abbreviations
•Definitions
•Research
Methodology
•Secondary Research
For more information visit http://www.researchandmarkets.com/research/78850f/lymphedema_global
Contacts
Research
and Markets
Laura Wood, Senior Manager,
U.S. Fax: 646-607-1907
Fax
(outside U.S.): +353-1-481-1716
December 23, 2011
Buddycheck23
reducing side effects – WXXA –
When Katie Brophy learned she had breast
cancer, she wasn't surprised.
"I sort of expected it, obviously when you
have a lump, you just assume," she said.
A lumpectomy and radiation took
care of her cancer but left her with the risk of lymphedema, a side effect
of treatment that causes fluid build-up in the limbs. As an interior
designer, that worried her.
"I'm physical. I paint walls. I wallpaper,
refinish wood. The last thing you need to do is have an impaired
arm,"
Katie said.
Mayo Clinic Dr. Andrea Cheville says radiation may destroy
arm-draining lymph nodes. Once they're
damaged, the risk of lymphedema
rises so does the risk of infection.
"It's unattractive and so I think,
socially, it's a very difficult condition for people. Our best hope is to
prevent
people from getting it," Dr. Andrea Cheville said.
To do that,
she's testing a new technique that combines CT scans with spect-imaging. That
powerful combo
pinpoints exact locations of critical lymph
nodes.
"The physicians who are planning a woman's radiation can know
exactly where those critical nodes are and
avoid them, block them from the
radiation field," the doctor said.
Studies show it reduces the number of
critical lymph nodes that receive harmful radiation by more than 55
percent.
"We treated 30 women. None of those women have developed
lymphedema," Dr. Cheville said.
Katie was one of those women.
"At
the moment, I'm very pleased with the result," she said.
December
27, 2011
Lymphedema Following Breast Cancer Surgery May Occur Later -
Patch.com –
Even when lymphedema flares years after breast cancer surgery or
radiation, the pain and swelling can be
treated. There is no rhyme,
reason, or way to predict if a woman will experience lymphedema following
surgery or radiation to treat breast cancer.
Swelling of the arm,
breast, or chest may begin shortly after breast cancer surgery or radiation but
some
women experience lymphedema months -- or years -- later.
While
lymphedema can’t be cured, it can be treated, even when it occurs long after
breast cancer surgery or
radiation.
“The two things that help most are
keeping your weight in a manageable range and light exercise of the arm,”
said Monique Tiffany, R.N., nurse navigator at Los Alamitos Total Care
Breast Center at Los Alamitos
Medical Center.
Doing gentle
weight-bearing exercises with the affected arm helps prevent a sudden
occurrence of swelling
after doing something like reaching for an object on
a top shelf, she says.
“Lightly massaging the arm also helps. Even if one or
two lymph nodes are still there, they can be retrained
to do the job of
draining fluid.”
According to the American Cancer Society, most women who
have had breast cancer do not develop
lymphedema, but those who do can take
steps to manage the swelling and pain, which can range from mild
to
severe.
Lymphedema results when lymph nodes and vessels are removed or
scarred during breast cancer surgery.
With fewer lymph nodes and vessels, it
is more difficult for the upper body to drain lymph fluid. When
excess
lymph fluid builds up, pain and swelling occur.
Radiation for breast cancer
also affects the flow of lymph fluid in the arm, chest, and breast area and can
also cause lymphedema.
“Lymphedema is always a risk when a woman has had
any lymph nodes removed or radiation for breast
cancer,” said
Tiffany.
Tiffany advises women about lymphedema not only as a breast cancer
care nurse, but also as a breast
cancer survivor. She celebrated being
cancer-free for 10 years this month.
Tiffany said she remains aware that
lymphedema can still occur, even after a decade. “I still have to think
about it if I’m going to get on a plane,” she said.
Air travel can cause
lymphedema to flare.
There is no way to prevent lymphedema prior to breast
cancer surgery or radiation.
Tiffany recommends that women get measured for
compression sleeves right after surgery, so they can be
used if
needed.
However, a woman newly diagnosed with breast cancer may find
information about lymphedema
overwhelming on top of everything else she is
dealing with, so not all women will have the measurements
done until
lymphedema becomes an issue.
To manage the pain and swelling immediately
after surgery, women are advised to raise the affected arm
above heart
level two to three times a day for 45 minutes, and to open and close their
fists gently to help
move lymph fluid out of the arm.
Physical therapy
and special exercises can help regain full range of motion in the weeks after
surgery or
radiation. A compression sleeve or special bandaging may be
needed when pain and swelling persist.
Because cuts, burns, or insect bites
on the affected arm make the body respond with extra lymph fluid --
causing
or worsening lymphedema -- it’s important to avoid these injuries.
Wearing
gloves while cleaning or gardening, a mitt while handling hot foods, and a
thimble while sewing can
help prevent cuts and burns. Cuts and scratches on
the affected arm need to be treated right away with
antibiotic
ointment.
Heat can make lymphedema worse, so hot tubs, saunas, or heating
pads are on the list of things to avoid,
along with harsh soaps, which can
dry the skin and make it more prone to cracking.
Lymphedema can seem
particularly onerous when it begins several years after breast surgery or
radiation.
Having to deal with compression sleeves and massaging and
elevating the arm comes as a newly
inconvenient and unwelcome after-effect
of breast cancer treatment.
“Lymphedema can occur at any time,” noted
Barbara Stone, physical therapist at MemorialCare Todd
Cancer Institute at
Long Beach Memorial Medical Center.
Stone sees patients at the outpatient
Lymphedema Program at Memorial, which is part of the MemorialCare
Rehabilitation Institute.
The Lymphedema Program is open to anyone in
the community who needs treatment for lymphedema.
Stone recently encountered
a patient who just developed lymphedema, although her mastectomy was 25
years ago.
“She recently began using a walker, and the extra strain on
that arm may have caused the excess fluid,” she
explained.
In another
case, a breast cancer survivor developed lymphedema three years after her
breast cancer surgery
while caring for her ill husband.
Helping him up
and turning him in bed strained her affected arm, and she developed
lymphedema.
Stone pointed out that water exercise can be very helpful in
managing lymphedema. “When you’re in the
water, it’s like wearing a
compression garment,” she said.
Women who have joint pain that makes walking
or other exercise difficult can get in the water to help
maintain mobility,
she said.
More information on lymphedema is available from the National
Lymphedema Network.
December 28, 2011
Can Massage Help Lymphedema? –
ABCNews –
This is a video at this address with no text to support it:
http://abcnews.go.com/Health/video/massage-
lymphedema-9373495
Helping
others get a leg up during the holidays - Greenwich Citizen – by Beth
DolinarThe leg thing has
become exhausting. It's the first thing on my mind
every morning and the last thing every night. And I think
about it during
the night too, awakening as I do when the special boot I wear to bed starts to
tear at the skin
behind my knee.
Cancer has left me with lymphedema in
my left leg; some lymph nodes were removed during surgery and
then the
radiation killed off most of the rest. And now, my life has become a daily
battle to keep the leg from
getting any bigger. A question mark looms over
every morning: what pants will fit over my swollen thigh?
What shoes can I
wear? There is now such a disparity between my left and right feet I must
either buy two
pairs of shoes -- a 9 and an 11 and you should see my Zappos
bill -- or just go with an 11 and knowing my
normal right foot is going to
flop around inside of it like a penny in a jar.
Of all the challenges I've
faced, this is the worst. Pounding is bad for my foot, so I can no longer run.
I
spend hours of time and hundreds of dollars every week at the physical
therapist, having the leg massaged
back to a somewhat smaller size. And
maybe worst of all, cute shoes are just a memory. And I pine for a
short
dress.
If this sounds like a great big pity party, it is. At some point each
day, usually while stopping to smooth a
wrinkle in the compression garment
I must always wear, I stop and throw the party, dousing myself with the
pathetic confetti of selfish woe. Like I'm the only one with
problems.
It's been time -- for a long time now -- for an attitude
correction. Maybe life can't fix my leg, but it can fix
my head.
And
that's how I ended up serving Thanksgiving dinner to a personal care home. My
family and I served
turkey and stuffing to 18 adults who have mental
disabilities. Some were non-conversant, others chatty but
somehow
withdrawn. All wore the faded expressions of those who have had to dial back
expectations so
far that hope doesn't really factor any more.
The woman
who cares for them said "maybe three" have family who will visit for the
holidays.
After we'd served the meal, I noticed a bag of the little plastic
jelly packets you find on the table at diners -
the cranberry sauce for the
turkey. I ran back into the dining room to hand it out before everyone had
finished the turkey. One lady grinned as I peeled back the lid; she'd been
wondering.
I happen to have been born into a good place, to good people, and
with everything about me working well
enough to propel me into a life that
98 percent of the people on the planet would consider unimaginably
comfortable and easy.
Maybe the exhausting thing is not my leg, but my
constant thinking about the leg. It will be a challenge for as
long as I'm
around. But no matter how big it gets, it's really such a small part of a big
and fortunate life.
I think of the residents of that care home, and how
grateful they were to find there really would be cranberry
sauce for the
turkey. How "maybe three" of them would see family for Christmas. And I thank
my lucky
stars.
Beth Dolinar is a former Riverside resident and
Pittsburgh television reporter who is staying at home to raise
her two
children. She can be reached at [email protected].
New lymphedema group formed
- Beausejour Review –
A Lac du Bonnet woman and her son have yet another
accomplishment to be proud of in their mission to
raise awareness of
lymphedema.
Manitobans will soon be served by a new advocacy group dedicated
to improving services and increasing
awareness of lymphedema. The
Lymphedema Association of Manitoba (LAM) has been incorporated,
developed
its by-laws and is in the process of recruiting members. The first meeting of
members is expected
to be held in January 2012.
Lymphedema is a lifelong
chronic condition. People with lymphedema have various degrees of swollen limbs
or other parts of their body, caused by the inability of the lymphatic
system to drain properly. There is no
known cure and treatment is required
daily. Lymphedema is an accumulation of lymphatic fluids; the
lymphatic
system moves lymph fluid containing white blood cells that help to fight
infection, filter out toxins
and germs.
It's a condition Lac du Bonnet's
Kim Avanthay and son Austin know all too well.
Last year marked significant
progress in her mission for recognition of the disease which is quite common
but
not publicized to any great extent. Many medical professionals have
never heard of lymphedema, which the
World Health Organization estimates
affects more than 250 million people worldwide.
"The more people hear, the
more they will be aware [of lymphedema] and can seek help if they need it,"
Avanthay explained about the importance of making the disease
understood.
Avanthay's efforts are inspired by her young son, Austin, who
suffers from the disease. The Leader first
wrote about Avanthay two years
ago when she graduated from the Lymph Science Advocacy Program in
California. She was there to learn more about the illness that's affected
Austin since shortly after birth.
"Lymphedema is a chronic disease with no
known cure and treatments that for some, are less than
adequate," Avanthay
told the Leader.
"Much work needs to be done in this area as lymphedema
requires daily care."
The disease can become a disability that prevents
those affected by it from continuing in normal daily
activities including
their professions.
Cancer patients who have had surgery and radiation
treatment often suffer from lymphedema and are often
unaware of the causes,
opportunities for prevention or approaches to treatment. While estimates vary,
experts in Canada estimate that up to 25% of cancer patients suffer from
lymphedema. It is a silent
condition; very little is known about it and the
health care system is poorly informed about its role in
prevention and
treatment.
A study by the Canadian Lymphedema Framework found a lack of
standardized care, non-existent or
inadequate provincial health coverage, a
lack of resources for assessment and treatment and inadequate
awareness of
lymphedema prevention and self-management. The impact of lymphedema can be
minimized
by early intervention; the condition requires a highly
specialized treatment known as Manual Lymphatic
Drainage/Combined
Decongestive Therapy and the proper use of compression garments.
The
Lymphedema Association of Manitoba follows similar associations in other
provinces and is linked to
the National Framework and International work in
this area.
For more information, please contact the Lymphedema Association
of Manitoba at lymphmanitoba@yahoo.
ca or write to Box 403, Lac du Bonnet,
MB R0E 1A0.
Lymphedema management - The Daily News Journal –
The
StoneCrest Medical Center Physical Medicine Department is now offering
lymphedema management
provided
by certified lymphedema therapists. Lymphedema can be managed, but not cured.
Since
lymphedema
treatment is often ongoing and frequent, StoneCrest is proud to make this
treatment
conveniently
accessible to the community.
Lymphedema
is swelling in various parts of the body caused by a build-up of lymphatic
fluid in the tissues. It
can
be caused by damage to lymph nodes or vessels as a result of surgery or
radiation treatments for cancer
patients.
It can also be caused by other trauma, infections, or the result of rare
inherited conditions.
StoneCrest’s
certified lymphedema therapists are specially trained in the treatment and
management of
lymphedema.
They may provide patient education on proper skin care and hygiene, manual
lymph drainage
(by
skin moving techniques), or compression therapy.
January
4, 2011 - Pensioner without heating for 12 days tells of "worst Christmas ever"
– This is Scunthorpe
–
A
PENSIONER said she had the "worst Christmas ever" after she was left without
heating or hot water for
12
days over the festive period.
Sheila
Harvey, 68, of Willoughby Road, Scunthorpe, suffers from lymphedema (fluid
retention) in her legs
and
has to bathe them with hot water every day.
But
she was left without central heating or hot water after her boiler broke down
on December 18.
She
contacted social housing landlords North Lincolnshire Homes and it took three
visits before her heating
was
fully restored.
She
said: "It's the worst Christmas I've ever had. I can't believe they've left me
this long.
"Somebody
came out to sort it on December 18 because they thought it was a frozen pipe,
but when they
realised
it was the boiler they said they would have to send a gas man.
"At
dinner on Christmas Eve, a joiner came to look at it. He said a gas man would
be sent, but nobody has
been
since.
"I've
not had a bath for 11 days. I've had to use the kettle to have a strip wash and
I've had to use two
electric
heaters, which I cannot afford to use."
A
spokesman for North Lincolnshire Homes said: "We are really disappointed to
find that some of our
customers
have had a very difficult time over this period.
"The
reason that some of our tradesmen have been attending to heating problems which
they were not
necessarily
qualified to solve is that some repairs involved frozen condensing pipes, an
operation which does
not
break rules or law.
"It
is true that Mrs Harvey has not had any reliable heating since December
18.
"We
have tremendous sympathy for Mrs Harvey. During that time our tradesmen
attended the property
twice
and on the third occasion we are not able to say whether the tradesman gained
access to the property,
as
Mrs Harvey stayed with family over this period.
"A
full repair was carried out on Thursday."
January
5, 2011 - Docs say breast cancer survivors should lift weights - Newsworks.org
(blog) – By
Meggan
Kole –
Research
from the University of Pennsylvania school of Medicine reverses long-running
advice that breast
cancer
survivors should avoid lifting anything over five-pounds to prevent lymphedema
-- an incurable side
effect
of cancer treatment.
The
study shows a slow progressive weightlifting regimen not only didn't increase
lymphedema, but reduced
the risk by 35
percent in the 154 participants. These results go against typical doctor's
orders.
The
debilitating condition prevents women from living a normal life after cancer.
It causes chronic swelling
in
the arm. It's so common, some survivors are warned not to pick-up their own
children because it may
bring
on the disorder.
Lead
author Kathryn Schmitz said the conclusions from the study are game changing.
“I am at this point on a
mission
to make it standard of care for breast cancer survivors to be automatically
referred for evaluation of
arm
and shoulder problems at the end of their breast cancer treatment,” Scgnutz
said. “It is my hope that
some
day breast cancer rehabilitation will be as common as cardiac rehabilitation
after a heart attack," she
said.
Schmitz
also said, the weightlifting should only be done with a certified fitness
professional.
Marie
McCrone participated in the study. McCrone said other than cancer returning,
the fear of
lymphedema
is huge. Developing it would be a constant reminder of the cancer. She said,
“You know you
do
your treatment and then they kind of send you on your way. Things have changed
and it's nice to have
someone
understands that we do want to survive and we do want go on and live a normal
life instead of
always
being a breast cancer survivor”
McCrone
says she is still lymphedema-free. Her arm, where the nodes were removed is
stronger.
January
6, 2011 - Start Out Your New Year By Helping With a Great Project - BlogHer
(blog) – by
Melissa
Ford –
BlogHer
Susan Niebur of Toddler Planet was speaking with her lymphedema therapist
during a session to
reduce
the swelling in her arms post-mastectomy when she learned that many cancer
survivors cannot afford
the
compression sleeves worn to deal with the swelling brought on by lymphatic
fluid.
Susan
thought, "Can't afford lymphedema sleeves? Well of course that's true, isn't
it, as they cost $100 and
up
for each arm, and it's important to have two sets - one to wash, and one to
wear. I started rolling
solutions
around in my brain."
And
out of adversity a great advocacy project was born. Creating a union between a
foundation and a
compression
sleeve company, Susan is working to bring these sleeves to cancer survivors who
can't afford
the
cost. And she is opening up this project to all of us -- and here is what you
can do to help:
Put
it on Twitter and Facebook or blog about the project.
Donate
your connections, money, or time by leaving a comment on the post stating how
you can help.
Connect
those in need with the project so they can receive these much needed
sleeves.
See,
simple.
I
spoke with Susan about her new project on Wednesday:
So
many people don't realize the on-going side effects from cancer and surgery.
What is lymphedema and
how
does it affect your day-to-day world?
Three
years ago, I had chemotherapy, radiation, and a double mastectomy to fight
inflammatory breast
cancer.
Like many of us, I assumed that after that treatment, I'd be fine. Or at least
after recovery, I'd be
fine.
I was surprised to learn that the act of having a mastectomy, the removal of a
breast, also typically
includes
the removal of one or all of the lymph nodes under that arm. Now these lymph
nodes normally act
to
remove waste fluid and proteins from the tissue in the arm, wrist, and hand.
When the nodes are
removed,
the waste fluid isn't removed. I quickly learned that every time I exercised,
cooked, or went
outside
in warm weather, my arm would swell, up to an inch in diameter. They call this
"congestion" in the
arm,
and it feels about as great as congestion in your sinuses. And I don't know
about everyone, but it
makes
me crabby!
Because
of lymphedema, I limited myself to indoor activity. I stopped going to
playgroups at the park, and I
turned
down the opportunity to coach my kids in preschool soccer. In fact, I pulled my
kids from soccer
entirely
last summer, and we all missed it.
What
is the role of lymphedema sleeves?
Compression
sleeves play an important part in the treatment of lymphedema, whether it is a
side effect of
treatment
for breast cancer or a stand-alone disease. Sleeves are made of knit, latex,
and/or silicone fabrics
that
stretch as a person moves, allowing them to be worn all day, but they apply
enough pressure that the
arm
does not swell as quickly, allowing people to be outside for longer periods, to
do strengthening
exercises,
and to cook on or near a hot stove (but don't tell my husband that last part,
okay?).
And
the need for lymphedema sleeves remains with the person forever?
Yes.
Sleeves typically cost about $100 each and have a typical lifespan of about six
months. Each patient
needs
two sets (and this is important) because the garments need to be washed after
each wearing to
maintain
the graduated compression in the fabric. Patients also need to do manual
lymphedema therapy each
day
and/or see a professional for reduction of the swelling, but the sleeves are an
essential part of therapy,
so
that the progress isn't lost the moment a patient steps outside.
The
two places you're working with to bring these sleeves to people in need are the
foundation Crickett's
Answer,
and the company, LympheDIVAs. Can you tell people a little bit about this
organization and
company?
Crickett’s
Answer is a 501(c)3 nonprofit organization founded in memory of Crickett
Julius. Crickett
survived
breast cancer only four months after her diagnosis at 39, but her mother and
cousin are dedicated
to
helping other women enjoy their life post-diagnosis by providing wigs,
mastectomy products,
oncology/mastectomy/
lymphedema massage, facials, and other pampering services as a way to help
women
feel
feminine and beautiful after losing their hair and/or breasts.
LympheDIVAs
was founded by Rachel Troxell and Robin Miller, friends and breast cancer
survivors who
wanted
to create a more elegant and comfortable compression sleeve. Rachel continued
to build the
company
during her later recurrence. Even though she died two years ago, at the age of
37, her father,
mother,
and brother continue to grow the company in her honor and in the hope that
LympheDIVAs’
compression
apparel will continue to inspire breast cancer survivors everywhere to feel as
beautiful, strong,
and
confident as Rachel was.
How
did life change for you when you went from wearing the original sleeve to the
LympheDIVA sleeve? I
think
for many people, when they think about appearance and cancer treatments, they
think about hair. How
do
you think these compression sleeves will change the emotional lives of other
cancer survivors?
From
the first, I wore my sleeve and glove everywhere, but it was hard. More often
than not, even well-
meaning
friends and former associates looked shocked when I approached with the thick
work-glove like
glove
outstretched, and they thought the thick sleeve was a kind of cast. Strangers
commented regularly, and
everyone
and anyone would ask brusquely: “What on Earth happened to your arm?” When I
dutifully
answered
their questions, saying that I had had inflammatory breast cancer, had a
mastectomy, and now
wear
these sleeves, yes, for the rest of my life, the questioners would react
strongly, and conversation would
be
difficult. I didn’t like going out to meet new people anymore, and I stuck
close to friends when we did. It
wasn't
good for me. I love being around people, and it got harder and harder to force
myself to go out,
when
I knew I'd have to answer strangers' questions.
Now,
I hear "Ooh, that's so pretty!" or "Girl, where did you get those tats?" as
often as I do rude questions,
as
the pretty designs on my LympheDIVAs sleeves prompt people to smile first, and
ask questions later.
I
hope that by providing lymphedema sleeves to women who need them but can't
afford them, it will help
breast
cancer survivors to continue to step out of the shadows and get back into
life.
The
announcement for this project falls during a difficult time for you. How has
working on this project been
as
you wait for your next oncology appointment?
When
I asked Crickett's Answer and LympheDIVAs to help other women in this way, it
was at a time when
I
was finishing chemo for my third cancer, and I was happy to wrap up my
treatment with this project,
forcing
something good to come of this horrible disease and its recurrence. I had hoped
to announce it on
Monday
along with the news of clear scans (meaning that my cancer was still gone, and
I would be in
remission
again). Well, I didn't get clear scans, but I'm moving ahead on the project
anyway.
Cancer
takes so much from us, but it cannot take away two things: love and the power
to act. Nothing the
oncologist
can tell me on Thursday will change that.
Please
help spread word about this very important project and help connect those in
need with this
incredible
gift of tools that can aid in life with cancer.
January
6, 2011 - Seroma After Breast Cancer Surgery Triples Lymphedema Risk - Internal
Medicine
News
Digital Network – BY Bruce Jancin –
SAN
ANTONIO – Women who form a seroma following breast cancer surgery are at
threefold increased
risk
of developing lymphedema, a case-control study has shown.
Of
135 breast cancer survivors (26%) participating in the study, 35 developed
postsurgical symptomatic
seromas
requiring needle aspiration. The seromas were located in the axilla, upper
chest, and breast.
Of
the 35 women with a seroma, 33 had a greater than 200-mL increase in arm
volume. Based on the
International
Criteria for Lymphedema Diagnosis, 26 of the 35 women with a seroma had severe
lymphedema,
6 had moderate lymphedema, and 3 had mild lymphedema symptoms, Mei R. Fu,
Ph.D.,
reported
at the annual San Antonio Breast Cancer Symposium.
Patients
with a higher body mass index were significantly more likely to form a seroma;
however, age, type
of surgery
performed, axillary lymph node status, and number of nodes removed proved
unrelated to the
occurrence
of a seroma, according to Dr. Fu of the New York University College of
Nursing.
Lymphedema
is caused by accumulation of lymphatic fluid in interstitial spaces due to
injury to the lymphatic
system
as a consequence of breast cancer therapy. Patients dread this common,
distressing, long-term, and
indeed
often lifelong complication, she said.
Lymphedema
is a syndrome with multiple symptoms. In this study, seroma formation – that
is, excessive
build-up
of serous fluid – was associated with a markedly increased likelihood of the
lymphedema-related
symptoms
of arm swelling, heaviness, numbness, stiffness, firmness, tenderness, and
redness, as well as
increased
arm temperature. Patients with a seroma had a greater number of
lymphedema-related symptoms
than
did women who developed lymphedema without a seroma.
A
seroma is believed to form in response to surgical trauma and leakage of
inflammatory exudates in the
acute
phase of wound healing. The excessive build-up of serous fluid leads to delayed
wound healing, with
tissue
inflammation followed by fibrosis and necrosis.
Current
standard management of a symptomatic seroma consists of needle aspiration,
which may need to be
done
repeatedly. The clinical implication of this study is that aspiration of serous
fluid isn’t sufficient to
prevent
lymphedema, Dr. Fu said. Further research is warranted on a novel means of
preventing
symptomatic
seroma formation as a means of avoiding the development of lymphedema.
Possibilities include
the
use of ultrasound for early detection and drainage of subclinical seromas, as
well as potent anti-
inflammatory
therapy.
Her
study was funded by the Avon Foundation and grants from other nonprofit
organizations. She said she
had
no relevant financial disclosures.
January
7, 2011 - Gottfried Medical, Inc. celebrates its anniversary in its new
facility - Healthcare Digital
(press
release) - BY: Nargis Namazi –
Medical
device manufacturer Gottfried Medical talks about its stint in the healthcare
industry on its
anniversary
For
Gottfried Medical, Inc., the American Dream is alive and well. This second
generation, family-owned
and operated business settles in to their new facility, doubling their size. In 2011 they celebrate 30 years in
business
in Toledo, Ohio, the city of its birth.
Gottfried
Medical manufactures medical devices. They specialize in the engineering and
manufacturing of
made-to-measure
compression garments, including: stockings and sleeves. The majority of their
products aid
in
controlling numerous vascular conditions and lymphedema. They also manufacture
compression garments
specially
engineered to suppress and control hypertrophic scarring, resulting (most
often) from serious burn
injury.
Their
new facility is almost 12,000 square feet, nearly double the
previous.
What
amenities, or improvements, does the new location provide, that previous did
not?
“We
absolutely love our drop docks, as well as the additional warehouse capacity
and a spacious parking
lot,
all notably absent at our previous location.”
What
prompted the re-location and was it anticipated?
“Based
upon our historical growth and projections, we anticipated needing either a
newer, larger facility or
an
extensive expansion of our (then) current one within three years. Previous
experience and the state of the
Real
Estate market suggested we begin our search when we did.”
“The
building we ultimately purchased was (curiously enough) one of the first ones
we considered. Six
months
later and after $75,000 in renovations and upgrades, it was ready for Gottfried
Medical to occupy.
From
our initial search to the move-in, everything came together much faster than we
had experienced
previously.”
“Much
of our good fortune is a result of the wonderful companies that helped make it
all happen. The entire
project
was financed by: Signature Bank N.A. Our general contractor was: JMS Real
Estate Services. Both
companies
are (like us) also Toledo-based and worked very closely with us.”
“Our
30 year success story is due (in large part) to our customer service. Even
today, every call Gottfried
Medical
receives is answered by a person. No voicemail, no buttons to push. In our new
facility, we
invested
in state-of-the-art fiber optics for even more efficient communication both
internally and with our
customers.”
“It’s
not just about getting bigger,” Brent continued, “As we grow, we are constantly
evaluating our methods
and
workflow. Our new facility provides the added space we need to accommodate the
staff and equipment
necessary
to meet the increased demand. By design, the facility has also allowed us to
streamline some of
our
operations, thereby increasing our efficiency, so that we may continue to
provide the delivery service our
customers
have come to expect.”
Why
Toledo? What keeps your business from moving offshore?
“Toledo,”
said Brent, “is not only my home and birthplace; it is the birthplace of the
industry Gottfried
Medical
serves. Conrad Jobst, who originated and developed the concepts for gradient
pressure stockings,
lived
in Toledo and worked for Owens-Illinois, then a Toledo-based company. Jobst
(Conrad Jobst’s
namesake)
was also originally a Toledo-based company. My father, Max Gottfried, the
founder of Gottfried
Medical,
began his career in this field working for Jobst.”
“Manufacturing
offshore is not practical for our business model. Virtually everything we
produce is one of a
kind;
therefore, economies of scale do not apply. Our products are time-sensitive.
For the reason of efficacy
alone,
from the time an order is placed, engineered, manufactured and finally
delivered, is counted in days.
Although
it might be possible to save a few pennies (in my opinion) the loss in time and
quality control could
never
justify the savings of moving manufacturing offshore.”
You
mentioned Max Gottfried, your father, and the company’s founder. How did it all
start?
“Max
Gottfried believed a lower cost and longer life made-to-measure compression
garment could be made
without
reducing its quality or compromising its efficacy. With three employees in
1,000 square feet of
space,
he proved he was right and so in 1981 Gottfried Medical, Inc. was born. His
dream lives-on in our
new
facility, now employing 30 people.”
How
will e-business, technology and virtual world affect Gottfried
Medical?
“To
look into our future, we must look at our past. Our first fax machine was very
expensive. At the time we
wondered
if its cost would ever be justified, yet we made the investment to better serve
our customers.
Before
there were PC’s, we had an internal computer network that could multi-task.
This provided us a
means
for efficient and accurate recordkeeping, helping to keep costs
down.”
“We were also
early entrants into Internet and are proud of our website:
www.GottfriedMedical.com, going
through
several major upgrades over the years. We continue to work on improvements and
online content.
Soon,
we hope to be offering online ordering.”
“Reflecting
on how the company technology has changed in the last 30 years makes the future
look very
exciting.
3D imaging and ultrasonic sewing are just two of many areas that hold promise.
It’s simple: at
Gottfried
Medical, we embrace technology we feel will improve our products and
service.”
How
do you envision the move to the new location will affect your role at Gottfried
Medical and why?
(Brent
Gottfried, President) “The move has taken some pressure off me. We now have
elbow room and the
space
to grow. That’s what we have done every year of our existence. We also now have
the space to
evaluate
some of the new technologies we are interested in. Personally, I am gratified
by the level at which
the
employees are enjoying our new home.”
(Beth
Joy, General Manager) “By moving to the new building and including the entire
staff throughout the
process,
the sense of ownership is heightened for each employee. This sense of ownership
creates more of a
team
atmosphere. We all love our new surroundings and want to continue to grow the
business and provide
the
service we are known for. The move has affected my role as General Manager by
the positive attitude of
the
employees and their willingness to do what it takes.”
(Brandon
Scanes, Sales Manager) “A move such as this, by default, puts added pressure on
all those
involved.
As an example, my role expanded and shifted to one of logistics – organizing
the transfer of
product
and inventory to the new location. Prior to and throughout the move itself, new
situations required
quick
and decisive decisions. As we settle-in to our new offices although things are
returning to ‘normal,’ as
a
result of that move (going forward) I now possess new skills to call upon that
will help me deal with my
workday.”
(Darla
Hredzak, National Sales Representative) “What the move represents has a huge
impact on my
motivation.
To be a part of a company that grows every year is an honor. It stands upon the
promise of its
President, Brent Gottfried: ‘do one thing and do it well.’ As their national sales rep, that means providing our
customers
the highest quality products to aid in their patients’ journey to either
recovery or maintenance of
their
unique health concerns.”
As
Gottfried Medical turns the corner on thirty years in business, their future
remains bright, as does their
commitment
to the Toledo-area as their home and to their promise to remain a company
sought-out by
employee
and customer alike.
January
7, 2011 - Tahoe Forest Health System's 'Exercise for Energy' for current and
recovering cancer
patients
- Sierra Sun –
TAHOE/TRUCKEE,
Calif. —This free six-week class, Exercise for Energy, is a supportive care
program
for
current and recovering cancer patients. It offers patients guidance, support,
and useful tools to return to
and
maintain health and wellness. The class will incorporate strengthening,
stretching, breathing, balance,
cardio,
yoga and wellness education. Education topics may include foods that fight
cancer, cooking
demonstration,
lymphedema prevention, stress, Feldenkrais and exercise strategies. All classes
are
supportive,
medically managed and taught by health professionals, giving you the tools you
need in a
supervised
environment.
Classes
are offered in Truckee and Incline Village. New sessions begin in Incline
Village Jan. 12 and April
13.
Class meets Wednesdays and Fridays, 12:30-1:30 p.m., with Wednesday Wellness
Educational Topics
1:30-2:30
p.m. at IVCH Physical Therapy and Medical Fitness, 333 Village Blvd. Suite 201,
on the corner
of
Village and Alder, one block from Incline Village Community Hospital. Truckee
sessions begin March 1
and
May 31.
Prescreening
required. For more information or to sign up call 582-7415 or e-mail
[email protected]. Visit
www.tfhd.com.
January
9, 2011 - Weight lifting does not appear to increase risk of arm swelling,
discomfort for breast
cancer
survivors - The Virtual Medical Centre –
A
slowly progressive weight lifting program for breast cancer survivors did not
increase their risk of
lymphedema
(arm swelling and discomfort), according to a study in the December 22/29 issue
of JAMA.
The
study is being released early online to coincide with its presentation at the
San Antonio Breast Cancer
Symposium.
Lymphedema
is a frequent complication among breast cancer survivors and ranks high among
their
concerns,
as it may impair arm function and quality of life. "Breast cancer survivors at
risk for lymphedema
alter
activity, limit, activity, or both from fear and uncertainty about their
personal risk level, and upon
guidance
advising them to avoid lifting children, heavy bags, or other objects with the
at-risk arm. Such
guidance
is often interpreted in a manner that de-conditions the arm, increasing the
potential for injury,
overuse,
and, ironically, lymphedema onset," according to background information in the
article. The authors
add
that adherence to these precautions may limit physical recovery after breast
cancer.
Lymphedema
often occurs after lymph vessels or lymph nodes in the axilla (armpit) are
removed by surgery
or
damaged by radiation, impairing the normal drainage of lymphatic
fluid.
Kathryn
H. Schmitz, PhD, MPH, of the University of Pennsylvania School of Medicine and
Abramson
Cancer
Center, Philadelphia, and colleagues examined the incidence of lymphedema after
a one year weight
lifting
intervention among survivors at risk for breast cancer related lymphedema
(BCRL). The randomised
controlled
trial included 154 female breast cancer survivors who had been diagnosed one to
five years prior
to
entry in the study and had at least twio lymph nodes removed and were without
clinical signs of BCRL at
study
entry. Participants (ages 36 to 75 at the beginning of the study) were
randomised to either the weight
lifting
intervention, which included a gym membership and thirteen weeks of supervised
instruction, with the
remaining
nine months unsupervised, or no exercise (control group). Data collection ended
in August 2008.
A
total of 134 participants completed follow-up measures at one year.
The
researchers found that the proportion of women who experienced new BCRL onset
was 11% (eight
out
of 72) in the weight lifting intervention group and 17% (thirteen out of 75) in
the control group. "Among
women
with five or more lymph nodes removed, the proportion who experienced incident
BCRL onset was
7%
(three out of 45) in the weight lifting intervention group and 22% (eleven otu
of 49) in the control group.
Clinician-defined
BCRL onset occurred in one woman in the weight lifting intervention group and
three
women
in the control group (1.5% vs 4.4%)."
"The
majority of breast cancer survivors do not have lymphedema; however, they alter
the use of their arms
and
upper body activities out of fear of developing lymphedema. The findings from
our trial should help
clarify
clinical advice to patients who have completed breast cancer treatment
regarding the safety of
resuming
or beginning a weight lifting program," the authors write.
The
researchers note that the primary goal of this study was to test safety of
weight lifting, not superiority,
and
that additional research is needed before concluding that weight lifting
prevents lymphedema. "However,
even
with the finding of no harm, our results combined with previously published
results for women with
breast
cancer related lymphedema suggest that the many health benefits of weight
lifting should now become
available
to all breast cancer survivors."
January
11, 2011 - Manual Drainage Fails to Prevent Lymphedema in Breast Cancer
Patients - Internal
Medicine
News Digital Network – by Kerri Wachter –
SAN
ANTONIO – Adding manual lymph drainage to exercise therapy did not prevent
lymphedema in a
study
of 160 breast cancer patients who underwent axillary lymph node
dissection.
Researchers
reported that the incidence of lymphedema following axillary lymph node
dissection (ALND)
was
similar whether or not women had manual drainage in a randomized trial
presented at the annual San
Antonio
Breast Cancer Symposium.
[Check
out our comprehensive coverage of the San Antonio Breast Cancer
Symposium.]
Based
on these findings and previous data, "breast cancer patients have to perform
exercise therapy
immediately
started after the axillary dissection to prevent arm lymphedema," said Nele
Devoogdt, a
physical
therapist at University Hospitals Leuven in Belgium.
Manual
lymph drainage involves stretching/massaging the skin around lymph nodes to
improve resorption by
the
lymph capillaries, increase lymph transport (by stimulating lymph collectors),
and to create collateral
pathways
of lymph transport, Ms. Devoogdt said. Although manual lymph drainage is used
in several
countries,
including Belgium, to prevent lymphedema, the preventive effect has not been
previously
demonstrated
in a peer-reviewed randomized trial.
For
this study, the researchers recruited 160 breast cancer patients, who underwent
ALND in one arm.
Both
arms were assessed prior to the procedure to assess the natural difference in
size.
A
total of 79 patients were randomized to exercise therapy and manual lymph
drainage, while 81 patients
had
only exercise therapy. Both groups were given lifestyle guidelines for
minimizing lymphedema.
Patients
in both groups attended 1-2 sessions per week (29 exercise therapy sessions on
average). In the
treatment
group, manual lymph drainage was performed 1-3 times per week (34 sessions on
average).
At
1 month post-ALND, patients started treatment and an arm assessment was
performed. Arm
assessments
followed at 3 months, 6 months (at which point treatment was stopped), and 12
months.
The
primary outcome measure was the incidence of arm lymphedema – defined as a
circumference increase
of
at least 2 cm at two successive measurements. The researchers found no
significant difference in
lymphedema
incidence between the two groups at any time point. At 3 months, the incidence
was 7% in the
drainage
group, compared with 5% in the exercise-only group; at 6 months, the incidence
was 12% and
10%,
respectively; and at 12 months, it was 23% and 18%.
Secondary
outcomes also showed no significant differences in time to lymphedema, increase
in arm volume,
mental
and physical health-related quality of life, and functional problems related to
arm lymphedema.
The
investigators reported that they have no relevant financial
relationships.
January
11, 2011 - Support Groups, updated Jan. 11 – TCPalm –
DATED
MEETINGS
Lymphedema
Support Group: Focus on encouragement, education, socialization. Advanced
Motion
Therapeutic,
2965 20th St., Vero Beach, 6:30 p.m., Jan. 13, Feb. 10, Mar. 10. RSVP:
772-567-8585;
AMTvero.com.
Lymphedema:
St. Lucie Medical Center, 1800 S.E. Tiffany Ave., Port St. Lucie, 5:30 p.m.,
Jan. 28, Feb.
24,
March 24, April 28, May 26, June 23, July 28, Aug. 25, Sept. 22, Oct. 27.
772-335-4000;
StLucieMed.com
January
11, 2011 - HOUSE CALL: Lymphedema —yes, it's treatable - San Angelo Standard
Times –
SAN
ANGELO, Texas — Lymphedema is the result of an abnormal accumulation of
protein-enriched fluid
that
causes swelling of a body part, usually the arm or leg. Approximately 2.5
million Americans suffer from
lymphedema,
and many of them go undiagnosed or untreated.
If
left untreated, lymphedema can potentially cause repeated soft tissue
infections, inability to use the arm or
leg,
and could possibly lead to amputation of the arm or leg.
Lymphedema
often develops after cancer-related treatments, surgery, obesity, injury,
rheumatoid arthritis, or
chronic
venous insufficiency. Approximately 30 percent of women who develop breast
cancer and undergo
radiation
will develop lymphedema, and approximately 74 percent of men who develop
prostate cancer will
develop
it. With age, a person who undergoes total knee or hip replacement is at higher
risk of developing
lymphedema.
Whereas in the past a person may have been told there was no treatment
available, now
through
lymphedema therapy, there is hope for alleviating this debilitating
condition.
Untreated
lymphedema could progress through the following stages:
*
Stage I is identified when lymphedema fluctuates throughout the day. Patients
often express, “My legs are
only
swollen at the end of the day.” Or, “The swelling comes and goes, but I’m
fine.” Symptoms include
feeling
of tightness, achy discomfort, heavy feeling of the arm or leg, and pitting. If
left untreated, it can
progress
to Stage II.
*
Stage II is the state when the soft tissue turns hard and it becomes difficult
to press a finger into the
affected
skin, skin color begins to change, repeated infections (cellulitis) occur, and
leakage of fluid through
the
skin (weeping edema) appears.
*
State III, termed elephantiasis, may be more difficult to treat. However,
through lymphedema therapy, the
person
may regain the quality of life they may have lost.
Lymphedema
therapy, a specialized therapy also known as Complete Decongestive Therapy,
consists of:
(1)
Manual lymph drainage, a gentle specialized massaging technique used to
reroute lymph flow around
the
blocked areas into more centrally located healthy lymph vessels that drain into
the venous system;
(2)
Compression therapy that applies short stretch bandaging to the affected body
part to maintain the
progress
made through manual lymph drainage, prevent back flow of the lymph fluid, and
improve the
muscle
pumping action that assists proper lymph flow;
(3)
Lymphedema exercises;
(4)
Skin care and infection prevention education;
(5)
Compression garment measurement and fitting, which will help the person
maintain the progress made
through
lymphedema therapy.
Cost
of lymphedema therapy is covered by Medicare, Medicaid, and most private
insurances. A doctor’s
referral
is required to receive therapy.
At
San Angelo Community Medical Center, a medical admissions specialist is
available at (325) 947-6989
to
answer questions regarding insurance coverage to receive this therapy. For more
information or to
schedule
an appointment, please call (325) 949-5900.
Selina Elder, is an Occupational Therapist,
Certified Lymphedema Therapist and Certified Custom Garment
Fitter
who practices at San Angelo Community Outpatient Therapy.
February 1, 2011 - A Spa Dedicated to
Complementary Cancer Care - MD News –
Expanding
upon its impressive array of services for cancer care, The START Center for
Cancer Care in
San
Antonio, TX, recently celebrated the opening of Inspiritas, an integrative
wellness spa designed
specifically
to meet the unique needs of cancer patients and their families.
“The
development of Inspiritas has been several years in the making and serves as an
important
complement
to the first-class medical care that is provided to cancer patients through The
START Center
for
Cancer Care,” says Amy Lang, M.D., medical oncologist at The START Center for
Cancer Care.
“Cancer
is not just a physical disease — it affects a person’s physical, mental and
spiritual well-being. We
knew
that our patients were suffering in ways that medications were not able to
address, so we made a
commitment
as a group to create an integrative oncology wellness center that would address
the whole
patient.”
Caring
for Body, Mind and Spirit
Inspiritas
is the only spa of its kind in South Texas. Designed to provide a tranquil and
relaxing area for
cancer
patients to be pampered, it features treatment rooms, changing rooms and
showers, an outdoor Zen
garden,
lounge, waterfall and a multipurpose studio designed for movement classes,
yoga, guided imagery,
meditation,
nutritional and other classes. The spa’s retail area offers paraben-free,
fragrance-free organic
skin
care products, inspirational books, soothing music and guided imagery CDs,
nutritional supplements
and
organic tea.
Mindful
of the issues women face with hair loss and mastectomies, Inspiritas dedicated
an area for wigs,
prosthetics,
head coverings and other beauty products. Women in need of these services are
seen by
certified
prosthetic fitters and beauty consultants in the privacy of two beautiful
rooms.
Based
on the five domains of complementary and alternative medicine developed by the
National Institutes
of
Health — alternative medicine systems, mind-body interventions, biologically
based therapies,
manipulative
and body-based methods, and energy therapy — services include massage,
meditation,
guided
imagery, Reiki, acupuncture, spiritual counseling, nutrition counseling and
free movement classes,
such
as yoga and tai chi.
Staff
members at Inspiritas have considerable experience caring for cancer patients.
For example, the
nutritionist
on staff is a certified oncology dietitian with more than 10 years of
experience in the field. In
addition,
all of the massage therapists employed by Inspiritas are certified oncology
massage therapists.
“When
developing Inspiritas, we surveyed our patients and found that many of them
were seeking these
services
elsewhere and, sometimes, not very safely,” says Dr. Lang. “For example, many
of our cancer
patients
were receiving massages to help with pain management. However, if a patient has
cancer in their
bones,
massage techniques must be adjusted to prevent harm. This same principle is
also true for patients
who
have had lymph nodes removed and are at increased risk for lymphedema. If they
receive a massage
from
a massage therapist who is not trained in oncology, the massage could
exacerbate this condition.”
Complementary
therapies, including guided imagery, spiritual direction and energy therapy,
have shown to
increase
quality of life for cancer patients as well.
Guided
imagery helps empower patients to deal with the mental challenges of cancer and
its related
treatments.
This provides a way for patients to channel their inner strength to help manage
anxiety,
depression
and other disturbing emotions. When this is achieved, patients gain control
over the stress
response
that accompanies a cancer diagnosis.
“By
providing guided imagery, patients are able to tap into their inner resources,
which help them heal,”
says
Ginger Kemmy, R.N., B.S.N., Director of Inspiritas. “Research has shown that
addressing these
emotions
can even help improve immune function.”
Spiritual
direction helps patients work through any spiritual concerns that may arise due
to their cancer
diagnosis,
and energy therapy is ideal for patients who are suffering from severe pain
that makes touch
uncomfortable.
An
Evidence-Based Approach
Research
has shown that cancer patients who have access to supportive services,
including massage,
guided
imagery and other integrative modalities, have better outcomes than patients
who receive traditional
medical
care only. In fact, a recent study published in The New England Journal of
Medicine analyzed the
effectiveness
of palliative care in patients with metastatic lung disease and showed that
patients who
received
palliative care and complementary medicine in addition to chemotherapy and
other medical
modalities
experienced increased quality of life, less depression and reduced need for
aggressive treatment
measures.
Patients who received palliative care also had an average survival that was two
and a half
months
longer than patients who did not.
“Patients
who are engaged and participate in supportive care do better than patients who
just see their
oncologists
alone,” says Kemmy. “Because these services help address both the physical pain
and mental
ramifications
of cancer, patients experience less stress, an improved quality of life and
enhanced immune
function.”
Providing
Support for Family Members
Even
though the services provided through Inspiritas have been designed with cancer
patients in mind, all
services
are open to the public. The facility offers a variety of classes that are free
to the community.
Anyone
who is interested in achieving better balance and enhancing his or her overall
health can benefit
from
the services available. For caregivers of cancer patients, this can be
especially beneficial, as they often
experience
stress and anxiety while caring for their loved ones.
“All
of the services provided through Inspiritas can help caregivers manage the
stress they experience,”
says
Kemmy. “I recently conducted a guided imagery class, and a couple attended. The
wife had breast
cancer,
but the class was beneficial to her spouse as well because he was able to deal
with his own
emotions
regarding her diagnosis. Caregivers are also welcome to participate in our spa
services, including
massage.”
Caregivers
have access to the quiet room and Zen garden at Inspiritas. These areas provide
a relaxing
environment
for them while waiting for their loved ones to finish their
treatments.
To
learn more about the services provided for cancer patients, survivors and
caregivers through Inspiritas,
please
visit ?thestartcenter.com.
February
2, 2011 - SA has highest number of gunshot assaults - Primedia Broadcasting -
Eyewitness
News
– by Catherine Rice –
South
Africa has the highest number of gunshot assaults in the world.
Local
doctors treat gunshot wounds daily.
Seven
hundred delegates have gathered at Cape Town International Convention Centre
for a global wound
care
conference, in a bid to educate primary healthcare workers about effective
wound treatment and
exchange
ideas on best practices.
Wounds
International is hosting the event and hopes to leave a legacy by providing
hands-on information
about
the effective treatment of wounds.
The
World Alliance for Wound and Lymphedema Care’s Secretary-General John McDonald
said there
are
significant consequences for patients if wounds are not treated
properly.
McDonald
said 70 percent of all leg amputations are done on diabetic patients, but this
could be avoided
with
proper prevention care.
February
2, 2011 - New Clinical Research Study Aims to Prevent Lymphedema in Women
Treated for
Breast
Cancer - HealthCanal.com –
Washington,
D.C. – Pain and swelling in the arm or hand can occur as a side effect of
breast cancer
surgery,
but a new national clinical research study underway at Georgetown Lombardi
Comprehensive
Cancer
Center, part of Georgetown University Medical Center and Georgetown University
Hospital, is
looking
at ways that might prevent the onset of these symptoms called
lymphedema.
“Lymphedema
is a complication that many women dread. It can negatively impact a woman’s
ability to
complete
simple daily activities and can take a toll on her physical and emotional
well-being,” says
Georgetown’s
chief breast surgeon Shawna Willey, MD, director of the Betty Lou Ourisman
Breast Health
Center
and lead researcher of the study. “As we understand more about what triggers
lymphedema, we’re
learning
of possible ways to prevent it.”
Lymphedema
can occur in some women who have lymph nodes removed from their underarm as
part of
their
breast cancer surgery. (Lymphedema can also occur with other cancer surgeries
when lymph nodes
are
removed such as with the removal of the prostate). Lymph nodes filter fluid as
it circulates in the body
and
help to mobilize this fluid throughout the body. Swelling and pain can occur
when the fluid pools in the
arm
or hand and isn’t able to be removed because of a decrease in the number of
lymph nodes.
The
Lombardi study looks at the impact that an education program has in preventing
lymphedema
compared
to education plus a customized exercise plan. Information about quality of life
for these women
also
will be gathered.
Women
interested in the study sign up before having surgery for their breast cancer.
If lymph nodes are not
removed
during the study, then those women do not continue in the study because
lymphedema is not likely
to
occur. Those who have lymph nodes removed continue in the research program and
are randomly
assigned
to one of two groups: the education-only group or the group with education plus
an exercise plan.
The
women will be asked to participate in about four surveys throughout the
two-year study.
“It’s
possible that exercise can improve or even prevent the onset of lymphedema,”
explains lymphedema
specialist
Johanna C. Murphy, MS, PT, CLT, director of physical medicine and
rehabilitation at
Georgetown.
“Having a tailored exercise program, however, is important because there are
activities that
might
actually trigger the swelling and pain. For the women assigned to the education
plus exercise, learning
the
correct way of doing the exercises will be an important part of the
study.”
In
addition to exercise, women in this group will be fitted for a special sleeve
and glove that apply light
pressure,
which might also help prevent lymphedema when combined with the exercise plan.
The education
program,
exercise plan, and sleeve are offered without cost to the patient. Standard
instruction and written
material
about lymphedema will be provided for those choosing not to participate in the
study.
“We
don’t yet know if the exercise plan and sleeve will be better than education
only to prevent the
symptoms,”
Willey concludes. “We’re grateful to all of our study participants, past and
present, as they
truly
help in advancing our knowledge about this issue.”
Patients
interested in learning more about this study should contact Ann Gallagher at
[email protected]
or
call 202-687-7606.
The
study is sponsored by the Cancer and Leukemia Group B, a cooperative group of
cancer centers.
Willey
and Murphy report no personal financial interests related to the
study.
About
Georgetown Lombardi Comprehensive Cancer Center
Georgetown
Lombardi Comprehensive Cancer Center, part of Georgetown University Medical
Center
and
Georgetown University Hospital, seeks to improve the diagnosis, treatment, and
prevention of cancer
through
innovative basic and clinical research, patient care, community education and
outreach, and the
training
of cancer specialists of the future. Lombardi is one of only 40 comprehensive
cancer centers in the
nation,
as designated by the National Cancer Institute, and the only one in the
Washington, DC, area. For
more
information, go to http://lombardi.georgetown.edu.
About
Georgetown University Medical Center
Georgetown
University Medical Center is an internationally recognized academic medical
center with a
three-part
mission of research, teaching and patient care (through MedStar Health). GUMC’s
mission is
carried
out with a strong emphasis on public service and a dedication to the Catholic,
Jesuit principle of
cura
personalis -- or "care of the whole person." The Medical Center includes the
School of Medicine and
the
School of Nursing and Health Studies, both nationally ranked, the
world-renowned Georgetown
Lombardi
Comprehensive Cancer Center and the Biomedical Graduate Research Organization
(BGRO).
In
fiscal year 2009-2010, GUMC accounted for 79 percent of Georgetown University's
extramural
research
funding.
February
2, 2011 - Multiple Hurdles in Treating Lymphatic Filariasis in Haiti - Angels
in Medicine – by
Zeena
Nackerdien, PhD –
Lymphatic
Filariasis in Haiti
Beset
by the plagues of poverty, political instability and infectious diseases, Haiti
remains on the world's
radar
as a place of ongoing suffering. Headlines skim the surface of its promising
origins as the world's first
black-led
republic,[1] and linger on the more familiar tales of political violence under
the leadership of past
presidents,
notably the Duvaliers ("Papa" and "Baby Doc") and Jean-Bertrand Aristide. As if
political
disasters
were not enough, Haiti has had to deal with an alphabet soup of hurricanes,
storms, earthquakes
and
tsunamis, recorded as early as 1770.[1]
Compounding
the country's problems is the lack of sanitation and an inadequate health
infrastructure, which
have
created a perfect breeding ground for infectious diseases. Among these
scourges, lymphatic filariasis
(LF),
a mosquito-transmitted parasitic disease, is known to be endemic to the region
and is a leading cause
of
permanent disability worldwide.[2,3] Viewed as a remnant of the slave trade,
this disease occurs mainly
in
Haiti in the Western hemisphere, where at least 10% of individuals are
symptomatic. More than half the
population
in high transmission areas could be asymptomatic carriers.[4]
Although
the disease is seldom fatal, the passage and procreation of the roundworm,
Wuchereria bancrofti,
wreaks
havoc to the lymphatic system of affected individuals.[4] Threadlike worms lurk
in their favorite
nesting
areas (breasts, genitals and legs),[5] releasing millions of baby worms into
the blood and causing
lymphedema
in many affected individuals. The one-two combination of untreated parasitic
disease and
accompanying
microbial infection cause the debilitating and disfiguring condition of
elephantiasis.
Fortunately,
individuals and health organizations have waged an ongoing war against this
emblematic
"disease
of the poor." One such effort is the LF-elimination initiative directed by
Father Tom Streit,
affectionately
known as Pere Tom,[4] who directs the program under the auspices of the
University of
Notre
Dame (UND). Sarah Craig, the program manager, estimated that there are about 45
people
currently
engaged in efforts in Leogane, a coastal town, as well as in offices and at the
Hopital Sainte Croix
in
the capital, Port-au-Prince.
The
UND group, together with other researchers in Haiti, had determined that the
only option for effective
LF
elimination was mass drug administration to the local population for the
duration of the worm life cycle
--
5 years.[4] The UND initiative, in partnership with IMA World Health, and in
support of the Haitian
government,
achieved its goal of 5.2 million treatments per annum in the 2009/2010
treatment cycle. In
2008,
50 of the most at-risk 140 communities were treated for this disease using the
WHO-recommended
approach
of mass drug administration with drugs that target both LF and intestinal worms
(S. Craig,
personal
communication).
Aftermath
of the 2010 Earthquake
Located
on the western side of the island of Hispaniola, Haiti is perched on a fault
zone predicted in 1979
to
have the highest probability of rupturing into a big quake.[7] The date,
January 12 2011, marks the one-
year
anniversary of the devastating earthquake which hit this impoverished nation.
Its painful consequences
unfolded
in television images and stories of untold suffering and death. The earthquake
killed as many as
300,000
people, toppled buildings and left 1.5 million homeless.[6] This disaster also
slowed the LF
program
and many other health initiatives in the country.
Moments
before the event, UND workers and their collaborators were enjoying drinks on
the fourth floor
of
a Port-au-Prince hotel on that fateful day. Ms. Craig recalled feeling the
building collapse until "we
ended
up somewhere between the first and second floor with rubble beneath us." The
survival of the
workers
and heroic relief efforts by others are outlined in a Science article[4] and
further described on the
UND
website.[8]
By
January 20, at least 52 4.5-rated aftershocks had been reported. Like other
health initiatives in the
country,
the program switched immediately from research to disaster management mode.
Leogane,
eighteen
miles away from Port Au Prince and near the epicenter of the quake, which
registered 7.0 on the
Richter
scale, counted 30,000 to 40,000 dead and 80-90% of its buildings completely
decimated.[9]
Medical
supplies rapidly dwindled as the staff treated thousands of hungry, dehydrated
and wounded
Leogane
residents. It was the UND staff on the ground who facilitated the
transformation of a local
highway
into a makeshift landing strip so that much-needed additional supplies could be
flown in to save
lives.
Against a distant backdrop of debris and growing refugee camps, a number of
medical teams worked
feverishly
to treat the traumatized residents. Similar stories of suffering and medical
relief echoed across
Port
Au Prince.
Cholera:
A Dire Blow to the Program
Taking
care of the injured and providing humanitarian relief proved only to be the
beginning of the new
challenges
facing the UND initiative and other health programs operating in Haiti.
Cholera, all too familiar in
developing
countries as a disease transmitted mainly through contaminated water and food,
provided an
unexpected
new challenge. This disease, first reported on 21 October in the rural
Artibonite region, far
away
from Port Au Prince, spread rapidly through the country. As of December 2010,
there have been
121,518
cases reported, resulting in 63,711 hospitalizations and 2,591
deaths.[10]
Crowded
refugee camps, a population with no immunity against the microbe and a
teetering healthcare
system
provided the fuel for the cholera epidemic. Politics inevitably crept into
containment efforts once the
microbe
was genetically matched with a South Asian strain. UN peacekeeping troops from
Nepal were
accused
of being carriers of this virulent strain, precipitating riots against the UN
and further impeding
medical
relief efforts.[6] The rationale that the epidemic was imported flies in the
face of expert opinion that
Vibrio
cholerae likely spread via the environmental route.[11] This assessment is
based on knowledge that
the
microbe, normally resident in low numbers in brackish water or found in
association with small
crustaceans
in rivers and lakes, can proliferate in the presence of environmental stimuli
such as increasing
water
temperatures and nutrient levels, causing zooplankton blooms. Locals ingesting
the water and poor
sanitation
facilitate the spread of the disease.[11]
Regardless
of debates about the origins of the epidemic, the reality is that the LF
program faces a
formidable
obstacle in cholera. Experts predict that cholera is likely to persist in
Haiti, with the country
facing
100,000 cases in the next few years, given its low ranking on the socioeconomic
development scale.
[11]
The current global cholera vaccine supply of approximately 100,000 doses is
inadequate to protect all
Haitian
citizens. Since medications are consumed with local water to keep costs at a
minimum, it is perhaps
understandable
that the Haitian government has asked the LF program to halt medication
distribution due
to
the cholera outbreak. Thus, from a public health standpoint, cholera damaged
the program far more than
the
earthquake. One estimate given was that 5 to 10 years would be needed to put an
infrastructure in
place
to deal with the country's health woes. Post-election riots may prolong the
journey towards
economic
and health stability.
Dateline
NBC featured the heroic efforts of Remote Area Medical to provide some Haitians
with cholera
medicines.
While these heroic efforts bear testament to the depths of human compassion,
sustainable
solutions
are being sought for the plight of the Haitians. Chlorinated water and
innovative biosand filter
projects
devised by the Clean Water for Haiti program may provide part of the answer,
but each approach
is
subject to the need for additional funding. Given its commitment and successful
public health track record
in
the country, the UND and its collaborators are seeking additional financial
resources to expand the
scope
of the neglected tropical disease program in order to improve the overall
quality of life of the Haitian
people.
About
the Author
Zeena
Nackerdien, PhD is a microbiologist and writer and can be reached at
[email protected].
edu.
References
1.
Haiti country profile, from the BBC.
2.
WHO. World Health Report. Geneva: World Health Organization.
3.
Beau de Rochars MV, Milord MD, St Jean Y, et al. Geographic distribution of
lymphatic filariasis in
Haiti.
Am J Trop Med Hyg 2004;71(5):598-601.
4.
Roberts L. Relief among the rubble. Science 2010;327(5966):634-637.
5.
Reynolds M. Blessed are the healers. Notre Dame Magazine, Summer 2001
6.
Fraser B. Haiti still gripped by cholera as election looms. Lancet
2010;376(9755):1813-1814.
7.
Kerr RA. Seismology. Foreshadowing Haiti's catastrophe. Science
2010;327(5964):398.
8.
University of Notre Dame - Haiti Program
9.
Demas N. Wes, Jean Marc and the Fighting Irish of Leogane!
10.
Update on cholera --- Haiti, Dominican Republic, and Florida, 2010. MMWR Morb
Mortal Wkly
Rep
2010;59(50):1637-1641.
11.
Enserink M. Infectious diseases. Haiti's outbreak is latest in cholera's new
global assault. Science 2010;
330(6005):738-739.
Links
Related to This Article
University
of Notre Dame Haiti Program
Sarah
Craig
Program
Manager
309
Brownson
Notre
Dame, IN 46556
Phone:
574-631-3273
Fighting
Poverty by Treating Parasites
by
Zeena Nackerdien, PhD and Toni Nicholls, PhD
Neglected
Tropical Diseases and Drug Donation Programs: Successes and
Challenges
by
Zeena Nackerdien, PhD
About
Angels in Medicine
Angels
in Medicine is a volunteer site dedicated to the humanitarians, heroes, angels,
and bodhisattvas of
medicine.
The site features physicians, nurses, physician assistants and other healthcare
workers and
volunteers
who reach people without the resources or opportunities for quality care, such
as teens, the
poor,
the incarcerated, the elderly, or those living in poor or war-torn regions.
Read their stories at www.
medangel.org.
February
2, 2011 - Community Bulletin and Business Briefs - Winter Park/Maitland
Observer –
Dr.
Stuart Dropkin, DMD, of Winter Park participated in the TeamSmile clinic,
Friday, Jan. 21.
Several
hundred low-income kids from Orange County came in for free dental
treatment.
The
following students were named to the President’s or Dean’s List of their
college or school at Mercer
University
for the Fall 2010 semester: Justin D. Burchett of Winter Park and Bryan B.
Danley of Maitland
Jonathan
Hill, a resident of Maitland and a junior at Southern Methodist University in
Dallas, is listed on the
honor
roll with high distinction.
Chad
Modomo of Winter Park has been named to the 2010 fall semester Dean’s List at
West Virginia
Wesleyan.
The
Metropolitan Opera National Council Auditions/Vocal Competition took place on
Saturday, Jan. 22
at
Trinity Prep School in Winter Park. “Thanks to donations collected from the
audience, we were able to
send
four winners to Atlanta instead of the usual three,” Swantje Knye-Levin and
Kathleen Miller wrote in
an
e-mail.
Tax-Aide
volunteers, trained and certified by the IRS, will provide free income tax
assistance at the Winter
Park
Library, 460 E. New England Ave., from 11:30 a.m. to 3:30 p.m., Tuesday,
Wednesday and
Thursday,
through April 14. Visit aarp.org/taxaide or call 1-800-227-7669.
The
Winter Park Chamber of Commerce recognized its members at the organization’s
annual Membership
Awards
Celebration on Friday, Jan. 21, at Full Sail. Florida House of Representatives
Speaker Dean
Cannon
was honored as the Winter Park Citizen of the Year. The Chamber
presented
the first Chamber Hero award to Ronnie Moore, assistant director for Parks and
Recreation for
the
City of Winter Park. Visit WinterPark.org
Over
400 brave souls were “freezin’ for a reason” at Aquatica on Saturday, Jan. 22,
for the second annual
Polar
Plunge, benefiting Special Olympics Florida. The event raised more than
$191,000!
On
Jan. 26, Jewish Academy of Orlando held its annual Invention Convention.
Students’ challenge was to
create
a machine, using at least 15 steps and no form of electricity, to put a .5L
water bottle into a
recycling
bin. The students presented a short video presentation of the building process
on iPads. Visit
JewishAcademyOrlando.org
The
Dr. Phillips Center for the Performing Arts received a $1.5 million gift from
Winter Park
residents
Marc and Sharon Hagle, who previously pledged $1 million to the project in
2007. Visit
DrPhillipsCenter.org
Tickets
are now on sale for CHOICES 2011, held March 16 at the Westin Lake Mary on
International
Parkway.
This annual event is the largest fundraising event for the Jewish Federation of
Greater Orlando
Women’s
Division. Call 407-645-5933 or visit jfgo.org
Registration
is now open for the 31st Annual Conference of the Florida Native Plant Society.
It will take
place
at the Sheraton Orlando North in Maitland on May 19-22. Visit
www.fnps.org/pages/conference or
for
sponsorship opportunities or to receive information by mail, contact FNPS at
321-271-6702 or e-mail
[email protected]
The
National MS Society Mid Florida Chapter is looking for anyone who wants to
support their
community
to take part in Walk MS 2011 and Bike MS: The Citrus Tour 2011. Visit
MidFloridaMSwalks.
org
and FLC.NationalMSsociety.org or call 813-889-8363.
The
Orlando Garden Club is looking for new members. Monthly meetings are at 10 a.m.
on the third
Friday
of the month during Sept.-May, 710 E. Rollins St. Call 407-682-1726 or e-mail
[email protected]
Seniors
First is seeking drivers to deliver Meals on Wheels to elderly clients in
Orange County. Contact
Lorraine
Shumaker at 407-615-8982.
Business
Briefs
Cocina
214 has leased the 10,000-square-foot building at 151 E. Welbourne Ave. for a
Mexican
restaurant
and bar, called Cocina 214. Formerly Apenberry’s, the building is owned by the
Charles
Hosmer
Morse Foundation. After a total reconstruction of the interior, opening is
planned for Spring 2011.
Margarita
Correa MD, Board Certified in Physical Medicine and Rehabilitation, announces
the opening of
her
new office, Physical Medicine Institute at Winter Park North Pointe Place, 2900
N. Orange Ave. Suite
205,
starting on Friday, May 6. Services include cancer rehabilitation, lymphedema
treatment, pain
medicine,
EMG & NCS. For appointments, call 352-404-6959. Visit
PhysMedi.com
Winter
Park-based A.T. Thomas LLC, which owns and operates Kennedy’s All-American
Barber Club in
Winter
Park, has opened a new location in downtown Orlando. The new Kennedy’s Club is
located at
716
E. Washington St. Suite C.
Fifth
Third Bank’s 47 Central Florida branches recently collected more than $17,000
for the Camaraderie
Foundation,
an Orlando-based nonprofit that provides counseling services at a discounted
rate to veterans
and
their families.
Posting
79 fourth quarter closings for $27.63 million, Fannie Hillman + Associates of
Winter Park saw its
annual
closings of existing homes increase by 6 percent over the previous year, a sign
that company
officials
feel bodes well for 2011. Visit FannieHillman.com
Full
Sail University announced that eight of its alumni are nominated for this
year’s Grammy Awards airing
live
on CBS Sunday, Feb.13. A total of 74 Full Sail graduates worked on 53 nominated
projects.
NAI
Realvest recently completed a lease agreement for 9,675 square feet of
office/industrial space at
Winter
Park Commerce Center near downtown Winter Park.
Larry
Vershel Communications, based in Winter Park, has added five new clients since
the start of 2011
and
projects major growth through the end of the year.
February
3, 2011 - Lymphedema Products Demonstrates Compassionate, Effective Lymphedema
Management
– Benzinga –
Lymphedema
Products has spent years promoting safe, ethical, and compassionate treatment
for
lymphedema.
Its expertise and track record show how lymphedema treatment should be
supplied.
Matawan,
NJ (Vocus/PRWEB) February 03, 2011
Bringing
its industry-leading expertise and understanding of ethical and effective
lymphedema treatment to
the
supply of lymphedema treatment tools for more than ten years, Lymphedema
Products has established
itself
as a lymphedema supplies provider that prioritizes patient satisfaction. It
emphasizes its staff's first-
hand
knowledge of every phase of lymphedema and the importance of providing only the
most medically-
safe,
cutting-edge treatment tools, offering its clients the power to effectively
combat the condition on their
own
terms.
About
Lymphedema Products' Founders
Lymphedema
Products was established by Steve Norton, a Complete Decongestive Therapy
Instructor,
Certified
Lymphedema Therapist (CLT), and highly-regarded lymphedema educator. Steve is a
renowned
authority
in the field of lymphedema therapy who personally trained many of today's
practicing
lymphedema
therapists. His educational company, the Norton School of Lymphatic Therapy, is
the leading
resource
for comprehensive education in this medical specialty.
His
vision for Lymphedema Products as a trend-setter in the industry, with product
selections based on the
expertise
of long-time lymphedema care experts, was inspired by his experiences treating
the condition, his
extensive
involvement in the field of lymphedema management and lymphedema care
education, and his
passion
for treating this condition with the utmost compassion and integrity.
Steve
founded Lymphedema Products with the goal of providing the highest quality
service to individuals
with
lymphedema who have successfully completed lymphedema treatment, but continue
to need the best
products
and expertise available to manage their condition. As the leading exclusive
supplier of
lymphedema
treatment supplies, it carries only the most advanced and medically-responsible
products
available
for the safe and effective management of primary and secondary lymphedema,
venous edema,
and
other edemas. Steve and his team of lymphedema experts personally vet products
based on years of
experience
to assure that they are effective, safe, and appealing for customers.
In
this way, Lymphedema Products harnesses the broad range of medical and
technical expertise of its
founder
and advisory staff, to the benefit of customers. When patients and medical
professionals choose to
purchase
their lymphedema supplies from Lymphedema Products, they are initiating a
relationship with the
industry-leading
resource for lymphedema-related treatment, knowledge, and expertise. Steve and
his team
don't
take this relationship lightly.
About
Lymphedema Products' Commitment to the Cutting Edge
Lymphedema
Products carries only the most current, ethically-sound, and medically-safe
treatment tools
for
lymphedema. It is constantly updating its catalogue with the newest in
treatment tools to offer clients
more
custom-tailored options to meet their needs and allow them to make managing
lymphedema an easier
part
of a normal life. All its products have been approved by many of the world's
leading authoritative
organizations
including the International Society of Lymphology (ISL), the National
Lymphedema Network
(NLN),
and many prominent educational institutions in the field of lymphedema
management. Steve
believes
that by holding all his lymphedema-related projects to the highest possible
standard when selecting
product
lines and lymphedema experts, he ensures that his customers will receive the
best treatment
available.
This is the philosophy that has made Lymphedema Products one of the most
trusted leaders and
valued
partners in the field of lymphedema management.
February
3, 2011 - Benefit planned for New Richmond businesswoman - Richmond-News – By
Jackie
Grumish
–
More
than a year ago, Carla Kelley was tired of her shoes and clothes not fitting.
She started dieting but
couldn’t
shed the weight.
Last
June, with swollen legs, she decided to consult a doctor. She tried a reduced
diet, but it didn’t do the
trick.
Eventually, she was diagnosed with lymphedema.
In
September, the swelling progressed into pain — horrific pain.
In
November, Kelley visited a specialist in St. Paul, Minn. After several tests,
doctors discovered a
problem
with her adrenal gland — which led to even more tests.
Eventually,
Kelley was diagnosed with Cushing’s syndrome, a hormone disorder caused by high
levels of
cortisol
in the blood. When doctor’s discovered the cause of Cushings syndrome — a
large, cortisol
producing
tumor — Kelley’s diagnosis changed to adrenal cancer.
After
being diagnosed and finding the tumor, things moved relatively
quickly.
Major
surgery was needed to remove the tumor; however, the tumor needed to be reduce
before the
surgery.
That’s when Kelley started an aggressive nine-day, seven dose chemotherapy
routine.
Dawn
Mahoney, Kelley’s sister, said Kelley has been in good spirits through the
whole process.
“Here
is my sister, actually choosing to look forward to shopping for a wig already
as she collects them for
use
in community theatre,” Mahoney said.
The
two actually went shopping in December, well before Kelley started losing her
hair.
At
one appointment, the family was able to see a 3D image of the tumor. That’s
when the family realized
the
“honkin’ big tumor” was actually a large cluster of tumors measuring roughly 10
inches long, 4.5 inches
wide
and 4.5 inches deep. It’s believed the cluster started in the right adrenal
gland, which sits on top of
the
kidneys.
At
the conclusion of Kelley’s chemo, doctors confirmed that the tumor mass had
shrunk. The next step
was
scheduling the “big surgery” for Jan. 24.
Five
surgical teams were assembled to remove the tumor cluster, Mahoney said. The
day started with a
laparoscopy
to look for other clusters and ended eight hours later after surgeons removed
part of Kelley’s
liver,
right kidney and adrenal gland.
Kelley’s
surgical team deemed the procedure a success and believe all tumors have been
removed. Now,
Kelley
is working to recover.
“To
say we’re cautiously optimistic is true, but probably as far out on the limb as
we’ll go right now,”
Mahoney
said. “Recovery will be a steep climb with pain for a while. But she has made
it through honkin’
chemo
with flying colors and now this honking huge surgery.”
As
most could imagine, a “honkin’ big tumor” creates equally big medical
bills.
To
help Kelley with the costs associated with numerous trips to Rochester, Minn.,
treatments, countless
prescriptions,
hotel rooms and gas, friends and family are organizing a benefit.
The
benefit is scheduled for Saturday, Feb. 12, at Ready Randy’s Sports Bar and
Grill, 1490 131st St.,
just
south of New Richmond.
A
spaghetti dinner and silent auction will begin at 4 p.m. and end at 7 p.m.
Dinner costs $10 per person;
kids
younger than 3 eat free. At 7:30 p.m., Pete Neuman and the Real Deal will hit
the stage.
Those
who are unable to attend, but would like to contribute, can send donations to:
First National
Community
Bank, c/o Carla Kelley Benefit, P.O. Box 89, New Richmond, WI 54017.
“We’ve
been going through a lot in a very short amount of time,” Mahoney said. “We’re
still very much
grieving,
healing, stunned and in a state of disbelief.”
February
4, 2011 - Business Notes - Brainerd Daily Dispatch –
Byland
completes training for certified lymphedema therapist
STAPLES
— Lakewood Health System occupational therapist Janet Byland recently completed
intensive
training
to become a certified lymphedema therapist.
To
become a certified lymphedema therapist, attendance of 135 hours of instruction
and successful
completion
of written and practical examinations are required.
Lymphedema
is a swelling of a body part, most often the extremities. Lymphedema may be
present at birth
or
develop later in life, and is often the result of surgery or radiation therapy
for cancer.
February
5, 2011 - North State Marketplace: Feb. 5, 2011 - Record-Searchlight - By David
Benda –
Tina,
this is notification of a meeting that has now passed, sorry.
February
9, 2011 - Some breast cancer patients can get less surgery - Boston Globe
(blog) – by Deborah
Kotz
–
Treatment
of breast cancer has been moving further and further away from the slash and
burn tactics of the
last
century. Most patients now get lumpectomies instead of mastectomies, less
extensive radiation and less
toxic
chemotherapy. And now some will be offered the option of not having their
underarm lymph nodes
removed
-- even if they contain cancer cells.
A
new study published Tuesday in the Journal of the American Medical Association
has found that women
with
early breast cancer (stage 1 or 2) who have lumpectomies with radiation do just
as well in terms of
cancer
recurrence and survival regardless of whether they retain potentially-malignant
lymph nodes.
The
big upside to sparing the lymph nodes is fewer adverse effects like arm pain,
frozen shoulder,
infections,
and lymphedema, which is permanent swelling in the arm. Some 70 percent of the
446 patients
who
were randomly assigned in the study to have their lymph nodes removed developed
such
complications
compared to 25 percent of the 445 patients who retained their lymph
nodes.
"Lymphedema
and quality of life become huge issues after breast surgery," says Dr. Mehra
Golshan,
director
of breast surgery at the Dana-Farber/Brigham and Women's Cancer Center who was
not involved
in
the study, "and it's a great thing to find that lymph node sparing surgery can
provide the same shot at
survival
with fewer complications."
Golshan
says he and his colleagues at the various Harvard hospitals decided last fall
to offer the lymph
sparing
surgery to some women with one or two positive nodes after hearing the study
presented by the
researchers
at a spring cancer meeting.
Until
then, Harvard surgeons removed just a few nodes to see if they contained cancer
and would only
leave
the rest of the nodes intact if that first node was cancer-free -- which has
been standard practice in
the
U.S. for the past decade.
While
the majority of cancer patients are diagnosed early before the cancer has
spread to the lymph nodes,
up
to 20 percent have an early stage cancer with some lymph node involvement.
Those who opt for
lumpectomies
with radiation, rather than mastectomies, can now be offered the lymph sparing
surgery since
the
radiation could kill any cancer cells left in the nodes, Golshan
says.
Oncologists
at other Boston hospitals, however, may differ somewhat in how they change
their practice as
a
result of the new finding. "This is exciting data, but it certainly doesn?t
apply to everyone," says Maureen
Kavanah,
a surgical oncologist at Boston Medical Center.
She
says oncologists at her institution often like to know the extent of lymph node
spread to determine
whether
to use radiation on that area or to offer the option of an experimental
treatment. Also, oncologists
might
be more willing to spare lymph node removal in those who have
"estrogen-receptor" positive cancers
that
can be treated with anti-estrogen drugs like tamoxifen. These drugs could
destroy any remaining cells
in
the lymph nodes.
And
even with the new study finding, surgeons aren't comfortable leaving
potentially positive nodes in
women
who had mastectomies without radiation -- since they weren't included in the
study -- nor in those
who
have enlarged lymph nodes that can be felt on a physical exam.
A
study now being conducted in Europe that involves 4,000 breast cancer patients
will answer the question
as
to whether it's safe to spare cancerous lymph nodes in women who don't get
radiation.
While
doctors up-to-date on the latest research may be eager to spare patients
unnecessary side effects,
they
may have a tough time convincing some women that it's okay to leave potentially
cancerous lymph
nodes
in the body.
Golshan
says he saw two patients yesterday who had a single positive node and early
stage cancer. He
offered
both the lymph node sparing surgery but only one took him up on it.
February
9, 2011 - Toronto Physiotherapy promotes awareness, education, and treatment of
chronic
swelling
called Lymphedema – by rdavey –
Toronto
, Ontario - February, 2011 - Toronto Physiotherapy, a leading provider of
healthcare in Toronto,
is
providing free Lymphedema services to individuals in financial need, and
offering on-line education
resources
to promote disease awareness.
Lymphedema
is a serious condition caused by a failure of the lymphatic system to maintain
the proper
balance
of fluid in an affected tissue. The resultant accumulation of lymphatic fluid,
usually in an arm or leg,
can
be painful, disabling, and disfiguring. In extreme cases, Lymphedema can lead
to serious infection or
even
a rare form of cancer called lymphangiosarcoma. Lymphedema frequently arises
in cancer patients
(in
particular breast cancer) following surgical lymph node removal or radiation
treatment, but can also
occur
congenitally. Although Lymphedema is a chronic disease, with proper symptom
management and
prevention
individuals with Lymphedema can enjoy a normal and active lifestyle.
Unfortunately,
many individuals with Lymphedema are unaware of simple self-management
practices, or
the
availability of effective tools to combat the disease including compression
garments and manual
lymphatic
drainage therapy. “To further compound this problem, proper Lymphedema
education and
therapy
is often unavailable or too costly for individuals with limited financial
resources” says Clinic
Director
Lindsay Davey, “as a consequence, patients with Lymphedema tend to withdraw
from normal
activities
due to discomfort, physical restrictions, or embarrassment”.
To
combat the lack of awareness and treatment of Lymphedema, Toronto Physiotherapy
is developing
educational
tools including online resources and self-management video
(http://www.torontophysiotherapy.ca/services/toronto_lymphedema_treatment.html),
as well as offering
Certified
Lymphedema Physiotherapy services including a complimentary service for
individuals with
limited
financial resources.
To
assist low-income individuals, Toronto Physiotherapy provides a complimentary
assessment of the
patient's
Lymphedema case history, as well as education on effective self-management
techniques and
other
treatment options available including the suitability of compression garments.
Toronto Physiotherapy
is
also a Certified Compression Garment Authorizer through the Government of
Ontario’s Assistive
Devices
Program (ADP), and can recommend and authorize therapeutic garments to
Lymphedema
patients
so that they can access the ADP subsidization.
About
Toronto Physiotherapy
Toronto
Physiotherapy (http://www.torontophysiotherapy.ca) is a leading Toronto-based
provider of allied
health
care services including traditional Orthopedic Physiotherapy and Massage
Therapy, as well as a
suite
of specialized services that includes Neurological Physiotherapy, Nutrition
Counseling, Acupuncture,
Manual
Lymphatic Drainage and Home Care Physiotherapy. Toronto Physiotherapy is
certified in
Combined
Decongestive Therapy for Lymphedema and is also a Certified Compression
Garment
Authorizer.
Contact:
Lindsay
Davey
Clinic
Director
416-792-5115
741
Broadview Ave., Suite 206
Toronto,
Ontario, Canada, M4K 3Y3
[email protected]
http://www.torontophysiotherapy.ca
February
9, 2011 - Will Treatment For Early-Stage Breast Cancer Change? - Wall Street
Journal (blog) -
By
Katherine Hobson –
New
research published in the Journal of the American Medical Association — on top
of previous studies
—
should change how certain early-stage breast cancer patients are treated, the
New York Times reports.
The
study subjects were breast cancer patients with early-stage tumors and cancer
in one or two lymph
nodes
in the armpits but no further spread. These women were treated with a
lumpectomy followed by
radiation
and chemo or other drug treatment. (About 20% of breast cancer patients fit
that bill, the NYT
says.)
The study found that these patients don’t benefit from having the cancerous
lymph nodes — as well
as
others — removed (beyond the initial biopsy, that is).
Given
the breast surgery and other treatments, you might think that taking out a few
lymph nodes is no big
deal,
but that’s not true. There can be painful complications, including lymphedema,
a debilitating swelling
of
the arm. An author of an editorial accompanying the study tells the paper that
he has a feeling “we’ve
been
doing a lot of harm” by taking out so many nodes as a matter of
course.
But
the story raises the question of how quickly surgeons will change their
practice. The paper says
Memorial
Sloan-Kettering Cancer Center changed its own guidelines already, based on an
early peek at
this
study, but that “more widespread change may take time, experts say, because the
belief in removing
nodes
is so deeply ingrained.”
A
study author and Sloan-Kettering physician tells the NYT that it’s much easier
for doctors and patients
to
accept a study pointing to an increase in cancer treatment rather than a
decrease.
February
9, 2011 - Consults: Q. & A.: Breast Cancer and Lymph Nodes - New York Times
(blog) –
An
article in Wednesday’s Times describes how a routine procedure for the
treatment of early breast
cancer
— the surgical removal of cancerous lymph nodes from the armpit — has been found
unnecessary
for
many patients. The finding turns 100 years of standard medical practice on its
head.
Today
the author of the article, Denise Grady, is taking questions about the finding
and its implications.
Please
post your questions in the Comments box below.
Q.From
what I understand, removing even only one or two lymph nodes can result in
chronic swelling of
the
arm. How certain is it that taking fewer nodes will result in a measurable
reduction in the risk of
developing
lymphedema?
—
Claudia Boyle, Mount Prospect, Ill.
A.There
is still a risk of lymphedema even after only a few nodes are taken for
sentinel biopsy, but the risk
is
much lower than when many nodes are removed.
Q.Is
there any information on the advisability of not doing the lymph node removal
for women who had a
mastectomy,
chemotherapy and radiation rather than lumpectomy?
—
Donna Landerman, Bloomfield, Conn.
A.The
results apply to women whose condition is like those in the study: stage T1 or
T2 tumors (less than
two
inches across), no palpable lymph nodes, no metastases to other parts of the
body and no more than
two
positive lymph nodes on the sentinel node biopsy. A woman with these
characteristics who is having a
mastectomy
and the other treatments would seem to fit the bill, but the ultimate decision
has to be made
with
a surgeon and an oncologist.
Q.My
breast surgeon told me that lymph node ratio is also important, and I’ve seen
studies to support it.
They’ve
shown that a person who has 1 positive lymph node out of 20 removed does better
than a person
who
had 1 out of 5 who does better than the person who had 1 out of 1. This implies
that that there is
some
survival benefit to the patient who has more nodes removed. Can you find out
from your sources:
what
about the studies that show that lymph node ratio is important? Does this new
study trump them, and
if
so why? Also, what about the length of follow-up in this study?
Breast
cancer can recur at any time — even 25 years after initial diagnosis. I’m very
glad for all these
treatments
that improve 5-year survival rates, but are they just pushing back our relapses
to a later date? If
so,
the results of this study may be premature. Are they planning to continue
following-up on these patients?
—
Breast Cancer Patient, NYC
A.There
is evidence that a higher number of positive nodes is associated with a worse
outcome, because it
may
mean that the cancer is more advanced or spreading more quickly. In the past,
the number was used
to
help plan what kind of chemotherapy to give. But the doctors interviewed for
the article published on
Wednesday
said that in most cases nowadays, the number of lymph nodes does not determine
the
treatment.
Women with any positive nodes are advised to have chemotherapy or
hormone-blocking
treatment,
or both, and the chemotherapy is the same regardless of the number of
nodes.
As
the article states, the researchers considered the follow-up time long enough
to detect a difference in
local
cancer recurrence rates, meaning in the armpit, because those tend to occur
fairly early. There was no
difference.
A local recurrence is not trivial: It would require more treatment, and 20 to
25 percent of
women
who have local recurrences ultimately die from the cancer.
It
is true that cancer can return at any time. More follow-up time would be more
reassuring. I don’t know
whether
there will be continuing follow-up of these women, but I will ask and post the
answer.
Q.My
niece has Stage 3C melanoma. She recently had a number of lymph nodes removed.
She originally
had
two nodes removed that were diagnosed as positive. Thereafter, she had
additional nodes removed
that
were negative. Does the data you’ve written about, as it pertains to lymph
nodes, translate to specific
cancers
other than breast cancer?
—
Dave Collopy, Hilo, Hawaii
A.No,
the data really applies only to patients with breast cancer, and only to breast
cancer patients like the
women
in the study.
Q.I
am curious about your opinion of reaching a negative conclusion based on a
statistical sample. First of
all,
the type of error that may be associated with such a conclusion — i.e. that
there is in fact a difference
that
was not detected — is typically not controlled and therefore can float to
unknown values.
Second,
there is little discussion in the newspapers about the fact that your or any
metanalysis is no more a
guarantee
than any initial study, but merely a statistical evaluation of the likelihood
of having detected (or
not
detected) a real effect.
—
Dr. S, Valhalla, N.Y.
A.The
New York Times did not reach a conclusion. We are reporting the conclusion that
the authors of a
peer-reviewed
journal article reached, that the editorialist in the journal supported, and
that cancer centers
are
already putting into practice. We did ask two independent experts on medical
statistics at two different
universities
to evaluate the study. They had some quibbles, but nothing serious enough to
throw the findings
into question. This was not the first study in this area; there have been others in the past, all pointing in the
same
direction — to the idea that at least some patients can be spared axillary
dissection and the serious
complications
that it can cause.
Q.I
have not seen raised in this discussion the issue of genetic findings related
to the familial propensity for
breast
cancer if that diagnosis is a part of the clinical picture. How are suspected
lymphatic involvement
and
possible surgical intervention influenced by genetic findings? Thank
you.
—
MJM, Shenandoah Valley, Va.
A.We
asked this question of Dr. Monica Morrow, an author of the study and chief of
the breast service at
Memorial
Sloan-Kettering Cancer Center in Manhattan. Her reply:
Genetic
breast cancer doesn’t influence how we treat the nodes. Due to the increased
risk of second
breast
cancers, many of these women chose mastectomy. Women with mastectomy require
axillary
dissection
if the nodes are involved.
Q.Surgeons
have been removing lymph nodes from the armpits of breast cancer patients for
100 years.
Why
has it taken so long to find out that not every patient needs this
surgery?
A.The
procedure is a holdover from the era of the radical mastectomy, before
radiation treatment and
chemotherapy
existed and when the only hope for controlling cancer was to try to cut it all
out. Removing
lymph
nodes became part of the standard of care, because the nodes might harbor
cancer cells that could
spread
around the body.
Before
the sentinel node technique was developed, there was no way to find which nodes
were most likely
to
be the ones where cancer cells would land; to be on the safe side, the only
thing surgeons could do was
to
take out as many nodes as possible. Women suffered from side effects, like
lymphedema, that could be
severe,
but the prospect of a cancer recurrence was worse, so doctors and patients
alike were afraid of
what
would happen if the nodes were not removed. Only when it became apparent that
the sentinel node
biopsy
was reliable did it become possible to ask the next question: If just one or
two nodes are positive,
do
they all have to come out? The answer seems to be no.
Part
of what makes it possible to leave the nodes alone is that there are now more
effective combinations
of
chemotherapy and radiation, which can wipe out microscopic traces of disease
that might be left behind.
Q.Which
women still need to have their lymph nodes dissected?
A.Surgeons
say that the lymph nodes must come out if they are big enough to feel or show
up as cancerous
on
imaging. Surgeons will also remove nodes if there are three or more positive
sentinel lymph nodes
(sentinel
lymph node biopsy is described in the article).
Surprises
can also turn up in the operating room, doctors say. Occasionally, the sentinel
node biopsy will
give
a false-negative result, which means failing to find cancer even though it is
present. That can happen if,
for
instance, the sentinel node is very cancerous and the lymphatic vessels that
feed it are choked off and
do
not pick up the dye. Then, the dye may go to a different node, one that does
not have cancer. Knowing
this
is possible — and knowing that the sentinel node biopsy, though highly
reliable, is not infallible —
surgeons
look and feel around in the armpit carefully during the operation and make
judgment calls about
what
to remove and what to leave alone.
Q.Why
are the study findings said to apply only to women who have whole-breast
irradiation, and not
partial
breast irradiation?
A.Whole-breast
irradiation hits part of the armpit, and therefore some of the lymph nodes.
This is what the
women
in the study received, and researchers think it may have wiped out any cancer
in the nodes that
were
left behind. They say they are also unsure about whether the findings would
apply to women who
have
irradiation while lying prone, on their stomachs. In that position, the
radiation may not reach the armpit.
Q.The
study findings apply to 20 percent of patients — about 40,000 women a year in
the United States,
according
to your article. What about the other 80 percent?
–
Brandon, Berkeley, Calif.
A.Here
is a further explanation: First of all, 20 percent (the estimate of the study’s
lead author, Dr.
Armando
E. Giuliano) refers to 20 percent of all the newly diagnosed cases of invasive
breast cancer each
year.
This does not include noninvasive breast cancer, or DCIS, ductal carcinoma in
situ. The total is about
207,000,
so 20 percent is roughly 40,000 women. That is about how many women would match
those in
the
study, in terms of tumor status, affected lymph nodes and course of
treatment.
To
answer the question about the other 80 percent, we need to look at how many
women get a breast
cancer
diagnosis at various stages. The figures from the American Cancer Society
indicate that 60 percent
of
all patients have “localized” breast cancer. That means they do not have
affected lymph nodes. They do
not
have to worry about extensive axillary dissection, as lymph node removal is
known; their sentinel node
will
be clean. Another 33 percent of women have “regional” disease, meaning that the
cancer has reached
lymph
nodes. These are the patients who might match those in the study.
By
Dr. Giuliano’s estimate, about two-thirds of these women will match the study
criteria, and one-third
will
not, so for that one-third, about 10 percent of breast cancer patients over
all, node dissection may be
needed.
Another 5 percent of all patients have “distant” disease at the time of
diagnosis, meaning the
cancer
has already spread to organs or bones. I don’t know if lymph node surgery is of
use or benefit to
women
whose disease is already advanced. In the remaining 2 percent of cases, the
stage of the disease at
diagnosis
is not known.
February
9, 2011 - Lymphedema Awareness Day is March 6th - Wire Service Canada (press
release) –
by
LymphedemaDepot –
The
17th annual Lymphedema Awareness Day will be observed across Canada and the US
on March 6,
2011.
Lymphedema is a condition of chronic swelling that affects a limb or other body
part due to an
accumulation
of lymph fluid.
Lymphedema
Depot, the importer and distributor of Solaris lymphedema care products in
Canada, is
helping
to promote Lymphedema Awareness Day this year.
February,
2011--- Lymphedema Awareness Day will be observed across Canada and the US on
March
6,
2011. Lymphedema Awareness Day is meant to bring public attention to this
medical condition.
Lymphedema
Depot, the importer and distributor of Solaris lymphedema care products in
Canada, is
helping
to promote Lymphedema Awareness Day this year.
“As
a therapist and clinician, I have been in a position to hear from patients
firsthand how frustrating it is to
try
to get treated for lymphedema,” says Lymphedema Depot Clinical Specialist John
Mulligan, a
Registered
Massage Therapist and Certified Lymphedema Therapist.
“Lymphedema
is diagnosed more than it used to be, but it is still under-treated. There are
not enough
practicing
lymphedema therapists,” said Mulligan. “I would hope that with increased public
awareness of
lymphedema
more therapists would be moved to get trained in lymphedema therapy. It is a
fascinating
field.”
Lymphedema
is a condition of chronic swelling that affects a limb or other body part due
to an
accumulation
of lymph fluid. You can be born with lymphedema or it can be acquired after a
traumatic
injury,
severe infection or surgical removal of lymph nodes. Lymph nodes are often
removed for the staging
of
cancer, to determine if cancer cells are spreading to the lymph system. In
sub-tropical countries
lymphedema
can be acquired from parasites.
Lymphedema
is not curable, but it can be managed through a blend of therapy techniques
that do not
involve
surgery or drugs.
In
North America, lymphedema has become known as the most-feared complication of
cancer, and yet
those
who fear it know very little about it. Lymphedema Awareness Day is a chance to
share information
about
lymphedema, clearing away some of the mystery and helping to raise awareness of
the condition and
the
need for effective treatment, funding for treatment and further
research.
In
Germany lymphedema treatment became reimbursable by national health insurance
in 1974, based on
research
done throughout the 1960’s by Dr. Johannes Asdonk and others. The treatment for
lymphedema
is
called Complex Decongestive Therapy and consists of manual lymph drainage,
multi-layer compression
bandaging,
exercise and meticulous skin care. In Canada, Complex Decongestive Therapy is
not
reimbursable
by any private, federal or provincial funding source, although separate aspects
of the protocol
can
be reimbursable on their own.
This
lack of comprehensive reimbursement causes real hardship to many lymphedema
patients. This is a
condition
that involves expert treatment, with costs being incurred by the need for
hands-on therapy and
education.
The patient requires hundreds of dollars’ worth of compression bandaging
supplies in addition
to
compression garments for day and night use. Without comprehensive coverage for
therapy the patient
must
seek funding for each aspect of lymphedema care separately, and often they must
pay for some parts
of
this complex therapy out of their own pockets.
In
Canada lymphedema patients must navigate a patchwork of payment sources in
order to obtain therapy.
These
payment sources are typically a mix of third party health insurance and cash
out of the patient’s own
pocket.
Patients without health insurance or the means to pay privately will simply not
get the therapy they
need.
This means living with a progressively swelling limb. Untreated lymphedema
leads to an increased
risk
of cellulitis infections, the most serious and common of lymphedema
complications. The cost of treating
patients
with these infections can be greater than the cost of proper, timely
treatment.
In
observance of Lymphedema Awareness Day on March 6, 2011, we encourage you to
print this article
and
give copies to your doctor, friends, MP or anybody who might be interested in
the treatment of
lymphedema
and associated costs and risks.
To
learn more about lymphedema, see the Lymphedema Depot’s page of links, a
clickable list of
lymphedema
resources: http://www.lymphedemadepot.com/links
To
learn more about Lymphedema Awareness Day please visit our website at
http://www.
lymphedemadepot.com
and click on the Lymphedema Awareness Day logo.
To
contact Lymphedema Depot directly email [email protected]
February
10, 2011 - health calendar - Washington Post –
Tina,
this is announcing stuff that has now happened, sorry
February
10, 2011 - Cancer Treatment: Breast Cancer Surgery Could Become Less Invasive –
ThirdAge
–
By Nina Sen –
Breast
cancer treatment could become less invasive, according to a new
study.
According
to a new study published in the Journal of American Medical Association, some
women may
not
need to have a painful procedure called axillary lymph node dissection. This
procedure aims to remove
nodes
around tumors that could also be cancerous. However, it is often painful and
could cause infection
or
lymphedema.
“Women
really dread the axillary dissection,” said chief investigator Dr. Giuliano,
head of surgical oncology
at
the John Wayne Cancer Institute at St. John’s Health Center in Santa Monica,
Calif., according to the
New
York Times. “They fear lymphedema. There’s numbness, shoulder pain, and some
have limitation of
motion.
There are a fair number of serious complications. Women know it.”
The
study examined more than 800 patients with early-stage tumors. All the patients
had only part of their
breast
removed in a lumpectomy. Additionally, they had radiation therapy and some had
chemotherapy.
February
10, 2011 - Pharmacy boutique focuses on needs of breast-cancer patients –
ModernMedicine -
By:
Christine Blank –
An
independent drugstore recently expanded its boutique section for breast-cancer
patients to include a
wide
variety of medical products and clothing.
Lehan
Drugs and Home Medical Equipment in DeKalb, Ill., now includes a
2,500-square-foot Women's
Health
Department and Boutique that boasts 3 private dressing rooms and 3 certified
lymphedema garment
fitters.
The
Lehan family, which includes owners Tim and Ann Lehan; their daughter-in-law
and pharmacist son;
Tim's
brother, Patrick; and his sister, Terri Lehan Hettel, first added women's
health products to the drug-
and
medical-equipment store 7 or 8 years ago, after cancer patients visiting the
store asked for
lymphedema
compression socks. "We wanted to be certified fitters in lymphedema garments,
and it
became
obvious to us that we needed to start looking into being a mastectomy fitter,"
said Lehan Hettel,
who
manages the store. Many specialized products followed.
Today's
expanded Women's Health Department and Boutique features products for all
women. "We do
bra
fittings for everyone, and we have everything from 'hot flash pajamas' to
scarves to hats with built-in
sun
protection," Lehan Hettel said.
More
than 90 area doctors refer their breast-cancer patients to Lehan's. And because
it is the only
drugstore
in the community to offer this service, new patients consistently seek out
Lehan Drugs.
February
10, 2011 - New Breast Cancer Treatment: Don't Remove Lymph Nodes – NewsTabulous
–
posted
by Mary –
For
years if you had breast cancer, then doctors would remove your lymph nodes
which can cause
extreme
swelling, pain, and even Lymphedema. New studies show that in early stages of
breast cancer the
lymph
nodes do not have to be removed.
This
may come as a shock to most women and families. Before this discover, when ever
you were thought
to
have breast cancer the doctors would take a sample of the sentinel lymph nodes.
These are the first
nodes
that they find in the channel of lymph nodes, and then test them to see if they
were positive or
negative
for cancer. If you were positive they would just remove all of the lymph
nodes.
This
was thought to be the best way to help to prevent the spread of the disease
into other parts of the
body
including the liver and brain. New studies show that if you are in the early
stages of breast cancer
and
your tumor isn’t more than 1 1/2 – 2 cm, then you don’t have to have these
lymph nodes removed.
The
reason, Dr. Cynara Coomer, says: “it doesn’t effect survival rates or
reoccurrance rates” and it “doesn’
t
help cure breast cancer”. Dr. Cynara Coomer, says that this is only for about
20% of women with breast
cancer.
It’s important to catch the cancer in the early stages, have a small tumor, and
minimal disease in
sentinel
lymph nodes.
Women
who have been diagnosed with breast cancer still need radiation and chemo
treatment.
Dr.
Cynara Coomer, is a Fox News medical contributor who is fighting thyroid cancer
and is undergoing
Radioactive
Iodine Treatments and is playing a big part in these new findings and in
getting the word out.
It’s
estimated that 207,000 women were diagnosed with breast cancer in 2010 and that
there is 2.5 million
breast
cancer survivors living in the United States alone. About 1 in 4 cancers are
breast cancer. This will
be
a nice alternative for many breast cancer patients that are looking for an
alternative breast cancer
treatment.
February
11, 2011 - New Study Supports Less Surgery for Breast Cancer - Huffington Post
(blog) – by
Dr. Elaine
Schattner –
A
new report in the Journal of the American Medical Association may influence --
and reduce -- surgical
treatment
for many women diagnosed with breast cancer. The key finding is that for women
with
apparently
limited disease before lumpectomy and what's called a positive sentinel node,
taking out all the
cancerous
nodes from the axilla (armpit) has no survival advantage after five
years.
I've
reviewed the study in more detail, elsewhere. It's got a lot of strengths: it's
randomized, Phase III and
multi-institutional
-- meaning that the trial was carried out by many surgeons caring for patients
at a variety
of
medical centers. In total, 891 women were enrolled, all of whom had clinically
small tumors and a
positive
sentinel node. Half of the patients underwent complete axillary lymph node
dissection; the others
did
not. Nearly all got chemotherapy; some received endocrine treatments.
What
the researchers found is that removing additional glands didn't improve
survival in women who had
positive
(involved) sentinel nodes upon lumpectomy. This finding supports that for
breast cancer patients
with
small tumors who will undergo radiation and chemotherapy, it's OK for surgeons
to leave malignant
lymph
nodes in place rather than remove those by more aggressive surgery.
Why
this matters:
For
women with apparently limited (stage I or II) breast cancer at the time of
diagnosis, approximately 20
percent
will turn to have a positive lymph node. Up until now, the usual care of those
patients has included
a
complete axillary lymph node dissection. During that part of surgery, typically
10 to 25 lymph nodes are
removed.
This procedure can lead to lymphedema, a condition of chronic arm and hand
swelling that can
be
painful and disabling.
Lymphedema
affects a small but significant fraction of the growing ranks of women
--approaching 3 million
in
the U.S. -- who are alive after breast cancer treatment. So if the axillary
lymph node dissection can be
eliminated
from the standard breast cancer surgery process, that would spare a lot of
women from an
uncomfortable,
compromising situation.
The
implications bear on costs and risks of breast cancer care, apart from the
lymphedema effects. There
would
be less time in the O.R. and reduced costs of pathology (think of examining one
lymph node instead
of
20 in 100,000 to 200,000 surgeries per year in the U.S.). There'd be less time
under anesthesia. With
fewer
lymph nodes removed, the risk of infection in a woman's hand or arm
diminishes.
An
irresistible aside to this story is that the findings should lessen the "costs"
side of any mammography
equation:
With the application of these results, expenses and potential complications of
breast cancer
treatment
will be reduced.
Why
aren't the results surprising?
Breast
cancer treatment, and our understanding of breast cancer biology, has advanced
steadily in the past
25
years. Now it's routine to give treatments -- like chemotherapy, hormone
modulators or antibodies like
Herceptin
-- that target breast cancer cells wherever they reside in the body. The whole
point of adjuvant
therapy
is to destroy malignant cells remaining after surgery. If there are residual
lymph nodes with
malignant
cells in the armpit region after surgery, those would likely be destroyed by
chemotherapy and
other
treatments, combined with radiation to the affected chest and underarm
area.
What
are the study's limitations?
What's
not adequately addressed in the paper and editorial, I think, is the situation
of women who undergo
mastectomy
and don't get radiation to the region, as is standard after lumpectomy. As much
as I'm drawn
to
the "less is more" approach to cancer therapy, I don't know that we can
extrapolate these data to the
circumstances
of women who don't get radiation.
Another
limitation is the study's relatively short follow-up of just over five years.
This is a valid concern in
any
study of breast cancer survival, but my own opinion is that the axillary node
intervention is unlikely to
result
in a big difference later. That's because in 2011 what matters most for
treatment decisions in breast
cancer,
after diagnosis and initial surgery, is the nature -- in terms of genetic and
molecular features -- of
the
malignant cells.
General
implications:
When
I studied oncology, the dogma was that the prognosis in breast cancer rests on
the size of the tumor
and
the number of lymph nodes involved. But that was 20 years ago. Now we know that
tumor markers --
if
the cells express estrogen or progesterone receptors, HER2, as well as other
factors including genetic
mutations
that affect the malignant cells's aggressiveness and responsiveness to
treatment -- are at least as
important
in determining outcome. So although some physicians will express concern that
we need the full
lymph
node pathology results to establish the prognosis and formulate treatment
recommendations, I think
in
2011 we can do better using molecular, modern predictors of disease
responsiveness.
Finally,
there's a suggestion in some of the coverage that doctors and patients may have
a hard time
accepting
"less" as better treatment for this disease. I don't really think that's the
case anymore, at least not
for
patients. From my experiences as an oncologist, as a breast cancer patient and
knowing so many
women
who've undergone debilitating treatments, I expect most patients will accept
this development as
progress
and a sound reason to avoid extra surgery. It may be the physicians who need be
persuaded that
taking
out all the lymph nodes does not improve a breast cancer patient's
prognosis.
Toronto
Physiotherapy, a leading provider of healthcare in Toronto, is providing free
Lymphedema
services
to individuals in financial need, and offering on-line education resources to
promote disease
awareness.
Toronto,
Canada, February 11, 2011 --(PR.com)-- Lymphedema is a serious condition caused
by a
failure
of the lymphatic system to maintain the proper balance of fluid in an affected
tissue. The resultant
accumulation
of lymphatic fluid, usually in an arm or leg, can be painful, disabling, and
disfiguring. In
extreme
cases, Lymphedema can lead to serious infection or even a rare form of cancer
called
lymphangiosarcoma.
Lymphedema frequently arises in cancer patients (in particular breast cancer)
following
surgical lymph node removal or radiation treatment, but can also occur
congenitally. Although
Lymphedema
is a chronic disease, with proper symptom management and prevention individuals
with
Lymphedema
can enjoy a normal and active lifestyle.
Unfortunately,
many individuals with Lymphedema are unaware of simple self-management
practices, or
the
availability of effective tools to combat the disease including compression
garments and manual
lymphatic
drainage therapy. “To further compound this problem, proper Lymphedema
education and
therapy
is often unavailable or too costly for individuals with limited financial
resources,” says Clinic
Director
Lindsay Davey, “as a consequence, patients with Lymphedema tend to withdraw
from normal
activities
due to discomfort, physical restrictions, or embarrassment.”
To combat the
lack of awareness and treatment of Lymphedema, Toronto Physiotherapy is
developing
educational
tools including online resources and self-management video
(http://www.torontophysiotherapy.
ca/services/toronto_lymphedema_treatment.html),
as well as offering Certified Lymphedema Physiotherapy
services
including a complimentary service for individuals with limited financial
resources.
To
assist low-income individuals, Toronto Physiotherapy provides a complimentary
assessment of the
patient's
Lymphedema case history, as well as education on effective self-management
techniques and
other
treatment options available including the suitability of compression garments.
Toronto Physiotherapy
is
also a Certified Compression Garment Authorizer through the Government of
Ontario’s Assistive
Devices
Program (ADP), and can recommend and authorize therapeutic garments to
Lymphedema
patients
so that they can access the ADP subsidization.
About
Toronto Physiotherapy
Toronto
Physiotherapy (http://www.torontophysiotherapy.ca) is a leading Toronto-based
provider of allied
health
care services including traditional Orthopedic Physiotherapy and Massage
Therapy, as well as a
suite
of specialized services that includes Neurological Physiotherapy, Nutrition
Counseling, Acupuncture,
Manual
Lymphatic Drainage and Home Care Physiotherapy. Toronto Physiotherapy is
certified in
Combined
Decongestive Therapy for Lymphedema and is also a Certified Compression
Garment
Authorizer.
Contact:
Lindsay
Davey
Clinic
Director
416-792-5115
741
Broadview Ave., Suite 206
Toronto,
Ontario, Canada, M4K 3Y3
[email protected]
http://www.torontophysiotherapy.ca
February
12, 2011 - Cape docs: Aggressive breast cancer surgery likely reduced – TMCnet
–
Feb
12, 2011 (Cape Cod Times - McClatchy-Tribune Information Services via COMTEX)
-- Doctors
expect
a decline in the number of Cape patients who undergo extensive lymph node
removal to combat
early-stage
breast cancer, following a new study on the efficacy of the surgery.
The
study, which appeared Wednesday in the Journal of the American Medical
Association, said there
was
virtually no difference in the survival rates of early-stage breast cancer
patients who had all their lymph
nodes
removed and those who had only a few nodes removed.
"We
kind of knew it was coming," said Dr. David Lovett, a medical oncologist at the
Davenport-Mugar
Cancer
Center at Cape Cod Hospital.
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"We
were probably doing too much surgery on folks with breast cancer," he
said.
Annually,
about 75 out of 300 newly diagnosed breast cancer patients at Cape Cod Hospital
have a
procedure
called axillary lymph node dissection, which removes all the lymph nodes found
in the armpit,
said
Dr. Robyn Sachs, breast surgeon at the Hyannis hospital.
She
expects that number to go down by about 50 patients because the new study shows
the benefits of
less
radical surgery.
Researchers
studied women who had undergone a lumpectomy to remove a breast cancer tumor as
well as
radiation
and, in some cases, chemotherapy.
By
removing a few lymph nodes through a process called sentinel lymph node
dissection they identified
890
women whose cancer had spread to one or two "sentinel" nodes, to which fluid
first drains from the
breast.
Of
these women nearly half -- 446 -- were randomly selected to receive the more
extensive axillary
surgery.
After
following the women for just more than six years, researchers found mortality
and five-year survival
rates
were virtually the same in both groups of women, as was the rate at which women
were disease-free
after
five years. But those who experienced the more radical surgery had higher rates
of swelling, called
lymphedema,
as well as tingling, numbness, pain and wound infection.
The
complication rate was 25 percent among those who'd just had a few nodes removed
but 70 percent
among
axillary patients.
"This
leaves patients with all kinds of problems," Nancy Ferzoco, breast care nurse
at Falmouth Hospital,
said
of the more radical surgery.
Lymphedema
can become a lifelong issue, she said. "It's painful. The arm can swell up to
three times its
normal
size," requiring breast cancer survivors to wear a special compression
sleeve.
Women
have 10 to 40 lymph nodes under their armpits. Balls of fluid the size of an
orange, called seromas,
also
can collect under the armpit and need to be aspirated, Ferzoco said.
Some
patients complain for years about damage to sensory nerves, she said.
Now,
the standard practice of going after all or most of the lymph nodes after
getting a positive cancer
reading
on one node will end, Lovett said.
Most
of the time, the cancer in one or two "simple" sentinel nodes has not spread,
Sachs said. She said that
patients
with aggressive tumors and a large amount of disease in the surrounding lymph
nodes will still need
the
axillary procedure.
The
new information is part of the evolutionary refinement of breast cancer
treatment, which has gone from
mastectomy
as the mainstay of treatment to the less invasive use of lumpectomy, Lovett
said.
Some
patients may need a measure of convincing that the less radical treatment is
just as good.
Jane
Mullenhour of Mashpee had a double mastectomy and 17 lymph nodes removed from
the area
around
her right breast five years ago and says she is happy with that
decision.
"How
do they know if it has gone into the lymph nodes if they don't take the lymph
nodes?" she asked,
adding
that she insisted on early treatment for her lymphedema symptoms.
"I
would rather be safe than sorry." To see more of the Cape Cod Times, or to
subscribe to the
newspaper,
go to http://www.capecodonline.com. Copyright (c) 2011, Cape Cod Times,
Hyannis, Mass
February
12, 2011 - Strength training does more than bulk up muscles - Los Angeles Times
– By Jeannine
Stein
–
It
may reduce depression, give older people better cognitive function, boost good
cholesterol and more.
Strength
training has strong-armed its way beyond the realm of bodybuilding.
A
growing body of research shows that working out with weights has health
benefits beyond simply bulking
up
one's muscles and strengthening bones. Studies are finding that more lean
muscle mass may allow
kidney
dialysis patients to live longer, give older people better cognitive function,
reduce depression, boost
good
cholesterol, lessen the swelling and discomfort of lymphedema after breast
cancer and help lower the
risk
of diabetes.
"Muscle
is our largest metabolically active organ, and that's the backdrop that people
usually forget," said
Kent
Adams, director of the exercise physiology lab at Cal State Monterey Bay.
Strengthening the muscles
"has
a ripple effect throughout the body on things like metabolic syndrome and
obesity."
Historically,
strength training was limited to athletes, but in the last 20 years, its
popularity has spread to the
general
public, said Jeffrey Potteiger, an exercise physiologist at Grand Valley State
University in Grand
Rapids,
Mich., and a fellow of the American College of Sports Medicine. "One can argue
that if you don't
do
some resistance training through your lifespan, you're missing out on some
benefits, especially as you get
older
or battle weight gain," he said.
When
we hit middle age, muscle mass gradually diminishes by up to about 1% a year in
a process called
sarcopenia.
Women also are in danger of losing bone mass as they age, especially after the
onset of
menopause.
Some studies have shown that moderate to intense strength training not only
builds skeletal
muscle
but increases bone density as well.
Strength
training often takes a back seat to cardiovascular training, but it can benefit
the heart in ways that
its
more popular cousin can't.
During
cardio exercise, the heart loads up with blood and pumps it out to the rest of
the body: As a result,
Potteiger
said, "the heart gets better and more efficient at pumping."
But
during resistance training, muscles generate more force than they do during
endurance exercises, and
the
heart is no exception, Potteiger said. During a strength workout, the heart's
muscle tissue contracts
forcefully
to push the blood out. Like all muscles, stress causes small tears in the
muscle fibers. When the
body
repairs those tears, muscles grow. The result is a stronger heart, not just one
that's more efficient at
pumping.
Another
big advantage of working out with weights is improving glucose metabolism,
which can reduce the
risk
of diabetes. Strength training boosts the number of proteins that take glucose
out of the blood and
transport
it into the skeletal muscle, giving the muscles more energy and lowering
overall blood-glucose
levels.
"If
you have uncontrolled glucose levels," Potteiger said, "that can lead to kidney
damage, damage to the
circulatory
system and loss of eyesight."
The
benefits don't end there. A 2010 study in the Clinical Journal of the American
Society of Nephrology
suggested
that people on dialysis can benefit from building muscle. Researchers found
that kidney dialysis
patients
who had the most lean muscle mass — a measurement derived from the
circumference of the mid-
arm
muscle — were 37% less likely to die than the patients who had the
least.
"This
is something that has an impact on survival," said Dr. Kamyar Kalantar-Zadeh, a
principal researcher
at
the Los Angeles Biomedical Research Institute and coauthor of the study. "It's
not just about having
more
muscle and looking better — we're talking about life and death."
Even
people who already have chronic kidney disease could benefit from strength
workouts. Germany
began
to incorporate modified exercise equipment into dialysis treatment centers in
1995, and a 2004
study
in the American Journal of Kidney Diseases examining that policy found that
exercise may improve
the
efficiency of dialysis by increasing blood flow through the muscle and
improving phosphate removal.
The
brain may get a boost from the body's extra muscle as well. A 2010 study in
Archives of Internal
Medicine found
that women ages 65 to 75 who did resistance training sessions once or twice a
week over
the
course of a year improved their cognitive performance, while those who focused
on balance and tone
training
declined slightly. One reason for the improvement, researchers believe, may be
that strength
training
triggers the production of a protein beneficial for brain growth.
This
study was triggered by another that looked at resistance training as a way to
reduce the risk of falls in
older
people, said coauthor Teresa Liu-Ambrose, a researcher at the University of
British Columbia's
Centre
for Hip Health and Mobility in Vancouver. As the study progressed, she said she
noticed that
participants
"were able to take on new tasks, like taking the bus by themselves. They were
able to prepare
and
plan for things and execute them."
Strength
training could be easier for people with mobility problems who might find it
easier to navigate a
stationary
weight than a moving treadmill.
"It's
never too late to start," Adams said. "The benefits are great."
February
13, 2011 - Women With Early Breast Cancer May Not Need Surgery - Care2.com
(blog) -
posted
by: Amelia Thomson-DeVeaux –
According
to new research findings, many early breast cancer patients won't have to have
the painful lymph
node
removal surgery that has, for over a century, been routine. This was because
the women in the study
had
chemotherapy and radiation, which most likely removed disease from the nodes,
despite the previous
assumption
that once these nodes are cancerous, they have the potential to spread to vital
organs and can
only
be removed by surgery.
According
to the new results, does not improve the patient's chance of survival or
decrease the likelihood
that
the cancer will return. And the surgery has significant complications, like
infection and lymphedema, a
chronic
swelling in the arm. It's not clear, though, whether the results are the same
for women who don't
have
chemotherapy or radiation.
The
study is especially newsworthy because it should change medical practice for
many patients. And it
may
take a while for doctors and patients to adjust to the idea that surgery is not
the best option. "This is
such
a radical change in thought that it’s been hard for many people to get their
heads around it,” said Dr.
Monica
Morrow, one of the study's authors. According to her, people find it easier to
accept the idea of
more
treatment instead of less, even if the data supports decreased
intervention.
In
the New York Times, Denise Grady points out the recent trend toward less
invasive treatments for
breast
cancer; mastectomy rates have dropped since the 1980's, and doctors now remove
large, dense
tumors
while using radiation to destroy smaller traces of the disease.
Although
it's good that doctors are responding well to the new research, this is a
reminder that medical
authority
is not infallible. That's why it's so crucial that studies like this continue,
and that we don't
unquestioningly
accept doctors' advice. One study co-author admitted that, by removing large
numbers of
nodes,
"I have a feeling we’ve been doing a lot of harm." And it does seem that if
women have been
having
these surgeries unnecessarily, they suffered through infection and lymphedema,
in addition to
chemotherapy
and radiation, for nothing. But we can't expect medicine to be perfect. And
so in that
sense,
a study like this is ultimately encouraging, if it means that women in the
future will be spared a painful
surgery.
February
13, 2011 -Toronto Physiotherapy Promotes Awareness, Education, and Treatment of
Chronic
swelling
called Lymphedema - PR-USA.net (press release)
Lymphedema
is a serious condition caused by a failure of the lymphatic system to maintain
the proper
balance
of fluid in an affected tissue. The resultant accumulation of lymphatic fluid,
usually in an arm or leg,
can
be painful, disabling, and disfiguring. In extreme cases, Lymphedema can lead
to serious infection or
even
a rare form of cancer called lymphangiosarcoma. Lymphedema frequently arises in
cancer patients (in
particular
breast cancer) following surgical lymph node removal or radiation treatment,
but can also occur
congenitally.
Although Lymphedema is a chronic disease, with proper symptom management and
prevention
individuals with Lymphedema can enjoy a normal and active lifestyle.
Unfortunately,
many individuals with Lymphedema are unaware of simple self-management
practices, or
the
availability of effective tools to combat the disease including compression
garments and manual
lymphatic
drainage therapy. “To further compound this problem, proper Lymphedema
education and
therapy
is often unavailable or too costly for individuals with limited financial
resources,” says Clinic
Director
Lindsay Davey, “as a consequence, patients with Lymphedema tend to withdraw
from normal
activities
due to discomfort, physical restrictions, or embarrassment.”
To
combat the lack of awareness and treatment of Lymphedema, Toronto Physiotherapy
is developing
educational
tools including online resources and self-management video
(http://www.torontophysiotherapy.
ca/services/toronto_lymphedema_treatment.html),
as well as offering Certified Lymphedema Physiotherapy
services
including a complimentary service for individuals with limited financial
resources.
To
assist low-income individuals, Toronto Physiotherapy provides a complimentary
assessment of the
patient's
Lymphedema case history, as well as education on effective self-management
techniques and
other
treatment options available including the suitability of compression garments.
Toronto Physiotherapy
is also a
Certified Compression Garment Authorizer through the Government of Ontario’s
Assistive
Devices
Program (ADP), and can recommend and authorize therapeutic garments to
Lymphedema
patients
so that they can access the ADP subsidization.
About
Toronto Physiotherapy
Toronto
Physiotherapy (http://www.torontophysiotherapy.ca) is a leading Toronto-based
provider of allied
health
care services including traditional Orthopedic Physiotherapy and Massage
Therapy, as well as a
suite
of specialized services that includes Neurological Physiotherapy, Nutrition
Counseling, Acupuncture,
Manual
Lymphatic Drainage and Home Care Physiotherapy. Toronto Physiotherapy is
certified in
Combined
Decongestive Therapy for Lymphedema and is also a Certified Compression
Garment
Authorizer.
Contact:
Lindsay
Davey
Clinic
Director
416-792-5115
741
Broadview Ave., Suite 206
Toronto,
Ontario, Canada, M4K 3Y3
[email protected]
http://www.torontophysiotherapy.ca
February
13, 2011 - Lymphedema Awareness in Ontario - Wire Service Canada (press
release) – by
LymphedemaDepot
–
Lymphedema
is a permanent condition of chronic swelling that is not difficult to treat.
Unfortunately, patient
access
to treatment is limited.
February,
2011---On March 6, 2011, lymphedema therapists, patients, patient advocates and
others will
observe
Lymphedema Awareness Day. While it is known that the condition of lymphedema is
under-
diagnosed
and under-treated, it is very difficult to find statistics on how many patients
in Canada suffer with
lymphedema.
In 2004, the Lymphedema Association of Ontario arrived at an estimate based in
part on
data
from Cancer Care Ontario:
Over
63,000 children and adults* live with primary or secondary lymphedema in
Ontario.
246,000
Ontario cancer survivors** are at a lifetime risk of developing
lymphedema.
Currently,
Ontario has just over 100 certified lymphedema therapists.
<>Some
parts of Ontario have little or no access to a certified lymphedema
therapist.
*
Lymphedema Association of Ontario estimate (2004).
**
Based on Cancer Care Ontario data (2004).
At
this time, this is the best estimate we have for how many people in Ontario
have lymphedema.
Lymphedema
is a condition of chronic swelling that affects a limb or other body part due
to an
accumulation
of lymph fluid. You can be born with lymphedema or it can be acquired after a
traumatic
injury,
severe infection or surgical removal of lymph nodes. Lymph nodes are often
removed for the staging
of
cancer, to determine if cancer cells are spreading to the lymph system. In
sub-tropical countries
lymphedema
can be acquired from parasites.
Lymphedema
is not curable, but it can be managed through a blend of therapy techniques
that do not
involve
surgery or drugs. This technique is known as Complex Decongestive Therapy
(CDT).
Unfortunately,
many physicians are not familiar with CDT, and, as a result, proper treatment
is under-
prescribed.
If
you know a cancer survivor, then you know someone who is at risk for developing
lymphedema. You
may
be able to help them understand this risk. Please learn more about this
condition by following the links
provided
below, and by talking about what you have learned.
Lymphedema
Depot, the importer and distributor of Solaris lymphedema care products in
Canada, is
helping
to promote Lymphedema Awareness Day this year.
To
learn more about lymphedema, see the Lymphedema Depot’s page of links, a
clickable list of
lymphedema
resources: http://www.lymphedemadepot.com/links
To
learn more about Lymphedema Awareness Day please visit our website at
http://www.
lymphedemadepot.com
and click on the Lymphedema Awareness Day logo.
February
14, 2011 - Breast cancer treatment in Minn. already following new study
guidelines - Minnesota
Public
Radio – by Lorna Benson –
St.
Paul, Minn. — Breast cancer care in the Twin Cities is rapidly moving toward
less aggressive surgery
for
the disease when it has migrated to a woman's lymph nodes.
Doctors
at several metro-area cancer centers say they have already dialed back their
surgical policies after
learning
about a stunning new study. The data showed there is no difference in survival
between women
who
had more of their lymph nodes removed and those who did not.
Breast
cancer patients say they're thrilled to have a less invasive treatment option,
that's equally effective.
The
study, published in the influential Journal of the American Medical
Association, captured news
headlines
across the nation last week.
But
as early as last September, breast cancer surgeon Todd Tuttle remembers reading
some preliminary
results
from the study in another, smaller journal, the Annals of Surgery. That article
prompted a lively
discussion
among Tuttle's colleagues at the University of Minnesota's Masonic Cancer
Center.
"This
is a practice-changing study. Breast centers all across the country are
deciding what to do with the
results
of this study," said Tuttle. "We've had the same discussions here. And it has
dramatically changed
our
practice."
Tuttle
says almost immediately after reading the study last fall, he and his
colleagues agreed they would no
longer remove
additional lymph nodes in early-stage breast cancer patients who had
microscopic disease in
their
lymph nodes.
Doctors
at the Piper Breast Center in Minneapolis made the same decision in December,
after bringing one
of
the study's authors to their center to answer questions about the data. Margit
Bretzke is a surgeon at
Piper.
"Whenever
we present a lumpectomy option to a patient now, and their nodes ... appear to
be negative,
we
talk about this study," said Bretzke.
Restraining
their surgical approach wasn't as easy as it sounds. Bretzke says there's a
long tradition among
breast
cancer surgeons of removing lymph nodes with any sign of cancer. But she says
the results of the
study
are just too compelling to ignore.
There
was no difference in recurrence of disease or survival between the women who
had the lymph node
procedure
and those who did not.
For
many patients, the change in treatment means they will have a much lower risk
of developing
lymphedema
-- a painful condition that causes swelling and numbness in the arm.
"That
was really comforting to know that I might not have to have more invasive
surgery," said Lucille, one
of
Dr. Bretzke's patients. "I was very aware of the possible outcome, and I know
people who have had
lymph
nodes removed and who suffer from lymphedema."
MPR
news agreed not to use Lucille's full name because she hasn't told all of her
family members about her
cancer
diagnosis.
Lucille,
53, says she feels fortunate that she received her diagnosis in time to take
advantage of the study.
Without
it, she probably would have had her lymph nodes removed
unnecessarily.
"It's
fantastic," she said. "It's wonderful that there's so much research going on.
And that the research
continues
to provide treatments that are less invasive."
But
patients should not assume that all breast cancer surgeons will be familiar
with the new data.
Margit
Bretzke at the Piper Breast Center says patients may need to advocate for
themselves.
"I
would tell women that when they're talking to their surgeon, to bring it up to
see if they're in fact a
candidate
for avoiding a node dissection," said Bretzke. "They need to challenge their
surgeon and ask the
question.
I would say if their surgeon doesn't seem to know what they're talking about,
they ought to get a
second
opinion."
Women
who are most likely to qualify for a less invasive breast cancer surgery must
have small breast
tumors
with no obvious sign of significant cancer in their lymph nodes on imaging
scans or during a physical
exam.
Candidates
must be willing to undergo a lumpectomy, followed by whole breast radiation and
possibly
chemotherapy
or hormone therapy to destroy any remaining cancer cells.
Women
who receive mastectomies without radiation or chemotherapy where not part of
the study, and
therefore,
not considered good candidates for this treatment option.
February
14, 2011 - Breast cancer finding to greatly change treatment - The Republic –
By Lindy
Washburn
–
HACKENSACK,
N.J. — Many women with breast cancer will no longer face a potentially
devastating
side
effect of their cancer surgery, as the conclusions of a newly published study
about the need to remove
underarm
lymph nodes are taken to heart by breast surgeons.
"This
was a celebratory day for me," said Dr. Laura Klein , medical director of The
Valley Hospital's
breast
center. "It's practice-changing. I personally will no longer be performing
axillary node dissections" on
women
who match the study criteria.
At
Holy Name Medical Center in Teaneck, N.J. , Dr. Erika Brinkmann , director of
the breast center, said
she
would act on the study results "immediately."
"It
will influence not only my practice but everyone's practice," said Dr. David
Pearlstone , chief of breast
surgery
at Hackensack University Medical Center . The medical center's breast-cancer
team, including
surgeons,
radiologists, medical oncologists and nurse practitioners, will discuss the
findings at its next
weekly
meeting on Wednesday, he said.
The
study, published Wednesday in the Journal of the American Medical Association ,
found that women
who
underwent lumpectomies for tumors of less than 2 inches and whose lymph nodes
did not have
obvious
signs of disease, showed no difference in survival if many lymph nodes were
removed or if only
their
sentinel nodes were removed.
Surgeons
will still remove one to three sentinel nodes, the first nodes that drain
lymphatic fluid from the
breast,
to see if the cancer is spreading beyond the breast. Finding cancer in those
nodes indicates that
disease
cells have migrated and could cause metastases elsewhere. Such patients almost
always are treated
with
chemotherapy.
But until now,
a finding of cancer in the sentinel node had led surgeons to remove more nodes
— either at
the
same time as the lumpectomy or with a return to the operating room later — to
try to make sure that no
cancer
cells remained in the body. The study showed that this makes no difference in
terms of cancer
recurrence
in the same breast, disease-free survival, or overall survival.
With
or without the additional surgery, called an axillary node dissection, more
than 90 percent of the
women
survived for five years. With or without it, the chance of a cancer recurrence
in the same breast
was
less than 4 percent.
That
conclusion upends one of the most closely held beliefs about cancer surgery,
that it is best to "get it all
out."
"As
cancer surgeons, it's anathema to us to know we leave cancer behind,"
Pearlstone said. "But here's a
study
that says, hey, it doesn't matter."
"We
always have felt that the role of the surgeon is to cut it all out," Brinkmann
said. "It's very hard not to
fall
into that hole. But we have to look at the data and the studies that have been
done. This will be the
standard
of care now" for women who match the study criteria.
The
findings further the trend toward less-invasive breast cancer treatment. In
recent decades,
lumpectomies,
when combined with radiation treatment, have been shown to be as effective as
mastectomies
for many women. And sentinel-node biopsies have replaced wholesale initial
excision of
lymph
nodes.
Knowing
how many additional lymph nodes contain cancer does not change decisions about
whether to
use
chemotherapy and what type of chemotherapy to use, said the study, by Dr.
Armando Giuliano of the
John
Wayne Cancer Institute in California and others.
Oncologists
increasingly base their chemotherapy treatment on the specific characteristics
of the patient's
tumor,
including the cells receptivity to estrogen and progesterone and their
molecular composition.
The
study is significant because for many women, the worst side effects of
breast-cancer surgery result not
from
the breast incision, but the lymph node removal. "A few women suffer medical
problems from having
a
sentinel node removed," Pearlstone said. "But many, many, many suffer medical
problems from having a
whole
lot" of nodes removed.
"There's
a lot going on in that area," under the arm, said Carolyn Monroe , a
nurse-practitioner in the
surgical
breast practice at Hackensack, N.J. "It's the junction from your arm to your
torso and shoulder
and
neck." Many muscles and nerves join and intersect.
Side
effects may include pain, tingling, numbness, weakness, tightening or a
cord-like feeling that can
extend
down the arm, and lymphedema, a permanent swelling that can limit motion and
for which there is
no
cure.
Recovery
after surgery is expected to be easier, too, because women will not require
underarm drains for
weeks
if they have not had multiple lymph nodes removed.
Some
surgeons said their patients were asking how the study conclusions would affect
them.
"I
had two new cancer consults (Wednesday)," Pearlstone said. "Both asked me about
it. On the way
home
I got three personal calls about it. Then my wife asked me if I'd seen the
'Today' show about it."
Klein,
at Valley in Ridgewood, N.J. , received several calls from patients whose
operations are on her
calendar.
"They said, 'We're not going to do an axillary lymph node dissection, are we?'"
she said. Women
embrace
the findings because of their worry over developing lymphedema.
For
one patient, the study was published at the perfect time. She won't have to go
back for further surgery
to
remove more lymph nodes, even though the sentinel node was positive for
cancer.
Surgeons
cautioned, however, that the study does not affect all women with breast
cancer. There is no
data
about women who undergo mastectomies, for example, or who have larger tumors.
And everyone in
the
study received "whole-breast radiation," which also irradiates the underarm
area.
They
were not treated with partial radiation, and they did not lie prone for their
radiation treatments, two
recent
innovations.
For
these women and others, more research is needed.
========================
February
15, 2011 - Susan G. Komen for the Cure® Awards Grants to Memorial - WDEF News
12 –
The
Susan G. Komen for the Cure Foundation awarded four grants to Memorial Health
Care System
totaling
more than $87,000.
Lymphedema
Treatment Assistance – The foundation awarded $14,500 to Memorial to provide
support
for
women newly diagnosed with breast cancer. The MaryEllen Locher Breast Center
has dedicated itself
to
providing support every step of the way beginning with education and a review
of the lymphatic system
and
signs and symptoms of lymphedema. The MaryEllen Locher Breast Center also
provides assistance
with
the garments necessary for lymphedema patients who do not have insurance and
would be burdened
by
purchasing them.
Access
to Mammograms – More than $52,600 was awarded to help provide access to
mammograms.
The
grant will help fund Memorial’s Mobile Coach outreach breast health education
program which
provides
mammograms for insured and uninsured women.
Breast
Health Day – A grant totaling $20,000 will help fund a series of breast health
educational programs
and
mammogram screenings to diverse populations with sensitive language and
cultural concerns.
February
15, 2011 - Restorix Health hyperbaric chamber leads to space-age medical
research - Issaquah
Press
– By Laura Geggel –
Mention
hyperbaric chambers, and most people start thinking about pressurized rooms
where scuba divers
afflicted
with the bends go to recover.
But
the chambers can be used for much more, and Issaquah’s Restorix Health plans to
participate in
hyperbaric
treatment and research to find other medical uses for the pressurized
chambers.
“We
think there is great potential nationwide for what they’re doing and what they
started in Issaquah,”
Issaquah
Chamber of Commerce CEO Matt Bott said, congratulating it for receiving one of
the chamber’s
three
Innovation in Issaquah awards.
Restorix
Health, which opened in Issaquah in December, has grand ambitions for its
comprehensive health
care
delivery system. With six hyperbaric chambers, it has the largest collection of
large monoplace
chambers
in the country. The chambers deliver oxygen with an increased atmospheric
pressure, and can
help
heal patients with diverse maladies, including diabetic patients who have dying
tissue deprived of its
regular
dose of oxygen.
“By
putting your whole body under pressure, we dissolve oxygen into the liquid part
of your body,”
Medical
Director Tommy Love said.
Increased
oxygen levels can stimulate different responses in the body, including faster
healing and increased
stem
cells, Medical Director Latisha Smith said.
Hyperbaric
chambers are approved for 14 treatments, and by opening 15 to 20 new clinics
along the West
Coast
in the next five years, Restorix Health will contribute to research looking for
more uses.
“Hyperbaric
therapy is another tool we can use to help heal wounds,” Love said. “We think
hyperbaric
therapy
can be beneficial in more things.”
A
handful of local health care centers have hyperbaric chambers, but their
chambers are often used for
paying
patients, not research, Love said. Restorix Health staff can easily schedule
patients and also have
room
for research participants, which will be double-blind studies in which neither
the patient nor the
doctor
know who is getting hyperbaric treatment in the chamber.
The
company’s nonprofit foundation is raising money to help pay for the research,
Love said. Much of the
research
will be done in concert with other hyperbaric facilities across the
country.
Some
of the studies will address concussions from vehicle accidents and sports
injuries, and traumatic brain
injuries
sustained in the U.S. armed forces.
The
company frowns on other hyperbaric companies that might “prey on desperate
people” looking for
miracle
cures, Love added.
At
Restorix Health, one health care worker monitors two chambers, and can use a
phone to communicate
with
the patients in the giant, clear tubes. Some patients watch TV, others read and
a few fall asleep during
their
two-hour treatments, Love said.
“A
lot of times you forget you’re in a vessel,” he said.
In
addition to its hyperbaric chambers, the clinic will also treat patients with
lymphedema, a disease that
happens
when a person’s lymphatic system is blocked and their leg or arm swells from
the increased fluid.
The
clinic has rooms dedicated to massage — so the patient’s lymphatic fluids can
start moving again —
and
has other rooms with wide doors so patients on stretchers can easily enter and
transfer to the
examination
chair.
A
spacious room with cushy chairs, wood floors and tall windows waits for
lymphedema patients receiving
IV
infusions. A nurses’ station is located behind a glass window, giving health
care workers the opportunity
to
monitor patients while entering information into electronic medical
charts.
Past
the nurses’ station is the pharmacy, a room where Restorix Health pharmacists
can prepare their own
drugs.
A room nearby serves as a dressing room for patients using the hyperbaric
chamber — they can’t
wear
polyester because its friction can cause sparks, a bad idea in a highly
oxygenated environment.
Restorix
Health does not plan to replace family doctors; it wants to work in tandem with
them on a referral
basis,
Smith said.
Bott
praised Restorix Health for its innovative ideas and encouraged it forward with
its research.
“Some
of the criteria that really stood out with them included the potential that we
felt they had with wound
treatment,
and the company’s affiliation with the research foundation,” he said. “We felt
that was an
innovative
model to drive wound treatment in this area.”
February
16, 2011 - Lymph Node Study May Revolutionize Breast Cancer Care - Citizens
Report –
A
recent study finds that women with early breast cancer do not need to undergo a
painful procedure long
thought
to be mandatory: removal of cancerous lymph nodes from the armpit. The news
impacts 40,000
women
a year in the United States for whom the surgery has no advantage.
Although
the treatment is standard, it can also cause complications that include
infection and lymphedema,
a
chronic swelling in the arm. Removing cancerous lymph nodes isn’t always
necessary, researchers say,
because
women in the study already had chemotherapy and radiation. These treatments may
eliminate
disease
in the nodes.
The
study included 891 patients at the median age of mid-50s, followed for a median
of 6.3 years. After
the
initial node biopsy, the women were randomly assigned to either have 10 or more
additional nodes
removed,
or to leave the nodes alone. The nodes were cancerous for 27 percent of the
women studied,
but
the two groups had no difference in rates of survival. More than 90 percent
survived over five years.
February
16, 2011 - Surgeons optimistic on lymph node study - Daily American Online –
Somerset --
Local
surgeons are cautiously optimistic about a new study that finds that many women
with early stage
breast
cancer do not need a procedure that has long been routine: Removal of all
cancerous lymph nodes
from
the armpit.
“This
is a major change,” said Dr. Dianna Craig, breast surgeon at Windber Medical
Center. “Research is
getting
us to be less and less invasive. This is a big step along that
pathway.”
Dr.
Gerard Garguilo, general surgeon at Memorial Medical Center, Johnstown, said a
lot of people had
been
calling into question the value of the more radical surgery.
“It’s
a notion that a lot of us were thinking — more radical surgery was not
necessary,” he said. “These are
quality
of life issues.”
Surgeons
have been removing lymph nodes from under the arms of breast cancer patients
for many years,
believing it
would prolong women’s lives by keeping the cancer from spreading or coming
back. Removal
of
nodes can cause infection and lymphedema, a chronic swelling in the
arm.
Now
researchers report that for women who meet certain criteria, taking out nodes
has no advantage.
“This
is what we have to caution readers about — it is very limited, not for
everybody,” Craig said.
The
criteria include women whose tumors were found at an early stage, five
centimeters or smaller, which
is
less than 2 1/2 inches across. Biopsies of one or two nodes had found cancer,
but the lymph nodes were
not
enlarged enough to be felt during an exam and the cancer had not spread
anywhere else. The women
had
lumpectomies. Most also had radiation to the entire breast or chemotherapy or
both. An estimated 20
percent
of patients, or 40,000 women a year in the United States, fit that
criteria.
“The
study didn’t look at women who had mastectomies, radiation of the partial
breast or chemotherapy
prior
to the surgery,” Craig said. “It was a very limited population, but there was
no difference in survival
rates.
We don’t have long-term data — that will come over time.”
After
armpit surgery, 20 to 30 percent of women develop lymphedema. Radiation
increases that to 40 to
50
percent.
“Women
who develop lymphedema have arm pain, they have to limit the motion of the
shoulder, they have
swelling,
they have to make lifestyle changes,” Garguilo said.
Craig
said there is no cure for lymphedema, but it can be managed.
“The
key is catching it early and using compression bandages and massage therapy,”
she said. “You don’t
lose
the use of your arm, but it’s not fun to deal with.”
Another
thing to be cautious about is that the study only included 891 patients and
they were followed for
just
over six years.
“That
is not as many women as they would have liked to have had in the study,” he
said.
Dr.
Armando E. Giuliano, lead author of the study, is the chief of surgical
oncology at the John Wayne
Cancer
Institute at St. John’s Health Center in Santa Monica, Calif. The study was
published this month in
the
Journal of the American Medical Association and in the Annuals of Surgery. The
National Cancer
Institute
paid for the study.
The
new findings are part of a trend to move away from radical surgery for breast
cancer, Craig said.
Rates
of mastectomy, removal of the whole breast, began declining in the 1980s after
surgeons found that
for
many patients, survival rates after lumpectomy and radiation were just as good
as those who had
mastectomies.
In
the 1990s, surgeons developed a technique called sentinel node biopsy, in which
they injected a dye into
the
breast and then removed just one or a few nodes that the dye reached first. The
theory was that if the
tumor
was spreading, cancer cells would show up in those nodes.
The
new study doesn’t cancel out the need for chemotherapy.
“The
great equalizer is chemotherapy,” Garguilo said. “It’s very effective in
treating nodes that have not
been
removed. Radiation covers part of the nodes as well. These keep the risk of a
reoccurrence (of
cancer)
low.”
He
believes that as more studies are done it will lead to the demise of more
radical surgery.
“To
me, this is the next big advance in treating women,” Garguilo said.
Craig
agrees that there have been a lot of changes in treatment of breast cancer in
the last decade.
“This
is a step in the right direction,” she said. “Right now, it’s a very limited
recommendation. Women
who
have a diagnosis of breast cancer must discuss options with their physicians.
We’re enthusiastic about
the
study, but cautious in going forward.”
February
17, 2011 - Re-teaching daily living at IOOF therapy center - Mason City Globe
Gazette – By
KRISTIN
BUEHNER –
MASON
CITY — A new Community Therapy Center at the IOOF Home in Mason City provides
a
larger,
more convenient area for therapy patients from the IOOF Home and the
community.
Located
on the southeast end of the IOOF Home care center at 1037 19th St. S.W., the
facility includes a
fully
equipped therapy gym, two private treatment rooms and a full kitchen and
bathroom used for re-
teaching
activities of daily living, said IOOF Home Marketing Director Pam
Klukow.
“We’ve
been gradually utilizing the space since Dec. 3,” Klukow said. Residents can
access it from inside
and
there’s public access from a parking lot.
Therapeutic
services are provided by Therapeutic Advantage of Hampton. Physical therapy,
occupational
therapy,
speech therapy and lymphedema therapy are available. Lymphedema is a condition
that results in
tissue
swelling and fluid retention.
Residents
benefit by having a mix of people from the outside using the center, said IOOF
Home
administrator
Deb Haugen.
“Skilled-care
patients know they’re still part of the community,” she said.
After
the patients return home, they will find the center easily accessible to
continue their therapy if
needed,
Klukow said.
“It’s
gorgeous,” said Glenna Putney of Clear Lake, who comes to the center for
lymphedema therapy. “It’s
very
handy.”
Wilma
Schriver, a resident of the IOOF Home, said she enjoys the larger space and the
new equipment.
“It
looks like a gym,” she said.
The
3,000-square-foot addition cost approximately $650,000 to build. It was
designed to blend in with the
existing
facility, which was built in 1994 and remodeled in 2009.
Groundbreaking
for the new addition was in April.
Bergo
Construction of Mason City was general contractor. Skott & Anderson
Architects of Mason City
provided
architectural services.
Regular
hours are 8 a.m. to 5:30 p.m. Monday through Friday.
A
ribbon-cutting ceremony will be at 1:30 p.m. Thursday, Feb. 24, at the IOOF
Home.
A
public open house will be 1:30 to 3:30 p.m. Saturday, Feb. 26.
February
17, 2011 - Head and Neck Lymphedema is Common; Help is Available - Wire Service
Canada
(press
release) – LymphedemaDepot –
Lymphedema
of the head, neck and face is more common than you might think.
If
you do any research on head and neck lymphedema following cancer-related
surgery you may come
across
this statement;
“...approximately
half of patients treated for head and neck cancer develop lymphedema.”
(Cancer.net)
Lymphedema
is a chronic, incurable swelling condition that requires lifelong
management.
Even
postsurgical swelling following cosmetic procedures can take months to
resolve.
Once
swelling develops, what resources are available to the patient?
Lymphedema
Depot is proud to carry the Solaris line of custom-made Tribute lymphedema
garments.
These
therapeutic garments can be tailored to help resolve chronic or acute edema in
the head neck and
face
regions. These garments are comfortable and work while you sleep to soften and
reduce swelling.
These
Tribute garments are available in several styles including a neck piece, a
facial garment and an eye
mask
for addressing swelling around the eyes. On the facial or neck garments
allowances can be made to
accommodate
a tracheotomy .
While
comfortable and relatively simple, the Solaris Tribute garments are the most
advanced garment-
based
therapy available for head, neck and face edema or lymphedema. Chipped foam
sewn into quilted
channels
gently sinks in to the proteins and fluid that make up the swelling, breaking
down fibrosis and
guiding
fluid away from saturated areas. The custom manufacture of each garment insures
a comfortable
and
effective fit.
These
garments are also adjustable to help manage fluctuations and reductions in
swelling without the need
for
a new garment. They can be worn comfortably overnight while sleeping. And
because each one is
measured
to the patient’s exact measurements, the fit is custom and
comfortable.
For
more information about Solaris head, neck and facial Tribute units available
through Lymphedema
Depot,
see our website at http://www.lymphedemadepot.com and look under Tribute to see
the head neck
and
face garments.
For
more information, contact Lymphedema depot at
[email protected]
February
17, 2011 - Family spreads awareness of Turner syndrome - Richmond-News – By:
Jackie
Grumish
–
When
Jozie Lewis was born with severely swollen hands and feet, her doctors thought
it was just because
of
the way she was positioned in the womb.
Derek
and Linda Lewis, Jozie’s parents, weren’t so sure.
“My
brother’s step-son’s nephew’s daughter has Turner syndrome,” Linda said. “When
I asked the
doctor
if that’s what it was, his jaw dropped open.”
Not
many people know about Turner syndrome, Lewis said. If it wasn’t for the case
knowledge in the
family
and the Lewis’ knowledge about the disease, it’s unlikely Jozie would’ve been
diagnosed so early in
life.
Turner
syndrome is a non-inherited chromosomal condition that affects one in 2,000
female births. About
50
percent of girls with Turner syndrome are not diagnosed until their pre-teen or
teenage years, when
puberty
never kicks in.
Part
of the problem with diagnosis is that most cases are different and the symptoms
can vary from girl to
girl.
For
example, other than Jozie’s lymphedema in her lower arms, hands, lower legs and
feet and her low set
ears,
she has no other apparent characteristics symptoms.
“She
doesn’t have anything abnormal,” Linda said. “No one is able to look at her and
know. Even her
lymphedema
is mistaken for chubby.”
Each
case is different and some girls experience different characteristics and
symptoms than others, Lewis
said.
“Jozie
has really been lucky that way,” Lewis said.
Jozie,
who is just 18 months old, was an early walker and is verbally advanced. She
also doesn’t suffer any
social
issues that some girls can experience. She is a very outgoing little
girl.
The
same can’t be said about everyone with the syndrome.
Common
symptoms of the syndrome include heart defects, learning difficulties, kidney
and liver concerns,
hearing
loss, prone to ear infections and social difficulties. Physical traits include
a short stature, and can
include
many moles, low-set ears, a triangular face and a webbed neck among other
things.
The
most common and usually the most obvious symptom of Turner syndrome is the
stunted growth.
Most
women with Turner syndrome only reach 4 feet 8 inches tall, Lewis
said.
“Some
girls take growth hormones just to reach five feet,” she said.
It’s
too early to know whether Jozie will be one of those girls, she said.
“Turner
syndrome girls who take growth hormones are prone to heart issues and dilation
of the heart,”
Lewis
said. “Medicine is always changing so we’ll just have to see where it’s at when
she gets older we are
faced
with making this decision for her.”
Jozie
currently falls in the 30th percentile for girls her age, but when compared to
other children girls with
Turners
syndrome, she falls in the 80th percentile range, Lewis said.
Also
working against Jozie is family genetics, Lewis said with a laugh.
“The
women on her dad’s side are all very short to begin with, it may not be in her
genetics to reach five
feet anyway”
she said.
Right
now the Lewis family’s biggest concern is Jozie’s blood pressure, which
measured in the 90th
percentile
of normal at her last wellness visit.
“If
it’s 90 percent when she’s calm and happy, you know it’s off the chart when
she’s upset,” Lewis said.
“That’s
our biggest concern right now.”
Because
high blood pressure could be an indicator of kidney or heart problems, Jozie
underwent a kidney
ultrasound
on Friday. Luckily, the results came back normal.
“Great
news about her kidneys!” Linda said.
In
the future, it’s likely Jozie will have to undergo hormone therapy to push her
through puberty, Lewis said.
“Without
it she wouldn’t develop the womanly curves, develop breasts or get her period,”
she said.
“Overall
she’s a really happy little girl,” Lewis said. “She just needs to be monitored
a little more closely.”
The
Lewises try their best not to fret about Jozie’s condition.
“You
can sit there and wait and worry or you can go with the flow and deal with it,”
Lewis said. “We just
try
to do as much preventatively as we can and take it one day at a time as it
comes to us.”
Lewis
said she’s thankful that she knew a little bit about the syndrome when Jozie
was diagnosed. Not
many
people — even doctors — know a lot about Turner syndrome, she said.
That’s
why the family recently decided to participate in the Turner Syndrome Society
of the United States’
awareness
campaign.
February
has been deemed National Turner Syndrome Month because it’s the shortest month
of the year,
Lewis
explained. The campaign’s slogan is “Short Happens!”
“We
were pretty scared when we found out she had Turner syndrome,” Lewis said. “We
just hope that by
sharing
Jozie’s story that we can help another family. If someone else gains at least
some knowledge
through
our story it may help them. We were so thankful my nephew and his wife shared
their story and we
want
to pay it forward. It’s also likely that there is a small girl out there
undiagnosed at this point. The
doctors
might be telling the parents that she’s just small and she really has TS. We
hope someone might
read
Jozie’s story and get help if they think that their daughter may have
TS”
Along
with sharing her story, Jozie also participated in a “Positive Exposure” photo
shoot. The goal of the
shoot,
done by former fashion photographer Rick Guidotti, is to educate people and
show the beauty of
the
people behind various syndromes.
“(Guidotti)
was in town talking to medical students at the U of M and trying to get them to
see the people
behind
their patients,” Lewis said. “While he was here, the Turner Syndrome Society of
the United States
got
Jozie and a group of girls and women with Turner syndrome together for the
photo shoot.”
Eventually
Jozie’s picture — along with others — will be on display in an art gallery to
promote the
awareness
of TS.
“If
it can help someone else down the road that would be the greatest gift we could
give,” Lewis said
February
18, 2011 - Breast Cancer Patients May Say Goodbye To Lymphedema - About - News
&
Issues
–
Lymph
node status is part of your breast cancer diagnosis - and many patients have
had large numbers of
nodes
surgically removed - so these can be examined for the possible spread of
cancer. Having the
greater
the number of lymph nodes removed via axillary lymph node dissection results in
a swelling called
arm
lymphedema. But a new study shows that patients with early stage breast cancer
- tumors less than 2
inches
and lymph nodes that appear unaffected - can safely opt for sentinel node
biopsy: the removal of
only
two or three lymph nodes.
This
Phase 3 trial study was designed by The American College of Surgeons Oncology
Group and was
set
at 115 different locations across America. Patients had similar diagnoses and
treatments: lumpectomy,
and
whole-breast radiation. One group had axillary lymph node dissection and the
other group had
sentinel
node biopsy. Patients in both groups had similar 5-year overall survival
rates. The study
concluded
that Sentinel Node Biopsy is all that is needed for early stage breast
cancer.
Axillary
lymph node dissection (ALND) and arm lymphedema will not go away altogether.
For breast
cancer
patients with tumors over two inches, or with swollen lymph nodes, the removal
of extra lymph
nodes
will be needed to determine the risk of metastasis.
This
news will change the way that breast surgeons and oncologists diagnose and
treat early-stage breast
cancer.
While some surgeons already confine lymph node removal to a targeted 2 or 3
nodes, it has long
been
standard surgical practice to remove between 15 and 40 nodes - putting patients
at higher risk for
arm
swelling. Women who have arm lymphedema must take special care of their arm
for the rest of their
lives
- using compression garments, preventing cuts, even small burns, and sometimes
requiring lymphatic
massage
to get relief. Now that more patients may be able to avoid the risk of arm
lymphedema, dealing
with
breast cancer survival will become easier.
February
19, 2011 - In breast cancer treatment, less underarm lymph-node removal may be
better
Los
Angeles Times – By Jill U. Adams –
Removing
many underarm nodes instead of just a few may not improve long-term survival, a
study says.
Sometimes
less is more in breast cancer treatment; so says a study that made headlines
earlier this month:
The finding,
published in the Journal of the American Medical Assn., reported that
surgically removing
multiple
cancer-containing lymph nodes under the arm in women with small tumors —
instead of just one
or
two — may cause more harm than good.
The
finding seems to fly in the face of what most people believe — that cancers
must be treated
aggressively
for the best odds of recovery and survival.
But,
in fact, many breast cancer surgeons say the study puts solid evidence on what
was already becoming
a
trend in practice — moving away from the more radical surgery in certain
patients. "It's not a revolution,
it's
an evolution," says Dr. John Glaspy, an oncologist at UCLA's Jonsson
Comprehensive Cancer Center.
It's
still unclear whether the advice from the study will be broadly accepted as the
new standard of care —
and
how long that will take.
"Many
changes in medicine — believe it or not — take 17 years to take hold," wrote
Dr. Len Lichtenfeld,
deputy
chief medical officer of the American Cancer Society, on his blog after the
JAMA report came out.
Here's
a look at the pros and cons of removing underarm lymph nodes in breast cancer
and who will be
affected.
The
study subjects were women with breast tumors up to two inches across and
evidence of cancer cells
invading
at least one nearby lymph node but not more than two, as determined by a
procedure called
sentinel
lymph node biopsy. In this procedure, a dye is injected near the tumor and the
first lymph nodes to
which
the dye travels are removed and biopsied for cancer cells.
All
891 patients received lumpectomy and radiation therapy, and a majority of them
also underwent
chemotherapy.
In addition to the one or two sentinel lymph nodes removed for diagnosis of
invasive
disease,
one group of women also underwent what surgeons call axillary lymph node
dissection, which
means
surgical removal of at least 10 lymph nodes from under the arm.
Survival
rates were statistically similar in the two groups, with more than 90% of women
surviving and
more
than 80% remaining disease-free for five years after treatment.
These
findings suggest that removing a bunch of lymph nodes from under the arm
doesn't make a difference
in
the long-term prognosis of breast cancer patients. Doctors say this makes
sense, because there are many
paths
by which cancer can escape the breast and spread.
February
21, 2011 - Study challenges need for lymph node removal in cancer patients -
Las Vegas
Review
– Journal - By Paul Harasim –
When
the news broke about a study that found many women with early breast cancer
need not have all
their
underarm lymph nodes removed -- even if they contain cancer cells -- Christine
Wunderlin was both
happy
and disappointed.
She
is happy that more women will be able to escape the lymphedema, a chronic,
often painful swelling in
the
arm caused by the retention of lymph fluid, that she has experienced as a
result of the excision of 11
nodes.
But
she can't help being disappointed about ever having to go through the
major lymph node removal in
the
first place.
"Exactly
a year after I have my procedure done, they come out with this," she said
Tuesday. "My breast
surgery
has been easier to deal with than the lymphedema."
Wunderlin,
who runs a career counseling business, must regularly visit Dr. Richard
Hodnett's Lymphatic
Center
of Las Vegas, where a specialized therapist massages her arm to disperse the
lymph fluid through
pathways
in her body that are still functioning.
And
she must wear a compression garment on her left arm for the rest of her life or
the lymphedema may
well
become disabling.
"If
I don't keep it in check, even being able to wear a blouse can be problematic,"
she said.
According
to the study published in the Feb. 9 Journal of the American Medical
Association, researchers
found
that removing lymph nodes in women with early stage breast cancer -- the
disease strikes about one
in
eight women -- did not improve their chances of a recurrence or surviving when
compared with leaving
the
nodes behind during breast cancer surgery.
Women
in both groups had about a 92 percent chance of survival.
on
the cutting edge
Dr.
Josette Spotts, a 54-year-old breast surgeon affiliated with Comprehensive
Cancer Centers of
Nevada,
was not at all surprised by the findings of the study that promises to change
what has been
standard
medical practice for decades.
"I've
stayed on top of the research and for the last several years have given my
patients who fit the proper
profile
the option of not having their lymph nodes removed," she said. "I just hate to
see women go through
lymphedema
unnecessarily. It can be debilitating and the literature shows there's about a
17 to 20 percent
risk
(of suffering from lymphedema) when you remove many of a woman's lymph
nodes."
Two
of her breast cancer patients who opted not to have lymph node removal as far
back as four years
ago,
Patricia Hovey and Christine Santiago, sat in the physician's Henderson office
last week and
discussed
why they chose to forgo excision when the standard of care at that time was to
have the lymph
nodes
removed. Both are now cancer free.
"In
a way I realize it was a leap of faith," said the 56-year-old Santiago, who was
trained as a registered
nurse
and works in risk management administration for the Clark County Administration
Department. "But
I
was impressed with Dr. Spotts' knowledge of the research and I also know that
medicine is sometimes
slow
to change the legal standard of care. I'm obviously happy that the study
validated my faith."
The
61-year-old Hovey, who has been laid off from her job as a sales manager for
Mexicana Airlines, said
Spotts
carefully explained all the possible pros and cons. "When she said I was a
candidate for not having
the
removal of the lymph nodes, it came down to the fact that I trusted
her."
Nearly
1,000 women, with a median age in the mid-50s, were involved in the study
carried out at more
than
100 medical centers throughout the United States. The women were followed for a
median of 6.3
years.
About
20 percent of breast cancer patients meet the criteria of the study, where
tumors are less than 2
inches
across and cancer has not spread outside the nodes.
Spotts,
a graduate of the Wayne State University School of Medicine in Detroit, had
told the women that
the
research she studied -- later borne out by the study -- found that removing the
cancerous lymph nodes
proved
unnecessary because the standard therapy today in addition to a lumpectomy,
radiation and
chemotherapy
likely killed the disease in the nodes.
Lymph
nodes, small bean-shaped glands, help eliminate bacteria and viruses and are
needed to drain and
regulate
the flow of lymphatic fluid. Spotts said that until research and technology
proved otherwise, it
made
sense to remove lymph nodes as part of breast cancer surgery because the breast
tissue lies close to
the
lymph nodes and lymph can harbor wayward cells that travel out of the original
tumor into other parts
of
the body.
"We
keep making advances, and as a physician you want to make sure your patients
get the best care in as
timely
a fashion as possible," Spotts said. "For a long time we only did mastectomies
(removal of the entire
breast)
and then we found out that lumpectomies (removing only part of the breast)
followed by radiation
have
basically the same survival outcomes."
mapping
the nodes
Both
Hovey and Santiago were found to have cancer in their lymph nodes when Spotts
did a procedure
known
as sentinel node mapping as part of their breast cancer surgery.
The
sentinel node is the first lymph node or nodes to receive drainage from a
cancer-containing area of the
breast.
Generally,
about an hour before a woman enters the operating theater for breast cancer
surgery, she is
injected
with a radioactive tracer that is used for the mapping. Soon after the patient
is on the table, the
surgeon
uses a handheld Geiger counter that sounds off as it finds the radioactive
tracer in the lymph nodes.
A
blue dye helps the physician get visual confirmation of the sentinel node on a
monitor.
With
an incision in the armpit, the surgeon takes out the node, sending it to a
pathologist to be checked for
cancer.
The lumpectomy follows.
"In
the past, if the sentinel node was cancerous, we'd do another surgery later for
the other nodes," Spotts.
"Now,
fortunately, we often don't have to go through that. The chemo and radiation
will kill the disease in
the
nodes."
Spotts
has known that she was taking a risk by telling some of her patients that she
believed they could opt
out
of lymph node removal surgery.
"If
it recurred because of that when the standard of care was removal, I could have
financial liability," she
said. "But I
feel an obligation to my patients to give them an opportunity for the best care
that research
shows
is available.
Dr.
Theodore Potruch, another Las Vegas breast surgeon who has given his patients
the benefit of such an
option,
agrees with Spotts.
"It
is imperative that we stay on top of the research for our patients," Potruch
said, noting that he hopes to
start
a trial therapy soon where cancerous breast lumps are rendered impotent through
freezing rather than
excision.
"It's
important that what we do leaves women scarred as little as possible both
physically and emotionally."
Though
research may indicate that a new treatment option is possible, Spotts said she
is never surprised
when
some women refuse it. Nor is she surprised that some doctors are reluctant to
change what seems to
have
worked.
It
is much easier for both patients and doctors to accept more cancer treatment on
the basis of a study
rather
than less. Given that breast cancer kills 40,000 American women a year, it can
be frightening to try
what
may seem, at first blush, less aggressive care, Spotts said.
"It's
hard for some people to get their arms around the fact that less can actually
be more," she said.
Some
women not only favor lymph node removal regardless of research, but also
mastectomies rather than
lumpectomies
"because they think it's better to be safe than sorry."
"The
fear is very real and very understandable. I want to do what makes the patient
most comfortable."
To
Christine Santiago, it is critical that women weigh carefully what their
doctors say in conjunction with
their
own research.
"You
have to find out as much as you can about what you're going to do with this
disease because it can
mean
your life. And then you have to hope you make the right decision."
February 21,
2011 - Aleva Stores Adds the Zensah Product Line to its Online Stores - openPR
(press
release)
–
Aleva
Stores recognizes the importance of compression therapy, so we’re always
looking for ways to
expand
our compression-related products catalog. Bringing on the Zensah line was an
easy decision due to
their
history of phenomenal compression technology.
Zensah
compression products provide an optimal blend of graduated and pinpoint
compression. The
graduated
compression provides maximum compression at the bottom of the garment and
gradually lessens
upward;
while the pinpoint compression targets the exact source of pain.
While
the Zensah catalog includes compression socks, arm sleeves, thigh sleeves,
bras, and shorts, Zensah
was
the first company to introduce compression leg sleeves.
February
21, 2011 - A continuing quest - Lac du Bonnet Leader - By Lory Mitton
–
Once
again, Lac du Bonnet's Kim Avanthay is promoting the recognition of March 6 as
Lymphedema
Awareness
Day.
Last
year marked significant progress in her mission for recognition of the disease
which is quite common
but
not publicized to any great extent. Many medical professionals have never heard
of lymphedema, which
the
World Health Organization estimates affects more than 250 million people
worldwide.
"The
more people hear, the more they will be aware [of lymphedema] and can seek help
if they need it,"
Avanthay
explained about the importance of making the disease understood.
Forty-one
municipalities across Manitoba and Manitoba's Minister of Health proclaimed
March 6, 2010 as
Lymphedema
Awareness Day a year ago.
"I
hope to have just as much, if not more success this year," Avanthay says. So
far in her correspondence
with
municipalities, 13 districts have agreed to her requests and she anticipates
many more will also.
Avanthay's
efforts are inspired by her young son, Austin, who suffers from the disease.
The Leader first
wrote
about Avanthay two years ago when she graduated from the Lymph Science Advocacy
Program in
California.
She was there to learn more about the illness that's affected four-year-old
Austin since shortly
after
birth.
"Lymphedema
is a chronic disease with no known cure and treatments that for some, are less
than
adequate,"
Avanthay told the Leader.
"Much
work needs to be done in this area as lymphedema requires daily
care."
The
disease can become a disability that prevents those affected by it from
continuing in normal daily
activities
including their professions.
The
condition is an accumulation of lymphatic fluid in the interstitial tissue that
causes swelling, most often in
the
arms and/or legs, and occasionally in other parts of the body. Lymphedema can
develop when
lymphatic
vessels are missing or impaired (primary), or when lymph vessels are damaged or
lymph nodes
removed
(secondary).
"Those
with primary lymphedema face a life of daily treatments and rising costs for
treatment and support
garments,"
Avanthay says. "No other life-time chronic disease has the low level of
awareness and support
from
the provincial health care system, health care professionals and the research
community."
Left
untreated, lymphedema interferes with wound healing, and provides a culture
medium for bacteria that
can result in
lymphangitis (infection).
Since
Avanthay has been promoting awareness, many people have contacted her. "One was
from Selkirk
who
had been living with this condition from childhood and was never diagnosed,"
she said.
The
National Lymphedema Network, based in Oakland, CA describes the importance of
March 6.
"On
this day we show the world that lymphedema is no longer a rare condition by
honoring the many
people
living with it today, and the exceptional health care providers who, with
dedication and support,
have
touched their lives and hearts."
The
International Lymphedema Framework (ILF) will be hosting their third ILF
Conference right here in
Canada,
in Toronto, in June 2011.
"This
is great news for the Lymphedema community," Avanthay says. She hopes Manitoba
will have some
representation
at the conference.
Also
picking up momentum is the Canadian Lymphedema Framework (CLF), which is
working to improve
the
management of lymphedema and related disorders in Canada. "They have three
active working groups
focusing
on education, research and partnership building. The volunteer members of the
working groups
are
from right across Canada," Avanthay explains.
The
forming of an association for Manitoba is also in progress.
February
22, 2011 - Removing Lymph Nodes in Breast Cancer Patients Is Not Essential -
TopNews
New
Zealand – by Neeraj Shahane –
The
new American study has revealed that it's not necessary to remove the
lymph-nodes from breast
cancer
patients as removing lymph nodes hasn't helped in improving survival chances of
breast cancer
patients.
Lymph
nodes are small bean-shaped glands, required to drain and regulate the flow of
lymphatic fluid.
Lymph
nodes also assist in eliminating bacteria and viruses from body. As part of
breast cancer surgery,
removing
lymph nodes was considered logical as lymph nodes are close to the breast
tissue and can
transfer
infection to other parts of body.
Christine
Wunderlin, who runs a career counseling business, had undergone the breast
cancer surgery last
year.
Wunderlin was glad that other women will not have to suffer with lymphedema,
the problem arising
due
to removal of lymph nodes.
Lymphedema,
a chronic swelling in the arm, sometimes painful, is caused by the retention of
lymph fluid.
Wunderlin
has to visit Dr. Richard Hodnett's Lymphatic Center regularly to have the
lymphatic fluid remove
from
her body. A specialist therapist massages her arm to disperse the fluid out of
the body. Moreover, for
rest
of her life, she must wear a compression garment on her left arm as lymphedema
can be disabling.
Spotts,
a graduate of Wayne State University School of Medicine explains that
lumpectomy, radiation and
chemotherapy
in addition with standard therapy these days, likely kill the disease in the
nodes therefore
making
their removal unnecessary.
February
22, 2011 - Study: Lymph node removal not always needed - Sioux Falls Argus
Leader – by
Jon
Walker –
Women
will be spared much pain and anxiety in light of research showing less need to
remove lymph
nodes
from the armpit to fight breast cancer, South Dakota specialists
said.
"With
cancer, it used to be the more treatment the better. This study shows extra
treatment doesn't affect
outcome,"
said Kristi Egland, an associate scientist for Sanford Research-USD.
Women
benefiting most are those in early stages of breast cancer and already
undergoing radiation and
chemotherapy.
Removing lymph nodes is a third step in stopping the disease, but the full
extent of that
approach
might be nonessential and perhaps unnecessarily harmful.
"This
study says having all the lymph nodes out does not increase the chance of
survival," Egland said.
Leaving
more nodes in place would spare women potentially painful surgery and lower the
risk of
lymphedema,
a swelling in the arms causing discomfort and other complications.
The
center of concern is lymph nodes under the the skin, including about 30 in each
armpit. The nodes,
smaller
than a garden pea, are a collection point acting like a river dam in the body's
self-defense system.
The
nodes collect intruding viruses and bacteria migrating under the skin and alert
the body's immune
system
to destroy the microscopic invaders.
Cancer
cells also collect at the lymph nodes, but they are oblivious to the body's
defenses and instead
multiply
out of control. Removing the nodes from the armpits has been a standard
approach to eradicating
the
problem.
"When
women had one to three lymph nodes with cancer, traditionally we said we need
radiation and
chemotherapy
and said we have to be very, very aggressive with treatment," said Dr. Juliann
Reiland, a
breast
surgeon in Sioux Falls.
"The
study shows going back to the operating room and removing more lymph nodes did
not make these
women
better. They also had chemotherapy and radiation. They didn't need all three.
They only needed
two,"
Reiland said.
A
study at 115 hospitals followed 891 women about six years, the New York Times
reported. Surgeons
removed
cancerous nodes in the women and in some, but not all, removed 10 additional
nodes as a
precaution.
Over time, the two groups showed the same survival rates. The National Cancer
Institute paid
for
the study, which Dr. Monica Morrow, from Memorial Sloan-Kettering Cancer Center
in New York,
explained
in the Journal of the American Medical Association.
Reiland
is medical director at interoperative electron radiation therapy at Avera
McKennan Hospital. She
has
been following a protocol for several years toward less aggressive removal of
nodes. Specialists inject
radioactive
material that migrates to the armpit to pinpoint which nodes host cancer
cells.
"For
80 percent of the women, we were overoperating. Now we know how to identify the
one or two
nodes
that have cancer," she said.
Betty
Meyer, South Dakota vice president of Susan G. Komen for the Cure, said the
study might spare
women
considerable difficulty. "Anything we can do to decrease the incidence of
lymphedema is going to
be
really good," she said.
February
23, 2011 - Lymphedema Depot: Lymphedema Awareness Day is March 6, 2011 - Wire
Service
Canada (press release) –
Do
you suffer from lymphedema and don’t know where to get help?
Lymphedema
is gaining notoriety as the “most-feared” complication of breast cancer
surgery. You may
have
heard of lymphedema but what do you know about it? On the other hand, you may
know a lot about
lymphedema,
but do you share what you know?
Do
you know someone with a chronically swollen arm or leg that you have never
asked them about?
Do
you suffer from lymphedema and find yourself reluctant to talk about it with
others?
Do
you suffer from lymphedema and don’t know where to get help?
On
Lymphedema Awareness Day we challenge you to learn something about lymphedema
and to tell
someone
else what you learned. You might start by searching Facebook for “Lymphedema
Awareness
Day
Canada” and seeing what you find.
Some
municipalities have been urged to officially proclaim March 6th as Lymphedema
Awareness Day to
help
bring about increased awareness of this lifelong condition.
February
23, 2011 - Study shows some breast cancer patients can safely keep lymph nodes
- Tampabay.
com
– By Irene Maher –
A
medical study published this month promised good news for thousands of women
whose breast cancer
surgery
might lead to a painful condition known as lymphedema.
This
drastic and persistent arm swelling is a frequent consequence not of breast
surgery itself, but of
removing
nearby lymph nodes.
But
it turns out that the women in the study who kept their nodes, even if cancer
was present, fared just as
well
as those who had them removed.
Still,
will doctors and patients knowingly leave behind anything cancerous, even just
a lymph node or two?
It
will be a tough sell, admits Dr. Peter Blumencranz, director of Morton Plant
Hospital's Comprehensive
Breast
Care Center and a co-author of the study, published in the Journal of the
American Medical
Association.
Leaving behind lymph nodes known to have cancer goes against physician training
and most
current
medical guidelines.
"We
had trouble recruiting patients for the study because surgeons were
uncomfortable with the idea of not
taking
the nodes," he said. Researchers hoped to enroll 1,900 patients, but only about
half that number
signed
up.
"What
we were asking them to do was radical," he said.
•
• •
For
decades, doctors removed all lymph nodes from all breast cancer patients.
Later, researchers found
that
only women with positive sentinel nodes (the first nodes where breast cancer
typically spreads) had to
have
all their nodes removed. Then in 1999, a group of physicians, including
Blumencranz, launched a
study to find
out if breast cancer patients with positive sentinel lymph nodes could be
spared complete
node
removal.
The
thought was that radiation and chemotherapy would eradicate stray cancer cells
in the lymph nodes.
"The
good news is, after six years of followup, those women who kept their nodes did
as well as those
who
had their other nodes removed," Blumencranz said.
Dr.
Christine Laronga, program leader of the Don and Erika Wallace Comprehensive
Breast Program at
the
H. Lee Moffitt Cancer Center in Tampa, helped recruit patients and remembers
the early days of the
study.
"When doctors first heard about this study, everybody thought, are you crazy?"
she said.
But
as results started trickling in and there was virtually no difference in
outcomes, Laronga and other
practitioners
started offering select patients the option.
When
the study made national headlines, "all the women we saw wanted to be
considered for not having
their
lymph nodes out," she said.
Only
certain patients are considered eligible for the node-sparing approach: those
who have early-stage
breast
cancer and are treated with lumpectomy, chemotherapy and whole breast
radiation.
Dr.
Suzanne Lynn, a breast surgeon at St. Joseph's Women's Hospital in Tampa, is
bracing for
disappointed
patients. "They come in so hopeful; you hate to burst their bubble, but this
doesn't apply to
everyone,"
she says. Patients who opt for a mastectomy or for partial breast radiation
were not included in
the
study, and may still be counseled to have their lymph nodes removed.
•
• •
Despite
the research findings and the lowered risk of lymphedema, some patients still
opt for node
removal.
Blumencranz said many women dropped out of the study when they found out their
nodes were
positive.
"They were just uncomfortable with leaving any cancer behind," he
said.
Cheri
Wetzel, 62, of Sun City Center, understands those women. She was diagnosed with
breast cancer in
2008
and had a lumpectomy. Three sentinel nodes were positive for cancer. A patient
of Laronga, Wetzel
wanted
the nodes out then and says she would make the same decision today — even
though she has
suffered from lymphedema (see
box).
"Leaving
lymph nodes behind, where you know there are cancer cells, no," Wetzel said. "I
feel more
comfortable
that it's been removed."
Will
this study change medical treatment guidelines?
Experts
say yes, but it may take time to win over skeptical physicians and
patients.
"Some
will be very happy to know they can keep their nodes," Lynn said. "Others will
still have the fear of
leaving
cancer behind. At least now we can let them know what the facts are."
March 2, 2011 - NBC29Cancer's Dirty Little
Secret - NBC 29 News –
It's
sometimes referred to as cancer's dirty little secret. Lymphedema is a lifelong
condition that can strike
patients
after cancer treatment. Carla Harris was diagnosed with stage three breast
cancer in 2009.
Treatment
included radiation and surgery. When she heard about lymphedema she didn't
think the
sometimes
painful condition would happen to her.
"It
was mentioned as one of the possible, rare, unlikely side effects of surgery,"
Harris said.
Two
months after surgery she was diagnosed with lymphedema and now faces a life
long battle. She's prone
to
infection from bug bites and sunburn and has to be careful of change in
altitude or physical activity that
may
cause her to swell.
"It
affects every minute of my day from getting dressed in the morning and putting
on my compression
garments
to what I can lift. Whether I can lift my children," Harris said.
Lymphedema
is when fluid builds up in the arms, legs or torso. This can happen after
lymphnodes are
removed
or damaged from cancer treatment. In breast cancer patients often times
lymphnodes are removed
in
the arm.
Cyndi
Stabenow is an Occupational Therapist and Certified Lymphedema Therapist at UVA
HealthSouth in
Charlottesville
and said there's no cure but Lymphedema can be controlled.
"This
is a condition that needs to be managed so that fluid build-up doesn't continue
to go on," Stabenow
said.
Treatment
includes fitting patients with compression bandages, garments and special
massage therapy.
"It's
a process that can take sometimes the intensiveness of it maybe five days a
week or two or three weeks
maybe
three times a week after that," Stabenow said.
People
with lymphedema have to be diligent about their care so the swelling stays
under control.
March
2, 2011 - Facts about lymphedema - The Republic –
What
is lymphedema?
The
lymphatic system collects and flushes out bacteria, viruses and waste products
from the body through
infection-fighting
cells in the lymph nodes. If nodes are removed, fluid builds up, causing pain
and swelling.
What
helps
Light
exercise, to keep fluid moving; massage; compression sleeves or stockings to
force fluid out of the
affected
limb.
Research
The H. Lee Moffitt Cancer Center in Tampa, Fla., is participating in an investigation of the use of liposuction
to
remove fat cells from lymphedema patients so fluid can't collect as easily. So
far, a 70 percent reduction
in
symptoms has been reported. Among the research subjects is Cheri Wetzel. "I'm
back into regular
clothing,
have full use of the arm and no discomfort,'' she said. "I still have
lymphedema, but it's not to any
degree
what it was."
Moffitt
is seeking additional funding for more research, estimated to cost $15,000 per
participant.
"Lymphedema
can pop up 20 years after breast-cancer surgery, so we'll need to continue
finding ways to
treat
it," says Moffitt's Dr. Christine Laronga.
(Distributed
by Scripps Howard News Service http://www.scrippsnews.com)
March
2, 2011 - Lymphedema Depot Addresses Hand Swelling - Wire Service Canada (press
release) –
Lymphedema
of the hand is troubling and difficult to treat. Lymphedema Depot offers the
Solaris
compression
glove, in both Caresia and Tribute styles, to control hand swelling.
March
2011, St. Catharines, Ontario
For
many lymphedema patients hand swelling is a particular concern. In lymphedema,
there is chronic
swelling,
usually of a limb. In cases of breast cancer where multiple procedures have
compromised the
ability
of the lymphatic system to drain the arm of excess fluid, arm swelling often
results. Having arm
swelling
does not guarantee that you will experience hand swelling, but if the arm is
swollen there is a risk
that
the hand will swell, too. Once hand swelling begins it can often be difficult
to control. The back of the
hand
can be a problem as there is relatively low tissue pressure there and it will
easily fill with fluid. Finger
swelling,
when it occurs, can be uncomfortable and disturbing and equally difficult to
manage.
Caresia
Glove bandage liners are excellent for those who have hand and/or finger
swelling. Every Caresia
Glove
has individual finger spacers to provide comfortable, non-binding compression.
Many therapists
recommend
this glove for their post-surgical hand patients and patients with arthritis or
lymphedema. It is
designed
to be worn while you sleep, effectively cradling the affected hand and fingers
with mild
compression
and stimulating the lymphatic system to mobilize fluid away from the saturated
area.
Depending
on the nature of the edema, the fingers may not swell, while the back of the
hand does swell.
Where
finger swelling is not a serious problem and more functional mobility of the
hand is desired, the
Caresia is
available in a gauntlet style which stops at the knuckles, leaving the fingers
free.
The
Caresia glove is the standard-sized version of the Solaris Tribute glove. The
Caresia is available in
small,
medium and large while the Tribute is custom made for those who need a more
precise fit.
As
with all Solaris directional-flow products, foam chips address tissue
thickening, and quilted channels help
guide
fluid away from affected areas. Caresia offers a simple, safe and effective way
to eliminate bulky and
troublesome
hand bandaging, and is easy to care for – simply wash and dry on permanent
press settings in
your
home laundry machines as often as needed.
Lymphedema
Depot and Solaris both strive for continuous improvement to make the management
of
lymphedema
less complex, more effective, and ultimately easier for patients.
For
more information, visit http://www.LymphedemaDepot.com
March
3, 2011 - Hallmark Health Cancer Center opens lymphedema clinic - Medford
Transcript –
At
Hallmark Health System, the patient always comes first. The local healthcare
organization is continually
looking
for ways to improve patients’ experience and achieve excellence each and every
day.
With
that goal in mind, Hallmark Health System recently opened a lymphedema clinic
at the Hallmark Health
Cancer Center
in Stoneham. The clinic will be staffed by a certified lymphedema specialist
that will provide
lymphedema
treatment and physical therapy to patients that need it.
Lymphedema
refers to the swelling of various body parts including the arms, legs and face.
It is a common
side
effect among patients that have had their lymph nodes removed due to
cancer.
Hallmark
Health’s certified lymphedema specialist will work one-on-one with patients to
treat their
lymphedema
through compression bandaging, manual lymphatic drainage and exercise. They
will also
address
fatigue and other side effects that result from cancer treatment.
The
new clinic will provide patients with yet another advanced level of service as
well as make scheduling
appointments
easier and more convenient for patients. With all of their appointments under
one roof patients
can
focus on what’s important, completing treatment and getting back on their
feet.
The
Hallmark Health Cancer Center has been honored by highly distinguished
organizations such as the
American
College of Surgeons (ACOS), which recognized the Center for high quality
programs. It received
approval
with commendations following a site visit where ACOS examined cancer registry
data, attended a
tumor
board meeting, toured the Center and reviewed more than 50 patient records. The
approval allows
the
Center to continue its designation as a “Community Hospital Comprehensive
Cancer Program.”
Copyright
2011 Medford Transcript. Some rights reserved
March
3, 2011 - Center educates women on risk with national lymphedema awareness day
- Aiken
Standard
(subscription) – by ROB NOVIT -
When
Peggy Wojtowicz was diagnosed with breast cancer in 1994, she went through a
regimen of
chemotherapy
and radiation and had 22 lymph nodes removed.
Her
doctor mentioned at the time that the surgery and radiation potentially could
lead to a condition called
secondary
lymphedema - a serious fluid buildup caused by damage to the lymphatic
system.
Today
Wojtowicz has become an advocate to educate women about lymphedema, after she
contracted it in
1999.
Hitchcock
Healthcare, which has an occupational therapist certified in treating the
disease, is promoting a
national
lymphedema awareness day on Sunday.
An
Aiken resident since 1985, Wojtowicz has remained cancer-free.
For
five years after her treatment, she avoided lifting heavy weights and, other
than a slight swelling in her left
arm,
had no other symptoms that would indicate lymphedema.
In
1999, the symptoms arrived almost overnight.
"My
arm was red and swollen to twice its normal size, and I got cellulitis,"
Wojtowicz said. "That's the most
dangerous
thing and can be life-threatening within a matter of hours, as the infection
can become systemic. It
was
terrifying and very painful."
Not
long before, Wojtowicz had taken an international flight for a church mission
trip. She was not aware at
the
time that an extended change in air pressure can trigger lymphedema.
Wojtowicz
visited her doctor and got immediate treatment from an occupational therapist
in Augusta.
For
the past three years, she has seen Hitchcock occupational therapist Holly
Shurtleff for periodic therapy.
A
staffer at Hitchcock for the past 20 years, Shurtleff used to refer lymphedema
patients to a Spartanburg
facility.
Hitchcock executives recognized a need for services on-site and sent Shurtleff
to a training program
to
become certified to assist patients with that condition.
As
with any newly-diagnosed person with lymphedema, Wojtowicz spent three weeks
with an occupational
therapist,
getting compression bandages and learning how to change them every 24
hours.
"I
also provide them a daily massage if needed to stimulate the lymphatic system,"
said Shurtleff. "The
purpose
is to decrease the girth of the extremity to as normal as possible - in this
case, the left arm."
Wojtowicz
also wears a compression garment during the day. While she sleeps, she uses a
ReidSleeve,
which
is designed to offer gentle compression that meets the patient's specific
needs.
"I
also continue manual massage, and Holly is always there for me for all kinds of
answers to my questions,"
said
Wojtowicz. "The other thing I've done is exercise. I was afraid to do it at
first, but now I do isometrics,
yoga
and Pilates, and free-weights, using my arm in moderation. I've maintained a
healthy weight, and I still
come
to Hitchcock once a year for measurements and management."
People
can be born with lymphedema, Wojtowicz said.
For
those who have had breast cancer, there is hope, she said.
Survivors
should educate themselves as much as they can about lymphedema, and there are
many sources
online.
Early
detection is important, and a Hitchcock pamphlet warns of symptoms such as
swelling of an extremity,
a
"full" sensation, frequent infections, limited movement of limbs and swelling
that prevents the wearing of a
ring
or watch.
"Lymphedema
doesn't have to stop life," said Tasha Savage, Hitchcock's director of
marketing and
development.
"We want to make sure that people have as much independence as they can. They
don't have
to
stop doing what they love to do."
With
her protective garment in place and bringing along IV antibiotics, Wojtowicz
traveled on mission trips
in
2006 and 2009 to the Central African Republic, where she worked with orphaned
children.
"I
was thrilled to go overseas, and I thank the Lord for all of this," she said.
"I'd rather not be a poster child
for
lymphedema, but this is something God has entrusted me with. If somebody else
can benefit from my
experience,
I can share it with them."
Contact
Rob Novit at [email protected].
March
3, 2011 - Group sheds light on chronic condition - Prince Albert Daily Herald –
by Shannon Lacroix
–
A
chronic condition, rarely heard of and hard to diagnose, will be getting some
attention Sunday.
Members
of the Saskatchewan Lymphovenous Learning Association (SLLA) have declared
March 6
Lymphedema
Awareness Day. The focus will be on bringing to light the condition that can be
mistaken for a
heart
or kidney condition or being overweight according to Barbara Lauterbach,
education chairperson of
the
SLLA.
The
lymph system is spread across the body and helps clean the system by producing
lymph fluid that picks
up
waste and brings it to different nodes. From the nodes the waste goes to the
circulatory system, which
brings
it to the kidneys and liver so they can get rid of it.
Lymphedema
is what someone experiences when the lymph fluid is not being absorbed back
into the body
Lauterbach
explained. The condition causes swelling the in the area where the system is
damaged, which can
eventually
lead to open sores. Lauterbach, who has the condition herself, noted that
diagnosis is vital to stop
the
condition from getting to that point.
“The
sooner you get it diagnosed, the quicker treatment starts, the less pain and
the less time it takes for you
to
get to a point where you can function again,” she explained.
March
4, 2011 - 'That Was Then' - Royal Oak Daily Tribune
This
is for a specific meeting that has now passed (March 10)
March
6, 2011, - Mountain Medicine: Occupational therapists can help cancer patients
- Arizona Daily Sun
MICKIE
TOUTANT –
One
of the most common side effects associated with cancer treatments is the
feeling of being fatigued.
This
feeling can affect many aspects of a person's life. It may affect an
individual's mood or emotions, or the
ability
to do usual daily activities, and it can affect the time they are able to spend
with family and friends or
their
ability to perform their job.
Fortunately
for those battling fatigue due to cancer treatments, there are specific
programs and services
available
that address a person's physical recovery.
It
is extremely important for individuals with cancer to maintain at least a
minimal level of exercise and
activity.
Doing so assists them in staying physically and emotionally strong and healthy
and contributes to
their
overall sense of well being. Even small amounts (three to 10 minutes) of
exercise a few times a day can
be
very beneficial.
Additionally,
it is imperative that those battling cancer, continue to perform their typical
daily activities as
much
as possible. Although it may be tempting to just let things go for a while,
daily activities help the
individual
to maintain energy levels, physical strength and range of motion. Of course,
some days are better
than
others, but the goal is to keep moving.
When
surgery is necessary to remove a lump or tumor, such as lumpectomy or
mastectomy, often there is a
loss
in range of motion and increase in pain, not to mention scar tissue forming and
the skin feeling sensitive
and
tight. Additionally, swelling may also occur around the surgery area causing a
condition called
lymphedema.
Lymphedema
most often is seen in the arm and under-arm areas of breast cancer patients.
The condition
can
be very painful and even debilitating. Patients with this condition can work
with occupational therapists
who
are specially trained to treat lymphedema to minimize the effects. OTs can
offer education, lymphedema
management,
specific exercises and pressure sleeves, all of which can be used to help
relieve and even avoid
this
condition.
In
addition to surgery, cancer treatments such as chemotherapy, radiation,
medication regimes and stress
can
cause fatigue and limit day-to-day activity tolerance. Occupational therapists
can address concepts such
as activity modification, self pacing, simplifying daily activities and strategies for energy restoration. All these
can
help minimize the impact of cancer treatments on the individual.
Focusing
on physical treatments and recovery is just one part of the journey --
emotional support and
recovery
also are extremely important. Support, encouragement and reassurance are a key
part of
rehabilitation
therapy.
Those
battling cancer should remember they do not have to do everything for
themselves. Save energy for
the
things that bring joy to your life and the things that are most
important.
If
you currently are undergoing treatments for cancer, the Cancer Centers of
Northern Arizona Healthcare
and
Flagstaff Medical Center would like to offer a complimentary session to address
an individual's cancer
fatigue
and course for rehabilitation. These services are provided by a licensed
occupational therapist that
specializes
in cancer rehabilitation. For more information on this complimentary program,
call FMC's
Therapy
Services at 773-2125.
Mickie
Toutant, O.T., occupational therapist in Flagstaff Medical Center's Therapy
Services, specializes in
neuro therapy,
hand therapy and working with cancer survivors. Is there a health topic you'd
like to know
more
about? Please write to Mountain Medicine, c/o FMC Public Relations, 1200 N.
Beaver St., Flagstaff,
AZ
86001, or visit FlagstaffMedicalCenter.com.
March
7, 2011 - New Range of Compression Stocking From SocksforLegs - BigNews.biz
(press release)
–
BigNews.Biz
- Mar 07,2011 - Limb swelling and other such diseases are a persistent problem
for a
considerable
number of people. There are certain things that can help you reduce limb
swelling and avoid
other
problems like leg swelling, venous insufficiency, varicose veins, lower and
upper extremity
lymphedema
and other kinds of edemas.
SocksforLegs
is a part of a renowned family owned medical supply store with over 30 years of
experience.
They
have been offering wide varieties of even some hard to find medical equipment
that also includes
compression
stocking. Recently they have launched their new range of compression stockings
that can be
very
effective against limb swelling. They have just boost their existing product
line and included some great
compression
stocking from the top makers like Jobst, Sigvaris, Juzo and medi. SockforLegs
has been
created
with the very aim of providing their customers with all kinds of varieties,
colors, sizes and brands
that
they dream about.
The
www is replete with sources offering almost all kinds of information on
different kinds of compression
garments
and their designs. People looking for reliable information on compression
stocking and other such
stuff
can also make the most of that source and get their desired information without
putting them into any
trouble.
The
wide range of compression stocking available at StockforLegs can make it easier
to find the stuff quite
according
to your different requirements. The nice thing is that whatever they show at
their website is also
available
in stocks. They are carrying thousands of compression products from almost all
renowned brands
and
even some hard to find products and stocking can be easily found from that
source. They are offering
product
ranges from brands like Juzzo, Jobst, Sigvaris and Medi. The new ranges of
compression stockings
from
different brands can definitely make it easier for you to choose compression
stocking quite according
to
your needs.
March
7, 2011 - Phase 3 Randomized Breast Cancer Lymph Node Study Likely to be
Practice-Changing -
Cancer
Network – By Anna Azvolinsky –
Axillary
lymph node dissections (ALND) remain the standard of care for breast cancer
patients that have
sentinel
lymph node metastases. This is based on a meta-analysis of breast cancer
patients showing that
locally
controlling breast cancer via lymph node dissection improved disease patient
survival. However, the
procedure
carries the risk of serious complications such as infection, lymphedema, and
seroma. Sentinel
lymph
node dissection (SLND) was developed to decrease these risks while still
accurately staging lymph
nodes.
Micrograph
showing a lymph node invaded by ductal breast carcinoma and with extranodal
extension of
tumor.
Courtesy of Nephron, Wikimedia Commons
Whether
ALND affects overall survival in breast cancer with SNL metastasis or whether
SNLD alone is
sufficient
is now addressed in a randomized, multi-center, Phase 3 non-inferiority trial
published in a
February
edition of the Journal of the American Medical Association (doi:
10.1001/jama.2011.90). The
study
of state I or IIA breast cancer patients began in 1999, enrolling 891 patients
who were randomized 1:
1
to receive either SLND followed by ALND or SLND alone. Both groups had a
lumpectomy (the removal
of
the tumor) and adjuvant systemic treatment. The study was funded and designed
by the American College
of
Surgeons Oncology Group in collaboration with the National Institute on
Cancer.
The
median number of lymph nodes removed in the ALND group was 17 compared with 2
in the SLND
group.
The adjuvant systemic therapies received by both groups were comparable: 96%
and 97% of the
ALND
and SLND patients, respectively, received similar adjuvant therapies. The
majority of patients
received
whole-breast radiation therapy. Age, stage of cancer, and tumor size did not
vary significantly
between
the two groups.
ALND
does not increase survival
The
use of SLND compared to ALND was not statistically inferior in terms of overall
survival (P=0.008).
The
5-year overall survival rates were 92.5% and 91.8% in the SLND-alone compared
to the ALND
group.
Likewise, disease-free survival did not vary between the groups. Morbidity,
however, was much
higher
in the ALND group: the rate of wound infections, axillary seromas, and
lymphedema were all
significantly
more frequent.
The
authors attributed the overall high frequency of good outcomes on improved
breast cancer management
including
better imaging, more detailed pathological evaluation, and improved surgical
and radiation
approaches.
Study
Implications
The
trial results suggest that women may be exposed to morbidity due to ALND with
no meaningful
improvement
in overall survival, including for women classified as high-risk (estrogen and
progesterone(Drug
information
on progesterone) receptor negative patients). The limitations of the study, as
cited by the
authors,
is a failure to achieve a target accrual of 1900 patients as well as a
potential randomization
imbalance
that favored the SLND-only cohort. Additionally, the patient follow-up was
approximately 6
years
and a longer-term follow-up would be beneficial, as early-stage breast cancer
can reoccur at 10 to 15
years
after diagnosis.
According
to this randomized Phase 3 trial, knowing the number of nodes containing
metastases by ALND
does
not change recommendations for systematic therapy decisions and is obtained at
the cost of higher
morbidity
from surgery, including pain, limited range of motion, and
lymphedema.
As
Gary Lyman, MD, professor of medicine and Chair of the ASCO Sentinel Lymph Node
Biopsy
Guideline
Panel pointed out in an ASCO editorial in response to the publication, the data
will likely change
physician
practice for early stage disease. However, he cautioned that the study results
do not apply to early-
stage
patients with high risk for reoccurrence including those with three or more
positive sentinel lymph
nodes,
larger tumors, or those who received preoperative chemotherapy
March
8, 2011 - Y exercise program helps cancer survivors regain strength -
MyCentralJersey.com (blog)
–
by BOB MAKIN -
EDISON
— Carol Weiss, a breast-cancer survivor, sometimes suffers from lymphedema,
tissue swelling
caused
by a blockage of the lymph nodes, which, in turn, is caused by the cancer.
Longing to exercise but
afraid
to injure her swollen arm, Weiss was thrilled to hear that the Livestrong at
the Y small-group exercise
program
not only was customized for cancer survivors but also for those dealing with
lymphedema.
The
township resident recently graduated with 13 other survivors from the latest
Livestrong class at the
Edison
YMCA.
The
12-week program is offered for free to cancer survivors through cycling great
Lance Armstrong's
Livestrong
Foundation at all branches of the YMCA of Metuchen-Edison-Woodbridge-South
Amboy, as
well
as the Somerset Hills YMCA in the Basking Ridge section of Bernards.
In
Edison, participants meet twice weekly for strength training, cardio work and
yoga.
"They
know how to guide you to do what you need and how to do it safely," said Weiss,
who now manages
lymphedema
through exercise.
Before
addressing a multi-purpose room full of Livestrong graduates past, present and
future and their
families,
Lexy Anderson, the Edison branch's associate executive and wellness director,
described the
program
as life-changing.
The
family of a recently-deceased graduate was so grateful for the program's impact
that they asked that
donations
be made to Livestrong at the Y, Anderson said.
"These
fragile people are not sure how they're going to respond to physical activity,"
she said. "But they
grow
in such a short period of time and get their life back. They begin to feel
stronger."
The
Feb. 17 graduation marked the Edison branch's fifth since the program was
launched a year and a half
ago,
Anderson said.
Halfway through
the program, participants are provided with a free three-month membership to
the Y, as
well
as free monthly yoga sessions for life. Half of the Livestrong graduates said
they plan to join the Y in
order
to keep working out with each other and to get help from their team of four
exercise instructors.
"I
think what I got most out of it was the camaraderie," Weiss said.
"We
all seemed to really meld," said Johanna Minucci, a breast-cancer survivor from
Edison. "We made a
nice
group."
Weiss
continued, "I think we are also a lot more confident now. We want to keep going
so that we will feel
better."
Expansion
of the Edison branch will begin in the spring and be completed in the fall,
Anderson said. The
Livestrong
at the Y program will expand with it, she said.
Sue
Tadros, a breast cancer survivor from the township, said she was looking
forward to the next class (that
started
yesterday).
"I
want to get my energy back," Tadros said. "From what I've seen, I think this
really can help."
The
cancer survivors are not the only ones who benefited from the program. By
getting to work with such a
specialized
population, the trainers grow professionally, said Tim Marshall, one of the
program's four
instructors.
Livestrong
at the Y inspired Marshall, 25, of Highland Park, to write his master's thesis
about cancer
survivors
overcoming exercise barriers.
"A
one-pound weight may seem very light, but a cancer survivor doesn't recover
from exercise in the same
way,"
said Marshall, who soon will receive a master's in exercise science from Kean
University in Union.
"It's
a challenge to create a program that won't make them so sore that they can't
function," he continued.
"The
purpose of the program is for them to function outside. They should have more
energy than when they
walked
through the door. And all of them do. They feel reinvigorated, ready to be
active again, even if
they're
going through chemo. We had one who was going through chemo. She would come in
really tired,
but
she would leave with more energy and a better quality of life."
March
8, 2011 Mather Hospital's Lymphedema Treatment Center Names Roger Geldert of
Bay Shore
Patient of the
Year – NewsLI
(Port
Jefferson, N.Y.) – Roger Geldert of Bay Shore had tried everything to find out
what was causing the
blisters
and fluid buildup in his legs. It wasn’t until Mr. Geldert, 46, was sent to
Mather’s Wound Care
Center
in Melville that he was diagnosed as having Lymphedema. He was immediately
referred to Mather’s
Lymphedema
Treatment Center in Port Jefferson.
Almost
a year after his diagnosis, Mr. Geldert was honored by Mather for his
extraordinary commitment to
his treatment
in recognition of National Lymphedema Awareness “D” Day on March 6. “D” Day a
special
day
set aside by the National Lymphedema Network to honor inspirational lymphedema
patients who have
contributed
to the community or who have shown great courage in their struggle with
disease.
“We
wanted to honor him and his wife, Michelle, for really stepping up to the plate
and exemplifying what
lymphedema
treatment is all about,” said Anne Babcock, a lymphedema therapist at Mather.
Babcock said
treatment
for lymphedema is time consuming and requires commitment on the part of the
patient to be
successful.
Geldert
credited the staff of the Lymphedema Treatment Center for helping him manage
his condition, and
Michael
Petersen, MD, Medical Director of Mather Hospital’s Wound Care Center, with
diagnosing his
illness
and also treating a related non-healing wound.
Lymphedema
is a swelling of the body’s soft tissue, usually in an extremity, caused by an
accumulation of
proteins,
cells and water. Usually, these proteins, along with excess cells and water,
are carried away by our
circulatory
or lymph systems. Lymphedema occurs when these systems are damaged. Although,
Lymphedema
is a chronic condition, it can be managed with proper care and
treatment.
An
adjunct of the Physical Therapy Department, the Lymphedema Treatment Center at
Mather is one of the
largest
hospital-based programs in the northeast. In 2010, Mather’s eight certified
Lymphedema therapists
provided
for more than 2,100 patient visits. The program also offers the only Lymphedema
support group in
Suffolk
County. Treatment is provided by Mather Hospital’s Department of Physical
Therapy.
Geldert
said that he was so pleased with his treatment at Mather that when he decided
to have weight loss
surgery,
he selected Mather’s Bariatric Surgery Center of Excellence. His procedure is
scheduled for later
this
month.
John
T. Mather Memorial Hospital is an acute 248-bed, non-profit community hospital
dedicated to
providing
a wide spectrum of high quality healthcare services to Suffolk County
residents, showing
compassion
and respect and treating each patient in the manner we would wish for our loved
ones.
For
more information on the Lymphedema Treatment Center call 631-686-7648 or online
at www.
matherhospital.org.
March
9, 2011 - Andersen Jones Lands New Breast Cancer Clients - SunHerald.com
–
Get
error code 404 when click on this link
March
9, 2011 - Heart failure can cause feet to swell - Payson Roundup –
DEAR
DR. DONOHUE: Please explain why I have to take my shoes off late every day
because my feet
and
ankles have swollen and don’t fit into the shoes. I flop around in slippers
without heels. In the morning,
after
a night’s sleep, my feet are back to normal. I am 77 and take no medicines. —
K.M.
ANSWER:
I can’t give you an unequivocal response because there are numerous causes of
foot and ankle
swelling.
The
medical name for such swelling is edema. Even in relatively healthy people, it
occurs if people sit or
stand
for any length of time. Gravity pulls fluid out of the circulation, and it
accumulates in the feet and
ankles.
This is especially true at older ages, when the circulatory system becomes
somewhat leaky.
For
this kind of swelling, the solution is to elevate the legs when sitting. The
most effective elevation is raising
the
legs above heart level, something that can be done only by lying down with
pillows propping up the legs.
Getting
up and moving about is another way to prevent fluid accumulation in the
feet.
Heart
failure is a more serious cause of such swelling. When the heart’s pumping
action becomes feeble,
fluid
escapes from blood vessels and again accumulates in the ankles and feet. Kidney
disease with retention
of
body fluid is another cause of edema. Liver disease does the same.
Another
condition called lymphedema produces the same picture. Lymph is fluid that
normally escapes the
circulation
to percolate around tissues and organs to provide nourishment and to wash away
germs. Small
vessels
called lymphatics vacuum up this fluid and return it to the circulation.
Anything that disrupts
lymphatics
can lead to ankle/foot swelling. An old infection and surgery are two such
disruptors.
Since
ankle and foot swelling is a sign of many urgent medical conditions, don’t fool
around with this. See
your
family doctor.
The
booklet on edema and lymphedema clearly describe these conditions and their
treatment. Readers can
obtain
a copy by writing: Dr. Donohue — No. 106W, Box 536475, Orlando, FL 32853-6475.
Enclose a
check
or money order for $4.75 U.S./$6 Canada with the recipient’s printed name and
address. Please
allow
four weeks for delivery
March
10, 2011 - Lymphedema awareness making headway - Lac du Bonnet Leader – By Lory
Mitton –
Last
Sunday was recognized by 43 Manitoban municipalities and by Minister of Health,
Theresa Oswald, as
Lymphedema
Awareness Day.
"I'm
ecstatic, I think that's just awesome!" Kim Avanthay said about the
participation of the province and so
many
communities. Having received only 55 responses to the 100 requests she made
that the day be
recognized,
Avanthay says their could be even more who acknowledged the important
day.
"Hopefully
this is a step forward," she said. "Lymphedema needs more awareness not only
among those
who
suffer from it but among health care officials as well."
Avanthay
has seen a good response to efforts made to promote the day.
"My
first contact came after the Lac du Bonnet Leader was posted on the web. I
received an email from the
UK
offering me information and assistance in finding a Canadian supplier for a
product that is being used in
the
UK for lymphedema treatment."
A
lady in rural Manitoba also contacted Avanthay after coming across an article
in the Selkirk Journal about
lymphedema.
"She
has suffered with severe lymphedema and aside from diagnosis, has not received
any care," Avanthay
told
the Leader.
Four
students from Lac du Bonnet Senior School — Jazlyn Johnston, Jessie Weir,
Kaylin Champagne, and
Justina
Bruchanski — wanted to help raise awareness of lymphedema.
Partnering
with the Fair Trade Action Committee at Centennial School, they decided to sell
ice cream
sundaes
for $3 on Friday at Centennial where Austin Avanthay, who lives with
lymphedema, goes to school.
Most
of the students purchased a sundae and together the students raised
$517.25.
"We
like to do stuff like this," Johnston said about the fundraiser. The four girls
did a similar event in
December
and collected canned goods and money for the food bank.
"I
can't believe that they would just do something like that," Avanthay said about
the student initiative.
Her
efforts to raise awareness for lymphedema this year were also met by an
invitation to speak about
Lymphedema
in April at Pinawa Secondary School.
Avanthay's
message:
"Lymphedema
is an accumulation of lymphatic fluid that causes swelling in arms, legs or
other areas of the
body
and it effects both men, women and children. The swelling caused by lymphedema
can lead to severe
infection
or loss of the use of limbs. Patients suffering from lymphedema must endure
physical discomfort
and
disfigurement and cope with distress caused by these symptoms.
"The
single largest group of people who get lymphedema are cancer patients. Recent
studies have indicated
that
patients that have had lymph nodes surgically removed or treated with radiation
are at a higher risk of
developing
lymphedema. According to Canadian Cancer Society, as of January 1, 2005,
723,000 people in
Canada
have been diagnosed with cancer in the previous 10 years.
"No
drug or effective surgical treatment for lymphedema currently exists and
research in all areas of
lymphedema
has been notably limited.
"Lymphedema,
which has no cure and can occur at anytime, has a severe financial, physical,
and
psychological
impact on patients."
For
more information on lymphedema, Avanthay can be reached at
[email protected].
March
11, 2011 - Lymphedema Depot: We Care For Your Feet Too - Wire Service Canada
(press
release)
–
Everybody
likes to have comfortable feet. Solaris Caresia Footwear and legwear were
designed for the
management
of lymphedema and diabetic feet. As it turns out, they make tired feet more
comfortable too.
March
2011
Lymphedema
Depot sells products for the management of lymphedema. However, those products
have
other
uses, too. Wherever swelling occurs and for whatever reason, Solaris quilted
directional flow garments
can
help to resolve it.
Solaris
Caresia Footwear are a good example. The Caresia Footwear consists of something
often referred
to
as “booties.” They fit over your feet and come up just high enough to cover
most people’s ankles. They
are
quilted into channels and those channels are filled with medical-grade chipped
foam. They are made
from
a soft high-tech material, which is breathable, wickable and thermo-releasing.
The foot and ankle are
completely
surrounded by soft fabric and cushioned by medical grade foam.
Caresia
Footwear were originally designed for patients with diabetic feet. However,
many people have been
finding
these “booties” to be not only comfortable but therapeutic. Feet tend to swell
toward the end of the
day,
and many people have mildly swollen ankles after a day on their feet. With the
Caresia Footwear on
your
feet in the evening hours, your feet receive a treatment that increases micro-
circulation and treats mild
swelling.
Your feet can feel refreshed and renewed. The Caresia footwear are so
comfortable they are
sometimes
worn on airplane flights to relieve restless feet and to reduce
swelling.
Caresia
also comes in a knee high model that is perfect for people suffering from
chronic venous
insufficiency,
a condition where the blood in the lower legs cannot be completely pumped back
from the
lower
extremities. The same combination of soft, high tech fabric and medical grade
chipped foam massage
the
feet and legs and support the venous and lymphatic systems to create a more
dynamic and healthful
environment
for the legs.
While
these garments were originally designed for patients with diabetes, lymphedema
and venous
insufficiency
we find that they are being purchased more generally by people with tired, achy
and mildly
swollen
feet and legs. In fact, this past year a few people told us that they gave
these to their mothers for
Christmas,
and their mothers loved them!
To
learn more about Caresia foot and leg wear visit the Lymphedema Depot website
at :
http://www.lymphedemadepot.com/products/solaris/caresia/selections/foot/
http://www.lymphedemadepot.com/products/solaris/caresia/selections/belowknee/
Contact:
[email protected]
March
15, 2011 - Tickets now on-sale for 2011 Stylin' Against Breast Cancer - Aledo
Times Record –
Bettendorf,
Iowa --
The
Trinity Health Foundation is now accepting reservations for the 2011 Stylin’
Against Breast Cancer.
Trinity
Health Foundation, in partnership with Always a Woman, Midwest Hope and
Healing, The American
Cancer
Society, the Trinity Cancer Center and women who do not represent an
organization but who are
advocates
of breast health and survivors, organize the events each year to raise funds
for projects that
benefit
local breast cancer survivors and promote education about breast cancer and
breast health.
On
Wednesday, April 20, the group will host a wine and cheese party from 6:30-9
p.m., at the Quad-
CitiesWaterfront
Convention Center, 2021 State St., Bettendorf. New this year is Penguins
Entertainment
who
will provide “dueling pianos” during the event. The party will also include a
raffle as well as light hors d’
oeuvres
and wine served by area men who have a personal connection to someone diagnosed
with breast
cancer.
Tickets for the wine and cheese party are $20 per person with a reservation or
$25 at the door.
Groups
of 20 or more will receive 20 free raffle tickets.
The
second winner of the Roxanne Kramer Award will be honored during the sixth
annual Stylin’ against
Breast
Cancer luncheon and fashion show that features local breast cancer survivors
modeling clothing from
area
stores on Thursday, April 21, also at the Quad-Cities Waterfront Convention
Center. Doors open at
11
a.m. with the luncheon beginning at 11:30 a.m. Tickets are $25 per
person.
A
combo ticket for admission to both events is also available for $40. One
hundred percent of the proceeds
from
both events benefit stay in the Quad-Cities area to fund projects that help
local breast cancer patients
and
promote education about breast cancer and breast health. To reserve tickets,
call the Trinity Health
Foundation
at (309) 764-7610 or visit www.trinityhealthfoundation.com.
About
the Roxanne Kramer Award
The
Roxanne Kramer Award is an annual honor to be given to an outstanding
individual(s), organization or
business
that has tirelessly contributed to the quality of life of breast cancer
survivors and which through
deed,
word and ongoing advocacy, has helped educate the community about breast cancer
and breast
health.
Kramer,
a breast cancer survivor herself, owns “Always a Woman” boutique in Moline and
co-founded the
Quad
City Breast Cancer & Lymphedema Support Group.
Copyright
2011 Aledo Times Record. Some rights reserved
March
15, 2011 - Lymph node study may change treatment of breast cancer - ABC Action
News – By:
Linda
Hurtado
CLEARWATER,
Fla. - Marion Mage is a concert pianist whose music overflows into many areas
of her
life.
So when she learned she had breast cancer and may have to have lymph nodes
under her arm removed,
she
said, "My biggest concern was that it would affect my arm."
Surgeons
have been removing lymph nodes from under the arms of breast cancer patients
for 100 years,
believing
it would keep the cancer from spreading, and thereby prolong a woman's
life.
But
removing all lymph nodes often results in debilitating side effects.
Doctor
Peter Blumecranz is a breast surgeon at Morton Plant Hospital’s Breast Care
Center. “The biggest
and
worst of that is lymphedema. That's swelling of the arm. It can get big and
swollen and can stay that way
the
rest of your life. Unfortunately, there is no way to fix it if you have
it."
Marion
would, “Pray every day, ‘Please God, just don't let that happen to me.’ Because
at that point,
playing
was my livelihood."
But
Dr. Blumencranz, Marion’s surgeon, was involved in a study to see if removing
all of a woman's lymph
nodes
had any advantage. The study, eventually published in the Journal of the
American Medical
Association,
included Marion and around 1,000 others over five years.
The
women in the study had surgery followed by radiation and chemotherapy. Some had
lymph nodes
removed,
others did not. Dr. Blumencranz says, “It turns out reoccurrence under arms and
overall survival
from
their breast cancer were identical whether you had other nodes removed or not.
This is practice-
changing.
That's why it so important. This flies in the face of all prior teachings and
changes the way we
manage
breast cancer."
Dr.
Blumencranz took out five of Marion's lymph nodes because cancer had spread to
the first two but he
left
the rest. But she says, “I've had a cousin who had almost the same exact
surgery two years later, not in
this
state. Cancer showed up in two or three of her lymph nodes and they just took
all of them and she's
having
all kinds of problems with the swelling of her arm, the lymph fluid. In
hindsight, we are very glad we
were
part of this study."
Because
after one month of recovery, Marion has had no side effects at all.
March
15, 2011 – Study reveals lymph node removal surgery useless for many breast
cancer patients – by:
David
Gutierrez (NaturalNews)
The
common practice of removing the lymph nodes of breast cancer patients does
nothing to reduce the rate
of
cancer recurrence, according to a study conducted by researchers from the John
Wayne Cancer Institute
and
published in the Journal of the American Medical Association.
In
about one-third of breast cancer cases, the cancer spreads to one or more lymph
nodes in the body. In
these
cases, doctors normally recommend surgical removal of the lymph nodes in the
armpits, regardless of
whether
the cancer has spread to those particular nodes or not. This surgery is meant
to reduce the risk of
cancer
recurrence, but it is painful and leads to a more difficult recovery. In
addition, many women whose
lymph
nodes have been removed suffer from complications such as infection and a
chronic, disabling
swelling
in the arms called lymphedema.
"Of the 161,000
women with breast cancer who have lymph nodes removed every year, 35 to 40
percent
develop
lymphedema," writes Phyllis A. Balch in the book Prescription for Herbal
Healing.
"If
a tumor and the adjacent lymph nodes are removed, the natural drainage of
lymphatic fluid through that
area
is blocked. Fluid accumulates and becomes stagnant in the tissues of the limb
closest to the obstruction.
The
limb may then swell to several times its normal size. Lymphedema is made even
worse by recurrence of
cancer,
as tumors attract sodium and cause fluid retention."
In
the current study, researchers compared women who had been treated for breast
cancer at 115 different
locations
across the United States. All participants had cancer that had spread to lymph
nodes but no
further,
and had relatively small tumors (classified as T1 or T2). The researchers found
no significant
difference
in cancer recurrence rates between the 445 women whose lymph nodes had been
removed and
the
446 women whose lymph nodes had been left in place.
Based
on the new study, as many as 70 percent of women who have lymph node removal
recommended
may
now opt to forego the surgery, said Gary Lyman of the American Society of
Clinical Oncology.
"This
is good news," Lyman said. "It's a substantial number of women."
March
17, 2011 - DCH Opens New Breast Care Center - Eagle 99.3 FM WSCH –
(Lawrenceburg,
Ind.) - The new Breast Care Center at Dearborn County Hospital is now open.
Located
adjacent
to the hospital in Suite 120 of the Dearborn County Hospital Professional
Building, the DCH
Breast
Care Center melds state of the art healthcare with the feel and personalized
service found in upscale
salons
or boutique hotels.
Beyond
the lovely furnishings and attentive personnel, however, is a healthcare
facility comprised of the
latest
imaging technology and staffed by General Surgeons, Oncologists, a
Plastic-Reconstructive Surgeon,
Radiologists,
a Nurse Navigator/Family Nurse Practitioner, Radiologic Technologists and a
Social Service
Consultant.
“The
Breast Care Center is designed to be a positive, welcoming place. Its purpose
is to encompass all
aspects
of breast health,” noted Kelly Ferreira, DCH Breast Care Center Nurse
Navigator/Family Nurse
Practitioner.
“Our intent is for the Center to be a site for routine breast health and
advanced diagnostic and
clinical
services, as well as for education, reference and support.”
Featured
in the Center are two new, state of the art digital mammography units. These
units provide the
latest
technology for both screening and diagnostic mammography and stereotactic
biopsy.
“Everyone
who comes to DCH for a screening or diagnostic mammogram utilizes the Breast
Care Center,”
continued
Mrs. Ferreira. “While our emphasis is on total breast health, the vast majority
of individuals who
come
to the Breast Care Center will visit for a clinical breast exam and/or a
screening mammogram. For
those
individuals who require additional care, the Center is able to offer a full
complement of services.”
The
Center offers comprehensive breast care ranging from screening and diagnostic
mammography to the
coordination
of advanced diagnostic, therapeutic, surgical and/or reconstructive procedures
and related
support
services. In cooperation with the individual’s personal physician, advanced
care is provided under
the
direction of General Surgeons Dr. Shannon Davis, Dr. Mark McAndrew and Dr.
Michael McAndrew,
who
are members of the American Society of Breast Surgeons.
Procedures
performed in the DCH Breast Care Center include clinical breast exams;
screening and
diagnostic
digital mammography; pre-operative needle localizations; cyst aspirations and
stereotactic core
biopsies.
Physician consultations with General Surgeons, a Plastic-Reconstructive
Surgeon, Oncologists and
Radiologists
are also available in the Center, as is coordination for in-hospital procedures
such as breast
MRI
or diagnostic ultrasound.
“As
the Center’s Nurse Navigator/Family Nurse Practitioner, my job is to answer
questions and provide
breast
health information to all individuals, however, my primary function is to
assist patients who have an
abnormal
mammogram or those who have been diagnosed with breast cancer.
“Under
the direction of their surgeon, I work with the patient as requested, to help
coordinate specific
portions
or all aspects of their continuing care. My work may be as simple as scheduling
an appointment for
a breast MRI or
as detailed as helping to coordinate the ongoing plan of care for a person
newly diagnosed
with
breast cancer. It all depends upon the clinical needs of the patient and the
type and degree of assistance
the
individual desires,” she explained.
“While
much of my work deals with the patient’s immediate clinical issues, I am also
available to assist with
non-medical
problems which could impede proper or timely treatment. Sometimes issues such
as
transportation
or lack of financial resources cause patients to delay follow-up diagnostic
procedures or even
treatment.”
The
Breast Care Center is also available to assist breast cancer patients and
breast cancer survivors with
other
services including the acquisition of wigs and headwear; breast prostheses;
lymphedema compression
garments
and personal care products.
“In
my position as the Center’s Nurse Navigator, my focus is to offer support to
the individual and to help
guide them
through their diagnostic testing and when necessary, their treatment and
recovery,” Mrs. Ferreira
added.
“A
diagnosis of cancer or a potential diagnosis of cancer is very frightening. It
not only affects an individual’s
immediate
plans but can have an effect on how they view life. My job is to help alleviate
some of their
anxiety,
fears or stress and to assist them in maintaining a positive outlook. I let
them know that they are not
alone
in dealing with their illness and I help to serve as their advocate. Together
we can sort out the
complexities
of their clinical care so they can devote more of their time and energy to
getting well.”
Physicians
and physician practices working in coordination with the DCH Breast Care Center
include Dr.
Shannon
Davis, Dr. Mark McAndrew and Dr. Michael McAndrew of Dearborn County Surgery;
Dr. Mary
Albers,
Dr. Kurt Leuenberger, Dr. John Sacco and Dr. Louis Schroder of
Oncology/Hematology Care; Dr.
Thomas
Jackson of Southern Indiana Aesthetic and Plastic Surgery and Dr. John
Botsford, Dr. James Cole,
Dr.
William Drew and Dr. Kyung Noh of River Valley Imaging.
March
20, 2011 - Celebrating a 9-Year Cancerversary From Breast Cancer - About - News
& Issues –
By
Pam Stephan –
Today
is my 9-year Cancerversary! On March 20, 2002 I was diagnosed with ductal
carcinoma in situ, and
one
year to the day later, I was given the all-clear. That diagnosis and the year
in treatment for breast cancer
changed
me in many ways. The whole experience was a very hard teacher - but the lessons
have stuck with
me.
For the last 5 years through this site, I've had the chance to pass along many
of the things I've learned
during
treatment and survival. I've continued learning about dealing with breast
cancer - and many of my
readers
have taught me from their own wisdom. The more we know, the better we can fight
this cancer, and
perhaps
someday, it will be totally preventable.
At
first, I did not expect to survive breast cancer - everyone I had known with
that diagnosis had suffered
and
died. My husband's mother Nancy had fought it - twice - for 6 years, but we
eventually lost her, in
1980.
Treatments have improved since then, as have diagnostic procedures and imaging
technology.
Patients
have become more empowered - we get to choose between a mastectomy and a
lumpectomy -
instead
of leaving that up our surgeons. In the past, many women went in for a breast
biopsy and didn't
know
if they would wake up with, or without breasts! Before the widespread adoption
of sentinel node
biopsy,
many women endured a full axillary dissection (nasty term!) and then suffered a
lifetime of arm
lymphedema.
Now the practice of having almost all your lymph nodes removed to be tested for
metastasis is
fading
- thank goodness!
Best
of all, more and more of us are becoming breast cancer survivors. In fact, the
National Cancer Institute
says
that there are about 2.5 million of us living 5 or more years after being
diagnosed with breast cancer. In
addition,
we survive longer than previous generations did.
So
how did I celebrate? Just by doing normal things - went to church, made lunch
at home, did some
yardwork,
and played with our little dogs. All of these things are nice, everyday
occupations - and I am so
happy
to still be around to enjoy them! I had my 85-year old father and my wonderful
husband to spend the
day
with, and then had internet time with my sister. Such moments I no longer take
for granted. I am not
grateful
that I had breast cancer - so that's not what I celebrate. It is survival and
endurance I enjoy, and
that's
what I am thankful for today.
March
20, 2011 - Study supports less-aggressive lymph node surgery for some breast
cancer patients - By
Jan
Jarvis –
For
women with small breast cancer tumors, removing just a few lymph nodes from
under the arm instead of
several
could be just as effective as more extensive surgery, a recent study has
found.
If
the data hold up, the less-invasive approach could spare some women from
further surgery to remove
lymph
nodes and the problems that sometimes go with it, such as lymphedema, which
causes fluid retention
and
tissue swelling.
Numbness,
a decrease in the range motion and pain can also occur.
"Most
women are pretty happy when I can tell them that we don't have to do as
extensive auxiliary surgery,"
said
Dr. Mary Brian, a breast surgeon with Texas Oncology.
But
it's not that simple.
"The
less you do the better it is for the patient," she said. "But you don't want to
do the wrong thing and
leave
cancer behind."
The
study, published in the February issue of the Journal of the American Medical
Association, found that
for
women with breast tumors less than 2 inches in diameter the survival rate was
the same whether only two
lymph
nodes were removed or multiple nodes were taken out.
All
891 women in the study had small tumors and cancer cells in no more than two
lymph nodes. A sentinel
lymph
node biopsy was used to detect any cancer cells. The procedure involves
injecting dye in the tumor to
see
which lymph nodes it travels to.
After
the surgery, the pathologist examined the lymph nodes over multiple days. The
study helps address the
question
of what to do if there's a very small amount of cancer found after the patient
has left the hospital.
"If
there's a tiny drop of cancer in the lymph nodes, no more surgery is
acceptable," Brian said. "The study
showed that
there is no improvement in survival by doing more."
The
study flies in the face of the longtime practice of aggressively treating
cancer by removing at least 10
lymph
nodes.
But
the trend has been shifting toward performing less surgery, and the study may
prompt more doctors to
follow
suit.
Going
into surgery last fall, Kathy Reich, 49, knew a sentinel node biopsy would be
performed, and she
hoped
she would be spared more aggressive surgery.
"If
it had been negative, my doctor would have made the decision at that time never
to take out any lymph
nodes,"
she said. "But I did have more nodes involved."
She
underwent a more aggressive surgery.
March
20, 2011 - The PINK Album – A Musical Celebration of Courage and Hope To
Benefit The Maine
Breast
Cancer Coalition - PR Web –
PATCO
Construction, Inc. of Sanford Maine to serve as Executive Producer on an
unprecedented CD
featuring
Maine's most talented female singer songwriters. Veteran performers, Grammy
nominees, and
rising
stars unite to make life a little easier for Maine women (and men) battling
breast cancer.
PATCO
Construction, Inc. of Sanford, Maine, will serve as Executive Producer on an
unprecedented CD
featuring
Maine's most talented female singer songwriters. Veteran performers, Grammy
nominees, and
rising
stars unite to make life a little easier for Maine women (and men) battling
breast cancer.
PATCO
Construction, Inc of Sanford, Maine is a company on a mission. Family owned for
over 26 years,
and
a leader in the States residential and commercial building industry, PATCO
understands that they have a
responsibility
to give back to the community. Because so many families – including those of
PATCO
employees
– are touched by breast cancer, they chose to help provide financial support to
The Maine
Breast Cancer
Coalition Support Service Fund (MBCC).
Mark
and Greg Patterson, co-owners of PATCO, like the fact that the Fund provides
assistance directly to
Maine
residents. “It helps cover the costs of items not taken care of by insurance
companies”, said Mark.
“It’s
also used to help defray costs for individuals who may be under insured.”
According to MBCC
President
Pam Sirois, the fund has covered mammograms and ultrasound, hospital bills,
physician bills, bras
and
prostheses, wigs, prescriptions, lymphedema therapy and compression garments,
genetic testing,
transportation
costs, as well as temporary living expenses for people in active breast cancer
treatment.
In
2008 PATCO launched the first in a series of campaigns on behalf of the MBCC.
"The Pink Key
Project"
pledged a donation for every contract, residential or commercial, signed that
year. This campaign
was
just the beginning of PATCO’s passionate commitment to the cause. To date PATCO
has contributed
nearly
$20,000 to the Support Service Fund.
This
year, PATCO is serving as Executive Producer on "The Pink Album," scheduled for
release October 1
to
coincide with National Breast Cancer Awareness Month. An unprecedented two CD
collection, the
project
will bring together, for the very first time, over two dozen of Maine’s most
talented female
performers.
Among those participating are artists such as Cindy Bullens, Kate Schrock, Anne
Clark, Sara
Cox,
and Women In Harmony. These veteran performers, rising stars, and Grammy
nominees – some of
whom
have shared the stage with such legends as Elton John and Johnny Cash - will be
contributing tracks
they’ve
selected specifically for this musical tribute. The album's producer, Con
Fullam, has a long history in
the
music business and is perhaps best known locally as the composer of "The Maine
Christmas Song" and
the
driving force behind "The Amazing Music of Mainers," a fundraiser to help end
hunger in Maine.
The
official kick-off for "The Pink Album" will be held on Wednesday, March 23 at
SPACE Gallery, 538
Congress
Street, Portland, Maine from 12:30 to 2:00 PM. Members of the public are
welcome. During this
event
proceeds from the 2010 PATCO and New England Building Materials "Kitchens That
Care"
promotion,
will be presented to representatives of The Maine Breast Cancer Coalition by
Mark Patterson of
PATCO
and Joy Martel of NEMB.
March
21, 2011 - This Way Up: Breast cancer survivors pull together on a boat - By
Art Carey –
In
his new book, The Social Animal, David Brooks makes a strong case for
connection, community, and
group
participation. According to one study he cites, joining a group that meets even
just once a month
produces
the same happiness gain as doubling your income.
That
assertion came to mind the other night as I listened to Tobi Goldberg Maguire
give an impromptu thank-
you
speech to the women on her dragon boat team.
It
was 10 years to the day since her mastectomy, Maguire announced. Seven years
ago, she joined the
team,
and six weeks after that, her sister died.
Maguire,
of Melrose Park, recalled the consoling words of a teammate: "I'm sorry to hear
about your sister,
but
you have a whole boatload of new sisters here."
They
call themselves Hope Afloat, a name both inspired and inspiring because the 40
or so women who
paddle
for the team are all breast-cancer survivors. This is the team's 10th
anniversary, and over the years it
has
included women ranging in age from the late 20s to mid-70s, of all shapes and
sizes, all levels of physical
condition
and athletic ability.
That
was evident on a recent evening as a couple of dozen members of the team
practiced in the new paddle
pool
at Main Line Health & Fitness in Bryn Mawr.
"Push
with the legs, pull with the core!" exhorted their coach, Robin Parker, 57, of
Plymouth Meeting.
"Crunch
down and remember your exit. It's just as important as the catch."
The
women plunged their paddles into the churning water and pulled hard, seeking to
move in unison as they
increased
power and pace. Some looked fierce and seemed fueled by anger. A few vocalized
each stroke
with
a grunt, like a pro tennis player swatting a tremendous forehand.
"They're
tough broads," said Meg Fasy, 46, of Society Hill, a three-time cancer survivor
who recently joined
the
team. "Everybody is really welcoming, but at the same time, very competitive.
These women have been
through
a lot, and nothing stops them."
Dragon
boat racing, with roots in ancient China, is increasingly popular in the United
States. Philadelphia
hosts
two big events, the Independence Dragon Boat Regatta in June and the
International Dragon Boat
Festival
in October.
Breast-cancer
survivors began flocking to the sport after Don McKenzie, a Canadian physician
and exercise
scientist,
proved in the '90s that it was not only unharmful but also beneficial.
Previously, such women had
been
told to avoid strenuous upper-body exercise, for fear it might cause or
aggravate lymphedema, a
painful
swelling of the limbs.
In
Vancouver in 2005, at the first regatta exclusively for breast-cancer
survivors, Hope Afloat beat all the U.
S.
teams and placed second overall.
Hope
Afloat has traveled also to Italy and Australia and will take part this summer
in the Pan Am Games in
Florida.
Practice
on the Schuylkill begins in April, and before the season ends in November, the
team typically vies in
four
to six regattas. This year, the paddle pool, which opened in January and is
billed as unique in the United
States,
has given the team a jump.
March
23, 2011 - Integrating Bevacizumab, Everolimus, and Lapatinib into Current … –
Medscape
A
pilot study of vascular endothelial growth factor inhibition with bevacizumab
in patients with lymphedema
following
breast cancer treatment. ...
Sorry
Tina, this one you need to be a member of something to access it
March
25, 2011 - Elizabeth Taylor: Beautiful Mutant - Slate Magazine – By Roxanne
Palmer –
The
late Elizabeth Taylor was widely known for her violet eyes—so much so that she
named her newest
fragrance
after them. I was slightly crushed, then, to discover that, by most official
accounts, Taylor's eyes
were
actually a deep blue that appeared purple when enhanced by lighting and makeup.
(Truly violet eyes
occur
only in albinos.)
While
she might not have had bona fide purple eyes, as anyone who saw Elizabeth
Taylor onscreen knows,
they
were still arresting: large, liquid, and framed by a thick fringe of eyelashes.
With respect to those
eyelashes,
Taylor apparently hit the jackpot, genetically. According to biographer J.
Randy Tarborelli, just
after
her birth, Taylor's parents were ushered into the doctor's office and told that
their newborn daughter
had
a mutation:
"Well,
that sounded just awful," the girl's mother later recall[ed], "a mutation. But,
when he explained that her
eyes
had double rows of eyelashes, I thought, well, now, that doesn't sound so
terrible at all."
Double
rows of eyelashes are usually the result of a mutation at FOXC2, a gene that
influences all kinds of
tissue
development in embryos. FOXC2 mutations are thought to be responsible for,
among other things,
lymphedema-distichiasis
syndrome, a hereditary disease that can cause disorders of the lymphatic system
in
addition
to double eyelashes.
The
eyelash mutation isn't always as cosmetically enhancing as Taylor's turned out
to be—the extra
eyelashes
can sometimes grow inward and damage the cornea. And it turns out that 7
percent of people
with
lymphedema-distichiasis syndrome also suffer from congenital heart disease.
Taylor herself had a
history
of heart problems—in 2009, Taylor underwent surgery to repair a "leaky valve",
and her death on
Wednesday
was attributed to congestive heart failure.
The
late actor Richard Burton, who accounted for two of Taylor's eight marriages,
was oddly dismissiveof
her
beauty, saying that she had a double chin, an overdeveloped chest, and short
legs. But, he conceded,
"she
has wonderful eyes."
Special
thanks to Dr. Janet Sparrow and Dr. Stephen Tsang from the Ophthalmology
Department at
Columbia
University, and to makeup artist Elias Gutierrez.
Photograph
of Elizabeth Taylor courtesy of Getty Images.
March
25, 2011 - New Technology at NewYork-Presbyterian/Columbia Aids Surgeons With
Early
Detection
of Lymphedemain Breast Cancer Patients – Newswise –
Early
Detection and Intervention May Prevent Disabling Complication of Breast Cancer
Surgery
Newswise
— NEW YORK (March 24, 2011) -- Breast cancer specialists at
NewYork-Presbyterian
Hospital/Columbia
University Medical Center are offering patients new ways to detect early signs
of
lymphedema,
a common side effect of breast cancer surgery that causes painful, debilitating
and disfiguring
swelling
in the arms following removal of lymph nodes.
As
many as 30 percent of women who have breast cancer surgery with lymph node
removal will develop
lymphedema.
Radiation treatment increases this risk to as high as 50 percent. While it is
possible to arrest
the
condition through physical therapy and bandaging, there is no cure.
"Just
as we've used early detection to improve breast cancer survival, we are using
early detection to reduce
women's
risk for developing lymphedema,"says
Dr.
Sheldon Feldman, the Vivian L. Milstein Associate Professor of Clinical Surgery
at Columbia University
College
of Physicians and Surgeons and chief of breast surgery at NewYork-Presbyterian
Hospital/Columbia
University Medical Center.
Dr.
Feldman and his colleagues at NewYork-Presbyterian/Columbia are employing a
technique called
bioimpedence
spectroscopy to help them identify the earliest onset of lymphedema. An
FDA-approved
device
called L-DEX (ImpediMed Inc.) uses a mild electrical current to measure minute
changes in
extracellular
fluid, allowing for a diagnosis of lymphedema by the physician well before any
swelling is
noticeable.
"By catching it early, we can reverse the process and prevent unnecessary pain,
embarrassment,
debilitation
and risk of infection,"says Dr. Feldman.
Alongside
its clinical use, the bioimpedence technique is also being used in research to
better understand
which
patients are most at risk for lymphedema and whether the condition always
progressively worsens, or
if
it can naturally correct itself over time. Other studies will investigate the
common belief that lymphedema is
negatively
affected by air travel and weight training.
Another
method of reducing risk for lymphedema is a technique called "reverse arm
mapping.""The lymph
nodes
that drain the arm are sometimes removed during breast cancer surgery because
they're situated
within
the armpit (axilla) in the same area as the lymph nodes that relate to the
breast. With reverse arm
mapping,
we inject dye into the patient's arm to differentiate the two kinds of lymph
nodes. This allows the
surgeon
to avoid removing any nodes related to arm drainage while still accurately
identifying the sentinel
nodes,
which are important for breast cancer evaluation and treatment,"says Dr.
Feldman. "This should
reduce
the risk of developing lymphedema.”
Arm
mapping is part of a larger trend toward reducing or eliminating the need to
remove a woman's lymph
nodes
-- thereby reducing the incidence of lymphedema. Beginning in the 1990s,
sentinel node biopsy used
dye
injected into the breast to target the sentinel lymph node, the gatekeeper to
the axilla and the one most
at
risk for cancer spread. Today, the latest research indicates that fewer
patients need any lymph nodes
removed
than previously thought. Even if the sentinel node is shown to be positive,
patients with early-stage
breast
cancer who are treated with lumpectomy, chemotherapy and radiation may not need
to have any
further
lymph nodes removed.
For
more information, patients may call (866) NYP-NEWS.
Columbia
University Medical Center
Columbia
University Medical Center provides international leadership in basic,
pre-clinical and clinical
research,
in medical and health sciences education, and in patient care. The Medical
Center trains future
leaders
and includes the dedicated work of many physicians, scientists, public health
professionals, dentists,
and
nurses at the College of Physicians & Surgeons, the Mailman School of
Public Health, the College of
Dental
Medicine, the School of Nursing, the biomedical departments of the Graduate
School of Arts and
Sciences,
and allied research centers and institutions. Established in 1767, Columbia's
College of Physicians
and
Surgeons was the first institution in the country to grant the M.D. degree and
is now among the most
selective
medical schools in the country. Columbia University Medical Center is home to
the largest medical
research
enterprise in New York City and state and one of the largest in the United
States. For more
information,
please visit www.cumc.columbia.edu.
NewYork-Presbyterian
Hospital
NewYork-Presbyterian
Hospital, based in New York City, is the nation's largest not-for-profit,
non-
sectarian
hospital, with 2,353 beds. The Hospital has more than 2 million inpatient and
outpatient visits in a
year,
including more than 220,000 visits to its emergency departments -- more than
any other area hospital.
NewYork-Presbyterian
provides state-of-the-art inpatient, ambulatory and preventive care in all
areas of
medicine
at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical
Center, NewYork-
Presbyterian
Hospital/Columbia University Medical Center, NewYork-Presbyterian/Morgan
Stanley
Children's
Hospital, NewYork-Presbyterian/The Allen Hospital and NewYork-Presbyterian
Hospital/Westchester
Division. One of the most comprehensive health care institutions in the world,
the
Hospital
is committed to excellence in patient care, research, education and community
service. NewYork-
Presbyterian
is the #1 hospital in the New York metropolitan area and is consistently ranked
among the best
academic
medical institutions in the nation, according to U.S.News & World Report.
The Hospital has
academic
affiliations with two of the nation's leading medical colleges: Weill Cornell
Medical College and
Columbia
University College of Physicians and Surgeons. For more information, visit
www.nyp.org.
March
25, 2011 - The Benefits Of Liposuction On Breast Cancer Patients - Bay Net
–
The
Benefits Of Liposuction On Breast Cancer Patients
Reconstructive
plastic surgery is often a necessity for breast cancer survivors. Insurance
companies will
normally
pay for reconstructive plastic surgery procedures that have been linked to a
medical illness but will
not
cover certain procedures that are still considered cosmetic. One such procedure
is liposuction.
Insurance
companies view liposuction as a strictly elective procedure that is used to
remove fat deposits for
cosmetic
improvement. New research is starting to discover that liposuction can offer
help for breast cancer
patients
that have developed secondary medical conditions from their cancer treatments.
The most
prominent
illness that is linked to breast cancer treatment is Lymphedema.
Lymphedema
occurs when the lymph nodes near the breasts and upper arms are removed due to
the
presence
of cancerous cells. Once the lymph nodes are removed from the upper arms, the
lymphatic fluid is
trapped
with no way to be purged from the body. The excess lymphatic fluid is absorbed
into the
surrounding
fat cells. This process results in the painful condition called Lymphedema.
Symptoms of
Lymphedema
include: severely swollen arms, numbness of the arms, heaviness and poor
mobility.
Both
traditional liposuction and
smart
liposuction have proven to be very effective treatments in reducing the effects
of Lymphedema.
Removing
excess fat cells in the upper arm region decreases the amount of swelling that
is associated with
this
medical condition. Currently Insurance companies refuse to acknowledge the
benefits of liposuction as a
treatment
to Lymphedema.
Liposuction
cost can range anywhere from $12,000 to $17,000. Without insurance coverage,
patients are
often
left to pay for these procedures out of pocket. The medical community is
currently doing case studies
to
prove that both regular and laser liposuction can help improve the quality of
life in breast cancer survivors.
However,
these medical case studies can take several years to complete. Patients who are
currently
suffering
from Lymphedema have no other options to cover the liposuction cost other than
paying the entire
fee
upfront or borrowing in the form of a medical loan.
The
health benefits associated with liposuction in regards to Lymphedema are worth
the costs of the
procedure.
Many patients have reported relief of the swelling and regained use of the
affected limbs. Until
the
medical community can prove to the insurance companies that liposuction can be
a medical necessity,
there
are other financial options available to patients who wish to use liposuction
as a means to relieve
Lymphedema.
www.liposuctioncost.com/smart-liposuction
www.liposuctioncost.com/
March
27, 2011 - Good Deeds, March 27 - Omaha World-Herald –
The
following are fundraisers, donations and other charitable events or
opportunities happening in the
Midlands.
E-mail your information about good deeds to [email protected] or call
402-444-1040.
Help
for colleague, wife, mother: The Immanuel Medical Center community has
organized a Saturday
fundraiser
for the family of one of its own. Rachel Stotler Clasemann, a lymphedema
therapist at Immanuel,
sustained
a severe brain injury in a Jan. 10 traffic accident and is at Immanuel
Rehabilitation Center. Her
husband,
Jon Clasemann, and their sons, Jacob and Nathan, live in Papillion. The pancake
breakfast and
silent
auction will be from 7:30 a.m. to 12:30 p.m. Saturday at St. Columbkille
Catholic Church, 200 E.
Sixth
St. in Papillion. The cost is $6 for adults and $4 for children ages 2 to 12.
T-shirts also will be sold for
$10
each. Jacob and Nathan designed the shirts.
TeamMates:
Tuesday will be TeamMates Day at Runza. All 75 Runza restaurants will donate 10
percent of
Tuesday’s
proceeds to benefit local TeamMates chapters.
Bowling
for Recovery: Community Alliance will host a Bowling for Recovery fundraiser
Thursday at
Sempeck’s
Bowling and Entertainment, 20902 Cumberland Drive in the Elkhorn area. Form a
team, join a
team
or sponsor a bowler in support of those with mental illness. Visit
www.community-alliance.org and
click
on the events tab to learn more, register or donate. The first bowling session
will start at 5 p.m. For
$15,
you get two hours of bowling, pizza and pop.
Reaching
out: Creighton University social work students will offer information at the
Heart Ministry Center,
2222
Binney St., to help attendees connect with Nebraska services. The students will
be there from 10 a.m.
to
noon Friday. Among the topics to be addressed are applying for Medicaid, Title
XX and other state
programs;
healthy eating and good nutrition; budget matters; and information to help in
applying for jobs and
services.
Grease
the griddle: The Waffle Man will be in action Friday to raise funds for the
American Cancer Society’
s
Relay For Life of Cass County. Kris’ Krew is putting on the all-you-can-eat
Belgian waffle event from 5 p.
m.
to 7:30 p.m. at Conestoga Elementary School in Murray, Neb. Cost: $6 per person
but free for ages 4
and
younger.
Kicking
cancer: Zeta Tau Alpha, a sorority at the University of Nebraska at Omaha, will
host its annual
Kick
Out Cancer kickball tournament beginning at 10 a.m. Saturday in Elmwood Park.
Proceeds go for
breast
cancer education and awareness. Teams of eight to 10 members each can register
with Sarahbeth
Averill
at 402-201-5734 or [email protected]. Registration costs $65. Watching the
tournament is free
and
open to the public.
Polka
time: The Polka America Corp. has organized a Saturday and April 3 fundraiser
to benefit polka
music
promotions and college scholarships. Four bands will perform. Concessions will
be available for
purchase.
Doors will open at 11:30 a.m. both days at the Starlite Ballroom in Wahoo, Neb.
Admission is
$10
Saturday and $8 April 3. Tickets available at the door only.
Just
a reminder: Boy Scouts will attach door hangers Saturday to alert residents
that Scouting for Food’s
pickup
of nonperishable items will be April 9.
Benefit
for Campfire USA: A tailgating event before the April 3 Creighton University
versus University of
Portland
baseball game will raise money for the Midlands Council of Campfire USA, a
nonprofit that works
with
children. The fundraiser will be from 11 a.m. to 2 p.m. at the McGloin parking
lot in front of the
stadium.
A “Wing Fling” lunch will include wings, vegetables, chips, desserts and soda
for $5. Sponsoring
the
lunch is the CU chapter of Gamma Phi Beta Sorority.
Dodgeball:
Sigma Kappa Sorority at the University of Nebraska at Omaha will host a
dodgeball tournament
to
raise money for Alzheimer’s research. The tournament will begin at noon April 9
at UNO’s pep bowl and
the
Health Physical Education and Recreation Building. Teams of six to eight
players will play 20-minute
games.
Teams must have two women on the court during play time. Registration is $5 per
player. E-mail
Samantha
Mancuso at [email protected] to register.
There
he is: The Fremont (Neb.) Area Habitat for Humanity Mr. Habitat Pageant 2011
will be April 16 at
Midland
University’s Hopkins Arena in Fremont. Five men will compete in several
categories, including
fundraising.
The event is open to the public. Visit www.fremonthabitat.org to purchase
tickets, $45, or to
make
a donation.
Prosthetics:
Step Global, a Nebraska-based charity, refits unneeded prosthetics for its
charity therapy work
in
Nicaragua. Both monetary donations and prosthetics that are no longer needed
are accepted. Step Global’
s
website, www.stepglobal.org, has information about donating. For more
information, call Jacob Keough at
402-614-7321.
Biking
for housing: Anne Troyer — a native of Shickley, Neb., and a student at Goshen
College in Indiana
—
will pedal 3,600 miles from Seattle to Washington, D.C., to raise awareness and
support for the Fuller
Center
for Housing, a nonprofit Christian housing ministry. The ride will start June
10 and end Aug. 14. Her
fundraising
goal is $3,600. To help sponsor her ride, e-mail her at [email protected] or
visit www.
fullercenter.org/bikeadventure.
Still
time to give: The Twin Rivers YMCA in Valley, Neb., has surpassed previous
years’ fundraising efforts
and
added more than $70,000 to its Strong Kids Campaign funding for the next year.
The fundraising effort
will
end Thursday for the entire YMCA of Greater Omaha Area locations. Additional
donations are
welcome
through the Twin Rivers YMCA or online at www.metroymca.org, click on
Opportunities.
Helping
the sisters: A week ago, 264 guests joined the Notre Dame Sisters at Omaha
Roncalli High School
to
celebrate their 100-year ministry in the United States and to honor Sister
Marilyn Ross, executive director
of
Holy Name Housing. The fundraiser grossed $40,000 for the ministries of the
Notre Dame Sisters and
featured
a silent auction and raffle.
Compiled
by Sue Story Truax
March
27, 2011 - Breast biopsy may be first step in cancer battle - Pueblo Chieftain
– By DR. CARL
BARTECCHI
–
Q:
I just found out that I have an abnormal mammogram, and a biopsy is
recommended. What will happen
to
me?
A:
For help with this sensitive question, I consulted Louis Balizet, M.D., a
medical oncologist at the Rocky
Mountain
Cancer Center. Here is his answer:
When
radiologists read mammograms, they place the results in one of five categories
ranging from totally
normal
to very suspicious for cancer. Your mammogram is abnormal enough that biopsy is
recommended
(Category
4 or 5).
Breast
biopsies are usually done using a special type of mammogram, which allows the
radiologist to see the
abnormality
—frequently only a tiny cluster of white dots, or microcalcifications — in three
dimensions.
After
local anesthesia, he places a small needle in the middle of the abnormality and
takes one or several
samples.
These samples are then reviewed by a pathologist, who determines if cancer is
present. If he finds
cancer,
he then performs a number of other studies on the biopsy specimen to determine
how aggressive it
might
be, and what medicines might be helpful in treatment. Approximately 20 percent
of Category 4
mammograms
come back positive on biopsy; almost all Category 5 ones do.
Obviously
this is a scary time for any woman; it is very upsetting to go from feeling
perfectly normal one day
to
worrying about harboring a potentially fatal cancer the next. If your biopsy
comes back positive, it is
important
to remember three things: (1) Most women with breast cancer are cured; (2) the
overwhelming
majority
of women whose breast cancer is discovered by mammogram, without a lump that
they can feel,
are
cured; and (3) mastectomy is rarely needed in the treatment of breast
cancer.
If
the biopsy does come back positive, your primary care provider will refer you
to a surgeon, who will
perform
a lumpectomy —removal of a relatively small portion of the breast surrounding
the original biopsy
site.
This will be sent to the pathologist, who will determine the size of the cancer
(usually a fraction of an
inch)
and whether a rim of normal tissue surrounds the cancer (in medical terms,
whether the “margins are
clear.”)
The surgeon may also suggest removing a “sentinel node” — a lymph node under the
armpit that is
first
in line to collect cancer cells if any decide to migrate in that direction. The
incisions for these procedures
are
usually only a few inches in length.
These
days we rarely proceed to remove any more lymph nodes under the armpit, even if
the sentinel node
is
positive — research has shown that next to nothing is gained by doing any more.
The value of finding out if
the
sentinel node is positive is to guide subsequent use of medical therapy; it is
done more to get information
about
the way the cancer is likely to behave than to treat it. These and other
discoveries have virtually
eliminated
the “fat arm” (lymphedema) that women experienced in the past as a consequence
of surgery to
remove
lymph nodes under the armpit.
At
this point we are about halfway through treatment for the breast cancer. Even
if all the cancer seen on the
mammogram has
been removed, with negative margins, there is still a good chance that there is
(invisible)
cancer
left in the breast. Eradicating this, while still keeping the breast intact and
looking as close to normal
as
possible, is the job of the next specialist you will see— the radiation
oncologist. He will use X-rays —
invisible
but deadly to any remaining cancer — delivered in small daily doses for three
to five weeks to the
entire
breast. This treatment is painless but, toward the end, you might develop a
“sunburn” on the breast
that usually
goes away in one to two weeks. Radiation therapy after lumpectomy virtually
guarantees that
cancer
will not return in the breast. It is natural at this stage for you to feel that
therapy should be done —
the
cancer in the breast has been removed, and, for good measure, the entire breast
has been irradiated.
However,
there remains one critical element of therapy— medical or “systemic” therapy.
In fact, it is this
portion
of therapy which has made the treatment of breast cancer more likely to be
curative than in the past.
We
know that women who die from breast cancer die from cancer cells that have
escaped beyond the
breast
before the diagnosis is made, then grow months to years later in other parts of
the body (metastatic
cancer).
All the treatment in the world, if directed only at the breast, will not touch
these cells. Fortunately,
there
is a large selection of medicines that do attack these cells, wherever they may
be. To decide about
whether
they are needed, and if so, which ones, you will meet yet another member of the
breast cancer
treatment
team — a medical oncologist. To guide his decision the medical oncologist turns
to the information
given
by the pathologist: How big is the tumor? Is it influenced by female hormones?
Is it driven by other
growth
factors? Is the sentinel node positive? Sometimes, to further refine the
selection of anti-cancer
medicines,
he will order an additional study on the biopsy material that can actually
measure the activity of
16
cancer-promoting genes. Armed with this information, the medical oncologist can
recommend a regimen
of
medical treatment tailored to the characteristics of your individual cancer, as
well as to your individual
overall
health status. This regimen could be as simple as a once-daily pill for five
years, or as complicated as
a
five-drug cocktail including intravenous chemotherapy.
Chemotherapy,
when needed, is by far the most difficult part of breast cancer treatment. It
can entail the
placement
(by a surgeon or radiologist) of a “port” to facilitate frequent intravenous
injections; it usually
causes
hair loss that is temporary but still distressing; it rarely causes nausea but
almost always causes
fatigue.
It is recommended only when it gives a woman a significant boost in her chances
of cure beyond
what
they would be without it. It is the medical oncologist’s job to explain to you
why additional medical
therapy
might be needed, and if so, what medicines would be best and why. The medical
oncologist also will
describe
the possible side effects of the proposed regimen, and what steps can be taken
to lessen or
eliminate
them.
Breast
cancer is common and the treatment is complex. But thanks to reduced use of
hormone replacement
treatment
and to mammograms, it is being diagnosed less frequently, and in earlier
stages. Thanks to
improvement
in surgical and radiation therapy techniques, disfiguring consequences of
treatment are rare.
Thanks
to early application of a variety of drugs, treatment is more likely to be
curative.
An
American woman’s chance of dying from breast cancer is 20 percent less now than
it was 20 years ago,
with
even more improvements likely on the horizon. If your biopsy does come back
positive for breast
cancer, you
will likely be cured of your disease, and your appearance should remain
essentially the same.
Dr.
Carl Bartecchi is an internal medicine specialist. Please submit general health
questions to him via e-mail
at
[email protected].
March
28, 2011 - Breast cancer specialists offer new technology for patients to
detect early-stage
lymphedema
–
Breast
cancer specialists at NewYork-Presbyterian Hospital/Columbia University Medical
Center are
offering
patients new ways to detect early signs of lymphedema, a common side effect of
breast cancer
surgery
that causes painful, debilitating and disfiguring swelling in the arms
following removal of lymph nodes.
As
many as 30 percent of women who have breast cancer surgery with lymph node
removal will develop
lymphedema.
Radiation treatment increases this risk to as high as 50 percent. While it is
possible to arrest
the
condition through physical therapy and bandaging, there is no cure.
"Just
as we've used early detection to improve breast cancer survival, we are using
early detection to reduce
women's
risk for developing lymphedema,"says Dr. Sheldon Feldman, the Vivian L.
Milstein Associate
Professor
of Clinical Surgery at Columbia University College of Physicians and Surgeons
and chief of breast
surgery
at NewYork-Presbyterian Hospital/Columbia University Medical Center.
Dr.
Feldman and his colleagues at NewYork-Presbyterian/Columbia are employing a
technique called
bioimpedence
spectroscopy to help them identify the earliest onset of lymphedema. An
FDA-approved
device
called L-DEX (ImpediMed Inc.) uses a mild electrical current to measure minute
changes in
extracellular
fluid, allowing for a diagnosis of lymphedema by the physician well before any
swelling is
noticeable.
"By catching it early, we can reverse the process and prevent unnecessary pain,
embarrassment,
debilitation
and risk of infection,"says Dr. Feldman.
Alongside
its clinical use, the bioimpedence technique is also being used in research to
better understand
which
patients are most at risk for lymphedema and whether the condition always
progressively worsens, or
if
it can naturally correct itself over time. Other studies will investigate the
common belief that lymphedema is
negatively
affected by air travel and weight training.
Another
method of reducing risk for lymphedema is a technique called "reverse arm
mapping.""The lymph
nodes
that drain the arm are sometimes removed during breast cancer surgery because
they're situated
within
the armpit (axilla) in the same area as the lymph nodes that relate to the
breast. With reverse arm
mapping,
we inject dye into the patient's arm to differentiate the two kinds of lymph
nodes. This allows the
surgeon
to avoid removing any nodes related to arm drainage while still accurately
identifying the sentinel
nodes,
which are important for breast cancer evaluation and treatment,"says Dr.
Feldman. "This should
reduce
the risk of developing lymphedema."
Arm
mapping is part of a larger trend toward reducing or eliminating the need to
remove a woman's lymph
nodes
-- thereby reducing the incidence of lymphedema. Beginning in the 1990s,
sentinel node biopsy used
dye
injected into the breast to target the sentinel lymph node, the gatekeeper to
the axilla and the one most
at
risk for cancer spread. Today, the latest research indicates that fewer
patients need any lymph nodes
removed
than previously thought. Even if the sentinel node is shown to be positive,
patients with early-stage
breast
cancer who are treated with lumpectomy, chemotherapy and radiation may not need
to have any
further
lymph nodes removed.
Source:
NewYork-Presbyterian Hospital
March
28, 2011 - $356K in grants for local breast cancer programs - Fresno Business
Journal –
The
Central Valley affiliate of Susan G. Komen for the Cure has announced its award
of 10 grants totaling
$356,216
to programs providing breast cancer services in the Fresno County
area.
The
awards will be presented in a press conference at ValleyPBS on April 1, which
begins the Susan G.
Komen
for the Cure fiscal year that concludes on March 31, 2012, said Sharon Johnson,
executive director
of
the Central Valley affiliate.
“We
have identified specific, unmet breast health needs within our community and
‘filled in the gaps,’
delivering
the life-saving message of early detection and providing assistance to
medically-underserved
breast
cancer patients and their families," Johnson said in a statement.
Susan
G. Komen for the Cure is a network of 125 affiliates that bills itself as "the
world's largest and most
progressive
grassroots network fighting to end breast cancer forever."
The
grantees include:
Association
for Community Enhancement: Breast Cancer Awareness Project - $10,000
?
B-CAP
will provide the nutrition education and portable exercise program in the
Hispanic and Lao
communities.
Designed to implement a series of discussion programs regarding risk reduction,
early
detection,
and treatment of breast cancers.
Centro
la Familia Advocacy Services, Inc.: Cancer del Seno - $50,000
Offers
a culturally and linguistically appropriate program specifically for Latinas
with bilingual education,
awareness
and advocacy on their behalf and screening referral resources. There are plans
to reach 500
women
in the following areas: Huron, Parlier, Sanger, Selma, and Reedley.
Children's
Hospital Central California: Children’s Hospital Central California Breast
Cancer Awareness and
Education
Project - $10,143
Research
indicates that young women who have received radiation as part of chemotherapy
have a higher
incidence
of breast cancer than the general population and need to be screened for
secondary recurrences
starting
as early as age 25. As a result, breast cancer awareness and education is vital
to early detection of
secondary
cancer conditions.
Clovis
Community Medical Center-Lymphedema Clinic :Effective and Timely Treatment of
Lymphedema,
Axillary
Web Syndrome and Related Conditions Regardless of the Ability to Pay for
Services or of Cultural
Barrier
- $50,000
Program
will provide treatment to underserved breast cancer survivors who have been
diagnosed with
lymphedema.
Deaf
and Hard of Hearing Service Center, Inc. (DHHSC): Cancer, Awareness, Recovery,
and Education
(CARE)
- $33,206
Provide
culturally and linguistically appropriate breast cancer education to the deaf
and hard of hearing.
Disability
Legal Rights Center – Cancer Legal Resource Center : Guide to Navigating Breast
Health Care
Options
in Fresno County - $10,000
Educate
those who do not have adequate information about their legal rights and
options. These groups are
less
likely to receive optimum health care and are more prone to experience
increased stress and less
positive
survivorship outcomes.
Fresno
Health Consumer Center, a project of Central California Legal Services, Inc.:
Breast Cancer
Education
Project - $50,000
The
culturally diverse staff is trained to assist families with health care access
issues in their own language.
Individuals
served represent an ethnically diverse clientele, with an increasing number of
residents for whom
English
is a second language. Will provide advocacy and educational breast cancer
awareness services and
offer
free mammograms for men and women in Fresno County through the administration
of the $200
Challenge,
funds raised from Komen Central Valley Race for the Cure.
Hinds
Hospice: Palliative Care/Hospice for Breast Cancer Patients - $43,900
Financial
assistance to help offset the un-reimbursed cost of care provided to the
uninsured or underinsured
terminally
ill breast cancer patients who are in need of Hospice Care in Fresno
County.
Valley
Public Television, Inc. DBA ValleyPBS : Multi-media Educational Outreach
Project-$50,000
Multi-media
educational outreach project for the Central Valley Affiliate of Susan G. Komen
for the Cure
focused
on developing culturally appropriate breast health education materials for
Central Valley residents.
West
Fresno Health Care Coalition, Inc.: Body and Soul United - $48,967
Community-based
and faith-based partnership project working with predominately
African-American
churches
for increasing awareness on breast health education
Thirteen
specialists in Hanford recently earned accreditation for their Adventist
Health/Central Valley
Network
surgery center.
The
Accreditation Association for Ambulatory Health Care denoted the Kings River
Surgical Center as
officially
certified, recognizing the outfit at the Hanford Medical Pavilion for its
quality of services and its
performance
based on a national standard.
“I’m
very excited we received the maximum accreditation available,” said Dr. Jeffrey
Csiszar, the center’s
medical
director. “It reflects our commitment to the quality of care our patients
receive.”
Ambulatory
means “able to walk” and refers to outpatient services, or those that don’t
require a hospital
stay.
Surgeons at the center specialize in gastroenterology, orthopedics, podiatry,
urology, gynecology,
general
surgery and ear, nose and throat operations.
The
surgeries are performed in a 7,000 square-foot center on the first floor of the
pavilion, next to Adventist
Medical
Center. The Kings River Surgical Center was designed to emphasize personalized
care and faster
surgeries
and recoveries.
March
28, 2011 – Sentinel Lymph Node Dissection – openPR –
openPR)
- Health care professionals at the King Hussein Cancer Center (KHCC) work
tirelessly not only
to
treat cancer, but to treat the patient with cancer. Doctors are trained in the
latest available techniques and
findings;
employ the most recent proven methods of diagnosis, procedures and treatment;
and utilize state-of-
the-art
medical equipment. KHCC care is patient centric, focusing on the best interests
of the patient-
aggressively
attacking cancer while working to minimize side effects for the patient.
Sentinel Lymph Node
Dissection
(SLND) is one example of the many highly-advanced techniques offered to KHCC
patients.
SLND
is an effective surgical procedure for multiple types of cancer. According to
Dr. Mahmoud Al
Masari,
Department Chairman of Surgery at KHCC, “SLND has been the standard of patient
care at the
Center
in determining the spread of disease for breast cancer since 2003.” Doctors
began using this
procedure
because of its extreme benefits to patients, offering a much less invasive
alternative, quick
recovery
and fewer post-operative complications than the traditional staging method of
Auxiliary Lymph
Node
Dissection (ALND).
Lymph
nodes are small organs grouped in the neck, underarms, chest, abdomen and groin
that help the
body
fight infection, clean and filter foreign cells. Although not all cancers
spread in an orderly progression,
the
flow of fluid from a breast tumor is predictable; it will first drain into
lymph nodes under the arm. If cells
from
a malignant breast tumor begin to spread, they are found trapped in an underarm
lymph node closest to
the
tumor before potentially spreading to other areas of the body. Doctors refer to
the sentinel lymph node
as
being the first lymph node fed directly from the tumor.
Years
ago, breast cancer patients would undergo conventional ALND where surgeons
remove most
(approximately
10-30) nodes in the armpit area to determine if cancer has spread. This
intrusive procedure
has
post-operative risks such as lymphedema (permanent, life-long swelling of the
arm). In contrast, SLND
involves
the removal of only 3-4 nodes, those suspected to be the sentinel lymph node.
If the nodes are
found
to be cancer-free after careful analysis, doctors determine that cancer from
the breast tumor has been
contained
and not spread to create any secondary tumors.
A
middle-aged woman, Rania, detected her breast cancer through screening from a
Jordan Breast Cancer
Program
(JBCP)-sponsored campaign. Upon being diagnosed, she immediately sought
treatment at KHCC,
where
she underwent a concurrent lumpectomy and SLND procedure. Like countless other
KHCC
patients,
she is grateful that Dr. Al Masari used this method which not only assured that
all cancer had been
removed,
but allowed “excellent mobility” within days of the operation. She quickly
resumed daily activities
with
her three active children, relieved to have not endured the possible nerve
damage or potential
lymphedema
commonly associated with ALND. Rania credits the excellent medical care she
received at
KHCC
- accuracy in diagnosis, advanced procedures, cutting edge technology, and
highly-skilled doctors-
for
being “a cancer-free survivor” today.
Procedure
When
a patient is diagnosed in the early stages of breast cancer and presents only a
small malignant mass,
doctors
determine in pre-operative exams if the patient is a likely candidate for SLND.
If a patient meets
required
prerequisites for SLND, surgeons perform the SLND procedure before beginning
the patient's
lumpectomy
or mastectomy to access if cancer has spread beyond the breast.
For
KHCC surgeons to accurately locate the specific sentinel lymph node(s)
requiring removal, patients are
injected
near the tumor site with two tracers- blue dye for visual identification and a
low-level radioactive
material
detected via a Gamma Probe machine. With the help of the dual tracers, a
specially-trained surgeon
identifies
the sentinel lymph nodes. Only dye-stained nodes, nodes detected with any
radioactive activity,
and
any other suspicious nodes are removed for comprehensive analysis.
KHCC
pathologists analyze the excised sentinel lymph nodes while surgeons
concurrently perform their
patient’s
lumpectomy or mastectomy. The KHCC pathology lab tests nodes by varied methods
in order to
provide
the most accurate results. Initially, a portion of the nodes are immediately
examined during surgery
to
give doctors a preliminary indication if cancer is detected. If cancer is
found, an ALND is performed to
determine
the extent of the cancer's spread. However, if preliminary pathology results
show that cancer is
not
present, it is likely that cancer has not metastasized. Pathologists perform
additional laboratory tests for
verification
which provide more reliable accuracy in detection but take longer to analyze.
For this reason,
there
is a possibility that cancer could be detected days after SLND from one of the
other methods of
analysis.
If cancer is identified, patients return to undergo the ALND procedure for
deeper analysis.
At
KHCC
The
Center's overall SLND success rate is an amazing 98%, exceeding the
international average. A
relentless
commitment to the success of SNLD is evident in rigorous training and
unparalleled,
uncompromising
quality at KHCC.
Training
Standard learning protocol requires SLND surgeons to perform at least 20-30
procedures where
sentinel
nodes have been correctly identified in over 90% of cases. All KHCC surgeons,
residents and
fellows
are thoroughly trained under the watchful eye of Dr. Al Masari, an expert in
the procedure, who
helped
pioneer this technique in Jordan as one of the first surgeons in the region to
employ SLND. Since
SLND
is regularly performed at the Center, KHCC provides a learning platform for
doctors in Jordan (and
the
region), to gain invaluable experience by receiving significant hands-on
observational training from
KHCC
experienced surgeons.
Quality
KHCC has always provided quality cancer care, utilizing only the latest and
greatest tools and
techniques
for its patients. The Center's commitment to quality has been recognized
nationally and
internationally.
Among the honors, the Center received accreditation from the Joint Commission
on
Accreditation
of Healthcare Organizations (JCAHO) as both a general hospital in 2006 (renewed
in 2009)
and
a disease-specific cancer center in 2007. Additionally, in 2009, the Department
of Pathology and
Laboratory
Medicine of KHCC was awarded an accreditation from the College of American
Pathologists
(CAP),
testifying to the exceptional high quality of KHCC’s pathology and laboratory
services. KHCC's lab
is
the first and only lab in Jordan to achieve the high criterion set by
CAP.
Statistics
since 2005 indicate 335 procedures of SLND performed at KHCC. A staggering 90
of these 335
procedures
were performed between 1/1/2010 to 8/2010. Dr. Al Masari credits increased
public
awareness
and advocacy of regular breast examinations through the JBCP, with more
incidences of breast
cancer
being detected at early stages. At these early stages of detection, SLND is
most likely to be
performed
to detect any potential spread of cancer, thereby reducing mortality.
References
Dr.
Mahmoud Al-Masri, KHCC Department Chairman of Surgery
Mrs.
Rania Odeh, KHCC patient
www.breastcancer.org/treatment/surgery/lymph_node_removal...
www.cancer.gov/cancertopics/factsheet/therapy/sentinel-no...
www.cancernews.com/data/Article/202.asp
www.emedicinehealth.com/sentinel_node_biopsy/article_em.htm
www.gammaprobe.com/clinical/lymphnodes
www.imaginis.com/breast-health/sentinel-lymph-node-biopsy-2
www.wikipedia.org/wiki/Sentinel_lymph_node
The
King Hussein Cancer Center (KHCC) is the only specialized cancer center in the
Middle East that
treats
both adult and pediatric patients. Founded in 1997, KHCC is a non-governmental,
not-for-profit
comprehensive
center dedicated entirely to cancer care. It has achieved several international
and national
P.O.Box
1269 Al Jubeiha Amman 11941 Jordan, Tel.5300460
Monday,
March 28, 2011 - Boscov's Berks Jazz Fest: Sharon Bailey battles back to the
jazz limelight – By
Susan
Shelly –
After
a two-year battle with breast cancer and melanoma, the Bethlehem resident and
Berks native reunites
with
the Ladies of Jazz for a Saturday Berks Jazz Fest concert.
After
nearly two years of battling breast cancer and melanoma, singer Sharon L.
Bailey will return to the
stage
with the Ladies of Jazz during a Boscov's Berks Jazz Fest performance Saturday
in the Abraham
Lincoln
Hotel.
Her
return to singing is a triumph, both of the medical professionals who cared for
her and Bailey's spirit,
which
wavered during the intensive cancer treatments but wouldn't be
broken.
"There
were times when I didn't know what would happen to me," said Bailey, 54, a
Berks County native
who
lives in Bethlehem. "The radiation affected my throat, and I wasn't sure about
being able to sing. But, I
tried
to stay positive through it all. At the worst times, I would imagine myself
being on stage, singing."
Singing
is what Bailey does, and has done since she was 4 years old. She has been a
part of the area music
scene
for years, and in 2003 left her nursing job to pursue singing full time.
Audiences embraced her, and
she
was hired to perform at venues including the Berks Jazz Fest, Bethlehem's
Musikfest, the Hotel
Bethlehem
and Philadelphia clubs.
She
was preparing for a show in Jenkintown, just outside of Philadelphia, in June
2009 when she discovered
a
lump in her breast and was diagnosed with an aggressive form of
cancer.
"I
am one who has had mammograms faithfully, and I'd had one just six months
before the diagnosis," Bailey
said.
"They did another mammogram and, when the doctor called me on the same day, I
knew the news
was
not good."
She
began extensive treatment, including surgeries, chemotherapy and radiation, at
Lehigh Valley Hospital,
where
she had worked as a nurse five years earlier. While she was being treated for
breast cancer, doctors
removed
some moles from Bailey's leg and discovered that she also had melanoma, a
serious form of skin
cancer.
"I
always say that things happen for a reason," Bailey said. "If it hadn't been
for the breast cancer, we might
not
have discovered the melanoma."
Today,
Bailey is in complete remission from both cancers, and ecstatic to finally be
getting back to her life.
She
recently returned from a trip to the West Coast, where she attended her
grandson's one-year birthday
party.
Bailey was still undergoing chemotherapy when Steven Xavier Bailey was born
prematurely on March
11,
2010, weighing a little more than 3 pounds.
"It was
difficult to be so far away from my son (Erik Bailey) and his wife at the time,
but I just wasn't able to
travel,"
Bailey said. "I was recently able to visit them in their new home and take part
in his first birthday
celebration."
Feeling
that she can provide valuable support and help to other women, she is looking
to shift her career
focus
to working with women suffering from lymphedema, a condition involving swelling
of the arm or arms
that occurs in
10 to 15 percent of breast-cancer patients. And she is anticipating her return
to the stage with
the
Ladies of Jazz and The Last Big Band.
"I
feel like it's going to be wonderful to be up there and see all those faces and
have the band behind me
again,"
Bailey said. "There's no other feeling like that."
Suzie
Ernesto and Toni Lynne, the other ladies of the group, are thrilled to have
Bailey back.
"Sharon
is a tough lady, and I really admire her stamina," Ernesto said. "We're happy
to get together again
and
offer up this performance as a tribute to a lady who's winning the
fight."
Lynne,
who said she and Ernesto kept in touch with Sharon via e-mail during her cancer
treatments, said the
fact
that Bailey is not only well again, but able to sing and perform with the
group, is overwhelming.
"Just
to see her strong and alive is one thing," Lynne said. "But she still sings.
She can still sing. And, that is
just
awesome."
Bailey
is philosophical about her ordeal with cancer, and grateful to the medical
staff and advancements that
enabled
her recovery. While she dealt with her illness in a somewhat private manner,
she feels it is important
to
share her story to bring additional awareness about breast cancer and melanoma,
and to serve as a
source
of hope and inspiration to people who are in treatment for cancer.
"I
just feel so blessed," Bailey said. "My cancer is gone, and I'm thrilled to be
able to do what I can do now.
I
want other people to know there's hope. I can't do everything I'd like to, but
I can sing again, and I'm just
thrilled
about that."
Contact
Susan Shelly: [email protected].
March
28, 2011 - Local Soldiers, Girl Scouts Display Best of Americans - Patch.com –
ByAnna Renault –
Witnessing
acts of bravery, generosity highlight columnist's week 'around town.'
Traveling
around town is always an interesting experience.
Last
Thursday, I had mixed emotions as I attended the deployment for a unit from the
175th Infantry
Regiment
of Maryland’s National Guard. Eric Friesl, an usher at Our Lady of Mt. Carmel
Parish, is a
member
of the Towson unit that deployed 88 men. This is Friesl’s fourth
deployment.
Family,
friends and parishioners are wishing him all the best.
“I’m
glad I have the special skills and training needed that keeps my name on the
‘available for deployment’
list,”
Friesl said.
His
unit left from the Towson Armory, bound for six weeks of focused training at
Fort Atterbury, IN. The
training
will be followed by a 12-month assignment in Egypt.
The
Armory was abuzz with dignitaries, family and friends, all there to say
farewell as the men departed on
their
dangerous mission. It seemed a bit strange seeing the men carrying their
machine guns on their shoulder,
across
their back, or along their front. While it is recognized that soldiers deploy
to a war zone and must use
heavy
weapons, it isn’t every day you see them carrying the weapon like a backpack or
a baby. The guys
admit
they quickly learn that it is necessary to have hands on your weapon at all
times—it becomes second
nature
when in a war zone.
Days
after watching soldiers ship out for an unknown mission, I had the chance to
see another great group
of
Americans display what makes this country great. On Saturday night, I was on
hand as 16 Girl Scout
Troops
came together for one of their community events at St. Clements in
Rosedale.
Their
focus was Kami’s Jammies, a nonprofit organization that collects new pajamas
that are distributed to
children
who must spend time in hospitals. Watch for more details on this type of
fundraising projects.
Congrats
to Girl Scout Troop #1081 for hosting the event and for collecting 112 pairs of
pajamas.
At
the event was Laila Lowery representing Kami’s Jammies, a program of the Casey
Cares Foundation.
Laila
is a second grader who attends the Friends School. Laila has Sickle-Cell
Anemia, a chronic condition,
which
causes severe pain when her blood cells form crescents in the blood or “sickle
shapes” that cause
pain
as these clumps pass through her veins and arteries.
Many
other symptoms impede normal childhood activity and development. As a frequent
visitor to
University
Hospital, Laila understands the importance and influence receiving a gift of
new jammies has for
young
children who face unpleasant hospital stays.
along
with book signings has made my face more recognizable.
Thank
you to all who have taken the time to speak with me about my journey through
both domestic
violence
and cancer. Yes, there have been tough times, but know that many positive
things have happened
along
my life’s journey—perhaps that will have to be another book … something like
Anna’s Journey: The
Rest
of the Story! Would anyone be interested in things that are rather ordinary,
fun, exciting, weird and
otherwise
filling in the blanks of my life?
And
yes, the journey is continuing as I live through cancer reactions like
Lymphedema on top of a
rollercoaster
ride as a newly published author.
March
29, 2011 - NewYork-Presbyterian/Columbia Uses Latest Technology for Early
Detection of
Lymphedema
in Breast Cancer Patients - By Jyothi Shanbhag –
To
offer a quick relief for Breast Cancer Patients, specialists at
NewYork-Presbyterian Hospital/Columbia
University
Medical Center are using new methods and technology to detect early signs of
lymphedema, a
common
side effect of breast cancer surgery that causes painful, debilitating and
disfiguring swelling in the
arms
following removal of lymph nodes.
A
new technique called bioimpedence spectroscopy has been implemented by Dr.
Sheldon Feldman, the
Vivian
L. Milstein Associate Professor of Clinical Surgery at Columbia University
College of Physicians and
Surgeons
and chief of breast surgery at NewYork-Presbyterian Hospital/Columbia
University Medical
Center,
and his colleagues at NewYork-Presbyterian/Columbia to help identify the
earliest onset of
lymphedema.
“Just
as we've used early detection to improve breast cancer survival, we are using
early detection to reduce
women's risk
for developing lymphedema,"says Feldman.
An
FDA-approved device called L-DEX (ImpediMed Inc.) uses a mild electrical
current to measure minute
changes
in extracellular fluid, allowing for a diagnosis of lymphedema by the physician
well before any
swelling
is noticeable. "By catching it early, we can reverse the process and prevent
unnecessary pain,
embarrassment,
debilitation and risk of infection,"says Dr. Feldman.
Along
with this clinical use, the bioimpedence technique is also being used in
research to better understand
which
patients are most at risk for lymphedema and whether the condition always
progressively worsens, or
if
it can naturally correct itself over time.
Other
studies will investigate the common belief that lymphedema is negatively
affected by air travel and
weight
training. Even other methods like reverse arm mapping are used to reduce the
risk of developing
lymphedema.
NewYork-Presbyterian
Hospital, based in New York City, is the nation's largest not-for-profit,
non-
sectarian
hospital, with more than 2 million inpatient and outpatient visits in a year,
including more than
220,000
visits to its emergency departments.
March
29, 2011 - EMMC's motion for new trial in miscarriage case denied - Bangor
Daily News – By
Nok-Noi
Ricker –
BANGOR,
Maine — U.S. District Judge John Woodcock on Monday upheld a jury’s October
decision
that
awarded a Millinocket woman $200,000 in a civil lawsuit against Eastern Maine
Medical Center, and
he
also denied the hospital’s motion for a new trial.
The
decision is just another step in the appeal process, EMMC’s lawyer said in
response to Woodcock’s
ruling.
Lorraine Morin’s lawyer said it affirms the jury’s decision that the hospital
violated the law and in so
doing
directly caused her to suffer personal harm.
Morin,
who was having contractions when she was discharged from EMMC on July 1, 2007,
after finding
out
the 16-week-old fetus she was carrying had no heartbeat, went home and
delivered her dead son in the
bathroom
of her Millinocket home.
She
sued the hospital in U.S. District Court in Bangor, claiming that doctors
violated the Emergency Medical
Treatment
and Active Labor Act when they sent her home. The law prohibits a hospital from
discharging a
patient
who is in an emergency medical condition, which includes being pregnant and
having contractions.
A
jury of six women and two men issued their verdict in October after
deliberating for nearly seven hours.
They
awarded Morin $50,000 in compensatory damages and $150,000 in punitive
damages.
Woodcock’s
decision, which was filed Monday, means “the jury got it absolutely right,”
said A.J. Greif,
Morin’s
attorney, “and that he wasn’t going to undo seven hours of hard work by this
very bright jury.”
George
Schelling, EMMC’s attorney, said in an email that he was not surprised by
Woodcock’s decision.
“The
judgment released today in the Morin case is as expected,” he said. “The ruling
clears the way for
EMMC
to appeal the jury’s October 20, 2010, verdict to the federal appeals court.
While EMMC’s
profound
sympathies are with the Morin family, EMMC is confident the appellate court
will find that EMMC
treated
Mrs. Morin in keeping with national standards of care in cases of miscarriage,
and that EMMC is in
full
compliance with EMTALA.”
EMMC
had filed a renewed motion for judgment and a motion for a new trial more than
a month ago based
on
three claims.
The
Bangor hospital “attacks the verdict, claiming that EMTALA distinguishes
between viable and non-
viable
pregnancies, that the Court erred in allowing a nurse to testify as an expert,
and that the trial evidence
did
not sustain the verdict,” Woodcock said in his decision denying EMMC’s
post-verdict motions.
The
hospital asked for a new trial “because the Court did not instruct the jury
that the ‘may pose a threat’
language
of EMTALA depends on whether the woman in labor has any medical condition that
could
interfere
with the normal, natural delivery of her healthy child,” Woodcock
said.
The
judge responded by saying he rejected the same motion during the trial because
Morin did not deliver a
healthy
child, but a dead fetus, and therefore the language did not apply. He again
denied the motion.
The
issue about whether a veteran nurse called as a witness by the defense should
have been allowed to
testify
also was dealt with during the three-day trial in October, the judge said in
rejecting the hospital’s
second
reason for a new trial. The final assertion, that the evidence didn’t support
the verdict, also was
denied
by Woodcock.
The
judge also denied a motion by Morin, which she filed after the October verdict,
for the hospital to
change
its policies regarding the discharge of women going through
miscarriages.
“The
Court declines to issue such an injunction because the law does not authorize
it and the facts do not
support
it,” Woodcock said.
Greif
said his client filed the motion because “she would never want another woman to
go through what she
went
through. This has never been about Lorraine, and this has never been about
money.”
March
30, 2011 - Uterine Cancer Treatments: Success Without Side Effects - SYS-CON
Media –
SARASOTA,
Fla., March 30, 2011 /PRNewswire/ --
Regina
Baldwin was 57 and post-menopausal when she started spotting and experiencing
pain during
intercourse.
She was shocked when her gynecologist told her she had endometrial cancer. And
she shocked
her
family when she announced that she was going to a treatment center in Mexico.
According to TMD, a
medical
tourism research company, Baldwin was one of half a million US citizens going
out of the country
for
medical treatment each year.
An
aerobics instructor and avid jogger, Baldwin maintained a healthy weight, had
never taken estrogen or
Tamoxifen
or had radiation to the pelvis. She had 3 children, and her periods had always
been normal, so
she
had none of the risk factors associated with endometrial cancer.
Endometrial
cancer is the most common cancer of the female reproductive system. Ninety-five
per cent of
uterine
cancers, like Baldwin's, develop in the lining of the uterus. Sarcomas that
develop in the muscle of the
uterus
are very rare. In 2010, there were 43,470 new cases in the USA, most in women
over 55. There
were
7,950 deaths due to endometrial cancer in that same year.
The
uterus is pear shaped and located in the pelvis between the bladder and rectum.
During childbearing
years,
the uterine lining grows thicker each month to prepare for pregnancy. When
pregnancy does not
occur,
the thick bloody lining is shed through the vagina. This cycle occurs regularly
until menopause.
When
normal cells in the uterus begin to change and grow uncontrollably, tumors may
form. The most
common
symptoms of endometrial cancer are abnormal bleeding or discharge, difficulty
emptying the
bladder,
pain in the pelvic area, or pain during sex or urination.
Diagnosis
is done by pelvic exam, ultrasound, biopsy, a pap test to see if the cancer has
spread to the cervix
and
labs to measure kidney function and tumor markers. Other tests may include
chest X-ray, CT scans and
MRIs.
When
Baldwin was presented with conventional medicine's standard treatment -
surgery, chemotherapy and
radiation
and hormone therapy - she began to research side effects.
Surgery usually
involves removing the ovaries, fallopian tubes, part of the vagina, lymph nodes
and the uterus
itself.
Side effects include nausea and vomiting, loss of bladder control,
constipation, loss of desire, hot
flashes,
vaginal dryness and night sweats. Removing lymph nodes may cause lymphedema, a
painful swelling
in
the legs.
Radiation
and chemotherapy causes hair loss, skin tenderness, diarrhea, vomiting, vaginal
burns, infections,
exhaustion,
low blood counts, mouth and lip sores, numbness in extremities, hearing loss,
joint pain and
swelling.
Further
research told her that when caught early, about 84% of patients live up to 5
years. The survival rate
for
late stage endometrial cancer is only 10%. Faced with these dismal statistics,
Baldwin told her doctor
she
wanted to get a second opinion before deciding on a course of treatment. And
she began to look into
alternative
clinics located both in and outside of the US.
"I
found many clinics in the states that offered excellent programs for detox and
immun
e
support, but none could offer the aggressive natural therapies that are only
legal outside of the US,"
Baldwin
explained.
"I
learned that the cancer had been in my uterus for a long time before symptoms
appeared, so I felt
comfortable
taking a few weeks to look at all my options. I was not going to be rushed into
a treatment that
had
so many side effects. I wanted to live, and I wanted to be able to enjoy life
with my children and
grandchildren."
Baldwin
faxed her medical records to several clinics in Baja California, Mexico, just
across the border from
San
Diego, California. "I talked to the head doctor at each clinic, and they
answered my questions,
suggested
treatment plans and told me what I could expect. And they all told me there
would be no side
effects,"
Baldwin said.
Eventually,
Baldwin was admitted to Hope4Cancer Institute, near Rosarito Beach in Baja. "I
chose this
small
private clinic because they have 8 physicians on staff and they take only 10
patients at a time. And they
were
the only clinic I interviewed that did not offer any chemotherapy, not even low
dose chemo. The warm,
personal
attention and caring staff made my stay a pleasure. The clinic is small enough
that you really bond
with
the other patients and their families, and I made some lifelong friends," she
said.
According
to Baldwin, it was her research findings on local and whole body hyperthermia
treatments that
made
her choose Hope4Cancer.
Dr.
Antonio Jimenez, founder and medical director of Hope4Cancer Institute, uses
both local and whole
body
hyperthermia. "It has been scientifically proven that if you can sustain a
temperature of 106 degrees
inside
a tumor for one hour, the cancer cells will be destroyed," Jimenez explained.
"Because malignant
tumors
have poor circulation, they are more sensitive to temperature changes, and
normal cells are not
affected,
so the treatment has no side effects. We attribute our success to the way we
combine a variety of
therapies,
with an individual treatment plan for each patient. And we educate our
patients, so they
understand
what they need to do to regain their health and then stay healthy."
Hyperthermia
has been used in Germany for over two decades. Recently the FDA approved
microwave
hyperthermia
for medical use in the US, but microwaves can only be used on a small area at a
time, and only
penetrates
a short way beneath the skin. Sound wave or radio wave hyperthermia can be used
as a whole
body
treatment to find and destroy cancer cells throughout the body. This type of
treatment also kills
parasites,
virus and fungi while stimulating the immune system. Baldwin's research
confirmed that this
treatment would
be safe and effective in fighting her cancer.
"My
treatment was pretty intense - I was in therapy from after breakfast until
dinner time, seven days a
week
for two weeks," said Baldwin. "I had local and whole body hyperthermia,
SonoPhoto Dynamic
Therapy,
several different IVs, a vaccine, lots of detox, counseling and nutrition
classes. The food was all
organic
and I've learned why I need to change my eating habits. My husband was able to
come with me - he
stayed
in my room and attended classes and learned how to help with home
therapies."
According
to Baldwin, making this decision was not easy. "My parents were appalled that I
was traveling to
Mexico
for treatment. My kids were very supportive. My gynecologist thought I was
crazy. My best friend
said
she was 100% behind whatever decision I would make and that was the best thing
anyone could have
said
to me. I needed the people around me to respect my decision as the right one
for me."
"It's
been 4 years since my treatment at the clinic, and I feel confident I will
remain cancer free. My test
results
are still clean. I maintain a healthy diet, and stay on a maintenance program
from the clinic. I think I
made
the right decision."
Author
Marla Manhart is a health writer affiliated with TMD Limited and is a patient
advocate. She can be
reached
at: [email protected]
SOURCE
TMD Limited
March
30, 2011 - Lesser-known illness comes to light – StarPhoenix – By Hannah
Scissons –
Having a
medical condition that most people have never heard of can be frustrating —
especially when one
of
those people who has never heard of it is you.
Angela
Connell-Furi started experiencing severe swelling in her ankles when she was
21.
"When
I went to doctors and showed them, they would just say, 'Oh, yeah, there's
something going on. Put
your
feet up. Lose a little weight, it'll go away,' " said Connell-Furi, now 30
years old.
Working as a
home-care aid made the directive to put her feet up a difficult one to follow,
but she did her
best.
As the years progressed, however, the swelling only got worse. Connell-Furi's
legs and ankles
ballooned
to such a point that she had trouble finding shoes that fit, let alone
assisting her home-care clients.
Six
years on, suffering from a toe infection, Connell-Furi visited a doctor who
took one look at her legs, told
her
it looked like primary lymphedema and referred her to a vascular specialist who
confirmed that diagnosis.
"He
just lifted so much weight off my shoulders when he said, 'I'm going to send
you to someone who
knows,'
" Connell-Furi said about the family doctor who gave her the
referral.
WHAT
IS LYMPHEDEMA?
Lymphedema
occurs when the lymphatic vessels -part of the immune system -don't perform
properly,
causing
a buildup of lymph fluid.
Primary
lymphedema is a rare, hereditary condition. Secondary lymphedema occurs when
the lymph nodes
or
vessels are damaged by things such as surgery, cancer, radiation treatment for
cancer or an infection that
invades
the lymph vessels.
It's
a chronic condition and treatment can only slow its progression. There is no
cure.
Treatment
includes reducing the swelling through a process called manual lymph drainage
-a massage
technique
also known as complex decongestive therapy -and the use of compression garments
that are
specially
fitted to the patient.
Patients
who are diagnosed with lymphedema in Saskatoon are referred to the outpatient
physical therapy
department
at Royal University Hospital to be fitted with the compression garments. Janice
Block, a senior
physical
therapist, said the department gets between 60 and 70 referrals every
year.
"The
vast majority of clients we see are people who develop lymphedema after surgery
for cancer,
particularly
breast cancer," Block said.
Clients
who are interested in manual lymph drainage and who are approved by their
doctor to get it can be
referred
to therapists in the city who offer it. Evelyn Tucker receivied training in
manual lymph drainage in
1993
and many of her clients have lymphedema.
"The
goal of the treatment is to arrest the progression of the condition and then I
would be teaching the
clients
how to do selfbandaging and self-massage, making sure they're taking really
good care of the skin in
that
area, because it's so susceptible to infection," Tucker said.
Similar
to Block, Tucker also sees many breast cancer patients who are post-mastectomy
and who
developed
secondary lymphedema.
"They've
had treatment for cancer and now, much to their chagrin, they've developed
lymphedema and . . . I
think
the hardest thing for them is they dealt with the cancer and now, life-long
likely, they have this," said
Tucker.
BORN
WITH IT
In
Connell-Furi's case, the lymphedema is primary, meaning she was born with the
susceptibility to the
condition.
After her
diagnosis, she was sent to Royal University Hospital to be fitted for
compression garments to keep
the
swelling down. It was a difficult fitting process and Connell-Furi ended up
with compression garments
for
her lower legs -not ideal, because her upper legs would also swell, but better
than it was before.
Two
years after that, her arms also started swelling. Connell-Furi now had
lymphedema in all four limbs.
When
she was 28, Connell-Furi reached a point where she had to face the fact that
her condition made
continuing
as a home-care aide impossible. She went on disability. She said it's still
hard to talk about the
day
she had to leave her job.
"I
had to wear sunglasses because I was just bawling," she said.
Later
that year, she was referred to the Foeldi Clinic in Germany, where she finally
was treated by lymphatic
specialists
-there are none in Canada. During her five weeks there, she received manual
lymph drainage
massage
twice a day and was fitted for compression garments that reached from just
under her breasts
down
her legs and ones for her arms that reached down to her fingertips.
She
was also in exercise classes every day and her husband Trevor received massage
training.
PUSHES
HERSELF
Back
home in Saskatoon, Connell-Furi found it very difficult to learn more about her
condition, even in the
years
after she finally knew what it was. Tucker, her massage therapist, told her
about the Saskatchewan
Lymphovenous
Learning Association (SLLA), a group that was created in 2004. ConnellFuri is
now a
board
member with the association.
One
of the goals of the association is to increase awareness of lymphedema among
both the general public
and
health-care professionals. Connell-Furi tells the story of when she was in the
emergency room and the
struggle
she had communicating to the nurse about her condition.
"With
lymphedema in your arms, you're not supposed to have a blood pressure cuff.
It's like blunt trauma, it
can
make your arm blow up, I'm exaggerating a bit, to six times its size. It can
really make it worse," she
said.
"Nurses
have fought with me. I'll explain to them why, and they just don't listen. . .
. Now I have a note from
(my
doctor) that I'm not to get lab work, blood pressure or an IV unless it's
life-threatening. The health-care
system
definitely needs more education on it."
One
of the goals the SLLA had was to establish a website with links and other
information on lymphedema.
Connell-Furi
volunteered to do that.
"I
thought, 'how hard can it be?' " she said. "It took me a good five months. I
would just do a little bit every
few
days, because I can only sit for so long and type for so long too."
The
site went live earlier this month. It can be found at
www.sasklymph.ca.
March
30, 2011 - A Regional Leader in Orthopedic Care - MD News –
The
Tahoe Center for Orthopedics — with offices located in beautiful Lake Tahoe and
the surrounding
areas
— provides an integrated care approach in treating a wide range of orthopedic
conditions. A resource
for
physicians and patients, it is a regional destination for exceptional
orthopedic care.
Focusing
on quality and personalized care that covers the full spectrum of
musculoskeletal injury and disease
states,
the Tahoe Center for Orthopedics provides preventive care and wellness,
surgical and nonsurgical
services
and a rehabilitation program in a world-class destination.
“At the Tahoe
Center for Orthopedics, our goal is to provide exceptional patient care while
ensuring an
excellent
patient experience,” says Michael Lewis, M.D., M.B.A., Director of the Tahoe
Center for
Orthopedics.
“Our top-level health care providers, including dedicated physicians, nurses and
physical
therapists,
exercise an integrated care approach that allows us to deliver high-quality
clinical care as well as
maximize
patient outcomes.”
Service
lines provided to patients through the Tahoe Center for Orthopedics include,
sports medicine, joint
replacement
and reconstruction, spine care, hand and upper extremity care, medical imaging
and
rehabilitation.
Providing a true continuum of care, staff from home health and case management
also work
closely
with the treatment team, patients and their caregivers, creating the smoothest
possible transition from
hospital
to home.
“When
patients are in need of musculoskeletal care, they benefit from seeing our
staff of dedicated and
experienced
medical professionals, including fellowship-trained orthopedic surgeons and
radiologists,” says
Dr.
Lewis. “Other services provided to patients include care for metabolic bone
disease, osteoporosis and
rheumatology.”
Advanced
Medical Imaging
Radiologists
at Barton Health routinely collaborate with orthopedic surgeons and
physiatrists at the Tahoe
Center
for Orthopedics, providing medical imaging services through a 1.5T MRI, a
64-slice CT scanner and
X-rays.
“As
radiologists, we work closely with orthopedists to quickly and efficiently
obtain images of the injured
body
parts,” says Leonard Holmgren, M.D., radiologist on staff at Barton Health.
“Primarily, we do sports
imaging,
as injuries of the knee and shoulder are the most commonly seen conditions due
to the popularity of
recreational
sports activities such as mountain biking, skiing and rock climbing. Our goal
is to provide
enhanced
access to imaging and help return people to an active lifestyle as soon as
possible.”
Radiologists
also work with physiatrists and spine surgeons through the spine program at the
Tahoe Center
for
Orthopedics to help address concerns, including back pain, neck pain and other
spinal conditions.
“Part
of the care that we provide to spinal patients is MRI services,” says Dr.
Holmgren. “However, we are
also
involved in nonsurgical management of spinal pain, including epidural steroid
injections and nerve root
blocks.
We also perform percutaneous kyphoplasty for patients who have spinal
compression fractures or
osteoporosis.”
During
a percutaneous kyphoplasty procedure, a needle is injected into the damaged
vertebral body. An
inflatable
balloon is used to restore the vertebral body to its normal height and cement
is then injected into
the
space to maintain proper spine alignment.
Ensuring
the Best Possible Outcome
To
ensure a patient’s recovery to optimal functionality following care,
rehabilitative services, including
physical,
occupational, speech and aquatic therapy, are provided through Barton’s
Rehabilitation Services, a
division
of the Tahoe Center for Orthopedics.
“Orthopedists
at the Tahoe Center for Orthopedics will refer patients who need nonoperative
injury
management or
rehabilitation after surgical care,” says Alan Barichievich, P.T., Director of
Rehabilitation at
Barton
Memorial Hospital. “Once referred, we perform a complete musculoskeletal
evaluation to design a
customized
treatment plan that is then communicated back to the orthopedist to enhance
collaboration.”
Additional
services offered through Barton’s Rehabilitation Services include a running
program, mechanical
traction
and aquatic therapy, hand therapy and lymphedema management. Barton Memorial
Hospital
employs
the only certified hand therapist on the South Shore.
The
runner’s program provides footwear, orthotic assessment and video analysis to
evaluate runners to help
prevent
injury and help them get back into shape after injury. Many therapists employed
at Barton Memorial
Hospital
are avid runners themselves, so patients and physicians can rest assured that
the program was
developed
by trail runners and racers who understand runners’ specific needs.
“Each
therapy protocol is individually customized,” says Barichievich. “We see
patients of all ages from
pediatric
to geriatric patients, and depending on each individual’s injury and
rehabilitation goal, we develop
individualized,
hands-on care.”
Enhancing
the Education ?of Other Medical Professionals
For
the past 20 years, the Lake Tahoe Sports Medicine fellowship, part of the Tahoe
Center for
Orthopedics,
has provided a sports medicine fellowship program for physicians who have
completed a
residency in
orthopedic surgery and are seeking additional training in the area of sports
medicine. Because
Lake
Tahoe is home to an array of outdoor activities, fellows are exposed to a high
level of sports medicine
cases
during their fellowship training. Additionally, fellows gain experience in both
academic and private
practice
settings.
Lake
Tahoe’s Sports Medicine Fellowship Program is one of 95 programs accredited
through the
Accreditation
Council for Graduate Medical Education. This year-long program allows
orthopedic surgeons
to
gain subspecialty expertise in the area of sports medicine. Specific areas of
focus include musculoskeletal
trauma
of the ligaments, bones and joints.
“Through
the fellowship program, training physicians become part of our orthopedic
sports team and take
care
of everything from evaluating patients to participating in treatment, including
surgery,” says Keith
Swanson,
M.D., Program Director of the Lake Tahoe Sports Medicine Fellowship Program.
“Not only
does
this allow us to participate in the training of another generation of
physicians, but it also enhances the
care
provided to our patients.”
Because
the program is accredited, the Tahoe Center for Orthopedics is held to a higher
standard in regards
to
the level of research and care provided to patients. Active research programs
are in place, and training
physicians
can expect to complete more than 500 surgeries throughout the duration of the
fellowship
program.
Located in beautiful Lake Tahoe, the location of the center can be a draw as
well. A wide variety
of
recreational sports are available, and the Tahoe Center for Orthopedics is also
proud to be the official
medical
provider of the United States Ski and Snowboard teams.
A
Community Resource
The
Tahoe Center for Orthopedics strives to be a resource for patients and
community physicians. Staff
work
closely with referring physicians who often know their patients best,
especially at the onset of care.
Referrals
are accommodated in a timely fashion, and inpatient and outpatient treatments
are facilitated by
staff
to enhance patient convenience.
Weekly
educational conferences are open to community physicians and the Tahoe Center
for Orthopedics’
medical
staff. Orthopedic surgeons, primary care physicians, physical therapists and
radiologists generally
attend
the conference, which is held at 7 a.m. on the Barton Hospital campus. At this
conference, topics in
sports
medicine are discussed and difficult orthopedic cases are presented, which
allows for education as
well
as increased collaboration among the treatment team.
Seminars
for community members are also routinely held. Each program features a specific
musculoskeletal
condition and
includes educational information, such as wellness, treatments and symptoms.
The Tahoe
Center
for Orthopedics’ sports medicine staff is very involved with high school sports
programs as well.
Through
the Center’s preventive care and treatment, local high school sports teams have
increased access to
a
wide variety of medical providers, including physicians, athletic trainers and
physical therapists.
“Aside
from the high-quality clinical care provided, the commitment we have to our
patients and our
community
is what makes the Tahoe Center for Orthopedics unique,” says ?Dr. Lewis. “We
are
knowledgeable
and respectful of each patient’s goals and abilities and strive to
individualize treatment plans
to
provide ideal outcomes for every patient.”
For
more information about the Tahoe Center for Orthopedics or to refer your
patient, please call (877)
543-5554
or visit tahoeorthopedics.com.
March
31, 2011 - Area breast health organizations get grants - ConnectAmarillo.com
powered by KVII –
by
Nastassia Tamari –
AMARILLO,
TEXAS -- In order to address the specific unmet breast cancer needs of the
panhandle
community,
the Susan G. Komen Greater Amarillo Affiliate works has handed out grants to a
tune of
$285,000
dollars.
The
four programs all provide breast cancer services to the panhandle area, with
the goal of saving lives. "It
will
provide mammograms for women who don't have insurance or who don't have the
means to pay for the
deductibles.
Women will put it off because there's other things in life that they put first
you know as mom as
a
woman," said Julie Evenson, the Radiology Director at the Moore County
Hospital. "I have friends that
came
in for their first screening mammogram and found cancer," continued Evenson.
The Moore County
Hospital
District will use the funds to provide breast cancer screening, diagnostic
follow-up and surgical
treatment
as well as community outreach and education to underserved women in Moore
County and the
surrounding
communities.
That
funding will help them reach the community. "We cover the Texas and Oklahoma
panhandle and it lets
us
to reach all those ladies," said Terri Prescott, the Community Manager of
Health Initiatives for the
Amarillo
Cancer Society, a division of the American Cancer Society. It will use the
funds for the Amarillo
Breast
Prosthesis and Lymphedema Accessory Program. It will give the patient emotional
support, a kit
containing
a leisure bra, a lightweight temporary breast form, and rehabilitative exercise
educational
information.
These
grants will provide that detection for free. The money will go specifically to
address women in the
panhandle
by providing education, support, and services, even properly fitted
prosthesis.
"Early
detection has you know, if you can detect breast cancer early, the chances of
you surviving are much
longer,
it's when we don't detect breast cancer early is that the chance for cure is
much less," said Aneta
Younger,
the Director Diagnostics and Therapeutics at Don Harrington Cancer Center. The
funds will be
used
to help cover screening and diagnostic mammography, breast biopsy, breast MRI,
and some treatment
regimens
for medically underserved women of all ages who are not covered by other
funding.
So
that's why these programs are so important for those unmet needs.
"This
reaches women who might never have mammogram, they will get mammograms through
the grant, free
of
charge," said Leticia Goodrich, Executive Director of the Amarillo Area Breast
Health Coalition and
Project
Director of WISE Woman. The WISE program is a "train the trainer" concept. It
selects and trains
women
in basic breast health practices that stress the value of screening and early
detection.
To
date, the Susan G. Komen organization has invested $1.3 million in the
panhandle's 26 counties.
Here
are the 2011-2012 Grant Programs:
American
Cancer Society: $10,000
Amarillo
Area Breast Health Coalition (WISE Woman): $12,000
Moore
County Hospital District: $43,000
The
Don & Sybil Harrington Cancer Center: $220,000
March
29, 2011 - Peterson Chiropractic introduces Power Plate technology - Ridgefield
Press -
Peterson
Chiropractic has incorporated advanced technology known as “vibrational
therapy” to increase
circulation
and rehabilitate patients quickly. Power Plates are three-dimensional vibration
technology that
transmits
waves of energy, activating muscle contractions between 25 and 50 times per
second.
“Good
for patients with osteoporosis and lymphedema, as well people looking for a
challenging but painless
abdominal
workout, it works so quickly that most people only spend five to 10 minutes on
the machine,”
said
Dr. Nick Peterson. “Patients can be treated for lower extremity rehabilitation
just standing on the
Power
Plate.”
Power
Plate exercise improves ROM, increase bone density as well as reduces the
appearance of cellulite,
Dr.
Peterson said. “This type of a workout is also known as acceleration training.
It was first introduced by
Russian
cosmonauts to reduce the effects of zero gravity in space.”
Owner
Nick Peterson, D.C. was introduced to this new machine by his son Nicholas A.
Peterson, D.C.,
who
attended the sports centric Life University in Atlanta where the machines were
used by all athletes as
well
as the coaches who wanted to stay fit without the high impact of most training
regiments.
“After
our patients are out of acute pain we start then on more active treatments like
the Power Plate,” said
Dr.
Nicholas Peterson. “It only takes a few minutes to feel the benefits of the
vibrations and circulation
immediately
increases into muscles and joints.”
“Many of our
patients only have a few precious minutes to get a stretch and the vibration
speeds a warm-up
by
involving 100%o of muscle fibers.
For
a free demonstration, call 203-438-9609.
April
1, 2011 - Charity's dedicated helpers improve the lives of cancer victims and
their families –
MANY
lives are affected by cancer. One in three of us will get the disease and
countless more will feel its
impact
indirectly through the suffering of loved ones.
Beyond
the diagnosis and treatment at hospitals such as Good Hope, one Sutton charity
has dedicated itself
to
improve the lives of those affected by cancer – whether they are patients or
their family and friends.
Set
up a little over ten years ago, The Cancer Support Centre's (CSC) goal is to
provide a haven away from
the
physical and psychological effects of the disease.
When
CSC started in 2000 it offered alternative therapies one day a week, as well as
support for cancer
sufferers.
In the first year 145 treatments were carried out at its Farthing Lane site.
Last year that number
rose
to 2,900, including one-to-one sessions and group therapies, everything from
acupuncture to yoga, art
classes
to aromatherapy, counselling and meditation.
CSC
provides complementary therapies free of charge to its clients and to
accommodate the expanding
need,
it has recently moved to the St Giles site in Lindridge Road, on the edge of
Sutton's leafy suburbs.
Here
it will be open five days a week, Monday to Friday, helping thousands of people
cope with the rigours
of
dealing with cancer.
I
met CSC's chief fund-raiser, Pat Brighton and trustee, Alan Bunn, whose wife
Denise used the service for
three
years before succumbing to lymphoma.
The
pair were delighted to have completed the move from the charity's former site
in Midland Drive in the
town
centre to the St Giles' building, which St Giles uses to help people with
illnesses including multiple
sclerosis,
Parkinson's, lymphodema and bereavement counselling.
"With
the services that St Giles offers and what we offer for cancer patients, the
two organisations
complement
each other," Pat said. "Anyone who has cancer can come here. Once they have
been
diagnosed
they are sent on their way from hospital which deals with the medical side but
we offer support
beyond
that. The management at St Giles has been terrific in helping us," Pat said.
"St Giles contacted us
about
having a supportive care centre for Sutton Coldfield last year. The more we
talked about it, the more
we
realised how good it would be for the local community."
Another
advantage of the new venue is ground floor treatment rooms and lifts to the
upper level.
"At
the other place the treatment rooms were upstairs," Alan said. "Anyone who came
in a wheelchair had
to
make do but here it is a lot easier."
The
new site is indeed in a stunning location.
Homely
touches have been brought to the inside of St Giles' building.
In
the talking therapy room comfy chairs are in place and pictures are ready to
hang on the walls.
Sofas
replace hard chairs in the main meet and greet area, which has now become CSC's
library. Therapy
rooms
are called Sunflower, Lavender and Poppy, the latter decked out with children's
characters and soft
toys,
for young clients use St Giles' children's lymphedema clinic.
A
more controversial change took place at the site's entrance. "People from CSC
were sensitive about "St
Giles
Hospice" and we asked them to remove hospice from the sign," Alan
said.
At
the centre of the building is The Sanctuary room, with pictures of woodland
surrounding you, chairs
carved
from logs and subtle lights changing colour, creating a calming
escape.
"My
wife was here three years and tried everything," Alan explained. "We used to
travel to Solihull for
meetings
every other week as we didn't know this place existed.
"Two
years after losing my wife I became involved with the charity. It has provided
me with something to
give
back.
"I
had an email about a meeting "to discuss the future of the CSC". That was when
I came on board. I didn't
know
if it was going to close but in fact it was to discuss the move."
Alan
has been a director for blue chip companies and his business acumen has been an
important element
for
the charity. The cost of providing free treatments to clients, running the
building and paying for a full time
finance
manager means CSC must raise £100,000 a year -or £2,000 a week.
By
expanding its service from four to five days a week, the pressure on costs can
only go higher.
"At
the end of the day you have got to run it like a business," Alan said. "If you
haven't got the funds to pay
for
the services that the therapists provide, you can't do it."
By
moving to St Giles site, the two charities are sharing the costs of the
building but the way to pay for all
the
costs is "lots of hard work".
"The
Great Midlands Fun Run is our biggest fund-raiser," Pat said. "We were the
second most supported
charity
last year and we need lots of people to run in the Fun Run this year for
us.
"We
raised £10,000 last year, with £8,700 in sponsorship and the rest with Gift
Aid. Anyone who runs for
us
can get a free t-shirt to run in."
CSC
has just recruited 20 new volunteers, bringing its total to 35. With trustees
and other helpers it has
nearer
to 50 unpaid staff. It has no guaranteed funding.
"We
apply for grants and we have to be able to prove the benefits," Alan said. "We
measure the results of
treatments
here from the feedback."
Demand
is ever increasing and Pat is always on the look out for more help.
"We
are open five days a week and the need is there," Pat said. "This is the
problem. We want to give as
many
treatments as needed and since we have moved we have been pretty well fully
booked. The more
treatments
the more money we need."
The
Cancer Support Centre is open Monday to Friday from 9.30am to 4.30pm and can be
contacted by
calling
0300 012 0245
May 2, 2011
Complementary
Treatments for Cancer: The Role Reiki And Massage Can Play in Treatment -
Huffington Post – by Joseph Nowinski, Ph.D. –
Modern
medicine has transformed death and dying. Whereas a "terminal" diagnosis once
meant that
death was more or less imminent, increasingly "terminal" illness
refers to a chronic and potentially fatal
disease. It begins with a
diagnosis. That can lead to a protracted process that includes treatment,
remission, possible relapse, treatment again and so on. In this way, death
has become a process for
millions of us, as opposed to the sudden event it
once typically was.
In the course of writing "Saying Goodbye:
How Families Can Find Renewal through Loss," we
interviewed a great many
patients, caregivers and family members. We were looking for common
themes
and experiences in an effort to draw a rudimentary "road map" of what families
can expect --
and what they can do to make this process more manageable.
One of the themes that emerged was
the increasing use of alternative and
complementary treatments (ACT's) conjointly with treatments
such as
chemotherapy, radiation therapy and surgery, all of which can have pernicious
side effects.
As I did in my first blog on complementary
treatments, I have tried to base this material as much as
possible on
objective evidence that can be found through the National Institutes of Health,
the
National Cancer Institute and the National Center for Complementary and
Alternative Medicine
(NCCAM). Recognizing that there are many advocates for
various kinds of complementary
therapies, I should make it clear that I am
a clinical psychologist, not a massage therapist or Reiki
practitioner. As
a psychologist, however, I am well aware that it is possible to obtain
testimonials
attesting to the effectiveness of virtually any treatment. That is not to say that those treatments did not
help those individuals.
But that is not the same as controlled clinical research. I carry no brief for
any
complementary treatment, and I am open to the possibility of their
effectiveness.
My previous blog looked at acupuncture. This one
focuses on two additional therapies: Massage and
Reiki. Conceptually, they
are thought to work in somewhat opposite, yet perhaps complementary
ways.
Massage is a hands-on therapy that is based on manipulating tissue. Reiki, in
contrast, is a
hands-off (or light touch) therapy that seeks to free up
innate bodily energy (ki) that is believed to
have healing
power.
Reiki
Reiki, in its original form, is a
self-administered treatment; however, it cannot be self-taught. One must
learn Reiki from an experienced practitioner and it involves three levels
of learning. As a
complementary treatment, it has been used to treat many
conditions. Although Reiki can theoretically
be performed at a distance, in
the cancer treatment centers where it is used, it is often applied
in-
person at one-to-one sessions lasting anywhere from 30 to 90 minutes. In
these sessions the Reiki
practitioner places his or her hands close to or
lightly touching the patient's body, using as many as 15
different hand
positions. The idea behind Reiki is that the practitioner is able to feel the
flow (or lack
of flow) of the body's energy (ki) and to free it up so as to
facilitate the patient's overall health. Reiki
can be a very calming and
reassuring therapy for the patient who receives it.
Is Reiki
Effective?
The Journal of Alternate and Complementary Medicine
recently published a review of 12 clinical trials
of Reiki. While nine of
these investigators reported positive effects for Reiki, 11 of the 12 studies
had
serious methodological flaws, such as the lack of a control group
and/or a comparison treatment. It is
therefore impossible to say whether
the reported effects were due to patients' expectations of benefit
-- the
placebo effect. In another review of research published in the International
Journal of Clinical
Practice, 205 studies were evaluated and boiled down to
nine that were scientifically sound. The most
common benefits of Reiki that
were reported in these studies was in the area of relieving depression
and
anxiety. There were no substantiated results for pain relief. Finally, none of
these studies has been
replicated to show that the results can be reliably
repeated.
If Reiki is effective, then, it is most likely to be
with respect to patients' overall emotional state. That,
of course, matters:
Depression and anxiety are two side effects of medical treatments for cancer
that
are often overlooked.
Massage
According to
NCCAM, the leading reason why Americans turn to massage therapy as an adjunct
to
cancer treatment is to help relieve pain. To the extent that massage is
effective in relieving the physical
aspects of stress (tight muscles,
etc.), we could say that massage is also used to relieve stress. And
surely
treatment for cancer is stressful, for the patient as well as loved
ones!
There are a variety of "schools" of massage therapy, but
all of them involve the direct manipulation of
bodily tissue in one way or
another. In addition, the majority of massage therapists I spoke with said
they incorporate a variety of techniques in their practice, including the
use of pressure, deep muscle
massage, body alignment and so
on.
Is Massage Therapy Effective?
Keep in mind that
we are talking specifically about the use of massage as a complement to cancer
treatment, not its effectiveness in general. In a study funded in part by
NCCAM, 380 participants
were randomly assigned to receive either six
30-minute sessions of actual massage therapy or six
three-minute sessions
of simple touch therapy that did not include the kinds of methods cited above.
Both groups showed significant reductions in reported pain, physical and
emotional distress and
overall mood. However, these effects were greater
for the group that received actual massage
therapy.
Two
things strike me as important about the above findings. The first is that touch
-- any kind of touch
-- appears to be beneficial when you are fighting
cancer, including the side effects of medical
treatments. Second, the fact
that these beneficial effects were not sustained after the massage therapy
ended suggests that this form of complementary treatment needs to be
ongoing as opposed to a one-
time intervention.
One final
note on massage: A treatment known as manual lymphatic drainage, in which
massage is
used to move fluid away from areas where lymph vessels are
blocked, appears to be effective in
reducing lymphedema associated with
surgery for breast cancer.
Both Reiki and massage therapy are
available to patients who reside (for free) at the Hope Lodge in
Boston
while they undergo treatment in one of that city's several major cancer
centers. However, as
people have commented in response to my earlier blog,
it is a mistake to assume that a cancer
treatment center -- even an
expensive or well-known one -- will offer such services. Their availability
may reflect in part the bias of the center's administration regarding the
effectiveness of complementary
treatments. So the best advice I can offer
to these patients and their families is to pursue these options
on your own
if you think they might be worth a try.
Insurance may not cover
complementary treatments; on the other hand, they are much less costly than
any medical treatment, such as chemotherapy. And some have commented that
it may be possible to
negotiate rates, especially if several patients get
together and seek a discount.
Perhaps as more rigorous research is
conducted and reported we will learn more about which
complementary
treatments do what, and for whom. Surely all of the above symptoms -- anxiety,
depression, pain -- complicate cancer treatment. To the extent they can be
ameliorated, it makes
sense to include them in a comprehensive treatment
plan.
The "new grief" that is the result of the transformation
of death and dying will affect every one of us
eventually, if it hasn't
already. Families do best when they approach terminal illness by learning about
primary treatment as well as complementary treatment, and bringing both to
bear.
May 3, 2011
Hawthorn Medical Associates in
Dartmouth hires new full-time physical therapist - Fall River Herald
News
–
DARTMOUTH --
The Hawthorn Medical Associates’
Physical and Occupational Therapy Department announces that
Sherry
Spencer-Brown has become a full-time member of the staff. Spencer-Brown is an
experienced physical therapist and a nationally certified lymphedema
therapist. She specializes in the
care of oncology patients and vascular
patients who have symptoms of lymphedema.
With the addition of
Spencer-Brown, the Physical and Occupational Therapy Department is able to
offer its patients a progressive and comprehensive approach to oncology
rehabilitation. Spencer-
Brown’s expertise will ensure that cancer patients
have access to rehabilitation that will assist them in
their recovery.
Patients who will benefit include those with symptoms of lymphedema, joint
pain,
limited range of motion, loss of function, decreased independence in
home and work activities and
deconditioning.
A graduate of
Northeastern University, Spencer-Brown was most recently employed at St. Anne’s
Hospital in Fall River as a lymphedema specialist. She has also been in
private physical therapy
practice and is a past manager of the
rehabilitation department at Morton Hospital and Medical
Center in
Taunton.
May 4, 2011
Thursday's Pink Fair emphasizes
women's health and wellness - TheDay.com –
Norwich — Enhancements
to the Breast Health Patient Navigator program at The William W.
Backus
Hospital will be featured during the third annual Pink Fair from 3 to 6 p.m.
Thursday at the
hospital.
The fair focuses on women’s health
and wellness, and includes free screenings such as bone
densitometry and
blood pressure. Admission is free. This year, special attention is being given
to the
services available through the navigator program. It has been at
Backus since 2008 but has recently
been enhanced, James O’Dea, assistant
vice president at the hospital, said Wednesday. The program
helps guide
women through the healthcare system after a suspicious
mammogram.
Offices for the navigator program have moved to a
more prominent location in the hospital so the
services are more easily
accessible, O’Dea said. One area contains resources for breast cancer
patients including wigs, garments and an information library. O’Dea said
other recent enhancements
include prompter follow-up imaging for women who
have had an “inconclusive” mammogram finding,
so that instead of waiting 20
days they are now have a diagnostic mammogram or ultrasound within
six
days.
The hospital is also starting a lymphedema screening
program to track women for up to three years
who have had breast surgery
for signs of this painful, disfiguring condition that can become a chronic
condition, O’Dea said. If detected early, there are effective treatments,
he said. Thanks to donations
to the navigator program, the hospital was
able to purchase lymphedema screening equipment.
May 5,
2011
BrightLife Direct Introduces 3 New Lymphedema Product Lines
- PR Newswire –
Washington, DC-based medical compression garment
distributor adds several lymphedema products
to its
inventory.
WASHINGTON, May 5, 2011 /PRNewswire/ -- BrightLife Direct, a
compression clothing
distributor, recently added three new lymphedema
products to its inventory. Products by Farrow
Medical, Solaris and
Gottfried are now available online through the Washington, DC-based
company.
These compression garments are used in lymphedema
treatment. Lymphedema is a medical condition
that involves swelling of the
arms, legs or hands. Although it can be caused by a genetic condition, it is
often caused by lymph node removal after breast cancer surgery. Statistics
show that up to 50
percent of breast cancer survivors develop lymphedema.
About 32 percent have persistent swelling
three years after surgery. While
there is no cure for this condition, lymphedema can be managed with
the use
of compression sleeves, gloves, stockings and wraps.
"We have received
requests from therapists for hard-to-find products, so we are trying to address
that need," said Kip Bright, president of BrightLife Direct. "We want to be
a resource for patients and
therapists who need these compression
garments."
BrightLife Direct will begin carrying jobst bandages
over the next few months. These are long-stretch
and short-stretch bandages
which accommodate patients during different stages of their treatment.
The
FarrowWrap resembles a sports brace and has adjustable hook and loop closures.
The Farrow
Microfine glove is another new addition to BrightLifeDirect's
inventory. It is made of more lightweight
material than other types of
compression gloves, allowing for more hand
flexibility.
BrightLife Direct also carries Swell Spots,
manufactured by Solaris, Inc. Swell Spot is typically
placed under
clothing, bandaging, or a compression garment to gently massage the underlying
tissue
and break up problem areas of swelling.
Gottfried Medical
makes custom compression garments for all parts of the body. These reasonably
priced garments are custom ordered to meet the specific needs of the
patient, making them more
comfortable to wear.
About
BrightLife Direct, Inc.: BrightLife Direct (http://www.brightlifedirect.com/)
has been serving
those who wear compression garments for more than 10
years. The Washington, DC-based
company offers name brand products at
discounted prices. This includes compression stockings from
Jobst, Mediven,
Sigvaris and Juzo. The company features a private label brand, Allegro
stockings,
which meets all rigorous testing standards and is available at
50% to 60% less than name brands.
SOURCE BrightLife Direct,
Inc.
Activcare Physical Therapy Combines with Wellness One -
dBusinessNews Triangle –
Triangle - RALEIGH, NC – Effective May
9, Activcare Physical Therapy and Wellness One, two of
Raleigh’s most
respected private physical therapy practices have combined their physical
therapy and
support teams. The entire staff, including physical therapists
from Wellness One, will become
employees of and operate under the name of
Activcare Physical Therapy.
Wellness One patients will continue to see
their same Wellness One therapist at Activcare Physical
Therapy’s
state-of-the-art facility, just down the road at 3100 Blue Ridge Road, Suite
204. Patients
should not experience any gap of service, and their same
insurance will continue to cover their
physical therapy treatments. The
current Wellness One phone and fax numbers will also remain in
service.
Wellness One patients will have access to more credentialed insurance companies
and
additional hours of service — from 7am – 7pm Monday through Friday and
8am – 12pm on
Saturdays.
“By joining forces with Wellness One,
Activcare Physical Therapy has created what we believe to be
the most
extensive physical therapy resource in the Triangle area,” said Brad Hancock,
MPT and
owner of Activcare Physical Therapy. “We have worked diligently to
make this transition as seamless
as possible for all the Wellness One
patients and we’re happy to be able to continue to offer them the
very best
possible physical therapy services and care.”
Activcare Physical Therapy
is a privately held physical therapy practice with three current locations:
two in Raleigh on Blue Ridge Road, and one in Fayetteville. With the
combined capabilities of
Activcare Physical Therapy and Wellness One,
patients can now access a multitude of treatment
options under one roof,
including: Orthopedic Therapy, Neck and Back Therapy, Neurological
Rehabilitation, Incontinence, Vestibular and Balance, Women’s Health,
Sports Medicine, Oncology,
Geriatric Therapy, Pain Management, Cardio
Conditioning, TMJ Disorder and Lymphedema.
For more information about
Activcare Physical Therapy, visit www.activcarept.com.
Backus
health fair especially 'pink' this year - Norwich Bulletin – by JAMES MOSHER
–
Norwich, Conn. --
Breast cancer survivors were in an
especially festive mood Thursday as The William W. Backus
Hospital
celebrated moving a key program to a larger space in addition to its annual
women’s health
fair.
The Breast Health Patient Navigator
Program officially took up its quarters in three refurbished offices
as the
program’s leader, nurse Joyce Kuusela, cut pink ribbons on two of the
second-floor offices
including her own.
“It’s a great day,” said
Kuusela, who lives in Lisbon and is a breast cancer survivor. “We’re going to
be able to better direct people and help a lot more.”
Before
joining colleagues on the first floor for the 3rd annual Pink Fair, hospital
workers reflected on
the program’s milestone and looked forward to
more.
James O’Dea, the administrator who oversees the navigator
program, described himself as “giddy”
over the establishment of a
lymphedema screening program. Lymphedema is a painful condition that
can
result from mastectomy surgery.
“All of this reflects a real commitment
to women’s health in this community,” he said.
The program has
strong support at the hospital’s top echelon.
“It’s nice to see
all this come together,” President and CEO David Whitehead said. “It’s just the
beginning. We’re looking for opportunities to expand health care in this
regard.”
During the Pink Fair, cancer survivors raised money for
an Oct. 20 fashion show planned for
Foxwoods Resort Casino. About 20 models
are expected to participate. At last year’s show,
organizers sold out of
all 60 pink boas. They will bring 200 this year, said Barbara Chiangi, a
Norwich resident who is director and co-producer of the show and a two-time
cancer survivor.
“It all goes back into the Backus community,”
said Donna Palumbo of Niantic, the show’s co-
producer and also a survivor.
“We’re building up women’s health through all this.”
The fair
featured 17 stations of information and therapies including facial massage and
harp music.
Nurse Elizabeth Fracchia and social worker Wendy Heilweil
strengthened the theme of looking ahead
by discussing medical directives,
also known as living wills.
Visitors praised the
offerings.
“It’s great,” said Yvonne Wright of Norwich, while
walking the fair with daughter Michele Bilodeau
of Preston. “Lots of useful
information. And free chocolates don’t hurt.”
May 6,
2011
Tai chi offers special benefits for cancer survivors - News
Record and Sentinel –
Every Thursday morning, a group of women
who share a common bond gather at Mission Hospital's
Wellness Resource
Center at 50 Doctors Drive on the Memorial Campus.
The bond we
share? We're all Cancer Thrivers and Survivors. Why do we gather? Mainly
because of
the camaraderie. And because tai chi is relaxing and good for
the soul.
We continue because tai chi is a great motivator to
help slow aging, and regain strength, energy and
range of
motion.
Our tai chi class has been offered for just over a year, and is
sponsored by the resource center. It
meets 10:30-11:30 a.m. every
Thursday.
Nancy Chatham, our instructor and a breast cancer
survivor herself, has taught exercise classes for
10 years and is certified
as a tai chi for arthritis instructor. We are fortunate that she now brings
that
program to us, for cancer survivors.
Tai chi, often described
as “meditation in motion,” can also be described as “medication in motion.”
Good body alignment and slow, flowing moves increase flexibility and
strengthen muscles weakened
by surgery.
The emphasis on
relaxed breathing and gentle moves enhances the lymphatic system, adding to the
benefits for women at risk of lymphedema following
surgery.
As we focus on balance and weight transference and move
with intent, we improve our mental focus
and internal strength. The flowing
motion relaxes the body and fosters a sense of peace and calm. Did
I
mention that it's fun, too?
I have attended this class since its
inception in August 2008, just 2 weeks after my own double
mastectomy. In
addition to the benefits from exercise and movement, there's the ever-present
friendship and support among the women in our class. Together, we've been
through surgery,
reconstruction, and many other challenges of
life.
And that, my friends, is priceless.
Women
dealing with cancer or other chronic illness who are interested in this journey
are welcome to
join our class. The health benefits are for
everyone!
For more information, or to register for the class,
call Mission Hospital's Wellness Resource Center at
213-8246.
Scabies Outbreak Linked to Nurse's Dirty
Compression Glove - Infection Control Today –
A dirty
compression glove worn by a healthcare worker is implicated in a scabies
outbreak among
newborns. In a study appearing in Infection Control and
Hospital Epidemiology, Barbara G. Ross, of
the Department of Infection
Prevention and Control at New York-Presbyterian Hospital, and
colleagues,
report that after three cases of scabies in infants were identified by a
pediatric
dermatologist during a three-month period, an intensive
investigation was launched to find additional
cases by contacting local
pediatric dermatologists and hospital-affiliated
pediatricians.
Scabies is a contagious infestation of the skin
caused by the mite Sarcoptes scabiei; it is transmitted
through close
personal contact with infested individuals or their personal items and can live
on
inanimate items for up to two days.
The researchers report that
seven additional case patients, including three neonatal intensive care unit
patients, were identified. Cases were diagnosed both by microscopic
examination of skin scraping
specimens and clinically. They add that
environmental rounds were conducted in the newborn
nursery, postpartum
rooms, nursing stations and patient and staff lounges, and no cloth furniture
or
grossly contaminated fomites were found. The researchers then looked for
a healthcare worker index
case patient; six employees were identified as
having contributed to the electronic medical record for
three or more case
patients; five were found to be without symptoms and they accepted
prophylaxis.
Ross, et al. (2011) report further that a per diem
nurse had contributed to 10 of 10 electronic medical
records examined:
“When evaluated, she was noted to have a rash and wore a noticeably dirty
compression glove for lymphedema while on duty, making it impossible for
her to clean her hands
effectively. This nurse reported that she had been
treated for scabies by a private dermatologist at
least five times in the
previous year, although she had not reported this
treatment.”
The researchers hypothesize that the dirty
compression glove that the nurse wore at work contributed
to her
re-infestation or was a means for transmission to patients and add, “Staff who
require hand or
wrist braces or compression gloves or sleeves must be
evaluated and reasonable accommodations
considered by hospitals so that
infection prevention policies can be followed. A single case of scabies
in
a newborn should be considered a sentinel event of a nursery
outbreak.”
Reference: Ross BG, Wright-McCarthy JK, DeLaMora PA and
Graham PL. Transmission of
Scabies in a Newborn Nursery. Infection Control
and Hospital Epidemiol. Vol. 32, No. 5.
May
2011
Stillwater team goes to nationals: Rutherford Elementary
Lego League Robotics Team heads to
national competition, hopes to make a
difference - Stillwater Gazette - By HANNAH JOHNSON
It's not
just a competition. It's personal.
In its third year competing, a
sixth-grade Lego League Robotics Team from Rutherford Elementary
School is
going on to the First Lego League (FLL) national competition at the end of the
month.
Every September FLL releases a themed challenge based on a
real-world scientific topic. Each
challenge has two parts: the Robot Game
and the Project. Each team with one adult coach
participates in the
challenge by programming an autonomous robot to score points on a themed
playing field (Robot Game) and developing a solution to a problem they have
identified (Project).
The seven-student team placed first in the
regionals and qualified as "Champions" at the state
competition. Now the
team will be heading to Lego League Nationals near San Diego, California
May 20-22.
This year's theme was Biomedical Sciences and
Engineering. The Rutherford team chose to research
lymphedema, which is a
condition that causes chronic swelling from the build-up of tissue fluid in an
area of the body. Normally lymph vessels transport protein-rich lymph fluid
into the circulatory
system, but if it can't transport the fluids then
swelling and skin thickening occurs. If it's left untreated it
can harden
the tissues, cause infections and even cancer.
The students didn't
randomly select its research topic. The team decided to study lymphedema
because one of the team's coaches was recently diagnosed with the disease.
The project then became
more than constructing an award-winning piece - it
also became an opportunity to make a difference.
"This year has been
exciting for (the students) because as they studied the topic they discovered
each
(student) has a connection with someone suffering from lymphedema,"
said Teresa Cook, one of the
team's coaches. "They had no idea they had
these connections so it became a real topic to them."
While conducting
their research the students met with doctors and researchers, learning that
lymphedema affects people young and old. People can be born with it or
receive the disease from
cancer treatment. As a result, the students
designed The LymphESocc, a compression garment that
combines electric
stimulation and channel foam to alleviate pressure on the
limbs.
Normally patients wear a knee or thigh-high stocking that puts
pressure on the limb and then patients
see therapists for individual
therapies. This garment brings together all therapeutic aspects, eliminating
the need to see a therapist and alleviate relieve their pain at any
time.
The students' product has been recognized by more than the Lego
League judges. The students were
recently recognized by the research
department at the Sister Kenny Institute in Minneapolis.
"In coming up
with the garment they didn't know where it was headed, but we've been told this
is a
viable garment that could be put to use in the next few years," Cook
said. "For them to come up with
something really innovative that could
possibly better the lives of someone with lymphedema was neat
for
them."
In addition to attending the Lego League Nationals, the students
will also compete in the Global
Innovations competition that awards a paten
process to an innovative and viable product.
The students will be
hosting three fundraisers in the next couple of weeks to raise the necessary
funds
to pay for their trip to Nationals. On Wednesday, May 11 the students
will host a fundraiser at
Buffalo Wild Wings in Oak Park Heights. For every
diner who joins the students and turns in a ticket,
BWW will donate 10
percent of the person's meal spent.
If people also choose to do their
garden shopping and turn in a team voucher at Linder Mart, Linder
will
donate 15 percent of the sale to the team.
To print vouchers and tickets
or to learn more information visit www.twizbots.webs.com.
May 8,
2011
Pregnant with cancer, mom makes gut-wrenching decision -
GoErie.com - By LINDY
WASHBURN –
HACKENSACK, N.J. -- Sheri
Quattrocchi was just 13 weeks pregnant when the cancer she
thought she'd
beaten two years earlier surged back.
A swollen lymph node
beneath her rounded belly turned out to be metastatic melanoma, an advanced
form of the deadliest type of skin cancer.
This was to be
her first child, the happy outcome of in-vitro fertilization after two
heartbreaking
miscarriages.
But now her choice was stark.
Doctors said she had two options: terminate her pregnancy and begin
treatment immediately, or carry her pregnancy as close to full term as
possible and begin treatment
after the baby was born.
"They
said it really had to be my decision," recalls the 33-year-old, who lives in
Lodi, N.J. with her
husband, Michael Quattrocchi.
But the
physicians' preference was clear: Termination.
"It was not my
recommendation that she continue (the pregnancy)," said Dr. Anna C. Pavlick, a
specialist in melanoma at New York University Medical Center. "I think it
was not anybody's medical
advice that she
continue."
Melanoma can spread to the brain and lungs; when it
reaches that advanced stage, few treatments are
available. It is also one
of very few cancers that can cross the placenta and affect the fetus: The
longer
she carried the pregnancy, the greater the risk that the baby would
be born with cancer.
Cancer occurs in about one in 1,000
pregnancies. It's rare, but becoming more common as women
wait until they
are older to bear children, when the risk of cancer is
higher.
Metastatic melanoma, though, is even more unusual. "You
don't see too many of them," said Dr.
Abdulla Al-Khan, Sheri Quattrocchi's
high-risk pregnancy specialist at Hackensack University
Medical Center. "We
didn't have a lot of data out there to tell us the best thing to
do."
Pavlick and Quattrocchi's obstetrician laid out the risks
and benefits of each course for the couple.
"She needed to know
that her life, and possibly even the baby's life, may have been in jeopardy by
continuing," Pavlick said.
But doctors make recommendations;
patients are supposed to make the decisions.
The doctors saw a
pregnant woman with melanoma. Sheri Quattrocchi knew there was more to the
story than that.
For the couple, the melanoma's recurrence
began another harrowing chapter in several years of
hardship.
In 2007, a month after her 30th birthday, Sheri
Quattrocchi learned she had multiple sclerosis.
"I had some
weird sensations in the legs, and thought nothing of them," she said. She went
to the
doctor for something else, received a referral to a neurologist and
had a battery of tests.
In December 2007, an internist treating
her for a virus noticed a mole on Sheri Quattrocchi's
abdomen and told her
to get it checked out. Surgery took place the following June. The mole was
removed with a wide excision and the lymph nodes in the groin nearby
dissected.
When it turned out to be melanoma, Sheri Quattrocchi
was shocked: there'd been no blistering
sunburn, there was no family
history. She was glad that the lymph nodes were deemed
"clear."
"Life was getting too short," though, she said. She and
Michael Quattrocchi became engaged five
days after the cancer
diagnosis.
The couple, who had been together since they were 14
and 15, decided to start a family right away.
Then, six months
after the wedding, Michael Quattrocchi was diagnosed with testicular cancer.
Two
operations followed.
Once he got better, they turned to
in-vitro fertilization.
Their first two cycles, undertaken at
great expense, resulted in two failed pregnancies.
Then they
made a third and final attempt. It succeeded.
Although wary at
first, Sheri Quattrocchi had made it through her first trimester and was
entering her
second when the lymph node started to swell.
A
Hackensack, N.J., surgeon, Dr. Donald McCain, removed it while Sheri
Quattrocchi was under
local anesthesia. She and her husband were watching
television in the recovery room when they
learned the devastating news: The
melanoma had come back.
"I was in shellshock," she
said.
The doctors presented her choices a few days
later.
She didn't hesitate.
"I'd heard the
heartbeat already," she said. "I had seen the baby move on the ultrasound
screen."
She couldn't wait to meet this new member of the
family. "There was no question I was going to take
my chances," she said.
"God was not going to finally give me this gift and then, you know, take it
away, or make her (the baby) sick."
"She thinks the baby is
more important, and I think the mother is more important," said Al-Khan, a
director in Hackensack's division of maternal-fetal medicine, recalling
their early discussions. "These
are the difficult dilemmas that physicians
face."
Should he do everything for Sheri Quattrocchi --
diagnostic imaging with CT and PET scans, careful
staging of the cancer,
followed by aggressive treatment? "Or do we buckle our seat belts and take it
day by day?"
He talked with the couple, talked with
colleagues, reached out for second, third and fourth
opinions.
The combination of pregnancy, multiple sclerosis and
melanoma was a "perfect storm," said Pavlick,
each condition affecting or
affected by her immune system. "These are the cases that make me stay up
at
night."
There was little record of previous cases to guide
them.
"No one can really say with certainty that waiting three
to six months is going to be the difference
between long-term living or
dying" with most cancers, said Dr. Andrew Pecora, vice president for
cancer
services at Hackensack. "Lots of times you can stall and not adversely affect
the outcome."
"You do your best," Pecora said. "You share all
that and give their options and then respect their
choice."
Sheri Quattrocchi chose. The waiting and watching
began.
Sheri Quattrocchi's plastic surgeon, Dr. David Byckoff,
removed a small melanoma from her
abdomen under local anesthesia. It had
not gone deeply into the skin and was not a major worry.
Then,
at the end of February, Sheri Quattrocchi felt something new where her
lymph-node surgery
had been. "My scar was getting lumpy," she said. "It was
starting to hurt. I was getting concerned."
She was 30 weeks
pregnant. The doctors' goal for her pregnancy: 36 weeks.
Her
pregnancy crowded the other organs and made it hard to see what was going on
with ultrasound
imagery. But something was clearly
growing.
Al-Khan spoke with Sheri Quattrocchi after the
ultrasound, on a Friday afternoon. Get ready, Al-
Khan told her. The baby
would be delivered at 32 weeks.
On March 21, her baby was
born.
It was an emotional scene in the delivery room, but the
birth itself "was uneventful, thank God," said
Sheri Quattrocchi. She cried
as the baby was held to her face. So did her husband.
The
incision was stitched up -- a vertical rather than a lateral scar, because of
the additional
abdominal surgery that was sure to be
needed.
Baby Mikayla weighed 4 pounds, 14 ounces -- big for a
premature baby.
Meanwhile, the cancer was getting hotter and
hurting more each day.
When doctors saw the results of the CT
scan, they changed their minds about waiting to let the C-
section scar
heal. Two days after Mikayla's birth, Sheri Quattrocchi returned to the
operating room.
The mass the surgeon removed was "the size of an
Idaho potato," she said. The contents of the node
had spilled into the
surrounding tissue. But it could have been worse: There were no signs of
melanoma in other organs of her body.
Afterward, Sheri
Quattrocchi rested in her hospital bed, and wore pressure sleeves on her legs
intermittently to treat the lymphedema, or swollen legs, that had
developed. As often as she could, she
visited Mikayla in the intensive-care
nursery.
The placenta was analyzed: no signs of cancer. The
melanoma had not spread to the baby.
They are at home now. The
baby -- 5 pounds of tiny perfection in a green sleeper with matching cap
and booties -- sucks from a bottle as she nestles on a cushion on Sheri
Quattrocchi's lap.
Michael Quattrocchi takes the overnight shift
with Mikayla, then goes to his job at a group home for
developmentally
disabled adults.
He admits he's scared. "I just pray. I pray
every night. I put it in God's hands," he says.
"We got our
miracle -- Mikayla," he adds. "I don't feel that God is going to give us this
wonderful little
girl and take her mother away. I'm scared, but I'm staying
positive."
Sheri Quattrocchi needs radiation therapy to target
the area where the lymph node was removed with
51/2 to 6 weeks of daily
treatments. She'll also get chemotherapy, in pill form, to prevent future
cancer spread.
Pavlick says she is "cautiously
optimistic."
"The fact is, she made it through the whole
pregnancy without (the cancer) going to other parts of
body," Pavlick said.
"Now her immune system may be going back to normal," although with MS, it
won't ever be entirely normal.
Al-Khan agrees. "I think she
will do well -- my mouth to God's ears," he said.
"People say
I'm very unlucky," Sheri Quattrocchi said. "I feel like I'm lucky. I survived
it. My husband
survived it. I have this awesome, feisty little baby girl.
... I have great friends, great family. I have
awesome
co-workers.
"This is my light at the end of the tunnel: having
my baby," she said.
May 9, 2011
Hospital
hosts clinical trials - Cookeville Herald Citizen – by Liz Engel Clark
–
COOKEVILLE -- Cancer patients participating in clinical trials
could be laying the groundwork for
future care, say health care officials
at Cookeville Regional Medical Center.
The hospital offers a wide
variety of trials for patients with prostate, colon, breast and lung cancer,
among others. And although only a small percentage can actually participate
in such research studies,
the information gathered could have a lasting
impact down the road.
"The majority of patients that we approach about a
clinical trial, most of them want to do something to
help somebody else,"
said Joy Hilliker, RN, certified clinical trials coordinator at Cookeville
Regional.
"Time after time I have women who say, 'If this is something that
will help my daughters or
granddaughters, then I'm going to do it, even if
it doesn't help me.' And obviously that philosophy is
huge, because the
treatments we use today are those things that have been tested in the
past."
All trials offered at the hospital are phase two or higher. Phase
one trials, for example, test an
experimental drug or treatment in a small
group of people for the first time to evaluate safety,
determine safe
dosage ranges and identify side effects. Trials in phase two and three would be
given
to larger groups to further test a drug's effectiveness and evaluate
its safety.
"Phase two is more researchy from the standpoint that you
might be using a drug that's less
established, but it's still gone through
a phase one, which means there's some track record there," said
CRMC Dr.
Paul Jacquin. "Phase one is really the first human testing of a drug, and I
don't really think
that community hospitals should do a phase one or even
pre-clinical drugs, particularly. Because then
you're truly experimenting
on your population base."
The hospital, he said, offers a wide variety
of trials for prostate, colon, breast and lung cancer. Many
are currently
active or enrolling patients.
There's one new trial, for example, for
advanced lung cancer patients. It utilizes a drug recently
approved in
melanoma treatment, and participants should have never had chemotherapy
before.
There's also a lung trial that utilizes a vaccine, which attacks
the cells that these cancers produce.
"Probably almost 50 percent of our
cases are lung cancer in this community," Jacquin said. "There's
different
kinds of lung cancer, and we kind of like to hit all of them. We're trying to
get a number of
different protocols for that."
CRMC also offers a
myeloma trial and is in the process of opening a radiation therapy trial.
Another
trial is testing a new drug that could help prevent mouth sores, a
common side effect from radiation
therapy in head and neck cancers. The
hospital has also started a lymphedema prevention trial for
breast cancer
patients. Hilliker says participants should enroll before they have
surgery.
"That's actually a real interesting trial, and it was
originally funded with (Susan G.) Komen and Lance
Armstrong," Hilliker
said. "It's studying an exercise program in hopes of preventing lymphedema in
women after they've had breast surgery, and specifically, lymph node
surgery related to breast
cancer."
The trials offered are a
combination of observation and controlled. They are either
pharmaceutical-
sponsored or cooperative group trials, like those offered
through SWOG, or the Southwest
Oncology Group, one of the nation's largest
clinical trial networks. A cooperative group membership
allows the hospital
access to trials being conducted nationwide, which means patients don't always
have to go elsewhere for treatment.
There are risks with trials, of
course, but Hilliker said SWOG audits are conducted every couple of
years.
Pharmaceutical companies are also active in the monitoring process.
"The
only resistance you get sometimes is people say, 'Gee, I don't want to be a
guinea pig,' but we're
only doing trials in phase twos and threes," Jacquin
said. "There's only a small percentage of people
nationwide that go through
trials, so we're basing our standard of care on minority population of
people who volunteer for this.
"They're really getting the
best-known treatment," he said.
May 10,
2011
Class helps women with exercise after breast cancer surgery
- Ventura County Star - By Alicia Doyle
–
Some women may be
reluctant to get involved in an exercise class right after breast cancer
surgery.
"They have questions about what they can and cannot
do," said Sara David-Feyh, who leads women
who have undergone breast
surgery related to cancer during a free class, "Exercise is Wise After
Breast Cancer Surgery." It meets at St. John's Outpatient Therapy Center in
Oxnard.
"The goal is to provide a relaxed, supportive setting
where the women can see themselves as the
women they used to be or want to
become as they go through the cancer experience together," said
David-Feyh,
57, of Ventura, who has been leading the class since 2005.
A
physical therapist assistant for 15 years, she was mentored by Claudia
Steele-Major, who
launched the program in 2001.
The class
incorporates low-impact stretching and strengthening, with an emphasis on the
upper body.
Exercises are designed to improve range of motion in the
shoulders, upper back and neck, as well as
improve posture. A
cardiovascular component to improve endurance and general mobility is included
and adjusted to each individual. Breathing and relaxation techniques are
integrated to enhance well-
being and reduce stress.
Class
participants also have access to information about lymphedema, which is
swelling in the arms
and legs. A participant may be referred to a physical
or occupational therapist if their physical needs
exceed the scope of the
class.
"Initially after surgery, reaching overhead or lying on the
affected side is difficult due to pain and scar
tissue formation. Exercise
should be designed to regain flexibility in the arms, and prevent poor
posture," said Steele-Major of Ventura, a physical therapist for 23 years.
She also is a lymphedema
therapist with a background in orthopedics and
women's health and has worked with breast cancer
patients and their
rehabilitation for more than a decade.
"Pain must be respected,
and as the healing process advances, so will the activity tolerance,"
Steele-
Major said. "The goal for each woman should be to return to her
prior level of function. As a
minimum, that should include activities such
as reaching overhead, driving, light housework and
carrying her purse on
the affected side."
A common misunderstanding is that
weightlifting and carrying objects are no longer permitted.
"The
reality is that limitations are dictated by the type of surgery or
reconstruction, prior medical
conditions, as well as level of function
before surgery," Steele-Major said. "As women undergo
chemotherapy and
radiation, their energy levels will greatly fluctuate. Fatigue is a common side
effect
that can be managed better with exercise. Each patient should be
cleared by her physician before
starting an exercise
program."
The physical benefits are evident not only in the
increasing activity tolerance but also in the
management of
fatigue.
Women who participate in the class often bond with one another
and develop friendships that reach
beyond the scope of the class,
Steele-Major said.
Rose Martinez, 85, has been taking the class
since 2000.
"I was fortunate that I did not have chemo, which is
almost as bad, or worse, as hearing the dreaded
word 'cancer,' " said
Martinez of Ventura. "I am fortunate that I have made so many friends. One
makes friends and acquaintances during our lifetime, but they are not like
cancer survivors."
Ventura resident Eileen Kanatzar, 77, started
attending in 2003.
"It's a great group of people," she said. "I
go for the exercise and the wonderful camaraderie. We're
all in the same
boat, so it's a great support group."
The class is offered from
4 to 5 p.m. Wednesdays at St. John's Outpatient Therapy Center, 961 N.
Rice
Ave., Suite 3, in Oxnard. For more information, call
988-2641.
Remembering all the victims of the Vietnam War - Ct
Post –
Unlike today, the troops that returned home from Vietnam
were regarded with indifference. Thanks
to the Vietnam Veterans Memorial
Fund, honor and appreciation is bestowed on them through the "In
Memory
Honor Roll."
On April 18, I attended a ceremony in Washington,
D.C., in which my brother, Gregory Patrick
Russell, was inducted, along
with 92 others, into the "In Memory Honor Roll." To be an honoree, one
must
have served in the military in Vietnam. The veteran must have died of a disease
or committed
suicide that was traceable to the time spent there and his or
her death does not meet the Department
of Defense's criteria for being
added to the Vietnam Veterans Memorial ("The Wall"). There are
approximately 2,100 people on the honor roll and 58,000-plus names etched
into the black granite
wall.
Greg's disease was prostate cancer that
was traced to exposure to Agent Orange. He enlisted in the
United States
Marine Corps in Bennington, Vt. He served in Vietnam in 1970-1971; he hadn't
yet
reached his 20th birthday. Greg was diagnosed in 1997 after complaints
to his doctor two years
earlier were dismissed as "something that happens
to men over 40." By the time the diagnosis came,
the cancer had already
spread outside of the prostate gland. He was in excellent physical condition
and very active in both work and play -- a blessing and a curse since his
cancer was also active and
aggressive in his healthy body. Over the next 14
years, the disease painfully manifested itself in his
back, skin, lungs and
hips. He and his wife made countless visits to Mass General for chemo,
radiation and pain management. Some of these treatments caused serious
problems including
lymphedema, blood clots and incontinence, to name a few.
The last several years his pain was
lessened by a methadone pump which
administered pain medication 24/7. Greg never complained
and enjoyed life
to the fullest. He lost the battle on Thanksgiving Day 2010, when his body
could no
longer overcome pneumonia and kidney problems.
If
you have a loved one who was in Vietnam and died due to complications from
exposure to Agent
Orange or other causes attributed to being in Vietnam,
fill out an application to have him or her added
to the "In Memory Honor
Roll." The ceremony gave my siblings, my sister-in-law and me yet another
chance to grieve the life of this remarkable man and allowed us to meet
other families who lost their
loved ones, too. A description of the program
and the application are on this website:
http://www.
vvmf.org/InMemoryProgram. I thank all the veterans for their
service to our country and salute them
this Memorial Day and every
day.
How Meditation Can Support Cancer Treatment - Huffington
Post - Joseph Nowinski, Ph.D. –
My two previous blogs in this
series have focused on several different treatments that are used as
adjuncts or complements to contemporary medical treatments for cancer
(chemotherapy, surgery and
radiation therapy). While some people advocate
for these treatments as alternatives to such medical
treatment for cancer,
to this point I have found testimonial data to support that position, but no
convincing research. In this blog we'll look at a very popular
complementary treatment: meditation.
Meditation as a Complement
to Cancer Treatment
Let's begin by acknowledging that millions
of people have used meditation for general health and
mental health
benefits for centuries. When I was a graduate student in clinical psychology,
my wife,
who was then suffering from frequent head and neck aches, tried
everything from massage (delivered
by me in a less than expert manner) to
medications to the original "earth shoes" in an effort to find
relief, with
little effect. Then one day she told me that she'd signed up for a class in
Transcendental
Meditation (TM). All I knew about TM was that it was
something The Beatles were into, and I was
skeptical. Nevertheless, my wife
took the day-long class, returned home with her secret mantra, and
proceeded to practice TM twice a day. Three weeks later she told me that
she'd had only one brief
headache, whereas she was used to having two or
three serious ones a week. So there you go --
some testimonial data from
your blogger!
The two primary modalities of meditation that are
practiced here are:
Concentrative Meditation (CM)
This
describes TM and similar meditation practices that teach individuals to focus
on a single image,
sound or mantra, or even on their own
breathing.
Mindful Meditation (MM)
In mindful meditation,
individuals are taught not to focus their attention in a singular way, but
rather to
be aware of any and all thoughts, feelings, sounds and images
that may pass through their mind. And
that is the key to MM: Letting them
pass through your mind, as opposed to trying to hold on to any
one of
them.
Is Meditation Effective?
There is good news when it
comes to meditation as a complementary treatment, and that is that a
number
of rigorous clinical trials are underway. Using controlled clinical trials,
these investigators are
studying the effects of both types of meditation on
health issues such as hypertension, cardiovascular
disease and the side
effects of cancer treatment. The common denominator driving this research is a
general recognition that chronic stress is linked to a variety of health
problems, such as increased
heart disease, compromised immune system
functioning and premature cellular and cognitive aging. It
makes sense,
then, to take a closer look at how meditation can help. Here is a sample of
what
researchers have discovered and verified so far:
· In a
study of 60 breast cancer survivors, women who practiced meditation reduced the
number and
severity of hot flashes and also reported improvements in mood
and sleep.
· A study of 63 people with rheumatoid arthritis found
that mindfulness meditation helped to improve
quality of life and reduce
psychological distress.
· A study of 298 college students found that
transcendental meditation helped students reduce stress
and improve coping
strategies.
· A "meta-analysis" of 10 studies found that mindfulness
meditation improves the overall mental health
of cancer
patients.
The above should be encouraging to those who are facing cancer
and contemplating a comprehensive
treatment plan. As with the other
complementary treatments looked at in this series, there is no
evidence as
yet that meditation arrests or cures cancer. That said, comprehensive treatment
should
include mental health as well as reductions in the pernicious side
effects of cancer treatment.
Looking Beyond What
Works
Clinical research (including research in psychology) often
seeks to ask a simple question: Does a
treatment work? That is an important
question. But an equally important question is: What works for
whom, and
when? Consider the following email message I received from a woman who has been
working with her doctors to confront metastatic cancer
("mets"):
"This recent cancer treatment is very hard on me ... and I
don't suspect the remaining chemos will be
much different. I want to spend
the years I have left on a healing spiritual quest ... for me.
I
have bone mets and massage is not advised due to pressure on the bones that are
already
weakened. I have lymphedema in my arms and chest, leaving just my
legs, feet, back, face and ears
for acupuncture needles. In the earlier
stages, I did get relief from acupuncture, but not so much
now.
I am a big time meditator and do lots of energy work.
Frankly I think that has had some impact on my
being alive eight-plus years
with mets. We all have to die of something. I am not afraid to die, but am
afraid to die before I am able to fully accept myself with no judgments.
That is what I am devoting my
remaining time to."
For this
woman, as for many women (and men) who are faced with cancer, the issue becomes
not
just "what works" but "what works and when." Clearly, what worked
before does not necessarily
work now for this woman -- but that does not
mean that the various complementary treatments she
tried were not
worthwhile at the times she turned to them
Health calendar:
Weekly events in Brevard County - Florida Today
–
SEMINARS/WORKSHOPS
Aches and pains: The free
lecture will focus on aching joints, fibromyalgia and other pain at 7:30 p.m.
today at CARE Chiropractic and Wellness Center, 1938 Dairy Road, West
Melbourne. Registration
is required. Call 321-728-1387 or visit
drwalshcares.com. Acupressure workshop: Lama David Bole
will host an "Art
of Living" acupressure workshop from 12:30 to 3:30 p.m. Sunday at Aquarian
Dreams, 414 N. Miramar Ave., Indialantic. The cost is $30. Registration is
required. Call 321-729-
9495. AIDS/HIV: Brevard Community College offers
online mandatory HIV/AIDS courses for
health care professionals. The cost
is $40. Call 321-433-7535 or visit brevard.edu/ice. Balance
workshop:
Parrish Medical Center will offer "A Matter of Balance" workshop from 1 to 3
p.m.
Mondays through May 23 at Parrish Health & Fitness Center, 2210
Cheney Highway, Titusville.
Participants will learn to view falls and fear
of falling as controllable and set goals for increasing
activity. Call
321-268-6596. Better health lecture: Dr. Joe Strater will give a free talk on
"5 Facets of
Health" at 12:30 p.m. May 17 at Freedom 7 Senior Community
Center, 5000 Tom Warriner Blvd.,
Cocoa Beach. Call 321-783-9505.
Breastfeeding: Classes for beginners are from 6:30 to 9 p.m.
every third
Monday at Children's Center, 5650 S. Washington Ave., Titusville. Admission is
free. To
register, call 321-268-6682. Cancer center lecture: Dr. Richard
Levine, a medical oncologist with
Space Coast Cancer Center, will host a
free lecture on the medical services and resources at Space
Coast Cancer
Center at Viera Health Park at 10:30 a.m. Thursday at One Senior Place, 8085
Spyglass Hill Road, Viera. A complimentary lunch will be served.
Registration is required. Call 321-
268-4200, ext. 3500. Caregiver education
classes: Caregiver Education and Resources Program at
Hospice of St.
Francis will host free classes starting from 2 to 3:30 p.m. Monday at Merritt
Island
Public Library, 1195 N. Courtenay Parkway. Classes will be Mondays
and Wednesdays through
May 30. Registration is required. Call 321-269-4240,
ext. 330, or e-mail
[email protected]. Childbirth: Parrish
Medical Center, 951 N. Washington Ave.,
Titusville, offers "Moments to
Miracles: Childbirth Education" classes. The cost is $50 per couple.
For
times, dates and registration, call 321-268-6110. Childbirth: Birth Resources
of Brevard offers
classes in several locations. The cost is $50 per family.
To register, call 321-252-4573 or visit
birthresoucesofbrevard.com. CPR
classes: American Red Cross instructors make house calls for
"Safe Baby
Presentation," an orientation to infant CPR. Sessions last about two hours. The
cost is
$25 for each person, with a minimum of eight people. Call
321-890-1002 or visit redcross.
org/fl/brevard. CPR course: American Heart
Association will offer instruction from 9 a.m. to noon
May 21 at Satellite
Beach Fire Department, 1390 South Patrick Drive. The cost is $35 and includes
certification card. Books are available for $15. To register, call
321-773-4405. Dementia tutorials:
The Brevard Alzheimer's Foundation hosts
free dementia tutorials from 1 to 3 p.m. every third
Thursday at Joe's Club
Central, 4676 N. Wickham Road, Melbourne. Call 321-253-4430.
Dementia
presentation: East Central Florida Memory Disorder Clinic will offer a
presentation on the
Lewy Body Dementia Association from 1:30 to 3 p.m. May
25 at Sunflower House, Merritt Square
Mall, 777 E. Merritt Island Causeway.
Call 321-452-4341. Domestic violence: A free class to
educate participants
about emotional and physical abuse in relationships meets from noon to 1:30
p.
m. on the second Friday of each month at the Women's Center, 1425 Aurora
Road, Melbourne.
Classes are offered in Spanish. Call 321-242-3110. Family
memories: A free scrapbooking class to
build memory books for caregivers
and loved ones dealing with memory loss meets from 1:30 to 3:30
p.m.
Thursdays at Health First Leeza's Place, 3661 S. Babcock St., Melbourne. Call
321-951-
7118. Hormone lecture: Dr. Sal Martingano will present "How to
Balance a Woman's Hormones
Naturally" at 10:30 a.m. May 24 at the Family
Center for Chiropractic, 1320 Palm Bay Road NE.
Call 321-729-9430. Free
health lecture: Beachside Physical Therapy, 2030 South Patrick Drive,
Indian Harbour Beach, hosts free lectures at 6:30 p.m. on the last Tuesday
of the month. Learn about
back pain, triathlon training, golf fitness and
more. To register, call 321-725-2267. Free health
lecture: Dr. Sal
Martingano will present "The Three Solutions to Your Health Problems" at 10:30
a.m.
today at the Family Center for Chiropractic, 1320 Palm Bay Road NE,
Palm Bay. Admission is free.
Call 321-729-9430. Free Medicaid seminar: Free
lecture from 10 to 11 a.m. May 17 at One Senior
Place, 8085 Spyglass Hill
Road, Viera. Call 321-253-1667. Health awareness: Joseph Eplett will
discuss strategies for how to get well and stay well and how to deal with
stress, among other things, at
6:15 p.m. Mondays and 12:45 p.m. Fridays at
The Eplett Chiropractic Life Center, 429 Fifth Ave.,
Indialantic. Call
321-733-4434. Health classes: Free health awareness classes covering
meditation,
exercise, posture awareness, spinomics and nutrition, meet from
3 to 4 p.m. last Saturdays at
Aquarian Dreams, 414 N. Miramar Ave.,
Indialantic. Call 321-733-4434. Health lecture: Charlie
Mora will lecture
on health, nutrition and weight loss at 1 p.m. every second Tuesday at Cocoa
Beach Public Library, 550 N. Brevard Ave. Admission is free. Call
321-868-1104. Healthy Living
workshops: Parrish Medical Center, 951 N.
Washington Ave., Titusville, will host workshops for
people with chronic
conditions to help improve health and reduce hospitalizations from 9:30 a.m. to
noon Tuesdays, May 17 through June 21. Call 321-268-6596. Hip replacement
lecture: Orthopedic
surgeon Dr. John Perry will present a free lecture on
the anterior approach hip replacement from 11 a.
m. to noon today at Holmes
Regional Medical Center, 1350 S. Hickory St., Melbourne. Call 321-
434-4359.
Injury protection lecture: Registered nurse Tammy Clemens will host a free
lecture on
senior lifestyle and injury protection from 10 to 11 a.m. May 18
at Holmes Regional Medical Center,
Auditorium A, 1350 S. Hickory St.,
Melbourne. Call 321-434-4359.
Lymphedema lecture: Lecture starts at 6:30
p.m. June 6 at Beachside Physical Therapy, 4270 Minton
Road, Suite 120,
Palm Bay. Registration is required. Refreshments will be provided. Call
321-777-
4033. Life management: Metabolic Research Center of Merritt Island
offers a free course at 5:30 p.
m. Wednesdays at 255 Fortenberry Road,
Merritt Island. Also, at 5:30 p.m. Mondays at 1966 Dairy
Road, West
Melbourne. To reserve a space on Merritt Island, call 321-452-3355; for
Melbourne,
call 321-953-0203. Look Good, Feel Better: American Cancer
Society teaches beauty techniques to
Palm Bay residents/patients who are
battling cancer. Sessions are on the first Tuesday of the month.
For
information and registration, call 800-227-9954. Marital/sex therapy: Florida
Tech's Community
Psychological Services Clinic offers a marital and sex
therapy/counseling service for adult couples in
committed relationships who
are experiencing relationship conflict or sexual difficulty. For
appointments, call 321-727-9956. Meditation class: Learn Eastern meditation
techniques with Ellen
Cameron from 7 to 7:45 p.m. Tuesdays at Aquarian
Dreams, 414 N. Miramar Ave., Indialantic. The
cost is $7. Call
321-729-9495. Memory loss lecture: Learn tips and strategies for coping with
memory loss at 2 p.m. May 24 at One Senior Place, 8085 Spyglass Hill Road,
Viera. Call 321-751-
6771. Natural approaches to illness: Sylvie Morin,
doctor of Oriental medicine, will discuss natural
approaches to illness at
1 p.m. every third Friday at Cocoa Beach Public Library, 550 N. Brevard
Ave. Call 321-868-1104. Osteoporosis lecture: CARE Chiropractic and
Wellness Center, 1938
Dairy Road, West Melbourne, will host a free lecture
on osteopenia/osteoporosis at 7 p.m. May 23.
Call 321-728-1387 or go to
drwalshcares.com. Parenting and life skills: Classes are from 6 to 7:30
p.
m. Wednesdays at the Alternative Pregnancy Center, 205 Magnolia Ave.,
Merritt Island. Child care
provided. Call 321-454-9853. Postpartum
adjustment: Learn skills to regain control of your life,
decrease symptoms
of stress and depression and get support from other moms. Classes are from
10:
30 to 11:30 a.m. Tuesdays at Girlfriends Health, 503 5th Ave., Suite
103, Indialantic. The cost is
$30. Registration is required. Call
321-536-1724. Prenatal classes: Pediatrics in Brevard physicians
Dr. Tara
Forcier and Dr. Jan Borowski will offer free classes at 6 p.m. Tuesdays at
Pediatrics in
Brevard, 134 S. Woods Drive, Rockledge. Call 321-636-3066,
ext. 206. Restless leg syndrome
lecture: Learn the causes and cures at 1
p.m. May 27 at Cocoa Beach Public Library, 550 N.
Brevard Ave. Call
321-868-1104. Smoking cessation: Classes are offered from noon to 1 p.m. or
from 5 to 6 p.m. Wednesdays at Patrick Air Force Base Health and Wellness
Center, 1223 Atlas
Ave. You must have base access to attend. To register,
call 321-494-2660. Smoking cessation: Quit
Smoking Tobacco Cessation
program will be from 3:30 to 4:30 p.m. Tuesdays, now through May
31, at One
Senior Place, 8085 Spyglass Hill Road, Viera. The program will feature support,
educational information, handouts and a free, six-week supply of nicotine
replacement. Registration is
required. Call 1-877-252-6094. Stroke
prevention lecture: Dr Jill Miller will present the free lecture
from 11
a.m. to noon May 25 at Holmes Regional Medical Center, Auditorium A, 1350 S.
Hickory
St., Melbourne. Call 321-434-4359. Free Secrets to Weight Loss: The
lecture begins at 7 p.m. May
19 at CARE Chiropractic and Wellness Center,
1938 Dairy Road, West Melbourne. Call 321-728-
1387 or visit
drwalshcares.com. Spanish health care phraseology course: Brevard Community
College offers online courses that teach Spanish health care phraseology to
help nurses, doctors and
patients understand each other clearly. The cost
is $99. To register, call 321-433-7535 or visit
brevard.edu/ice.
"Superfoods II: Health and Nutrition": The Space Coast Cancer Center, 490 N.
Washington Ave., Titusville, presents the workshop for cancer survivors and
their families from 4 to 5:
30 p.m. the first Tuesday of each month. Call
321-269-4200, ext. 3500, or visit
spacecoastmedicalassociates.com. Violence
prevention: "Family Violence Prevention" is a 12-week
course for adults
that will be taught in 90-minute sessions at 4680 Lipscomb St., Suite 10H, Palm
Bay. The cost is $90 per person. Call 321-394-7179. Water rescue:
Pro-Health & Fitness Center
offers an American Red Cross Basic Water
Rescue Course on a monthly rotational basis at 255
Borman Drive, Merritt
Island. The cost is $25, $40 per family. Call 321-434-5816 or 321-409-
8215.
Youth anger management: The 10-week course offers youths ages 10 to 16 insights
into
causes of personal anger and provides effective techniques for
managing stress and anger. Weekly
classes meet juvenile justice
court-ordered requirements, 4680 Lipscomb St., No. 10H, Palm Bay.
The cost
is $50. Call 321-394-7179.
May 12, 2011
Roanoke
Wounded Warrior "accidentally" meets President Obama - Lynchburg News and
Advance
- By Jarett Henshaw –
ROANOKE, VA
–
30-year-old veteran Sarah Bonner walks pretty well, but is
otherwise limited physically.
"I took a fall in basic training
and had problems with my back,” said Bonner.
She was never able
to serve her deployment to Germany, and was medically discharged. From her
injury, she developed Lymphedema, causing painful swelling in her lower
legs.
"It's very hard. I don't wear shorts anymore, because I'm
very embarrassed,” said Bonner.
But Sarah tries to be as active
as she can. Last week she participated in the Soldier Ride, as part of
the
wounded warriors program in Washington, D.C. Organizers fitted Sarah with a
special
recumbent bicycle that allowed her to pedal more
comfortably.
"I felt free again. I felt like a kid. I had more
fun than I ever had a Christmas. On the bike, my back
didn't hurt. My
feet didn't hurt,” said Bonner.
She and 29 other vets got to
ride on the White House grounds. President Obama even came out to
watch.
But when Sarah got close to the President, the unthinkable
happened.
"The next thing I know, the chain is off the gears and
that bike, as hard as I'm trying to pedal, it wasn't
moving,” said
Bonner.
Other members of the ride rushed over to help, and they
weren't the only ones.
"The President walks over, and I didn't
know what was going to happen, and was just like 'Come on,
fix the bike
guys.' And he (President Obama) goes with his hands (gesturing) 'I thought
these things
only happened to me,'” said Bonner.
They eventually got
the chain back on track.
"He shook my hand and he goes, 'It
looks like you're getting taken care of' and I said yeah and he
kind of
patted me on my back,” said Bonner.
It was an unlikely meeting
that Sarah says she'll never forget. Later that day she received a
Presidential coin to remember her special encounter with the Commander in
Chief.
May 13, 2011
National African American
Breast Cancer Conference starts today – WBXH - by mmccalope
–
Sisters Network Incorporated, the only national African
American breast cancer survivorship
organization in the United States, will
host its 12th Annual National African American Breast Cancer
conference on
May 13 through May 15 at the Crowne Plaza Hotel in Baton Rouge. The three-day
conference is generously underwritten by the Centers for Disease Control
and Prevention.
Breast cancer is the most common cancer among
African American women. Research shows nearly
20,000 newly diagnosed cases
of breast cancer are expected to occur among African American
women, and
5,640 are expected to die from the disease.
The incidence rate
of breast cancer is higher among younger African-American women (under age
40); than among white women. The incidence rate of breast cancer is 12%
lower in African-
American women; however, the mortality rate is higher
compared to white women.
During the conference, Sisters Network
will launch a new national program, Young Sisters Initiative
(YSI). In
response to the alarming mortality rate in African
American
women under the age of 45. Over 40 partial scholarships were given to Young
Survivors
from across the United States.
A pioneer in the
African American breast cancer awareness movement, Sisters Network hosts the
only national conference specifically addressing the devastating impact of
breast cancer among
African American women. The conference attracts over
400 participants, including breast cancer
survivors and non-survivors from
around the United States, nationally recognized medical experts,
elected
officials and the general community.
"Sisters Network is honored
to bring the national conference to our affiliate chapter city of Baton
Rouge, Louisiana. It is important that we host our national conference in
our affiliate chapter cities to
increase African American breast cancer
awareness, reinforce the great outreach efforts of the local
chapter and
celebrate survivorship with our members and the communities in which they serve
on
behalf of the National office," said Karen Jackson, Founder/CEO Sisters
Network Inc." We
welcome everyone from around the nation to attend the
national conference to be educated,
empowered and energized to join Sisters
Network's African American breast health movement,"
added
Jackson.
The Honorary Conference Chair is Congresswoman Sheila
Jackson Lee, 18th Congressional District
State of Texas. Conference Chair
is Lisa A. Newman, MD, MPH, F.A.C.S., and Professor of
Surgery &
Director of Breast Cancer Care Center, University of Michigan and C. Kent
Osborne,
MD, Director, Dan L. Duncan Cancer Center, Baylor College of
Medicine. Conference Co-Chair is
Edie Staples, President, Sisters Network
Baton Rouge.
Conference highlights include the State of Sisters
Network Address by Karen E. Jackson, General
Session on Exploring Triple
Negative Breast Cancer, Lymphedema Management, Clinical Trials; the
Renewing Hope Series; Genetics & Heredity; Treatment Update on
Metastatic Breast Cancer and
Young Survivors Focus Groups; Spirituality and
Fear of Recurrence will be offered. Celgene Day of
Wellness Luncheon,
Annual Awards Signature Luncheon, Gospel Prayer Breakfast and Remberance
Celebration Ceremony are also included in the national conference
agenda.
Sponsors include Avon Foundation for Women,
sanofi-aventis, Genentech,GlaxoSmithKline
Oncology, Celgene; Cancer
Treatment Centers of America; Baton Rouge General; Mary Bird
Perkins Cancer
Center and the Breast Cancer Wellness Magazine.
National
organization partners include Alpha Kappa Alpha Sorority, Delta Sigma Theta
Sorority, the
Cancer Support Community and the Center for Research on
Minority Health at The University of
Texas M. D. Anderson Cancer
Center
May 22, 2011
Health Collaborative obtains grant for
another year of services - Enterprise-Record –
CHICO — California Health
Collaborative is seeking low income, under or uninsured people in
Butte,
Colusa, Glenn, Plumas and Tehama counties to help them overcome barriers to
breast care
services through the Clinical Education, Coordination and Nurse
Navigation Program.
Funding for the second year of this program, through
March 31, 2012, has been secured by a grant
received from the Sacramento
Affiliate of Susan G. Komen for the Cure.
Services provided to those
eligible include assistance getting through the health care system, education
regarding medical options, referral to local resources and financial
assistance with medical costs.
Financial assistance may include help with
transportation, child/elder care, food vouchers, utility bills,
housekeeping, post-mastectomy products, wigs/head coverings, lymphedema
garments and overnight
accommodations necessary to comply with treatment
recommendations.
During its first year, California Health Collaborative
worked with volunteers around the community to
accomplish its services to
175 women in need.
The collaborative reports that some 100 residents
were helped through the processes of screening,
diagnosis, treatment and
follow up from April 1, 2010 to March 31, 2011. That included more than
$14,000 in claims reimbursement for diagnostic medical services and
associated needs for 44 women
in need of breast care in Chico, Forest
Ranch, Gridley, Magalia, Oroville and Paradise.
CHARITY NOTEBOOK: Race
for hope cyclists raise money for medical research - Syracuse.com
–
Syracuse.com
Bicyclists will take to the rolling hills above Skaneateles
Lake in the fifth annual Race For Hope that
starts 8:30 a.m. May 29 at the
intersection of East Lake Road (Route 41) and Rose Hill Road in
Borodino.
The 24-mile timed race was inspired by Dick Shaffer, a
Borodino resident and triathlete, who died of
cancer in 2006. Proceeds from
the race support research at Upstate Golisano Children's
Hospital.
Riders can register online until noon May 27 at
www.SkanRaces.com for $30. Race day registration
is $35. Riders can
register from 7:30 a.m. to 8 a.m.. Parking and check-in will be at Midlakes
Club
Golf Course, Bockes Road.
The race is open to riders 15 and
older. Awards will be given to the top three male and female overall
finishers. Age group awards will be given to the top three finishers in
each category.
Results
Owasco Reformed Church raised $3,000 in a
chili cook-off that raised money to help pay for beam
restoration in its
200-year-old church.
The Syracuse University Sport Management Club, a
student-run organization in the College of
Human Ecology, donated $24,000
to the Central New York SPCA.
Village of Cleveland Spirit Committee
raised $600 from an Easter bunny breakfast and $440 from a
raffle to help
pay for a 9/11 Memorial Gazebo.
Scholastic rowers from the Cascadilla
Boat Club of Ithaca earned more than $5,300 in pledges in an
"Erg A Thon"
at Ithaca Mall.
Upstate Medical University employees raised more than
$609,270 for the United Way of Central
New York and the State Employees
Federated Appeal.
Grants
The Allen Speiser Memorial Fund for
Vocational Rehabilitation, a fund of the Central New York
Community
Foundation, awarded $4,770 in grants to CNY Works, Oswego Industries, Enable,
Unity House of Cayuga County and ARC of Onondaga.
The Central New
York affiliate of Susan G. Komen for the Cure awarded an $18,260 grant to St.
Joseph's Hospital Health Center Foundation to support lymphedema education
and prevention.
Donations
Metro Mattress is donating new beds to
21 charitable organizations in the Syracuse/Southern Tier
region.
Alternatives, a nonprofit bakery operated by Madison
Cortland ARC, donated 252 pies to the
Rescue Mission for its Easter
dinner.
Kidney Foundation seeks cars
The Kidney Foundation of
Central New York is seeking donations of old cars, boats, recreation
vehicles, campers, motorcycles, riding lawn mowers and tractors. To donate
an item call the
foundation at 800-488-2277.
May 23,
2011
Jennifer Tull named Exceptional Therapist – Crookston Daily Times
–
Crookston, Minn. --
Jennifer Tull, PT was awarded the Benedictine
Health System’s Exceptional Therapist for the second
quarter of 2011. The
exceptional therapist award was initiated in May of 2006. This award was
created to recognize the extraordinary efforts and contributions from
therapists throughout the
Benedictine Health System (BHS).
Jennie
“Coauette” Tull graduated from Crookston High School in 1995 and then went on to
the
University of North Dakota where she received her Bachelor’s and
Master’s degrees of Physical
Therapy with a minor in Psychology in 2001.
She has worked at the Villa St. Vincent since
December of 2009 and became a
lymphedema certified therapist in November of 2010.
Jennie is known for
providing outstanding patient care and consistently meeting the needs of her
patients. She is an excellent clinician and member of the Villa therapy
team. Quality and evidenced
based care is always provided by Jennie. By
working closely with the interdisciplinary team, she
ensures a holistic
approach to her patients. She has offerred continuing education to the therapy
department, the skilled nursing facility staff and community members.
Jennie demonstrates the BHS
core values of hospitality, respect, justice,
and stewardship everyday in her practice. She exhibits
moral and ethical
standards that exemplify the BHS Mission and Values.
In addition to
providing outpatient therapy to members of the Crookston community, Jennie
works
with the residents of the Villa St. Vincent and the Summit. Please
feel free to stop in to the Villa
Therapy Department and congratulate
Jennie on her accomplishment.
May 24, 2011
Your Hero: Local woman
helps breast cancer patients - FOX43.com – by Jaime Garland
Bonnie
Julius is helping women across the country in honor of her late
daughter
YORK COUNTY--
A local woman, who lost her daughter to
breast cancer, is now helping all women battling the disease.
From her
computer, Bonnie Julius is giving the ladies their identity back; that makes
her this week's
FOX43 "Your Hero."
From wigs to massages,
Bonnie Julius is taking care of breast cancer patients across the country. She
operates an online non-profit organization that connects women with the
products they need to
restore their self confidence. She started
'Crickett's Answer For Cancer' in 2008, in honor of her
daughter, Crickett
Julius.
Julius earns no paycheck, she only the satisfaction she feels
from above.
"I know that Crickett is smiling, smiling, smiling down on
us all the time," Bonnie says.
Crickett was just 39-years old when
doctors diagnosed her with breast cancer.
"I said what is Stage 4?
Because I never had anything to do with it, didn't know people who had
breast cancer and before he (the doctor) could answer, she said 'Mama, that
means I'm terminal," she
says.
Bonnie was by her daughter's side
through chemotherapy, but her fight ended just four months later.
After
Crickett's death, all Bonnie could do was wonder how it could
happen.
Bonnie says, "she was vivacious, she was energetic, she had a
personal trainer, she kept herself in
good shape, she did self breast exams
and all the sorts of things that you're supposed to do."
Through her
fight, Crickett had strength. Bonnie decided to carry that torch and help women
nationwide who are battling the same disease.
Through her website,
CrickettsAnswerForCancer.org Bonnie provides wigs, mastectomy and
lymphedema products, as well as pampering services to female breast cancer
patients across the
country.
It's all for free for patients; paid
for solely by donations and fundraisers.
But, the products come with a
price; one that Bonnie hopes to be able to pay for many years to keep
her
daughter's memory alive.
"I'm having the time of my life and I hope to
help many, many more," Bonnie says.
Bonnie operates the website with
help from her niece. Since they started it in 2008, they have helped
265
women.
Lymphedema support group helps educate those suffering -
Villages Daily Sun – By APRIL TOLER
–
THE VILLAGES — When Phyllis
Campbell first began experiencing swelling in her legs she wasn’t
sure what
to do.
She sifted through the advice of others — keep your legs up, wear
support hose — but nothing
worked eventually making it difficult for
Campbell to even get around.
“It effected my mobility and it also
depressed me,” the Spruce Creek South resident said. “When you
are heavy
and you keep gaining, and gaining and gaining because of fluid and you’re not
eating hardly
anything you begin to think what’s happening? Depression is
big.”
What was happening was lymphedema — a condition with which local
doctors say few people seem
to be aware.
Lymphatic obstruction is a
blockage of the lymph vessels that drain fluid from tissues in the body and
allow immune cells to travel throughout the body.
This causes
lymphedema, which is swelling due to the blockage of lymph
passages.
Primary lymphedema happens either at birth or develops at the
onset of puberty. Reasons for primary
lymphedema are
unknown.
Secondary lymphedema, the most common type, can be caused by
surgery, particularly the removal
of lymph nodes, infections, injury and
radiation therapy.
For Campbell, she believes it developed after she had
open heart surgery where veins were removed
from her left leg.
Like
most people suffering from lymphedema, she had no previous knowledge of the
condition.
“I never knew about this,” she said. “I suffered all these
years and knew nothing.”
That also was the case for area resident Regina
Browne, whose case was so bad it confined her to a
wheelchair the few times
she was able to travel outside her home.
“I had this condition for over
a year before I could find help for it,” she said. “No one knew.”
Meenu
Jethwani, certified lymphedema therapist and occupational therapist at Therapy
For You, said
a lack of knowledge about the condition, and how to treat it,
is common.
“The challenges are a lot of time they don’t know what is
happening,” Jethwani said. “The physicians
are not able to catch
it…”
Although lymphedema itself is not painful, it can cause discomfort,
Jethwani said, and make it difficult
to maneuver limbs due to the heaviness
of the collected fluid.
There is no cure for lymphedema, she said, but
there are ways to manage it.
“It is not a disease, it is a condition,”
she said. “It’s a compromised system so when we open these
lymphatic
channels we are not curing them of lymphedema we are just controlling the
condition.”
Jethwani treats patients with manual drainage using the
Vodder techniques and compression
bandages. How long a person is in
treatment, she said, depends on the severity of the condition.
It is
important, she said, for patients to continue their part of the treatment once
they leave a therapist’
s care.
“It’s important that once patients
get discharged from here, we put them on compression garments,
they
continue wearing those compression garments,” she said. “It’s very important
because that
compression garment is what’s going to keep the extremity
contained in a position.”
Other measures those dealing with lymphedema
can do is educate themselves.
Scottie Bull, a certified lymphology
association of North America therapists, started a lymphedema
support group
some 10 years ago to help educate people on the condition and possible
treatments.
“I started it simply because there wasn’t a support group
around and I thought it would be good to
educate people …,” said Bull, of
Physio Med Outpatient Rehab.
When seeking treatment it is important,
Bull said, to find a therapist certified in treating lymphedema
especially
since being certified it is not mandated in the state of
Florida.
Because there are few people who are well educated about the
condition, Bull said it is important for
each patient to do their own
research and make sure they are receiving proper treatment.
“There’s not
very many therapists that are technically certified and that is extremely
important,” she
said. “If a patient is being treated by a therapist not
trained in proper technique they can get worst or
can waste the number of
treatments (covered by their insurance).”
As for Browne, as the swelling
in her leg continues to shrink, she continues to follow her therapist’s
orders and is thrilled each time she sees a change in her
swelling.
“I’m going to be patient and do whatever I need to do,” she
said.“It took a long time to get that way;
it’s not going to go away over
night. You have to be patient, you have to think ‘I’m going to see this
thing through.’”
May 25, 2011
BioCis Pharma and Lx Therapies
Combine to Create Laurantis Pharma Oy - Genetic Engineering
News
–
BioCis Pharma Oy and Oy Lx Therapies Ltd. announced today that the
companies have combined to
create Laurantis Pharma Oy (“Laurantis Pharma”),
a clinical-stage specialty pharmaceutical
development company. The new
entity has a broad portfolio of first-in-class products based on two
proprietary technologies. The Company’s lead products target the treatment
of a variety of
inflammatory diseases and conditions including atopic
dermatitis, dry eye syndrome, interstitial cystitis,
and lymphatic
disorders, as well as the treatment of bladder cancer. In connection with the
creation of
the new Company, Riku Rautsola, PhD, was appointed as President
and CEO of Laurantis Pharma.
In addition, Inveni Capital and Helsinki
University Funds made an investment in Laurantis Pharma.
“We are excited
about the potential created by forming this new company. We have a broad
portfolio, cost-efficient operation model, and several upcoming clinical
milestones in the next couple
of years,” said Dr. Rautsola. “This provides
the unique opportunity to build Laurantis Pharma from an
early clinical
development company to a successful specialty pharmaceutical company in the
coming
years.”
Riku Rautsola has more than 25 years of international
biopharmaceutical experience, most recently as
President and CEO of VIRxSYS
Corporation in the United States. Previously, Dr. Rautsola held
various
senior executive positions, among others, at Boehringer Ingelheim, Beiersdorf
and Fresenius
and served on the board of directors of the Finnish drug
development company Biotie Therapies.
“We are very excited about having
the capacity to a build a competitive specialty pharmaceutical
company with
a strong technology base. Laurantis Pharma is well positioned to reach several
significant clinical milestones for its lead products in the next two to
three years,” said Lasse Leino,
COO of Laurantis Pharma and previously CEO
of BioCis Pharma.
Laurantis Pharma’s pipeline includes proprietary and
patent-protected formulations and applications
of cis-urocanicacid
(cis-UCA), a locally acting anti-inflammatory and anti-proliferative agent.
Clinical
candidates include an emulsion cream for atopic dermatitis (human
and veterinary use), an intravesical
product for the treatment of
non-muscle invasive bladder cancer and inflammatory conditions of the
bladder such as interstitialcystitis, and an eye drop product for dry eye
syndrome. The Company is
also developing Lymfactin™, a vascular endothelial
growth factor C (VEGF-C) in an adenoviral
vector, for the treatment of
secondary lymphedema. The first indication will be breast cancer-
associated
lymphedema.
About Laurantis Pharma
Laurantis Pharma Oy is a
privately held specialty pharmaceutical company based in Finland. Laurantis
Pharma Oy was formed in 2010 through the merger of two independent
companies, BioCis Pharma
Oy and Oy Lx Therapies Ltd. More information can
be found at www.laurantis.com.
Kenilworth's David Brearley students
collect thousands of pennies for patients - Suburban News –
KENILWORTH —
The 2010-11 “Pennies for Patients” fundraiser was just completed. The David
Brearley Middle and High School raised a total of $5,654 this year. In
memory of Jeffrey Bubnowski,
the money was donated to the Leukemia and
Lymphoma Society’s School and Youth Program.
Bubnowski is the younger
brother of Brearley’s Assistant Principal Ronald Bubnowski. Jeffrey died
of
leukemia in August of 2010.
The Brearley students were extremely
committed to this very worthy cause. Since 2004, David
Brearley Middle and
High School has raised $27,710.09 for the Leukemia and Lymphoma Society’s
School and Youth Program through the “Pennies for Patients”
fundraiser.
In the high school, the individual class that raised the most
money this year was Mrs. Greten’s
homeroom class. These first place winners
raised $291.79 and won a pizza party.
In the high school, the individual
class that raised the second greatest amount of money this year was
Ms.
Spampinato’s homeroom class. These second place winners raised $174.70 and won
an ice
cream party.
In another very charitable action, these winning
high school homeroom classes have decided to
donate the money for their
pizza and ice cream parties ($70 total) to the Michael N. Bibbo Surgery
Fund (thebibbofund.com). Michael Bibbo is a junior at David Brearley High
School. He has been
diagnosed with Primary Lymphedema and is in need of
major surgery.
In the middle school, the homeroom class that raised the
most money was Mr. Shapiro’s homeroom
class. These first place winners
raised $356.16 and won a pizza party.
In the middle school, the homeroom
class that raised the second greatest amount of money was Mrs.
Alvarez’s
homeroom class. These second place winners raised $188.84 and won an ice cream
party.
The “Pennies for Patients” committee this year was chaired by
David Brearley High School senior
Amy Roman. Assisting with the fundraiser
were Brearley seniors James Hannon, Megan Gilligan and
Jaclynn Vaughn. The
generosity of the David Brearley Middle and High School students, faculty, and
staff during this charitable fundraiser is a fine example of true
volunteerism. It is also proof of their
commitment to helping
others.
May 26, 2011
Spa Treatments During Cancer? Visit a
Certified Oncology Esthetician - Opposing Views – by Cinco
Vidas
–
Research has shown that massage, facials, reflexology, and other spa
treatments can all help reduce
stress, nurture the skin, slow the
appearance of aging, and even reduce side effects from cancer
therapies and
medications.
Because so many people are now turning to spa treatments
for health reasons, today’s therapists
need to know a lot more than just
how to make you feel good. I was fortunate enough to meet one
spa owner and
esthetician who is taking her responsibilities very seriously. Beverly Miller
owns and
operates Tranquility Spa & Wellness in St. Charles, Illinois.
We attended a training course together
on oncology esthetics (given by
Morag Currin, pioneer of the Clinical Oncology Esthetics (COE)
certification for licensed estheticians), and I was so impressed that she
paid for most of her staff to
take the course with her. They’re all
committed to making a difference in the lives of cancer patients
and wanted
to gain certification before promoting themselves as a spa that works with
fighters and
survivors.
“We have five estheticians working at the
spa,” Beverly said, “and I wanted all of us to have this
knowledge. We’re
very involved in a center in Geneva called the Living Well Cancer Resource
Center, and we would like to be able to donate our services
there.”
Beverly says that her personal experience with cancer made her
want to do more: “Over the last
several years, I’ve had many of my clients
come in and say, ‘I’ve just been diagnosed with breast
cancer,’ or ‘I just
found out I have ovarian cancer.’ I’ve seen friends and clients go through
chemotherapy and radiation and I’ve seen what it does to their skin. The
treatments, medications, and
surgeries create unique situations that you
have to know how to deal with so you don’t cause any
injuries.”
When
talking with Beverly about the need for additional education, she pointed out
that there have
been a lot of changes in the industry that require it.
“Back when I started, spa treatments were mainly
a ‘fluff and puff’ sort of
thing you did to pamper yourself on a special occasion,” she says. “Since
then, science has learned a lot more about the skin and body, and we now
have more beneficial
ingredients in our skin care products like
antioxidants and peptides. More likely than not, one of us
will detect a
suspicious mole or dark spot on the skin before anyone else does, making us the
first line
of defense against skin cancer. And our spas aren’t just about
looking pretty anymore—we’re
catering to people’s health and well being
with things like acupuncture, reflexology, and yoga classes,
in addition to
the standard massage and facial treatments. So we have to be a lot more
educated to
fulfill that role.”
After the course was finished,
Beverly said the most important thing she learned was to be extra
careful
with people who’ve had lymph nodes removed. “It’s very important to know how
not to
massage, because you could cause lymphedema [long-term swelling],”
she said. “I want to create a
safe haven for my clients. No matter what
they’re going through, I want them to feel comfortable in
my spa, and know
that they’re putting their bodies in the hands of someone who knows what
they’re
doing.”
When asked what advice she would give people living
with cancer when looking for the right
esthetician, Beverly said, “Call the
spa or wellness center. Check their certifications. They should
have their
basic training, plus additional training from the International Dermal
Institute (for
estheticians), or from a course like this one. When you go
in, observe how they react. Do they have
you fill out an extensive
questionnaire? They need to know if your blood count is low, for example, so
that they’re extra cautious about risk of infection. Finally, if I were
going through cancer, I would call
and say, ‘Do your estheticians know how
to treat someone going through cancer?’ And I would
make sure to tell them
everything about my condition.”
Today, armed with her new knowledge,
Beverly is excited about expanding her services. “A spa
treatment is
soothing, relaxing, and truly healing. It can definitely help you deal with the
side effects so
you feel more confident and refreshed.”
Lymphedema
Depot Adds New Solaris Caresia Arm Sleeve - Wire Service Canada
–
Lymphedema Depot presents the new Caresia arm sleeve from
Solaris.
Lymphedema Depot is happy to announce that Solaris has
introduced a new model of the Caresia
Bandage Liner arm sleeve. The new
sleeve is called a Wrist to Axilla (armpit) Caresia Bandage Liner
and it
does not cover the hand but starts at the wrist and goes up to the shoulder. It
can be worn with
the Caresia glove or gauntlet if hand compression is
needed or desired. The new Wrist to Axilla
garment can also be paired with
the Caresia Glove or Gauntlet in order to provide individualized full
arm
coverage.
The Wrist to Axilla Caresia does not replace the regular
Caresia Bandage Liner arm sleeve, which is
a one-piece, MCP’s to Axilla
style with a thumb hole and coverage over the dorsum of the hand to
the
knuckles, but it does add another option to the line of Caresia arm
garments.
Like all of the Caresia products, the new design helps
simplify the active phase of therapy; clients
simply don their Caresia and
wrap over it with short-stretch bandages to achieve the desired
compression.
Come and visit us at the Solaris booth at the 3rd
International Lymphedema Framework Conference
and Lymphedema Association of
Ontario Conference in Toronto June 16- 18. For more information
on this
combined conference, visit our events page here!
http://www.lymphedemadepot.com/events.
About Caresia
Caresia
Bandage Liners are standard-sized bandage liners which simplify complex
multi-layered
bandaging protocols while enhancing therapeutic outcomes in
the active phase of therapy. Caresia
Bandage Liners replace stockinette and
multiple layers of padding or foam. Patients simply don the
Caresia and
then, using a spiral or figure-eight wrapping style with 50% overlap, wrap over
top of
their Caresia with short-stretch bandages. The short-stretch
bandages should be applied to provide a
snug fit, but not tight.
The
unique foam chips used in every Caresia will help resolve tissue induration,
stimulate interstitial
fluid movement, and diffuse irregular wrapping
pressures. Solaris manipulates the insertion of foam
chips to create a
medial to lateral pressure differential to encourage interstitial fluid
movement toward
the collateral pathways.
Caresia with over-wrapping
is much more comfortable and effective than standard bandaging for
patients
during the active phase of therapy. Caresia decreases the level of time and
effort commitment
required for self-care, thus increasing compliance with
the vital bandaging routine
About Solaris
With over a decade
of manufacturing experience, Solaris has become a leader in nighttime
lymphedema management and is quickly developing a reputation in venous
edema and wound care
treatment. Solaris prides itself on its products,
customer service, and involvement in their local and
lymphedema
communities. For more information on Solaris, please visit
About
Lymphedema Depot
Lymphedema Depot is a Canadian company dedicated to
bringing new options in lymphedema care
products to Canada. We are the
exclusive Canadian distributor of the Solaris line of medical
compression
garments for the management of lymphatic and venous edemas.
Lymphedema
Depot and Solaris both strive for continuous improvement to make the management
of
lymphedema and related conditions less complex, more effective, and
ultimately easier for patients.
Learn more about Lymphedema Depot, and
the Solaris products we offer in Canada by visiting us
online at
http://www.lymphedemadepot.com.
Understanding Lymphedema - NBC2 News
–
FORT MYERS, FL -
Lymphedema is extreme swelling of an arm or
leg, that often occurs after surgery in many cases for
breast cancer. Once
the lymph nodes are removed it leaves lymphatic fluid with nowhere to
go.
"You end up breaking the lymphatic channels, they don't have a way
of getting back to the heart,"
says Dr. Frank Rodriguez. "When that happens
it pools up and you can have a lot of swelling of the
hand, or of the
arm."
Patient's limbs can swell up to 2 or 3 times their normal size.
There's no cure for lymphedema, people
are left managing their symptoms.
Starting with understanding the condition.
Lymphedema therapist Jackie
Speas teaches patients how to ease the constant swelling.
"We'll teach
them manual lymph drainage which is a massage technique to redirect the fluid
to parts of
the body that do not have edema," she says. "Then we'll also do
compressive wrapping."
It's important to understand the condition
because it can lead to bigger health consequences.
"You can have all
sorts of problems with infection and you really, really want to keep it under
control
because you don't want to get into one of these higher-level
problems."
More than a lifestyle issue, managing lymphedema is accepting
it is a lifelong process
Main Named Chattanooga Area Manager of the Year
– WTVC –
Robert P. Main, President and Chief Executive Officer of Siskin
Hospital for Physical Rehabilitation,
is the recipient of the Chattanooga
Chamber of Commerce’s Chattanooga Area Manager of the Year
Award for
2011.
The Manager of the Year Award is made annually by member
organizations of Chattanooga Area
Manager of the Year (CAMOY). Now in its
24th year, the award recognizes an executive manager
who has made a
significant contribution to the Hamilton County area.
Robert Main is
serving in his 23rd year as President and Chief Executive Officer of Siskin
Hospital
for Physical Rehabilitation. He was instrumental in the
development of the hospital and officially
became the first employee in
1987. He has remained steadfast in his leadership for the past 23 years,
providing paramount insight and direction in establishing Siskin Hospital’s
presence as one of the most
successful regional rehabilitation hospitals in
the country. Mr. Main remains the longest tenured
healthcare Chief
Executive Officer in the Chattanooga area.
The Chattanooga community has
directly benefited from Mr. Main’s vision of providing specialized
programs
such as the Brain Injury Unit, the Lymphedema program, the Balance and
Dizziness
program, and the Driving Evaluation program. These programs
provide the Chattanooga community
with localized specialty care that would
otherwise be unavailable in this area. Mr. Main and his team
continue to
search for new ways to better serve patients with special needs.
As a
way to continue serving the disabled population, Mr. Main has worked diligently
with staff to
develop the Fitness Center at Siskin Hospital. The focus of
the Fitness Center is to provide a place
where disabled and able-bodied
people, whether former patients or not, can exercise side-by-side
with the
benefit of using specially designed equipment developed to accommodate their
needs. The
Chattanooga community directly benefits from the Fitness Center,
since it is the only full-service
adaptive exercise facility in the
region.
Mr. Main is an active member of the boards of directors of
United Way, Blood Assurance, Hospice
of Chattanooga, and The Jordan Thomas
Foundation. He is also a member of the Rotary Club of
Chattanooga, and a
past board member of the Chamber of Commerce and Notre Dame High
School. In
his professional life, he has served as Chairman of the Chattanooga Area
Hospital District.
He has also served as Chairman and is currently a board
member for the Tennessee Hospital
Association.
Mr. Main is past
Chairman and a member of the American Hospital Association Governing Council
for Rehabilitation, and is the past Chairman and current board member of
the American Medical
Rehabilitation Providers Association. He also serves
on the Regional Policy Board of the American
Hospital Association. He was
the founding Chairman of the Southeast Rehabilitation Network. Mr.
Main is
a past member of the Professional and Technical Advisory Committee of the Joint
Commission on Accreditation of Healthcare Organizations, as well as
continuing to chair a number of
other committees and task forces on a
national level.
Robert Main’s community service also includes past board
membership on the Chattanooga
Symphony and Opera Association and membership
on the University of Tennessee at Chattanooga
Chancellor’s
Roundtable.
Locally, Mr. Main’s leadership was essential in enhancing
the field of rehabilitation education. Under
his direction, Siskin Hospital
joined in a three-way partnership with the University of Tennessee
Health
Science Center in Memphis and the University of Tennessee at Chattanooga to
offer a Master’
s Degree program in Occupational Therapy on the UTC
campus.
Mr. Main has also been very active on a state and federal level
with lobbying efforts for the disabled
to ensure their access to
rehabilitation care. On a federal level, Mr. Main was a founding member of
the FAIR Fund, a common legal fund formed to preserve access to inpatient
rehabilitation care. The
members of the FAIR Fund pursue test cases across
the country challenging inappropriate medical
necessity denials of
Medicare/Medicaid.
In his professional and personal life, Robert Main
values and rewards hard work, encouraging growth
and promotion within his
organization. He worked his way through his own schooling to earn a
Bachelor of Science in Education from State University of New York (SUNY)
at Buffalo and a
Masters of the Arts in Hospital and Health Administration
from the University of Iowa. He has a
special fondness for those who are
willing to work hard and have the motivation to excel in their field.
He is
a great teacher and mentor, as witnessed by a large number of Siskin Hospital’s
staff members
who were recently honored for their longstanding employment
terms ranging from five to 20-plus
years.
Siskin Hospital is the
only freestanding, not-for-profit rehabilitation hospital in Tennessee,
employing
nearly 400 people. Mr. Main’s primary objective for Siskin
Hospital is to provide services that will
enable patients to return to an
active lifestyle within the community. For many Siskin Hospital patients,
this includes returning to work and volunteer activities, allowing them to
discontinue disability benefits,
and ultimately saving taxpayer
dollars.
Paddling in the pink - Woodstock Sentinel Review – By Heather
Rivers –
WOODSTOCK — There may be plenty of stories of duels against the
deadly disease, but these
breast cancer survivors have picked another
fight.
"We don't go as breast cancer survivors," explained Hooters
member Alice Parsons. "We're dragon
boaters."
The Woodstock dragon
boat team, comprised of breast cancer survivors, is currently looking for new
members.
Joining the team is free of charge, and participants are
provided with free coaching, T-shirts, a pink
life jacket and
paddle.
The team of paddlers aged 30 to 70 years of age includes one
male breast cancer survivor and meets
every Monday night at the boat launch
at Roth Park, starting on May 30.
Paddlers compete against other breast
cancer survivor teams at the annual Caressant Care
Woodstock Rotary Dragon
Boat Festival.
"The good thing about Hooters is you don't need any
experience," Hooters member Laurel Gillespie
said.
Gillespie said
medical research was the instigation for the formation of a wave of breast
cancer
survivor dragon boat teams.
"Prior to 1995, upper body
exercises were believed to be a cause of lymphedema in people who had
their
lymph nodes removed," she explained. Lymphedema, which commonly occurs in
people who
have had breast cancer, is a painful chronic swelling of the
tissue due to a blockage of the lymph
vessels. However, Dr. Don McKenzie, a
sports medicine physician at the University of British
Columbia, believed
that following a specialized exercise and training program could help prevent
lymphedema.
"He started the first breast cancer dragon boat team in
Canada," Gillespie said. "He chose dragon
boating because it increased
upper body flexibility and strength, and aerobic output."
As it turned
out, McKenzie's theories rang true and a new dragon boat movement was born. But
Hooters paddlers said their team is about much more than activity and
exercise, providing members
with "uplifted spirits, companionship and
support."
"It's about the power of these women going through something
together and coming out at the other
end," Gillespie said. "It's
reaffirming the positive side of life after cancer — life goes
on."
Hooters member Deb Daub said each member of the group has their own
story to tell about their
struggles with disease.
"We're all able to
get together and support each other," she said.
Gillespie said being a
member of the team is also a way to make life a more joyful
experience.
"It's about mostly having fun," she said.
Parsons
said members of Hooters often meet socially outside of dragon boat
activities.
"There are so many opportunities beyond Hooters," she
said.
Hooters is sponsored by the Woodstock Rotary Club, the Zonta Club
of Woodstock and Shoppers
Drug Mart.
For more information on
Hooters, contact Donna Stewartsmith at 519-539-4134.
May 27,
2011
MU hospital expansion nears halfway mark - Columbia Business Times
–
Ellis Fischel Cancer Center will have a new home in early 2013. The
center, which has been located
on Business Loop 70 since it was established
in 1940, will move into University of Missouri Health
Care’s new $203
million patient care tower that’s under construction.
Preparation for
the patient care tower began in August 2009, and ground was broken nearly a
year
and a half ago. Workers are completing internal concrete framing on
the seven-level structure and will
put up external panels next.
The
tower is on the north side of University Hospital and will provide 300,000
total square feet for
Ellis Fischel Cancer Center along with additional
operating rooms, pre- and post-procedure rooms
and 90 private patient rooms
for University Hospital.
Ellis Fischel will occupy the first and second
floors of the patient care tower, where personnel will
provide outpatient
services and clinical services such as chemotherapy treatment, radiation
therapy
and cancer screening. There will also be space for the Margaret
Proctor Mulligan Breast Health and
Research Center, Cancer Screening
Services, Missouri’s only lymphedema center and a variety of
cancer
survivor and quality-of-life services such as a resource center, family support
services, a
boutique and an outdoor “healing” garden.
Construction
of the Ellis Fischel portion of the tower is funded through $30 million in
revenue bonds
that the MU Board of Curators approved in May 2010 and $22
million in operating revenue from
MU Health Care.
The third and
fourth floors of the patient care tower will house surgical services, including
six
operating rooms, with enough space for six more operating rooms in the
future. The new tower will
also include 25 new pre- and post-operating
rooms — all private — with expansion space for 26
more rooms. The tower
also will offer an expanded surgery waiting room.
The fifth, seventh and
eighth floors will house inpatient units with 90 private patient rooms for
patient-
centered care, visitor lounges and facilities for physicians,
nurses and other health care providers to
treat patients. Because of the
alignment of the new tower with University Hospital’s critical care
tower,
there is no sixth floor.
MU Health Care is seeking Leadership in Energy
and Environmental Design certification of the patient
care tower with these
green features:
• The landscaping plan will feature water-efficient
plants to reduce the demand for irrigation.
• Thirty percent efficiency
of sinks, toilets and shower fixtures will reduce water use.
• The
building will be 16 percent more energy efficient than the ASHRAE 90.1 energy
standard.
• Monitoring systems will confirm that the building is
performing as designed.
• Fifty percent of construction waste is
scheduled to be recycled.
• At least 20 percent of construction
materials are scheduled to come from within a 500-radius of
Columbia.
• The building materials will have at least 20 percent
recycled content.
• Surgery spaces will “power down” when not in
use.
Ellis Fischel Cancer Center will have a new home in early 2013. The
center, which has been located
on Business Loop 70 since it was established
in 1940, will move into University of Missouri Health
Care’s new $203
million patient care tower that’s under construction.
Preparation for
the patient care tower began in August 2009, and ground was broken nearly a
year
and a half ago. Workers are completing internal concrete framing on
the seven-level structure and will
put up external panels next.
The
tower is on the north side of University Hospital and will provide 300,000
total square feet for
Ellis Fischel Cancer Center along with additional
operating rooms, pre- and post-procedure rooms
and 90 private patient rooms
for University Hospital.
Ellis Fischel will occupy the first and second
floors of the patient care tower, where personnel will
provide outpatient
services and clinical services such as chemotherapy treatment, radiation
therapy
and cancer screening. There will also be space for the Margaret
Proctor Mulligan Breast Health and
Research Center, Cancer Screening
Services, Missouri’s only lymphedema center and a variety of
cancer
survivor and quality-of-life services such as a resource center, family support
services, a
boutique and an outdoor “healing” garden.
Construction
of the Ellis Fischel portion of the tower is funded through $30 million in
revenue bonds
that the MU Board of Curators approved in May 2010 and $22
million in operating revenue from
MU Health Care.
The third and
fourth floors of the patient care tower will house surgical services, including
six
operating rooms, with enough space for six more operating rooms in the
future. The new tower will
also include 25 new pre- and post-operating
rooms — all private — with expansion space for 26
more rooms. The tower
also will offer an expanded surgery waiting room.
The fifth, seventh and
eighth floors will house inpatient units with 90 private patient rooms for
patient-
centered care, visitor lounges and facilities for physicians,
nurses and other health care providers to
treat patients. Because of the
alignment of the new tower with University Hospital’s critical care
tower,
there is no sixth floor.
MU Health Care is seeking Leadership in Energy
and Environmental Design certification of the patient
care tower with these
green features:
• The landscaping plan will feature water-efficient
plants to reduce the demand for irrigation.
• Thirty percent efficiency
of sinks, toilets and shower fixtures will reduce water use.
• The
building will be 16 percent more energy efficient than the ASHRAE 90.1 energy
standard.
• Monitoring systems will confirm that the building is
performing as designed.
• Fifty percent of construction waste is
scheduled to be recycled.
• At least 20 percent of construction
materials are scheduled to come from within a 500-radius of
Columbia.
• The building materials will have at least 20 percent
recycled content.
• Surgery spaces will “power down” when not in
use.
May 29, 2011
Lymphedema patient seeks a home - News Chief –
By CHASE PURDY –
LAKELAND -- Sitting in a hospital bed on the third
floor of Lakeland Regional Medical Center on
Friday, Yvonne Gallimore, 51,
dabbed her eyes and shook her head.
A 17-year battle against lymphedema
has left the Lakeland woman weighing 770 pounds, limiting her
mobility and
banishing her to a life confined to her apartment.
Despite treatment
surgeries, her condition escalated and prevented her from moving freely through
the
front door of her home, she said.
On May 19, medical crews tore
through a wall of the apartment to transport her to the hospital. An
infection in one of her legs needed immediate medical treatment, she
said.
About a week after doctors admitted her to the hospital, they
deemed Gallimore ready for release.
But extrication damage to her Section 8
apartment in the 1100 block of Martin Luther King Avenue
left her homeless.
Because she doesn't face a life-threatening condition, Gallimore said she
doesn't
qualify for admittance to area bariatric facilities for
treatment.
"But I'm not going to let anybody break my spirit," she said
"I've come too far. I have grandchildren
and I want to spend time with my
grandchildren."
Visiting with Gallimore on Friday afternoon was Chaundra
Greer, a private healthcare nurse, who
said her patient and friend is now
stuck between a rock and a hard place.
Because of her weight, Gallimore
can't live with Lakeland family members, not without significant
modifications to their homes.
Greer said Gallimore needs an
apartment where she won't be confined to a bed, with access to fresh
air
outside the house
Information published by the Mayo Clinic states that
lymphedema creates blockage in a person's
body that prevents fluids from
draining well. As a result, Gallimore's legs swelled significantly and her
chances for infection enhanced.
There is no cure for the condition,
but it can be controlled.
Ashley Link, a spokeswoman for the hospital,
said doctors would not discharge the woman if she had
no place to
go.
Aware of the predicament, officials with the Lakeland Housing
Authority said they led Greer and
Gallimore's family through a handicapped
accessible apartment to replace the previous apartment.
"We did offer
her what we had available ... that we would be willing to modify," said John
Calcagni,
senior director of housing. "It was not accepted. And we've
spoken with her and the family this week
about half-a-dozen
times."
The substitute apartment didn't appeal to Gallimore's family,
particularly Alnieta McKenzie, her sister.
McKenzie said the housing
authority conceded to make some modifications, but not enough to give
her
sister access to all the rooms. Not the kitchen. Not the living room. Just the
back door and the
bedroom, she said.
Housing Authority Administrator
Herbert Hernandez said he could not confirm that claim because the
man who
led the family through the apartment was not in the office Friday.
"We
attempted to meet all of our obligations," Hernandez said. "We made an offer
and it wasn't
accepted, and at this point we are going to be talking to our
consultants."
The family sought help at area nursing homes, but said
they were turned away for lack of adequate
accommodations. Now they're
appealing to the community.
"The place she was in, she wasn't getting
proper care," McKenzie said. "What we're trying to do is
get her somewhere
here in Lakeland where somebody from our family can get there every day to
check on her."
Weepy about her misfortunes, Gallimore cried into her
hospital gown, little gold earrings swaying
back and forth. She said she
hopes somebody in Lakeland can help her find a place to live. A place
to be
a grandmother again.
"I don't just want to give up my life," she said.
"I ain't trying to say I'd like to run a marathon, but I
want quality of
life."
May 30, 2011
Complementary Cancer Treatments: Which Is For
You? - Huffington Post – Joseph Nowinski, Ph.D.
–
This series has
looked at a variety of complementary therapies that are often used by cancer
patients.
They include: Acupuncture, Reiki, Therapeutic Massage,
Meditation, Tai Chi and Yoga.
Although the effectiveness of these
treatments on physical symptoms such as nausea and pain vary, all
of them
appear to have one thing in common: They have the potential to reduce chronic
stress in many
of the people who use them. Which raises the question: Is
stress related to cancer, and if so, how?
Linking Stress, Depression and
Cancer
According to a study conducted at Stanford University School of
Medicine, women with breast
cancer who are also clinically depressed are at
higher risk for a recurrence of cancer than are women
who have only the
cancer but not the depression. The reason could possibly have to do with the
way
depression affects the immune system. This was a study of women with
metastatic breast cancer --
cancer that has spread from the breast to other
organs. There is little doubt that these women were
under chronic stress,
even if they were able to continue functioning in their daily lives. It was
found
that the more symptoms of depression these women had, the less their
immune systems were able to
respond to a variety of bacteria, fungi and
yeasts.
Some researchers have suggested that there is a difference
between how acute versus chronic stress
may affect the immune system.
Acute, relatively brief stress may actually enhance the effectiveness of
our immune system, at least for a short period of time. Depression,
however, is most often the result
of chronic stress that wears us down.
Researchers at the Health Sciences Center at the State
University of
Londrina in Brazil, in a review published in The Lancet of many studies on the
immune
system concluded that "chronic stress impairs the immune response
and contributes to the
development and progression of some types of
cancer." Chronic stress causes the body to produce
more cortisol, a hormone
that suppresses the immune system. This could potentially be one of several
biochemical mechanisms through which chronic stress and depression
contribute to cancer.
Janice Kiecolt-Glaser, Ph.D., a psychologist and
researcher at Ohio State University, has also studied
the relationship
between chronic stress, depression and the immune system. She looked at a
sample
of 47 men and women who were all caregivers to patients with
Alzheimer's and found that all were
experiencing moderate levels of
depression -- not serious enough to prevent them from functioning,
but
enough to affect their mood and their sleep. Again, you could reasonably argue
that these people
were experiencing chronic, not acute stress. When this
group was given a standard flu shot (which
triggers an immune response)
their bodies over-reacted, producing much higher than normal amounts
of the
chemical interleukin-6, which can cause inflammation in various organs. Such
chronic
inflammation is associated with cardiovascular disease, diabetes
and other disorders. In effect, these
persons' immune systems were
overworking, to their detriment. It makes sense that a chemical that
can
contribute to something like cardiovascular disease or diabetes can also
complicate cancer and its
treatment.
Readers who have been following
this series may have noticed one other finding that stuck out for me:
Complementary treatments reduce stress more effectively when they are
followed consistently over a
long period of time. As an example, women who
had been practicing yoga consistently for at least
two years had
significantly lower heart rates and better overall mental health than a group
who had
been practicing yoga for only a short time. Similarly, the
beneficial effects of massage on stress levels
soon dissipate if massage
was discontinued.
Which Complementary Treatment To
Choose?
Studies such as the above raise another important question: If
the kinds of complementary therapies
we have been looking at in this series
all have the power to reduce chronic stress and depression,
could they not
-- in combination with medical treatment -- potentially improve the prognosis
and
extend the lives of cancer patients?
In turn, the fact that what
complementary treatments seem to have in common is the ability to reduce
chronic stress leads to an interesting hypothesis:
Which
complementary treatment a patient chooses may be somewhat less important than
the fact that
they choose one or more and follow through. In other words:
Find something you like and stick with it.
Consider the way one woman
who has been living with Stage 4 cancer for many years wrote about
her use
of meditation:
"I am a huge fan of meditation and would be a mess
without my practice. It has centered me and
brought to my awareness when I
am the cause of my own suffering, and then I need to let it go as a
cloud
just passing by. Pain is a part of life ... but suffering is optional.
Frequently in the world of
cancer treatment, prescriptions for
tranquilizers or antidepressants are given out. While at times this is
a
valid and needed approach, there are many people who don't know what to do with
their fear and
anxiety, and rather than dealing with it through something
like meditation, they pop a pill for a quick
fix."
This woman wrote
to me that she had also made use of massage and acupuncture as part of her
holistic approach to dealing with her cancer, and that these had been
useful at different times, but that
her overall health (weakened bones,
lymphedema, etc.) had led her to turn to meditation. In each
case, however,
this woman followed through with the complementary treatment, as opposed to
merely dabbling in it.
What About Caregivers?
As a corollary
to the above, it is reasonable to argue that complementary therapies can be
helpful to
the caregivers of cancer patients, as well as to the patients
themselves. Numerous studies have
documented the deleterious effects that
long-term caretaking can have, especially if that caretaking
falls
primarily on the shoulders of one or two people (as it typically does). My blog
on disabled
veterans, for example, cited research on the negative effects
on the mental and physical health of the
wives who care for them -- often
for years and years. These findings were strongly supported in
interviews
Dr. Barbara Okun and I conducted in preparation for writing our book, "Saying
Goodbye:
How Families Can Find Renewal through Loss," which is a guide for
helping patients as well as their
families cope with a terminal illness.
Does it not make sense, then, to encourage (and even facilitate)
access to
complementary therapies to caregivers?
Want More Information?
To
join the conversation about how medicine has transformed death and dying, and
how to help a
loved one who is facing cancer, visit
www.newgrief.com.
Links to more information on complementary treatments
can also be found by visiting the Annie
Appleseed Project at www.annieappleseedproject.org
May 13, 2011
Ann Hildebrand earns
hospital award for excellence - Ventura County Star - By Alicia Doyle
–
For Ann Hildebrand, earning the Core Value Award for Excellence for her
work with cancer patients
is not just about her.
"It brings
awareness to the Cancer Center, highlighting the importance of all that is
offered here," said
Hildebrand, of Ventura, who was recognized for her role
as supervisor of the Cancer Center at St.
John's Regional Medical Center in
Oxnard. "It is affirmation that I am able to make a difference."
At the
Cancer Center, Hildebrand's responsibilities include collecting cancer data,
meeting numerous
quality standards, scheduling weekly tumor boards and
maintaining services. A certified tumor
registrar by profession, she is
responsible for reporting all cancer cases as required by law.
Tumor
board is a weekly multidisciplinary conference where all the medical
professionals in different
specialties gather for an hour to discuss
interesting or difficult cancer cases.
"The patient benefits by a
coordinated, multidisciplinary team approach to the best available
diagnostic and treatment options," Hildebrand said. "The physicians benefit
from the shared
knowledge and experience of the peers."
She also has
volunteered with the American Cancer Society for more than 25 years. She said
she
consistently promotes its activities and services.
"We have
similar missions. ... They are the only other organization I will fundraise
for, as they have
funded 42 Nobel Prize-winning cancer researchers," she
said.
Hildebrand's role on the community council for the American Cancer
Society requires a deep
personal commitment of time and energy, said Ray
Vasquez, administrative assistant at the Cancer
Center.
"This is a
group which meets to plan and strategize priorities and fundraisers Relay for
Life, the Gala
and Cancer Survivors Day are just a few of the events
sponsored by the American Cancer Society,"
Vasquez said.
The work of
the Cancer Center, which offers support and resources to cancer patients and
their
caregivers, is made possible through more than 20 volunteers who
together donate more than 100
hours a month. Free services include support
groups for colon cancer, prostate cancer and Latinos
with cancer, as well
as art classes, yoga, lymphedema education courses and exercise classes for
patients after breast cancer surgery.
"Ann goes beyond the call
of duty for patient advocacy. We see new patients on a daily basis, and
she
demonstrates her commitment to these persons without fail," Vasquez
said.
Inspired by her efforts to make the world a better place, Vasquez
nominated Hildebrand for the Core
Value Award for Excellence. She was
recognized with the honor in April at St. John's.
"I have 30 years of
experience working with severely injured accident victims and very ill persons,
and being there for them and their families," said Vasquez, a retired
firefighter. "Here at the Cancer
Center, I have had the extraordinary
experience of watching Ann do what she does, and that is to
bring some
comfort to persons in their darkest moments. I have seen many people come in
frightened
and leave comforted, some with a smile, knowing someone cares so
much as Ann."
For Hildebrand, the desire to help others began with her
parents.
"They taught me a strong work ethic and the importance of
making a difference and giving back to
society," she said.
She also
credits her grandfather, who died in 1956 of pancreatic cancer when she was
2.
"I never got to know him. It sparked something in me that still burns
to this day," she said.
May 14, 2011
A chronic disease? -
Malaysia Star - By Dr YIP CHENG HAR –
Can breast cancer be considered a
chronic disease, and, what are the support systems available to
women with
breast cancer?
A CHRONIC disease is a disease that persists for a long
time. The US National Centre for Health
Statistics defines chronic disease
is one lasting three months or more.
Traditionally, diseases like
hypertension or diabetes are considered chronic diseases, while cancers
are
generally not, as they usually present as a life-threatening condition,
requiring urgent attention.
In cancers where treatment options are
limited, and diagnosis is usually made at a late stage, such as
seen in the
majority of lung, gastric, and liver cancer, survival is poor. Hence, such
cancers are not
likely to be considered as a chronic
condition.
Redefining breast cancer
However, survival rates for
certain cancers, notably breast, colorectal and prostate, have risen
steadily over the past 10 years. Because survival rates for breast cancer
have improved so much,
there are now more than four million women worldwide
who have been diagnosed and treated for
breast cancer over the past five
years, compared to an incidence of slightly more than a million new
cases
per year.
Survival rates of breast cancer has increased to more than 80%
in some of the more developed
countries. Hence, there are more breast
cancer survivors than any other cancer survivors.
It is no surprise that
there are so many breast cancer support groups all over the country, while
there
is not a single lung cancer support group. Because of the large
numbers of women living with breast
cancer, the Institute of Medicine in
the US now recognise breast cancer as a chronic disease, bringing
greater
focus to this area of research.
After the cancer
After being
treated for breast cancer, there are still a few remaining issues. Chemotherapy
can lead to
an early menopause. With early menopause, women have to face
problems with decreased libido, dry
skin, earlier onset of osteoporosis
(where the bones become brittle and prone to fracture), hot
flushes, and
depression.
While the majority of women deal with menopause well, there
is a small proportion where
menopausal symptoms persist, hence interfering
with quality of life. For oestrogen-receptor positive
breast cancer (which
occurs in up to 60% of women with breast cancer in Malaysia), an
anti-
oestrogen drug called tamoxifen is prescribed for five
years.
In premenopausal women (more than 60% of women with breast cancer
in Malaysia are in the
premenopausal age group), this may cause menopausal
symptoms, such as hot flushes, dry skin, sleep
disturbances, and
genitourinary symptoms. Hence, these women experience a poorer quality of
life.
Side effects of surgery may persist, such as numbness and pain of
the upper limb, problems with
shoulder movement, and lymphedema. Pain over
the chest wall is also a common symptom.
These women also have to deal
with discrimination at the workplace. Indeed it is not uncommon for
women
to be coerced into resigning from their jobs. Insurance companies will also not
insure women
with a “history of breast cancer”. Because of the stigma that a
diagnosis of breast cancer brings, some
women do not even tell their family
members about their condition.
Quality of life
CanSORT (Cancer
Surveillance and Outcomes Research Team) is a multidisciplinary group of
investigators based at the University of Michigan and the Ann Arbor VA
Centre for Clinical
Management Research in the US, and studies the quality
of cancer care across a continuum of care,
from prevention to
survivorship.
CanSORT studies the impact of cancer and its treatment on
the quality of life, especially in breast
cancer, to understand the unique
issues that breast cancer survivors face.
In a study carried out by this
group, women interviewed eight months after completion of breast
cancer
treatment report ongoing symptoms – fatigue, sleep disturbances, breast and arm
discomfort,
and reduced emotional well-being.
Younger women and
women with a poorer health status at the time of diagnosis reported more
symptoms, and younger women tended to report a lower quality of life
overall.
Apart from discrimination, fear of recurrence persists, even in
women with early-stage breast cancer,
where the prognosis is
excellent.
The slightest twinge of pain, even in their big toe, can send
women into a panic and running to their
doctors.
This fear of
recurrence is difficult to cope with for some women, while others accept it
pragmatically
and move on with their lives, living every day to the
fullest.
The breast cancer experience differs with each women, as coping
mechanisms differ widely between
women, based on their previous life
experiences, educational level, socio-economic status, and
degree of family
support.
However, “benefit-finding” is a new concept where a woman,
after experiencing a life threatening
event, goes on to live life more
fully, taking part in activities such as mountain-climbing or
trekking.
A family affair
What about the role of the family in
women surviving after a diagnosis of breast cancer?
One of a woman’s
greatest fear is that her husband may leave her because of cancer, and
certainly,
among the less educated, there are myths that cancer can spread
to the spouse and that sexual
intercourse will bring on a
relapse.
Some women are told by their family members that they cannot
eat chicken and a whole host of other
types of food, so social life which
revolves around eating out, can be severely curtailed.
This is unlike
other chronic diseases like hypertension and diabetes, where there are less
superstitions
and taboos.
In metastatic breast cancer, where the
cancer has spread beyond the breast into areas like the bones,
liver and
lungs, it meant that it was time to write your will and get your affairs into
order, because in
the early years, only 10% of women were alive five years
after a diagnosis of metastatic breast cancer.
However because of
improved treatment, women are living longer with metastatic breast cancer and
it is common now to see as many as 40% of women with metastatic breast
cancer surviving five years
or more. Hence, even metastatic breast cancer,
which used to have such a bleak outlook, is being
viewed as a chronic
disease.
Ultimately, it is important to develop interventions and
programmes to meet the needs of the breast
cancer survivor. Interventions
include decision making tools to assist women to make good decision
about
surgery, chemotherapy, and their treatment options, including breast
reconstruction.
Interventions to help women to better manage their
condition is also required so that a woman, after
being treated for breast
cancer, can move on and live a normal life, somewhat like a woman who has
a
chronic disease like hypertension, which is so common.
This article is
contributed by The Star Health & Ageing Panel, which comprises a group of
panellists
who are not just opinion leaders in their respective fields of
medical expertise, but have wide
experience in medical health education for
the public. The members of the panel include: Datuk Prof
Dr Tan Hui Meng,
consultant urologist; Dr Yap Piang Kian, consultant endocrinologist; Datuk Dr
Azhari Rosman, consultant cardiologist; A/Prof Dr Philip Poi, consultant
geriatrician; Dr Hew Fen
Lee, consultant endocrinologist; Prof Dr Low Wah
Yun, psychologist; Datuk Dr Nor Ashikin
Mokhtar, consultant obstetrician
and gynaecologist; Dr Lee Moon Keen, consultant neurologist; Dr
Ting Hoon
Chin, consultant dermatologist; Prof Khoo Ee Ming, primary care physician; Dr
Ng Soo
Chin, consultant haematologist. For more information, e-mail
[email protected]. The Star
Health & Ageing Advisory Panel
provides this information for educational and communication
purposes only
and it should not be construed as personal medical advice. Information
published in this
article is not intended to replace, supplant or augment a
consultation with a health professional
regarding the reader’s own medical
care. The Star Health & Ageing Advisory Panel disclaims any
and all
liability for injury or other damages that could result from use of the
information obtained from
this article.
Women's Health: Significant
Developments Regarding Breast Surgery - MD News – by : Barbara D.
Goldberg
-
Two recent studies involving breast surgery will likely have an impact
on cases in which a patient
requires a breast biopsy following a suspicious
mammogram, or where cancer has been found in the
lymph nodes.
A
study of breast biopsies found that many women who undergo surgical biopsies do
not need them
and should be having needle biopsies instead. As reported in
The New York Times, a study of
172,342 biopsies in Florida found that 30%
of the biopsies from 2003 to 2008 were surgical, while
the rate should have
been only 10% or less, according to medical guidelines. Assuming that the
figures
for the rest of the country are similar, this would mean that more
than 300,000 women a year are
having unnecessary surgeries.
This is
significant because a surgical or open biopsy typically requires an inch-long
incision, sedation
or general anesthesia, and carries the risk of scarring
and infection. A needle biopsy, by contrast,
requires only a local
anesthetic and involves a minimal risk of scarring and infection. Moreover, in
those women who are found to have cancer, a surgical biopsy may make a
subsequent mastectomy
more difficult than it would otherwise have
been.
The other study indicates that dissection of axillary lymph nodes
may often be unnecessary — even in
women who have residual disease in the
remaining nodes — and that surgeons may safely remove
only the sentinel
lymph nodes. In the study, which was conducted at 115 sites and enrolled
patients
from 1999 to 2004, women who had invasive tumors that were less
than 5 cm and one to two
positive sentinel nodes were randomized into two
groups. The 445 women randomized to axillary
node dissection underwent
removal of 10 or more nodes, compared to two nodes for the 446
women in the
other group. Women in both groups underwent lumpectomies and whole-breast
radiation. Whether they would also have chemotherapy was decided by their
treating physicians.
The study measured both overall and “disease-free”
survival rates, and, significantly, these were found
to be almost identical
for the two groups. For the women who had axillary lymph nodes removed, the
five-year overall survival rate was 91.8%, compared to 92.5% for those with
only the sentinel nodes
removed. Similarly, the five-year, disease-free
survival rate was 82.2% for the women who had
axillary nodes removed and
83.9% for those with only the sentinel nodes removed.
The study thus
demonstrates that for women who qualify, not removing the axillary nodes has
minimal,
if any, effect on overall survival and disease-free survival
rates. The significance for patients is that, by
not having their axillary
lymph nodes removed, they can avoid potentially serious sequelae, such as
arm stiffness, pain, lymphedema and numbness.
Of course, the results
of a single study can never substitute for a surgeon’s best judgment in a
particular case. Nevertheless, surgeons would be well advised to proceed
cautiously in light of these
two studies and carefully document the reasons
for deciding on an open biopsy or axillary node
dissection instead of the
less invasive procedures. A surgeon who performs an open biopsy when a
needle biopsy would have sufficed may find himself or herself facing a
lawsuit if the patient’s breast is
scarred or deformed as a result of the
procedure. Likewise, a surgeon who unnecessarily removes
axillary nodes in
a patient who would have qualified for sentinel node dissection may face
litigation if
the patient develops lymphedema or other serious
complications as a result.
Barbara D. Goldberg is a partner and Head of
Martin Clearwater & Bell LLP’s appellate
department. Goldberg is well
known for her appellate expertise in high exposure and complex cases
and
has handled hundreds of significant motions and appeals in state and federal
courts.
References
i See Grady, Denise, “Study of Breast Biopsies
Finds Surgery Used Too Extensively,” The New
York Times, February 18,
2011.
ii Giuliano, A.E., et al., “Axillary Dissection vs no Axillary
Dissection in Women with Invasive Breast
Cancer and Sentinel Node
Metastasis,” JAMA 2011:305(6): 569-575
Race for the Cure: Enhancing
lives - Columbus Dispatch - By Misti Crane –
A cancer diagnosis is never
welcome news. But for the more than 207,000 women and men who
learn they
have breast cancer each year, there are reasons to be hopeful.
Nine of
10 people with early-stage breast cancers will live at least five
years.
Treatment advances not only are keeping people alive longer, but
they increasingly are improving
quality of life, too.
Researchers
are searching for ways to further tailor care to the individual. And they
continue to
pursue work that not only will tackle the disease, but also
circumvent it.
"The real thing I hope for is prevention, and we're
putting more dollars into research looking for ways
to prevent breast
cancer from ever occurring," said Dr. Mark Cripe, a breast surgeon at Grant
Medical Center and Doctors Hospital.
Some women are doing that by
taking preventive medications or undergoing surgery because of
elevated
risk. Everyone can benefit from healthy-lifestyle choices, including shunning
cigarettes,
limiting alcohol consumption and staying fit, he
said.
"And hopefully we can find a vaccine to prevent patients at high
risk from developing a breast
cancer," Cripe said.
At Ohio State
University Medical Center, researcher Pravin Kaumaya is working on just that,
an
experimental vaccine that targets a molecule that occurs in abnormally
high levels in about one-third of
breast cancers and another molecule that
is overexpressed in many other tumors.
"We've always been looking for
vaccines. That would be a huge way of preventing cancer," said Dr.
William
Farrar, a surgical oncologist and director of Ohio State's JamesCare
Comprehensive Breast
Center.
Farrar said that one of the most
exciting recent developments in the field - and one that already is
changing patients' lives - is the discovery that surgeons don't have to
remove all the lymph nodes in
some patients whose nodes test positive for
the disease.
Women who have their lymph nodes taken out suffer from
varying degrees of lymphedema, a
condition in which excess fluid builds up
in the arm and causes swelling.
"It can be anything from very mild
swelling where they can't get their rings on to tremendous arm
swelling
that truly limits what they can do," Cripe said.
Dr. Deb Norris, a
surgical oncologist at Mount Carmel West hospital, recently returned from a
medical conference and said there was a lot of buzz about new agents that
offer promise in attacking
specific kinds of tumors in specific
patients.
The recognition that one approach doesn't work for all
patients and that some do especially well on
certain drug regimens is
revolutionizing cancer care.
"Breast cancer is not one disease," Farrar
said. "As we learn more and more about the biologic
parameters of breast
cancer, it really separates how one breast cancer is going to behave over
another."
A lot of work is being done on what are known as
triple-negative breast cancers, which tend to be
more aggressive, have
genetic links and occur in younger women, Farrar said.
Medha Sutliff of
Granville is especially interested in work that will help both the treatment
and
identification of disease in young women.
Sutliff, 44, has had
breast cancer twice. She was 27 the first time. The second was diagnosed 10
years later, after the birth of her four children.
"It can many
times be more aggressive. It can be different biologically, and there isn't
really any
effective screening tool," because mammograms aren't routinely
recommended for women younger
than 40, she said.
Sutliff is the
educational-programming chairwoman for the Young Survival Coalition and works
with
breast-cancer patients through a program at the Licking County Health
Department that is funded by
Susan G. Komen for the Cure.
She was
fortunate, she said, because she found the original lump and opted for removing
it even
though a needle biopsy didn't reveal cancer. As it turned out,
there were cancer cells around the
margins of the lump.
After that,
she had yearly mammograms, which detected the second cancer.Both were found
early,
vastly improving Sutliff's chances for survival.
"If I had
waited and watched (the original lump), we really don't know."
Screening
has improved drastically in recent years for those who do get mammograms, but
there is
much room for improvement on the detection front, Farrar said. A
blood test, for example, could
make it easier to find hard-to-detect
cancers.
Even as they cheer advances in surgical techniques and therapy
for breast cancer, doctors say they
remain frustrated by a very old
problem: Women with advanced cancer that could have been stopped
through
early detection, either because the woman noted an early change in her own
breast or it was
detected through mammography.
"I still have women
coming in with advanced-stage cancer, and it's just so hard and you know at one
point it was less than the size of a dime and it could have been a simple
lumpectomy for her," Norris
said.
"This is 2011: Why are we still
seeing this? It's just terrible."
May 16, 2011
Local health
happenings - Daytona Beach News-Journal –
Breast Cancer/Lymphedema
Networking Group meets from 6:30 to 8 p.m. the third Monday of each
month
at Halifax Health Medical Center Meeting Room F, 1st Floor, France Tower, 303
N. Clyde
Morris Blvd., Daytona Beach. First time attendees, should arrive
at 6:15 pm. For more information,
call Catherine McQuade at 386-238-2219.
5K RUN FOR MISSIONS
Komen Foundation Donates $1M To Sharp Healthcare -
KGTV San Diego –
Donation Aims To Help Woman Get Access To Breast Cancer
Care
SAN DIEGO -- The Susan G. Komen Foundation's San Diego chapter
donated $1 million to Sharp
Healthcare programs to help women with little
or no insurance coverage gain access to breast cancer
care, the hospital
system announced Monday.
Among the awards were $335,000 to Sharp Chula
Vista Medical Center to increase access to
diagnostic services to
low-income, uninsured women at-risk for breast cancer in the South Bay;
$152,800 to Sharp Memorial Hospital to help women afflicted by lymphedema,
a chronic and
debilitating condition that causes swelling after surgery or
radiation treatment; and $140,000 to Sharp
Grossmont Hospital to provide
financial assistance to uninsured, or under-insured, women in the East
County.
"Since 2004, thousands of patients at Sharp have benefited
from the vision and generosity of the San
Diego affiliate of the Susan G.
Komen for the Cure," said Bill Littlejohn, chief executive officer of the
Sharp Healthcare Foundation.
"We are proud to be the beneficiary of
their dedication to helping medically uninsured and under-
insured women
fight breast cancer and are honored to partner with such a pioneering
institution," he
said.
Sharp Healthcare is the first San Diego
organization to receive $1 million from the Komen
Foundation, famous for
its "Race for the Cure" and outfitting athletes in pink to raise breast cancer
awareness.
The San Diego chapter also granted money toMama's
Kitchen, the Council of Community Clinics,
San Ysidro Health Center and
Vista Community Clinic, among others, to provide assistance for
women with
little or no medical coverage.
May 18, 2011
Breast cancer support
group hears from medical equipment providers - Scottsboro Daily Sentinel -
By Charlene Larson –
MMI Breast Center celebrated Mother's Day for
the breast cancer support group recently with
representatives from Kerley
Medical Equipment as the guests. The 11-year old privately owned
company is
located in Huntsville.
Brenda Kerley, owner, brought a van full of
merchandise so the women could go home with their new
garments. Other fit
specialists, Barbara Garrison, Sharon Jones and Ashlea Redard, worked with
each woman fitting foundation garments and other merchandise that help
“reclaim a positive body
image and healthy lifestyle during and after breast
cancer.”
The representatives brought brochures that covered products
which are available from Amoena, a
company that specializes in “recovery
care products”; exercises for after breast cancer surgery and
how to deal
with lymphedema.
MMI staff not only supplied the main dish for the meal
but also had a pink Gerber daisy, a token
imprinted with “strength, hope,
faith and courage” and a card that read, “May this token be a
reminder for
you that support and awareness will see us through.” One of the door prizes was
in
memory of Jerry Varnedoe, donated by her family.
Each person
bought a loaf of Robin Taylor's famous banana nut bread to support Relay for
Life.
Early detection is the key to successful breast cancer treatment
and yearly mammography is still the
best way of detecting a malignancy. MMI
Breast Center will direct uninsured and underinsured
women in the correct
procedures to obtain financial help. Just call 256-574-2883 for this
information.
The next meeting will be at 5:15 p. m., Tuesday, June 14 at
the MMI Breast Center on South Broad
Street in Scottsboro. Teresa Alley of
New Beacon Hospice will the guest.
Day Break Massage Reflects Expansion
with Launch of Re-Designed Website
Online PR News – Web development and
SEO client of Web Full Circle, launches newly enhanced
website
-
Online PR News – 18-May-2011 –CHARLOTTE, NC — Website Design and SEO
Company,
Web Full Circle, is pleased to announce the launch of Day Break
Massage’s re-designed website
www.dbmassage.com. Web Full Circle provided
the company with an improved website that reflects
their expansion of new
product lines, additional therapists, and continual expertise.
Day Break
Massage is a Charlotte massage center that enables clients to affordably
receive the best
therapeutic massage possible in a comfortable and relaxing
setting. Their services include therapeutic
(Swedish and deep tissue),
sports, hot stone, pregnancy, and couples massage as well as massage
instruction for couples to learn basic massage techniques for use in their
own home. Additionally, Day
Break offers Medical Massage that complements
mainstream western practices for those who suffer
from a wide array of
maladies such as Fibromyalgia, Carpal Tunnel Syndrome, headaches,
sprain/strains, and chronic pain associated with numerous neurological
disorders. Day Break has on
staff a Certified Lymphedema Therapist (CLT)
that specializes in the treatment and management of
those suffering from
excessive swelling in the body, primarily the arms and legs, as a result of
cancer
treatment.
The spa services also include the slim and detox
body treatment from their newly introduced
Eminence Organics line.
Alongside establishments such as the Ritz Carlton, and the Ballantyne, Day
Break Massage is proud to be the only massage therapy center in Charlotte
that features this award-
winning provider of the most effective skin care
products in the natural & organic skin care industry.
The
re-designed site reflects the growth of Day Break Massage by providing a
plethora of
information for potential clients. Therapist profiles are
showcased as well as benefits of massage
therapy, and FAQs to answer
questions and ease any concerns a client may have but may not feel
comfortable asking. Specials and rewards are also provided to site visitors
such as the current “Refer
four people and receive a free 60 minute
massage” promotion. The new website also offers the ability
for a client to
book an appointment online after reading extensively about each of the services
Day
Break provides.
“Web Full Circle shares similar interest in Day
Break’s core values of building relationships with
clients and community
partners” said Josh Astete, President of Web Full Circle. “We are happy to
aid Day Break Massage with this newly enhanced website so they are able to
showcase themselves
to their fullest potential.”
For more
information about Web Full Circle, please visit www.WebFullCircle.com or call
(980) 322-
0518.
About Web Full Circle:
Web Full Circle is Website
Design and SEO Company that specializes in developing websites that
generate leads for companies. Our team of Internet consultants and SEO
experts develop solutions
that are customized around companies’ online
marketing goals. Web Full Circle is located at 207
Regency Executive Park
Dr., Suite #150, Charlotte, NC 28217.
About Day Break Massage:
Day
Break Massage requires therapists to hold an associate’s degree, and/or a
minimum of two years
of licensed massage therapy experience. Day Break
values vigorous qualifications and believes
demonstrated excellence among
their therapists is the only way to properly care for their clients. For
more information about Day Break Massage and the services they offer please
visit: www.dbmassage.
com.
Solaris Simplifies Upper Extremity
Lymphedema Management - PR-USA.net –
WEST ALLIS, WI - People living with
lymphedema have another management option during the
active phase of CDT
therapy: the Caresia Wrist to Axilla arm garment. Solaris is proud to introduce
this new design and offer their customers a full range of upper extremity
solutions. The new Wrist to
Axilla garment can also be paired with the
Caresia Glove or Gauntlet in order to provide
individualized full arm
coverage.
Caresia bandage liners were designed to increase therapeutic
results and improve compliance by
simplifying the active phase of therapy,
and have been a popular choice among clients and
professionals for years.
Therapists like Caresia's unique foam particles which help open initial
lymphatic gaps and soften indurated tissue, while patients love Caresia's
comfortable and breathable
materials and the simplicity that Caresia brings
to their therapy. Caresia is designed to replace all of
the under layers of
traditional bandaging, such as stockinet, gauze, and foam or cotton padding;
patients simply donn their Caresia and wrap over the top with short-stretch
bandages.
Other designs in the Caresia product line include the Foot,
Below Knee, Thigh, Glove, Gauntlet, and
MCPs to Axilla garments. The MCPs
to Axilla garment has also been recently redesigned to increase
comfort
based on user feedback. To learn more about Caresia and other Solaris products,
please
visit www.solarismed.com.
About Solaris
With over a decade
of manufacturing experience, Solaris has become a leader in nighttime
lymphedema management and is quickly developing a reputation in venous
edema and wound care
treatment. Solaris prides itself on its products,
customer service, and involvement in their local and
lymphedema
communities. For more information on Solaris, please visit
www.solarismed.com.
May 19, 2011
Breast Cancer Survivors Go Pink!
DC Find Meaning at the Dragon Boat Festival - Washingtonian.
com - By Debra
Bruno –
It’ll be hard to miss the breast-cancer survivors at Saturday’s
Dragon Boat Festival in Georgetown--
just look for the pink
Update (2
PM): The Dragon Boat Festival has been canceled this weekend due to high river
waters.
Organizers are working to plan a make-up date.
If you go
to the Washington DC Dragon Boat Festival in Georgetown on Saturday morning,
don’t be
surprised if you see lots of pink. Those pink-and-purple-clad
paddlers on the Potomac are breast-
cancer survivors.
“Breast cancer
made me think, ‘I gotta do something different in my life,’ ” says Brigid
Krizek, 63, a
breast-cancer survivor and dragon-boat paddler. “I had never
been an athlete, never been on a
sports team. But I called and went down
there, and I was hooked.”
The connection between breast-cancer survivors
and dragon-boat paddling started in 1996 with a
Canadian sports-medicine
physician named Don McKenzie, who wanted to do research on whether
lymphedema, the swelling that often results from surgery for breast cancer,
gets better or worse with
upper-body exercise. He formed a group, Abreast
in a Boat, and coached the women through
exercises and training. While his
research couldn’t quite prove that it helped with lymphedema, he did
determine that the swelling didn’t get worse. McKenzie had set in motion a
group of women who
suddenly had a positive way to deal with a breast-cancer
diagnosis.
Since then, interest in the sport has blossomed throughout
the world, and there are dragon-boat races
specifically for breast-cancer
survivors around the country. At the DC festival, which is in its tenth
year, five boats of breast-cancer survivors will join roughly 70 other
boats from around the world in
an event that combines Chinese folklore, a
competitive spirit, and a lot of colorful outfits.
Dragon boats are
long, narrow vessels with a dragon head on the front and a wooden tail in
back.
Paddlers face forward—don’t confuse them with rowers on crew
teams—and are guided by a
drummer who faces the paddlers and bangs a drum
to keep the rowing rhythm. Saturday’s race will
begin with a traditional
“eye-dotting ceremony,” in which the eyes in the dragon heads are painted.
The goal, say organizers, is to wake the sleeping dragon.
The
breast-cancer survivors will have their own ceremony: Those boats will raft out
together, the
paddlers will hold hands, a poem will be read, and every
paddler will throw a pink carnation into the
water in what participants
call a gesture of “hope and remembrance.”
But this is not all about
cancer, say members of Go Pink! DC, a local dragon-boat team made up of
breast-cancer survivors. Team member Mary McComb, 62, says, “When we’re
preparing and
practicing and competing, it’s not ‘Oh, you poor cancer
survivor,’ it’s ‘Oh, look what you can do
today that you couldn’t do four
weeks ago.’ ”
Jane Crawford, a Go Pink! DC board member and paddler,
says that the topic of cancer does come
up, “but it’s not something we
dwell on. It’s all about celebrating life and putting cancer behind
us.”
Leslie Caplan joined the group several years ago when she had just
finished chemotherapy and
radiation; she was nearly bald. What she
discovered was a sense of empowerment. “When you’ve
been a patient for a
long time and people are doing things to you, you don’t have a lot of control,”
she
says. “In a dragon boat, it’s all about what you can do, and that’s a
very freeing, liberating experience
for someone who has been in the
health-care system for a while.”
Being out on the water is another plus.
“If I could paddle seven days a week, I would,” says member
Diana
Dean.
“I’ve never been an athlete,” says Krizek, who now rows with a
coed team called the DC Dragons.
“And yet it’s Saturday morning and it’s
raining and we’re sitting out there in a boat. Every time I put
my paddle
in the water for the first time, I’m like, ‘This is so neat.’ ”
KEYWORD
NEWS – YAHOO! ALERTS FORMATTED DOCUMENT:
May 16, 2011
Lymphedema
takes toll emotionally, physically - Pittsburgh Post-Gazette - By Pohla Smith
–
Kim Marmarosa says she wishes she could have her body back, but she
knows that's not going to
happen.
Because of breast cancer, she had
a double mastectomy, removal of lymph nodes and radiation about
four years
ago. She wasn't a candidate for breast reconstruction, but she was a for
lymphedema, an
incurable but controllable condition marked by swelling.
Found usually in an arm or a leg, it's a
buildup of fluid caused by a
blockage in the lymphatic system.
A year after her cancer treatment, Ms.
Marmarosa, 49, who owns an insurance agency and lives in
Brighton Heights,
developed a less common variety of the condition called torso, or truncal,
lymphedema.
The swelling affects her "torso and back, basically, and
the arms are included. It's kind of
proportional," she said.
It also
has affected her emotionally and psychologically.
"It really plays havoc
with your body image, to want your body back, the body you're used to," Ms.
Marmarosa said. "For a woman, it's not the easiest thing to deal with. When
you end up in a different
body, it's hard; it's difficult. I think I'm less
social."
The lymph system, says Atilla Soran, the surgeon who serves as
director of UPMC's Lymphedema
Screening, Early Detection and Prevention
Program, is "the cleaning lady of the body."
Lymph is the name of the
fluid that circulates through the body via lymph vessels, picking up bacteria,
viruses and waste products to be filtered through the lymph nodes; the
fluid is then returned to the
bloodstream.
Either cancer, surgery,
radiation or infection in any area of the body near the lymph system can cause
the blockage that results in lymphedema. In Ms. Marmarosa's case, she said,
it's "chicken or the egg.
It's probably from the surgery and the radiation.
That's pretty much the thought of it."
There also are several inherited,
rarer types of lymphedema known as primary lymphedema, but, Dr.
Soran said,
the genes that cause them aren't yet known.
He said the highest
incidence of lymphedema in the United States, however, occurs in women who
have had breast cancer surgery with lymph node dissection and mostly
affects the arm. The rate of
occurrence is about 25 percent for those who
have had surgery; "radiation adds 5 to 10 percent
more," he said.
It
is treated by various methods collectively called "complete decongestive
therapy," says certified
lymphedema therapist Suzanne Cavanaugh. All of
them have to do with pushing the lymph fluid
through the system.
One
technique is manual lymph drainage, or massage; others include compression
bandaging,
compression garments and therapeutic exercises. Certified
lymphedema therapists can do the
massage and teach the patient how to do it
at home. There also are pumps, Dr. Soran said, in which
the patient puts
her limb and body in a garment, pushes a button and lets the machine do the
massaging.
Ms. Marmarosa recently got a machine called a Flexitouch,
which simulates the massaging drainage
technique. She spends one hour on it
twice a day.
Dr. Soran's clinic is designed to help women catch
lymphedema before it becomes a life-altering
complication. Using a machine
that measures extracellular fluid, he takes a baseline measurement
before
the breast cancer patient's surgery and again afterward. Yearly assessments
then are taken for
five years, and if there is any change in fluid volume,
treatment is started.
"If you can start the whole complement of
lymphatic treatment you may never get big swelling," he
said. "It won't
affect your social life, psychology or quality of life."
Dr. Soran said
the clinic sees about 1,200 breast cancer patients per year, 40 percent of whom
have
the presurgical assessment. The clinic was the first in the world to
perform the presurgery
measurements, he said, but New York Presbyterian
Hospital has recently started a similar program.
The first symptom of
lymphedema is a feeling that one arm is heavier than the other. "Then the
swelling starts, and if it's not treated, they get an arm infection and
also it gets hard, tough," he said.
"Then if it's not treated, it gets
bigger and bigger."
Ms. Marmarosa has only been using the Flexitouch for
several weeks, so it hasn't done much to
reduce her swelling. "But, I feel
better because the fluid is moving" through the lymphatic system, she
said.
Meanwhile, she also expects to feel better psychologically
when the Cancer Caring Center joins with
Allegheny Chesapeake Physical
Therapy to start a lymphedema social support group on May 24.
Free to
patients, friends, family and caregivers, it will be held at the Cancer Caring
Center, 4117
Liberty Ave., Bloomfield, from 6:30 to 7:30 p.m.
"I'm
really looking forward to [it]," Ms. Marmarosa said. "I think I'll find out I'm
not the only one and
find healthy ways of coping ... ways to better explain
it to people and my family, ideas I don't have
now."
Ms. Cavanaugh
will be the facilitator for the sessions, which also will be held at the Cancer
Caring
Center on June 28 and July 26.
"I've been treating the
[lymphedema] population almost 81/2 years; this is a group that really has no
support as of yet," Ms. Cavanaugh said. "Our goal is to bring the community
together and give
educational components, as well as a networking group for
those who are touched with lymphedema."
Until then, Ms. Marmarosa has a
message for other people with cancer-related lymphedema: "Just
don't give
up, and realize you're just as lovable in the body you're in.
"All of us
are grateful to be alive. Cancer costs all of us something. Sometimes you think
you paid the
ultimate price -- both breasts, things I can't get back. It
sneaks up on you like that. You think, 'I want
my body back.'
"
Reservations are necessary for the support group sessions
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 [email protected]
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
[email protected].
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 [email protected].
More
information about WeCanRow can be found here.
Amy
Laskowski can be reached at [email protected].
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
July 1, 2011
National
Alliance of Wound Care® Announces a New Advanced Certification in the Specialty
of
Lymphedema
Lower Extremity Management – RedOrbit –
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).
Glendale
WI (PRWEB) June 30, 2011
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.
For
the original version on PRWeb visit: http://www.prweb.
com/releases/prweb2011/6/prweb8610053.htm
Source:
prweb
Antimicrobial
Prophylaxis in Adults - Dentistry IQ –
Antimicrobial
prophylaxis is commonly used by clinicians for the prevention of numerous
Infectious
diseases,
Including herpes simplex infection, rheumatic fever, recurrent cellulitis,
meningococcal
disease,
recurrent uncomplicated urinary tract infections in women, spontaneous
bacterial peritonitis
in
patients with cirrhosis, influenza, infective endocarditis, pertussis, and
acute necrotizing pancreatitis,
as
well as infections associated with open fractures, recent prosthetic joint
placement, and bite
wounds.
Perioperative antimicrobial prophylaxis is recommended for various surgical
procedures to
prevent
surgical site infections. Optimal antimicrobial agents for prophylaxis should
be bactericidal,
nontoxic,
inexpensive, and active against the typical pathogens that can cause surgical
site infection
postoperatively.
To maximize its effectiveness, intravenous perioperative prophylaxis should be
administered
within 30 to 60 minutes before the surgical incision. Antimicrobial prophylaxis
should be
of
short duration to decrease toxicity and antimicrobial resistance and to reduce
cost.
Mayo
Clin Proc. 2011;86(7):686-701
AAOS
= American Association of Orthopedic Surgeons; ADA = American Dental
Association;
ANP
= acute necrotizing pancreatitis; AP = antimicrobial prophylaxis; AUA =
American Urological
Association;
CP = chemoprophylaxis; FDA = US Food and Drug Administration; HlV = human
immunodeficiency
virus; IDSA = Infectious Diseases Society of America; IE = infective
endocarditis;
IS
= Information Statement; MRSA = methicillin-resistant Staphylococcus aureus;
PJl = prosthetic
Joint
Infection; PJR = prosthetic Joint replacement; RF = rheumatic fever; SBP =
spontaneous
bacterial
peritonitis; SCIP = Surgical Care Improvement Project; Tdap = tetanus toxoid,
reduced
diphtheria
toxoid, and acellular pertussis vaccine, adsorbed; UGI = upper
gastrointestinal; UTI =
urinary
tract infection
On
completion of this article, readers should be able to: (I) identify common
surgical and nonsurgical
indications
for the use of antimicrobial prophylaxis in adults, (2) formulate selected
surgical and
nonsurgical
antimicrobial prophylaxis regimens for adults, and (3) summarize the arguments
for and
against
the use of antimicrobial prophylaxis in adults.
Antimicrobial
prophylaxis (AP) can be used effectively to prevent infection, but its use
should be
limited
to specific, well-accepted indications to avoid excess cost, toxicity, and
antimicrobial
resistance.
Antimicrobial prophylaxis may be considered primary (prevention of an initial
infection) or
secondary
(prevention of the recurrence or reactivation of an infection), or it may also
be
administered
to prevent infection by eliminating a colonizing organism. This article reviews
widely
accepted
indications for AP in nonsurgical and surgical patients and is an update of a
previously
published
review of this topic.1 In selected situations, vaccination may be recommended
as part of a
prophylaxis
regimen. This article is meant to be a point-ofcare overview topic for the busy
clinician.
Many
of these recommendations are based on expert opinion rather than on prospective
clinical
trials.
Most of the recommended antimicrobial agents are not approved by the US Food
and Drug
Administration
(FDA) for prophylaxis. Current full prescribing information available in the
package
insert
of each drug should be consulted before prescribing any product. Detailed
information on
individual
topics can be found in the cited references.
The
potential risks and benefits of AP should be discussed in detail with the
patient. Potential risks
include
allergic reactions that may be severe or life-threatening as well as
Clostridium difficile colitis
with
the use of antibacterial agents.2 Patients taking fluoroquinolones should be
warned of the risk of
developing
tendinitis, including Achilles tendon rupture.3 For all antibiotic dosing
recommended in this
article,
normal hepatic and renal function are assumed.
NONSURGICAL
AP
RHEUMATIC
FEVER
Rheumatic
fever (RF), which is associated with tonsillopharyngitis caused by the group A
?-hemolytic
streptococci,
may result in carditis with or without valvulopathy. Primary prevention of RF
involves
prompt
and appropriate antibiotic treatment of group A ?-hemolytic streptococcal
pharyngitis with a
penicillin
(drug of choice) or alternative antibiotic.4 Continuous secondary AP prevents
recurrent
episodes
of RF, which could otherwise lead to worsening of the severity of rheumatic
heart disease
that
developed after the initial attack or the development of rheumatic carditis in
those who did not
develop
carditis with the initial RF episode. Guidelines for secondary AP of RF have
recently been
updated
(recommendations for AP regimens are summarized in Table I).4 Penicillins are
the
antibiotics
of choice for secondary prophylaxis for RF, and intramuscular penicillin is
superior to oral
penicillins.25
Macrolides (eg, erythromycin, clarithromycin, azithromycin) should be reserved
for
patients
who are allergic to both penicillin and sulfa antibiotics. The duration of
secondary prophylaxis
for
RF is reviewed in detail elsewhere and is summarized in Table 2.4 Physicians
should tailor the
duration
of secondary prophylaxis to the individual patient, taking into account the
patient's risk
factors
for RF recurrence, such as exposure to young children and the presence of
carditis with or
without
underlying valvular disease. Antimicrobial prophylaxis should be considered for
at least 10
years
or until age 40 years (whichever is longer) for patients with carditis with
persistent valvular
disease.
Prophylaxis should be continued in patients even after prosthetic valve
replacement surgery.
Antibiotic
suppression for the prevention of RF is not adequate for infective endocarditis
(IE)
prophylaxis
before dental procedures.
RECURRENT
CELLULITIS
Patients
with lymphedema or severe venous insufficiency of their extremities are at
increased risk of
recurring
?-streptococcal cellulitis. Common scenarios for recurrent cellulitis of the
lower extremity
include
patients with venous insufficiency after saphenous vein graft harvesting or
pelvic
lymphadenectomy.
Recurrent cellulitis has been observed in the upper extremity after
lymphadenectomy
performed at the time of mastectomy for breast cancer. Antimicrobial
prophylaxis
may
be a useful addition to the control of lymphedema with local measures and
treatment of
concurrent
tinea pedis in the prevention of recurrent cellulitis. However, this
recommendation is based
on
small, uncontrolled studies.26"28 Typically, more than 2 or 3 episodes per year
should occur
before
AP is initiated. Recommended prophylactic antibiotics for recurrent cellulitis
are summarized in
Table
1. Oral penicillin V (Phenoxymethylpenicillin) is a reasonable first choice,
but optimal dosing of
this
agent is not well established.5"7 Although monthly administration of 1.2 MU of
intramuscular
benzathine
penicillin is recommended as an alternative to oral penicillin V, this dosing
regimen was
shown
to be effective only in those patients not at risk of cellulitis recurrence.28
Some experts
recommend
intramuscular administration of benzathine penicillin every 2 to 3 weeks for
individuals
who
break through once-monthly intramuscular benzathine penicillin
regimens.5
Recurrent
pyogenic skin infections caused by Staphylococcus aureus, including
methicillin-resistant S
aureus
(MRSA), may be managed by encouraging good personal hygiene, the avoidance of
shared
personal
items, and the diligent cleaning of high-touch environmental surfaces. If a
patient is found to
be
colonized by S aureus , nasal decolonization with mupirocin for 5 to 10 days
with or without a
topical
body decolonization with a skin antiseptic solution such as 4% Chlorhexidine
for 5 to 14 days
may
be reasonable in an attempt to decolonize the patient.8 Antimicrobial
prophylaxis options are
listed
in Table 1 for recurrent methicillin-susceptible S aureus skin
infections.9,29Long-term oral AP
of
recurrent MRSA skin infections is not well studied, and formal recommendations
for this situation
were
not included in recently published MRSA treatment guidelines.8
MENINGOCOCCAL
DISEASE
Antimicrobial
prophylaxis for meningococcal diseases should be offered to close contacts of
sporadic
cases
of Neisseria meningitidis infection (Table 1). Close contacts include household
members, day
care
center staff, and any person directly exposed to an infected person's oral
secretions (for
example,
through kissing, mouth-to-mouth resuscitation, endotracheal intubation, or
endotracheal
tube
management).11 Public health authorities may recommend population-based
prophylaxis in the
event
of an outbreak. Prophylaxis should be offered as soon as possible. Close
contacts should be
offered
meningococcal vaccination if the outbreak strain is one that is contained in
the currently
available
meningococcal tetravalent conjugate vaccine.30
ASPLENIC
PATIENTS
Penicillin
prophylaxis is recommended in children during the first few years after
splenectomy to
prevent
overwhelming Streptococcus pneumoniae sepsis.31 French and American authorities
have
advocated
this form of prophylaxis (eg, 250 mg of oral penicillin V or amoxicillin twice
daily) in adults
for
1 to 2 years after splenectomy, although data showing the efficacy of this
approach are lacking.
3133
Haemophilus influenzae type B, meningococcal, and pneumococcal vaccinations
should be
current
in asplenic adults.
URINARY
TRACT INFECTION
Several
prophylactic antibiotic options are available to nonpregnant women with
recurrent (?3 per
year),
uncomplicated urinary tract infections (TJTIs)13 (Table 1). Continuous low-dose
AP and
patient-initiated
treatment after onset of symptoms are both effective.13?14 During AP, monthly
urine
cultures
should be performed to monitor for bacteriuria and the development of
antibiotic resistance.
34
Structural abnormality of the urinary tract, renal involvement with infection,
or chronic prostatitis
(in
men) should be considered in the setting of recurrent VTIs. Methenamine
hippurate (dosage, 1 g
twice
daily) has been approved by the FDA for UTI prophylaxis. A recent Cochrane
review
concluded that
methenamine hippurate may be effective for short-term prophylaxis (^l week) in
patients
without known renal tract abnormalities.35 The typical duration of an initial
trial of continuous
AP
is 6 months. Patients with prolonged exposure to nitrofurantoin should be
counseled about the
rare
but serious complications associated with this agent, including hepatitis,
pulmonary reactions, and
neuropathy.
Cranberries contain 2 substances that prevent fimbriated Escherichia coli from
adhering
to
uroepithelial cells.36 Clinical studies have shown that cranberry juice and
cranberry products may
reduce
the recurrence of UTIs in women. A recent Cochrane review noted limitations in
these
studies,
including variable cranberry products and dosing used in the various studies,
as well as high
study
participant dropout rates.37 Other patients who may be considered for
prophylaxis of frequent
UTIs
include pregnant women, persons with spinal cord injuries, persons with
neurogenic bladders,
renal
transplant recipients, and men with chronic bacterial prostatitis.13?34
Postcoital regimens may
be
appropriate for female patients with UTIs temporally related to sexual
intercourse.15?38 Patients
who
use postcoital regimens should be informed that only 1 dose per day is
recommended,
regardless
of the frequency of intercourse. Postcoital AP in pregnancy can be managed with
a single
dose
of either cephalexin (250 mg) or nitrofurantoin (50 mg).34 Tetracyclines and
fluoroquinolones
should
be avoided during pregnancy, and sulfonamides should be avoided during the last
weeks of
gestation
to minimize the risk of hyperbilirubinemia and kernicterus in the newborn.
Topical vaginal
estrogen
therapy has been shown to reduce the risk of recurrent UTIs in postmenopausal
women; it
may
be a consideration for postmenopausal women who are not receiving estrogen
replacement
therapy
and who have no contraindications to estrogen therapy.39
SPONTANEOUS
BACTERIAL PERITONITIS
Spontaneous
bacterial peritonitis (SBP) in patients with cirrhosis is associated with
increased
morbidity
and mortality. Aerobic gram-negative organisms and streptococci are the most
frequent
causes
of this infection. In a recent Cochrane review of 12 treatment trials,
empirical oral or
parenteral
antimicrobial treatment of patients with cirrhosis and upper gastrointestinal
(UGI) bleeding
reduced
the incidence of bacterial infections and was associated with shortened
hospital stays and
reduced
rates of overall mortality, mortality from bacterial infections, and
rebleeding.40 No one
antibiotic
regimen or route of administration was found to be superior. On the basis of
these data, 7
days
of empirical antibiotics are recommended for patients with ascites and UGI
bleeding16 (Table
1).
In prospective randomized clinical trials, primary prophylaxis in high-risk
patients and secondary
prophylaxis
after an initial episode of SBP have been shown to be effective in preventing
SBP.41"44
A
recent Cochrane review of 7 trials of empirical AP to prevent SBP in cirrhotic
patients with ascites
without
UGI bleeding revealed a pooled reduction in SBP and mortality but noted issues
with trial
methodology
and findings suggestive of systematic bias in publication and design.45 A 1998
analysis
concluded
that prophylaxis in high-risk patients (serum bilirubin level 2.5 mg/dL [to
convert to
umol/L,
multiply by 17.104]; ascitic fluid protein level, 1 g/dL) is cost-effective.46
The American
Association
for the Study of Liver Diseases has published guidelines that recommend
long-term daily
AP
for patients with previous SBP and for primary prophylaxis in those with an
ascitic fluid protein
level
of less than 1 .5 g/dL and at least 1 of the following criteria: a serum
creatinine level of 1.2
mg/dL
or higher (to convert to ?p???/L, multiply by 88.4), a blood urea nitrogen
level of 25 mg/dL or
higher
(to convert to mmol/L, multiply by 0.357), a serum sodium level of 130 mEq/L or
less (to
convert
to mmol/L, multiply by 1), or a Child-Pugh score of 9 points or higher with a
bilirubin level of
3
mg/dL or higher16 (Table 1). Before initiation of AP, SBP should be ruled out
in all patients with
ascites
at hospital admission and in cirrhotic patients with ascites with signs,
symptoms, or laboratory
abnormalities
suggestive of infection.16
ACUTE
NECROTIZING PANCREATITIS
Severe
pancreatitis with necrosis is associated with an overall mortality rate of 17%
and a mortality
rate
of 25% to 30% with infected necrosis. Debate is ongoing as to whether AP in the
setting of
acute
necrotizing pancreatitis (ANP) leads to improved outcomes (some consider the
use of
antibiotics
in this setting preemptive).47 A recent Cochrane database review of 7
randomized studies
concluded
that patients randomized to receive AP for ANP had no statistically significant
reduction in
infections.48
Recent practice guidelines published by the American College of
Gastroenterology do
not
recommend AP for ANP.49 If AP is initiated, a broadspectrum ?-lactam such as
imipenem-
cilastatin
is often recommended and should be limited to computed tomographydocumented
pancreatic
necrosis involving 30% or more of the pancreas for 14 days or less.50
BITE
WOUND INFECTION
Five
percent of dog bites and 30% of cat bites become secondarily infected because
these wounds
are
highly contaminated by microorganisms present in the oral cavity of these
animals. These
infections
can lead to septic arthritis, tenosynovitis, severe soft tissue infection, or
sepsis.51 The
microbiology
of dog and cat bite infections is typically polymicrobial and includes
Pasteurella species
as
the most common isolate, followed by staphylococci, streptococci, and
anaerobes.52 Although
AP
for animal bites remains controversial, a meta-analysis of 8 clinical trials by
Cummings53 found
that
AP significantly protects against subsequent wound infection. Antimicrobial
prophylaxis of a
contaminated
wound may be more accurately considered expectant therapy to prevent the
development
of a wound infection in a contaminated but not yet infected wound. No clinical
trials
have
shown superiority of one antibiotic regimen over another; choices should be
based on the likely
microbiology
of dog and cat bite infections.54 Antimicrobial prophylaxis for bite wounds has
recently
been
reviewed and should be offered to all patients who are thought to have an
increased risk of
infection17
(Table 1). High-risk situations include, but are not limited to, bites to body
areas where
deeper
structures (tendons and bones) can become easily injured, bites to the hand(s)
or close to a
bone
or joint, crush injuries, puncture wounds (difficult to clean), bites in which
treatment is delayed
more
than 8 to 10 hours, wounds requiring closure, bites in compromised persons
(diabetic patients,
persons
with no spleen, immunocompromised patients), bites in persons with indwelling
prosthetic
devices,
and all cat bites.17?18 Consideration for hospitalization and intravenous
antibiotics may be
reasonable
for patients in the setting of fever, sepsis, spread of cellulitis, significant
edema or crush
injury,
loss of function, compromised immunity, or patient nonadherence to treatment.19
All dog and
cat
bites should be appropriately irrigated and d?brided, and rabies prophylaxis
should be
administered,
if indicated. Delayed primary closure of heavily contaminated wounds should be
considered
to decrease the risk of wound infection.
Human
bite wounds, including clenched fist injuries, are considered to be at
high-risk of infection with
organisms
such as Streptococcus anginosus, S aureus, Eikenella corrodens, and anaerobes.
Recommended
AP is similar to that for animal bite wounds17?55 (Table 1). Patients who have
sustained
human bites should be assessed for human immunodeficiency virus (HTV) and
hepatitis B
infection
risk, and prophylaxis should be offered as indicated according to published
guidelines.
Tetanus
immune globulin and tetanus toxoid should be administered to patients who have
not been
immunized
or tetanus toxoid alone to any patient who has not received a tetanus booster
within the
past
5 years.
PERTUSSIS
Pertussis
(whooping cough), an upper respiratory tract infection caused by Bordetella
pertussis, is
associated
with prolonged bouts of coughing that may last 1 to 6 weeks. Numerous
pertussis
outbreaks
have occurred in the United States during the past 6 years among adolescents
and adults
as
immunity from childhood vaccination has waned. Because pertussis is spread by
aerosolized
respiratory
droplets, it is recommended that all household and other close contacts of
infected
patients
who did not use respiratory precautions while in contact with an infected
patient receive AP,
regardless
of age or immunization status20 (Table 1).
The
first tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis
vaccine, adsorbed (Tdap)
licensed
for adults was approved by the FDA in 2005 (ADACEL; Sanofi Pasteur; Swiftwater,
PA
[US
Headquarters]; Lyon, France [Global Headquarters]) as a single-dose booster
vaccine for
persons
aged 1 1 to 64 years to provide protection against tetanus, diphtheria, and
pertussis. Tdap
was
initially recommended to replace the next adult booster dose of tetanus- and
diphtheria-toxoid
vaccines
in patients whose last tetanus booster was 10 years or more earlier. The
interval between
the
most recent tetanus vaccination and Tdap for persons with contact with infants,
child care
providers, or
health care professionals with direct patient contact could be as short as 2
years or less.
56
Given the poor adult pertussis vaccine coverage (5.9% in 200857), and in the
setting of increasing
numbers
of pertussis cases in the United States (16,858 cases in 2009, including 14
infant deaths58),
the
Pertussis Vaccine Working Group of the Advisory Committee on Immunization
Practices59
recommends
the administration of a single Tdap (either ADACEL or BOOSTRTX
[GlaxoSmithKline
Biologicals;
Morrisville, NC]), when indicated, for any adult, at any interval since the
previous
tetanus-diphtheria
vaccination. A single Tdap should be considered for adults 65 years or older
who
have
or anticipate having close contact with an infant younger than 12 months as
well as for children
aged
7 through 10 years who are not fully vaccinated against pertussis. Tdap is not
licensed for
revaccination.
A provisional recommendation from the Advisory Committee on Immunization
Practices
(February 23, 2011) states that the data on the need for postexposure AP for
Tdap-
vaccinated
health care professionals are inconclusive.60 In view of this, Tdap-vaccinated
health care
professionals
may still be at risk of acquiring pertussis and should be considered for
chemoprophylaxis
(CP) after a significant pertussis exposure, particularly if they are likely to
be
exposed
to a patient at risk of severe pertussis, such as hospitalized neonates and
pregnant women.
INFECTIVE
ENDOCARDITIS
Infective
endocarditis is a relatively rare endocardial infection that can lead to
catastrophic
complications
and death. Guidelines for the prevention of LE have been published by the
American
Heart
Association for more than 50 years. The first 9 guidelines (1955-1997) were
based on low-
level
evidence; more recently, guidelines have been stratified according to the
lifetime risk of LE. The
recommendations
of the most recent (2007) guidelines reflected a new reticence about using AP
for
LE
based on the following premises: (1) cumulative bacteremia risk is much greater
with daily
activities
than dental procedures; (2) antibiotics do not eliminate bacteremia or clearly
reduce IE risk;
(3)
there are no prospective, placebo-controlled AP trials; and (4) even if 100%
effective, antibiotics
would
prevent only rare cases of TE.61 The 2007 AP guidelines for LE from the
American Heart
Association
and the Infectious Diseases Society of America (LDSA) recommend AP only for
patients
at highest risk of complications of LE (Table 3) and only for selected dental
procedures
(Table
4). Administration of prophylactic antibiotics is no longer stratified
according to lifetime LE
risk.
The antibiotics that are recommended for TE prophylaxis before dental
procedures are fisted in
Table
5. Patients receiving a penicillin for RF prophylaxis should not receive a
penicillin for LE dental
prophylaxis.
Prophylaxis
is no longer recommended for uncomplicated gastrointestinal bronchoscopy
without
incision
of the respiratory mucosa and for urinary procedures. If the urine is colonized
or infected
before
an elective cystoscopy, antibiotic therapy to eradicate the infection before
the urologie
manipulation
is recommended. If an urgent cystoscopy is to be performed in the setting of
colonized
or
infected urine, then an antibiotic with activity against enterococci should be
administered.
Ampicillin
or amoxicillin are the preferred agents in this setting; vancomycin should be
used in the
setting
of severe penicillin intolerance. Urinary tract colonization or infection with
enterococci known
or
suspected to be resistant (including those resistant to vancomycin) may require
a consultation with
an
infectious diseases expert.61
Although
many respiratory tract procedures reportedly cause bacteremia involving a wide
variety of
microorganisms,
no published data conclusively demonstrate a link between these procedures and
LE.
Antimicrobial prophylaxis (for regimens, see Table 5) is thought to be
reasonable for patients at
highest
risk of complications from LE (Table 3) who undergo invasive procedures of the
respiratory
tract
that involve incision or biopsy of the respiratory mucosa (eg, tonsillectomy,
adenoidectomy).
Patients
at highest risk of complications from TE who undergo an invasive respiratory
tract procedure
to treat an
established infection, such as drainage of an abscess or empyema, should
receive an
antibiotic
that is active against the viridans group streptococci. If an infection is
known or suspected
to
be caused by S aureus, the antibiotic regimen should contain an
antistaphylococcal penicillin or a
cephalosporin
for patients who are unable to tolerate a penicillin. Vancomycin should be used
in
those
in whom an infection is known or suspected to be caused by a
metWcilfin-resistant strain of S
aureus
or in those who have a history of a severe reaction to ?-lactam
antibiotics.61
PROSTHETIC
JOINT INFECTIONS
By
2030, an estimated 4 million total knee or hip arthroplasties will be performed
annually in the
United
States.62 Prosthetic joint infections (PJIs), which are rare but serious
complications of
prosthetic
joint replacements (PJRs), occur in 0.3% to 1.0% of patients after primary
total hip
replacement
and 1.0% to 2.0% of patients after primary total knee replacements, with the
greatest
risk
occurring during the first 2 postoperative years (6.5, 3.2, and 1.4 infections
per 1000 patient-
years
during the first year, second year, and after the second year,
respectively).63,64 These
infections
may be associated with devastating financial and personal consequences. Most
PJIs are
acquired
in the operating room as a result of colonization of the prosthesis at the time
of implantation
or
airborne contamination of the wound.63 Infection of a prosthesis via
hematogenous seeding is a
less
common cause of PJI. Among PJIs occurring via the hematogenous route, most are
the result of
S
aureus bacteremia, skin infections, or urosepsis.65"67 The development of a PJI
due to
hematogenous
seeding after dental procedures is thought to be a rare event. According to a
recent
literature
review, this occurred in 0.04% to 0.20% of reported PJR case series; many of
these
infections
were seen in patients with dental disease.68 Pins, plates, and screws not
within the synovial
joint
are not thought to be at increased risk of hematogenous seeding by
microorganisms. No studies
have
shown that AP before dental procedures prevents PJI.69 A recently published
prospective
case-control
study concluded that dental procedures were not risk factors for subsequent
total hip or
knee
infection. Additionally, the use of AP before dental procedures did not
decrease the risk of
subsequent
total hip or knee infection.70
Despite
the lack of data supporting AP before dental procedures, many surveys of health
care
professionals
have shown that a substantial number of them recommend AP before dental
procedures
in patients
with a PJR.71?72 Antimicrobial prophylaxis for patients with a prosthetic joint
undergoing
a
dental procedure or other invasive medical procedure has been controversial for
decades.67?71?
73"75
Consensus guidelines for this practice were initially published in 1997 and
affirmed in 2003 by
the
American Dental Association (ADA) and the American Association of Orthopedic
Surgeons
(AAOS)
on the basis of low-level evidence.69?76 It was proposed that AP be
administered before
dental
procedures thought most likely to be associated with bacteremia for patients
who were
considered
to be at highest risk of bacteremia-associated PJI. High-risk patients are
thought to
include
all patients during the first 2 years after joint replacement,
immunocompromised or
immunosuppressed
patients, patients with comorbid conditions (eg, diabetes, obesity, HTV
infection,
smoking),
and patients with inflammatory arthropathies (eg, rheumatoid arthritis),
systemic lupus
erythematosus,
medication- or radiation-induced immunosuppression, previous PJI,
malnourishment,
hemophilia,
HTV infection, insulin-dependent (type 1) diabetes, megaprosthesis, or
malignancy.
More
recently (February 2009), the Patient Safety Committee of the AAOS posted an
Information
Statement
(IS) advising that "clinicians consider antibiotic prophylaxis for... all total
joint replacement
patients
prior to any invasive procedure that may cause bacteremia."77 The ADA no longer
supports
the
2003 AAOS/ADA Guidelines and refers patients and health care professionals to
the AAOS IS
(Karen
London, American Dental Association, written communication, March 28, 201
1).77
Although
specific dental procedures that may cause bacteremia are not listed in the AAOS
IS, the
ADA
lists the dental procedures that may cause bacteremia in the AAOS/ ADA 2003
guidelines.76?
77
The antibiotics recommended in the AAOS IS to be administered to patients with
PJR before
dental
procedures include 2 g of oral cephalexin, cephradine, or amoxicillin 1 hour
before dental
procedures.
The AAOS IS makes no mention of parenteral antibiotic options or antibiotic
alternatives
for penicillin-allergic patients. The 2003 AAOS/ADA advisory statement
recommended
1
g of intravenous cefazolin or ampicillin as parenteral antibiotic alternatives
or 600 mg of clindamycin
(intravenous
or oral) for penicillin-allergic patients, to be administered 1 hour before the
dental
procedure;
in our opinion, these remain valid antibiotic alternatives.76
A
panel that included representatives from the ADA, AAOS, and LDSA was recently
convened with
the
goal of producing an evidence-based antimicrobial guideline for patients with
PJR before dental
procedures
(D.R.O. is a member of the working group). It is hoped that this will lead to a
simpler
consensus
guideline for patients and health care professionals. Good dental health before
and after
total
joint replacement and prompt treatment of active oral infection should be
encouraged for all
patients
with PJR.
Antimicrobial
prophylaxis in patients undergoing invasive gastrointestinal procedures is not
recommended
by the American Society of Colon and Rectal Surgeons78 or the American Society
for
Gastrointestinal Endoscopy.79 If clinicians elect to recommend AP for the
prevention of
hematogenous
PJI in these patients, they should discuss with them the possibility of
life-threatening
adverse
reactions (rare) and the more common drug toxicities. If used, antimicrobial
agents should be
chosen
on the basis of the expected flora at the site of the procedure.
The
American Urological Association (AUA) and the AAOS first published consensus-
and expert
opinion-based
AP guidelines in 2003 for patients with total joint replacement who were
undergoing
urologie
procedures.80 Antimicrobial prophylaxis is recommended for patients at
increased risk of
hematogenous
PJI who undergo urologie procedures associated with an increased risk of
bacteremia.
The
details of these recommendations can be found in the 2007 AUA Best Practice
Policy Statement
on
Urologie Surgery Antimicrobial Prophylaxis, which is available on the AUA Web
site.80?81 The
guidelines
assume that the urine is sterile preoperatively. If bacteriuria is present, it
should be treated
with
appropriate antibacterial agents before manipulation of the urinary
tract.
TRAVELERS'
DIARRHEA
Antibacterial
agents have been shown to decrease the risk of travelers' diarrhea by up to
84%.8284
Antimicrobial
agents are not routinely recommended for the prevention of travelers' diarrhea
because
antibiotic
self-treatment is so rapidly effective. The traveler may be instructed to carry
a supply of an
antibiotic
(often a 1- to 3-day course of a fluoroquinolone for travel to Central or South
America or
Africa
or of azithromycin when traveling to Asia or the Indian subcontinent) to be
taken on an as-
needed
basis.12 In certain circumstances (riskaverse travelers, athletes, persons
taking antacids, or
persons
with diabetes, an elevated gastric pH, or inflammatory bowel disease), a daily
oral antibiotic
regimen
may be considered on a short-term basis (ideally 2-3 weeks) to prevent
travelers' diarrhea.
Fluoroquinolones
may be less effective in areas with quinolone-resistant Campylobacter species
infections
(eg, India, Southeast Asia), so an agent such as azithromycin (250 mg once
daily) may be
considered,
although this has not been studied. In a 14-day study among travelers to
Mexico,
rifaxirnin
(200 mg 1-3 times daily) was 72% effective in preventing travelers' diarrhea.23
Bismuth
subsalicylate
prophylaxis (Pepto-Bismol [Proctor & Gamble; Cincinnati, OH]: two 262-mg
chewable
tablets
4 times daily, with meals and once in the evening) is less effective (62%-65%
effective) than
antibiotics,
is inconvenient to take, contains a salicylate (to be avoided if receiving
anticoagulant
therapy
or high-dose salicylates), causes a black tongue, and may interfere with the
absorption of
medications
such as doxycycline.12 Probiotics containing Lactobacillus GG or Saccharomyces
boulardii
are of limited efficacy (0%-60% effective) in the prevention of travelers'
diarrhea and
generally
are not recommended for this purpose.85,86
OPEN
FRACTURES
Open
fractures, particularly Gustilo grade 3 fractures, are at an increased risk of
infection.87 The key
to
infection avoidance of open class LTJ fractures is wound irrigation, surgical
debridement of
devitalized
tissue, and delayed wound closure. A recent Surgical Infection Society
Guideline
recommended
AP with a first-generation cephalosporin after open fracture until 24 to 48
hours after
wound
closure.88 Some groups recommend adding gram-negative coverage for class UI
open
fractures.89
HERPES
SIMPLEX VIRAL INFECTION
Frequent
recurrent genital herpes simplex viral infections (5-6 episodes per year) are
amenable to
prophylaxis
with continuous acyclovir (400 mg twice daily), famciclovir (250 mg twice
daily), or
valacyclovir
(500-1000 mg once daily).90?91 Famciclovir may be less effective for
suppression of
viral
shedding, and 500 mg of valacyclovir once daily might be less effective than
other valacyclovir
or
acyclovir dosing regimens in patients who have very frequent recurrences (ie,
?10 episodes per
year).91
Patients should be counseled regarding consistent condom use and avoidance of
sexual
activity
during recurrences in addition to suppressive antiviral therapy.
INFLUENZA
Chemoprophylaxis
of influenza A and B infection with a neuraminidase inhibitor (zanamivir
[inhaled]
or
oseltamivir [oral]) is 70% to 90% effective92?93 (Table 1). These agents are
particularly useful
for
prophylaxis after exposure in unvaccinated high-risk patients and unvaccinated
health care
professionals
in an outbreak setting in a medical institution or community. Chemoprophylaxis
is
recommended
for persons who are at high risk of influenza complications (Table 6) and those
who
are
hospitalized or have severe, complicated, or progressive illness.94 Lowrisk,
healthy persons who
are
not in contact with high-risk patients do not typically require CP. Adults for
whom antiviral CP
should be
considered during periods of increased influenza activity in the community are
listed in
Table
7. Zanamivir and oseltamivir are classified as category C (risk cannot be ruled
out) for use
during
pregnancy. Influenza CP should be considered as an adjunct to influenza
vaccination.
Chemoprophylaxis
should not be administered 48 hours before or 2 weeks after administration of
the
intranasal
live-attenuated FluMist influenza vaccine (Medlmmune, Gaithersburg, MD); CP has
no
effect
on the inactivated influenza vaccine.21 Chemoprophylaxis may be stopped 10 days
after
exposure
for household contacts and 7 days after other exposures.94 For control of
outbreaks in
long-term
care facilities and hospitals, the Centers for Disease Control and Prevention
recommends
CP
for a minimum of 2 weeks, even for vaccinated persons, up to 1 week after the
last known case
was
identified.22?94 In patients who are unable to receive influenza vaccination
and who are at high
risk
of complications, treatment should be continued for the duration of the
influenza season in the
community.
Oseltamivir- and zanamivir-resistant influenza A strains have been reported;
one should
monitor
the Centers for Disease Control and Prevention influenza Web site (http://
www.cdc.gov/flu)
for
seasonal updates. The adamantanes (amantadine and rimantadine) are active only
against influenza
A;
with the emergence of adamantane resistance in most seasonal A H3N2 and
pandemic 2009-
2010
A HlNl strains, these agents are no longer recommended for CP.
SURGICAL
AP
Surgical
site infections account for 14% to 18% of all health care infections and are
the third most
frequently
reported nosocomial infection.96?97 Factors that may increase the risk of
surgical site
infection
include those related to the patient (age, nutritional status, diabetes,
smoking status, obesity,
coexisting
infections at a remote site, colonization with a pathogenic microorganism,
altered immune
response,
and length of preoperative stay) and the operative procedure (duration of
surgical scrub,
skin
antisepsis, preoperative shaving, preoperative skin preparation, duration of
operation, AP,
operating
room ventilation, inadequate sterilization of instruments, foreign material at
the surgical site,
surgical
drains, and surgical technique).98 The risk of surgical site infection also
depends on whether
the
surgical procedure is clean, clean-contaminated, contaminated, or
dirty-infected based on
standard
definitions of these terms.98 Improvements in operating room ventilation,
sterilization
methods,
barriers, and surgical technique as well as the use of perioperative topical,
oral, and
intravenous
AP have been important in decreasing the incidence of surgical site
infection.98,99
Perioperative
antimicrobial surgical prophylaxis is recommended for operative procedures that
have a
high
rate of postoperative wound infection, when foreign material is implanted, or
when the wound
infection
rate is low but the development of a wound infection results in a disastrous
event.98100
Prophylactic
antimicrobial agents should be bactericidal, nontoxic, and inexpensive and have
in vitro
activity
against the common organisms that cause postoperative wound infection after a
specific
surgical
procedure. Consensus panels most often recommend cefazolin and other
cephalosporins
because
they meet the aforementioned criteria.98?100 Broad-spectrum antibiotics (eg,
ertapenem)
should
be avoided for surgical prophylaxis.100,101 Perioperative antimicrobial
surgical prophylaxis
regimens
for various surgical procedures adapted from the published recommendations of
2
consensus
panels are summarized in Table 8.99,100,102 The use of vancomycin for
prophylaxis is
appropriate
in the event of true type I hypersensitivity or other serious reaction to
penicillin or when
the
incidence of surgical site infection is high due to methicillin-resistant
staphylococci.132 Adherence
to
this practice will help to avoid the emergence of vancomycinresistant organisms
and vancomycin-
related
toxicity.133136 Prophylactic antimicrobial agents should be administered not
more than 30 to
60
minutes before surgery, including cesar?an sections.100?112?137?138 Exceptions
to this include
oral
administration of antimicrobial agents before colonic and urologie procedures
(Table 8).
Infusions
should be completed before the tourniquet is placed with orthopedic surgeries.
Vancomycin
and
fluoroquinolone infusions should be started 90 to 120 minutes before surgical
incision because
these
require at least 1 hour to infuse. Therapeutic concentrations of antimicrobial
agents should be
present
in the tissue throughout the period that the wound is open. Additional
antibiotic doses may
need
to be administered intraoperatively for prolonged procedures or with
antimicrobial agents with
short
half-lives.102?139 Initiating intravenous antimicrobial therapy before the
perioperative period
provides
no benefit. Prolonged postoperative AP should be discouraged because of the
possibility of
added
antimicrobial toxicity, selection of resistant organisms, and unnecessary
expense. The duration
of
AP for most procedures should not exceed 24 hours, with the exception of
cardiac surgeries, in
which
antibiotics may be continued for up to 48 hours.99?100?102?103?140 The duration
of
antibiotic
therapy for ophthalmic procedures has not been established. An advisory
statement for AP
in
dermatologie surgery has been published recently.141 The LDSA, American Society
of Health-
System
Pharmacists (ASHP), Society for Healthcare Epidemiology of America, and
Surgical
Infection
Society are currently in the process of revising the 1999 ASHP Antimicrobial
Prophylaxis in
Surgery
Guideline.99
In
2002, the Center for Medicaid and Medicare Services implemented a quality
initiative project,
currently
entitled the Surgical Care Improvement Project (SCLP), in an attempt to
decrease
postoperative
surgical site infections.140 As part of the SCLP, medical institutions are
being graded
on
3 surgical AP performance measures with cardiothoracic, vascular, colon,
hip/knee, and vaginal or
abdominal
hysterectomy surgeries: (1) the proportion of patients who have parenteral AP
initiated
within
1 hour before surgical incision, (2) the proportion of patients who are
provided an antibiotic
agent
that is consistent with currently published guidelines, and (3) the proportion
of patients whose
prophylactic
antibiotic is discontinued within 24 hours after the end of the operation (48
hours for
cardiothoracic
surgery). The most up-to-date list of approved antibiotics for various
surgeries is
posted
on the SCLP Web site.140
CONCLUSION
The
use of AP has led to the prevention of a large number and variety of infections
and to substantial
declines
in surgical site infections. Antimicrobial prophylaxis should be limited to
specific, well-
accepted
indications to avoid excess cost, toxicity, and antimicrobial resistance.
Patients should
understand
the potential risks and benefits of any AP regimen. Although some AP practices
are
evidence-based,
many are based on low-level evidence or expert opinion. More studies in the
area
of
AP are needed.
Mark
J. Enzler, MD; Elie Berbari, MD; and Douglas R. Osmon, MD, MPH
From
the Division of Infectious Diseases, Mayo Clinic, Rochester, MN.
Address
correspondence to Mark J. Enzler, MD, Division of Infectious Diseases, Mayo
Clinic, 200
First
St SW, Rochester, MN 55905 ([email protected]). Individual reprints of this
article and
a
bound reprint of the entire Symposium on Antimicrobial Therapy will be
available for purchase from
our
Web site www.mayoclinicproceedings.com.
©
2011 Mayo Foundation for Medical Education and Research
Copyright
2011 ProQuest Information and LearningAll Rights ReservedCopyright 2011 Mayo
Foundation
for Medical Education and Research
Mayo
Clinic Proceedings
July
2, 2011
Woman
Remains Hospitalized at LRMC - The Ledger – By CHASE PURDY –
LAKELAND
| A Lakeland woman opened her eyes this morning to the monotonous sight of
same
old
room.
Yvonne
Gallimore, after 46 days in Lakeland Regional Medical Center, will remain at
the hospital this
Fourth
of July weekend, her infection long healed and her anticipation
mounting.
Deemed
ready for release by doctors more than a month ago, the Lakeland woman said
she's waiting
for
a temporary home to become available before moving into a brand new house
scheduled for
construction
later this month. The new house will be tailored especially for her, using
$100,000 from
an
anonymous donor, said Claire Twomey, chief executive officer of Lakeland
Habitat for Humanity.
The
generous donation came after Gallimore pleaded to her community for help
following her
hospitalization.
A longtime sufferer of lymphedema, a disease that makes her lower body to
become
extremely
large, she was admitted to the facility May 19 for a leg infection. The
770-pound woman
said
rescue crews had to rip a wall from her home to remove her from the house,
which left her
homeless.
Sitting
in her hospital room last week, Gallimore said she's ready for the day she can
leave the
Lakeland
Hills Boulevard facility.
"I
tell you, I'm bored with it, because when I'm at home I can look at different
things and see my
grandchildren,"
Gallimore said. "I miss that, definitely miss that. Ain't no place like
home."
She
said being in the hospital for so long has her missing the mundane routines she
used to enjoy.
Twomey
said she anticipates Gallimore will remain in the hospital for five to six more
weeks, or until
temporary
housing can be arranged. Construction on the new house could take four to six
more
months,
she said.
Gallimore
said she did feel some relief last week when she learned the check from the
anonymous
donor
transferred successfully to Habitat for Humanity.
"There
is an end to this," Twomey said. "The place where we picked to build her a
house was the
place
where she was living. We're going to sit and talk with her about the
plans."
In
the meantime, Gallimore said she looks forward to visits by her family and
friends at the hospital.
[
Chase Purdy can be reached at [email protected] or 802-7516.
]
Early
Physiotherapy of the Arm After Breast Cancer Surgery Reduces Lymphedema
-
MedIndia
–
Present
statistics indicate that women with breast cancer have a 77% chances of
survival for at least
10
years; therefore it is important to effectively prevent and manage
complications after treatment of
the
cancer.
Any
node excision can lead to stasis of lymph in the area and it is no different
when it comes to breast
cancer
surgical treatment. The axillary lymph nodes drain from breast tissue and are
responsible for
spread
of the cancer to other parts of the body, hence their removal is indicated when
doing curative
surgery
in breast cancer. A randomized, single- blinded, clinical trial of women after
unilateral breast
cancer
surgery with axillary lymph node dissection was carried out at the Pr�ncipe de
Asturias
Hospital
in Madrid between May 2005 and June 2007 by Maria Torres et al and their
findings were
published
recently in British Medical Journal.
The
study strived to analyze the unaddressed needs of women, in whom symptoms and
signs indicate
the
presence of lymphoedema, post breast cancer treatment.
The
study tried to determine the efficacy of an early physiotherapy programme in
reducing the risk of
lymphoedema
in women after breast cancer surgery involving dissection of axillary lymph
nodes.
Subjects-
237 women with signs and symptoms of lymphoedema formed the subject of
study.
Women
without axillary lymph node dissection or with bilateral breast cancer,
systemic disease, loco-
regional
recurrence, or any contraindication to physiotherapy were excluded from the
study.
About
Lymphedema
An
acquired interruption or damage to the axillary lymphatic system after breast
cancer surgery, or
after
radiotherapy for breast cancer, may result in generalized or regional
accumulation of lymph fluid
in
the interstitial space. This condition, known as secondary lymphoedema, is the
most important
chronic
complication after axillary lymph node dissection. It has a tendency to
progress.
Secondary
lymphoedema can cause physical discomfort, disfigurement, and functional
impairment.
Other
factors seen in patients with secondary lymphoedema include anxiety,
depression, and
emotional
distress.
The
condition can badly undermine self esteem and can affect social relationships.
It can aggravate
cellulitis,
erysipelas, lymphangitis, and can occasionally cause lymphangiosarcoma ( a form
of cancer).
The
factors that influence secondary lymphoedema development after
surgery:
•
Number of lymph nodes removed
•
Radiotherapy to the axilla
•
Post -surgery wound infection,
•
Post-surgical drainage time
•
Lack of mobility,
•
Obesity.
The
incidence rates for secondary lymphoedema, ranges from 5% to 56%, two years
post- surgery.
Method
- Each subject was evaluated pre-operatively and also between days 3 and 5 after
hospital
discharge.
Equal numbers of participants were then randomly assigned to either:
•
The early physiotherapy and an educational strategy (early physiotherapy group)
or
•
The educational strategy only (control group).
The
incidence of secondary lymphedema was the main outcome.
Management/
Interventions - Early physiotherapy group and control group would receive the
same
educational
intervention.
a)
Early physiotherapy group - In this group, manual lymph drainage technique was
used to treat post-
operative
oedema. This group also did shoulder exercises and stretching in their homes,
once daily
during
the three -week intervention period.
b)
Educational strategy (both groups)- Here, printed materials with instructions
about the lymphatic
system,
concepts of normal load versus overload, the factors leading to secondary
lymphoedema,
identification
of potential precipitating factors, and the four categories of interventions to
prevent
secondary
lymphoedema were given to the patients.
Follow-up
- Four follow-up visits were to be carried out. They were four weeks three
months, six
months,
and 12 months after surgery. These dates were flexible, depending on the
availability of the
participant.
If patients experienced pain, discomfort, or any other symptoms a
physiotherapist was
asked
to visit them.
If
secondary lymphoedema developed, complex decongestive physiotherapy was carried
out on
those
patients.
Results
and Conclusion - Of 120 women studied, 60 were slotted in the early
physiotherapy and an
educational
strategy group and 60 to the educational strategy only group.
It
was discovered through the study that early physiotherapy along with an
educational strategy
helped
to lower the risk of secondary lymph edema in women post breast cancer surgery
involving
dissection
of axillary lymph nodes, in comparison to the educational strategy only
(control group).
Secondary
lymphoedema developed from six to 12 months post surgery. The authors suggest
that the
manual
lymph drainage after breast cancer surgery in the early physiotherapy group
could be one of
the
contributing factor towards better results in that group.
The
study concludes that early physiotherapy couldplay a role in preventing and
reducing secondary
lymphoedema
in post- breast cancer surgery patients involving dissection of axillary lymph
nodes, at
least
for one year following surgery.As for understanding its role long-term, more
work is required.
The
researchers also stress upon the positive role of physiotherapy in creating
awareness, prevention,
early
diagnosis, and management of secondary lymphoedema.
Source:
Priorities for women with lymphoedema after treatment for breast cancer:
population based
cohort
study; Maria Torres et al; BMJ 2010; 340:b5396
*
http://www.bmj.com/content/342/bmj.d3442
Source-Medindia
July
5, 2011
Hormone-blocking
drug reduces breast cancer risk - Nevada Appeal –
CHICAGO
(AP) — 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 suggested 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.
Still,
it could be a tough sell. These women have only about a 2 percent to 3 percent
risk, individually,
of
being diagnosed with breast cancer in the next five years. A prevention pill
that cuts that chance by
65
percent means they'll have about a 1 percent risk, said Dr. Eric Winer, breast
cancer chief at
Dana-Farber
Cancer Institute in Boston.
“Many
women are not willing to take a daily medicine” for such a small risk, he
said.
Brand-name
aromatase inhibitors cost $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.
Results
of the study were published online by the New England Journal of Medicine. The
Canadian
Cancer
Society, Pfizer 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.
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 received standard treatment with radiation to the breast, and half
also had radiation
in
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.
The
National Cancer Institute and Canadian Cancer Society paid for the
study.
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.
July
5, 2011
#78-
Take a Walk for a Cause - Patch.com –
Join
the National Walk for Lymphedema and Lymphatic Disease.
We're
frequently encouraged to walk for different causes, but not everyone
understands the
significance.
The
very act of walking, jogging or running around these tracks and arenas
certainly promotes a
healthy
lifestyle, but it also serves as a way to raise funds for those suffering from
various life-
threatening
ailments. Teams have already started registering for the Sept. 24 National walk
for
Lymphedema
and Lymphatic Diseases, so join a team, donate or register your own group at
the
National
Walk for Lymphedema and Lymphatic Diseases web site.
While
problems with the lymphatic system are related to a number of different
possible conditions,
some
of the diseases walkers help to fight against include cancer, arthritis,
systemic lupus and AIDs,
according
to the Lymphatic Research Foundation.
This
year's walk will take place at Eisenhower Park, and it will begin at the
Merrick Avenue
entrance.
Registration begins at 1 p.m., and the walk starts at 2 p.m. The distance of
the walk is three
miles
(5K), but the site cheerily states to complete whatever you are able to
accomplish. The walk
will be held
rain or shine, so get your rain boots and umbrellas ready in case drops decide
to fall.
Even
if you are unable to physically attend the walk, consider setting up a
Fundraising Page to show
your
support.
July
6, 2011
'Zumbathon'
benefits Ross Jewish Community Center's Wellness Club - Sun-Sentinel – |By
Shani
McManus
-
Latin
music blared from a loudspeaker. The music was so deafening that conversation
was
impossible,
but no one seemed to mind. They were there to dance — and sweat — to help make
a
difference.
"I
like to dance and I wanted to support a good cause," said Sara
Ingles.
Ingles
was one of more than 150 enthusiasts who turned out for the Ross Jewish
Community Center's
first
"Zumbathon" in Boynton Beach. The event was a fundraiser for the JCC's Pink
Ribbon Wellness
Club,
a program designed for cancer survivors and patients to add physical activity
to their lives.
The
program includes dieticians, social workers, healing touch therapists,
lymphedema specialists and
JCC
fitness professionals who design a program to improve the physical and
emotional condition of
those
dealing with breast cancer.
July
7, 2011
Hospital
purchases cancer center to give patients more comprehensive care - Carroll
County Times –
By
Alisha George –
When
Wendy Garver was diagnosed with Stage III breast cancer in 2003, she started
visiting Dr.
Flavio
Kruter.
"I'm
here today because of Dr. Kruter and my husband," Garver said during her yearly
exam with
Kruter
in Westminster Thursday.
Kruter
gave the Littlestown, Pa., resident a hug and asked about her summer plans and
how she
feels,
and Garver had only good things to report.
"Life
is good," said Garver, now cancer-free.
At
the start of the month, Carroll Hospital Center expanded its cancer services by
purchasing Carroll
Hematology
Oncology from US Oncology and renaming it the Carroll Regional Cancer Center.
The
center,
a separate building beside the hospital, has kept the majority of its staff
members and is set to
provide
a more holistic approach to serving patients.
"What's
exciting about this is now we can take cancer care to the next level," said the
hospital's Chief
Operating
Officer, Leslie Simmons.
Both
the hospital and center offer various cancer care services, but right now they
are fragmented,
she
said. Rather than a patient bouncing between the hospital, center and
specialists, the hospital
hopes
to expand and open a larger center where all cancer services can be packaged
together to
better
serve more patients.Garver said she utilized the hospital and center for cancer
treatments and
lymphedema
specialists in different locations in Carroll and Pennsylvania. Lymphedema is a
condition
that
resulted from her surgery after surgeons removed her arm's lymph nodes because
her cancer
spread.
Now, the hospital provides services for that condition.
She also
struggled with knowing where to find things such as a wig when she was going
through
chemotherapy.
But Garver likes the idea of having everything under one roof at the
center.
"I
think it's great because you'll have everything you need right there," she
said.
Some
additional services the hospital plans to add to the center include more
coordinated care,
remission
support and genetic testing, Simmons said.
"With
the hospital owning it, we can invest more in the growth of that center," she
said.
Simmons
said patients should not have to leave the community to receive cancer
care.
"With
the new name, we are trying to communicate that we want to branch out to not
only
Westminster,
but all of Carroll County and beyond," she said.
Kruter,
who will remain the center's medical director, said incorporating all the
services under one
roof
will be a significant benefit for patients. Now, the goal is to offer more
emotional and
psychological
support and specialized services.
The
center wishes to get input from groups like cancer coalitions to better
incorporate community
needs,
he said.
The
hospital is going to launch a major campaign to raise money for the new
comprehensive cancer
center.
The vision is to open the new center in two years, Kruter said.
Kruter
said the hospital and the center have always had a strong relationship and he
has always been
involved
with the hospital's cancer programs. It doesn't really matter what name is on
the door as
long
as patients are getting the best care possible, he said.
"If
this association can help me do a better job, then it's a good deal for
everyone," Kruter said.
Reach
staff writer Alisha George at 410-857-7876
[email protected].
Find
Promotions Galore and Discount Compression Stockings at - Online PR News
–
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Many
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Cancer
patients take part in restorative yoga - The Daily Advance – By Anna Goodwin
Mccarthy –
"Allow
your eyes to shut,” Tami Richards says to a group of cancer patients. “Quiet
your mind.”
Richards
commences the Restorative Yoga for Cancer Patients class in a dimly lit room at
the
Albemarle
Health Education Center on the first floor of the hospital. She places a chair
in front of
each
of the participants, elevating their legs into the seat.
Their
backs remain on their yoga mats on the carpeted floor, as their arms extend to
their sides,
fingertips
loosely dangling in a graceful position. Richards supports their head and neck
with soft
blankets,
asking each if they are comfortable and adding more blankets where they are
needed.
In
a relaxed, supported savasana pose, participants begin to experience the
benefits of the calming
atmosphere.
“Let
your inhalation be nice and full,” Richards says softly. “Connect with the
breath.”
Tension
lifted from their limbs, they start to breath easily. Holding each pose for 10
to 12 minutes is
essential
to gaining the maximum advantages of the yoga exercise, said
Richards.
At
the end of the allotted time for the pose, Richards says, “Take some nice long
healing breaths,
exhale
your tension and worries.”
She
advises the participants to slowly move their fingers and toes, open their eyes
and bring their legs
down
to floor when they are ready to begin the next exercise.
Richards
moves a long table with its legs folded so that it lays flat on the floor
beside each person.
“Sometimes
you need a lot of props,” to achieve the correct poses, said the yoga
instructor. She
helps
adjust each person’s body so a hip leans against the table as their torso and
head is twisted on
its
surface, supported by numerous blankets.
“Bring
lightness and healing energy into the body.” The supported twist pose is
helpful for “massaging
the
organs” within the body, Richards explains.
Richards
culminates the session with the supported modified inversion pose. The regular
class
attendees
begin to laugh with pleasant familiarity as they slide their mats against the
wall for what most
consider
their favorite pose.
With
their backs on the mat, they lift their legs against the wall. Richards places
a strap around each
person’s
legs to keep them together and supported.
In
her closing comments, Richards asks the participants to “notice how you feel
prior to the class and
now.”
Martha
Jackson, who was first diagnosed with cancer 32 years ago, said “My back feels
strengthened.”
The cancer survivor said several surgeries left her with scar tissue.
“I
feel better,” said Jackson after attending the class.
“It
is not hard to do,” said Alean Holden, referring to the yoga positions. Holden
who was diagnosed
with
cancer a couple of years ago said she feels “relaxed” after completing the
exercises.
Richards
provides individualized attention to each participant in the class. Helping
each person find
the
most support in every exercise is integral to a successful outcome. “Every pose
can be modified”
to
maintain the comfort of the participant.
After
receiving training in Los Angeles, Calif., Richards taught yoga classes for
almost a decade. A
physical
therapy assistant and certified lymphedema therapist at the hospital, Richards
realized her
knowledge
of yoga could help cancer patients.
She
began instructing the Restorative Yoga for Cancer Patients class at Albemarle
Health in April.
Decreasing
stress through the breathing exercises helps participants “get rejuvenated” and
“emotionally
heal.”
Specifically
tailored for cancer patients, the exercises produce “restorative poses to
stretch tissue and
get
motion back.” However, Richards said the free class is open to any person who
wants to
experience
the restorative effects of the exercises.
Richards
encouraged her mother, Marti Jones, to attend the class. Jones remarked on her
increased
“flexibility”
and limberness after just one session.
Yoga
assists people with having a “little more balance in life,” said Richards. “The
beauty of yoga is
the
benefit to psychological well being.”
Richards
recommends class participants practice the poses they have learned at home on a
daily
basis.
Energized
by the positive comments she has received from class participants, Richards
said many
people
have a “peaceful feeling at the end of class.”
Richards
smiles, remembering a totally relaxed person telling her at the end of the
instruction, “This is
so
wonderful. Do I have to get up now?”
While
some people arrive at the class with high stress levels, pain and anxiety, they
leave finally able
to
“exhale.”
The
Restorative Yoga Class for Cancer Patients is held the last Wednesday of each
month from 6:30
p.m.
to 7:30 p.m. at the Albemarle Health Education Center. For more information or
to register for
the
free class, call Tami Richards at 384-4632.
Anna
Goodwin Mccarthy is a correspondent for The Daily Advance
July
8, 2011
St.
Catharines, Ontario
In
the last week of June, 2011, St. Catharines based John Mulligan, a Registered
Massage Therapist
and
Certified Lymphedema Therapist, as well as Clinical Specialist for Lymphedema
Depot Ltd.,
spent
5 days at the Foldi Specialist Clinic for Lymphology, the European Centre for
Lymphology in
the
Black Forest of southern Germany.
The
training took place entirely in English as part of the Klose Training and
Consulting English
language
series of classes given annually at the Foldi Clinic.
The
classes consisted of lectures, hands-on demonstrations, case studies and manual
therapy and
bandaging
workshops. The students were also able to observe treatments given by members
of the
Foldi
Clinic therapist staff. “It was great to have the opportunity to observe such
skilled manual
therapists.
Each one of them has such a deep understanding of the lymphatic system, manual
lymph
drainage
and multi-layer lymphedema bandaging that it was a privilege to observe them as
they
worked,”
said Mulligan.
Physicians
at the Foldi Clinic also delivered in-depth lectures on lipedema, infections in
lymphedema
and
the relationship between chronic venous insufficiency and lymphedema.
Students
also had a chance to empathize with patients by experiencing the rigours of
multi-layer
lymphedema
bandaging.
“All
of the therapists that were attending as students bandaged each another one
morning and we
went
through our whole morning wearing our bandages. We even had to eat lunch while
wearing the
bandages.
It gave us a better insight into what lymphedema patients go through, even if
it was only a
small
taste of what they have to put up with” said Mulligan.
“The
Foldi Clinic in many ways represents the model for what a lymphedema facility
can be and what
lymphedema
treatment can be,” said Mulligan. “There are other similar clinics in Europe,
such as the
Wittlinger
Clinic and the Asdonk Clinics, but I feel a special kinship with the Foldi
Clinic. The
European
approach to lymphology has a lot to offer to North Americans, where lymphology
is an
obscure
and little understood field and patients have a hard time finding
treatment.”
“I
feel refreshed and inspired and ready to return to my own work in a renewed
frame of mind,”
Mulligan
stated. Mulligan is also involved the Canadian Lymphedema Framework as a member
of the
Education
Committee. In addition to his work with as in-house Clinical Specialist with
Lymphedema
Depot,
Mulligan also teaches classes in multi-layer lymphedema bandaging and manual
lymph
drainage.
He
can be contacted [email protected].
His
website is http://www.LymphedemaTherapist.com
The
Lymphedema Depot website is http://www.LymphedemaDepot.com
His
blog is at http://www.LymphedemaDepot.com/blog
July
11, 2011
Docs
discovering breast cancer earlier - Columbia Daily Herald –
A
new study may bring welcome news to many women diagnosed with early stage
breast cancer,
according
to John P.W. Brown, M.D., a surgeon on the medical staff at Maury Regional
Medical
Center.
With
improvements in technology such as digital mammography, Brown indicates that
clinicians are
able
to detect cancers in much earlier stages than in years past. Women diagnosed
with early stage
breast
cancer often choose breast conservation surgery known as a lumpectomy, local
removal of the
cancerous
mass and a margin of tissue surrounding the site. During the lumpectomy, the
sentinel
lymph
node — the first lymph node in the series of those located underneath the arm —
is removed
for
testing. The procedure is commonly referred to as a sentinel node biopsy and is
a key indicator to
determine
if the cancer has spread beyond the breast.
In
the past, any positive sentinel lymph node was followed by a complete removal
of all of the lymph
nodes
from under the arm, known as axillary dissection. The lymph nodes would then be
tested for
the
presence of cancer. This operation was associated with a significant risk of
arm lymphedema, a
condition
in which the arm retains fluid and the tissue swells as a result of the
compromised lymphatic
system.
A new clinical trial demonstrates that some women with two or fewer positive
sentinel lymph
nodes
do not need further lymph node removal, according to Brown.
“The
results of this long-awaited six-year clinical trial were presented at the
American Society of
Clinical
Oncology last summer. Many found the results surprising and practice-changing.
Women
who
are found to have only two or three minimally involved nodes at the time of the
sentinel node
biopsy
are no longer recommended to have the remaining lymph nodes removed,
eliminating the need
for
invasive surgery and greatly decreasing the side effect of lymphedema,” said
Brown.
Gardening
for health - Columbus Telegram – by Julie Blum –
COLUMBUS
- Gardening isn't just a hobby. For some, it is a way to better their
health.
That
is the idea behind the OT Garden Club.
Occupational
therapists from Columbus Community Hospital started the club last year with
the
opening
of the Columbus Community Garden. Two plots are used by occupational therapists
Megan
Freier
and Liz Gonka.
They
invite patients to garden, which can help them in their recovery.
"It's
kind of like free therapy," Gonka said.
Patients
like Wilda Buckle have been coming to the garden for several weeks, helping
with planting,
weeding
and harvesting vegetables. Buckle suffered a broken left wrist in a January
fall and has
incorporated
gardening into her therapy.
"Any
little thing you do helps," Buckle said of activity she has done to help her
wrist heal.
As
a natural right-hander, Buckle said it was easy to use her dominate hand for
most everything, but
in
order to get strength and movement back in her left wrist, she had to do
exercises to move the
process
along. She went to occupational therapy, but also found gardening
helped.
Gardening
is especially good for those recuperating from injuries like Buckle had, Freier
said.
"When
people have a hand injury, they are hesitant to do activities that involve
their hands. With
gardening,
you have to use your hands," Freier said.
A
variety of people have volunteered to work in the garden including stroke
victims and lymphedema
patients.
Special
tools that have been supplied by master gardeners are used by the patients. The
tools have
been
extended and adapted with ergonomically angled handles to keep the wrist in a
more natural
position.
Gonka
said the garden has been a great way to get patients to transition into daily
activities. She
hopes
in the future the hospital will have its own garden where patients could work
in raised beds,
which
could be utilized by those who are in wheelchairs.
Working
in the garden is optional and patients can volunteer as many hours as they
choose. This
year,
about five patients have regularly been tending to the plots. The garden has
become self-
sufficient.
Much of the vegetables grown last year were sold and some of the profits were
used to
purchase
seeds for this year's crops. The group also gave a donation of money from the
sale to the
Columbus
Area United Way.
The
OT Club isn't the only one from the hospital that has been taking advantage of
the Community
Garden.
Another plot is being used by Deb Moore, a registered dietitian. She hopes by
next year to
get
families, students or children involved in raising vegetables in order to learn
about healthy eating
and
fighting obesity.
Most
of those who have plots at the garden are couples and families. For some, like
Jenny Sylvester,
this
is her first experience growing vegetables.
Sylvester
is often at the site with her children, Jackson, 9, and Jaylynn, 5. As a first
time gardener, it
has
taken Sylvester some trial and error to get vegetables sprouting and producing,
but now she has
rows
of radishes, carrots, cucumbers, tomatoes and jalapeno peppers.
The
veggies that have been harvested have been shared with other family members
including her
husband's
uncle and grandmother. One of Sylvester's sisters is going to use the
vegetables to can
salsa
and spaghetti sauce.
Gina
Matson started gardening last year with her two boys, Alex and Erik. She said
gardening has
helped
save on her grocery bill. Matson is able to freeze some of the vegetables like
squash and use
long-lasting
potatoes throughout the fall and winter months instead of having to buy
more.
The
experience has also made her children, age 13 and 9, more apt to eating
vegetables.
"We
grew it so they want to try it. They have that ownership of growing it
themselves," she said.
As
members of 4-H, the kids have also used what they have grown in as entries in
the Platte County
Fair.
July
12, 2011
Methodist
opens one-of-a-kind triple negative breast cancer clinic - Your Houston News
–
For
a woman with no family history of cancer, 60-year-old Brenda Sorrells was
shocked to discover
that
a lump on her sternum was later diagnosed as triple negative breast cancer, a
rare form of cancer
that
can be highly aggressive and is only present in about 15 percent of breast
cancer patients.
Breast
cancer is usually diagnosed based on three common receptors known to help the
cancer
develop.
The cells in triple negative breast cancer do not express any of these
receptors, making
them
generally unresponsive to standard treatments.
This
type of cancer can be especially aggressive and there is a greater chance of
recurrence. To help
patients
with this particular type of cancer, The Methodist Cancer Center recently
opened a triple
negative
breast cancer clinic, the first of its kind in the nation. It is located at
6445 Main St., with
imaging
services at 2615 Southwest Freeway, Suite 110.
Patients
have access to services including genetic counseling, psychosocial support,
nutritional
counseling,
lymphedema management and even massage therapy, said Dr. Angel Rodriguez, the
clinic’
s
director and a breast medical oncologist. “This clinic focuses efforts on a
type of breast cancer that
is
very difficult to treat, giving women convenient access to these
services.”
Research
shows this highly aggressive form of cancer accounts for half of all breast
cancer deaths.
The
only method for treating it right now is chemotherapy, but current therapies
most effectively
target
only the three common receptors.
“The
support I have received from the entire Methodist team has given me the
confidence to get back
into
my daily routine and continue living my life,” said Sorrells, who recently
began participating in
clinical
trials in hopes of enhancing her treatment along with chemotherapy.
“We’re
always looking for better and more promising treatments that might increase our
chances of
finding
a cure,” Rodriguez said. Through clinical trials, patients have the opportunity
to explore other
options
that could be beneficial toward their treatment, he said.
For
information, call 713-790-2700 or visitwww.methodisthealth.com.
Young
Gymnast Tumbles on One Leg after Overcoming Cancer - KGO-AM –
NORTHFIELD,
Minn.) -- Adam Starr stepped into the Northfield Gymnastics Club last week; it
had
been two years since he last tumbled. Gymnastics skills aren't like riding a
bike.
Any
gymnast would be rusty after two years of no physical preparation. It takes
enhanced muscle
memory,
daily practice and sheer mental strength to convince the mind to
tumble.
It
takes courage for any gymnast to jump into the air and flip the human body
backward in unnatural
ways,
fully knowing the danger that waits on the ground if one small mistake is
made.
But
Starr's situation was different. This time he was attempting his first
gymnastics trick with only his
left
leg.
Starr
started gymnastics at the age of three and continued practicing as a teenager.
His mother, Leslie
Starr,
said he was always a "monkey" climbing around their home. His father, Garrett
Starr, said that
his
son was always an acrobat.
The
21-year-old senior at St. Olaf College in Northfield, Minn,. lost his leg to
cancer in 2009. Being
a
lifelong gymnast, captain of his high school track team and an All-American
diver, losing one a leg
was
devastating.
Starr
was born with a rare condition called Lymphedema, which causes swelling in
limbs. In this case,
Starr
always had swelling issues with his leg that would come and go, but he was
still able to compete
in
athletics.
During
his freshman year, Starr went to the doctor for swelling and a bruise on his
foot that would not
go
away. The doctor called him on Valentine's Day in his college dorm room and
told him he had a
form
of low-grade cancer, but it still required amputation of his leg.
The
doctor gave Starr two choices for his surgery: either to have his
below-the-knee amputation in
just
one month over spring break or to wait until his summer break. Starr chose to
go ahead and have
his
surgery over spring break -- a decision his parents agreed with, but they were
worried for their
son.
Once
the doctors did the surgery, they found that Starr actually had a very
aggressive and rapidly
growing
cancer that had spread -- stage four angiosarcoma, which has a very high
mortality rate.
His
mother said they were shocked by the news, but her multi-talented son, who is
also a guitarist,
kept
them grounded after the devastating diagnosis.
Two
days later, Starr went through another amputation, this time above the knee to
remove the
aggressive
cancer that had spread. He said it was odd to see where his leg should have
been after the
amputation.
Starr
took the spring semester off from college and for the next seven months he
endured a rigorous
schedule
of chemotherapy.
Starr
was fitted with a prosthetic leg and learned to walk with his new body. He said
the most difficult
part
was building up his endurance to walk long distances.
Starr
said one thing that pulled him through his cancer was his desire to become a
doctor. He is a pre-
med
student and will be applying to medical school after he graduates next year. He
is considering the
field
of physical medicine and rehabilitation after going through his
illness.
Starr
spent the last two years rehabilitating, and just last week he decided to go
back to the gym to
see
if he could still tumble.
Starr
walked into the gym with a couple of friends and a camera, with a goal in mind
of completing a
back
tuck.
To
Starr's surprise, he could still land a back tuck and began attempting other
gymnastics tricks that
were
also successful.
Starr
posted the tumbling video online for his family and friends to see. The video
became a viral
sensation
online with hundreds of thousands views. Messages came pouring into Starr's
inbox from all
over
the country, some from amputees who were inspired by what Starr could
do.
Starr
says his return to the gym serves as an affirmation that he can achieve his
goals and be
successful.
Copyright
2011 ABC News Radio
July
22, 2011
HBO's
Potential Anti-Cancer Effects on Breast Cancer Cells - MD News – By: James
Slaby, MD -
James
Slaby, MD, discusses hyperbaric oxygen therapy's (HBO's) effect on breast
cancer cells.
The
total metastatic load in the lung is reduced after HBO --— that’s one of the
most significant new
findings
from a 2007 study. Despite the misconception that HBO could actually have
cancer-
enhancing
effect, HBO is frequently administered to cancer patients.
In
the 2007 study, Haroon, Patel, and Al-Mehdi decided to evaluate the growth of
murine breast
cancer
cells in the lung after hyperbaric oxygen treatment in an experimental
metastasis assay. To do
this,
young nu/nu mice were injected intravenously with 3x 10(3) 4T1-GFP tumor cells
per g body
weight
followed by lung isolation, perfusion, and intact organ epifluorescence
microscopy 1 to 37
days
after injection. A group of animals (n=32) was exposed once daily for five days
a week to 45
minutes
of 2.8 ATA hyperbaric oxygen in a research animal chamber.
Control
animals (n=31) were not subjected to HBO, but received similar intravenous
administration
of
3x 10(3) 4T 1- GFP tumor cells. Single tumor cells and colonies were counted in
the subpleural
vessels
in areas of about 0.5 cm2 of lung surface [Haroon et al]. What Haroon et al
found was that
HBO
treatment did not lead to an increase in the number of the large colonies or
small colonies in the
lungs.
Instead, there was a significant reduction in the number of the large colonies
when observed at
varying
periods of the time after hyperbaric treatment.
Most
importantly, there was a significant decrease in large colony size in the HBO
group during all
periods
of observation. The results indicate that HBO is not prometastatic for breast
cancer cells,
but,
instead restricts the growth of large tumor cell colonies [Haroon et al]. One
of the most
significant
new findings from the study was that the total metastic load (the combined mass
of large
colonies,
small colonies, and the single cell colonies in the target organ) in the lung
is reduced after
HBO.
What’s more, HBO treatment did not lead to an increase in the combined number
of metastic
foci
in the lung. The load reduction was accomplished because the size of the
colonies was limited
states
Haroon et al.
Studies
reveal that there is no adverse effect of HBO on tumor growth. In fact, the
research suggests
that
HBO may have an anti-cancer effect with breast cancer cells. Use of HBO in
human breast
cancer
patients did not have any adverse effects in a recent long-term follow up study
and is even
considered
for treating lymphedema associated with breast cancer surgery.
These
findings represent good news for patients that have cancer and other issues
that would benefit
from
HBO therapy. In the past we were hesitant to use HBO on patients with cancer
for fear of
encouraging
tumor growth. Now, for example, a patient with breast cancer that needed
radiation
therapy
and developed soft tissues radiation neurosis would benefit from HBO therapy.
As a result,
her
healing ability after breast reconstruction would improve.
Dr.
James Slaby is a plastic surgeon specializing in wound care and a panel
physician at the Wound
Healing
& Hyperbaric Oxygen Center at Wooster Community Hospital
July
23, 2011
Cabrini
receives Komen grant - Alexandria Town Talk –
The
Christus St. Frances Cabrini Hospital's Cancer Center has received a grant from
the Northeast-
Central
Louisiana Affiliate of Susan G. Komen for the Cure to help the Breast Cancer
Rehabilitation
Program
provide free initial and ongoing lymphedema screenings for breast cancer
survivors.
The
grant also will help pay for bandages for those undergoing treatment for breast
cancer-related
lymphedema
and provide compression garments for breast cancer lymphedema
patients.
Cabrini's
group for breast cancer survivors, the Pink Ribbon Club, meets monthly on the
third
Thursday
of each month at 5:30 p.m. in the Women's Life Center.
July
24, 2011
Cuts
for a cause - Slidell Sentry News – By Erik Sanzenbach –
If
your hair is getting a little shaggy and unkempt, and you need a haircut, wait
about a week, and
then
go get a haircut that will not only make you look good again, but you will be
helping out a good
cause.
Kirsten
O’Shaughnessy and Rebecca Peters, owners of the Simply You Salon in Slidell
are
organizing
a unique fundraiser to help cancer victims.
If
you get your hair cut July 31 from 3 – 6 p.m. at the salon, all haircuts will
cost $10 and all the
money
will go to the Pink Hearts Funds. The Pink Heart Funds is a non-profit that
operates out of
Long
Beach, Miss., and they provide free wigs to adults and children who have lost
their hair due to
chemotherapy
or other medical causes. The organization also provides free breast prostheses
for
breast cancer
victims and free lymphedema sleeves.
Lymphedema
is a disease that affects a lot of breast cancer victims.
It
is the overproduction of lymph node fluid and causes arms, legs, hands and feet
to swell painfully.
The
sleeves help to keep the swelling down.
O’Shaughnessy
said that not only will they be raising money for The Pink Heart Funds, but
they will
also
be collecting hair for the wigs. If your hair is 8 inches or longer and you
want to donate it, O’
Shaughnessy
and her crew will cut your hair for free.
“We just want
to do a good thing and bring the community together,” O’Shaughnessy
said.
She
and Peters did a similar event last year. That was to help one of Peters’
cousins that had fallen
off
a horse and was in a coma. This year, the two stylists decided to expand their
generosity and raise
money
others.
O’Shaughnessy,
was raised in Slidell, and Peters is a Slidell transplant from Picayune,
Miss.
They
met six years ago when they were in school learning to be hair stylists. Since
then, they have
been
best friends and business partners. They bought the Simply You Salon last
December.
We
want this to be more than just a haircut,” O’Shaughnessy said. To that end, the
two women have
gotten
inflatable bounce house for the children that will be set up in the parking
lot. There will also be
face
painting There will also be live entertainment with DJ David Storm spinning the
tunes. There will
also
be a karaoke competition.
The
Simply Cakes Bakery next door to the salon will be serving up baked goodies and
there will also
be
cotton candy, nachos and hot dogs.
O’Shaughnessy
said she is still looking for other businesses to help out with prizes for
raffles, and she
said
she could always use as many volunteers as she can get to help out.
“We
want the whole community to come out, have fun, get a haircut and help out a
good cause,” she
said.
O’Shaughnessy
said that July 31 is a good time for the event because it is a week away from
school
opening.
“Come
get your back-to-school haircut and donate to a good cause,” she
said.
July
26, 2011
First-Class
Bariatric Surgical Care - MD News –
The
bariatric surgery program at Princeton Baptist Medical Center is one of a few
programs in the
state
accredited by the American College of Surgeons, verifying the high level of
services provided.
At
Princeton Baptist Medical Center, patients undergoing bariatric surgery benefit
from
comprehensive
care. A Bariatric Center of Excellence through the American College of
Surgeons,
Princeton
Baptist Medical Center has met and exceeded standards set forth to ensure
high-quality
care.
“To
receive certification as a Bariatric Center of Excellence, Princeton underwent
a retrospective
analysis
of cases spanning the last three years,” says John Mathews, D.M.D., M.D., FACS,
bariatric
surgeon
at Princeton Baptist Medical Center. “A site visit was also conducted by a
bariatric surgeon
who
inspected the operating rooms, emergency department and intensive care units,
and also
interviewed
members of the medical staff, including our bariatric surgical team and other
specialists.
The
American College of Surgeons sets benchmarks that facilities must meet, and we
surpassed each
of
the requirements.”
Enhancing
Quality of Life Through Bariatric Surgery
Patients
who undergo bariatric surgery experience significant improvements in quality of
life.
Treatment
of comorbidities, including high blood pressure, high cholesterol, lymphedema,
infertility,
degenerative
joint disease and diabetes, is also greatly enhanced.
“Management
of comorbidities associated with morbid obesity — defined as a body mass index
of
40
or higher — is one of the most common reasons that patients are referred for
bariatric surgery,”
says
Andrew DeWitt, M.D., FACS, bariatric and minimally invasive surgeon at
Princeton Baptist
Medical
Center. “However, patients also experience improvements in lifestyle, as things
that we take
for
granted — such as sitting in an airplane or tying your shoes — are a challenge
for this patient
demographic.
Following bariatric surgery, patients are able to care for themselves and
participate in
activities
without feeling restricted because of their weight.”
At
Princeton Baptist Medical Center, patients have access to laparoscopic
adjustable banding using
either
the Realize Band or LAP-BAND, laparoscopic roux-en-Y gastric bypass, and
laparoscopic
sleeve
gastrectomy. Utilizing various factors, including overall medical condition,
patient age, weight-
loss
goals and the presence of comorbidities, physicians work closely with patients
to help determine
the
option that will provide the best possible outcome.
Future
Growth
A
$60-million expansion is currently underway at Princeton Baptist Medical
Center. Bariatric
surgeons
and patients will benefit from this expansion through renovated operating rooms
that will
feature
the most up-to-date laparoscopic equipment. In the future, a physical center of
excellence, a
Bariatric
Care Center, is planned, and will provide physicians with a one-stop, dedicated
space
where
patients can undergo laboratory work, pre-admissions testing, psychiatric
evaluations,
nutritional
counseling and exercise therapy, as well as attend educational seminars,
perioperative and
postoperative
classes, a “back on track” recovery program for patients who have gained weight
back
postoperatively
and support group meetings — services that were always available through the
bariatric
surgery program but were previously held at various locations throughout the
hospital.
For
more information about the bariatric surgery program at Princeton Baptist
Medical Center, call
(205)
783-7991 or visit www.bhsala.com.
New
Continuing Education Video Courses from HomeCEUConnection.com – Benzinga
–
HomeCEUConnection.com
is excited to announce the release of two new Seminars on Demand
(video)
continuing education courses designed for rehabilitation professionals -
Sensory Impairments
Across
the Lifespan, by Heather Vasilopoulos, MT, OT/L, and Practical Applications of
Manual
Lymphatic
Therapy by Carmen Thompson, BS, LPTA, CMT, CLT.
Plano,
TX (PRWEB) July 26, 2011
HomeCEUConnection.com
is excited to announce the release of two new Seminars on Demand
(video)
continuing education courses designed for rehabilitation professionals -
Sensory Impairments
Across
the Lifespan, by Heather Vasilopoulos, MT, OT/L, and Practical Applications of
Manual
Lymphatic
Therapy by Carmen Thompson, BS, LPTA, CMT, CLT.
Both
of these continuing education courses use of demonstrative video, slides,
graphs, and other
visual
aids, in combination with professional lectures create a virtual classroom
setting. As fully-
interactive,
continuing education courses, the user has complete control of the course and
is able to
navigate
between various segments. As with all HomeCEUConnection.com continuing
education
courses,
"Sensory Impairments Across the Lifespan", and "Practical Applications of
Manual
Lymphatic
Therapy" both provide students with the opportunity to interact with the
author.
Sensory
Impairments Across the Lifespan
"Sensory
Impairments Across the Lifespan" is a two contact hour continuing education
course
available
to Physical Therapists, Physical Therapist Assistants, Occupational Therapists,
and
Occupational
Therapist Assistants. "Sensory Impairments across the Lifespan" focuses on
neurology,
etiology,
techniques, and clinical applications of sensory impairments.
Heather
Vasilopoulos, MS, OT/L, is a licensed Occupational Therapist with more than ten
years of
experience
specializing in dementia care. She is the CEO and founder of Vital Spark LLC,
an
occupational
therapy and life coaching company, where she provides therapy consulting
services and
clinical
education for health care practitioners on dementia care. She also works
clinically as an
Occupational
Therapist in Home Care and Sub Acute Rehab/Long-Term Care.
Practical
Applications of Manual Lymphatic Therapy
"Practical
Applications of Manual Lymphatic Therapy" is a four contact hour continuing
education
course
available to Physical Therapists, Physical Therapist Assistants, Occupational
Therapists,
Occupational
Therapist Assistants, and Athletic Trainers. "Practical Applications of Manual
Lymphatic
Therapy" focuses on the basic uses of manual lymphatic therapy.
Carmen
Thompson, BS, LPTA, CMT, CLT 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 sub-acute
care.
All
available Seminars-On-Demand online continuing education courses have been
approved by the
Athletic
Trainers' Board Of Certification (BOC) and 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
in applicable 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.
Specializing
in quality online continuing education courses, HomeCEUConnection.com offers
CEUs
for
physical therapists, occupational therapists, speech language pathologists,
athletic trainers and
certified
strength and conditioning specialists that are convenient, affordable and
user-friendly.
Advertorial-Living
with lymphedema ‑‑ understanding & managing your symptoms -
StarNewsOnline.com
– By Amanda Hromadka, DPT, CLT –
Did
you know the human body has one system that regulates immunity, digestion, and
the balance of
fluids
and proteins? The lymphatic system is complex, and serves a vital role in human
health,
circulating
lymph fluid, which is made up of proteins, fats and other cells, from the skin
to the blood
system.
The
lymphatic system requires healthy lymph nodes and vessels to function
efficiently. The most
common
lymphatic system disorder is called lymphedema. Lymphedema is the accumulation
of lymph
fluid
and most commonly shows up as swelling in the arms or legs, but it can also be
present in other
areas
of the body.
There
are two types of lymphedema: primary and secondary. Primary lymphedema means a
person is
born
with abnormal or missing lymph nodes. Secondary lymphedema is caused from
trauma or
surgically
removing lymph nodes. (ie: following surgery for breast or uterine cancer).
Either way,
typical
lymphedema symptoms can include: decreased flexibility in the affected arms or
legs,
increased
size of the arms or legs, prolonged infections, feelings of heaviness and/or
discomfort, and
possibly
malignancy.
While
there is currently no cure for lymphedema, physical therapy can greatly assist
with ideal
management.
Lymphedema can be treated through the use of Complete Decongestive Therapy
(CDT).CDT
has four components: skin care, manual lymphatic drainage (MLD), compression,
and
specifically
designed exercise programs.
For
skin care, it is important to protect the involved area of the body against any
signs of infection or
trauma.
Lotion is recommended to prevent any cracking of the skin that could eventually
lead to
infections.
MLD is the hands-on process of re-routing the lymph fluid from unhealthy to
healthy lymph
nodes.
This light and gentle massage technique has been proven to reduce the amount of
swelling,
decrease
discomfort, regenerate tissue, and improve venous conditions. MLD helps reduce
the size
of
the swollen area, and the compression garments help maintain the size of the
affected area.
Compression
garments can be ordered in a variety of different pressure amounts, sizes,
colors, and
textures.
These compression garments are to be worn during the day and during exercises.
Additional
methods
of compression may be recommended for nighttime wear. Exercise programs are
designed
for
each individual and can include movements to increase flexibility, strength,
stabilization,
endurance,
etc.
A
good CDT program of skin care, MLD, compression, and exercise helps manage
lymphedema.
Prevention
and early intervention are important parts of the success of managing
lymphedema. It is
recommended
to avoid extreme temperatures, infections, and/or trauma to the involved area
of the
body
to significantly decrease the risk for developing lymphedema
symptoms.
Physical
Therapy for Women offers Complete Decongestive Therapy (CDT) by Certified
Lymphedema
Therapists (CLT). If you, or someone you know, could benefit from lymphedema
management,
please call Physical Therapy for Women for more information.
Risk
for Melanoma in Kids Not Clear Cut - Skin and Allergy News Digital Network –
By:
SHARON
WORCESTER –
BOCA
RATON, FLA. – The risk factors for melanoma are well established in adults, as
is the well-
known
ABCD method for self-evaluation for the disease, but assessing risk and
recognizing
melanoma
in children are far less clear cut.
The
typical risk factors, such as a history of changing moles, white race, and sun
sensitivity, don't
seem
to apply in children to the degree they do in adults, and although the ABCDs
(asymmetry,
border
irregularity, color variations, diameter over 6 mm) have withstood the test of
time in adults, for
whom
they were developed, they don’t necessarily apply in children, Dr. Seth J.
Orlow said at the
meeting
of the Florida Society of Dermatology and Dermatologic Surgery.
The
relatively recent addition of an E to the ABCD method adds an element that is
applicable to
assessment
of suspected melanoma in children, noted Dr. Orlow, chair of dermatology and
the
Samuel
Weinberg professor of pediatric dermatology at New York University.
The
E stands for evolving, and it refers to any unexpected change in a mole. It is
the word
"unexpected"
that is important when it comes to moles in children, because in many cases –
such as
with
Spitz nevi – some change is normal, he noted.
Adding
to the challenge of predicting and diagnosing melanoma in children is the fact
that the disease
is
very rare in this population, he said.
Based
on information from the National Cancer Institute's Surveillance, Epidemiology
and End
Results
(SEER) Program database from 1973 to 2001, only 95 of 140,206 cases of melanoma
were
in
children under age 10 years. Compared with older children with melanoma, those
in this age group
who
had melanoma were more likely to be nonwhite; have metastatic disease; show
nodular
histology;
have primary tumors on the head, face, and neck; and have a history of other
cancer (J.
Clin.
Oncol. 2005;23:4735-41).
Among
the melanoma patients younger than 10 years old, survival was about 90%, which
was
comparable
to that in individuals aged 10-19 years and 20-24 years. Among those under age
20,
survival
was 100% if the melanoma was in situ, and 96%, 77%, and 57% if it was
localized, regional,
or
distant, respectively.
Dr.
Orlow noted that findings from other series over the years have also
underscored the rarity of
pediatric
melanomas: Children's Hospital of Boston reported only 23 cases over 36 years,
a
Montreal
hospital reported only 13 cases over 22 years, and Istituto Nazionale Tumor
reported only
33
cases over 25 years. Many of the cases included nodular or amelanotic disease,
reinforcing other
data
suggesting that children tend to have a different presentation than adults. For
example, studies
have
shown that about 20% of melanomas are nodular in adults, compared with 30%-40%
in
children,
and about 10%-20% of melanomas in adults are amelanotic, compared with about
30% in
children.
Dr.
Orlow noted that his own experience over 21 years underscores the rarity and
differences of
melanoma
in children, compared with adults.
He
has encountered only five authentic cases (excluding giant congenital
melanocytic nevi), including
one
that he said "made the most sense" because it involved a 12-year-old boy from
Chernobyl, the
site
of a 1986 large-scale explosion at a nuclear power plant in Ukraine. Radiation
levels at that site
remain
high to this day. The child had a lesion on his lower back and innumerable
dysplastic nevi. The
boy's
mother also had a history of melanoma as a child.
The
other cases included one involving a 12-year old Ashkenazic Jewish girl with a
less than 1-mm-
thick
lesion on her shoulder, one involving a 14-year-old Peruvian Indian girl with
deeply pigmented
skin
and a 1-mm-thick lesion on her fingertip, one involving a 15-year old
Ashkenazic/Sephardic boy
with
xeroderma pigmentosum C and two melanomas in situ, and one involving a
16-year-old
Jamaican
girl with very deeply pigmented skin who had an 8-mm-deep lesion on her
posterior thigh
and
who died of her disease within 3 months.
"I
think this list is typical in that it shows you that these are not people you
would necessarily predict
to
have a problem," he said.
Children
seem to differ from adults not only in terms of who gets melanoma, but also in
terms of how
they
develop the disease.
Molecular
alterations appear to differ in children, Dr. Orlow noted. While BRAF/NRAS
pathway
genetic
mutations are present in 50%-70% of adults with superficial spreading
melanomas, and
mutations
in the c-KIT gene are present in acral lentiginous and mucosal melanomas in
adults, in
children
melanomas appear to have an increased incidence of deletion of c-KIT as well as
mutations
in
the CDKN2A gene, according to one study (J. Invest. Dermatol.
2009;129:1759-68).
The
workup and treatment of children with pediatric melanoma are well established.
The prognostic
value
of sentinel lymph node biopsy – which is well established in adults – is also
believed to apply in
children.
There is no evidence regarding lymph node dissection in either adults or
children, although it
is
used frequently. Risks of lymph node dissection include infection and
lymphedema, he noted.
As
for treatment, adjuvant therapy includes high-dose interferon-alpha, which is
approved for use in
adults
but not children. It has been used in several case series in children. Risks
include fever,
malaise,
neutropenia, and abnormal liver function tests.
While
there remains a great deal to learn about melanoma in children, there are
several fallacies about
the
disease that dermatologists should know. The top five falacies, according to
Dr. Orlow, are:
•
Any new mole that appears suddenly in a child, or a mole that has grown over the
past 6 months,
should
prompt concern about melanoma just as it does in adults. Reality: The
appearance of new nevi
in
children is normal, and it is also normal for nevi to grow and evolve until
they reach their zenith.
•
Nevi on the scalp are particularly worrisome and should be removed because they
are difficult to
follow.
Reality: The scalp is a common site for nevi to arise in white children. Such
nevi will often
have
a targetlike appearance or resemble a fried egg. Many resolve by
adulthood.
•
All atypical/dysplastic nevi must be removed. Reality: Even in patients with the
highest risk, such as
those
with familial atypical mole melanoma syndrome, more than 50% of melanomas will
not have
any
evidence of a preexisting nevus.
•
If melanocytic cells are found in a sentinel lymph node biopsy, it must be
melanoma. Reality: Such
cells
can be found in the lymph nodes of children with Spitz nevi, atypical spitzoid
melanocytic
tumors,
and blue nevi.
•
We can prevent most prepubertal melanomas by applying our experience with
melanoma and
melanoma
risk in adults. Reality: Such melanomas are unusual both clinically and with
respect to the
patients
in whom they arise.
Dr.
Orlow had no disclosures relevant to his presentation.
'Hidden'
cancer cells not a factor in early-stage breast cancer survival rates –
EurekAlert – Contact:
Sandy
Van -
Study
reported in Journal of the American Medical Association
LOS
ANGELES (EMBARGOED UNTIL 3 P.M. CT ON TUESDAY, JULY 26, 2011) –A new
study
shows that removing lymph nodes due to the presence of occult, or microscopic,
cancer cells
found
in the sentinel lymph node – the one closest to the tumor -- has no impact on
survival outcomes
of
women with early-stage breast cancer. The principal investigator of the study
is Armando E.
Giuliano,
MD, of Cedars-Sinai, who already is renowned for his clinical expertise and for
his seminal
research
on lymph node removal in women with early-stage breast cancer.
The
latest study, conducted by the American College of Surgeons Oncology Group
(ACOSOG) and
supported
by the National Cancer Institute, was published in the July 27 issue of the
Journal of the
American
Medical Association. Giuliano is the executive vice chair of surgery for
surgical oncology
and
holds several leadership positions at Cedars-Sinai's Samuel Oschin
Comprehensive Cancer
Institute.
His
previous findings related to sentinel lymph node biopsy and cancer diagnosis
revolutionized the
accepted
approach to treating early-stage breast cancer. His groundbreaking research,
published
earlier
this year in the Journal of the American Medical Association, challenged the
commonly held
belief
that removing all lymph nodes– not just the sentinel nodes closest to the
tumors – was key to
improving
survival rates.
The
ACOSOG research showed the opposite: Survival outcomes were no different
between women
undergoing
total lymph node removal and those only having the sentinel lymph node removed.
This
finding
dramatically changed the surgical approach for these patients. Women now can be
spared the
pain
and side effects of comprehensive lymph node removal.
In
this new study, Giuliano and colleagues sought to determine whether there is an
association
between
patient survival rates and the presence of microscopic cancer cells that have
spread from an
early-stage
tumor to nearby lymph nodes.
Occult
metastases usually cannot be seen in routine pathological or clinical
examination. The tiny cells
were
detected with immunochemical staining of sentinel lymph nodes and bone marrow
specimens
from
patients with early-stage breast cancer.
Some
5,210 women with breast cancer enrolled in the American College of Surgeons
Oncology
Group
trial at 126 sites nationwide from May 1999 to May 2003. All subjects underwent
breast-
conserving
surgery and sentinel lymph node dissection.
"This
study shows that the presence of tiny sentinel lymph node metastases has no
bearing on survival
outcomes,"
said Giuliano, co-director of the Saul and Joyce Brandman Breast Center – a
Project of
the
Women's Guild.
According
to Giuliano, removing lymph nodes can cause complications such as lymphedema,
a
chronic
and often painful swelling in the arm that can be debilitating. "Treating the
patient doesn't end
with
stopping the cancer," he says. "We want to make sure we maximize the patient's
quality of life
even
after cancer treatment is completed."
Lymph
Node Test Doesnt Improve Breast Cancer Care, Study Finds - U.S. News &
World Report
–
By Maureen Salamon -
Tiny
cancer cells found in first node to which disease typically spreads did not
affect survival
TUESDAY,
July 26 (HealthDay News) -- A lymph node-sparing test hailed as revolutionary
for its
conservative
approach does not lead to longer survival times for women undergoing
lumpectomies
whose
early-stage breast cancer has spread microscopically, a large, new study
suggests.
Examining
the medical records of more than 5,200 patients who underwent
breast-conserving
surgery
for early, invasive breast cancer, researchers found that tiny cancer cells in
the sentinel lymph
node
-- the first node to which malignant cells are likely to spread from a primary
tumor -- detected
with
a diagnostic procedure called immunohistochemical (IHC) staining had no effect
on overall
survival.
The
biopsy procedure known as sentinel lymph node (SLN) dissection has been praised
for averting
the
removal of large numbers of armpit lymph nodes during breast cancer surgery,
which can lead to
a
painful buildup of fluid called lymphedema.
"I
think I'd have to say it was highly controversial whether these occult [hidden]
metastases would be
clinically
relevant," said study author Dr. Armando Giuliano, chief of surgical oncology
at Cedars-
Sinai
Medical Center in Los Angeles. "If it's not going to affect mortality, it
shouldn't affect treatment."
The
study is published in the July 27 issue of the Journal of the American Medical
Association.
The
observational study included data from women included in the American College
of Surgeons
Oncology
Group trial at 126 sites from May 1999 to May 2003, and all patients were
followed until
April
2010. Results were blinded to treating physicians to avoid the bias of
overtreatment, Giuliano
said.
At
a midpoint follow-up of 6.3 years, 435 women had died and 376 experienced
recurrence of their
cancer.
Based on IHC staining, five-year overall survival rates of those whose samples
tested positive
for
node involvement were 95.1 percent, compared to 95.7 percent for those whose
SLN biopsies
tested
negative. Corresponding five-year rates of disease-free survival were 90.4
percent and 92.2
percent,
respectively.
Giuliano
said the research, when adopted clinically, can save patients several hundred
dollars or more
in
unnecessary tests. Women with microscopic metastases in their SLNs can also be
spared from
certain
more aggressive treatments that were thought to increase their survival rates,
he said.
Dr.
Lora Weiselberg, chief of breast cancer service at the Monter Cancer Center of
North Shore-
LIJ
Health System in Lake Success, N.Y., said many physicians have questioned the
significance of
the
SLN biopsies evaluated in the study.
"In
certain cases . . . we would want to do them anyway, but otherwise I think this
is very strong
evidence,"
Weiselberg said. "I think more and more pathology laboratories are going to go
in that
direction
[of fewer tests] because adding another costly test, if it's not going to help
the patient, is
unnecessary."
More
information
The
U.S. National Cancer Institute has more on sentinel lymph node
biopsies.
Copyright
© 2011 HealthDay. All rights reserved.
July
27, 2011
Expert
Panel Issues Lymphedema White Paper: Calls for Early Detection and and
Intervention to
Reduce
Lymphedema Progression - PR Newswire (press release) –
Avon
Foundation for Women-sponsored white paper reports latest lymphedema clinical
advances
that
could benefit many of the 2.3 million U.S. breast cancer survivors
NEW
YORK, July 27, 2011 /PRNewswire-USNewswire/ -- An expert panel issued a white
paper
examining
new evidence that shows early detection and intervention hold the greatest
promise for
reducing
breast cancer-related lymphedema, which affects up to one-third of the 180,000
newly
diagnosed
breast cancer patients annually and 2.3 million breast cancer survivors in the
United States.
The
Avon Foundation for Women, in partnership with the Lymphatic Research
Foundation and the
National
Lymphedema Network, convened a group of leading scientists, clinicians and
advocates in
April
2011 to discuss recent advances in the early detection and early intervention
of upper extremity
lymphedema.
The expert panel produced several recommendations, which are shared in a white
paper
released today, Recent Advances in Breast Cancer-Related Lymphedema Detection
and
Treatment.
Breast
cancer-related lymphedema is a chronic, debilitating disorder following
surgery, chemotherapy
or
radiation therapy that causes limb swelling and chronic inflammation. According
to the white
paper,
monitoring for lymphedema onset in breast cancer patients is essential—and
medically
necessary—and
should include capturing baseline arm volume measurements prior to treatment
and
follow-up
measurements at regular intervals once breast cancer treatment is completed. By
the time
lymphedema
is visually detectable, it has already progressed to advanced stages. Regular
surveillance,
using tools such as perometry or bioimpedance spectroscopy (BIS), in the years
following
breast cancer treatment can reduce the development of irreversible lymphedema
and
improve
quality of life.
"Lymphedema
can have devastating physical and emotional consequences for breast cancer
survivors,"
said Marc Hurlbert, executive director of the Avon Foundation for Women Breast
Cancer
Crusade.
"The expert panel's recommendations for lymphedema care can dramatically change
the
lives
of breast cancer patients. Early detection of lymphedema can identify
sub-clinical lymphedema
at
a time when simple, cost-effective interventions can be used to prevent it from
evolving into
advanced
stages of lymphedema and reduce the condition's severity."
The
white paper recommends that breast cancer survivors be closely monitored for
the development
of
lymphedema and learn how to reduce their risk of developing the disorder, such
as by recognizing
the
physical triggers (e.g. cuts or burns on the fingers) that may transform the
disease from latent to
active
and by maintaining meticulous skin care hygiene and a healthy body weight.
Recent studies in
weight
lifting, exercise and weight loss also have demonstrated a benefit in
preventing lymphedema:
stretching,
aerobics and arm and leg weight lifting resulted in fewer flare-ups among
patients with
lymphedema
and reduced the chance of developing the condition among at-risk patients by
70%.
"The
Lymphatic Research Foundation (LRF) and our National Lymphatic Disease and
Lymphedema
Registry
(NLDLR) were pleased to partner with the Avon Foundation for Women in
co-sponsoring
this
important conference," said Jacqueline Reinhard, executive director of the
Lymphatic Research
Foundation.
"Publication of the resulting White Paper – Recent Advances in Breast
Cancer-Related
Lymphedema
Detection and Treatment – provides a much-needed resource for the many
patients
living
with lymphedema, as well as the researchers and treatment professionals
involved in this field."
At
the Avon Foundation symposium, the National Lymphedema Network (NLN) also
shared its
recent
position paper on lymphedema screening and treatment. The NLN's position paper
recommends
all breast cancer patients receive pre- and post-treatment measurements on both
arms,
as
well as consistent measurements throughout their treatment, and use
bioimpedance spectroscopy
(BIS)
or infrared perometry as alternatives to a tape measure. These precautions have
proven to
reduce
the occurrence of false negative and false positive results which could be
obtained by using a
tape
measure.
For
more information about lymphedema or to download Recent Advances in Breast
Cancer-
Related
Lymphedema Detection and Treatment or the National Lymphedema Network's recent
white
paper, please visit
www.avonfoundation.org/programs-and-events/lymphedema-information.
html.
Avon
Foundation for Women
The
Avon Foundation for Women, the world's largest corporate-affiliated
philanthropy focused on
issues
that matter most to women, was founded in 1955 to improve the lives of women.
Through
2010,
Avon global philanthropy has donated more than $800 million in more than 50
countries for
causes most
important to women. Today, Avon philanthropy focuses its funding on breast
cancer
research
and access to care through the Avon Breast Cancer Crusade, and efforts to
reduce
domestic
and gender violence through its Speak Out Against Domestic Violence program.
Avon also
responds
generously to provide support for relief and recovery efforts in times of major
natural
disasters
and emergencies.
Avon
Breast Cancer Crusade
Since
the Avon Breast Cancer Crusade launched in 1992, Avon breast cancer programs in
more
than
50 countries have raised almost $700 million for research and advancing access
to care,
regardless
of a person's ability to pay. The Avon Foundation for Women awards funding to
beneficiaries
ranging from leading cancer centers to community-based grassroots breast
health
programs
to support breast cancer research and access to care. In addition to receiving
generous
support
from Avon Products, Inc., and its sale of Avon "pink ribbon" products, the
Foundation raises
funds
through a variety of events, such as the U.S. Avon Walk for Breast Cancer
series, which is the
Foundation's
largest fund-raising source.
Available
Topic Expert(s): For information on the listed expert(s), click appropriate
link.
Marc
Hurlbert, Ph.D.
https://profnet.prnewswire.com/Subscriber/ExpertProfile.aspx?ei=95833
SOURCE
The Avon Foundation for Women
July
29, 2011
770
lb. Lakeland woman learns help is close by - WTSP 10 News – by Tammie Fields
–
Lakeland,
Florida - For a little more than two months, a hospital room has been home for
Yvonne
Gallimore.
She even celebrated her 52nd birthday in the hospital. Balloons and flowers
decorated her
room
Friday morning.
For
the past 17 years, Gallimore has battled a medical condition called Lymphedema.
It's caused by
a
blockage that allows fluids to build up in the body, causing excessive
swelling.
Gallimore
weighs 770 pounds.
After
a recent infection in her leg, she was transported to Lakeland Regional Medical
Center. While
the
infection was cleared up in about a week, she couldn't go home because her
Section 8 apartment
was
badly damaged during the process of removing her to get her to the
hospital.
Gallimore's
sister, Alnieta McKenzie, was moved to tears recently when she stumbled across
the
hospital's
website for Lakeland Regional Rehabilitation and Sports Medicine Clinic, which
is located
about
four miles away from the hospital. She says her family didn't know about the
clinic.
The
website shows it has therapists on staff specially trained in
Lymphedema.
With
tears streaming down her face, McKenzie says, "We've seen her get mistreated so
many times
because
of her size and people passing the buck like the doctor could have said, 'OK,
you have
Lymphedema.
Let's do something while you're here in the hospital. We don't have anything
else to
treat.'"
10
News spoke with Cindy Sternlicht, the director of Public Relations and
Marketing
Communications
for Lakeland Regional Medical Center. While privacy laws prohibit her from
talking
about
Gallimore's case, she explained how the clinic operates.
Sternlicht
says, "Lakeland Regional has an outpatient rehabilitation clinic. We do have
certified
Lymphedema
therapists."
But
she says patients have to be able to get to the facility on their own, which is
something that
Gallimore
can't do because she can't walk.
Sternlicht
adds, "You have to be able to get out of the vehicle, get into the facility,
and get yourself
onto
the patient bed."
McKenzie
says while they appreciate the care Gallimore has received at Lakeland Regional
Medical
Center,
they just can't understand why the inpatient hospital and the outpatient clinic
couldn't work
together
to offer some type of solution to help her sister.
McKenzie
broke down and put her hand over her eyes to cry and said, "Excuse me. I'm
sorry. It's
just
because we love her and we want what's best for her."
On
Friday evening, Gallimore was slated to be released from the hospital. She's
staying at a different
Section
8 apartment for now that is specially equipped so she can be transported inside
through two
french
doors.
Gallimore
has both Medicaid and Medicare and says her coverage for her hospital stay
ended on
July
11th. She says she doesn't know how much the hospital stay will cost.
Her housing
there is temporary, however, because an anonymous donor has volunteered to
build her
and
her family a free home that will accommodate her special needs.
Meanwhile,
Gallimore's family says neither her doctor nor her nurse practitioner have
written
Gallimore
an order that would allow her to seek treatment at the Lakeland Regional
Rehabilitation
and
Sports Medicine Clinic.
September 2, 2011
Healthy
Living: TruJoy promotes breast cancer education – YNN – by Web Staff
-
If
you were told your chance of getting cancer was 90% - what would do? How would
you change your
life?
Marcie Fraser shares one woman's inspirational story.
When
Trudie Kelly's mom lost the battle from both ovarian cancer and breast cancer,
genetically, she knew
the
odds were against her.
"I
carry the genetic mutation. I decided at that point and time to have a complete
hysterectomy so that would
alleviate
the ovarian risk," said Trudie Kelly, TruJoy Founder.
Two
years after her hysterectomy, she found a cancerous tumor in her left breast.
Trudie decided to have a
double
mastectomy.
"I
ended up had a routine MRI before the surgery and found I had it in my right
side also that didn't show up
in
the mammogram," said Trudie.
It's
been a year after surgery and treatment, her prognosis is excellent. After
experiencing cancer, Trudie
Kelly
was on a mission.
"Once
you have been through it, I knew what was missing, I knew the pieces that were
missing for women
and
that is what I wanted to address," said Trudie.
She
created TruJoy.Inc, an organization to hold breast cancer educational forums,
support, and a tool kit for
comfort.
"We
have included a reacher, a mastectomy pillow, a stress ball to alleviate any
kind of swelling that may
lead
to lymphedema down the road," said Trudie.
One
of TruJoy’s objectives is community education, targeting young women and
teaching them about the
risk
factors for breast cancer.
In
an effort to raise money for the tool kits and the education forums, a
motorcycle poker run is being held.
For
more information, visit www.trujoy.org.
September
4, 2011 –
Gene
Defect Predisposes People to Leukemia - Science Daily –
A
new genetic defect that predisposes people to acute myeloid leukemia and
myelodysplasia has been
discovered.
The mutations were found in the GATA2 gene. Among its several regulatory roles,
the gene acts
as
a master control during the transition of primitive blood-forming cells into
white blood cells.
The
researchers started by studying four unrelated families who, over generations,
have had several relatives
with
acute myeloid leukemia, a type of blood cancer. Their disease onset occurred
from the teens to the
early
40s. The course was rapid.
The
findings will be reported Sept. 4 in Nature Genetics. The results come from an
international
collaboration
of scientists and the participation of families from Australia, Canada, and the
United States.
In
collaboration with Dr. Hamish Scott and Dr. Richard J. D'Andrea at the Centre
for Cancer Biology,
University
of Australia, Adelaide, the U.S. portion of the study was conducted by Dr.
Marshall Horwitz,
University
of Washington (UW) professor of pathology. Horwitz practices genetic medicine
at UW Medical
Center
and the UW Center for Human Development and Disability, both in
Seattle.
The
genetic mutation was first discovered in a patient from central Washington. The
research participant had
been
successfully treated for leukemia in 1992 through a bone marrow transplant at
UW Medical Center. At
that
time, Horwitz decided to seek a possible genetic reason after learning his
patient had several family
members
with myelodysplastic syndrome, myeloid leukemia, and intractable mycobacteria
infections.
Myelodysplastic
syndrome is a difficulty in producing certain kinds of blood cells. The problem
originates in
the
bone marrow with a decline in the number and quality of blood-forming cells.
Patients often have severe
anemia and need
frequent blood transfusions. The disease generally worsens due to bone marrow
failure and
low
blood counts. About one- third of those with the syndrome soon develop acute
myeloid leukemia, in
which
abnormal white cells build up in the bone marrow and interfere with normal
blood production.
Horwitz's
Australian colleagues had described a family with a similarly inherited blood
disorder. Eighteen
years
later, after rifling through many candidate genes, the researchers on both
continents were relieved
finally
to have hit upon the mutated gene responsible for the leukemia that affect
these families. They have
gone
on to identify abnormal GATA2 genes in more than 20 families and
individuals.
"It's
likely that this inherited error is more common than we had thought," the
researchers noted. In some
families
with a GATA2 mutation, the over-riding concern has been leukemia, while others
suffer dangerous
infections
from bacteria, viruses and fungi because of a lack of white blood cells to
fight off germs.
The
lab of Dr. Dennis Hickstein, formerly of the UW School of Medicine and the
Puget Sound Veterans
Affairs
Health System and now at the National Institute of Health, in collaboration
with NIH colleague Dr.
Steven
Holland, associated the mutation with mycobacteria infections. Those results
were reported in
separate
study appearing in the journal Blood.
Activcare
Physical Therapy Announces Executive Drive Office Grand Opening On September 12
-
dBusinessNews
Triangle –
Triangle
- Activcare Physical Therapy, Raleigh NC’s premiere physical therapy practice,
has expanded
operations
to serve the community around Duke Raleigh Hospital with the opening of a new
clinic on
Executive
Drive.
RALEIGH,
NC: Brad Hancock, MPT, of Activcare Physical Therapy, is pleased to announce
the opening
of
their newest clinic at 3410 Executive Drive, Suite 205 in Raleigh, adjacent to
Duke Raleigh Hospital,
formerly
Raleigh Community Hospital. Opening day will be celebrated at the new clinic on
Monday,
September
12 with lunch from 11:30am to 2:00pm and wine and cheese at 5:00pm.
Visitors
will be able to tour the new facilities as well as meet the knowledgeable and
experienced therapists
at this state-of-the-art clinic. Services offered at this facility include: orthopedic therapy, sports related
injuries,
neck and back pain and injuries, pain management, neurological rehabilitation,
geriatrics, oncology-
related
and lymphedema therapy and cardiovascular conditioning therapy, as well as
balance and vestibular
dysfunctions.
“It is our
mission to not only provide the highest quality physical therapy services, but
to provide a friendly
and
supportive atmosphere to our patients,” said Hancock. “This patient-centric
approach helps ensure that
patients
will reach their goals through continued treatment, and it is the key to our
continued growth in the
Triangle
market.”
For
more information about Activcare Physical Therapy, visit www.activcarept.com or
call 919-786-7434.
About
Activcare Physical Therapy
Activcare
Physical Therapy, with convenient locations in Raleigh and Fayetteville, NC
provides physical
therapy
services with a strong emphasis on orthopedic injuries, geriatrics, women’s
health, neurological,
incontinence,
general conditioning/cardiovascular, balance and vestibular disorders, foot and
ankle
biomechanics,
spine treatments including cervical decompression therapy and oncology-related
and
lymphedema
therapies. Our quality therapy services provide continuity of health services
and positively
influence
their patient outcomes. Activcare provides patients from all walks of life with
world-class,
comprehensive
physical and occupational therapy services that improve function, encourage
independence,
and
enhance quality of life. For more information, visit www.activcarept.com or
call 919-786-7434.
Media
Contact:
Charlie
Caserta
Activcare
Physical Therapy
[email protected]
919-786-7434
www.activcarept.com
September
5, 2011
Swollen
ankles have several possible causes - The Detroit News – Dr. Paul Donohue
–
Dear
Dr. Donohue: I am a diabetic male, age 96, with many aches and pains but no
high blood pressure. I
have
low cholesterol and am in control of my diabetes. In the past few weeks, I've
noticed swelling of my
ankles and feet. I have been taking two water pills a day for it. I never use salt or eat salty foods. What can
you
suggest for me?
Dear
S.S.: That swelling is edema, and it has many causes. One is sitting for long
periods with the legs
dangling
down. With the legs in that position, gravity pulls fluid from the legs' blood
vessels. Treatment for
this
kind of edema consists in elevating the legs. Every hour, lie down for 10
minutes with pillows under your
legs
and feet so that they are above heart level. When sitting, squeeze the leg
muscles over and over. Muscle
contractions
stop the oozing of fluids from the blood vessels. And take a morning and
afternoon walk.
Elastic
hose can keep fluid in blood vessels and out of the surrounding
tissues.
Dilated
leg veins — varicose veins — promote edema. A clot in a leg vein is another
cause. That's usually
quite
painful, and you'd be aware that something is going on if you had a clot. Liver
ailments can lead to
edema.
The liver makes a blood protein, albumin, that keeps fluid in circulation. With
a low production of
this
protein, fluid leaks out of vessels. Kidney failure is another reason why edema
occurs. Medicines can
lead
to it.
The
booklet on edema and lymphedema explains this kind of swelling. Readers can
obtain a copy by writing:
Dr.
Donohue — No. 106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money
order (no
cash)
for $4.75 U.S./$6 Can. with the recipient's printed name and address.
Write
to Dr. Donohue at P.O. Box 536475, Orlando, FL 32853-6475.
Another
paper appearing Sept. 4 in Nature Genetics from a London group found similar
mutations of
GATA2
in leukemia patients with lymphedema and, in some cases, deafnesss. By blocking
the vessels that
drain
fluid from the body's tissues, lympedema causes swelling of the arms or
legs.
Ongoing
work in Seattle and Adelaide has identified a congenital syndrome associated
with developmental
delay
and a risk of myelodysplasia. This syndrome results from chromosomal loss of
GATA2 and adjacent
genes.
Comparable
GATA2 mutations also have been found in people with the more common,
non-inherited
leukemias.
Scientists
are trying to figure out why apparently similar gene mutations in GATA 2 cause
such assorted
health
problems. Also perplexing is how hard it has been to find genetic errors
underlying blood cancers,
compared with
other cancers.
"While
several genes have been discovered and linked to solid, malignant tumors such
as breast cancer in
families
susceptible to those types of cancer, so far very few inherited mutations have
been uncovered for
blood
cancers," Horwitz said.
Previously,
other scientists linked mutations in two other genes -- RUNX1 and CEBPA -- to
injerited forms
of
myelodysplastic syndrome and acute myeloid leukemia. These genes bind to DNA
and control the
copying
of information encoded in this molecule.
Keeping
this in mind, researchers looked for mutations in similar genes in families who
did not have the
RUNX1
and CEBPA mutations and who had no other explanations for their inherited blood
cancer. In so
doing,
the researchers identified the GATA2 mutations. They also observed that these
mutations relate to
loss
of function by making the gene unable to perform the molecular duties necessary
to manufacture healthy
white
blood cells.
According
to Horwitz, the GATA2 mutations in DNA occur adjacent to an amino acid mutated
in some
patients
with terminal chronic myeloid leukemia. This proximity suggests a common
pathway may be critical
for
several types of myeloid malignancies, he said.
People
at risk because of their pedigree eventually may obtain tests to detect this
genetic error before
symptoms
emerge. Learning that they have the gene mutation might help patients and their
doctors decide on
appropriate
follow-up for early diagnosis and treatment of problems that might
arise.
Additional
knowledge about how the GATA2 gene and its mutations operate may foster the
development of
new
therapeutic agents.
A
clinical trial under way in the United States may point to specific treatment
recommendations for persons
with
a GATA2 genetic mutation.
The
research for "Heritable GATA2 Mutations Associated with Familial
Myelodysplastic Syndrome and
Acute
Myeloid Leukemia," was supported by grants from the National Health and Medical
Research
Council
of Australia, a Dora Lush Postgraduate Award, Leukaemia Foundation of
Australia, the Cancer
Council
of South Australia, MedVet Pty Ltd., and the U.S. National Institutes of
Health.
The
researchers extend their gratitude to the families and individuals who
participated in this project.
Horwitz
has been invited to speak on the role of GATA2 in myelodysplastic syndromes at
a National
Institutes
of Health conference Sept. 7-8 in Bethesda, Md.
September
15, 2011
National
Walk For Lymphedema And Lymphatic Diseases – Garden City News –
As
Executive Director of the Lymphatic Research Foundation, Garden City resident
Jacqueline Reinhard
coordinated
the organization’s first walkathon last September at Belmont Lake State Park.
“It was a
resounding
success,” says Reinhard, “and the idea has clearly caught on with lymphatic
disease patients
around
the country. In the coming weeks the National Walk for Lymphedema and Lymphatic
Diseases will
take
place in Texas, New York, and Massachusetts!”
Founded
in 1998 by Roslyn resident Wendy Chaite, LRF has become a leader in patient
advocacy and a
primary
force behind advancements in lymphatic science worldwide. LRF’s advocacy
programs have been
effective
in gaining Congressional and National Institutes of Health (NIH) support for
lymphatic research at
the
National Institutes of Health and at major academic research centers, elevating
lymphatic diseases from
relative
obscurity to a position on par with other national health priorities. The
organization directly funds
cutting-edge
lymphatic research by funding Postdoctoral Research Fellowship Grants, a
National Lymphatic
Disease
Patient Registry and Tissue Bank, a peer-review biomedical journal in
lymphatics, and the first-ever
endowed
academic Professorship in Lymphatic Research and Medicine (Stanford University
Medical
School,
2008). Reinhard became the Foundation’s first executive director in July
2008.
The
New York Walk will be at Eisenhower Park in East Meadow on September 24th.
Registration begins
at
1:00 p.m. “I’m inviting all our Garden City neighbors to join this effort, said
Reinhard, “ . . . and promising
a
fun afternoon of live entertainment, refreshments, and the great feeling you
get in supporting an important
and
meaningful cause.” To learn more about the Walk, to register or donate, go to
www.walklrf.org.
The
Skin IQ™ Mattress Cover Does More to Lower Costs of Pressure Ulcers - Online PR
News (press
release)
–
With
the current economic climate, hospitals and long-term care facilities are
looking to find innovative ways
to
cut costs. Vascular PRN™ provides compression therapy equipment to treat
ulcers, deep vein
thrombosis,
and lymphedema, so they uniquely know the pressures that nurses, hospital
directors, and
nursing
home administrators are under to save money.
Online
PR News – 15-September-2011 –With the current economic climate, hospitals and
long-term care
facilities
are looking to find innovative ways to cut costs. It is not every day that new
products make their
way
into a patient’s room that cut down health care costs, workload, and the cost
of medical treatment.
“We
were floored when we found the Skin IQ™ Microclimate Manager,” said Vascular
PRN’s president
Greg
Grambor. “This KCI coverlet costs $6 a day versus low air loss mattresses that
usually cost our clients
$30
a day.”
Vascular
PRN™ provides compression therapy equipment to treat ulcers, deep vein
thrombosis, and
lymphedema,
so they uniquely know the pressures that nurses, hospital directors, and
nursing home
administrators
are under to save money. Every day they help specialists in long-term and
critical care centers
to
find the right products at the best value.
“Pressure
ulcers are a major cost and cause more treatment, regulatory fines, and the
potential for a lawsuit
in
health care settings every day,” said Grambor. “For KCI to address this big
need is huge to prevent and
manage
a patient’s skin breakdown and pressure ulcers.”
The
National Pressure Ulcer Advisory Panel says that, “Support surfaces are an
integral part of any plan of
care
for the prevention and treatment of pressure ulcers.” The Skin IQ™ waterproof
mattress cover
promotes
healing and addresses the variety of challenges an immobile person has. It
reduces moisture from
the
skin’s surface, reduces skin temperature while maintaining a patient’s comfort,
and has powerful odor
control
features. KCI’s case studies show that patients with stool incontinence, skin
breakdown, bariatric
concerns,
and associated issues can greatly benefit from using the Skin IQ™ within days
or a few weeks.
“The
Skin IQ™ is 30 percent better than the average healthcare facility mattress
cover,” said Grambor. “It
is
easy to use and fits over any pressure re-distribution mattress.”
The
Skin IQ™ pulls air down through the mattress cover and cools a patient’s
contact points while pulling
moisture
away. This is more effective than low air loss, which blows warmed room air up
through the
mattress.
A Skin IQ™ mattress cover prevents new pressure ulcers and better treats
existing ones, thus
helping
the health care field to lower their overall costs on the non-reimbursable,
"never events" of decubitus
ulcers.
To
learn more, visit www.vascularprn.com or call 800-886-4331. Vascular PRN’s
website at www.
vascularprn.com
is the go-to site for directors of nursing, nursing home administrators, and
medical
professionals
to find out more about the Skin IQ™ MCM and compression therapy. The site
spotlights
industry
news, frequently asked questions, and director of nursing and healthcare
jobs.
September
14, 2011
Pink
Ribbon Program at Avon Rec Center Friday, Saturday - Vail Daily News
–
AVON
— The Pink Ribbon Program is an exercise program designed specifically for
post-operative breast
cancer
survivors. Program founder and director of the Pink Ribbon Program, Doreen
Puglisi, became aware
of
the need as she herself was diagnosed with breast cancer. She used the Pink
Ribbon Program to regain
her
range of motion, as well as strength in her affected arm.
The
Avon Recreation Center will be hosting a two-day workshop on Friday and
Saturday for individuals
who
come in contact with breast cancer survivors through physical therapy,
occupational therapy, massage
therapy,
personal trainers, nurses, group exercise instructors, lymphedema treatment
specialists and spa
services
such as facials, manicures, etc. The goal of this interactive two-day course is
to provide the
participants
with a knowledge base that is essential to the successful evaluation of the
breast cancer survivor,
from
diagnosis to treatments, recovery, preventions of lymphedema and proper
exercise guidelines and
protocols.
Evidence based practice and integration of material from the areas of
functional exercise, shoulder
rehabilitation
and Pilates exercise will be the emphasis of the course sessions.
The
Pink Ribbon Program is offered on Friday starting from 2 to 8 p.m. and Saturday
from 9 a.m. to 3 p.m.
Workshop
cost is $425 per person, plus $35 for course materials. Space is still
available for this two day
workshop.
Visit www.pinkribbonprogram.com or call 888-445-3089.
September
12, 2011
Komen
QC Affiliate and Gilds's Club to hold educational symposium - Quad-Cities
Online –
Susan
G. Komen for the Cure-Quad Cities affiliate to hold 2nd annual educational
symposium
September
12th, 2011---DAVENPORT, IA—Breast cancer survivors and their supporters are
invited to
launch
breast cancer awareness month in the Quad Cities on October 1st at the 2nd
annual Educational
Symposium
sponsored by the Komen Quad Cities Affiliate and Gilda's Club Quad
Cities.
The
Symposium is an effort to connect survivors to others that share a common
journey and offer discussion
about
topics of interest to survivors, such as lymphedema and breast
reconstruction.
"We
hope that breast cancer survivors take advantage of this opportunity to learn
and heal," said event
organizer
Sheila Soltow. .
The
October 1st event runs from 8 a.m.-1:30 p.m. at the Isle of Capri in
Bettendorf, and includes a lunch
and
panel discussion about the pros and cons of breast reconstruction.
The
cost to attend the event is $15 for survivors and $20 for others. To register
for the Symposium, call
Mackenzie
Batterbee at 563-421-1905. Early registration is encouraged as space is
limited.
The
Susan G. Komen for the Cure-Quad Cities Affiliate was formed in 1999, after the
Komen Quad Cities
Race
for the Cure® began in 1990. Over the past 22 years, the Affiliate has raised
nearly $5 million in the
fight
against breast cancer. For more information on the Affiliate or the Komen Quad
Cities Race for the
Cure,
please visit www.komenquadcities.org
Once-Homeless
Lakeland Woman Awaits Construction of House - The Ledger – By Chase
Purdy
LAKELAND
| Echoing from another room in the house, Yvonne Gallimore's grandchildren
squealed with
delight.
After more than two months in the hospital, it's a sound to which she's still
getting accustomed.
Michael
Wilson | THE LEDGER
Cooped
up in Lakeland Regional Medical Center for longer than she liked, Gallimore
smiled from the
bedroom
of her temporary home in North Lakeland. She pointed to her view of the
backyard.
In
June, an anonymous donor stepped forward with an offer to build Gallimore a new
house. She recently
looked
over the blueprints, she said, but continues to wait for Habitat for Humanity
construction crews to
break
ground.
"There's
no place like home," she said. "There's no place like home."
For
more than a decade she's suffered from a severe case of lymphedema, a condition
that led to an
infection
that left her hospitalized in May. Her medical issues left her weight at about
750 pounds.
On
May 19, medical crews were forced to tear through a wall of her apartment so
she could be transported
to
the hospital. An infection in one of her legs needed immediate medical
treatment, she said.
But
that left her homeless, necessitating a longer stay at LRMC.
"I
was miserable because I didn't have anywhere to go," she said. "It was a
situation that I had no say-so
about."
Lymphedema,
a condition that can be controlled but not cured, creates blockage that
prevents bodily fluids
from
draining well. As a result, Gallimore's legs swelled significantly, preventing
her from moving freely.
With
her weight, Gallimore still cannot move from room to room in her home. Claire
Twomey, the chief
executive
officer of Lakeland Habitat for Humanity, said the new home will be designed to
offer plenty of
room
for mobility.
September
9, 2011
Coping
with breast cancer pain - Baltimore Sun –
This
has passed on Septbember 13 sorry
September
6, 2011
Mammography:
More is not necessarily better - Kansas.com – By Abigail Trafford
Mom
— what are you talking about?" My friend was on a family vacation when her
mother mentioned she
had
to get her annual mammogram. My friend continued: "You don't need a mammogram!
You're 88!"
Her
mother gave her a withering look: "What? I'm so old at 88, you want me to die
of breast cancer?"
So
ingrained is the annual mammogram habit in this country that any challenge to
it is met with a combination
of
scorn and outrage.
We
belong to the pink ribbon sisterhood that worked hard to strike down the stigma
of breast cancer and
get
better care. We walk for the cure. We lobby Congress for research funds. We
demand coverage of
screening,
including high-tech digital mammography. In the past 20 years, deaths from
breast cancer have
gone
down by about 30 percent.
But
what role has screening played in this decline?
At
a forum in March at the Harvard School of Public Health in Boston, physicians
and policy officials
debated
the question "Mammograms: Who in the world are they good for?"
Mette
Kalager, a surgeon at Oslo University Hospital and a visiting scientist at the
Harvard School of Public
Health,
told the forum about a study she had led in Norway.
The
researchers looked at the records of 40,075 women who received diagnoses of
breast cancer between
1986
and 2005. Some had been screened every two years. Others had not been screened;
their cancers
had
been detected by physical examination. Both groups were treated by teams of
specialists. Over the 20-
year
period of the study, both groups saw a decline in death rates from the
disease.
By
comparing the groups, researchers determined that only about a third of this
decline was due to
screening.
Most of it was due to state-of-the art treatment and comprehensive care.
Previous studies had
suggested
a greater impact from screening, and the study, published in the New England
Journal of
Medicine,
caused a stir in the breast cancer community.
A
little history is in order.
When
mammography screening got under way in the United States 40 years ago, it put
breast cancer on the
public
agenda. Catch-it-early-when-it's-curable became a mantra of hope. Since then,
treatments have
improved,
and the understanding of breast cancer has changed. Perhaps more important than
the timing of
detection
is the biology of the cells.
"There
are some very tiny cancers that are just bad biology and are destined to
relapse, no matter how early
you
find them," Julie Gralow, a professor of oncology at the University of
Washington Medical School, told
the
Harvard forum.
And
some cancers don't progress even when they are found late.
"I've
had patients who have had very aggressive, large cancers, which, for one reason
or another, they have
ignored,"
continued Gralow. "And still years later, it never spreads. It doesn't come
back. . . . We're
struggling
to understand the biology."
Diagnosing
a cancer early often leads to more-conservative treatment (such as lumpectomy
instead of
mastectomy),
a great advantage to patients. But the annual mammogram may not be as important
as it once
was
in stemming the death toll.
"The
evidence seems to be that mammography screening plays less and less of a role
in reducing mortality in
countries
of the Western world," Kalager said.
That
may be true for older women in particular. In Europe, mammography screening is
recommended only
for
women ages 50 to 69. Yet when Kalager and her colleagues studied breast cancer
patients ages 70 to
84,
they saw a reduction in mortality that "was largely the same" as in younger
women who were screened.
The
key for both groups was access to good care.
But
Felicia Knaul, director of the Harvard Global Equity Initiative, offered a
different view: "I was diagnosed
with
a breast cancer 3 1/2 years ago in my first baseline mammogram at age 41," she
said. "If anything saved
my
life, in addition to expert care, it is that mammogram."
The
room went quiet. How to resolve the experience of Knaul with the findings of a
study based on more
than
40,000 women? Furthermore, as Knaul pointed out, many women, especially in
developing countries,
do
not have access to the state-of-the art care.
Such
is the conundrum for policymakers in setting health guidelines: Personal
anecdote often clashes with
wider
research. But screening policies should be based on evidence from large-scale
population studies: the
greatest
good for the greatest number.
The
United States has the most expansive mammography screening standards in the
world, starting at age
40
and continuing every year. But more is not necessarily better in health
care.
Wide-net
screening can cause harm, leading to over-detection, over-diagnosis and
unnecessary treatment,
according
to Kalager and other researchers. Once a woman has a suspicious mammogram, she
gets on a
medical
train and can't get off until the doctor-conductor gives the all-clear
signal.
Often
that requires just a repeat test. But some women are treated for cancers that
are not invasive or are
too
slow-growing to endanger their health. They undergo surgery or drugs or
radiation with side effects such
as
blood clots, breathing problems, lymphedema and high blood pressure.
"I
don't know how to weigh the over-detection piece," said Gralow. "We clearly
have to sort that one out."
Yes,
there's a lot of sorting out to do. My friend's mother, who believed in annual
screening, obviously
managed
her health pretty well. She never got breast cancer and lived to age 94. But my
friend was also
right:
Research is on her side.
More
coverage
Today's
story is the first in a series dealing with breast cancer. Find more in next
week's Healthy Living.
If
you go
2011
Komen Wichita Race for the Cure
What:
More than 10,000 people are expected to participate in the local benefit for
Susan G. Komen.
When:
Sept. 24. Registration begins at 6:45 a.m., followed later in the morning by
activities, including a
breakfast
and celebration for survivors. The competitive timed 5K is at 8 a.m., and the
non-competitive 5K
is
at 8:15 a.m.
Where:
At Douglas and Armour near Towne East Square
How
much: Advance registration before Sept. 24 is $30 for the competitive and $25
for noncompetitive
races.
Registrants receive a T-shirt.
To
register or learn about the complete schedule and additional related special
events — including Sleep-in
for
the Cure and Kids for the Cure — visit www.komenmidks.org or call
316-440-7033.
Breast
cancer in Kansas by the numbers
*
1,780: The approximate number of women diagnosed with breast cancer in Kansas
last year.
*
370: The estimated number of women who died from breast cancer in Kansas last
year.
September
20, 2011
NARH
Offers Q&A Session on Hyperbaric Wound Care - iBerkshires.com –
NORTH
ADAMS, Mass. — North Adams Regional Hospital will host a question-and-answer
session with
the
wound-care experts from the Wound Healing Center of the Berkshires on Tuesday,
Oct. 4, from 6:30 to
8
p.m.
The
free event takes place at the VNA & Hospice of Northern Berkshire Community
Room. Pie and coffee
will
be served. Registration is requested by calling 413-664-5142.
Dr.
Fred Landes, center Director Kelly Morse and hyperbaric oxygen technician
Gladys Conklin will take
questions
on wounds resulting from radiation side effects, lymphedema, diabetes,
peripheral vascular
disease,
and injuryThey will also discuss new state-of-the-art techniques used to heal
wounds including
hyperbaric
oxygen therapy.
The
Wound Healing Center opened in 2009 and has been recognized as a top-performing
center among all
those
operated in collaboration with National Healing Corp. The Wound Center boasts a
“heal rate” of 96
percent,
meaning that 96 percent of patients’ wounds are healed within nine
visits.
Landes
is a board-certified emergency medical physician and is the Wound Healing
Center’s medical
director.
He received his training from the New York Presbyterian Hospital, Cornell
University, in New
York
City.
Morse
is a registered nurse and has worked in the health-care field for 32 years.
Conklin is a licensed
practical
nurse.
September
20, 2011
Breast
Surgeon Addresses the Worries, the Wonders and the What-to-dos of Breast Health
– TribLocal –
Join
Breast Surgeon Jennifer Gambla, M.D., of Palos Community Hospital, as she
discusses the latest
mammogram
recommendations, measures to prevent breast cancer and the multiple steps
involved in
diagnosing
breast health concerns. This free event will be held on Monday, Oct. 3 from
6:30 p.m. to 7:30 p.
m.
at Palos Health & Fitness Center, 15430 West Avenue in Orland Park. Call
708-226-2300 to register.
Palos
Community Hospital's Comprehensive Breast Program combines the technological
capabilities of
digital
mammography, ultrasound and magnetic resonance imaging with a highly skilled
and compassionate
staff.
You benefit from the talents of radiologists who are fellowship-trained in the
field of mammography.
Breast
exams and procedures under all imaging modalities, as well as breast surgery,
are performed at Palos
Community
Hospital. Whether you need a routine exam or have a more serious breast
concern, you can
trust
Palos Community Hospital.
The
breast care treatment team at Palos Community Hospital provides a
multidisciplinary, integrated and
comprehensive
approach to screening, diagnosis and treatment. Our complete continuum of
services include:
Digital
Mammography, Breast Ultrasound, Stereotactic & Ultrasound Guided Needle
Biopsy, Excisional
Breast
Biopsy, Breast MRI and MRI Guided Needle Biopsy, Ultrasound Guided Cyst
Aspirations, Surgical
Treatment for
Breast Cancer, Breast Reconstruction and Lymphedema Program and Support
Group.
To
schedule a digital mammogram or other Breast Imaging service, call (708)
827-2030.
September
20, 2011
Hospital
celebrates National Rehab Week - Journal-Advocate –
Sterling
Regional MedCenter Rehabilitation department is celebrating National
Rehabilitation Awareness the
week
of Sept. 18-24. The mission of National Rehabilitation Awareness Week is to
educate people about
the
benefits and impact of rehabilitation and give credit to those who help people
with disabilities live up to
their
fullest potential through rehabilitation.
Sterling
Regional MedCenter's rehab department offers comprehensive therapy services
including physical
therapy,
occupational therapy, speech therapy, cardiac rehab, and the new oncology rehab
program.
Patients
receive individualized therapy programs that address a wide variety of patient
needs. The goal of
therapy
is to return patients to their highest level of function as quickly and safely
as possible.
The
oncology rehab program was created to assist individuals with cancer move past
the challenges of their
diagnosis.
Cancer treatment can be both physically and mentally challenging. Each
patient's experience is
different
and each patient faces unique side effects.
The
oncology rehab program provides specialized treatments to cancer patients
including a thorough
evaluation
to access baseline values (endurance, strength, flexibility and range of
motion) which lets the
rehab
providers create a specialized treatment program for each patient's unique
needs. Each session is
designed
to address the individual's needs and provides extensive education to assist in
recovery.
"The
physical therapy program for cancer patients is very good. I think the support
you receive helps
patients
to have a positive attitude," said Henry Littler, program
participant.
"It
is easy to be inactive during this time due to the side effects most patients
experience," notes Littler. "The
program
and the therapist offer a challenge to get stronger physically as well as
mentally because of the
weight
loss and other effects that one experiences from treatment. I would recommend
this program for
patients
going through treatment!"
The
program also offers lymphedema services provided by an occupational therapist
certified in upper
extremity
lymphedema therapy. These treatment options include manual lymph drainage,
bandaging,
exercise,
and skin care to assist in the effective management of this
condition.
Chemotherapy,
radiation, and surgical patients can all benefit from this exercise program, no
matter what
stage
of their diagnosis.
"We
are excited to offer a program that can help people through all stages of
recovery - from the initial
diagnosis
to possible side effects felt years after," said Amy Baseggio, occupational
therapist and certified
lymphedema
therapist at Sterling Regional MedCenter. "This is a unique program that is
meant to give those
with
a cancer diagnosis one more way to regain their health and live their lives to
the fullest. "
The
therapists at SRM are dedicated to making a difference in people's lives by
providing excellent patient
care
in a caring and friendly environment. For more information regarding
rehabilitation services at SRM,
please
contact us at (970) 521-3138
September
20, 2011
Pink
Ribbon Program Coming To New Orleans, LA - October 14 & 15, 2011 - PR Web
–
Become
a Post-Rehabilitative Breast Cancer Exercise Specialist
The
Pink Ribbon Program is an exercise program designed specifically for
post-operative breast cancer
survivors.
Program founder and director of the Pink Ribbon Program, Doreen Puglisi M.S.,
became aware
of
the need as she herself was diagnosed with breast cancer. She used the Pink
Ribbon Program to regain
the
range of motion as well as strength in her affected arm.
Xtend
Barre New Orleans will be hosting a two day workshop on Friday, October 14 and
Saturday,
October
15, 2011 for individuals who come in contact with breast cancer survivors
through Pilates, physical
therapy,
occupational therapy, massage therapy, personal trainers, nurses, group
exercise instructors and
lymphedema
treatment specialists. The goal of this interactive two day course is to
provide the participants
with
a knowledge base that is essential to the successful evaluation of the breast
cancer survivor, from
diagnosis
to treatment, recovery, prevention of lymphedema and proper exercise guidelines
and protocols.
Evidence
based practice and integration of material from the areas of functional
exercise, shoulder
rehabilitation
and Pilates exercise will be the emphasis of the course sessions.
The
Pink Ribbon Program is offered on Friday, October 14 starting at 3:00 p.m. to
8:00 p.m. and Saturday,
October
15 starting at 8:00 a.m. to 2:00 p.m. Workshop cost is $425 per person plus $35
for course
materials.
Space is still available for this two day workshop. Please visit
http://www.pinkribbonprogram.com
or
call 888-445-3089
September
7, 2011
Incredible
New Plastic Surgery Product Helps Accelerate Healing After Popular Armlift
Procedure
(Brachioplasty)
- DigitalJournal.com –
An
exciting new product to help speed up healing following arm lift surgery is the
latest addition to Nouvelle’
s
premier compression wear line. Convertible compression arm sleeves provide
lightweight, yet powerful
healing
compression and support for the arms. A key feature of the product is the ease
with which patients
can
adjust the bodice for a precise fit.
“Proper
care of the arms is critical to a successful surgical result,” said Dawn Cover,
president of Nouvelle.
“We’ve
fine-tuned our arm care line to include products that help patients get the
maximum care and best
outcomes
from surgeries involving the arms,” she said.
Key
uses of arm sleeves:
1.
Care following arm lift surgery (brachioplasty) and liposuction.
2.
Prevention of extreme, hypertrophic scarring from severe, skin-damaging
burns.
3.
Relief for symptoms associated with lymphedema, such as fluid retention and
tissue swelling.
Also
important to proper care of the arms following surgery is scar prevention.
Nouvelle carries the
internationally-recognized
ScarHeal product line, which features an outstanding combination of
ingredients
designed
to help calm inflammation and tame overactive collagen production in scars
resulting from surgery,
burns,
wounds, and keloids. The line features four proven products for treating scars
resulting from any
trauma
to the skin.
Additional
Resources
Web
site
The
newly-designed Nouvelle Inc. Web site includes comprehensive product details,
company history and
and
more.
Healing
Transformations
An
online forum dedicated to patients, physicians and families of anyone
recovering from the myriad of
emotional
and physical health issues surrounding aesthetic and reconstructive
surgery.
Page
Look
for new products, stories from customers, and helpful recovery tips on
Nouvelle’s Facebook page.
One
of the first 100 people to “like” the page will be entered into a special
drawing to win a free
compression
or shapewear product.
About
Nouvelle
Nouvelle
manufactures and distributes post-surgical compression wear, body shaping
garments, and scar
care
products worldwide from its facility in Virginia Beach, Va. Its
internationally-recognized products are
available
through approved distributors and online at
http://www.nouvelleinc.com.
International
Distribution Opportunities
For
more information about purchasing or distributing the company’s products,
please contact Dawn Cover
via
email or telephone: dawn(at)nouvelleinc(dot)com or
888-653-0113/757.965.3767.
September
9, 2011
Why
Knees Fail in 2011: Patient, Surgeon, or Device? - Ortho SuperSite – by Steven
J. Fitzgerald, MD;
Robert
T. Trousdale, MD
Abstract
The
outcome of total knee arthroplasty (TKA) is influenced by multiple
interconnected factors, including
patient
selection, implant design, and surgical technique. Total knee arthroplasty has
been shown to be highly
successful,
with patient satisfaction rates reported from 85% to 95% with low rates of
failure, but if failure
occurs,
its impact is significant. In 2003, 402,000 primary TKAs and 32,000 revision
TKAs were
performed
in the United States, and the number of TKAs is expected to double by 2015.
Recent data on
modern
implant designs and techniques have demonstrated a surprising number of early
failures, although the
true
number of early failures is unknown. Patient medical comorbidities should be
optimized preoperatively,
while
psychosocial issues and workers compensation are more nebulous yet contribute
greatly to patient
perceived
outcomes. Understanding current failure mechanisms of primary TKA and how to
prevent
complications
will be critical to help manage a potentially overwhelming TKA revision burden.
This article
discusses
failure rates as well as factors from the patient, surgeon, and device, that
contribute to TKA failure.
Dr
Fitzgerald is from Department of Orthopedic Surgery, University Hospitals Case
Medical Center,
Cleveland,
Ohio; and Dr Trousdale is from the Mayo Clinic, Rochester, Minnesota.
Dr
Fitzgerald has no relevant financial relationships to disclose. Dr Trousdale
receives royalties from DePuy,
Wright
Medical Technology, and MAKO.
Presented
at Current Concepts in Joint Replacement 2010 Winter Meeting; December 8–11,
2010;
Orlando,
Florida.
Correspondence
should be addressed to: Robert T. Trousdale, MD, Mayo Clinic, 200 First St SW,
Rochester,
MN 55905 ([email protected]).
Posted
Online: September 09, 2011
The
outcome of total knee arthroplasty (TKA) is affected by patient selection,
implant design, and surgical
technique
( Figure). Total knee arthroplasty has been shown to be highly successful with
patient satisfaction
rates
reported from 85% to 95% with low failure rates, but if failure occurs, its
impact is significant. 1,2 In
2003,
402,000 primary total knee and 32,000 revision TKAs were performed in the
United States. The
number
of total knee revisions is expected to double by 2015. 3 Understanding current
failure mechanisms
of
primary TKA, and how to prevent complications will be critical to help manage a
potentially
overwhelming
TKA revision burden. This article will discuss failure rates as well as factors
from the patient,
surgeon,
and device, which all contribute to the TKA failure.
Rates
of Failure
Long-term
studies have demonstrated excellent survivorship rates for TKA. 4–6 Rand and
Bryan 7
reported
failure rates of condylar total knee prostheses implanted at the Mayo Clinic
over a 20-year period
and
demonstrated 91% survivorship at 10 years, and 78% at 20 years. These rates
improved for patients
who
were women, older at the time of surgery, and had not undergone previous knee
surgery. Survivorship
of
patients older than 70 years at the time of surgery also increased to 94% at 10
years. Other factors that
were
attributed to increased survivorship were cruciate retaining and non-modular
tibial designs, although
these
factors may be related to prosthesis design issues that have been improved with
modern designs in
2011.
We currently advise our patients that they have approximately a 1% cumulative
chance per year of
their
total knee failing.
Why
and When do Knees Fail?
Historically,
reasons for TKA failure have been attributed to infection, loosening,
instability, and
patellofemoral
complications. 7 Surprisingly, data detailing failure mechanisms of modern TKA
is relatively
scant.
Sharkey et al 2 retrospectively reviewed reasons for 212 revisions over a
3-year period from 1997 to
2000
at a tertiary referral center. Failures were subdivided into early (<2
years) and late (>2 years), with
55%
falling into the early group. Overall, the most common reasons for revision
were polyethylene failure,
aseptic
loosening, instability, and infection. Not surprisingly, polyethylene wear and
aseptic loosening were
more
common in the late group comprising >70% of all late revisions combined. The
most common reason
for
failure in the early group was infection, comprising 25%. The early group also
demonstrated a
surprisingly
high rate of aseptic loosening of 16.9%, which points to surgical technique as
a major
contributing
factor to early revision since early loosening cannot be attributed to
polyethylene wear.
Fehring
et al 8 retrospectively reported reasons for revision of 440 total knees at a
tertiary referral center.
They
specifically looked at reasons for early failure, which they defined as
revision within 5 years from the
index
arthroplasty. An alarming 64% of revisions fell into this early failure group
over a 10-year period.
Infection
(38%) was the most common reason for early revision, followed by instability
(26%), and failure of
cementless
fixation (13%). Both of these studies are limited by data from tertiary
referral centers, clouding
the
true incidence of the mechanisms of TKA failure. They, however, demonstrate an
alarming number of
early
failures, and indicate room for improvement in surgical technique.
Patient
Factors
Patient
factors significantly contribute to the TKA failure. Medical comorbidities such
as obesity, diabetes,
inflammatory
arthropathy, tobacco use, lymphedema, immunosuppressive medications, and
depression can
all
contribute to early postoperative complications as well as long-term outcomes.
9–13 Kang et al 12
recently
suggested HbA1C >8% as an independent risk factor for postoperative wound
complications.
Foran
et al 11 demonstrated a significantly higher revision rate in morbidly obese
patients undergoing TKA
compared
to non-obese patients. Other patient factors, such as patient-surgeon
relationship, patient
expectations,
psychosocial issues, and workers compensation add an additional layer of
complexity to TKA
outcomes.
14 While not all patient factors are correctable in patients undergoing TKA;
medical optimization
of
diabetes, cardiopulmonary disease, smoking cessation programs, weight control,
and treatment of
lymphedema
should be pursued preoperatively to help mitigate the risk of complications
following TKA.
Patient,
Surgeon, or Device?
Failure
of TKA is multifactorial with combined contributions attributable to the
patient, surgeon, and device.
Medical
optimization of patient comorbidities such as cardiorespiratory disease,
obesity, diabetes, and
venostasis
should be attempted to help mitigate the risk of perioperative
complications.
Current
implant design has improved greatly over the past 2 decades, but the rate of
developing technology
is
largely uncontrollable by both patient and surgeon. Most TKA designs today, if
implanted correctly, will
have
excellent long-term outcomes. Surgeons should choose an implant design that
they are comfortable
with
putting in well that has a proven track record. Implant design and improved
materials in the future
should
lead to further decreases in failure rates. However, surgeons should be
cautioned against early
adoption
of new technologies that have not been proven over time.
Surgeons
can do the most to limit factors that lead to early failure. Judicious use of
perioperative antibiotics,
good
soft tissue handling techniques, and safe and efficient operative times can all
help to decrease chances
of
early postoperative infection. Early loosening and instability, also directly
attributable to surgical technique,
can
be limited with good cement technique and adherence to traditional arthroplasty
balancing and alignment
principles.
Continued professional education through national meetings and literature
review can also keep
surgical
technique up to date and help prevent the surgeon from repeating previous
failures.
References
Noble
PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: Patient expectations
affect
satisfaction
with total knee arthroplasty. Clin Orthop Relat Res. 2006; (452):35–43. doi:
10.1097/01.blo.
0000238825.63648.1e
[CrossRef]
Sharkey PF,
Hozack WJ, Rothman RH, Shastri S, Jacoby SM. Insall Award paper. Why are total
knee
arthroplasties
failing today? Clin Orthop Relat Res. 2002; (404):7–13. doi:
10.1097/00003086-
200211000-00003
[CrossRef]
Kurtz
S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip
and knee
arthroplasty
in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;
89(4):780–785. doi:
10.2106/JBJS.F.00222
[CrossRef]
Ranawat
CS, Padgett DE, Ohashi Y. Total knee arthroplasty for patients younger than 55
years. Clin
Orthop
Relat Res. 1989; (248):27–33.
Rand
JA, Trousdale RT, Ilstrup DM, Harmsen WH. Factors affecting the durability of
primary total knee
prostheses.
J Bone Joint Surg Am. 2003; 85(2):259–265.
Scuderi
GR, Insall JN, Windsor RE, Moran MC. Survivorship of cemented knee
replacements. J Bone
Joint
Surg Br. 1989; 71(5):798–803.
Rand
JA, Bryan RS. Revision after total knee arthroplasty. Orthop Clin North Am.
1982; 13(1):201–212.
Fehring
TK, Odum S, Griffin WL, Mason JB, Nadaud M. Early failures in total knee
arthroplasty. Clin
Orthop
Relat Res. 2001; (392):315–318. doi: 10.1097/00003086-200111000-00041
[CrossRef]
Peersman
G, Laskin R, Davis J, Peterson M. Infection in total knee replacement: A
retrospective review of
6489
total knee replacements. Clin Orthop Relat Res. 2001; (392):15–23. doi:
10.1097/00003086-
200111000-00003
[CrossRef]
Namba
RS, Paxton L, Fithian DC, Stone ML. Obesity and perioperative morbidity in
total hip and total
knee
arthroplasty patients. J Arthroplasty. 2005; 20(7 suppl 3):46–50. doi:
10.1016/j.arth.2005.04.023
[CrossRef]
Foran
JR, Mont MA, Etienne G, Jones LC, Hungerford DS. The outcome of total knee
arthroplasty in
obese
patients. J Bone Joint Surg Am. 2004. 86(8):1609–1615.
Kang
S, Han H, Yoon KS. Preoperative HBA1C is a good marker for predicting wound
complications
after
TKA in diabetics. J Bone Joint Surg Br. 2010; 92(suppl):135.
Shrader
MW, Morrey BF. Insall Award paper. Primary TKA in patients with lymphedema.
Clin Orthop
Relat
Res. 2003; (416):22–26. doi: 10.1097/01.blo.0000092985.12414.6e
[CrossRef]
Mont
MA, Mayerson JA, Krackow KA, Hungerford DS. Total knee arthroplasty in patients
receiving
Workers’
Compensation. J Bone Joint Surg Am. 1998; 80(9):1285–1290.
September
8, 2011
Lymphedema
From Breast Cancer May Respond To Weightlifting – EmpowHer – By Jody
Smith
Treatment
for breast cancer can lead to an unpleasant condition called lymphedema which
causes the arms
to
swell. Research from the University of Pennsylvania School of Medicine
indicated that weightlifting may
prevent
the development of lymphedema. Previous research by the same team found that
when women with
lymphedema
lift weights, they can prevent the condition from becoming worse.
This
Article
·
VoteImproved My Health
·
VoteChanged My Life
·
VoteSaved My Life
The
results were presented on December 8, 2010 at the San Antonio Breast Cancer
Symposium. It was
published
at that time in the Journal of the American Medical Association as
well.
According
to a Eurekalert also released on December 8, 2010, lymphedema is most likely to
occur after
surgery
removing multiple lymph nodes in the area of the breast that had cancer. Up to
47 percent of women
who
have had this type of surgery can experience lymphedema.
Women
in the study took part in a membership at a fitness center for 13 weeks where
they used free
weights
and machines under the watchful eyes of certified fitness professionals. They
worked out twice a
week
for 90 minutes at a time. For the rest of a year, the women exercised on their
own, monitored monthly.
The
women with lymphedema who participated in this routine had fewer setbacks and
fewer symptoms than
women
who did not take part in weightlifting.
It
is important for a woman who has or may develop lymphedema to be in touch with
her doctor, and a
certified
fitness professional for safety's sake.
According
to the New England Journal of Medicine's website Nejm.org, more than 2.4
million American
women
are survivors of breast cancer. Depending on the type of treatment received, a
woman may run a 6
percent
to 70 percent chance of developing lymphedema.
Many
of these survivors have been trying to restrict the use of their affected arms
under the impression that
this
will help. However advice along these lines is counterproductive. Instead,
lymphedema responds best to
a
carefully controlled increase in activity, including weightlifting.
Nejm.org
concurred with the results referred to in the eurekalert, that weightlifting
had an effect on hand and
arm
symptoms, decreasing both severity and frequency.
Apparently
exercise enhanced the flow of lymph and enhanced protein reabsorption. The
effects of regular
exercise
on the lungs seemed to boost lymph flow as well. It is speculated that the
increase in muscle
strength
may have reduced the effects of stress on the arm in daily
activities.
This
Article
·
VoteImproved My Health
·
VoteChanged My Life
·
VoteSaved My Life
This
research was funded by grants from the National Cancer Institute and the
National Center for Research
Resources.
Sources:
Weightlifting
slashes lymphedema risk after breast cancer treatment. Eurekalert.org. Web.
September 5,
2011.
http://www.eurekalert.org/pub_releases/2010-12/uops-wsl120610.php
Weight
Lifting in Women with Breast-Cancer-Related Lymphedema. Nejm.org. Web.
September 5, 2011.
http://www.nejm.org/doi/full/10.1056/NEJMoa0810118#t=articleTop
Visit
Jody's website and blog at http://www.ncubator.ca and
http://ncubator.ca/blogger
Reviewed
September 6, 2011
by
Michele Blacksberg R.N.
September
8, 2011
New
tool may help predict breast-cancer-associated lymphedema – HemOncToday
–
ASCO
2011 Breast Cancer Symposium
SAN
FRANCISCO — A set of statistical models have demonstrated more than 70%
accuracy for
predicting
the 5-year risk for developing lymphedema after lymph node removal during
breast cancer
surgery.
New
tool may help predict breast-cancer-associated lymphedema
ASCO
2011 Breast Cancer Symposium
SAN
FRANCISCO — A set of statistical models have demonstrated more than 70%
accuracy for
predicting
the 5-year risk for developing lymphedema after lymph node removal during
breast cancer
surgery.
Jose
Bevilacqua, MD, PhD, a surgical oncologist at the Hospital Sirio Libanes in Sao
Paulo, Brazil, and
colleagues
studied 1,054 women with breast cancer who underwent axillary dissection in
2001 and 2002.
They
used clinical factors such as age, BMI, ipsilateral arm chemotherapy infusions,
level of axillary
dissection
and others to develop three models and nomograms to predict the risk for
developing
lymphedema.
The
first model predicted lymphedema in advance of surgery and considered age, BMI
and number of
chemotherapy
cycles before surgery. The concordance index for this model was 0.706. The
second model
used
the same predictors within 6 months surgery, as well as the extent of axillary
dissection and the location
of
the radiotherapy field. The concordance index for this model was 0.729. The
third model predicted
lymphedema
6 months or more after surgery. It considered the same predictors, as well as
the development
of
fluid buildup and swelling. The concordance index for this model was
0.736.
“The
statistical models and the corresponding nomograms use readily available
clinical factors and allow for
quick
and easy estimation of individual risks of developing lymphedema after axillary
lymph node surgery in
women
with breast cancer,” Bevilacqua said. “For the sake of comparison, these
modeling tools are as
accurate
for predicting a woman’s risk of developing lymphedema as mammography is for
the detection of
breast
cancer.”
September
7, 2011
2011
Breast Cancer Symposium Research Reveals Trends in Survival, Treatment -
-Newswise
Newswise
— ALEXANDRIA, Va. – New studies on breast cancer screening, treatment, and
survival were
released
today in advance of the 2011 Breast Cancer Symposium. The symposium is being
held September
8-10,
2011, at the San Francisco Marriott Marquis in San Francisco.
Four
major studies were highlighted in today’s presscast:
-
Two Studies Report Similar Recurrence, Survival Rates for Breast Conservation
and Mastectomy among
Younger
Women with Breast Cancer: A pair of studies indicates comparable outcomes – in
local recurrence
and
survival rates – for lumpectomy (breast conservation surgery) or mastectomy
(entire breast removal)
among women
with breast cancer age 40 and younger.
a)
Study Finds Recurrence Rates are Similar in Younger Women Who Have Either
Breast Conservation
Surgery
or Mastectomy: A retrospective study of medical records of more than 600 women
aged 40 and
younger
who were diagnosed with up to stage III breast cancer, analyzed according to
the type of surgery
(lumpectomy
versus mastectomy) the women had, found no statistically significant difference
in local cancer
recurrence
risk.
b)
Large Analysis Shows Breast Conservation and Mastectomy Result in Similar
Survival Among Younger
Women
With Early Stage Breast Cancer: Using the National Cancer Institute’s SEER
(Surveillance,
Epidemiology,
and End Results) database, investigators compared overall survival and breast
cancer-
specific
survival among nearly 15,000 women age 40 and younger, finding no significant
differences between
the
two groups.
-
New Statistical Tool May Predict Risk of Common Debilitating Side Effect –
Lymphedema – Associated
with
Breast Cancer Surgery: Researchers have created a set of statistical models
that are more than 70
percent
accurate for predicting the five-year risk of developing lymphedema
(debilitating swelling) after
lymph
node removal during breast cancer surgery.
-
Large Michigan Study Suggests Continued Importance of Self-Exams, Annual
Mammography in Breast
Cancer
Detection, Even in Younger Women: An analysis of breast cancer diagnosis data
from nearly 6,000
women
in Michigan suggests that mammography and self-breast exams remain important
tools for detecting
breast
cancer, even among women aged 40 to 49 for whom routine mammography has been
questioned by
the
U.S. Preventive Services Task Force (USPSTF).
“Improvements
in detection, as well as insights into surgical treatment options and their
outcomes, have
increasingly
led to longer, improved lives for women with breast cancer,” said Andrew
Seidman, MD,
American
Society of Clinical Oncology Cancer Communications Committee member. “The
studies
presented
today reflect the impact of these advances in treatment approaches on patient
outcomes and
treatment
decision-making.”
In
2011, an estimated 230,480 new cases of invasive breast cancer are expected to
occur in women in the
United
States, and another 2,140 cases are expected in U.S. men. An additional 57,650
cases of in situ
(non-invasive)
breast cancer are expected to occur in U.S. women as well, totaling more than
290,000 new
cases.* This
year’s Breast Cancer Symposium will include more than 300 abstracts and focus
on a range of
breast
cancer topics that range from prevention and screening to treatment and
survivor care.
*Source:
Cancer Facts & Figures 2011. Atlanta, GA; American Cancer Society:
2011.
The
full release is available at the following link:
http://www.asco.org/ASCOv2/Department
Content/Communications/Downloads/BCS11 Research Release
Final.pdf
About
the 2011 Breast Cancer Symposium
The
fifth annual Breast Cancer Symposium is co-sponsored American Society of Breast
Disease, the
American
Society of Breast Surgeons, the American Society of Clinical Oncology, the
American Society for
Radiation
Oncology, the National Consortium of Breast Centers and the Society of Surgical
Oncology.
Susan
G. Komen for the Cure®, the world's largest grassroots network of breast cancer
survivors and
advocates,
is the primary supporter of the Symposium.
Information
for Media: www.asco.org/BCSpresskit
Relevant
Links on ASCO’s CancerProgress.Net Website:
http://cancerprogress.net/breast
Relevant
Links on ASCO’s Cancer.Net:
•
Guide to Breast Cancer
•
Cancer Screening
•
Mammography – What to Expect
•
Expert Perspective from ASCO on Mammography Screening for Breast
Cancer
•
Understanding Cancer Surgery
•
Talking With the Doctor About Breast Surgery Options
•
After Treatment for Breast Cancer: Preventing Lymphedema
•
Coping With Fear of Recurrence
ATTRIBUTION
TO THE 2011 BREAST CANCER SYMPOSIUM IS REQUESTED IN ALL NEWS
COVERAGE
September
7, 2011
New
Nomograms Predict Lymphedema After Axillary Lymph Node Dissection - Internal
Medicine News
Digital
Network – By: SUSAN LONDON
A
new set of nomograms based on easily assessed risk factors accurately predicts
a woman’s likelihood of
developing
lymphedema after axillary lymph node dissection for breast cancer, researchers
are reporting at a
breast
cancer symposium sponsored by the American Society of Clinical
Oncology.
The
nomograms, which enable risk assessment throughout the course of treatment
using data available at the
time,
had accuracy exceeding 70%, according to results presented in a press briefing
before the meeting.
"The
accuracy is the same as mammography to detect breast cancer. ... So that’s a
very good statistical
tool,"
said lead author Dr. Jose Bevilacqua, a surgical oncologist at the Hospital
Sirio-Libanês in São Paulo,
Brazil.
Being
able to identify high-risk patients has several potential applications, he
added. They could be
monitored
more closely and offered interventions that might prevent or reduce the
severity of lymphedema,
such
as use of compression sleeves. "The earlier you detect [it], the better is the
outcome," Dr. Bevilacqua
said.
Additionally,
high-risk patients with a positive sentinel lymph node could be counseled about
the risk of
further
surgery. Thus, "you have physicians who make closer follow-up and [have] a
better discussion with
the
patients."
Finally,
the nomograms could be applied in clinical research. "These tools might help
[ongoing] or new
studies
to select high-risk patients in order to avoid exposing the low-risk patients
to unproven therapies," he
explained.
Dr.
Andrew Seidman, moderator of the press briefing and a medical oncologist at the
Memorial Sloan-
Kettering
Cancer Center in New York, commended the investigators for a study that "has
real practical
implications
for patients."
"It
allows us to identify patients who then can be appropriately triaged for early
intervention and perhaps for
clinical
trials aimed at preventing what many consider inevitable, and that is the
development of lymphedema."
The
effectiveness of early interventions is controversial, according to Dr.
Seidman, who did not report any
relevant
conflicts of interest. "There are believers and there are nonbelievers," he
commented. "What I think
this
nomogram does is [allow] us in a scientific way to segregate out patients in
terms of their risk, and by
doing
that, we can have more uniform cohorts for which early intervention can be
studied more rigorously."
The
researchers prospectively followed 1,054 women with unilateral breast cancer
who underwent breast-
conserving
surgery or mastectomy with an axillary lymph node dissection in 2001-2002.
Median follow-up
was
41 months.
"As
far as we know, we have established the largest prospective cohort specifically
established to study the
incidence
and factors associated with lymphedema after axillary node dissection for
breast cancer,"
commented
Dr. Bevilacqua.
Using
Data to Predict Lymphedema
The
women had serial arm volume measurements starting before surgery. To facilitate
this process, the
researchers
created a tool that is now available free online (www.armvolume.com).
They
then developed and internally validated three multivariate nomograms (or
statistical models) for
predicting
lymphedema using data available at various time points.
The
first model, to be used preoperatively, incorporated age, body mass index, and
number of cycles of
neoadjuvant
chemotherapy infusions in the ipsilateral arm.
The
second model, to be used within the first 6 months after surgery, incorporated
all the factors from the
first
plus the extent of axillary dissection, the location of radiation therapy
field, and the number of cycles of
adjuvant
chemotherapy infusions in the ipsilateral arm.
The
third model, to be used 6 months or later after surgery, incorporated all the
factors from the second,
plus
the development of postoperative seroma and development of early
edema.
Study
results showed that within 5 years of axillary lymph node dissection, 30.3% of
the women developed
lymphedema
(defined as a difference in volume of at least 200 mL between arms at 6 months
or later after
surgery).
All
of the risk factors used in the models were significantly associated with the
development of lymphedema,
Dr.
Bevilacqua reported.
"One
of the novelties of our study is the [finding] that ipsilateral neoadjuvant
chemotherapy infusion is as
morbid
as adjuvant chemotherapy infusion to increase the risk of lymphedema," he
pointed out. "This is
somewhat
intuitive, but it has never been described, and the great majority of clinical
oncologists are not
aware
of this fact."
For
predicting the 5-year risk of lymphedema, the first, second, and third models
had accuracy of 70.6%,
72.9%,
and 73.6%, respectively. The investigators have converted the models into free,
user-friendly
calculators
that are available online (www.lymphedemarisk.com) during the ASCO Breast
Cancer
Symposium
(Sept. 8-10), but will be taken off line until the manuscript is published,
after which they are to
become
available again.
Dr.
Bevilacqua reported that he had no relevant conflicts of interest.
September
8, 2011
New
Research: Acupuncture treats Breast Cancer Lymphedema – HealthCMI –
Recent
Memorial Sloan-Kettering Cancer Center research demonstrates that acupuncture
significantly
reduces
lymphoedema related arm swelling in women after breast cancer surgery.
Lymphoedema is a when
there
is fluid retention and tissue swelling in the body due to disorders of the
lymphatic system. The
lymphatic
system controls the return of interstitial fluid to the bloodstream. After
breast cancer surgery, the
lymphatic
system can be damaged by lymph node surgery or radiation therapy. Symptoms may
appear
quickly
or take several months or years to become apparent. Swelling of the arms and
sides of the body is
most
common after lymphatic system damage due to breast cancer procedures.
The
researchers at Sloan-Kettering in New York note that existing conventional
treatments for
lymphoedema
are only “marginally beneficial, rarely reducing arm swelling in any meaningful
way.” The new
study
concludes that acupuncture is safe and that some of the women in the study
showed a 30 percent or
better
reduction of lymphoedema related arm swelling.
Acupuncture
Results
In
this study, lymphoedema was diagnosed when the affected arm was greater than
2cm in circumference
than
the unaffected arm. Participants received acupuncture at a rate of 2 times per
week for a total of four
weeks.
Results were tabulated after a six month follow-up. No serious events were
reported and the study
concludes
that “acupuncture appears safe and may reduce lymphoedema associated with
breast cancer
surgery.”
Acupunct
Med. doi:10.1136/aim.2011.004069. A safety and efficacy pilot study of
acupuncture for the
treatment
of chronic lymphedema. Barrie R Cassileth, Kimberly J Van Zee, Yi Chan, Marci I
Coleton,
Clifford
A Hudis, Sara Cohen, James Lozada, Andrew J Vickers.
Author
Affiliations:
Integrative
Medicine Service, Memorial Sloan-Kettering Cancer Center, New York.
Department
of Surgery, Memorial Sloan-Kettering Cancer Center, New York.
Breast
Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New
York.
Integrative
Medicine
September
8, 2011
New
Research: Acupuncture treats Breast Cancer Lymphedema – HealthCMI –
Recent
Memorial Sloan-Kettering Cancer Center research demonstrates that acupuncture
significantly
reduces
lymphoedema related arm swelling in women after breast cancer surgery.
Lymphoedema is a when
there
is fluid retention and tissue swelling in the body due to disorders of the
lymphatic system. The
lymphatic
system controls the return of interstitial fluid to the bloodstream. After
breast cancer surgery, the
lymphatic
system can be damaged by lymph node surgery or radiation therapy. Symptoms may
appear
quickly
or take several months or years to become apparent. Swelling of the arms and
sides of the body is
most
common after lymphatic system damage due to breast cancer procedures.
The
researchers at Sloan-Kettering in New York note that existing conventional
treatments for
lymphoedema
are only “marginally beneficial, rarely reducing arm swelling in any meaningful
way.” The new
study
concludes that acupuncture is safe and that some of the women in the study
showed a 30 percent or
better
reduction of lymphoedema related arm swelling.
Acupuncture
Results
In
this study, lymphoedema was diagnosed when the affected arm was greater than
2cm in circumference
than
the unaffected arm. Participants received acupuncture at a rate of 2 times per
week for a total of four
weeks.
Results were tabulated after a six month follow-up. No serious events were
reported and the study
concludes
that “acupuncture appears safe and may reduce lymphoedema associated with
breast cancer
surgery.”
Acupunct
Med. doi:10.1136/aim.2011.004069. A safety and efficacy pilot study of
acupuncture for the
treatment
of chronic lymphedema. Barrie R Cassileth, Kimberly J Van Zee, Yi Chan, Marci I
Coleton,
Clifford
A Hudis, Sara Cohen, James Lozada, Andrew J Vickers.
Author
Affiliations:
Integrative
Medicine Service, Memorial Sloan-Kettering Cancer Center, New York.
Department
of Surgery, Memorial Sloan-Kettering Cancer Center, New York.
Breast
Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New
York.
Integrative
Medicine Service and Department of Epidemiology and Biostatistics, Memorial
Sloan-Kettering
Cancer
Center, New York.
September
7, 2011
Software
Predicts Lymphedema Risk After Axillary Dissection – Medscape –
Sorry
have to be a member of something to access this article.
September
8, 2011
MBCS:
Tool Predicts Arm Swelling in Breast Cancer - MedPage Today – By Crystal
Phend
SAN
FRANCISCO -- Five-year risk of lymphedema can be predicted with at least 70%
accuracy using a
free
online statistical tool, researchers found.
Concordance
of predicted risk with actual outcomes was 70.6% when calculated
preoperatively, 72.9%
when
calculated within the first six months after surgery, and 73.6% when calculated
further along in the
postop
course, Jose Bevilacqua, MD, PhD, of Hospital Sirio Libanes in Sao Paulo,
Brazil, and colleagues
reported.
Although
some high-risk patients might be missed by the tool, this level of accuracy is
similar to what has
been
seen with mammography, according to Bevilacqua.
He
reported the results at a press telebriefing in advance of presentation at the
Multidisciplinary Breast
Cancer
Symposium here.
This
kind of risk prediction is an important step forward that could have real
practical implications for
patients,
commented telebriefing moderator Andrew D. Seidman, MD, of Memorial
Sloan-Kettering
Cancer
Center in New York City.
"It
allows us to identify patients who can then be appropriately triaged for early
intervention and perhaps for
clinical
trials aimed at preventing what many consider inevitable [lymphedema]," he told
reporters.
Bevilacqua
suggested a strategy of close follow-up for patients identified as high risk by
the lymphedema
prediction
tool.
Currently,
"patients are often referred when lymphedema is already very significant, where
it begins to
interfere
with function," Seidman noted at the briefing.
There's
debate about whether any prevention strategies are actually effective, but,
Seidman said, catching
the
complication at an early stage can delay progression to the later debilitating
stages.
Those
early stage patients can be referred for physical therapy, and given
compression sleeves and standard
instructions
on prevention, such as avoidance of heat and heavy lifting with the affected
arm, Bevilacqua
added.
His
study used a prospective cohort of 1,054 women followed for lymphedema after
axillary lymph node
dissection
as part of surgery for breast cancer done at the Brazilian National Cancer
Institute from Aug.
2001
to Nov. 2002.
The
five-year cumulative incidence of lymphedema was 30.3%.
Significant
independent predictors in the statistical models included:
For
preoperative prediction, age, body mass index (BMI), and number of cycles of
neoadjuvant
chemotherapy
For
prediction within six months of surgery, age, BMI, number of cycles of
neoadjuvant or adjuvant
chemotherapy,
level of axillary lymph node dissection, and extent of radiotherapy
field
For
prediction beyond six months after surgery, all the earlier factors as well as
development of seroma and
evidence
of early edema
The
researchers cautioned that their nomograms have yet to be validated on an
independent cohort of
patients.
The
online tool, found at lymphedemarisk.com, is hosted by the Cleveland Clinic,
which collaborated on the
project.
The Web site will be available temporarily during the conference (from
September 8 through 10)
and
permanently accessible after planned publication of the study.
The
researchers reported having no conflicts of interest to disclose.
Seidman
reported having served as consultant or advisor to Enzon and Wyeth and having
received
honoraria
from Celgene, Genentech, and Genomic Health.
Primary
source: Multidisciplinary Breast Cancer Symposium
Source
reference:
Bevilacqua
JLB "Nomograms for predicting the risk of arm lymphedema after axillary
dissection in breast
cancer"
MBCS 2011; Abstract 8.
September
7, 2011
Hampton
community events - Daily Press –
L.E.A.P-
Lymphedma, Education, Advocacy, Program Support Group Meeting. 6 p.m. Sept. 15,
Sentara
Hampton
Careplex first floor conference room C. All are welcome to attend. L.E.A.P. is
for patients, family
members,
and/or friends suffering from lymphedema. Also, come hear about how you can
make a difference
and
learn more about the Lymphedema Treatment Act. Contact Tiffany at
[email protected] for
more
information or visit http://www.wix.com/leapdirector/lymphedema.
This
one has passed but sounds like it might be a regular meeting on
Thursdays
September
7, 2011
Software
Predicts Lymphedema Risk After Axillary Dissection – Medscape –
You
have to be a member to access this article sorry
September
24, 2011
Telemedicine
Service Launched at Shirgaon through Spanco's Maha E Seva Kendra - Business
Wire India -
The
telemedicine service for Filarias (Lymphedema) disease was launched in Maha
e-Seva Kendra at
Shirgoan,
under the National e-Governance Plan. Government of Maharashtra has implemented
a National
e-Governance
Plan (NeGP) to provide government services to the rural population at their
doorstep at an
affordable
cost .The telemedicine project is a part of the Common Services Centers scheme,
and has been
implemented
by Spanco through the CSC centre at Shirgoan.
The
Telemedicine service was inaugurated, by the hands of Honorable Dr.Shashi
Bhushan Gogia Director
SAATHI
(NGO). Mr.Ravindra Jogal member of Zillah Parishad and Mr.Mangesh Dhopate
Shirgaon
Sarpanch were
also apart of the telemedicine launch event.
The
Shirgoan Maha E Seva Kendra will facilitate Lymphedema Patient to get a check
up done with a
nominal
consultancy fee ranging between Rs.30-50/-in their village. For this activity
Spanco Limited has
provided
the facility to install the necessary equipments costing Rs.1.5 lacs in the
Maha E Seva Kendra
center.
Beside this Spanco has also made 10 special medical kits available each costing
Rs.2000/- for
Lymphedema
patients through this Center.
Spanco
has taken this initiative in Sindhudurg as villagers are affected by this
disease and along with local
social
activist & health department Spanco intends to eradicate this disease from
Sindhudurg district. During
the
launch camp, 2 patients were methodically examined by Dr.Gogia as apart of the
launch program.
“Detailed
information about the disease is available in Spanco’s Maha e Seva Kendra and
those people who
are
suffering in the district are advised to take the benefit of this Telemedicine
service by visiting the centre
“said
Mr.Dhananjay Vartak- Head citizen Service Group, Spanco Limited.
For
this Inauguration Honorable Dr.Mrs. Arunarekha Gogia, Dr.Ashish Keche Shiragon
Primary Medical
officer,
Ms.Sugandha Satam Zila Bank Vice President, Ms.Archana Kalra Spanco’s General
Manager, Mr.
Sagar
Tope Asst. General Manager Spanco, Mr.Sandeep Uttekar Area Manager Spanco and
Mrs. Harsha
Ajit
Chahan representative of Maha E Seva Kendra, Shirgaon were present at this
function.
About
Spanco
Spanco
is in the business of creating Technology Infrastructure to help drive
governance efficiency across
key
sectors.Spanco is SEI CMM Level 3 and ISO 9001:2008 certified. We have more
than 12,000
employees
working across 4 continents.
Spanco
caters to large complex Technology Infrastructure projects across Government,
Power, Transport
and
Telecom Service Provider’s space. We also have a formidable presence in the BPO
space catering to
India,
US/Europe, Middle East and African markets
September
23
Pink
Ribbon Produce Launching at Price Chopper to Support Susan G Komen for the Cure
– WBGH
From
Price Chopper:
Pink
Ribbon Produce, a unique retail program committed to raising breast cancer
awareness, will return to
Price
Chopper stores for its fourth year from October 2 through October 29. The
educational fundraising
program
partners the grocery retailer with produce suppliers in an effort to raise
money for local Susan G.
Komen
for the Cure® Affiliates.
“Price
Chopper is proud to participate in the Pink Ribbon Produce program again this
year as part of our
multifaceted
year-round initiative to raise funds for breast cancer research and support
services,” said Mona
Golub,
vice president of public relations, consumer and marketing services for Price
Chopper
Supermarkets.
“During October, our customers can show their support for Susan G. Komen for the
Cure
by
buying healthy fruits and vegetables from the branded partners that are
participating in the program.”
Barbara
Connolly, who once worked at Price Chopper, is a courageous mother of five who
was diagnosed
with
breast cancer at just 29 years old. Connolly was passionate in her personal
fight against breast cancer.
She
drew inspiration from support groups led by Komen for the Cure and benefitted
from grants to receive
treatment
and supplies for Lymphedema, which developed after her breast cancer treatment.
Connolly now
gives
back to Komen by volunteering for the Northeast Pennsylvania (NEPA) Affiliate
of Susan G. Komen
for
the Cure. Connolly was awarded the Spirit of Hope Award by NEPA in 2011 and has
inspired many by
her
participation in “Pink in the Park,” a Northeast Pennsylvania Affiliate walking
program. In addition to
walking,
Connolly participated in Team Survivor and with just six weeks of training, ran
a 5k during the
Susan
G. Komen Race for the Cure®. She took third place in the survivor division in
September 2010.
Through
various fundraising activities, including Pink Ribbon Produce and the Race for
the Cure series,
Komen
has invested more than $1.9 billion in research and lifesaving community
programs.
By
bringing together Price Chopper, Komen and produce suppliers, Pink Ribbon
Produce provides
shoppers
with an easy way to give back to their communities and support efforts to find
cures for breast
cancer.
The money raised goes to local Komen Affiliates. Stores will direct shoppers to
the participating
produce
suppliers with a Pink Ribbon Produce program icon on posters and point-of-sale
signs at the
product.
Produce
partners supporting this year’s Pink Ribbon campaign include:
·
Calavo
·
Custom Pak
·
Del Monte Fresh Produce
·
Dole
·
Earthbound Farm
·
Fowler Packing
·
Mastronardi
·
POM Wonderful
·
Santa Sweets
September
23, 2011
A
Walk and a Wedding for Westbury's Nancy Safran - Westbury Times –
Westbury
resident Nancy Safran never suspected retirement would be so
frenzied.
Recently
retired from Nassau BOCES after a 34-year teaching career – the past 24 years
of which have
been
“extremely rewarding” as a speech teacher for the hearing impaired – Nancy is
now focusing on a
speech
of a quite different kind.
On
Oct. 1, Nancy and her husband, Howard, will proudly deliver some very special
words at the wedding
of
their daughter, Marnie.
“Helping
Marnie to plan her wedding has been a joy,” said Nancy recently. “I miss
teaching and the kids
and
my colleagues so much, but this year – with the wedding and with Lymphatic
Research Foundation’s
(LRF)
New York Walk right on top of one another, I’m almost too busy to feel that
September back-to-
school
pull on the heartstrings.”
In
addition to preparing for the wedding and volunteering with LRF, Nancy is
finding that retirement gives
her
time to pursue long-held interests and reconnect with friends.
She
is taking golf lessons, has joined a book club and a canasta club, and tries to
find time for frequent
walks
on the Jones Beach Boardwalk. Over the summer she has been working extra
volunteer hours with
the
Glen Cove-based Lymphatic Research Foundation (LRF) to help garner support for
their National Walk
for
Lymphedema and Lymphatic Diseases at Eisenhower Park on Saturday, Sept.
24.
“As
a family we have journeyed with lymphedema since Marnie was a little girl. We
have faced serious
health
issues, a frustrating lack of knowledge about lymphatic diseases, and a medical
system that offers few
treatment
options and little hope for reversing the sometimes devastating effects of
lymphedema and other
lymphatic
disorders,” Nancy explained. “Now I do what I can to inform and support other
families facing a
similar
situation; and I help LRF because I know that more scientific and medical
research offers the best
hope
for finding better treatments and cures.”
Born
with congenital lymphedema, Marnie Safran, a 1999 graduate of W. Tresper Clarke
High School and
now
an early childhood special educator with the NYL Gramercy Pre-School in
Manhattan, will be married
to
Scott Lesser at Temple Chaverim in Plainview on Oct. 1
“Everything
is finally all set,” said Marnie. “It’s going to be a great wedding. I’m still
working on getting the
right
shoes, but I know I’ve got the right life partner – and that’s what’s
important,” Marnie added.
In
honor of their wedding, Marnie and Scott are making a generous donation to
support the work of the
Lymphatic
Research Foundation. Founded in 1998 by Roslyn resident Wendy Chaite, LRF has
become a
leader
in patient advocacy and a primary force behind advancements in lymphatic
science worldwide.
LRF’s
advocacy programs have been effective in gaining Congressional and National
Institutes of Health
(NIH)
support for lymphatic research at the National Institutes of Health and at
major academic research
centers,
elevating lymphatic diseases from relative obscurity to a position on a par
with other national health
priorities.
The organization directly funds cutting edge lymphatic research by funding
Postdoctoral Research
Fellowship
Grants, a National Lymphatic Disease Patient Registry and Tissue Bank, a
peer-review
biomedical
journal in lymphatics, and the first-ever endowed academic Professorship in
Lymphatic Research
and
Medicine (Stanford University Medical School, 2008).
“I’m
glad to be walking for LRF and walking for Marnie the week before the wedding,”
said Nancy. “That’
s
going to be a great day, too, with all of our friends coming out to support
us.”
Visit
www.walklrf.org for details and to support Team Safran.
September
22, 2011
Tennis
Rally for the Cure, October 2, at the Mountain Home Tennis Center - Baxter
Bulletin –
The
Third Annual Tennis "Rally for the Cure" will be held Sunday, October 2, at the
Mountain Home Tennis
Center.
The Tennis Rally is open to women and men who want to help win the fight
against breast cancer.
Rally
for the Cure is the largest grassroots world-wide network of breast cancer
survivors and activists
hosting
a Rally that include tennis, golf, running and dining events created to support
the promise of Susan G.
Komen
for the Cure and spread the message that early detection saves lives. More than
1.3 million people
have
participated in Rally for the Cure events across the nation since its inception
in 1996. The program was
started
by the sister of Susan G. Komen, who died at only 36 of breast
cancer.
The
Mountain Home Tennis Center Rally will begin at 11:00 a.m. at the Tennis
Center. A complimentary
luncheon
will be served for all participants and donors, followed by more tennis in the
afternoon.. The cost
for
the day is $25.00 a person ($20.00 for full-time college students) with checks
made out to Rally for the
Cure
and all proceeds going to the Foundation.
Each
participant will receive a goody bag with Komen breast health information, an
exclusive Rally bandana,
a
pink ribbon pin, a Rally towel, a Rally Charm, Cards for the Cure from Hallmark
and a one-year
subscription
to a selection of Condi Nast magazines, including SELF, Bon Appetit,
Architectural Digest and
other
choices. Participants are encouraged to wear pink, the signature color of Rally
for the Cure.
"We
are proud and happy to again open the Mountain Home Tennis Center for the Cure
event which is a
fun
way to give our members and people from the area a chance to come together to
support an important
cause
while playing a sport they love", states Mark Klingelhoets, owner of the Tennis
Center.
On
October 2, Lisa McBrayer, Flippin, and Debbie Voss, ellvillle, will represent
women like them in our
community
who have battled breast cancer and survived. Lisa has been a local Ambassador
for this cause
and
instrumental in organizing the October Tennis Rallys the past two years, along
with Maria Acree, Cindy
Holeyfield,
Roberta Heldenbrand and Charlotte and Al Wynne. Lisa is grateful to the Komen
foundation,
which
provided her with a free wig and also a free massage every week while she was
undergoing radiation
therapy
at Carti.
Up
to 75% of the net income from each Rally or Race stays in that local community
" The Komen Grant
touches
us personally in Mountain Home because of this", states Karyn Klingelhoets, one
of the Rally
organizers.
"Here is some of what comes home to us from the Komen Grant":
CARTI
radiation treatment regardless of income, ability to pay or distance from a
CARTI facility.
Treatments
typically last 4-6 weeks.
Baxter
Regional Medical Center provides schools with a "TELL YOUR MOM, SAVE A LIFE"
outreach
program
aimed at education and prevention at all ages.
BRMC
Mobile Mammography Unit which travels to provide easy access to remote areas
and workplaces
to
provide reduced cost mammography.
Lymphedema
Outreach VI to provide compression garments to survivors after
surgery.
The
mission of Rally for the Cure has been to emphasize the vital importance of
early detection in the
successful
treatment of breast cancer and to someday eradicate this life-threatening
disease. According to
Komen
for the Cure, each year breast cancer is the leading cause of death for women
ages 35-54 and
accounts
for more then 75% of all cancer deaths in women 55 years of age and older.
Since 1996, Komen
has
received over $46 million from Rally events nationwide to support their
mission.
Rally
for the Cure is based in Wilton, Connecticut. They can be reached at
800.327.6811 or at their
website:
www.rallyforthecure.com.
To
register for the October 2 Rally in Mountain Home, call the Tennis Center at
425-5009 or stop in at the
Tennis
Center at 111 CR 27.
Take
Hwy 5 No. to Roller Funeral Home. Turn right just past the cemetery onto Canne
Baker (Hwy 27).
The
Center is located on the immediate right. Donations should be made out to Rally
for the Cure and sent
to
the Tennis Center, or call to have a Rally organizer pick up your
contribution.
September
22, 2011
Doctors'
Choice earns accreditation - Daytona Beach News-Journal – by Peggy
Ellis
SOUTH
DAYTONA -- Doctors' Choice, a home health service, has earned accreditation by
the
Accreditation
Commission for Health Care Inc. (ACHC) for the services of skilled nursing,
home health
aide,
therapy and social work.
Doctors'
Choice Home Health provides skilled nursing, therapy, medical social work and
home health aide
services
to clients in Volusia and Flagler counties. The company also offers psychiatric
and wound certified
nurses,
lymphedema treatment, intravenous therapy administration, cardiac care, balance
and low vision
programs,
diabetic education and pulmonary rehabilitation.
ACHC,
a private, not-for-profit corporation, was developed by home care and
community-based providers
to
help companies improve business operations and quality of patient care.
Accreditation is a voluntary
activity
where healthcare organizations submit to peer review for their internal
policies, processes and patient
care
delivery against national standards.
September
22, 2011
Laurantis
Pharma Release: New Treatment for Lymphedema Could Mean Breakthrough for Breast
Cancer
Patients
- PipelineReview.com
Laurantis
Pharma announced that LymfactinTM, adenoviral VEGF-C growth factor therapy, was
successful
in
rebuilding lymphatic vessels in pre-clinical animal models
STOCKHOLM,
Sweden | September 21, 2011 | Laurantis Pharma, a privately held biotechnology
company
based in Finland, today announced that LymfactinTM, adenoviral VEGF-C growth
factor therapy,
was
successful in rebuilding lymphatic vessels in pre-clinical animal models. The
use of VEGF-C growth
therapy to
regenerate lymphatic vessels over time may be used to assist lymph node
transfer surgery as a
technique
to treat secondary lymphedema.
The
results were presented at the 23rd International Congress of Lymphology in
Malmö, Sweden by Kari
Alitalo,
MD, PhD, Academy Professor, Molecular Cancer Biology Program
Biomedicum
Helsinki, University of Helsinki, and Anne Saaristo, MD, PhD, Consultant
Plastic Surgeon,
Turku
University Central Hospital, Turku, Finland. The researchers were able to
demonstrate VEGF-C’s
ability
to induce the spontaneous growth of lymphatic vessels during the first two
weeks of treatment, which
then
stabilized and matured over the course of the next six months.
The
ability of VEGF-C to regulate the growth of lymphatic vessels presents an
advantage for the use of
lymph
node transfer as a way of treating lymphedema. Currently lymph node transfer is
being tested as a
way
to rebuild the lymphatic vascular anatomy but no treatment currently helps to
assist the spontaneous
growth
of lymphatic vessels.
“Breast
cancer patients have an urgent need for better treatments for lymphedma,” said
Dr. Saaristo. “With
Lymfactin,
we see the potential to increase the impact of the operation and reduce the
amount of lymphoid
tissue
that needs to be removed from other parts of the body. Ideally Lymfactin will
result in more durable
lymph
node transplants, reducing the need for painful pressure bandages.”
Lymphedema
Lymphedema,
localized swelling due to fluid accumulation, is caused by the disruption in
the flow of
lymphatic
fluid, usually associated with the removal of lymph nodes as treatment for
breast cancer. About 20
to
30 percent of patients who have had lymph nodes removed as a part of treatment
for breast cancer will
develop
chronic lymphedema. Currently, there is no cure for the condition, and
treatments are limited in their
ability
to reduce swelling and reduce the risk of infection.
About
Laurantis Pharma
Laurantis
Pharma is a clinical-stage specialty pharmaceutical development company with a
broad portfolio
of
first-in-class products based on two proprietary technologies. The Company’s
lead products target the
treatment
of a variety of inflammatory diseases and conditions including atopic
dermatitis, dry eye syndrome,
interstitial
cystitis, and lymphatic disorders, as well as the treatment of bladder
cancer.
The
Company’s pipeline includes proprietary and patent-protected formulations and
applications of cis-uroc
anic
acid (cis-UCA), a locally acting anti-inflammatory and anti-proliferative
agent. Laurantis Pharma is also
developing
Lymfactin™, a vascular endothelial growth factor C (VEGF-C) in an adenoviral
vector, for the
treatment
of secondary lymphedema. Laurantis Pharma is located in Turku, Finland. More
information can
be
found at www.laurantis.com
SOURCE:
Laurantis Pharma
September
22, 2011
in,
Fatigue, Cognitive Deficits in Breast Cancer Survivors – Medscape –
Sorry
you have to be a member of something to get this article
September
25, 2011
Dighton
family seeks to raise awareness, a cure for lymphatic diseases - Taunton Daily
Gazette – By Joan
Psotto
–
Dighton
--
With
the exception of lymphoma – a cancer of the lymphatic system – most people have
never heard of
lymphatic
disease. That changed four years ago for one Dighton couple when their
daughter, Giana, was
born
with a lymphatic malformation of the head and neck.
Initially
diagnosed at birth with a bronchial cyst, a fairly common congenital anomaly,
little Giana was sent
home
at one week of age. But with a mother's instinct, Wendy Richard knew something
more serious was
interfering
with Giana's breathing. When she was two weeks old Giana was admitted to
Children's Hospital
Boston
where specialists diagnosed the lymphatic malformation.
“It
was a nightmare,” says Wendy now. “My son was 21 months old and my infant
daughter had a life-
threatening
condition that was preventing her from breathing normally.”
Giana
underwent schlerotherapy (injections to break down the cystic mass); and at one
month old was sent
home
with a tracheotomy to open her airway. “At first they told us the trach would
be removed by her
second
birthday; but she's 4 now, and now we're hoping that it will come out next
summer,” said her mother.
Wendy
recalls the first few difficult months at home: “It was terrifying ... not only
did Giana have special
medical
needs and infection risks because of the tracheotomy and breathing
difficulties, (but) she could not
make
any sound. You had to be looking at her to know she was crying. Someone had to
be with her all the
time,
even when she slept.”
The
family had home nursing assistance for Giana's first three years.
The
family struggled — and continues to struggle — with the difficulties of having
a child with a rare disease.
“Giana's
first year was a very difficult time, a terrible strain on our family —
emotionally and financially,”
recalls
Wendy. “I wasn't able to go back to work. There was so much to learn about and
so much to worry
about.
And no one could tell us what kind of future our little girl would have. We
felt like pioneers, but we
also
felt guilty thinking that — as parents — it was somehow our fault. That was the
hardest thing. There is
just
no way to know why this happened to Giana and still happens to other children.
At this point there isn't
enough
known about lymphatic diseases and malformations to know what causes them or
what will cure
them.”
Giana's
father Chris agrees, but says that their daughter's condition has also been a
blessing to the family.
“Giana's
struggle with this lymphatic malformation has helped our family grow closer
together and closer to
God,”
he said. “We just keep believing that God will help us to work it all
out.”
Now
4 years old, Giana runs and plays with other children, but doesn't understand
why she cannot romp in
the
waves at the beach or play in the pool with her brother and cousins. She began
pre-K this September,
and
her brother Zachary is in kindergarten.
Her
parents and grandmother, Taunton resident Karen Castro, have become advocates
for lymphatic
disease
awareness. They have reached out to the Lymphatic Research Foundation, a
non-profit organization
supporting
biomedical research of the lymphatic system and advocacy for lymphatic disease
patients.
“It's
amazing to me that no one has heard of this,” says Castro, Wendy’s mom. “They
ask why Giana has
the
tracheotomy ... and no one's ever heard of lymphatic malformations or even
knows what the lymphatic
system
is. Aside from worrying about Giana, that's the most frustrating thing ... no
one has even heard of
what
she has!”
The
family will be walking with Giana to raise awareness of lymphatic diseases and
to raise funding for
lymphatic
research at the Oct. 2 National Walk for Lymphedema and Lymphatic Diseases in
Melrose.
“Giana's
Dream Team will be out there walking for our girl,” says Castro.
To
learn more about the Walk, and to support the Richard family's efforts, visit
www.walklrf.org or www.
lymphaticresearch.org.
Joan
Psotto is affiliated with the Lymphatic Research Foundation.
Copyright
2011 The Taunton Gazette. Some rights reserved
September
25, 2011
Telemedicine
Service Launched at Shirgaon through Spanco's Maha E ... - IT News
Online
This
is a duplicate article see above September 24, 2011
September
25, 2011
Andrew
set for gruelling fundraiser - NW Evening Mail –
A
SEVERELY disabled man will complete a gruelling solo wheelchair push to raise
money for other people
affected
by his condition.
Double
amputee Andrew Stevens, who has spina bifida and hydrocephalous, will push
himself on a six-mile
route
around Barrow on October 15.
The
40-year-old, who lost both legs to lymphedema in 2005, will set off from The
Forum, in Duke Street,
and
travel around Holbeck, Roose and town centre streets.
His
friend Bryn Tyson, 17, will be accompanying him to provide moral
support.
Mr
Stevens completed a five-mile push last year in memory of a friend who died 20
years ago. This year he
was
determined to do it to raise money and awareness for people with spina
bifida.
It
took him around three hours to complete the task last year, and Mr Stevens has
a similar target for when
he
does it this time round.
Mr
Stevens, of Ewan Close, Barrow, is now drumming up support for the challenge,
which will raise money
for
the Association for Spina Bifida and Hydrocephalus.
He
said: “Last time, I did it in memory of a friend, but as spina bifida affects
people around the world, I
wanted
to do something for that.
“ASBAH
has helped so many people in my situation with help and advice, I think it’s
important to give
something
back so they can continue helping people.
“I
got a real sense of achievement from it last time, but this time it has been a
real struggle getting people to
sponsor me.
Everybody has got financial problems or worries.
“I
have been in a wheelchair all my life. I was born with spina bifida and because
there was a hole in my
spine,
my mother was told they could either operate to close it, which would paralyse
me, or I would not
survive.
“I’ve
been training for a few months for it. I try and get out and do a couple of
miles in my chair whenever I
can
motivate myself, because you need a lot of strength in your arms. I just keep
pushing until I’m tired.”
To
sponsor Mr Stevens, visit www.justgiving.com/Andrew-Stevens0.
September
26, 2011
Traveling?
Veterans share the lowdown on flying after cancer treatment - MLive.com – by
Sue Schroder
Karen
Hogan puts it well: You decide how much risk you let into your life.
Hogan,
a breast cancer survivor who has been cancer-free for three years, is no
stranger to risk, but there’s
one
she won’t take: air travel.
She
had 18 lymph nodes removed following breast cancer surgery, and two more nodes
five months later.
As
a result of that and radiation, she says air travel, with its changes in air
pressure, would increase her risk
of
developing lymphedema.
For
her, that would be a painful and debilitating swelling of her right arm and
hand, which could be, she says,
even
disfiguring.
“I
don’t know what percentage of risk that could be, but I have met too many women
with lymphedema,
and
when I ask them if they have traveled via an airplane, they have all said yes.
So, I am very scared to
potentially
trigger this lifetime side effect for me.
“I
treat my arm like having a special needs child with me,” said Hogan, who calls
it a small price to pay for
being
alive. She took part in a one-year clinical trial designed to prevent
lymphedema through the Lemmen-
Holton
Cancer Pavilion, Spectrum Health and Mary Free Bed Rehabilitation
Hospital.
“Maybe
I know too much now. But I follow the instructions/tips to a T — carrying my
purse on my
nonaffected
side, not carrying anything (that weighs more than) a gallon of milk, no
manicures on my right
side
— wearing my (compression) sleeve when I exercise, etc.”
She’s
given up air travel, but she’s still on the go on her terms: She drives, or in
the case of a cross-country
business
trip, takes a train.
“I
guess I would love to know — now, three years later — if those restrictions on
travel have changed? And
am
I being too overkill on this or not?”
The
risk has not gone away.
“Lymphedema
can flair up on airplanes, so the National Lymphedema Network has some
precautions,” said
Deb
Bisel, oncology nurse and manager of Cancer Program Compliance for Spectrum
Health Cancer
Services.
“There
are many considerations (about traveling and cancer),” Bisel wrote in an email.
“We have a fair
amount
of people who winter in warmer climates, and have part of their treatment here
and part elsewhere.
Due
to our electronic environment, it is becoming easier for physicians to
communicate and set up treatment
plans.
“If
(a patient is) under active treatment, there should be some pre-planning to
know where the hospitals and
local
resources are for your destination.
“I’ve
personally contacted an oncology nurse in the area where a patient is
traveling, if I have concerns that
they
could get in trouble while away. The patient then has a local contact number to
seek help or advice for
an
unplanned side effect, for example.”
Advice
which takes on extra significance for those of us who have experienced blood
clots: On long flights,
wear
compression hose. I just traded up to full foot-to-knee compression socks by
Zensa.
Sue Schroder,
former features editor for The Grand Rapids Press, was diagnosed with
non-Hodgkin’s
lymphoma
in late 2009. Email her at [email protected].
September
25, 2011
Cancer
survivor joins CIBC Run for the Cure - Calgary Herald –
CALGARY
— Active, healthy and a hard-working career woman in her late 40s, Diane Martin
had always
avoided
mammograms, figuring she was too young to worry about breast cancer.
In
May 2000, her doctor finally convinced her to go for a routine ultrasound as
part of her annual physical,
which
revealed swollen lymph nodes under her arm, near her left breast.
A
biopsy soon after confirmed stage 3 breast cancer, and Martin’s breath was
taken away.
“I
remember my doctor came into the room and sat down, pulling her chair very
close to me,” she said.
“I
knew something was up. But you can never prepare yourself.
“When
she said the two words ‘breast cancer,’ I lost my breath. I didn’t hear much of
anything else she said
after
that.”
About
two months before her diagnosis, Martin had lost her own father to lung cancer.
He died just two
weeks
after checking into the hospital, worried about pneumonia-like
symptoms.
“I
thought I would end up the same. I thought, that’s it, I have two weeks left to
live. What am I going to
do?”
But
the next few weeks brought on what Martin likes to call her “warrior face” and
she took her battle head
on,
realizing she had too much to live for.
“I
thought, ‘I want to live, I want to meet more people. And I want people to meet
me, because I’m a pretty
special
person,’” she said.
A
lumpectomy, followed by six weeks of chemotherapy and one month of radiation
left her exhausted,
shaken
and plagued by constant nausea.
But
a life once devoted to career, collecting money and material wealth, changed
completely for Martin.
She
still remembers one night during her recovery “I was sitting outside one summer
night. It was 4 a.m. and
I
couldn’t sleep. I looked around at the trees and the flowers and I thought,
‘have these always been here?
Because
I’d never really noticed them before.’”
She
quickly became involved in volunteer work, the CIBC Run for the Cure, and
helping other women
battling
breast cancer.
But
her difficult road wasn’t over.
A
year later, a small cut on her left hand led to massive, painful swelling all
along her left arm.
Because
lymph nodes had been damaged during her surgery, lymphatic fluid was building
up as it reacted to
infection
in her hand.
It
wasn’t cancer, but a case of lymphedema few doctors were able to help her
with.
After
hundreds of phone calls, Martin was able to finally find a lymphedema therapist
that was able to
massage
the fluid out of her arm and into the rest of her body.
Although
the ailment is typical in breast cancer survivors, help is hard to find. So
Martin and her therapist
created
the Alberta Lymphedema Association to provide support for sufferers and better
education and
awareness
within the medical community.
Over
the next several years, Martin continued her volunteer work and also helped her
sister battle kidney
cancer.
But,
by 2007, Martin found another lump near her left breast as she lathered up in
the shower.
It
was only days before her annual check up.
A
mammogram, followed up by another biopsy confirmed, again, stage 3
cancer.
And
while Martin, “warrior-face” on was ready to fight once more, it was her
husband Doug, that found the
news
really hard to take.
“I
could tell it was really hurting him this time.”
Her
second bout of chemotherapy was much more difficult than the first, forcing her
to lay in bed for up to
eight
hours at a time, connected to an IV, being fed an even harsher concoction this
time.“The pain was like
my bones were
being squeezed together, three or four days at a time,” she said. “It was
terrible. Every time
I
came back for the next round, I knew how bad it was going to be.”
After
her final round in late 2007, Martin found yet another lump in the same area
and was sent straight to
surgery.
But
this time doctors confirmed it was benign.
The
good news and her clean bill of health since has Martin now working as co-run
director for the CIBC
Run
for the Cure for the Prairies and NWT region.
Up
to 5,300 runners are already registered for this year’s run, eager to beat last
year’s fundraising total of
$1.7
million.
Martin
looks forward will be run alongside other survivors like her, ready to lend a
helping hand, and a
supportive
ear.
“When
you go you have to just stop and look around. It’s a sea of pink,” she said.
“And everyone is there
to
support each other.
“It’s
a wonderful feeling.”
September
24, 2011
Lymfactin™
Found To Significantly Increase Growth Of Lymphatic Vessels In Animal Study
–
Laurantis
Pharma, a privately held biotechnology company based in Finland, announced that
LymfactinTM,
adenoviral
VEGF-C growth factor therapy, was successful in rebuilding lymphatic vessels in
pre-clinical
animal
models. The use of VEGF-C growth therapy to regenerate lymphatic vessels over
time may be used
to
assist lymph node transfer surgery as a technique to treat secondary
lymphedema.
The
results were presented at the 23rd International Congress of Lymphology in
Malmö, Sweden by Kari
Alitalo,
MD, PhD, Academy Professor, Molecular Cancer Biology Program Biomedicum
Helsinki,
University
of Helsinki, and Anne Saaristo, MD, PhD, Consultant Plastic Surgeon, Turku
University Central
Hospital,
Turku, Finland. The researchers were able to demonstrate VEGF-C's ability to
induce the
spontaneous
growth of lymphatic vessels during the first two weeks of treatment, which then
stabilized and
matured
over the course of the next six months.
The
ability of VEGF-C to regulate the growth of lymphatic vessels presents an
advantage for the use of
lymph
node transfer as a way of treating lymphedema. Currently lymph node transfer is
being tested as a
way
to rebuild the lymphatic vascular anatomy but no treatment currently helps to
assist the spontaneous
growth
of lymphatic vessels.
"Breast
cancer patients have an urgent need for better treatments for lymphedma," said
Dr. Saaristo. "With
Lymfactin,
we see the potential to increase the impact of the operation and reduce the
amount of lymphoid
tissue
that needs to be removed from other parts of the body. Ideally Lymfactin will
result in more durable
lymph
node transplants, reducing the need for painful pressure bandages."
Lymphedema
Lymphedema,
localized swelling due to fluid accumulation, is caused by the disruption in
the flow of
lymphatic
fluid, usually associated with the removal of lymph nodes as treatment for
breast cancer. About 20
to
30 percent of patients who have had lymph nodes removed as a part of treatment
for breast cancer will
develop
chronic lymphedema. Currently, there is no cure for the condition, and
treatments are limited in their
ability
to reduce swelling and reduce the risk of infection
September
26, 2011
Lymphedema
Depot Fundraising for Lymphedema Association of Ontario - Wire Service Canada
–
It’s
that time of year again! It's time for Team Niagara to put on their walking
shoes to support the
Lymphedema
Association of Ontario in their annual fundraising 5K walk/run.
On
October 16, 2011, Lymphedema Depot and Team Niagara will be participating in a
local fundraising
event.
This local event in St. Catharines, Ontario, is a satellite event to the annual
Scotiabank Toronto
Waterfront
5k Run/Walk.
Lymphedema
Depot will be raising funds for The Lymphedema Association of Ontario (LAO) as
we take a
5K
walk (you can run if you like) along the scenic Welland Canal in St.
Catharines, Ontario.
The
work of the LAO supports the lymphedema community in Ontario and
beyond.
According
to John Mulligan, a registered massage therapist and certified lymphedema
therapist, and Clinical
Specialist
with Lymphedema Depot, "The LAO gives a voice to lymphedema patients and
connects them
with
therapists, goods and services and, most importantly, connects them with one
another. The LAO has
been
putting on conferences and publishing a newsletter for 15 years now, and they
need our support to
continue.The
LAO gives a voice to lymphedema patients and connects them with therapists,
goods and
services
and, most importantly, connects them with one another. The LAO has been putting
on conferences
and
publishing a newsletter for 15 years now, and they need our support to
continue."
"Not
only does the LAO support lymphedema patients and therapists but their work
crosses over into
helping
patients with lipedema, venous insufficiency and other related conditions. Not
only do they support
lymphedema
patients and therapists but their work crosses over into helping patients with
lipedema, venous
insufficiency
and other related conditions."
Mulligan
states, "If you are in the Niagara region and you would like to come out on
October 16 and join
Team
Lymphedema Niagara in this awareness and fundraising event for the Lymphedema
Association of
Ontario,
the Team would love to hear from you!"
Contact
team captain, John Mulligan
at
[email protected] or (905) 687-1828.
If
you can’t make it, please consider making a donation online in support of the
LAO using the link provided
here:
http://my.e2rm.com/TeamPage.aspx?teamID=259759&langPref=en-CA.
You
can learn more about the Lymphedema Association of Ontario here:
http://www.torontowaterfrontmarathon.com/en/charity/lao.htm.
"I
can’t overstate the importance of the Lymphedema Association of Ontario and the
work they do, and
have
done for the past 15 years," Mulligan continued. "Through their persistent
efforts they have made the
general
public and the medical profession more aware of lymphedema."
"No
donation is too small and every dollar helps this wonderful non-profit
organization to accomplish their
important
objectives. Any donation cheque must be made out to the Lymphedema Association
of Ontario,
or
simply LAO."
All
pledges will receive an official tax receipt.
September
27, 2011
Cancer
Patient Carrying Out Voluntary Work to Help Other Patients - French Tribune
–
Most
of the women do not go for mammograms and end up with cancer diagnosed at
advanced stages, this
is
what happened with Diane Martin who did not underwent mammograms thinking that
it was too early to
get
the check-up done.
But
finally in 2000, she underwent ultrasound where swollen lymph nodes under her
arm besides her breast
were
discovered, which was later identified as stage-three breast cancer.
Her
doctor had many a times asked her to go for the check-up but she delayed the
issue which resulted in
breast
cancer at advanced stage. If she would not have been thinking much, she would
have got her cancer
detected
timely. Similar is the case with lot of women who due to some reasons do not
consider it as
necessary
and end up in screwing up their lives.
After
undergoing treatment, she is now working as volunteer at the Canadian Breast
Cancer Foundation
CIBC
Run for Cure and has been providing help to women in need.
Even
after the surgery, lymphatic fluid was building up in her arm, so she finally
found a lymphedema
therapist
who helped her take the fluid out.
Now,
she and her therapists have joined hands with Alberta Lymphedema Association
that make the
women
aware about the early diagnosis and help them in related problems.
inful
surgery to remove the lymph nodes is not necessary for some women – Ocala – By
Molly Larmie -
For
more than 100 years, standard treatment for breast cancer has included a
painful surgery: the removal of
lymph
nodes under the armpit. But a new study finds that for 20 percent of invasive
breast cancer patients
—
around 40,000 women in the U.S. each year — radiation and chemotherapy treat the
cancer just as
effectively
as removing the nodes.
The
study, conducted by the American College of Surgeons Oncology Group, throws the
traditional view of
breast
cancer treatment "out the window," said Dr. Uma Swamy, a radiation oncologist
at North Florida
Regional
Medical Center.
Once
breast cancer reaches the lymph nodes, it has the potential to spread to other
vital organs. If cancer is
detected
in the armpit, wary surgeons typically remove about 10 nodes.
"The
thought with cancer has usually been ‘Cut, cut, cut — take as much out as
possible,'" Swamy said.
Painful
complications can accompany node removal surgery, including infection,
limitation of motion and
lymphedema,
a chronic swelling in the arm. These side effects have long been considered
necessary evils in
the
successful treatment of breast cancer.
But
the study, published in The Journal of the American Medical Association, finds
there is no difference in
overall
survival rate between women who had 10 or more lymph nodes removed and those
who had only
one
or two removed for testing.
The
findings turn over a new leaf in the much-evolved history of breast cancer
treatment.
Forty
years ago, the standard of treatment for breast cancer was the Halsted radical
mastectomy, in which
surgeons
removed the whole breast and surrounding muscles. Lymph nodes in the armpit
were removed in a
procedure
called axillary lymph node dissection, or ALND.
Over
time, as research shed new light on the disease, rates of mastectomy declined.
Most breast cancer
patients
today undergo a lumpectomy, in which doctors remove large tumors in the breast
and treat
microscopic
disease with radiation and chemotherapy.
A
technique called sentinel lymph node dissection, or SLND, is commonly used to
detect cancer in the
lymph
nodes. Using SLND, physicians inject dye into the breast and observe the path
the dye takes to the
lymph
nodes. If cancer has spread from the breast to the lymph nodes, this is the
route it would have taken.
The
illuminated or "sentinel" lymph nodes are removed and tested for cancer. If the
nodes test negative, the
patient
will not require further surgery in the armpit. If a positive result comes
back, surgeons usually remove
eight
to 10 additional nodes.
After
armpit surgery, some women experience numbness, limited range of motion or
lymphedema, a painful
swelling
in the arm that occurs when scar tissue blocks the flow of fluid. Radiation
increases the risk for
lymphedema,
which has no cure.
The
lead author of the study, Dr. Armando Giuliano, and his team worried that
physicians were ordering
painful
surgeries for patients with no proof that removing the lymph nodes actually
increases the chance of
survival.
With funding
from The National Cancer Institute, the researchers enrolled 891 patients at
115 medical
centers
into the study. All patients had early invasive breast cancer with tumors less
than 2 inches across and
no
more than two cancerous sentinel lymph nodes.
After
undergoing lumpectomies and whole-breast radiation, the women were randomly
assigned to either
undergo
ALND, with 10 or more lymph nodes taken out, or no further surgery.
The
reduced risk of complications could help sway their decision. With radiation
and SLND alone, patients
have
a less than 5 percent risk of lymphedema, Swamy said.
"As
a patient, you must be careful and talk to your physicians to make sure the
study applies to you,"
Swamy
said. "And it is the physician's responsibility to make sure patients
understand as much as they need
to
make an informed decision."
Marshall
Browning & SIH Reach Affiliation Agreement - Du Quoin Evening Call
–
Du
Quoin, Ill. --
Marshall
Browning Hospital (MBH) in Du Quoin and Southern Illinois Healthcare (SIH) in
Carbondale
today
announced a formal affiliation between the two facilities.
Under
the affiliation, patients of Marshall Browning Hospital will continue to
receive high-quality care from
the
providers they know and trust at the hospital they have long relied upon. MBH
will remain as a separate
entity
with its own Board of Directors, identity and endowment.
"Marshall
Browning Hospital is pleased to partner with a highly regarded organization
such as SIH to
enhance
services for the residents of Perry County through outreach, development and
clinical integration,"
says
William Huff, CEO, Marshall Browning Hospital. Huff emphasized that “this is
not a merger or
acquisition
and that Marshall Browning Hospital would retain its own identity. The
affiliation will provide a
rich
spectrum of educational, administrative, and clinical opportunities in the
healthcare professions, meet
community
needs for high quality, cost-effective healthcare and develop new regional
linkages among
healthcare
providers.”
A
significant benefit of the affiliation is for patients with complex medical
needs who require tertiary care or
specialty
services unavailable at MBH. The affiliation will offer better coordination of
care and services
through
such means as an expanded pool of consulting subspecialists. In addition, SIH
will work closely with
the
hospital to identify opportunities to enhance the services available at
MBH.
"The
Marshall Browning Hospital Board took extensive steps to consider the
affiliation prior to formal
adoption
and feels confident that the alignment is proper and in the best interest of
the hospital and the
patients
it serves," stated Harold Rice, President of the Marshall Browning Hospital
Board. William Huff,
CEO,
added that a key benefit of the affiliation is allowing the hospital to remain
a local facility with "local
citizens
serving on the Board to work to provide services for the citizens in its
service area."
The
affiliation builds on and expands the various collaborations that already exist
between SIH and MBH
such
as its partnership with SIH and Prairie Cardiovascular through its Prairie
STATHeart program.
STATHeart
identifies, treats, and transfers acute heart attack patients to a cardiac cath
lab within 90 minutes
of
arriving in Marshall Browning Hospital’s emergency room. The STATHeart program
melds cooperation
and
collaboration between the community hospital emergency department, EMS ground
and air transport,
Memorial
Hospital of Carbondale and cardiologists of Prairie Cardiovascular.
In
addition, SIH physicians have long consulted at MBH, seeing patients in such
specialties as cardiology,
oncology/hematology,
and pulmonology.
“The
affiliation is not meant to be disruptive of pre-existing clinical
relationships or referral patterns. Rather
we
want to work closely with the hospital to identify gaps in care and determine
how SIH can help fill in
those
gaps as well as reinforce or add services that will be helpful to Perry County”
said SIH President and
CEO
Rex Budde.
Marshall
Browning Hospital is a not-for-profit Critical Access Hospital providing a
broad range of services
to
citizens of Perry County and the surrounding communities. Founded in 1919, the
25-bed hospital
maintains
a deep tradition of providing high-quality care to a service area of over
20,000.
The
hospital also includes Marshall Browning Therapy Center, located on the
hospital campus. Services
offered
at the center include Physical Therapy, Occupational Therapy, Speech Therapy,
Athletic Training,
ImPACT
Concussion Testing, Aquatic Therapy, Lymphedema Therapy, Vestibular Therapy,
Hand
Therapy,
Pediatrics and Hippotherapy. Marshall Browning Therapy Center also has become
the only facility
in
southern Illinois to have certified instructors to offer the highly acclaimed
Sportsmetrics™ Training
Program,
effective in reducing the risk of knee injuries in female athletes.
The
campus also includes a 22-unit Independent Living Center and Marshall Browning
Medical Clinic that
includes
the practices of Dr. Gladstone Tucker, Dr. Terrence Hall, Dr. Beth Bigham, and
Family Nurse
Practitioner,
Felicia Kimbrough. Marshall Browning Hospital is fully accredited by The Joint
Commission.
The
hospital has in excess of 43,000 patient visits which include inpatient,
outpatient and ER visits per year.
Southern
Illinois Healthcare includes Memorial Hospital of Carbondale, Herrin Hospital,
St. Joseph
Memorial
Hospital, the SIH Cancer Institute and Miners Memorial Health Center.
Copyright
2011 Du Quoin Evening Call. Some rights reserved
September
28, 2011,
Life
After Breast Cancer Can Be Difficult: Dr. Pearman - MyFox Chicago -
Chicago
- More women than ever before are surviving breast cancer, but some still
struggle to feel normal
and
healthy after beating their disease. Dr. Timothy Pearman, a clinical
psychologist and director of the
supportive
oncology program at Northwestern Medicine and the Robert H. Lurie Comprehensive
Cancer
Center,
joined us.
Pearman
said after battling breast cancer, woman may struggle with fatigue, cognitive
problems (sometimes
known
as chemobrain), nutrition, depression and side effects that may present
themselves years after
treatment.
Quality of life for breast cancer survivors, in particular, is often affected
by lymphedema,
premature
menopause and concerns about their risk of recurrence and libido.
A
lot of these issues, which may be either disease related or treatment related,
tend to revolve around
emotional
support. Anywhere from 30 to 50 percent of patients will be clinically
depressed or experience
clinical
anxiety at some point during their treatment, Pearman said.
To
make the transition to life after breast cancer easier, woman can take care of
their mental and physical
health,
Pearman said. Specialists like social workers, cancer rehabilitation
therapists, nutritionists and health
educators
can be a big help in helping women striving to live healthy lives after
cancer.
The
free Lynn Sage Breast Cancer Town Hall Meeting on Sunday, Oct. 2 is open to the
public from 1 p.m.
until
4 p.m. in the Arthur Rubloff Building’s Thorne Auditorium, 375 East Chicago
Avenue, on
Northwestern
University’s Chicago Campus. Exhibits and registration start at noon.
Recovery
Club: Pro-Level Training Tools for Weekend Warriors - Wired News – By Joe
Lindsey -
I
lean back in a chaise lounge while what look like the world’s largest blood
pressure cuffs slowly inflate
around
my legs. But this is no medical test: This is the future of active recovery for
amateur athletes.
Professional
athletes have for years had access to better training tools and techniques than
us workaday
amateurs.
They benefit from more sophisticated approaches because the price, complexity,
or simple rarity
of
many of these modalities puts them out of reach of the rest of us.
Josh
Shadle hopes to change all that. A longtime massage therapist, Shadle earlier
this year opened
AllSports
Recovery Club, which he believes is the first open-to-the-public recovery
center in the world.
And
while his clientele includes pro athletes, he’s targeting amateurs, giving them
access to the same tools as
elite
competitors.
“I’ve
been doing massage for five years,” he says, “and the next step, to me, was a
walk-in recovery center
where
people could go and use these tools themselves, without anyone having to do it
for them.”
AllSports
is focused on FDA-approved products that you can use without medical
supervision. The suite of
tools
runs a broad range, from cold lasers to a custom temperature-controlled ice
bath that circulates
saltwater
at a constant 50 degrees. One ingenious hack is a $25 Ryobi six-inch orbital
buffer, perfect for
self-massage.
But
the star of the show is clearly the NormaTec MVP boots, a compression therapy
that Shadle likens to
an
extremely effective massage. You can buy static compression clothing, but the
research on its
effectiveness
is mixed.
The
NormaTec system, by contrast, uses dynamic sequential gradient compression,
which is a fancy way of
saying
it pressurizes five separate chambers in sequence; you can control intensity
and duration to match
your
needs.
Clinical
research in sports recovery hasn’t caught up to use yet, but the system —
invented for hospital
patients
— has been shown effective in medical settings at counteracting lymphedema, the
painful and
dangerous
pooling of lymphatic fluid in tissues.
Dynamic
compression’s action mechanism for sports recovery is unclear. It may help
speed toxins and
promote
circulation; it may enhance muscles’ thixotropic properties — their ability to
become more flexible
when
used.
Mesa
State University’s Bill Sands, a physiologist who formerly ran the United
States Olympic Training
Center’s
recovery facility, says compression — particularly dynamic compression like the
NormaTec
system
— is one of the few recovery modalities he’s studied that show clinical promise
for producing an
actual
performance benefit.
Anecdotally,
results are more emphatic. Mirinda Carfrae, the reigning Ironman World
Triathlon Champion,
and
an AllSports client, says that ice baths AND NormaTec boots are her top choices
for post-workout
recovery.
So
what’s to stop you from getting this stuff yourself? Well, a pair of boots is
$5,000, for one. An ice bath
from
iCool, one of the cheapest available, will set you back another $4,990 or more.
Cold lasers are cheap
by
comparison, starting around $300 for a basic model.
Shadle’s
club offers unlimited walk-in access to all that for $60 a month, plus
discounted à la carte services
like
chiropractic, massage and Graston technique. “I’ve been to the USOC’s recovery
room,” says
NormaTec
vice-president Gilad Jacobs, “and what Josh has going is every bit as good as
that.”
For
a retail model, Shadle is less focused on the gym or yoga studio model and more
on an icon from the
tech
industry: Apple. “I envision it like the Genius Bar,” Shadle says. “You come in
and tell us what
problems
you’re having and we set you up with the tools and a recovery protocol to help.
It’s free advice,
so
that we can help educate people to get the kind of help they need to be healthy
and improve their
performance.”
That’s
great, I think, but I still have two questions.
First,
do amateur athletes really need all that? After all, we don’t work out as hard
as pros.
Sure,
replies Shadle. “In fact, we think amateur athletes have more to gain here.
Pros are already focused on
recovery
and are looking at single-percent performance gains. But amateurs often don’t
have time for
recovery
workouts; when they work out they go hard every time. So muscles get tight from
all that
metabolic
waste, and it builds up and people never really recover. With amateurs, the
room for improvement
is
so much bigger.”
Second,
right now the only location is in Boulder, Colorado, a town known for being
packed wall-to-wall
with
endurance athletes at 4 percent body fat. Will it play, as they say, in
Peoria?
Shadle
hopes so. He realizes not every city could support an AllSports, but that’s
part of why the price is
set
where it is. “This is the same price as a one-hour massage,” he points out,
“but you can come here every
day
if you like.”
And
because everything is in one place, AllSports might be all you need. Carfrae
has a set of NormaTec
boots
at home, but comes in anyway, she says, because of what else AllSports offers.
“I can go in for a
massage,
do some Graston, or jump in the ice bath and use the boots,” she says of the
range. “It’s a one-
stop
shop.”
Carfrae
defends her title on Oct. 8. You can bet Shadle will be watching
closely.
September
28, 2011
Nomograms
can predict 5-year lymphedema risk - Oncology Nurse Advisor –
Estimating
the risk of lymphedema after axillary dissection for breast cancer is
difficult, but a group of
researchers
has used a large data set to develop graphical statistical tools known as
nomograms to help
predict
5-year probability.
Jose
L. Bevilacqua, MD, PhD, a surgical oncologist at Hospital Sírio-Libanês in São
Paulo, Brazil, and
colleagues
collected clinicopathologic features from a prospective cohort study of 1,054
women with
unilateral
breast cancer. All subjects had undergone axillary dissection, between August
2001 and
November
2002, as part of their surgical treatment
The
investigators determined the cumulative incidence of lymphedema and predicted
the risk of developing
the
condition based on the available data at each of three timepoints:
preoperatively, within 6 months
postoperatively,
and 6 months or more postoperatively. They defined lymphedema as a volume
difference of
at
least 200 mL between arms at 6 months or more after surgery.
As
reported at the American Society of Clinical Oncology 2011 Breast Cancer
Symposium, held
September
8-10, 2011, in San Francisco, California, Bevilacqua and associates found the
5-year cumulative
incidence
of lymphedema to be 30.3% (www.asco.org/ASCOv2/Meetings/Abstracts?
&vmview=abst_detail_view&confID=111&abstractID=86647).
Independent risk factors for the condition
were
age, body mass index (BMI), ipsilateral arm chemotherapy infusions, level of
axillary dissection,
location
of radiotherapy field, development of postoperative seroma, infection, and
early edema.
The
predicted 5-year risks calculated by the nomograms were more than 70% accurate
for all three
timepoints
assessed—70.6% for the preoperative model, 72.9% for the
within-6-months-postoperatively
model,
and 73.6% for the 6-months-or-more-postoperatively model.
The
investigators concluded that the proposed nomograms can help clinicians and
patients predict the 5-year
probability
of lymphedema after axillary dissection for breast cancer, knowledge that could
identify patients
who
may benefit from early intervention.
September
29, 2011
QH
Medical Supply Joins G'Town Chamber – Memphis Daily News – By JOHN
LINTNER
QH
Medical Supply hasn’t moved to a new location, but the company will celebrate
its membership into the
Germantown
Chamber of Commerce with a ribbon-cutting ceremony Tuesday, Oct. 4.
That
event will be followed by an open house at QH Medical Supply’s headquarters,
2965 N. Germantown
Road
in Bartlett.
QH
Medical is a durable medical equipment company specializing in mastectomy
products and pain
management.
It also carries a host of other items such as lymphedema sleeves, compression
hose, adult
diapers
and wheelchair cushions.
All
employees are certified to fit mastectomy products such as bras and
forms.
The
company, which works directly with patients, providing them with much-needed
supplies that are
ordered
by a physician, also has a retail location.
“I
have 25 years’ experience doing medical billing and medical software,” said
Patricia Barnett, co-owner of
QH
Medical Supply. “So, I’m a certified vendor – not QH – but I’m a certified
vendor with Medicare as far
as
medical software. (Co-owner) Jan (Freudenberg) and I both have been in the
(durable medical
equipment)
business with another company. We have extensive backgrounds in DME as well as
medical
billing.”
The
medical supply company now offers Freedom Alert, which is a two-way emergency
pendant
communicator
that allows wearers to call 911, family members or remotely answer incoming
calls. It carries
no
monthly maintenance fee.
QH
is Medicare-accredited and carries most insurance. It is also a member of the
Bartlett Chamber of
Commerce.
September
30, 2011
NJ
med firm, office manager admit fraud charges - Houston Chronicle –
TRENTON,
N.J. (AP) — State authorities say a southern New Jersey medical firm and its
office manager
have
admitted defrauding Medicaid and Medicare of $3 million.
Attorney
General Paula Dow announced the guilty pleas Friday, one day after The Center
for Lymphatic
Disorders,
based in Egg Harbor Township, and 54-year-old Farah Iranipour Houtan appeared
in state
Superior
Court in Atlantic County. Houtan admitted that between 2004 and 2007, she
billed the health care
programs
for treatment that wasn't provided.
In
a related matter, 45-year-old Khashayar Salartash of Linwood, a surgeon and
company owner, agreed
Thursday
to repay the $3 million as part of a separate consent agreement with the
state.
The
company treated patients with lymphedema, a disorder that causes fluid
accumulation and swelling of
the
arms and legs.
St.
John's Cancer Center of Ventura County Offers Several Free Classes and Support
Groups Each Month
-
Ventura County Star -
St.
John’s Cancer Center of Ventura County offers various free classes and support
groups to help those
affected
by cancer. For more information or to register for a class, please call (805)
988-2641.
The
following classes are offered at St. John’s Cancer Center of Ventura County,
located at 1700 North
Rose
Avenue, Suite 145 in Oxnard, unless otherwise indicated:
Colorectal
Cancer Support Group: second and fourth Thursdays of each month from 6 to 7:30
p.m. Co-
sponsored
by the American Cancer Society. Facilitated by MaryAnna Palmer, MS, MFT from
The
Wellness
Community.
The
Color of Love Group: first and third Thursdays of each month from 7 to 8:30
p.m. This group is
designed
to allow cancer patients and their families to express themselves through art.
Facilitated by local
artist
Kathleen Hagen, who has over eight years of experience in leading this
group.
Exercise
is Wise—an After Breast Cancer Surgery Exercise Class: Wednesdays from 4 to 5
p.m. Classes
are
held at St. John’s Outpatient Therapy Center, 961 N. Rice Avenue, #3,
Oxnard.
Free
Wigs, Hats and Scarves
Individual
Bilingual Counseling for Patients and Caregivers: By appointment only. Call
(805) 988-2641.
Kids
with Relatives with Cancer Support Group: Tuesdays from 6:30 to 8 p.m.
Facilitated by Diane Martell,
LMFT.
Co-sponsored by The Wellness Community.
Latina
Breast Cancer Support Group: first and third Thursdays of each month from 12 to
1 p.m. Facilitated
by
Rosie Hernandez, MSW.
Latina
Women’s Support Group: second and fourth Mondays of each month from 10 to
11:3-0 a.m. for
Latina
women with any kind of cancer. Facilitated by Diane Martell, LMFT. Co-sponsored
by The
Wellness
Community.
Latino
Cancer Support Group: fourth Thursday of each month from 6:30 to 8 p.m. for
patients and family
members.
Facilitated by Mario Cepeda, MA. Co-sponsored by The Wellness
Community.
Latino
Men’s Support Group: first and third Mondays of each month from 10 to 11:30
a.m. Facilitated by
Diane
Martell, LMFT. Cosponsored by The Wellness Community.
Lymphedema
Education and Screening Clinic: third Friday of each month from 2 to 3 p.m.
Individual risk
assessments
and valuable information for the prevention of chronic lymphedema will be
provided by
Cassandra
Norton, PT.
Nutrition
Counseling: Thursdays from 9 a.m. to 3 p.m. Individual one-hour sessions with
Susan J. Speer,
MS,
RD, FADA, CSO a certified nutritionist specializing in diets for cancer
patients that can help you eat
better
and feel better. She can explain problems related to your individual condition
and develop a dietary
plan
to meet your special needs.
Prostate
Cancer Support Group: third Tuesday of each month from 10 to 11:30 a.m.
Facilitated by Helmut
K.
Hoenigsberg, a volunteer with the American Cancer Society. Co-sponsored by the
American Cancer
Society.
Relaxation
Therapy in the Reiki Tradition: see the Cancer Center calendar for days and
times. Practitioners
strategically
place their hands on various positions of the body so Reiki Energy can begin to
flow. Patients
often
report they have less pain and nausea and are able to sleep better and think
more clearly.
Reinhabiting
You Yoga Classes: Gentle Yoga for Your Journey with Cancer—Thursdays from 1:45
to 3 p.
m.;
Feeling Better and Stronger with Yoga—Thursdays from 3 to 4:30 p.m. Taught by
Audrey Waltzer,
owner
and director of the Camarillo Yoga Center.
Women
with Cancer Support Group: Tuesdays from 1 to 2:30 p.m. Facilitated by Joyce
Boucher, LCSW,
MFT.
Co-sponsored by The Wellness Community.
October
1, 2011
Occupational
Therapist - Minot Daily News –
MEDICAL
HELP WANTED
OCCUPATIONAL
THERAPIST
Full-time
position. Mon.- Fri. day shift with some weekend coverage required. Job duties
include but not
limited
to: Orthopaedics, Vestibular, Incontinence, Fibromyalgia, Lymphedema, Pool
Therapy, Skilled,
Home
Health and Care Center. Occupational Therapy License required. Sign-on bonus
and paid CEU's.
HOSPITAL
PHARMACIST
Full-time
position. Mon.- Fri. 9:00 a.m. - 5:30 p.m. but will require flexibility. Job
will primarily be in the
hospital
pharmacy at both Wright Medical Center and Belmond Medical Center and will
float as needed in
the
retail pharmacy at Wright Medical Center. Position will be required to be on a
call rotation and work
every
fourth Saturday morning. Hospital pharmacy experience preferred.
Positions
offer outstanding wages & fringe benefits. Please stop by and pick up an
application, apply on-line
at
www.wrightmed.com or contact the Human Resouces Department at 515-602 9801 to
receive an
application
by mail. All positions are subject to criminal/department adult abuse
background checks, pre-
employment
physical and drug testing.
WRIGHT
MEDICAL CENTER
1316
S. MAIN STREET
CLARION,
IA 50525
Wright
Medical CENTER
Breast
cancer 'not a death sentence' - Taunton Daily Gazette – By Deborah Allard
–
FALL
RIVER --
In
the waiting room of Charlton Memorial Hospital’s Southcoast Center for Cancer
Care, Juanita
Thompson
sang softly to a tune that she alone could hear from her iPod.
Thompson,
a breast cancer survivor, had a mastectomy about a year ago and several rounds
of
chemotherapy.
Despite losing her hair and a breast, the spiritual woman has found a renewed
sense of joy.
“I’ve
come out of this with a brand new mind, body and spirit,” Thompson said. “It’s
really not a death
sentence.
It’s made me think about life and make every minute of it count.”
Thompson,
like most who suffer from breast cancer, has gone on to live a long and healthy
life — a far cry
from
what women endured not so many years ago when little was known about breast
cancer.
Today,
there are some 50 forms of chemotherapy, hormonal agents and targeted therapies
that work
together
to kill breast cancer cells, not to mention surgical options, radiation therapy
and clinical trials,
according
to materials from Saint Anne’s Hospital’s Regional Cancer Care
center.
Susan
O’Brien, an oncology nurse practitioner at Saint Anne’s Hospital, said breast
cancer has become
more
chronic than fatal.
“Once
a woman is diagnosed, it’s a journey that she undertakes,” O’Brien said. “It’s
so wonderful that these
women
with breast cancer are living so long.”
O’Brien
said breast cancer survival rates have been incredibly improved even since she
started at Saint
Anne’s
Hospital 25 years ago. Because of advances made in drugs and in education, more
women are
diagnosed
with curable Stage I and II cancers, rather than at more advanced
stages.
The
five-year survival rates for Stage I and II breast cancer now ranges from 74 to
88 percent, according to
the
American Cancer Society. The survival rates for stage III and IV breast cancer
are as high as 67 percent.
Until
the 1960s — and later, in some cases — survival rates were very low, and the
disease often resulted in
death.
People thought breast cancer was embarrassing, and it was a hushed topic that
often resulted in a
late,
if any, diagnosis.
Dr.
William Stewart Halsted is credited with being one of the fathers of modern
American surgery at Johns
Hopkins
University Hospital in the late 1800s. He developed the radical mastectomy,
which consisted of
removing
the entire breast, the underlying chest wall muscles and all lymph nodes in the
armpit, according to
the
National Surgical Adjuvant Breast and Bowel Project.
The
deforming operation resulted in a concave appearance, O’Brien explained. Women
who underwent the
procedure
often sought to wear a heavy prosthetic breast afterward.
This
procedure was the standard breast cancer surgery for decades, until brothers
Drs. Bernard and Edwin
Fisher
challenged the radical mastectomy in the 1960s.
Today,
doctors know that mastectomy has the same end result as lumpectomy plus
radiation for most
women.
Those undergoing mastectomy do not lose as much tissue as in decades
past.
Until
25 years ago, women also underwent 14 cycles of chemotherapy lasting for 14
months, as opposed to
today’s
roughly four months of chemotherapy.
“I
never thought I would die,” said Margaret McCaffrey, who had breast cancer in
1995. Now retired, she
is
a greeter at the Hudner Oncology Center at Saint Anne’s Hospital.
Because
most women live with breast cancer, there is a whole new population of women in
follow-up care
for
years after their surgery or treatments. For them, living with breast cancer is
the new normal.
For
Thompson, follow-up care has included doctor’s visits every three months and
monthly blood work.
Breast
cancer can also result in complications. Thompson experienced lymphedema in her
arm, a swelling of
the
tissue, due to the surgery.
O’Brien
said there are many “immediate and long-term effects.”
Besides
lymphedema, patients can suffer from cognitive difficulties, low energy and
depression. They may
also
suffer effects to the heart and lungs, or go into early menopause, which can
lead to osteoporosis.
Follow-up
care generally consists of following any side effects, and includes hormone
therapy for some.
Support
groups, yoga, meditation and spiritual retreats are also part of what is
offered at local hospitals.
Thompson
attends a monthly support group where she is free to talk about her experience
with breast
cancer
and other topics.
“I
love it,” Thompson said. “Talking about it helps other women through it. We
lift each other up.”
Thompson
plans to have reconstructive surgery in the near future, and is also planning
on getting gastric
bypass surgery to lose weight. Now 51, she
has begun computer programming classes at Bristol Community
College,
something the mother of five has wanted to do for decades.
“I
want to live,” Thompson said. “I want to enjoy the rest of my life. I feel
wonderful.”
ctober 30, 2011 – St. Mary opens new physical therapy center - phillyBurbs.com -
By Jo Ciavaglia -
MIDDLETOWN — St. Mary Medical Center has opened a new 2,500
square-foot physical therapy
center in Middletown and expanded its nearby
wound healing and hyperbaric medicine center to include
lymphedema therapy
for the head, neck and lower body.
Physical Therapy services at the Cornerstone Executive Suites will focus on orthopedic and muscular
rehabilitation for injury or troublesome conditions of the hip, knee,
shoulder and back. The new center also
will offer an amputation therapy program designed to help a patient re-learn skills and improve mobility to
attain the highest level of independence following the amputation of a
limb.
The lymphedema therapy program will focus on treating swelling of the
lower extremities as a result of
certain medical conditions, including
chronic venous insufficiency, as well as swelling of the head and neck,
typically occurring as a result of cancer treatment.
Lymphedema is an
abnormal swelling of a body part caused by an excessive buildup of fluid.
Lymphedema
most often occurs after a lymph node dissection, surgery or
radiation, all of which can damage the lymphatic
system during the treatment
of cancer.
October 30, 2011 - Secondary Lymphedema in the cancer patient -
WHIO Radio – By Steve Wilson -
The Dayton Daily News spent the entire month
of October giving our readers special and in-depth coverage
for National
Breast Cancer Awareness Month.
In today's story they look at a painful
limb-swelling condition known as lymphedema.
A study by the University of
Dayton confirm a common side effect of breast cancer treatment is
lymphedema.
Lymphedema is a condition characterized by swelling in one or
more extremities that results from impaired
flow of the lymphatic
system.
There's no cure for lymphedema, but it can be controlled.
November 3, 2011
Taking
steps to better health - Omaha World-Herald – By Katy Healey –
Joan
Fredrickson presses a miniature beach ball between her hands and the sage-green
wall. A handful of
others do the same as the sound track to "Grease" plays in the background. Then the group begins to do a
series
of standing push-ups.
The exercise is part of Healthy Steps, a therapeutic exercise program at Bergan Mercy Medical Center that
was
originally created for breast cancer survivors in the 1980s.
"Since
then, they've done research and have found out everyone benefits from this
program," said class
instructor
Michaela Fornoff.
Those
with other forms of cancer, Parkinson's disease, arthritis, chronic fatigue,
fibromyalgia and multiple
sclerosis,
among other illnesses, can also enroll.
Fornoff
said the exercises promote balance, muscle strength and perhaps most
importantly, prevent or
manage
lymphedema. Lymphedema is severe swelling that results from blocked lymph
passages. It inhibits
movement.
The swelling can make it difficult or even impossible to do everyday tasks like
reaching
something
on a shelf or brushing your teeth.
"You
don't hear about it very much so it gets missed, but your lymphatics can back
up with any cancer
treatment
or trauma to your limbs," said Fornoff, a certified lymphedema
therapist.
About
half a dozen regulars attend the class every Tuesday afternoon. Fredrickson, a
breast cancer
survivor,
first joined Healthy Steps in 2004. "This class helps keep the fluid moving and
the lymphedema
down,"
she said. "I want to keep it that way. That's why I keep coming."
During
the one-hour class, the group used miniature beach balls, chairs for balance,
resistance bands and
poles
roughly three feet long to improve their range of motion. They also used their
own body weight during
lunges
and dance numbers. The room was full of smiles and laughter during the dancing
portion of class.
"It's
not hard. Anybody could do it," said Connie Czaplewski of Omaha. Czaplewski
joined Healthy Steps a
year
ago. She is also a breast cancer survivor who attends class to manage
lymphedema.
"I
like the people there," she said. "You feel relaxed there, a little more
limber, a little more energetic, a little
more
flexible."
None
of the exercises are too difficult, she said. "We don't do anything on the
floor, which is good because
we'd
probably need a couple squads to help us back up," Czaplewski joked.
The
first six-week session is free. Additional sessions cost $36. The next session
begins Nov. 15. Contact
Alegent
Health for more information by calling 1-800-ALEGENT.
November
5, 2011
Hometown
briefs - Glens Falls Post-Star –
Cancer
center hosts benefit fashion show
The
C.R. Wood Cancer Center and The Rehabilitation Center at Glens Falls Hospital
will hold the third
annual
Lymphedema Awareness Fashion Show from 6 to 7:30 p.m. Friday at Glens Falls
Hospital Bistro on
the
first floor of the hospital's Northwest Tower, 100 Park St.
Supplies
needed to treat lymphedema are not always covered by insurance companies. All
proceeds from
the
event will be placed in a special fund to help individuals who are unable to
afford the costly supplies.
The
show will feature fall fashions from Finders Keepers Consignments in Glens
Falls and formal wear
supplied
by Jacqueline's Bridal Shoppe in Glens Falls.
Hair
and makeup for the models will be provided by Adonis Hair Design in
Queensbury.
A
silent auction also will be held that will include items donated by a number of
local businesses and artisans.
The
cost to attend the event is a donation. For more information, contact Vickie
Yattaw at 926-6639 or
Lisa
Mallette at 926-2067.
November
6, 2011
What
Your Feet Say About Your Health - Myjoyonline.com –
If
your toes are always cold, one reason could be poor blood flow -- a circulatory
problem sometimes
linked
to smoking, high blood pressure, or heart disease. The nerve damage of
uncontrolled diabetes can
also
make your feet feel cold to you. Other possible causes include hypothyroidism
and anemia. A doctor
can
look for any underlying problems -- or let you know that you simply have cold
feet.
Foot
Pain
When
your feet ache after a long day, you might just curse your shoes. After all,
eight out of 10 women say
their
shoes hurt. But pain that’s not due to sky-high heels may come from a stress
fracture, a small crack in a
bone.
One possible cause: Exercise that was too intense, particularly high-impact
sports like basketball and
distance
running. The weakened bones of osteoporosis increase your risk.
Red,
White, and Blue Toes
Raynaud’s
disease can cause your toes to turn white, then bluish, and then redden again
and return to their
natural
tone. The cause is a sudden narrowing of the arteries, called vasospasms.
Stress or changes in
temperature
can trigger vasospasms, which usually don’t lead to other health concerns.
Raynaud’s may also
be
related to rheumatoid arthritis, Sjögren’s disease, or thyroid
problems.
Heel
Pain
The
most common cause of heel pain is plantar fasciitis, inflammation where this
long ligament attaches to the
heel
bone. The pain may be sharpest when you first wake up and put pressure on the
foot. Arthritis,
excessive
exercise, and poorly fitting shoes also can cause heel pain, as can tendonitis.
Less common causes
include
a bone spur on the bottom of the heel, a bone infection, tumor, or
fracture.
Dragging
Your Feet
Sometimes the
first sign of a problem is a change in the way you walk -- a wider gait or
slight foot dragging.
The
cause may be the slow loss of normal sensation in your feet, brought on by
peripheral nerve damage.
About
30% of these cases are linked to diabetes. Nerve damage also can be due to
infection, vitamin
deficiency,
and alcoholism. In many cases, no one knows what caused the nerve
damage.
Clubbed
Toes
In
clubbing, the shape of the toes (and often the fingers) changes. The nails are
more rounded on top and
curve
downward. Lung disease is the most common underlying cause, but it also can be
caused by heart
disease,
liver and digestive disorders, or certain infections. Sometimes, clubbing runs
in families without any
underlying
disease.
Swollen
Feet
This
is usually a temporary nuisance caused by standing too long or a long flight --
especially if you are
pregnant.
In contrast, feet that stay swollen can be a sign of a serious medical
condition. The cause may be
poor
circulation, a problem with the lymphatic system, or a blood clot. A kidney
disorder or underactive
thyroid
can also cause swelling. If you have persistent swelling of your feet, see a
physician.
Burning
Feet
A
burning sensation in the feet is common among diabetics with peripheral nerve
damage. It can also be
caused
by a vitamin B deficiency, athlete’s foot, chronic kidney disease, poor
circulation in the legs and feet
(peripheral
arterial disease), or hypothyroidism.
Sores
That Don't Heal
Foot
sores that will not heal are a major warning sign for diabetes. Diabetes can
impair sensation in the feet,
circulation,
and normal wound healing, so even a blister can become a troublesome wound.
Those sores
also
are prone to infection. Diabetics should wash and dry their feet and check them
for any wounds every
day.
Slow-healing of sores also can be caused by poor circulation from conditions
such as peripheral artery
disease.
Pain
in the Big Toe
Gout
is a notorious cause of sudden pain in the big toe joint, along with redness
and swelling (seen here).
Osteoarthritis
is another culprit that causes pain and swelling. If the joint is rigid, it may
be hallux rigidus, a
complication
of arthritis where a bone spur develops. Finally, turf toe is an ailment of
athletes, particularly
those
who play on hard surfaces. It's caused by an injury to ligaments surrounding
the joint.
Pain
in the Smaller Toes
If
you feel like you're walking on a marble, or if pain burns in the ball of your
foot and radiates to the toes,
you may have
Morton’s neuroma, a thickening of tissue around a nerve, usually between the
third and fourth
toes.
It is eight to 10 times more common in women than in men. It is caused by
injury or too much pressure
on
the toes.
Itchy
Feet
Itchy,
scaly skin may be athlete’s foot, a fungal infection that's common in men
between the ages of 20 and
40.
A reaction to chemicals or skin care products -- called contact dermatitis --
can cause itching, too,
along
with redness and dry patches. If the skin on your itchy feet is thick and
pimple-like, it may be
psoriasis,
an over-reaction of the immune system. Medicated creams can relieve the
symptoms.
Claw
Toe
This
foot deformity can be caused by shoes that are tight and pinch your toes or by
a disease that damages
nerves,
such as diabetes, alcoholism, or other neurological disorder. Your toes will be
bent upward as they
extend
from the ball of the foot, then downward from the middle joint, resembling a
claw. They may respond
to
stretching and exercises of the toes or you may need special shoes or even
surgery.
Foot
Spasms
A
sudden, sharp pain in the foot is the hallmark of a muscle spasm or cramp,
which can last many minutes.
Overwork
and muscle fatigue are common causes. Other causes include poor circulation,
dehydration, or
imbalances
in potassium, magnesium, calcium, or vitamin D levels in the body. The changing
hormone levels
of
pregnancy or thyroid disorders may play a role. If spasms are frequent or
severe, see a doctor.
Strengthening
exercises can help.
Dark
Spot on the Foot
We
associate skin cancer with the sun, so we’re not as likely to check our feet
for unusual spots. However,
a
melanoma, the most dangerous form of skin cancer, can develop even in areas
that are not regularly
exposed
to the sun. Melanoma can even appear beneath the nail, where it might look like
a black spot.
Yellow
Toenails
Your
toenails tell a lot about your overall health. A fungal infection often causes
thickened yellow toenails.
Thick,
yellow nails also can be a sign of an underlying disease, including lymphedema
(swelling related to the
lymphatic
system), lung problems, or rheumatoid arthritis.
Spoon-shaped
Toenails
Sometimes
an injury to the nail or frequent exposure to petroleum-based solvents can
create a concave,
spoon-like
shape. However, iron deficiency also can cause this unusual shape.
White
Nails
Injury
to the nail or illness anywhere in the body can cause white areas in the nails.
If part or all of a nail
separates
from the nail bed (shown here), it can appear white -- and may be due to an
injury, nail infection,
or
psoriasis. If the nail is intact and most of it is white, it can sometimes be a
sign of a more serious condition
including
liver disease, congestive heart failure, or diabetes. Talk with your health
care team about any
concerns.
Pitting
of the Nails
Pitting,
or punctured-looking depressions in the surface of the nail, is caused by a
disruption in the growth of
the
nail at the nail plate. It affects as many as half of people with
psoriasis.
November
7, 2011
Indian
River Health Listings Updated updated Nov. 7 – TCPalm –
ONGOING
Lymphedema
Therapy Center: Vodder Technique to reduce swelling. 787 37th St., Ste. E-100,
Vero
Beach,
8:30 am-5 pm, Mon-Fri.
Kitsap
Physical Therapy and Silverdale Fitness celebrate remodel with open house -
Kitsap Peninsula
Business
Journal -
Come
and see the newly remodeled Kitsap Physical Therapy and Silverdale Fitness at
an open house on
Nov.
10 from 5 to 7 p.m.
Kitsap
Physical Therapy and Silverdale Fitness are a ‘whole body’ wellness facility
that helps its patients get
well
and stay fit.
Some
of the areas of specialty offered at the Silverdale office are: cardiac
rehabilitation phase 3 & 4,
amputee
prosthetic limb gait training and conditioning, vestibular/balance
rehabilitation, Bike Fit,
computerized,
fitness testing, myofascial/trigger release work, SportsMetrics/sports
performance programs,
industrial
injury and wellness programs, aquatic therapy, breast cancer lymphedema
management, senior
fitness/SilverSneakers
programs, weight loss programs, personal training and much more. For more
information,
call (360) 613-1834
Melrose
Pusey's Dilemma:Light at the end of the tunnel - Jamaica Gleaner –
Last
Wednesday, a kind reader, Violet Mahfood, donated $10,000 and local medical
expert, Patrice
Dwyer,
certified lymphedema therapist, met Mrs Pusey and after a consultation, she
told Flair that Pusey's
case
is treatable. She placed the order for the materials needed for the treatment.
So we are moving closer
to
getting Mrs Pusey some relief! With some help from Mrs Pusey's daughter and a
donation from The
Gleaner's
editorial department, we will be able to pay for the items needed to treat
her.
Flair
says a big thank you to Nadeen Matthews who pledged US$100 towards the cost.
Coincidentally, she
was
in a meeting with Dwyer last week and handed over the money. Both are sorority
sisters in the
Jamaican
chapter of Delta Sigma Theta Sorority, and Matthews said, based on their
conversation, there is
an
educational opportunity here for the Jamaican public, as well, beyond the care
for Mrs Pusey. Dwyer
ordered
the items from her own credit card.
Meanwhile,
Mrs Pusey comes close to tears when she speaks about the help she has been
receiving since
Flair
first aired her story. She is full of gratitude and prayers for everyone who
has called, written and sent
help
for her.
Materials
Needed
2
Double Arm Kits @ US$94 each
4
10cm Rosidol Soft Padding Bandages at US$5.94 each
1
Lymphoderm US$17.50
1
Eucerin Cream US$14.90
4
10cm Cellona Padding Bandages US$2.94 each
The
total is US$288.92 and an additional sum for shipping and customs costs. The
order was placed at the
Academy
of Lymphatic Studies http://www.acols.com.
Lymphedema
After Breast Cancer Surgery
The
term lymphedema comes from the lymphatic system, which helps coordinate the
immune system's
function
to protect the body from foreign substances and includes an extensive network
of lymph vessels and
lymph
nodes. Here's how the lymphatic system works:
Excess
fluid is collected from the space between tissues in the body and moves through
the lymph vessels.
The
fluid (now called lymph) isn't pumped through the body like blood, but instead
is 'pushed' through the
lymph
system as the vessels are compressed by surrounding muscles. Filters called
lymph nodes remove
certain
harmful substances from the lymph fluid, such as bacteria and debris. The fluid
from most tissues or
organs
is filtered through one or more lymph nodes before draining into the
bloodstream.
What
is Lymphedema?
Lymphedema
is an abnormal build-up of fluid that causes swelling, most often in the arms
or legs. The
condition
develops when lymph vessels or lymph nodes are missing, impaired, damaged, or
removed.
Two
Types
There
are two types of lymphedema: primary and secondary.
Primary
lymphedema is rare and is caused by the absence of, or abnormalities in,
certain lymph vessels at
birth.
Secondary lymphedema occurs as a result of a blockage or interruption that
alters the flow of lymph
through
the lymphatic system and can develop from an infection, cancer, surgery,
scar-tissue formation,
trauma,
deep vein thrombosis (a blood clot in a vein), radiation, or other cancer
treatment.
Reasons
for it
1.
Simple mastectomy in combination with axillary (arm pit) lymph-node
removal.
2.
Lumpectomy in combination with axillary lymph-node removal.
3.
Modified radical mastectomy in combination with axillary lymph-node
removal.
4.
Combined cancer surgery and radiation therapy to a lymph-node region (such as
the neck, armpit, groin,
pelvis,
or abdomen).
5.
Radiation therapy to a lymph-node region.
Lymphedema
develops after breast surgery because there is an alteration in the pathway
that drains the
fluids
involved in the immune system. It can occur at any time after the surgery. If
untreated, it can become
worse.
Following
breast-cancer surgery, a doctor will examine you and take arm measurements.
Sometimes, there
may
be redness or pain in the arm, which may be a sign of inflammation. Depending
on your symptoms, your
physician
will then consider the best treatment options for you.
Source:
webmd.com.
Powerful
combo: Reducing lymphedema - WFTV 9 Orlando –
Between
5 percent and 40 percent of women are estimated to experience some form of
lymphedema after
breast
cancer surgery; however, the condition is often overlooked or misdiagnosed.
Lymphedema occurs
when
the lymph system is damaged or blocked. It can cause fluid buildup and swelling
and usually affects an
arm
or a leg, but it can affect other parts of the body. Lymph fluid, tumors, lymph
vessels and lymph nodes
all
can play a part in lymphedema.
(SOURCES:
www.breastcancer.org, www.cancer.gov)
CAUSES
AND SYMPTOMS: Lymphedema can be either primary or secondary. Primary lymphedema
is
caused
by abnormal development and can occur at birth or develop later in life.
Secondary lymphedema is
caused
by damage to the lymph system due to infection, injury, cancer, scar tissue, or
radiation therapy.
People
can be at risk of developing lymphedema if they are obese, smoke heavily, have
diabetes or have
had
a mastectomy or previous surgery to the armpit area. Along with swelling,
people with lymphedema may
experience
a feeling of heaviness or tightness in the arm or leg. They may also feel
aching or discomfort and
possibly
hardening of the skin around the affected area.
(SOURCES:
www.cancer.gov, www.breastcancer.org and Mayo Clinic)
NEW
PREVENTION TECHNIQUES: Using single photon emission computed tomography
(SPECT)
along
with computerized tomography (CT) scans, doctors may be able to offer
substantial protection against
lymphedema.
Although a person may have as many as 62 lymph nodes under the arm, only a few
are
responsible
for the removal of fluids from the arm. The SPECT-CT technique works best for
patients who
do
not require radiation targeting any remaining lymph nodes. The risk of
developing lymphedema may be as
much
as 50 percent without taking measures to preserve the function of a person’s
lymphatic system.
Because
lymphedema can occur years after a surgery, patients will continue to be
monitored by their
physicians
for signs of lymphedema. Currently, there are two treatment plans for each
patient: a standard
plan
and one adapted for lymph node sparing based on the SPECT-CT scans.
(SOURCE:
Mayo Clinic)
Nevada
Man Wants Surgery For His 100 Pound Scrotum –
The
rare but incredible case of Wesley Warren Jr. puts our daily burdens into
perspective as the Nevada
resident
says he needs around a million dollars to pay for an operation to remove his
100 pound scrotum.
He
has a hugely enlarged scrotum, the sack that protects the testicles and its
size and weight causes him
discomfort,
pain and makes it incredibly difficult to get out and about.
"It's
not easy to get around... It makes me stay
in
most of the time."
Warren
told the Las Vegas Review-Journal of his 100-pound scrotum.
Warren
says the problems started in 2008 when he rolled over in bed and caught his
scrotum with his leg,
causing
him a terrible pain. As the pain subsided his scrotum swelled to the size of a
football and has been
getting
larger since.
Doctors
say that Warren's condition is extremely rare and although more common in
tropical Africa and
Asia,
in these cases the problem is usually put down to a mosquito spread parasitic
infection where thread
like
worms block the lymphatic drainage and fluids collect, that cause huge swelling
known as lymphedema.
However
physicians that have examined Warren's case say there is no sign of this kind
of infection and living
close
to downtown Las Vegas he's hardly at risk of these kinds of tropical
diseases.
Initially,
he sought basic medical treatment, being given antibiotics for what doctors
thought was a local
infection.
Slowly the swelling became so large he could no longer work, so he signed on
for disability
benefits.
In 2010 he tried medical treatment again at the University Medical Center in
Las Vegas. Doctors
classified
and reclassified his condition as scrotal elephantiasis, scrotal lymphedema or
scrotal edema, a
condition
characterized by an excess of watery fluid collecting in tissues of the
body.
Doctors
at UMC thought they might be unable to save Warren's penis and testicles, which
was a shock to
him
:
"Basically,
he was telling me there was a good chance that I would be castrated and have to
go to the
bathroom
through a tube for the rest of my life ... I really would like to have a
relationship with a woman. I
should
be in the prime of my life right now."
Doctors
at UCLA were more hopeful, but then money issues kicked in; even if Nevada
Medicaid would
cover
an out of state procedure, they wouldn't pay enough for what looks to be a
seven figure operation.
Warren
said after he came back from LA :
"I
really don't think people know what I have ... It's not something people have
seen before, I'm sure of that.
I
doubt if they can even imagine it."
November
14, 2011 –
Healthy
Dates - Macon Telegraph –
Lymphedema
Therapy
Women
who have had many lymph nodes removed or have had radiation therapy may
develop
lymphedema.
Ask physician to refer you to a lymphedema specialist by calling (478) 201-6748
or faxing a
referral
to (478) 757-0884.
November
10, 2011
Devon
Medical Products to Feature Compression Therapy Pumps, Secure European
Distributors at 2011
MEDICA
World Fair - MarketWatch
Devon
Medical Products, a global designer, manufacturer, and distributor of creative,
safe, and cost-
effective
medical devices, today announced it will present its featured product line on
the world stage at the
2011
MEDICA World Fair in Dusseldorf, Germany from November 16-19. The company will
be in the U.
S.
Pavilion in Hall 16/Booth D40-5MEDICA is the world's largest event for the
medical sector and has
operated
for over 40 years. Over 4,300 exhibitors, from small innovators to global
health giants, will present
services
and products in 17 halls totaling nearly 400,000 square feet of exhibition
space.
Devon
Medical Products will present its line of U.S. Food and Drug Administration
(FDA) 510(k)- cleared
CircuFlow(TM)
compression therapy pumps and its 510(k)-cleared ArterioFlow(TM) 7500 arterial
pump.
The
company's goal is to secure distributors in the European markets, including the
United Kingdom,
Germany,
France, Italy, and the Netherlands.
"We
are ecstatic to begin our expansion into Europe, and MEDICA is the ideal place
to launch our product
lines
and begin securing distributors," says Dr. John A. Bennett, CEO of Devon
Medical Products. "Our
research
indicates that the European medical device market continues to grow, and that
there is a constant
search for
devices that reduce swelling and improve quality of life for diabetics and
patients battling
lymphedema.
We look forward to sharing information with the world's top medical
professionals in
Dusseldorf."
Devon
Medical Products' CircuFlow(TM) compression therapy pumps and sleeves use
gradient pressure to
increase
the flow of lymphatic fluid, reduce swelling, and increase mobility for
patients suffering from
lymphedema
and venous insufficiencies. The ArterioFlow(TM) 7500 arterial pump and sleeves
apply
pressure
that increases blood flow to the legs of diabetics and patients with poor blood
circulation to help
treat
diabetic foot ulcers and prevent amputation.
Global
medical device distributors and the media can schedule private demos with Devon
Medical Products.
[email protected] to schedule an appointment, or visit the company
in Hall 16/Booth
D40-5
at MEDICA.
About
Devon Medical Products
Devon
Medical Products ( www.devonmedicalproducts.com ) is a global medical device
designer,
manufacturer,
and distributor that provides the medical community with innovative, safe, and
cost-effective
medical
products. The company has cultivated an exclusive line of medical devices
designed to advance
healthcare
treatments and maximize safety for healthcare workers and patients worldwide,
and works with
various
healthcare entities including durable medical equipment providers (DMEs),
hospitals, physician
offices,
nursing homes, physical therapy companies, and more. The company is
headquartered in King of
Prussia,
Pennsylvania, and has offices in China and other countries staffed with
bilingual engineers, product
developers,
and FDA-regulatory experts.
SOURCE:
Devon Medical Products
November
4, 2011
New
Study Reveals Concerns About Lymphedema and Other Complications as Cancer
Survivors Increase
–
Emailwire –
Some
cancer patients deal with lymphedema as a result of surgery or radiation
therapy that causes a
mechanical
alteration of the lymphatic system. It is critical that treatment for
lymphedema occurs early on, as
the
disorder can worsen over time. Compress
(EMAILWIRE.COM,
November 04, 2011 ) Tampa, FL -- A new study in the journal Cancer
Epidemiology,
Biomarkers & Prevention shows that during the next 10 years there will be a
42 percent
increase
of cancer survivors who are older than 65 years old. Health care professionals
will need to become
aware
of some of the distinct challenges these types of patients face to give them
high-quality care.
In
particular, some cancer patients deal with lymphedema as a result of surgery or
radiation therapy that
causes
a mechanical alteration of the lymphatic system. This chronic disorder can
greatly affect an individual’
s
quality of life. It is critical that treatment for lymphedema occurs early on,
as the disorder can worsen over
time.
“Health
care professionals need to do everything possible to keep the skin integrity
and prevent further
infection,”
said Greg Grambor, president of Vascular PRN, a company that helps healthcare
professionals
nationwide
with lymphedema pumps and lymphedema boots. “Compression therapy can keep fluid
from
repooling
so that other complications do not occur.”
Over
time, lymphedema can lead to cellulitis, disability, and psychosocial issues.
Swollen tissues can create
an
environment where infections can reappear and cause irreversible damage to the
tissues. Pain and
difficulty
moving can lead to a diminished quality of life, and affect other areas of a
person’s social and
intimate
relations.
“With a
doctor’s guidance, extremity pump systems and physical therapy can do a lot of
good to regain
comfort
and lessen the issues that can ensue,” said Grambor.
Vascular
PRN has decades of experience helping nursing homes, surgery centers and
hospitals, managed
care
organizations, and other institutions with their lymphedema product needs. To
learn more about
lymphedema
boots, lymphedema pumps, and Vascular PRN’s other products for rent or for sale
such as
sequential
compression devices or SCD boots, visit http://www.vascularprn.com/ or call
800.886.4331.
Press
Release Courtesy of Online PR Media: http://bit.ly/tzc2y6
Contact
Information:
Vascular
PRN
Vascular
PRN
Tel:
800-886-4331
us
This
is a press release. Press release distribution and press release services by
EmailWire.Com: http://www.
emailwire.com/us-press-release-distribution.php.
November
15, 2011
All
in the same boat - Irish Independent –
Dragon-boat
racing is putting breast cancer survivors back on the road to
recovery
A
GROUP of Irish cancer sufferers and survivors recently returned from a
12,000-mile round-trip to Kuala
Lumpur
where they competed for Ireland in dragon-boat racing. There they beat off
competition from 14
countries
to win silver and bronze in their two races.
The
Plurabelle Paddlers are our first dragon-boat team and were in Malaysia to
represent Ireland in the
inaugural
Cancer Survivors World Cup 2011. Before they hit our shores the only place
dragon boats were
regularly
seen was in 'Hawaii-Five-O's title sequence. Now they are being used to help
cancer sufferers to
rehabilitate
as they offer a safe way of doing upper body exercise.
The
Plurabelle Paddlers were set up last year by cancer survivor Fiona
Tiernan.
"I
had a recurrence of breast cancer two years ago and wanted to manage my health.
I had been reading
about
the benefits of exercise and came across dragon-boat racing and got stuck into
getting it set up. I had
an
open day when more than 100 people turned up. After that we started
fundraising."
The
Plurabelle Paddlers started with two members last year and now have more than
70 and two dragon
boats.
"We
had no money and no boats a year ago. Each boat costs €8,000. We fundraised and
got money from
the
HSE. To get to Malaysia we got support from companies like Etihad, who
sponsored our flights," she
says.
"Each
boat holds 22 people. There are 20 paddlers and the two others are steering and
beating a drum. We
don't
talk about cancer when we're out in the boats. You're focused on paddling,"
adds Fiona.
There
were 60 teams at the Malaysian event, made up of 1,500 competitors from 14
countries.
One
of the Irish dragon-boat competitors was mother-of-three Fiona Slevin. Fiona's
sister Jenny was
diagnosed
with breast cancer in August 2004. Jenny recovered but suffered a recurrence in
autumn 2007
and
died in 2009.
Fiona
was also diagnosed with breast cancer the week before Christmas in 2004 when
her youngest child
was
just one year old.
"I
left the meeting in the hospital that day, went to Smyth's toys and bought the
children the best Christmas
presents
ever." Fiona went on to have a lumpectomy, chemotherapy and radiotherapy and
has now
recovered.
Fiona
got into dragon-boat racing following a chance encounter with Plurabelle
Paddlers' founder Fiona
Tiernan
at a cancer conference in August 2010.
"When
you get cancer you are just getting through it. You are dealing with GPs,
oncologists, the hospital and
you
feel helpless in the whole process.
Easiness"Dragon-boat
racing is something you can do for yourself. We also just understand where we
have
been.
With friends and family, it can be a bit difficult as they sometimes don't know
how to deal with you,
but
there's an easiness with the team because we've all gone through the same
thing," adds Fiona Slevin.
One
of the main benefits of dragon boating is to reduce the occurrence of
lymphedema, a swelling of the
arms
and chest area caused by surgery, often to remove lymph nodes.
The
upper body exercise involved in the paddling helps manage lymphedema and has
also been shown to
aid
recovery from cancer.
Another
member of the Plurabelle Paddlers is Margy Fitzsimons from Clondalkin, who was
diagnosed with
breast
cancer in 2003 at the age of 43.
Cancer
has been ever present in Margy's life. "My mum died of a brain tumour, leaving
eight children behind
when
I was only 17. Dad died in 2000 from lung cancer. My youngest son got leukaemia
when he was five
--
he recovered -- and I was diagnosed in 2003.
"I
said to myself if my son can beat cancer I am going to beat it. He inspired
me."
Seven
years on and after a successful recovery Margy decided she had to get
fit.
"I
saw Fiona on the telly. They had an open day. Normally I wouldn't go along to
something like this but it
sounded
so different. It's hard getting fit when you're on your own. It's easier when
you're part of a team,"
she
says.
"When
I was diagnosed I was told 'don't do this' and 'don't do that' -- that's very
negative. If you're active
and
physical you're more likely to stay fit. I'd say to anyone -- come
along!
"The
nature of the illness is such that it knocks your confidence. You can't drive,
you can't do a lot of things.
Give
dragon-boat racing a go. You might just enjoy it!"
?Dragon
Boating -- www.plurabellepaddlers.com
?The
National Cancer Helpline -- 1 800 200 700
November
15, 2011
Helping
lymphedema sufferers - Brantford Expositor –
Soon
after her treatment for breast cancer, Pat Perkins began to notice persistent
swelling in her left arm.
In
June of 2004, the Brantford woman had a lumpectomy followed by chemotherapy and
radiation. By
October,
the swelling began and she was diagnosed with lymphedema.
The
condition is an accumulation of lymphatic fluids that occurs when there is
removal of, or disruption or
damage
to lymph nodes or vessels, usually following surgery or radiation treatment for
cancer.
"I
had never heard of it," said Perkins. "I wasn't really warned about it prior to
my surgery."
Trauma
caused by an accident, injury or a burn can also cause secondary lymphedema
like that suffered by
Perkins.
Some
people are born with a faulty lymphatic system. It may be present at birth,
develop when puberty
begins
or in adulthood. That condition is known as primary lymphedema.
A
2009 study by the Canadian Lymphedema Framework found a lack of standardized
care for patients in
Canada,
no provincial health coverage, a lack of resources for assessment, and a need
to teach lymphedema
prevention
and self-management.
Tissues
with lymphedema are at risk of infection.
Beverley
Speechley, a registered massage therapist who runs a practice from her Erie
Avenue home, said
that
while there is no cure for lymphedema, there is relief available. Pamela
Monarch, another registered
massage
therapist in the city, also provides treatment.
"A
lot of what I do is take away people's fears," said Speechley.
Treatment
includes not only massage therapy, but also compression therapy involving the
use of elastic
bandages,
sleeves, gauntlets or tights to control swelling.
"(With
lymphedema) it's hard to move the limb," said Speechley. "There is pain because
of the stretched
skin.
The muscles need to work harder to lift."
During
massage, the soft tissues of the body are lightly rubbed, tapped and stroked.
It is a very light touch,
almost
like brushing.
"It's
very gentle movement of the fluid from an impaired area to one that isn't,"
said Speechley.
She
also educates her clients about how to best manage lymphedema using exercises
that promote lymphatic
flow
and about skin care to prevent infection.
Perkins
said her arm can be painful, particularly in the summer when it's hot and
humid. Doctors have told
her
she carries about a litre of fluid in her arm. She needs to wear clothing that
will accommodate the
swelling.
She
wears a compressive sleeve and glove during the day and, at night, a special
sleeve that channels the
fluid
up her arm.
Perkins
said none of cost of the sleeves is covered by OHIP, nor are the massage
treatments. She is able to
have
some of the costs picked up by her insurance, but says others are not. She said
the massage treatments
provide
effective temporary relief but she is has the treatments less frequently than
she'd like because of the
cost.
"This
is a medical condition and it should be covered."
November
16, 2011
Hospital
to coordinate, improve cancer-care programs - Outer Banks Sentinel –
Hospital
to coordinate, improve cancer-care programs
Outer
Banks Sentinel
The
hospital added Digital Stereotactic Biopsy and Lymphedema Therapy services in
2011, also introducing
the
Breast Health Program to provide mammograms for ...
SORRY
TINA, THIS ONE NEEDS TO HAVE A USER ACCOUNT WITH THEM
November
14, 2011
Villagers
recruiting members for first all-women's and breast cancer survivor dragon boat
teams - Villages
Daily
Sun – By ASHLEY SLOTA –
THE
VILLAGES — Breast cancer survivor teams are not uncommon in the world of dragon
boating. When
Marguerite
Muller saw these teams at other competitions, she thought it would be a great
idea to start a
team
in The Villages, but she went one step further.
She
decided that it was time The Villages also had an all-women’s team.
“I’ve
seen other women’s teams at races and I thought it would be a fun thing to do.
It’s a challenge; I like a
challenge.
Since I went to my first race and saw breast cancer survivor teams there, I
said‘I’m going to start
one
of those in The Villages’. I’d love to be a part of something like that,”
Muller said.
Muller
is now in the process of recruiting at least 40 members for the two teams. The
all-women’s team will
be
called Dragon Sisters and the team comprised of breast cancer survivors will
tentatively be named Hope
for
the Breast.
On
Nov. 5, the current members of the team gathered with potential members to
teach them a little about
dragon
boating and to let them try it out for themselves. Unfortunately, the water was
too unstable, so
everyone
was landlocked for the day.
However,
the potential members did get a chance to try out paddling on dry land to get a
feel for what it
was
like. Village of Caroline resident Bonnie Blate was one of the women interested
in joining the team.
“I’m
from Key Largo so I’m a water person. I love the water. That’s the only thing I
miss about living in The
Villages
is being on the water,” Blate said.
Blate
had never done any paddling before but she was willing to give it a
shot.
“The
thing about being in The Villages is just connecting with other people with
similar interests. This could
maybe
be my thing,”she said.
Also
present during the informational session were members of the breast cancer
survivor team from Tampa
called
The Pink Dragon Ladies. They explained the benefits that paddling can offer to
those who have had
breast
cancer.
“There’s
a marriage between dragon boating and breast cancer survivors,” said Connie
Bainbridge.
“It’s
a great support network, but it’s also great physical fitness. You’re typically
weak after breast cancer
surgery
so it’s great to build up your upper body strength. One of the goals of the
organization really is to
promote
physical fitness,” added Elaine Emmanuel.
Women
who have had breast cancer also have a higher risk of getting lymphedema, which
causes a woman’
s
arms to swell up. Studies have shown, however, that the motions of paddle
boating can actual help
decrease
a woman’s chances of getting lymphedema.
In
addition to the physical benefits that come with dragon boating, there is also
a connection for those who
had
breast cancer.
“The
mission is ‘Sport and Support’ for women, so while they want to win, their
first mission is support,”
explained
Bainbridge.
“We
all got cancer. Then I went to a conference and there were fliers about dragon
boating and I went
down
and tried it and fell in love with it,” said Sylvia Moss. “For me, soon after I
joined the team my
husband
died and they became my family sort of. It was very good for me and it helped
me over my initial
loneliness.”
Muller wants
every woman in The Villages to be able to reap these benefits if they are
interested in dragon
boating.
“It’s
just a wonderful activity. It’s so healthy and so good for you and it’s so much
fun,” she said. At 3 p.m.
every
Wednesday, members of the Dragon Sisters set out at Lake Miona to practice and
Muller invited
anyone
who is interested to come and join them or just come and watch.
“Come
and try it. There’s no obligation. If you don’t try it, you’ll never know. It’s
like anything else, you’ve
got
to try it then make your decision,” Muller said.
For
more information, call Muller at 259-2175.
Ashley
Slota is a reporter with the Daily Sun. She can be reached at 753-1119, ext.
9303, or ashley.
[email protected]
November
14, 2011
Husband
uses photos, blog to tell story of wife's struggle with cancer - Plain Dealer –
By Angela Townsend
–
At
just 39, Jennifer Merendino uses a walker and cane to get around. Special daily
exercises ward against
swelling
in her arms -- the consequence of lymphedema, a condition she developed after
surgeons removed
cancerous
lymph nodes following a double mastectomy.
Jennifer
is no longer able to work as assistant to the vice president of marketing and
product development at
a
cosmetics company in New York. Jennifer and her husband, Angelo -- Ohio natives
who moved to New
York
several years ago -- initially received a lot of support from family and
friends following Jennifer's breast
cancer
diagnosis in February 2008. As time went on, however, they didn't think many
people fully
appreciated
the drastic changes in their lives.
"We
had a hard time getting people to understand how serious things had become,"
said Angelo, 38.
"They're
not around day-to-day to see the fatigue, the exhaustion."
About
a year ago, Angelo began documenting Jennifer's experience through photos, a
way to express
themselves
to their families without words, he says.
"It
started making a difference," said Angelo, who estimates that he has taken
"tens of thousands" of photos
since
his wife's cancer diagnosis.
Angelo
Merendino has documented his wife's nearly four-year struggle with breast
cancer in a 35-piece
photo
exhibit that is on display at the 78th Street Studios in Ohio City, beginning
Friday.
Being
the center of attention isn't an issue for Jennifer.
"Since
I met him, he'd had that camera in my face," said Jennifer, who recently came
home from a 21-day
stay
in the hospital to manage her pain. "It's something I'm used to. It wasn't 'Now
all of a sudden I have
cancer
and suddenly you're taking my picture.' "
The
two met in Cleveland in August 2005. Jennifer, from Bath Township, was manager
of the former Fulton
Bar
& Grill Restaurant (now Momocho) in Ohio City. Angelo, originally from
Akron, was living in Ohio City
at
the time. He went to the restaurant to interview for a bartending
gig.
While
waiting on the restaurant's stoop for someone to open up the building, Angelo
saw Jennifer pull up in
her
black Volkswagen Beetle.
For
him, it was love at first sight. For her, not so much.
Angelo
got the job. The two became friends.
A
month later, Jennifer moved to New York to start a new job. They kept in touch
and eventually began a
long-distance
romance.
Angelo
moved to New York to be with Jennifer. The two married in Central Park in
September 2007.
The
following February, Jennifer was diagnosed with Stage 3 breast cancer that had
spread to her lymph
nodes.
The
news wasn't completely out of the blue. For more than a decade Jennifer had
felt a lump in her breast.
Yet
since her first mammogram and biopsy -- when she discovered that first lump --
all of the subsequent
tests
were always "inconclusive." Until it wasn't.
Nearly
four years later, Jennifer is living with what physicians have labeled chronic
cancer. The cancer has
metastasized
to her liver, hip and sacrum, and her brain. She continues to be treated at
Memorial Sloan-
Kettering
Cancer Center in New York.
As
time progressed, and as people from around the world emailed in response to the
nearly 200 images on
Angelo's
Facebook page and through an online photo contest that Angelo had entered, the
couple began
talking
about a photo exhibit.
"Being
from Akron and spending important time here, I wanted this to first happen [in
Cleveland]," said
Angelo,
who studied documentary photography at Cuyahoga Community College's Western
Campus in
Parma.
Angelo
emailed Matthew Fehrmann, a photographer and custom printer he had met several
years ago while
living
in Cleveland.
It
didn't take long for Fehrmann, whose own studio is housed in the same building
as the gallery, to respond.
"The
photo community is pretty tight in Cleveland," said Fehrmann, who found out
about Angelo's photos
from
the Facebook link sent by a mutual friend.
"I
had actually considered contacting him to see if he was working on a show, but
he beat me to it," he said.
"What
drew me to his work in the first place was the beauty of his images. Everyone
who encounters his
work
is touched in one way or another."
While
some of the couple's family will be at the exhibit opening, Jennifer won't be
able to travel for the event.
What
does she think of the photographs?
"I
think they're ridiculous," she said, adding, "I'm so proud, so
impressed.
"I
know that's not my normal body in those pictures. I think he's done an amazing
job. They take my breath
away."
November
14, 2011
Story
of lymphatic system expands to include chapter on valve formation – EurekAlert
–
St.
Jude Children's Research Hospital scientists show that a gene essential for
normal development of the
lymphatic
system also plays a critical role in forming the valves that help maintain the
body's normal fluid
balance
A
century after the valves that link the lymphatic and blood systems were first
described, St. Jude Children's
Research
Hospital scientists have detailed how those valves form and identified a gene
that is critical to the
process.
The
gene is Prox1. Earlier work led by Guillermo Oliver, Ph.D., a member of the St.
Jude Department of
Genetics,
showed Prox1 was essential for formation and maintenance of the entire
lymphatic vasculature.
The
lymphatic vasculature is the network of vessels and ducts that help maintain
the body's fluid balance and
serves as a
highway along which everything from cancer cells to disease-fighting immune
components
moves.
Oliver is senior author of the new study, which appeared in the October 15
edition of the scientific
journal
Genes & Development.
The
new research suggests that Prox1 is also essential for proper formation of the
one-way valves that
control
movement of fluid and nutrients from the lymphatic system into the blood
stream. Researchers found
evidence
that the Prox1 protein also has a role in formation of the venous
valves.
"Understanding
how valves form is crucial to efforts to develop treatments for valve defects
that affect both
children
and adults," said the paper's first author, R. Sathish Srinivasan, Ph.D., a
research associate in the St.
Jude
Department of Genetics. Those defects are linked to a variety of problems
including lymphedema and
deep
vein thrombosis, which are blood clots that form deep in veins and have the
potential for causing life-
threatening
complications. Lymphedema is the painful and sometimes disfiguring swelling
that can occur
when
lymph flow is disrupted.
For
more than a decade, the lymphatic system has been a focus of Oliver's
laboratory. The laboratory's
contributions
through the years include evidence that leaky lymphatic vessels might
contribute to obesity.
Oliver
and his colleagues also demonstrated how the lymphatic system forms from
Prox1-producing cells
destined
to become lymphatic endothelial cells (LECs) when they leave the developing
veins and migrate
throughout
the body.
The
investigators also showed the Coup-TFII gene is essential to the process. The
Coup-TFII protein binds
to
the promoter region of the Prox1 gene. The binding switches on production of
the Prox1 protein that is
required
to create and maintain the lymphatic system. The newer research builds on that
earlier work from
Oliver's
laboratory. The latest study focused on the lymphovenous valves. These valves
are found at just two
locations
in the body, on either side of the chest just under the clavicle bone where the
lymphatic vessels
intersect
with the subclavian and internal jugular veins.
Working
in mice, investigators discovered that these lymphovenous valves form from a
newly identified
subtype
of endothelial cell found in developing veins. Like the LECs that form the
lymphatic system, the
newly
identified endothelial cells make Prox1. But while the LECs leave the veins and
migrate throughout the
body,
these endothelial cells stay put to form the lymphovenous valves.
Researchers
demonstrated the process requires two copies of the Prox1 gene. That ensures
adequate levels
of
the Coup-TFII-Prox1 complex and with it enough Prox1 to build and maintain the
lymphatic system.
Mice
engineered to carry a single copy of Prox1 either did not survive or were born
without lymphovenous
and
venous valves.
"If
you have only one copy of Prox1 you are going to have a reduction in the
Coup-TFII – Prox1 complex
and
so a dramatic reduction in the number of cells available to build the lymphatic
system. That explains the
defects
we see," Srinivasan said.
###
The
study was supported in part by a grant from the National Institutes of Health
and ALSAC.
St.
Jude Children's Research Hospital
St.
Jude Children's Research Hospital is internationally recognized for its
pioneering research and treatment
of
children with cancer and other life-threatening diseases. The hospital's
research has helped push overall
survival
rates for childhood cancer from less than 20 percent when the institution
opened to almost 80
percent
today. It is the first and only National Cancer Institute-designated
Comprehensive Cancer Center
devoted
solely to children, and no family ever pays St. Jude for care. For more
information, visit www.
stjude.org.
November
16, 2011
3-D
body scans could ease pain for cancer survivors - Minnesota Daily – ByRachel
Raveling - The
technology
may help with clothing designs.
A
17-year breast cancer survivor and professor in the University of Minnesota
College of Design is striving
to
find ways to make the lives of fellow survivors’ less painful by using 3-D
imaging technology.
Karen
LaBat and a team of researchers from the school are using 3-D body scans in the
Human
Dimensioning
Lab to aid breast cancer survivors with body asymmetries, or figure
disproportionalities,
brought
on by surgery and radiation therapy. These often cause the survivors pain and
discomfort.
Last
fall, the group reached out to several breast cancer support groups in hopes of
finding volunteers for the
study,
said Karen Ryan, a fellow researcher on the project.
Twenty-five
breast cancer survivors volunteered to travel to the Twin Cities campus for the
3-D full-body
scans
and interviews about their apparel concerns and discomforts, Ryan
said.
She
said some volunteers come from hundreds of miles away to help in the research.
They bared nearly
everything
for the cause, allowing the group to scan them in little more than their
underwear.
The
project is funded by a grant from the Minnesota Agricultural Experiment
Station, which provides money
for
a number of research projects in the Human Dimensioning Lab.
LaBat
said the idea for the project came from her personal experience with breast
cancer and through
experiences
she read about other survivors.
Part
of their project focuses on developing apparel needs for survivors based on the
asymmetries, primarily
in
the arms, she said.
One
common irregularity in survivors is lymphedema, or swelling of the arms or legs
caused by lymph node
removal
during cancer treatments.
Ryan
said survivors experience a feeling of heaviness from the swelling and it is
important to control it
because
it can make them more prone to infection.
In
an attempt to control the swelling (there is no cure), some survivors use
lymphedema “sleeves,” or
compression
garments, LaBat said. But the sleeves can be difficult to get on, are usually
unattractive and can
be
uncomfortable.
Sherry
Sanden Will, undergraduate research assistant and apparel design student, said
women who have
overcome
cancer often complained about bra discomfort and the compression garments
irritating their skin
which
is already sensitive due to radiation therapy.
The
scans will hopefully shed light on ways to design apparel such as bras and
shirts, as well as compression
sleeves.
Using
the scans, the team will evaluate the effectiveness of current sleeve designs
and help shape future ones,
Labat
added.
The
scans were completed last spring, and now the group is focusing on data
analysis.
Chad
Sowers, a graduate research assistant, is working to gather information from
each set of arms.
They are trying
to compare the volume of one arm to the other. To do that they take a
paper-thin extract of
the
arm scan and match it to the same spot on the other arm, he said. They are
still trying new techniques to
make
this more accurate.
Once
the results are published, they will be open for use by students at the
University, as well as designers,
medical
researchers and doctors.
In
the future, Ryan said they hope the technique becomes exact enough so it may be
used for diagnosis and
rehabilitation.
Ryan
said the scans and analysis technique could document body changes with other
treatments like weight
training.
She
said the scan will hopefully be a scientific, documented way to prove what
works and what doesn’t so
survivors
can live without discomfort.
November
7, 2011
Disabled
teacher in tenure case fight - NorthJersey.com – BY LESLIE BRODY –
Paterson
officials are trying to fire a disabled teacher accused of making his young
students carry a plastic
bottle
of his urine to the bathroom to flush it away, legal papers say.
The
School 13 second-grade teacher, Ron S. Tuitt, said Friday the allegations were
completely false. The
district
suspended him without pay on Oct. 17 while it seeks to revoke his
tenure.
An
investigation into the teacher’s behavior began in September 2010 when a
custodian saw Tuitt urinate
into
a garbage can in his classroom. Tuitt, who uses a wheelchair due to severe leg
swelling from
lymphedema,
said that was a one-time incident and no students were present. He said he was
removed from
the
classroom that November, but continued to get his $63,375 yearly
salary.
The
district’s legal papers said that when an investigator interviewed Tuitt’s past
students, one 12-year-old
boy
said that when he was 8, the teacher had students close their eyes once a day
for a minute. Then the
boy
and a friend would take a partly full bottle to the bathroom to dump it out,
the papers said. The friend
also
described that practice in an affidavit, saying the stuff smelled “horrible”
and he thought it was “pee.”
A
woman who worked at School 13 until 2009 also said in an affidavit that Tuitt
gave her cash to buy him a
hand-held
plastic urinal at a nearby Walgreens pharmacy. She said that two or three times
a week for about
a
year, she saw students carrying the urinal to and from the bathroom.
Tuitt,
54, said the boys lied in the interviews and their answers were steered by the
investigator. “I had
hundreds
of other children – how come nobody else said it?” he asked. Tuitt said any
students spotted with
bottles
of liquid were carrying cleaning supplies used to wash the blackboard and
desks.
The
teacher, who joined the district in 1996, was profiled in the Herald News in a
2007 article that quoted
children
saying it made them feel good to help him. He often taught while sitting on the
floor, and the kids
liked
to sit in his wheelchair.
Tuitt,
of North Brunswick, said the district filed tenure charges in retaliation
because last summer he filed suit
in
Passaic County Superior Court, alleging they were discriminating against him
due to his medical condition.
He
said administrators refused to transfer him to a classroom closer to the
handicapped bathroom.
“There
is absolutely no merit to his claim that any action is being taken in
retaliation,’’ said the district’s
lawyer,
Joanne Butler. “We cannot and will not speak about ongoing litigation. However
the situation is such
that
the school district felt that action had to be taken … Districts don’t pursue
tenure charges lightly.”
An
administrative law judge who hears the case will make recommendations to the
education commissioner,
who
will decide the matter.
November
11, 2011
About
136 former cheerleaders got together to do a dance routine to benefit "Susan G.
Komen for the
Cure"
(Breast Cancer). Each time someone views the video, United Healthcare will make
a $.10 donation
to
the Komen organization. Their goal is to get a million hits, which will lead to
$100K raised.
Please,
can you take a moment to watch the video, and just as important, pass this link
on to your network
of
friends, family, and colleagues? It benefits a very important cause!
www.KomenPhiladelphia.org/Video
November
2, 2011
Lymphedema
Bandaging Class to Be Held in Kitchner, Ontario - Wire Service Canada (press
release) –
Mulligan,
a registered massage therapist and a lymphedema therapist, educator and
consultant, will be
teaching
a lymphedema bandaging class in Kitchener, Ontario on Saturday February
26th.
Lymphedema
therapist and educator John Mulligan will present an Advanced Lymphedema
Bandaging
Workshopon
Saturday, November 26th at Motion Specialties in Kitchener, Ontario. The
workshop is co-
sponsored
by Motion Specialties Kitchener and BSN Medical.
The
workshop will focus on the role of multi-layer lymphedema bandaging as a part
of the overall treatment
of
lymphedema, and how to introduce advanced and creative bandaging concepts into
the therapy regimen
to
use as needed.
“Lymphedema
is a complex condition, and therapists must be resourceful. A comprehensive
approach to
bandaging
should include a wide variety of materials and techniques so the therapist can
meet any challenges
that
arise in the treatment of patients with lymphedema and related disorders,” said
John Mulligan, workshop
leader.
“Lymphedema bandaging is a creative effort based in science.”
To
register for the workshop, visit the Lymphedema Depot web site
(www.LymphedemaDepot.com ) and
click
on the Events tab. Scroll down to the November listings and click on the
Advanced Lymphedema
Bandaging
Workshop and click on the registration form.
Lymphedema
is a condition of chronic swelling. It is a treatable and manageable condition.
The most
effective
treatment is Complete Decongestive Therapy, known as CDT.
Complete
Decongestive Therapy consists of :
·
Manual lymph drainage, a massage-like technique that facilitates movement of
congested fluids in a
saturated
or swollen areas of the body;
·
Multi Layer Lymphedema Bandaging (MLLB) to compress the limb, reduce swelling
and prevent further
swelling;
·
Decongestive Exercise; a series of exercises that helps to mobilize fluid in
the body;
·
Meticulous Skin Care, especially of the affected area. This is done to prevent
or minimize the occurrence
of
infection.
John
Mulligan has been a lymphedema therapist since September of 1998 and has worked
as a therapist,
educator
and consultant in the lymphedema field for the past 13 years. He is currently
serving as Clinical
Specialist
for Lymphedema Depot, importer of Solaris lymphedema products. He also sees
patients and
presents
classes.
For
further information contact [email protected].
To
learn more about lymphedema and lymphedema therapy visit
www.LymphedemaTherapist.com.
November
21, 2011
Compression
therapy firm Wright Therapy raises $1M - MedCity News –
Compression
device maker Wright Therapy Products has raised about $1.1 million of what the
company
hopes
is a $2 million fundraise, according to a regulatory document.
The
Pittsburgh-area company develops compression pumps and other accessories for
patients suffering
from
poor circulation or swelling in their limbs. Wright Therapy also markets its
pumps for the treatment of
sports
injuries that result in swelling.
Chief
Technology Officer Carol Wright didn’t return a call
Compression
therapy can be used to treat venous ulcers and lymphedema, swelling in the
limbs caused by a
blockage
in the lymphatic system. A compression pump inflates a sleeve that’s placed on
a patient’s limb
and
the inflated sleeve moves lymphatic fluid away from the limbs and
reducesswelling.
Wright
Therapy’s latest funding was sourced from 13 investors, with the first sale
happening in December
2010.
As of May 2011, the company had raised $565,000 of the investment, according to
an earlier
regulatory
filing.
Economic
development group Pittsburgh Life Sciences Greenhouse had previously invested
in Wright
Therapy.
Wright
Therapy got its start in the 1980s when Carol Wright’s father, Edward, created
a compression pump
for
a child suffering from chronic lymphedema.
November
28, 2011
Prisoner
in her own bed - Wigan Today –
A
WIGAN cancer sufferer has described the nightmare of becoming a prisoner in her
own bed after her
weight
ballooned to 40 stone.
Marjorie
Jones, of St Patrick’s Way, Scholes is bedridden and has to call emergency
services if she needs
to
move, because of a series of medical conditions.
The
61-year-old suffers with lymphedema, which causes her legs to swell from fluid
retention, along with
cervical
cancer and heart problems.
Up
until last year, the mum-of-four was mobile and was able to move around the
house unaided.
As
her cancer has got worse, Marjorie’s weight has increased, making it
increasingly difficult to get out of
bed
to go to the toilet, or even have a wash.
But
now Marjorie, who regularly has to call out the emergency services to help move
her, says she has been
denied
home care to help get her washed, and a suitable bed.
Marjorie
said: “I just feel abandoned and upset at being told I can’t have home help. I
was given a bariatric
bed
but it wasn’t suitable for me, I kept cutting my legs on the side every time I
tried to get out of bed.
“My legs are so
big because of lymphedema, and because I can’t move often, my skin is very
delicate and
sore,
so it cuts easily.
“I
was told I couldn’t have anything else and there was no home care available for
me because I have my
children
to help me. But they need help to look after me.
“I
can lie here for up to five days and not be moved and have, at times, had to
soil the bed and sit in it for
hours
until somebody came to help me.”
The
emergency services were called to Marjorie’s home up to six times in one week
but the last time she
needed
help, fire services refused to attend.
The
Ince woman also says she has not been able to have a recent cancer screening to
see if the disease has
spread,
due to her weight issues.
Marjorie
added: “If I had some help I wouldn’t have to keep ringing the emergency
services. I know they
are
busy and I don’t like troubling anybody but I need some assistance – I’m just
trapped in my own bed.
“I
know what people will think when they look at me and see my size, but it is
down to my illness.
“I
feel my treatment is less than that of somebody who would be an average weight
because I am so heavy.”
A
spokesman on behalf of Bridgewater Community Healthcare NHS Trust, Ashton,
Leigh and Wigan
Primary
Care Trust and Wigan Council, said: “We cannot comment on individual cases for
reasons of
patient
confidentiality, but we can give a reassurance that all the agencies involved
have been working
closely
together for a number of years and continue to do so.
“With
regards to the process, health and social care workers work together to carry
out regular assessments
of
both an individual’s and their carer’s needs.
“These
assessments will involve discussions with individuals, their carers and will
often recommend a variety
of
aids, equipment and care packages to ensure that care can be provided safely in
an individual’s own
home.
“Individuals
and carers are free to decline any equipment which is offered as a result, but
are advised that
this
is likely to impact on the package of care that can be provided.
“Any
decisions made will consider whether providing any element of care will be safe
for the individual, their
carer
and our staff.”
November
28, 2011
$8.3M
supports breast cancer research - Laboratory Products News –
Saskatoon,
SK - $8.3 million in funding has been announced by Canadian Breast Cancer
Foundation to
support
24 research projects in Alberta, Saskatchewan, Manitoba and the Northwest
Territories.
"We
want our stakeholders and everyone touched by the breast cancer cause to be
confident in the work
that
the region methodically selects to support, because the foundation is investing
in innovative research and
creative
education and awareness programs that are taking us one step closer to our
vision of a future
without
breast cancer," says Trish Bronsch, CEO Canadian Breast Cancer Foundation -
Prairies/NWT
Region.
The
following projects received 2011 research grants with funding provided from
2011 to 2014.
University
of Saskatchewan & Saskatchewan Cancer Agency; Dr Deborah Anderson. Project
title: Role of
p85
in EGFR-expressing triple negative breast cancer.
University
of Alberta; Dr Shairaz Baksh. Project title: The role of pro-apoptotic protein,
MOAP-1, in triple
negative
breast cancer.
University
of Saskatchewan & Saskatchewan Cancer Agency; Dr Keith Bonham. Project
title: Epigenetic
reprogramming
of transcription in breast cancer cells by HDAC inhibitors.
University
of Alberta; Dr David Brindley. Project title: Novel mechanisms of tamoxifen
resistance in breast
cancer.
University
of Alberta; Dr Sambasivarao Damaraju. Project title: Mechanisms underlying
postchemotherapy
outcomes
in early stage breast cancer treated with adjuvant docetaxel, doxorubicin and
cyclophosphamide:
Identification
and validation of predictive biomarkers.
CancerCare
Manitoba; Dr James Davie. Project title: Role of peroxiredoxin phosphorylation
in estrogen
receptor
negative breast cancer.
University
of Alberta; Dr Richard Fahlman. Project title: Alternative mechanisms of BRCA1
protein turnover
and
apoptosis.
University
of Alberta; Dr Larry Fliegel. Project title: Role and regulation of the Na+/H+
exchanger in
proliferation
of breast cancer cells.
University
of Calgary; Dr Don Fujita. Project title: Steps in the Src signaling pathway
that are important
mediators
in breast cancer metastasis and critical targets for targeted
therapeutics.
University
of Saskatchewan; Dr Ron Geyer. Project title: Antibodies targeting the
ErbB2/ErbB3/ IGF-1R
complex
as therapeutics for ErbB2 positive breast cancer.
University
of Alberta; Dr Roseline Godbout. Project title: Investigating the mechanism
underlying retinoic
acid
resistance in triplenegative breast cancer.
University
of Saskatchewan; Dr Troy Harkness. Project title: The antiproliferative effects
of insulin sensitizing
drugs
on multiple drug resistant breast cancer cells.
University
of Alberta; Dr Roger Leng. Project title: Mechanisms of inactivation of the p53
pathway in breast
cancer.
University
of Alberta; Dr Margaret McNeely. Project title: Feasibility of night-time
compression systems for
breast
cancer related Lymphedema.
University
of Calgary; Don Morris. Oncolytic Project title: Viral Immunotherapy for breast
cancer. (Funding
is
for 2011-2012 only.).
University
of Alberta; Dr David Murray. Project title: Targeting the apoptotic threshold
for improving breast
cancer
therapy.
University
of Alberta; Dr Manijeh Pasdar. Project title: The role of plakoglobin in the
p53 pathway in breast
normal
and carcinoma cell lines.
University
of Calgary; Dr Karl Riabowol. Project title: Can ING epigenetic regulators
predict response to
epigenetic
cancer drugs?.
Cross
Cancer Institute/University of Alberta; Dr Wilson Roa. Project title: Targeted
paramagnetic gold
nanoparticles
in the treatment of breast cancer.
University
of Saskatchewan; Dr David Sanders. Project title: Design of B-glucuronidase for
use in antibody-
directed
enzyme prodrug therapy (ADEPT).
University
of Saskatchewan; Dr Rajendra Sharma. Project title: Role of
N-myristoyltransferase in
modulating
breast cancer.
University
of Alberta; Dr Andrew Simmonds. Project title: Defining the role of
post-transcriptional regulation
for
the Wnt1 breast cancer associated oncogene.
University
of Alberta; Dr Jack Tuszynski. Project title: Towards individualized Tubulin
targeting
chemotherapy
for breast cancer.
University
of Saskatchewan & Saskatchewan Cancer Agency; Dr Jim Xiang. Project title:
A combinatorial
immunotherapy
of anti-HER-2 antibody and HER-2 specific adenoviral vector vaccine for
advanced HER-2
positive
breast cancer.
November
28, 2011
International
leader in lipedema management stresses need for greater awareness –
ModernMedicine – By:
Cheryl
Guttman Krader –
•Women
are affected by lipedema, which most often develops in the upper legs
•Abnormal
fat that accumulates in lipedema is resistant to conventional weight-loss
measures
•Early
intervention can help to prevent progression
Liposuction
using super tumescent local anesthesia is an important advance for the safe and
effective
treatment
of lipedema, but appropriate diagnosis is the first step to successful
management of this disorder,
which
causes significant morbidity and is more common than generally recognized, says
Louis Habbema, M.
D.,
Ph.D.
In
lipedema, there is abnormal accumulation of subcutaneous fat that can be
accompanied by mild edema in
the
extremities. Women, almost exclusively, are affected by the condition, which
occurs bilaterally and
symmetrically,
and most often develops in the upper legs. The lower legs and upper arms may be
involved,
but
lipedema rarely affects the lower arms, and fat accumulation in lipedema never
occurs in the trunk or
face.
Some
patients develop lymphedema as well, probably due to compression of the lymph
vessels. Lipedema
patients
also may show anatomically abnormal lymph vessels, Dr. Habbema says.
Due
to a low awareness of the condition among physicians, patients seeking help may
simply be counseled
to
lose weight and/or offered liposuction using conventional techniques. Although
women with lipedema may
also
suffer from obesity, the abnormal fat that accumulates in lipedema is very
resistant to conventional
weight-loss
measures, and it is destined to accumulate again after removal with
conventional liposuction,
says
Dr. Habbema, who has been at the forefront of developing treatment for lipedema
and efforts to
increase
awareness about the condition.
"Fat
accumulation in lipedema cannot be controlled or eliminated through diet, and
the swelling and aching
associated
with the condition are worsened by exercise. Women attempting to lose weight by
these methods
will
simply lose fat from areas of the body that are not affected by lipedema,
including the face, the breasts
and
the trunk, while the lipedema gets progressively worse," says Dr. Habbema, a
dermatologist specializing
in
cosmetic medicine and founder, Medical Centre 't Gooi, Amsterdam.
"Our
experience with around 800 women shows that lipedema treatment with
circumferential liposuction
performed
using a large volume of tumescent anesthesia safely and effectively removes the
fat and improves
patient
symptoms," he says. "Early intervention is desired to hopefully prevent
progression and improve
quality
of life. However, the doctor must first recognize the problem in order to offer
the correct treatment."
ASSOCIATED
MORBIDITY The morbidity associated with lipedema includes physical,
psychosocial and
functional
consequences. In addition to having low self-esteem because of their
appearance, affected women
become
frustrated and discouraged by the failure of their weight-loss efforts, and the
psychological burden
may
be compounded for those who go from physician to physician seeking help, only
to receive the same
advice
about diet and exercise that they have already tried and know doesn't
work.
In
severe cases, the enlarged extremities can cause mechanical sequelae, including
mobility issues and
friction-induced
skin breakdown. Expansion of the subcutaneous compartment with fat also causes
discomfort,
tenderness or even severe pain, and the affected areas may be prone to easy
bruising.
"Women
who've enjoyed long walks may find they must stop after just 10 minutes because
of their pain, and
merely
touching the surface of the skin can cause distress," Dr. Habbema
says.
"In
addition, the pain may be misdiagnosed as originating from some other
musculoskeletal condition and
lead
women to undergo unnecessary diagnostic and surgical procedures that will have
no benefit on their
chief
complaint."
SUPER
TUMESCENT SUCCESS Liposuction using massive amounts of tumescent anesthetic
solution
allows
safe and effective removal of the accumulated abnormal fat in patients with
lipedema because the
infiltrated
solution is sufficient to surround all of the fat cells, facilitating fat
removal while protecting other
tissues,
Dr. Habbema says.
"The
super tumescent technique minimizes the risk of injury to lymph vessels, which
would result in
worsening
of the lymphedema component, and to a delicate network of fibrous septae that
is present in
patients
with lipedema," he says.
Depending
on the area being treated, as much as 10 L to 12 L of tumescent anesthetic
solution is instilled.
The
solution is delivered very slowly to facilitate uniform distribution around all
of the fat cells.
Since
the liposuction needs to be performed circumferentially in one or multiple
procedures and patients
must
cooperate in altering their body position, only local anesthesia is
administered. Traditional power-
assisted
liposuction is used with a blunt cannula usually 3.0 mm in diameter that is
moved from the back to
the
front.
"Initially,
it was thought that a smaller-gauge cannula might be safer, but even though the
tip is blunt, a
cannula
with a small diameter has a knifelike quality and can damage the fibrous
network," Dr. Habbema
says.
NUMBER
OF SESSIONS Depending on the volume of fat that must be removed, two or three
sessions
done
at monthly intervals may be necessary to address circumferential treatment of
the upper legs. Usually,
the
maximum volume of supernatant fat removed per session is 5 L to 5.5 L; however,
the ultimate goal is to
remove as much fat as possible in the
treated area, because it appears that minimizing the amount of fat that
is
left behind will lower the risk of recurrence.
Post-liposuction
care is routine per other liposuction procedures, and post-procedure sequelae
are also the
same,
except that bruising and pain are more significant after treatment for lipedema
because of the greater
volume
of fat removed.
"However,
there is not any significant downtime, and women can expect to be mobile on the
first day after
the
procedure," Dr. Habbema says.
Dr.
Habbema is working on a paper about treatment of lipedema that will include
data from his clinical
experience.
He also co-authored a review article on the topic (Langendoen SI, Habbema L,
Nijsten TEC,
Neumann
HAM. Br J Dermatol. 2009;161(5):980-986).
December 1, 2011
Lymphatic Health And
The Importance Of Good Hydration - Healthy Wealthy n Wise – By: Karen L Davis
–
What is the correlation between proper hydration and the maintenance
of lymphatic health? To better
understand this point, let us take a look at
how the lymphatic system works. The lymphatic system is a
network of lymph
vessels carrying lymph fluid throughout the body in the direction of the heart.
The lymph
fluid is filtered through lymph nodes to trap and remove toxins
and bacteria that could cause disease. The
lymph nodes can be found
throughout the body but most prominently, in the armpit and stomach and are
filled with lymphocytes - white blood cells that help protect the body
against the disease by killing pathogens.
When the flow of lymph through
the lymph vessels is sluggish, the lymphatic system develops disorders such
as lymphedema or swelling in the arms and legs due to the buildup of lymph
fluid. As a result, auto-immune
diseases such as rheumatoid arthritis may
proliferate and even contribute to the spread of cancer cells
throughout
the body, as your lymphatic health collapses and no longer protects
you.
When you are poorly hydrated, the lymph fluid can become thick and
viscous, making it more difficult to
flow through the lymph vessels and
impairing the efficient functioning of your immune system. Poor hydration
can also cause other health disorders that affect the operative functioning
of the lymphatic system. One such
disorder is sluggishness, which makes it
more difficult for you to remain physically active, and causes the
lymph to
move more slowly through your body.
Experts recommend that you drink at
least eight to ten glasses (8 oz) of water a day to help remove the
toxins
from your body when they are filtered through the lymph nodes. How do you
maintain proper
hydration so that you can improve your lymphatic health?
Here are some tips:
1. Have a two liter bottle of water on your desk to
help you keep track of how much water you need to
drink.
2. Instead of drinking fruit juices, coffee and soft drinks to make up your fluid intake requirement, add some
flavor to your water with lime juice or fresh lemon.
Alternately, you can take herbal teas instead of water.
3. When you wake
up in the morning, take a drink of water to help energize you and flush your
system. Try
making some sole (pronounced so-lay) and adding it to that
first drink of water in the morning.
4. When you feel hungry, take some
water instead of a snack. This will help you address hunger pangs and
keep
your weight down since some snacks increase the strain on the lymphatic system,
and increases the
amount of toxins that have to be filtered from the
body.
5. Mix up your water consumption by taking water in various ways
such as teas, soup, plain and flavored
waters, fruits, and
vegetables.
Having a regular exercise program can also help improve your
lymphatic health since staying active can help
the lymph move more easily
through the body. However, the body loses more water during exercise, making
proper hydration more important. To ensure that you stay hydrated after
your workout, as well as
replenishing important electrolytes such as
potassium, sodium and chloride, take a mixture of fruit juice
diluted 50/50
with water and mixed with a half-teaspoon of unrefined sea salt per quart of
the mixture. Also
make sure to drink one glass of water thirty minutes
before exercising, and another glass for every additional
15 minutes of
exercise. Drink 12oz of the fruit juice mixture if you exercise for more than
one hour.
Everyone's water intake needs may not be the same. Please
approach any information you receive with
common sense and an informed
opinion. You can overdue anything, even those things that are good for you.
If you are unsure, some due diligence will give you the basis for any
questions you need to formulate.
Notice:
The article you are
reading is for your personal edification. The information contained therein is
for
educational purposes only and is not to be used in place of proper
medical advice, nor is it intended to treat,
diagnose or cure any ailments.
One should always seek out a properly licensed professional to answer any
questions or render treatment. As always check with your doctor before
engaging in any new activity.
December 2, 2011
Long Term Care Symposium
Attracts 500 Medical Pros - Space Coast Medicine and Healthy Living - By
CENTRALFLORIDAMEDICINE.COM –
CENTRAL FLORIDA, USA – The 2011 Long Term
Care Symposium, presented by the Brevard County
Medical Directors
Association (BCMDA), attracted more than 500 health care providers and enjoyed
great
support from the health and medical marketplace.Long-Term Care
Symposium founder, John H. Potomski,
Jr., D.O., CMD, is president of the
BCMDA and has been a medical provider for residents in area
rehabilitation
and nursing centers, as well as assisted living facilities, for more than 28
years.
Dr. Potomski, who serves as the medical director of Osler Geriatrics,
now part of Osler HMA Medical
Group, has always been an advocate for the
most vulnerable elders. As the chairman of the Brevard County
Commission on
Aging, he has advocated at the national, state and local legislative
levels.
Attendees included medical directors, physicians, nurse
practitioners, physician assistants, nurses, nursing
directors,
administrators, pharmacy consultants, hospice and home health care
representatives and facility
department heads.
“This program was started
as an educational dinner meeting for approximately 80 health care professional
in
long term care and has now grown to a spectacular educational event for
approximately 500 health care
providers,” said BCMDA Executive Director Jo
Ann Fisher.
The symposium, held Nov. 30 in Melbourne, Florida, was organized
by Fisher with support from the staff of
Osler Geriatrics and Brevard
Geriatric Assessment Services, who managed the registration process and
supplied the CEU credit.
This year’s nationally known speakers included
Norman Silverman, MD, of Rely Radiology Group on the
topic of “Bedside
Imaging Examinations: Indications and Results;” Robyn Bjork, MPT, WCC, CLT, on
the
topic of “Differential Diagnosis of Lymphedema and Treatment Options;”
and Kevin O’Neil, M., CMD,
chief medical officer of Brookdale Senior Living
on the topic of “Cross Train Your Brain.” The speakers
were supported by an
educational grant from Osler Geriatrics.
Boyle Wins Long Term Care
AwardAmong the highlights of the event was the presentation of the 2011
Long Term Care Award to Joyce Boyle, LPN, for her more than 25 years of
service to the older adults
residing in nursing facilities. Boyle is
currently a unit manager at Melbourne (Florida) Terrace Rehabilitation
Center.
The keynote address was delivered by DiAnn Barnes, RN, with
Hospice of St Francis; Father Robert
Bruckart of Health First Pastoral Care
gave the invocation; and the Pledge of Allegiance was led by Capt.
Jessica
Pabon form Patrick AFB.
“I have always felt that it is important to give
back to the community,” said Dr. Potomski. “This event not
only shows our
appreciation to the professionals in long term care, but also provides them
with education in
the field of geriatrics at no cost.”
For more
information log on to www.bcmda.comDecember 2, 2011
Exercise Benefits Breast
Cancer Survivors, Patients With Lymphedema, Say Researchers - Medical News
Today –
After reviewing published evidence, University of Missouri
researchers conclude the benefits of exercise
outweigh the risks for breast
cancer survivors, including those who develop lymphedema, a chronic swelling
that commonly occurs after breast cancer treatment. Co-author Jane Armer,
professor in the University's
Sinclair School of Nursing, and colleagues,
write about their findings in the December 2011 issue of the
Journal of
Cancer Survivorship.
Armer told the media, "exercise can be beneficial
and not harmful for breast cancer survivors," and patients
at risk for
lymphedema, a condition that affects around 3 million people in the US, can
exercise if they are
careful and watch what they are doing:
"Each
individual should balance the pros and cons of the activity she chooses, but
keep in mind that being
sedentary has risks and being active is beneficial
in many ways, including possibly reducing the risk of cancer
recurrence,"
she added.
Lymphedema usually results when lymph nodes are removed or
treated with radiation as part of cancer
treatment. It can develop any time
after treatment, and traditional thinking was that patients should avoid
exercise in case it prompted development of the condition.
But Amer
and colleagues found patients who exercise were at no greater risk of
developing lymphedema
than those who do not exercise. Furthermore,
exercising once lymphedema has developed does not make it
worse.
"Breast cancer survivors do not need to restrict their
activity as we once thought," said Amer.
"If patients want to be active,
they should carefully condition their bodies by increasing repetitions of
resistance exercises under proper supervision," she added.
However,
Amer said more studies would be needed to establish whether exercise actually
prevents
lymphedema.
For their review, Amer and colleagues searched
the available literature and found 19 studies out of over
1,000 potential
articles met their stringent inclusion criteria.
Seven of the studies
covered resistance exercise, another seven covered aerobic and resistance
exercise,
and five studies covered other forms of exercise.
"Studies
concluded that slowly progressive exercise of varying modalities is not
associated with the
development or exacerbation of breast cancer-related
lymphedema and can be safely pursued with proper
supervision. Combined
aerobic and resistance exercise appear safe, but confirmation requires larger
and
more rigorous studies," write the authors.
Written by Catharine
Paddock PhD
Copyright: Medical News Today
December 2, 2011
Exercise
does not worsen lymphedema - UPI.com –
COLUMBIA, Mo., Dec. 2 (UPI) -- The
benefits of exercise outweigh the risks for breast cancer survivors
and
patients with lymphedema, a chronic swelling, U.S. researchers say.
Jane
Armer, a professor in the Sinclair School of Nursing at the University of
Missouri, said patients at risk
for lymphedema can exercise if they closely
monitor their activities.
"Exercise can be beneficial and not harmful for
breast cancer survivors," Armer said in a statement. "Each
individual
should balance the pros and cons of the activity she chooses, but keep in mind
that being
sedentary has risks and being active is beneficial in many ways,
including possibly reducing the risk of cancer
recurrence."
Lymphedema
can occur any time after cancer treatment and is usually caused by the removal
or radiation of
lymph nodes as part of the treatment process, Armer
said.
Armer found patients who exercise had no greater risk for developing
lymphedema than those who do not
exercise, and patients with lymphedema did
not worsen their condition by exercising.
Future research is needed to
determine whether exercise prevents the condition, Armer said.
"Breast
cancer survivors do not need to restrict their activity as we once thought,"
Armer said. "If patients
want to be active, they should carefully condition
their bodies by increasing repetitions of resistance
exercises under proper
supervision."
The findings were published in the Journal of Cancer
Survivorship and the Annals of Surgical Oncology.
December 4,
2011
Manitowoc-Two Rivers Y program helps cancer survivors stay strong -
Herald Times Reporter –
MANITOWOC — Mary Kay Johns of Manitowoc was very
active before she was diagnosed with breast
cancer in 1993.
After
recovering from a mastectomy and reconstruction surgery, she was ready to get
back to exercising,
but didn't know how to go about it.
"Because of the
changes in my body, I had no idea where to begin or how to adapt myself to get
back to the
physical fitness level I had prior to my diagnosis," said
Johns, 55, who returned to the Manitowoc-Two
Rivers Y where she had worked
out before her illness.
Removal of her breast affected her balance. Johns
suffered neuropathy or nerve damage resulting in
numbness and tingling in
her hands. This condition is sometimes a side effect of chemotherapy in cancer
patients. Surgery also destroyed what Johns calls her "sit-up" muscles, so
she had to find new ways to do
that simple exercise.
"Because of
reconstructive surgery, I can't do sit-ups and abdominal exercises like other
people do … I do
them sitting on a ball," she said.
Johns learned what
she could and could not do by trial and error.
"I made a lot of mistakes
along the way, but I was able to get far beyond my expectations ... to the
point I
was doing half-marathons and triathlons," she said.
Program
introduced this year
Johns eventually became a staff member at the Y, which
last year received a grant to offer LIVESTRONG,
a free 12-week fitness
program for adult cancer survivors. The program eliminates the guesswork that
she
faced in her battle to regain her fitness.
Johns underwent extensive
training to become the program facilitator and is one of four instructors
knowledgeable in the limitations of cancer survivors and techniques that
can positively affect their lives, both
physically and
emotionally.
Through the program, which kicked off earlier this year, Johns
is now helping other cancer survivors
overcome their challenges. Having
first-hand experience gives her a better understanding of what they're
going through.
"We have to find a new normal for ourselves because our
bodies are no longer the same. We are forever
changed by our diagnosis and
the treatment we have gone through," she said.
The group, for survivors of
all different cancers, provides individually structured exercise programs that
focus on aerobic endurance and strength conditioning, Johns said.
In a
way, she is starting all over again. In January, a lump was found in her other
breast. Although it turned
out to be noncancerous, she decided to have
another mastectomy as a preventive measure, she said.
Retiree wanted to
regain lost energy
When Sandra Fraize, 70, moved from Boston to Manitowoc to
retire in 2007, she didn't envision a battle
with colon cancer as part of
that retirement.
After surgery and six months of chemotherapy, Fraize was
tired and weak, with neuropathy of the feet
affecting her
balance.
Cancer patients often experience balance issues, which the program
helps combat through simple exercises
on unstable surfaces and balance
equipment, said instructor Candy Ruffolo.
Exercise also can build up the
muscle tissue that has broken down through chemotherapy and inactivity
during the illness and treatment, Johns said.
"I wanted to regain the
way I had planned on living retirement. I wanted to be an energetic and vibrant
person," said Fraize, who found renewed stamina thanks to the
program.
When she started exercising, she could only tolerate a cardio
workout for two to three minutes. Now she is
up to 20 minutes, said the
recent LIVESTRONG graduate.
"It gave me hope and belief in the human spirit
and body," Fraize said of the program.
Exercises tailored to individual
needs
Breast cancer survivor Ann Wind, 58, of Manitowoc endured a
mastectomy, three months of chemotherapy
and 6½ weeks of radiation after
she was diagnosed with breast cancer in November 2010.
She's been
cancer-free since April but wears a compression sleeve on her left arm to help
control
lymphedema, which causes chronic swelling.
Survivors of breast
cancer, colon cancer and any cancer in which the lymph nodes have been removed
are
more susceptible to the condition; breast cancer patients like Wind,
who have lymphedema in the arm,
typically start out lifting lighter weights
so as not to aggravate the condition, Johns said.
"I feel much better
physically," said Wind, who recently completed the program and regained her
strength
and energy. "I've improved a lot."
And because Wind felt so
isolated during her cancer treatment, when her immune system was down and she
had to stay away from people, she welcomed the social aspects of the class
as well, she said.
In fact, the members of the group got along so well that
they plan to continue meeting.
Colon cancer survivor Joanne Vogds, 51, of
Manitowoc, found that the class improved her gait and her
balance.
"I'm
disabled to begin with and I got cancer and it just compounded things," she
said. "I can't walk as good
and I can't talk as good and cancer made the
condition worse."
The class customized some of her exercises so they could
be done while she was sitting in a chair, Vogds
said.
Program targets
emotional and physical health
It's common for cancer patients to suffer from
depression, said breast cancer survivor Connie Peterson, 49,
of
Manitowoc.
"Your whole life is turned upside down. Some of your treatments
make you feel worse," Peterson said.
"Now I feel a sense of hope. I have
new friends who are supportive, and that's a plus."
As Mary Nix, 63, of Two
Rivers put it: "No one else understands where you've been, and people can't
truly
identify with you unless they've walked the walk."
Nix said the
relaxation portion of the program helped her combat the anxiety of her battle
with breast cancer
in 2009, the death of her husband in 2010 and her
diagnosis of colon cancer this year.
LIVESTRONG is designed to improve
energy levels and self-esteem, build muscle mass and strength,
increase
flexibility and endurance, improve the ability to perform everyday tasks and
develop an ongoing
fitness plan, Johns said.
Not only can exercise help
you bounce back after cancer treatment, studies have shown that physical
fitness
and having a support system and a positive outlook will lessen your
risk of recurrence for cancer, she said.
Classes offered again in
January
LIVESTRONG classes will again be offered at the Y starting on Jan.
9, Johns said.
In addition to Johns and Ruffolo, instructors are Amy Tisol
Retzinger and Craig Pautz.
Participants are assessed and their progress is
charted. Each participant receives a free 12-week
membership to the Y for
the duration of the program. The class also is free to caretakers and spouses
as
well as cancer survivors. Guest speakers on topics of interest to cancer
patients are part of the program.
To register or for information, contact
Michelle Kernz at (920) 682-0341, [email protected] or visit
www.
mtrymca.org.
December 4, 2011
Cancer survivors step up therapy -
Dailyrecord.com –
On any given Monday morning, the sounds of “New York, New
York,” “Boogie Woogie Bugle Boy of
Company B” and “Mambo No. 5” waft
through the speakers of the Accents on Dance studio in
Ledgewood.
The
three women on the studio floor were not previously acquainted, but after being
classmates for nearly a
year, share a generous amount of laughter and
encouragement.
They are not, however, rehearsing for any dance competitions
or ballroom appearances.
Instead, the women are a close-knit sisterhood of
breast cancer survivors who have found beneficial therapy
— and an
unexpected support system — through a weekly exercise program rooted in
dance.
“Before the class, I found that it was harder for me to reach up and
stretch,” said Penny Johansen, a retired
retail sales associate from
Succasunna. “It has helped my balance tremendously.”
Johansen underwent a
double mastectomy and reconstruction surgery in 2008, and says she then
developed
neuropathy in her feet and hands following chemotherapy.
Prior
to the chance spotting of a newspaper ad for a class called “Focus on Healing
Through Movement and
Dance” that was starting up at the studio this past
January, Johansen said she had difficulty finding an
exercise regimen
tailored to her recovery.
“I found, with a lot of gyms, it just hasn’t been
for me,” Johansen said.
“Focus on Healing” is a gentle, therapeutic exercise
program geared specially to the needs of women in
recovery from breast
cancer surgery and related treatment.
Among other reported benefits, the
program helps women regain their range of motion and balance, and
counteract such conditions as lymphedema, frozen shoulder, neuropathy and
fibromyalgia.
The dance-oriented class uses what has come to be known as the
Lebed method, in honor of namesake
Sherry Lebed Davis.
Davis, a
professional dancer, dance teacher and breast cancer survivor devised the
program in the early
1980s with her two physician brothers, after the
siblings’ mother had a difficult recovery from breast cancer.
Accents on
Dance instructor Sherrin Claesson – a veteran jazz, ballet and tap dance
teacher who is also
Lebed-certified – is a proud cheerleader for her
students, to whom she endearingly refers as “my ladies.”
“These women are
wonderful,” Claesson said. “What my ladies love about this class is not how well
they do
it. It’s the fact that they’re moving.”
Eliminating any
intimidation is essential to the program, which calls for the placement of
chairs next to each
participant.
“Everything that we do you can do
sitting down or standing up,”
Claesson said. The chairs can be used for
extra balance and support or taking a break.
Between 8 and 12 songs of
varying tempo comprise the soundtrack for each class.
“We start with
soothing music for our lymphatic opening,” Claesson said. “We do breathing
exercises, head
movements, shoulder shrugs and rolls, and isolating and
moving the rib area.”
Before long, the women segue to knee bends, lunges,
arm movements and step touches, and are ready to
tackle something
Latin-flavored and upbeat along the lines of Ricky Martin’s "Livin' La Vida
Loca."
Karen Bonte, a former co-owner of Solar Living, Inc. in Budd Lake,
remembers having difficulty opening
her mailbox after undergoing a left
side mastectomy and radiation last year.
“I can now lift my left arm as high
as my right arm,” Bonte said. “My range of motion has come back with
the
exercise program.”
Breaks are taken for sips of water, and to allow the
women to chat — a part of the class that is arguably as
important as the
exercise.
“If one of us has a question, we can ask one of the others who
might have already been through something
we’re going through,” Bonte
said.
“It’s a nice little bond we have.”
Elaine Nader, a retired
bookkeeper from Succasunna, rounds out the class, and appreciates the
camaraderie with her exercise mates.
“We get along fabulously,” Nader
said. “There’s nothing that we don’t discuss before class and after class. I
do miss it when I go to Florida.”
Nader says she finds the routines
particularly helpful in combating arm swelling from lymphedema and
neuropathy in her feet — conditions that developed after a 2007
mastectomy.
Especially appealing, the women say, is the fact the class does
not have the rigid, impersonal feel of other
exercise and rehab
programs.
“It’s very relaxing because you’re dancing to the music,” Bonte
said.
“If you can’t keep up, Sherrin will slow it down. We laugh about it
when we do something wrong, but
nobody cares.”
At the nominal charge of
$10 per session, the program has not been a moneymaker, despite the
testimonials
and fierce loyalty of its three participants — who have even
shown up for class on Monday holidays.
“We're keeping it going because it’s
a great class for these women,” Claesson said. “As long as people are
coming and (Accents on Dance owner/manager) Lou Cordileone provides the
space, I'm willing to teach it.”
Claesson said the Monday morning class has
room for more people, and that the studio is willing to start
additional
classes if demand exists.
“One of my ladies asks every doctor she goes to if
she can put brochures (about the “Focus on Healing”
class) in the waiting
rooms,” Claesson said, noting there is still resistance from some doctors to
recommend
alternative therapy.
Although originally designed for breast
cancer survivors, the dance-infused exercises may also be beneficial
for
people with Parkinson's disease, multiple sclerosis, arthritis and
osteoporosis, Claesson says, as well as
"senior citizens in
general."
Finding a bit of irony that it took recovery from breast cancer to
finally get her to join a dance class,
Johansen says she looks forward to
the classes every week – and is passionate about wanting the program
to
continue.
“I can’t tell you how much I’ve enjoyed it – mentally and
physically,”
Johansen said. “As long as we don’t have to wear tutus and be
in dance recitals.”
December 5, 2011
Mohawk College Offers Lymphedema
Program - Wire Service Canada –
Lymphdema is one of the most feared and least
understood complications of breast cancer treatment.
Mohawk College in
Hamilton, Ontario, is offering a day-long overview that will prepare the
student to
understand the causes of lymphedema as well as its treatment and
management.
John Mulligan, RMT/CLT-LANA will present an Overview of
Lymphology and Lymphedema Management
at Mohawk College at the
Mohawk/McMaster Institute of Applied Health Sciences Hamilton Campus in
the
Applied Health Sciences building, on Saturday February 4th, 2012, 9:00 a.m. to
4:30 p.m.
This unique one day workshop will explore the different types and
stages of lymphedema, clinical pathways
for treatment and the need for
skilled care. Topics include basic lymphology, differentiating among different
types of edema, the role and mechanics of compression, manual lymph
drainage and complex decongestive
therapy. We will also discuss the
International Lymphedema Framework Movement, research resources
and
educational opportunities in the field of lymphology.
This one-day
introduction to the basics of lymphedema and lymphedema management will
immediately give
the attendees a solid base of knowledge of the lymphatic
system and disorders of the lymphatic system.
For more information
visitwww.LymphedemaDepot.com and click on EVENTS in the left-side menu. This
will bring you to the Mohawk online course catalogue where register for the
daylong overview. To locate the
course listing, simply go to page 53 of the
catalogue. To register, click on Registration Information.
For further
assistance contact John Mulligan directly at
[email protected].
For more information about Mr. Mulligan and
his practice, please visit www.LymphedemaTherapist.com.
December 5,
2011
ArjoHuntleigh Forms New Division to Enhance the Quality Home Medical
Care- PR Newswire –
ADDISON, Ill., Dec. 5, 2011 /PRNewswire/ --
ArjoHuntleigh Inc., a global leader of integrated solutions
for the care of
people with reduced mobility and related conditions, announced today the launch
of a new
division and product portfolio focused exclusively on developing
and distributing medical equipment to
people in home care settings.
The
new division, ArjoHuntleigh Home Care, will offer a broad range of product
solutions that aid in the
caring of individuals at home including patient
handling systems, hygiene systems, therapeutic surfaces,
medical beds,
treatment of lymphedema, and bariatric care.
"We are excited to announce the
formation of ArjoHuntleigh Home Care," said Phil Croxford, President and
CEO ArjoHuntleigh North America.
"The new Home Care division will
provide world-class solutions for the care of people with reduced
mobility
and related conditions that are specific to home care environments.
ArjoHuntleigh Home Care will
provide an enhanced sales and service network
that will enable our distribution partners to deliver high
quality and
cost-effective healthcare to people who have mobility challenges," continued
Croxford.
ArjoHuntleigh offers a broad range of integrated solutions for the
care of people with reduced mobility and
related conditions, with the aim
to enhance the quality of care in long-term care, acute-care and home care
environments. The company is known for high-quality and state-of-the-art
solutions including the Sara®
product line of standing-and-raising aides,
the Voyager and Maxi-Sky® ceiling lifts, the Freedom bathing
system,
Minuet® bed and the Nimbus®/DFS range of Therapeutic Surfaces.
Products are
currently available through a wide range of dealers located throughout the US
and Canada.
The new Home Care division will be based out of the
organization's North American Headquarters in
Addison, IL.
About
ArjoHuntleigh ArjoHuntleigh Inc. is a global medical technology company
providing a broad range of
integrated solutions for the care of people with
reduced mobility and related conditions. We aim to enhance
the quality of
care of people with reduced mobility and related solutions by providing medical
equipment and
integrated solutions for patient handling and hygiene,
medical beds and therapeutic surfaces, wound healing,
DVT prevention,
disinfection and diagnostics. With more than 4,400 dedicated employees
worldwide,
ArjoHuntleigh serves the needs of patients and healthcare
professionals in more than 100 countries. For
more information about
ArjoHuntleigh, visit our website at www.ArjoHuntleigh.com.
December 6,
2011
Exercise 'can be good for lymphedema patients' - International
Federation of Gynecology and Obstetrics –
Breast cancer survivors with
lymphadema are not putting themselves in danger by exercising, women's health
researchers have stated, saying physical activity could be good for these
patients.
Scientists at the University of Missouri in the US reviewed
the literature about this chronic inflammation
condition, which it was
previously thought could be caused or aggravated by fitness
pursuits.
The researchers said the evidence suggests the benefits of
exercise actually outweigh the potential risks, with
Sinclair School of
Nursing professor Jane Armer, who was involved in the study, reporting breast
cancer
survivors are not at a significantly higher threat of lymphadema if
they keep physically active.
Additionally, those who already had the
condition did not seem to get worse if they kept fit, but the expert
said
people in danger of developing the swelling should monitor their
pursuits.
"Breast cancer survivors do not need to restrict their
activity as we once thought," professor Armer said.
"If patients want to
be active, they should carefully condition their bodies by increasing
repetitions of
resistance exercises under proper supervision," she
added.
Dartmouth Institute for Health Policy and Clinical Practice
researchers in Hanover in the US recently
developed a model that can be
used to determine the survival rates of those who go through breast cancer
screenings.
December 6, 2011
Mom's illness sparks desire to fight the
fat - Stockton Record –
STOCKTON - With her own Web design business and a
job working with Spanish-speaking students in a
Lodi school, Lodi resident
Alejandrina Britschgi didn't need a new career.
Then her mom got
sick.
Britschgi, 27, said her mother, Lucresia Duran, was on a visit from
her home in Puerto Rico when
lymphedema - severe fluid retention in her
legs - made it painful to walk.
"I put her on a diet," Britschgi said. That
didn't work. A doctor warned that Duran was in danger of losing a
leg.
Finally, Britschgi found Amanda McCann, a personal health coach
based in Sacramento. McCann helped
Duran lose 47 pounds over five months.
Duran saved her leg.
But Britschgi was deeply involved in the entire effort.
McCann doesn't speak Spanish. By translating for her
mother, Britschgi
learned about nutrition, exercise and coaching.
Britschgi said she then
tried the system for herself, basically eating small, nutritious meals six
times a day and
avoiding junk food. It worked, and she, like her mom, felt
stronger and no longer suffered weight
fluctuations.
That was in 2009.
Two years later, Britschgi is a certified health coach and has won an award
from San
Joaquin County's Obesity and Chronic Disease Prevention Taskforce
for her efforts to combat obesity and
other health ills.
"In my family,
I thought being obese was something you inherited," Britschgi said.
In part,
that may have been because she was fond of the food in her native Puerto Rico,
much of which is
fried. She said she's retrained herself to cook with less
oil. Now, when she makes mafongo - a garlic-
flavored, mashed-plantain dish
- she boils the plantain instead of frying it.
One way she earns money as a
health coach is with a consulting contract at Jose Serna Charter School in
Lodi. There, she teaches cooking and offers children tips like this:
"Instead of white sugar, why don't you do
raw sugar or brown sugar?"
Britschgi said people can be healthy and still enjoy treats, but that it helps
to
substitute better ingredients and control portion sizes.
Britschgi's
other source of income as a health coach is through commissions on
meal-replacement products
sold by Medifast.
People using the Medifast
program can get her coaching services for free through a related program
called
Take Shape for Life. In addition, she offers free weekly classes on
various health topics.
McCann said that Britschgi has played a huge role in
bringing health-coaching services and meal-
replacement products to Spanish
speakers. And not just in Lodi and Stockton.
About four times a year,
Britschgi travels to Puerto Rico to coach clients there. When she is at home
in
Lodi, she keeps up with them through Skype.
"A lot of people think
you cannot change your habits," Britschgi said. "But yes, you can."
Contact
reporter Dana M. Nichols at (209) 607-1361 or [email protected]. Visit his
blog at
recordnet.com/calaverasblog.
December 5, 2011
Taking control
of the fear with breast cancer - MiamiHerald.com –
Andrea Torres is an
editor at The Miami Herald. Follow her breast cancer journey at
miamiherald.
com/health.
Narcotics detectives hunt addicts and
traffickers for the sort of painkillers that are prescribed to breast
cancer patients after a bilateral mastectomy. Oxycodone can destroy a
life.
I decided to stay away from it on the fifth day after the surgery.
That was a big mistake. It was torture. I felt
like there were little
creatures with sharp objects poking and tearing me from within. The pain was so
excruciating it made me weep.
“Why are you crying? That’s not going to
solve anything,” said my mom. “That’s enough. Just take it.”
She is a
believer in homeopathic remedies, and taught me how to use prana yoga and
breathing exercises to
deal with headaches when I was 8. She is the person
least likely to push pharmaceuticals, yet she was
standing in front of me
with a glass of water and a container full of white pills. I laughed and
swallowed one.
Within 40 minutes, I found peace.
The pills couldn’t
vanish the gray cloud floating over my head. The body image I had been used to
seeing in
the mirror after showering was no longer there. I felt deformed,
and still I had to find the courage to be
topless in front of two men at
the University of Miami’s Sylvester Comprehensive Cancer Center.
After
careful examination, Dr. Marc Lippman, chairman of the University of Miami’s
department of
medicine, said the outcome of the surgery was “great.” I told
him I disagreed. My doctors had done an
amazing job, and I had not had any
complications while healing. All was well. I just didn’t like the “under
construction” sign that was hanging over my chest.
“You could have come
out of this surgery a lot worse,” he said. “You are not going to have the
breasts you
used to have but it will come close.”
He was right. Vanity
twists perspective and makes one ungrateful.
“We are still aiming for a
cure? Aren’t we?” he asked.
“Yes, absolutely,” I said.
I wasn’t as
enthusiastic. The surgery had added the risk of developing lymphedema, which
causes painful
and chronic swelling of the arm due to fluid
retention.
The medical director of the Baptist Health Breast Center, Dr.
Robert DerHagopian, said the pain in my left
arm was going to
subside.
“Damage to the intercostobrachial nerve causes numbness on the
upper inner arm,” said DerHagopian, while
pointing to the back of my
arm.
The damage happened during the axillary lymph node dissection. This
procedure and another one — the
sentinel lymph node biopsy — were done to
examine whether the pea-sized filters under the arm had
collected cancer
cells that may have spread. The pathology report said DerHagopian had removed
“one
sentinel lymph node and 16 random lymph nodes” and that doctors had
found two with “macrometastases.”
The good news was that doctors did not
believe the cancer cells had spread to other parts.
“Your prognosis is good,
but there is no guarantee that a recurrence won’t happen,” DerHagopian
said.
To reduce the risk of a recurrence, both DerHagopian and Lippman
recommended that I undergo radiation
and referred me to UM Sylvester
Comprehensive Cancer Center’s radiation oncologist, Dr. Cristiane
Takita.
During my meeting with Takita, who specializes in using radiation to kill or
shrink cancer cells, I
learned that the therapy would reduce the risk of
recurrence from about 30 to 10 percent. Although when
used on children,
Takita said, radiation can become a cancer risk.
“We are going to use
radiation as a preventive measure,” said Takita. “That means that we are going
to
radiate the clavicular area.”
The chest wall was also a very common
area of recurrence, Takita said. She recommended I undergo six
weeks of
treatment Monday through Friday.
“The treatment is painless when
administered, but your skin becomes more sensitive. It will feel like you had
a sunburn,” said Takita. “Some patients experience tiredness … lowered
white cell counts and
inflammation.”
I had fears. What if the radiation
damaged my tissue so severely that it would cause my body to reject the
implant? “I am concerned about it affecting my reconstruction,” I
said.
Fear has taken different forms through my experience with breast
cancer treatment. The steps the doctors
have recommended are simple, and
I’m going to continue them despite Lady Terror’s creative mirage
December 6,
2011 –
Exercise for Breast Cancer Survivors - Biomed Middle East –
Jane
Armer says patients at risk for lymphedema can exercise if they closely monitor
their activities.
“Exercise can be beneficial and not harmful for breast
cancer survivors,” he said. “Each individual should
balance the pros and
cons of the activity she chooses, but keep in mind that being sedentary has
risks and
being active is beneficial in many ways, including possibly
reducing the risk of cancer recurrence.”
Lymphedema can occur any time after
cancer treatment and is usually caused by the removal or radiation of
lymph
nodes as part of the treatment process. Armer found that patients who exercise
had no greater risk
for developing lymphedema than those who do not
exercise. In addition, patients with lymphedema did not
worsen their
condition by exercising. She says future research is needed to determine
whether exercise
prevents the condition.
“Breast cancer survivors do not
need to restrict their activity as we once thought,” Armer said. “If patients
want to be active, they should carefully condition their bodies by
increasing repetitions of resistance
exercises under proper
supervision.”
“Many people think surgery will correct the underlying
lymphatic problem, but that is not correct,” Armer
said. “There are several
surgical techniques that may reduce the swelling associated with lymphedema. In
most cases, it is recommended that patients undergo traditional therapy
using specialised massage and
compression garments and bandages to reduce
fluid and swelling before considering surgery.”
Established in 2008, the
American Lymphedema Framework Project (ALFP) aims to increase awareness of
lymphedema, improve patient care and enhance training for professionals
caring for persons at risk or with
cancer-related lymphedema. The ALFP has
two main goals: maintain up-to-date best practices supported
with
evidence-based lymphedema treatment guidelines for health practitioners, and
create a minimum data
set of all available lymphedema research and clinical
data.
MEDICA.de; Source: University of MissouriDecember 6,
2011
Lymphedema 'is not caused by exercise' - Private Healthcare UK
–
Patients who have received breast cancer treatment have been told that
exercise will not instigate the onset
of lymphedema.
There had been some
controversy about advising people recovering from the illness to participate in
physical
activity, but scientists at the University of Missouri analysed
medical records and found that the benefits of
exercise were more
significant than the risks.
Lymphedema is caused by the removal or radiation
of lymph nodes in breast cancer treatment and can
cause a painful chronic
swelling in some patients.
"Breast cancer survivors do not need to restrict
their activity as we once thought," said Jane Armer, from the
Sinclair
School of Nursing at the university.
She explained that patients should
choose their physical activities carefully as being active has many health
benefits, including possibly reducing the risk of the tumours
reoccurring.
According to Cancer Research, it is in the second stage of
breast cancer when the disease first affects the
lymph nodes.
December
7, 2011
Comprehensive Lymphedema Patient Resource and Education Site to
Launch this Month - MarketWatch
(press release) –
LOS ANGELES, Dec 07,
2011 (BUSINESS WIRE) -- Emphasizing the notion that "Lymphedema doesn't
have to be a secret," a new online resource site, www.lymphconnect.com ,
has been developed to spread
the word about the largely misunderstood
condition suffered by hundreds of thousands of women. The site is
designed
to provide a comprehensive informational resource and support network for women
living with
lymphedema and their loved ones and families, as well as anyone
faced with breast cancer in general.
After the physical and emotional rigors
of a mastectomy or lumpectomy as part of the fight against breast
cancer,
patients often need to undergo extensive radiation or chemotherapy treatments
as well.
Unfortunately, for many of those who successfully beat breast
cancer, there is a chance they could face the
potentially debilitating
post-breast cancer condition called lymphedema.
Largely under diagnosed and
misunderstood, lymphedema is a condition resulting from damage to the lymph
nodes that causes swelling in the limbs. Early detection is critical for
survivors of breast cancer to manage
and control the condition. However,
the majority of women are unaware that lymphedema is a risk
associated with
breast cancer treatments. Too often, the condition is not diagnosed until after
swelling is
visible, the point at which the progression of the disease is
often irreversible.
The hope of LymphConnect.com is to create a community of
breast cancer patients and survivors, friends
and family, who support the
education, prevention, early detection, intervention and treatment of
lymphedema. The site creates a forum that offers women the opportunity to
get proactive about the
condition by sharing their stories and learning
those of others via the site's built-in online support community.
The site
also contains regularly updated news and information about the condition and
related research,
question and answer opportunities with medical
professionals, and information empowering readers to
spread the word about
the condition.
The ultimate goal of LymphConnect.com is to generate
increased awareness and knowledge of
lymphedema, as well as a support
network so that more breast cancer survivors will have the resources
necessary to be informed and to become advocates for early detection and
awareness. The easy-to-
navigate and interactive site goes live this
month.
SOURCE: LymphConnect.com
December 12, 2011Monday Medical:
Lymphedema treatment is vital - The Steamboat Pilot & Today – By
Christine McKelvie - Almost 12 years after being diagnosed with stage 3
breast cancer, Craig resident
Bonnie Curtis is beaming. The cause of her
celebratory smile is something most of us take for granted. She
can reach
above her shoulder and bend her right arm.
“I’ve got elbow!” Curtis
triumphantly says, flexing her arm to prove it.
With the help of two
specialist therapists at Yampa Valley Medical Center, Curtis has overcome the
worst
symptoms of her lymphedema. This nasty side effect of some cancer
treatments can create serious swelling,
discomfort and disability.
“The
lymphatic system transports and filters vital fluids throughout the body,”
explains Jodi Bringuel, physical
therapist and certified lymphedema
therapist at YVMC.
“Lymphedema is an accumulation of lymphatic fluid that is
not draining properly. It can be caused by
removal of lymph nodes or damage
to the lymphatic system,” she said.
Curtis’ breast cancer surgery in 2000
involved removal of 18 lymph nodes. About a year later, she noticed
that
her arm “started poofing up.” Although she sought treatment, the swelling kept
creeping up toward her
shoulder.
In 2004, Curtis began working at YVMC
as a housekeeper. Noticing Curtis’ badly swollen arm, one of her
new
co-workers suggested that she see Susan Ring, certified lymphedema therapist,
physical therapist and
director of SportsMed at YVMC.
“Susan and Jodi
have been my angels ever since,” Curtis said.
Bringuel has a passion for her
work, in part because of her own family history of cancer.
“In the United
States, lymphedema is most often a result from cancer surgery or treatments,”
Bringuel said.
“The main groups of lymph nodes are found in the armpit and
groin areas,” she explains. “These are often
the site of biopsies when
determining if cancer has spread to the lymphatic system. Sometimes lymph nodes
are removed in surgery or are damaged by radiation treatment.
“The key
thing we want people to know is that once lymphedema starts, it’s a matter of
managing it for the
rest of your life,” Bringuel said. “There is no cure.
But there are things people can do and avoid doing to
reduce their
risk.”
Warning signs can be subtle. Typically lymphedema can cause some
minor discomfort, but it is not painful,
Bringuel said. One arm or leg may
seem heavier. Clothing or jewelry may feel a little tighter.
Bringuel said
early intervention is vital to keep swelling to a minimum. That is why she
attempts to visit with
everyone who has cancer surgery at YVMC, either
before or soon after his or her surgery.
“We offer a free consultation,”
Bringuel said. “This education is available to all residents of the Yampa
Valley, regardless of where they have their surgery.”
Lymphedema
treatment has three components — education, manual lymphatic drainage and
bandaging or
compression garments.
Curtis credits her recent dramatic
improvement to the newest technique of manual lymphatic drainage, a
relaxing whole-body experience that “opens up” the entire lymphatic
system.
“Just this year, we started manual drainage,” she said. “Up until
then, it was just arm massage and wrapping.
My arm is so much smaller and
lighter now. I can see my wrist bone for the first time in years.”
At a
recent check-in with Bringuel and Ring, Curtis learned that she is eligible for
a new, smaller arm
compression “sleeve.” She wears one type of sleeve during
the day and a different one at night.
Lymphedema treatment at YVMC also
includes education about skin care. Because lymphedema increases
the risk
of infections, something as simple as a hangnail or scratch can cause an
infection.
Curtis spent years coping with her swollen arm, aching shoulder
and limited movement.
“I didn’t let it get me down, but my life is
definitely better now,” she said. “Jodi and Susan are always
learning about
new treatments and techniques, and they gave me back my arm.”
Christine
McKelvie is the public relations director of Yampa Valley Medical
Center.
December 12, 2011
Lymphedema After Breast Cancer Surgery:
Pain, Swelling May Occur Years Later - Patch.com –
There is no rhyme,
reason, or way to predict if a woman will experience lymphedema following
surgery or
radiation to treat breast cancer. Swelling of the arm, breast,
or chest may begin shortly after breast cancer
surgery or radiation, but
some women experience lymphedema months—or even years—later. According to
the American Cancer Society, most women who have had breast cancer do not
develop lymphedema, but
the many who do can take steps to manage the
swelling and pain, which can range from mild to severe.
Lymphedema results
when lymph nodes and vessels are removed or scarred during breast cancer
surgery.
With fewer lymph nodes and vessels, it is more difficult for the
upper body to drain lymph fluid. When
excess lymph fluid builds up, pain
and swelling occurs. Radiation for breast cancer also affects the flow of
lymph fluid in the arm, chest, and breast area, and can cause
lymphedema.
“Lymphedema is always a risk when a woman has had any lymph
nodes removed or radiation for breast
cancer,” says Monique Tiffany, R.N.,
nurse navigator at the Total Care Breast Center at Los Alamitos
Medical
Center. Tiffany advises women about lymphedema not only as a breast cancer care
nurse, but also
as a breast cancer survivor. She celebrated being
cancer-free for 10 years this month.
Tiffany says she remains aware that
lymphedema can still occur, even after a decade. “I still have to think
about it if I’m going to get on a plane,” she says. Air travel can cause
lymphedema to flare up.
January 12, 2012
This one has tables and a
lot of stuff in the full article, but I also found the abstract to use if the
formatting is
unusable Tina
Newswise — Articles featured in this issue
include— - Newswise
Abstract—Lymphedema is a debilitating complication
following mastectomy, affecting the arm functions and
quality of life (QOL)
effects of upper-limb exercises on lymphedema in clinical settings. However,
there is a
dearth of evidence regarding the effect of home-based exercises
on lymphedema; therefore, we examined
the effect of a home-based exercise
program on lymphedema and QOL in postmastectomy patients. Thirty-
two female
postmastectomy lymphedema patients participated in an individualized home-based
exercise
program for 8 weeks. Arm circumference, arm volume, and QOL
(36-Item Short Form Health Survey)
were measured before and after the
program. Data were analyzed with the use of paired t-tests for
circumferential and volumetric measures and Wilcoxon signed ranks tests for
QOL. Significance level was
set at p < 0.01 with Bonferroni correction
(alpha/n = 0.05/5 = 0.01). Analysis showed a statistically
significant
improvement in the affected upper-limb circumference and volume (~122 mL
reduction, p <
0.001) and in the QOL scores (p < 0.001) at the end of
the home-based exercise program. The
individualized home-based exercise
program led to improvement in affected upper-limb volume and
circumference
and QOL of postmastectomy lymphedema patients.
INTRODUCTIONLymphedema is a
chronic, debilitating complication that breast cancer survivors face
after
breast cancer treatment [1–8]. Incidence of secondary arm lymphedema varies
from 5 to 56 percent
[4,7–12]. About 60 percent of patients who undergo
axillary lymph node resection and irradiation will
eventually develop
lymphedema [13].
Lymphedema develops when the lymphatic flow is impaired and
excess fluid and protein accumulate in the
interstitial space. The
hemodynamic factors at the site oflymphedema may also play a role in its
development
[1]. Affected women can experience pain, swelling, arm
tightness, heaviness of the arm, and recurrent skin
infections. If left
untreated, lymphedema may predispose the affected limb to the development of
other
secondary complications like recurrent bouts of cellulitis or
lymphangitis, axillary vein thrombosis, severe
functional impairment,
cosmetic embracement, and lymphangiosarcoma [9]. Breast cancer survivors may
find lymphedema more distressing than mastectomy, because hiding the
physiological manifestations and loss
of function of lymphedema is harder.
Overall, these factors lead to decreased quality of life (QOL) for
breast
cancer survivors [14–15]. Rehabilitative interventions are considered the
mainstay for the treatment of
lymphedema, and exercises form an integral
component of such rehabilitation [16].
For decades, any kind of strenuous
activity has been feared to exacerbate the lymphedema. Current clinical
guidelines indicate that women with and at risk for lymphedema should
protect the affected arm from
overuse [17–18]. For this reason, patients
with lymphedema avoid using the affected limb, leading to
weakness and,
hence, predisposing the limb to injury even from small household tasks.
Further, such fear
poses an additional barrier to patients staying
physically active, potentially translating to weight gain, which
has been
shown to be associated with a worse clinical course for women with lymphedema
[5]. However,
the evidence shows no association between lymphedema and
strenuous activity; hence, upper-limb
resistance exercises can help in
recovery [19–26]. Previous studies support the view that upper-limb
exercises may decrease lymphedema risk by improving the lymphatic return
and lymphangiogenesis, i.e.,
regeneration of new collaterals [27–31]. On
the other hand, avoiding activity of the affected limb may lead
to poor
lymphatic clearance and, hence, stasis of the lymphatic fluid in the affected
limb [32]. During the
early 6 to 12 months after mastectomy, pain and
decreased shoulder movements are more common than
lymphedema [33]; these
can also be prevented by upper-limb exercises [34]. Particularly, strength
training
will help not only in recovering arm strength but also in
recovering bone mineral loss due to cancer treatment.
Inactivity of the
affected limb may lead to prolonged arm weakness, poor scapulohumeral function,
bone
mineral loss and, finally, lymphedema [35–36].
Since the 1990s,
efforts have been made by McKenzie and other researchers to disprove the
concept that
strenuous exercise of the affected upper limb may lead to or
worsen lymphedema [19–22]. A few recent
clinical trials [19–29], including
a well-controlled trial by Schmitz et al. [26], have proved that upper-limb
exercises have beneficial effects for lymphedema without exacerbating it.
Most of the exercise interventions
were provided in hospitals, clinics, or
fitness centers. These interventions may not be helpful for those
patients
who cannot afford the cost of or who lack transportation to institution-based
rehabilitation. So, a
need existed for the development of an exercise
program that these patients could easily follow and perform
at their
homes.
Evidence is lacking regarding the effect of home-based exercise
programs on lymphedema and QOL of
breast cancer patients. So, this study
was carried out to evaluate the effects of a home-based exercise
program on
lymphedema and QOL of breast cancer patients. We hypothesized that a structured
home-
based program of progressive resistance exercises of the upper limbs
combined with deep breathing and
self-care would help relieve the symptoms
of lymphedema and improve the QOL of breast cancer patients.
Hence, this
study may give valuable evidence supporting the importance of home-based
exercise programs
in the reduction of postmastectomy lymphedema symptoms
and thereby improve the QOL of breast cancer
patients.
METHODSThis study
was a pre-post intervention study in which measurements were taken before and
after the 8-week home-based exercise program. Convenience sampling was used
to select the participants.
The contralateral upper limb was used as the
control so that any physiological change happening would
happen equally on
both the limbs.
SubjectsBreast cancer patients who had undergone mastectomy
surgery and had completed neoadjuvant
chemo- and radiation therapy from
March 2006 to February 2008 were referred to the study by the
concerned
oncologist and oncology surgeon. We screened 137 patients for the inclusion and
exclusion
criteria given subsequently; of these, 38 met the ideal inclusion
criteria. Six were lost to follow up. Therefore,
a total of 32 patients
(all women) completed the exercise program. The flow of participants through
the
study is shown in the Figure.
Figure. Flow of participants through
study.
Inclusion and Exclusion CriteriaPatients were included if they had
undergone unilateral mastectomy and
completed chemo- and radiation therapy
for stage I or II breast cancer 1.5 years or more before
participating in
the study. Also, the patients must have subsequently developed ipsilateral
upper-limb
lymphedema with a difference of 2 cm or more at any one
measurement point or 200 mL or more compared
with the contralateral upper
limb. Patients were excluded if they had primary lymphedema, secondary
lymphedema due to other system pathology, stage III lymphedema, bilateral
disease, diagnosed cancer
recurrence, and any contraindication to the
affected upper-limb exercises (e.g., venous thrombosis).
MeasurementsAll the
measurements were taken at baseline and at the completion of 8 weeks of the
home-
based exercise program.
Lymphedema MeasurementLymphedema was
measured two ways: using circumferential measurements and
a volumetric
method. Patients using compression sleeves were advised to remove them 3 to 4
hours before
the following measurements were taken:
1. Upper-limb
circumference was taken using cloth measuring tape on bilateral upper-limbs at
four levels, i.
e., at the metacarpophalangeal joints, wrist joint, 15 cm
distal to the lateral epicondyle, and 10 cm proximal
to the lateral
epicondyle. Patients were positioned prone with their upper limbs at their
sides and their
elbows straight while the circumference measurements were
taken [20–21]. Two measurements were taken
and their mean was used. The
calculated difference between each circumference (in centimeters) at all four
levels between the affected and contralateral upper limbs was taken as
outcome.
2. Volumetric measurements were taken by the water displacement
method, which is based on
Archimedes’ Principle. Two readings were taken:
(1) at the ulnar styloid process level and (2) 45 cm
proximal to the ulnar
styloid process level for each upper limb. During measurement, patients were
advised
to keep their upper limb straight and immerse it slowly by sliding
their fingers straight down inside the wall of
the volumeter, which was
filled with water. Water displaced was collected from the point of immersion of
upper limb until the marked level was reached and no further dripping of
water was observed. The collected
water was transferred into a graduated
cylinder and the volumetric reading was taken to the nearest 5 mL
level.
This method of volumetric measurement has been used previously by McKenzie and
Kalda [22]. The
outcome measure was the calculated difference in volume (in
milliliters) displaced between the affected and
contralateral upper
limbs.
Quality of LifeQOL was measured by using the 36-Item Short Form
Health Survey (SF-36) QOL
questionnaire. The SF-36 has been widely used as
a reliable and valid tool to measure general QOL of
patients with various
medical conditions, including cancer. It is a 36-item scale with 8 major
components that
cover physical, social, and emotional functioning as well
as vitality, bodily pain, mental health, and general
health. Completely
filled questionnaires were scored using the SF-36 Health Survey Manual and
Interpretation Guide [37].
Home-Based Exercise ProgramEducation about
postmastectomy lymphedema and the home-based
exercise program (Table 1) was
given before the initiation of the exercise program. A qualified
physiotherapist gave the initial sessions of exercise prescription and
training. Patients practiced the exercise
sequence three to four times;
once their performance was found satisfactory, the exercise program (handout)
along with logbook were given to the patient. Patients were advised to
increase the weight only when 2 sets
of 15 repetitions became easy to
perform. Patients were monitored telephonically every week and at a
fourth-week follow up in the hospital or at home for those patients who
were not able (30%) to come in for
follow
up.
--------------------------------------------------------------------------------
Table
1.
Progressive resistance exercise program to enhance muscle strength and
endurance of upper limb and
scapular muscles (modified from Franklin et al.
and Harris et al. [1–2]). Participants used household items (e.
g., water
bottle, salt packets).
Parameter Description
Warm Up Active range of
motion exercises for glenohumeral joint for 5 min.
Muscle Groups Rhomboids,
middle trapezius (scapular retraction), latissimus dorsi (shoulder extension),
serratus anterior (scapular protraction), lower trapezius (scapular
depression), biceps (elbow flexion),
triceps (elbow extension), forearm
muscles (wrist flexion, extension), hand muscles (ball squeeze).
Frequency 5
d/wk.
Intensity Start with light resistance 50%–60% of 10 repetition maximum
weight progress within tolerance.
Repetitions 1 set of 8–10, increase
gradually to 10–15.
Sets 1 set, progress to 2 sets; at 2 sets of 12–15
repetitions, increase resistance weight by 5%–10%.
Stretching Exercises
Pectoralis major and minor, latissimus dorsi.
Deep Breathing Exercises Deep
breathing exercises between each set.
Indication to Reduce Workload
Excessive fatigue, postexercise muscle soreness >48 h, slight increase in
arm edema lasting <1 h, pain during or following exercise.
Indication
to Terminate Pain, discomfort, marked increase in arm edema, dizziness,
general malaise.
Self-Care Advice Daily monitoring of affected arm for any
injury or redness, gentle distal to proximal self-
massage, wearing of
compression garment, avoid insect bites, avoid sleeping on affected side, limb
elevation, etc.
1. Franklin BA, Whaley MH, Howley ET, Balady GJ. ACSM’s
guidelines for exercise testing and
prescription. 6th ed. Philadelphia
(PA): Lippincott Williams and Wilkins; 2000.
2. Harris SR, Hugi MR, Olivotto
IA, Levine M; Steering Committee for Clinical Practice Guidelines for the
Care and Treatment of Breast Cancer. Clinical practice guidelines for the
care and treatment of breast
cancer: 11. Lymphedema. CMAJ.
2001;164(2):191–99. [PMID: 11332311]
Statistical AnalysisData were
analyzed using SPSS version 16 (SPSS Inc; Chicago, Illinois) and Microsoft
Excel 2007 (Microsoft Corp.; Redmond, Washington).
Descriptive analysis
was done for patient age and time since mastectomy. Paired t-tests were used
for
comparison of mean values of the pre- and postexercise circumferential
and volumetric measurements and
the Wilcoxon signed ranks test was used for
SF-36 QOL scores. The significance level was set at p < 0.01
using
Bonferroni correction (α /n = 0.05/5 = 0.01).
RESULTSThe mean ± standard
deviation age of the postmastectomy lymphedema patients was 46.56 ±
6.98
years and time since mastectomy was 2.08 ± 0.65 years. A statistically
significant reduction in affected
upper-limb circumference was found at
three levels of measurement (p < 0.001), except at the
metacarpophalangeal joint level (p = 0.04) and in the affected upper-limb
volume (p < 0.001) (Table 2)
following the 8-week home-based exercise
program. Also, a statistically significant difference was found for
QOL
scores in all SF-36 domains postintervention (Table 3). Result analysis of the
data is shown in Tables
2 and
3.
--------------------------------------------------------------------------------
Table
2.
Pre-post exercise program changes in affected upper-limb circumference
and volume. Data presented as
mean ± standard deviation.
Measurement
Preexercise Postexercise Pre-Post Change
MCP Joints (cm) 19.17 ± 1.46 19.03 ±
1.37 0.14 ± 0.9
Wrist Joint (cm) 16.45 ± 2.09 16.20 ± 1.96 0.25 ± 0.13
15
cm DLE (cm) 22.16 ± 3.11 21.47 ± 2.83 0.69 ± 0.28
10 cm PLE (cm) 31.02 ±
4.38 30.06 ± 4.44 0.96 ± 0.06
Volume (mL) 2306.32 ± 627.82 2183.49 ± 597.45
122.83 ± 30.37
DLE = distal to lateral epicondyle, MCP =
metacarpophalangeal, PLE = proximal to lateral
epicondyle.
--------------------------------------------------------------------------------
Table
3.
Pre-post exercise program changes in 36-Item Short Form Health Survey
quality of life scores.
Parameter Preexercise Postexercise Change in
Score
Physical Function 33.90 44.40 10.50
Role Physical 37.30 43.40
6.10
Bodily Pain 37.60 46.10 8.50
General Health 42.20 44.60
2.40
Vitality 45.80 52.10 6.30
Social Function 37.75 45.90 8.15
Role
Emotional 32.60 44.20 11.60
Mental Health 37.30 44.40 7.10
Physical
Component Summary 41.25 46.30 5.05
Mental Component Summary 38.55 48.30
9.75
DISCUSSIONLymphedema is a chronic, progressive, long-term adverse
effect of breast cancer treatment
resulting in affected upper-limb
swelling, pain, heaviness, and discomfort. This not only affects the normal
functional use of the affected upper limb but also causes psychological
distress by altering the patient’s body
image because of visible swelling
of the arm. Together, these symptoms greatly reduce QOL [14–15].
Several
therapies have been used to treat lymphedema, but rehabilitative interventions
remain the treatment
mainstay and exercises play an important role in such
rehabilitation.
Therefore, we carried out this study to evaluate the effect
of an 8-week home-based exercise program of
progressive resistance
exercises, deep breathing, and self-care on the lymphedema and QOL of
postmastectomy patients. The results of our study showed that the
home-based exercise program led to
statistically significant reductions in
the circumference and volume (Table 2) of the affected upper limb and
improved QOL scores (Table 3) of breast cancer patients. Providing a
logbook and continuous monitoring
resulted in good adherence to the
exercise program (89% as per logbook records). Mean change in arm
volume
was 122 mL. In fact, in our study, exercise acted as a therapeutic intervention
instead of worsening
the lymphedema symptoms.
Many justifications can be
given regarding the use of gradual, progressive upper-limb exercise training
along
with deep breathing in the rehabilitation of lymphedema [19].
Gradually increasing the physiological stress to
the affected upper limb
through flexibility, resistance, and aerobic exercises will be better than
inactivity in
postmastectomy patients. Possible mechanisms by which
affected upper-limb exercise improves or helps
prevent lymphedema symptoms
include that such exercise not only enhances lymphatic flow [38–41] but
also improves protein resorption [42]. Lymphatic flow increases as a result
of decreased intrathoracic
pressure during inspiration phase [43]; this
leads to speculation that increased pulmonary work during
exercise may help
in decreasing the lymphedema [44]. Also, affected upper-limb venous drainage
has been
found to be compromised most frequently in lymphedema patients
[45]. Stretching exercises may help
reduce the soft tissue contractures
and, hence, decrease the blood and lymphatic obstruction [44].
Progressive
resistance exercises may also cause self-contraction of the lymphatic vessels
by regulating
sympathetic nerves innervating these vessels. Hence, the
exercises enhance control over the internal
contraction of these vessels by
resetting their sympathetic drive, which in turn is important for the
long-term
management of lymphedema [38–39]. Because skeletal muscle
contraction is a primary force in propelling
lymph fluid throughout the
lymphatic system, it can enhance lymphatic clearance. Lane et al. injected an
isotope into the hands of nondisabled women and determined that 5 minutes
of exercises using an arm
ergometer enhanced lymphatic clearance in the
hand [30].
In addition, deep breathing while performing any exercise for
lymphedema is doubly important. First, deep
breathing is vital to ensure an
adequate supply of oxygen to the tissues when the body is undergoing greater
than usual exertion. Second, deep breathing creates pressure change in the
abdomen, which acts like a
vacuum in the thoracic cavity, helping to drain
lymphatic vessels [44]. Moseley et al. reported that 38
women with
secondary arm lymphedema who performed 10 minutes of gentle arm exercises
combined with
deep breathing everyday for 1 month achieved a statistically
significant reduction in arm volume of 101 mL
(9.0%) [31]. In our study, we
found a similar reduction in arm volume of 122 mL, which might be due to
longer duration of the exercise program compared with Moseley et al.’s
study.
The contralateral upper limb was used as the control so that any
physiological change in arm composition
due to exercise would happen
equally on both limbs. This method is similar to previous studies [20,22]. The
outcome measures we used did not give accurate information regarding
changes at the tissue level, but
regular exercises cause hypertrophy of
muscles and adipose tissue loss. Not much change was seen in arm
circumference clinically, so any effect of exercise on lymphedema is
unknown to us; other tissue changes
may have occurred that masked any
positive change regarding accumulation of lymphatic fluid.
The participants
also reported improvement in their affected upper-limb health (i.e., decreased
pain,
heaviness, and discomfort along with softening of fibrotic areas
during daily household work) due to the
exercise program. Many participants
continued doing the exercises even after completion of the study
period.
Results showed a trend toward improved QOL scores in all aspects, including
physical, social, and
emotional well-being as well as general and mental
health and vitality scores after the completion of the
prescribed
home-based exercise program (Table 3). Increase in physical functioning scores
proved the fact
that affected upper-limb progressive resistance exercises
had a beneficial effect on postmastectomy
lymphedema. Participants reported
more confidence in using the affected upper limb during regular
household
work and were even able to lift groceries with ease. Due to this, they were
less often reminded of
having lymphedema, which may have improved vitality
and general health scores. These results are similar to
the study by
McKenzie and Kalda, which was also an 8-week exercise program [22]. Recent
studies by
Ahmed et al. and Schmitz et al. reported 80 and 88 percent
adherence rates to twice a week supervised
exercise programs for 6 months
and 1 year, respectively [23,25]; in our study, adherence was found to be
89 percent. Reason for this may be that the self- directed exercise program
for a short period of 8 weeks
included many features thought to comprise
effective home training, including baseline evaluation, written
guidelines
for home exercise, education about the exercise monitoring and self-care, daily
activities log, once
weekly telephonic monitoring by the therapist, and
interim evaluation (fourth week). It may also be the fact
that
self-directed exercises performed in the home and community facilities are more
convenient, and
therefore, participants adhered more to the prescribed
exercise program. In our study, none of the
participants reported increased
lymphedema symptoms as a result of the exercise program.
The prescribed
8-week home-based exercise program improved the affected upper-limb symptoms
and
also led to improved QOL. Home-based exercise programs should be
considered for improving the
symptoms of lymphedema resulting from breast
cancer treatments.
Lack of an appropriate control group and a small sample
size were two important limitations of our study.
Also, we did not follow
the patients to determine the long-term effects of the exercise program.
Long-term
studies with larger sample sizes and appropriate control groups
should be undertaken. Studies should also
be done comparing effects of
home-based versus institution-based exercise programs.
CONCLUSIONSA
home-based exercise program was found to effectively improve affected
upper-limb
symptoms and led to improved QOL of breast cancer patients.
Hence, this home-based exercise program
should be considered for improving
the secondary lymphedema and associated symptoms resulting from
breast
cancer treatments.
ACKNOWLEDGMENTSAuthor Contributions:Study concept and
design: A. P. Gautam, A. G. Maiya.
Acquisition of data: A. P.
Gautam.
Analysis and interpretation of data: A. P. Gautam.
Drafting of
manuscript: A. P. Gautam.
Critical revision of manuscript for important
intellectual content: A. G. Maiya, M. S. Vidyasagar.
Statistical analysis:
A. P. Gautam.
Administrative, technical, or material support: M. S.
Vidyasagar.
Study supervision: A. G. Maiya, M. S. Vidyasagar.
Financial
Disclosures: The authors have declared that no competing interests
exist.
Funding/Support: This material was unfunded at the time of manuscript
preparation.
Institutional Review: Ethical clearance for the study was
approved by the hospital ethical committee. A
written consent for willing
participation in the home-based exercise program was taken from all the
patients
before the baseline measures.
Participant Follow-Up: The
authors do not plan to inform participants of the publication of this study.
However, participants for whom contact information is available have been
encouraged to check the study
Web site for updated
publications.
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Submitted for
publication May 17, 2010. Accepted in revised form January 20, 2011.
This
article and any supplementary material should be cited as follows:
Gautam
AP, Maiya AG, Vidyasagar MS. Effect of home-based exercise program on
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DOI:10.1682/JRRD.2010.05.0089
January 12,
2012
The Benefits of Healing Touch - Huffington Post – by Julie Chen
Many
of my patients express their frustration that massage therapy generally is not
covered by their health
insurance, yet the health benefits seem tremendous
for them. I believe that the growing trend of discontent
with lack of
coverage for massage therapy is not just limited to patients, but from health
practitioners as well.
What is even more unfortunate is that sometimes
health care practitioners rarely fully lay hands on patients
even for
office visits and evaluations anymore. As a part of most healing modalities in
the past, the simple
touch therapy of examining and treating the patient
imparts a level of healing that is now becoming lost in
modern day
medicine.
Many of my patients joke that doctors these days don't even put
their hands on the patient anymore except
for a cursory exam at the first
visit or unless absolutely necessary. It is unfortunate that along with
declining
time allowed with each patient, even the simple but effective
practice of laying of hands on patients is slowly
becoming lost as
well.
Even as recent as just a few decades ago, the laying of hands and
massage therapy or manual therapy was
considered a normal natural part of
medicine. In more recent times, massage and manual therapy is seen as
more
of a luxury rather than a necessary part of healing and wellness.
This
is an unfortunate change in Western healing philosophy since studies show that
massage and manual
therapy are beneficial for many medical conditions and
health concerns, which is likely the reason why
manual therapy is still
considered an important part of healing in most other parts of the
world.
Based on numerous studies as listed below, massage and manual therapy
is in my opinion an essential part of
health and healing based on
improvement of circulation, muscle function and stress reduction, just to name
a
few.
Nowadays in medicine, we are all well aware of how stress affects
our body negatively. We see time and
time again that patients who are
stressed, anxious or depressed tend toward more negative health outcomes
than those who are feeling balanced, calm and positive.
Studies indicate
that manual therapy likely helps with stress reduction as well as other aspects
of physiology.
But even taking those other physiological benefits aside,
the reduction of stress alone has tremendous health
benefits to patients,
as related to more positive outcomes to overall health and daily
functioning.
So, my recommendation to everyone reading this article is to
stop thinking of massage or manual therapy as
a luxury. It is well worth
the investment on a regular basis if you can afford it. It is likely worthwhile
to
double check with your insurance company and ask whether you have some
coverage within your physical
therapy coverage, which many of my patients
were not aware of and were pleasantly surprised.
My second recommendation is
to find a physician who still uses the healing modality of touch in the clinic.
Frequently, just simply laying hands on a patient during an exam allows the
physician to both heal and
diagnose all in one motion.
I am a firm
believer that the therapeutic alliance between a patient and a health care
practitioner is stronger
when there is a respectful level of healing touch
involved in treatment and diagnosis. In order to achieve an
accurate level
of diagnosis, we were taught in medical school to obtain at least 90 percent of
the diagnosis
from the patient. In order to do that, we would need to lay
our hands on our patients to fully evaluate and
diagnose them... and that
is what I would recommend that you look for in your physician.
Overall, I
agree with my patients that insurance companies do not cover for this vastly
beneficial healing
modality enough. Not only do they not allow physicians
more time with patients for visits (short visits are
necessary in order to
keep a clinic financially afloat based on the current system), but frequently
they do not
cover for hands-on therapy such as massage or manual therapy.
Unfortunately then, it is left to us to pursue
this topic with our
physicians and our insurance companies and see if there is coverage hidden in
the fine
print of the physical therapy coverage.
If there is, I highly
recommend that you utilize the services and not wait until you have
longstanding chronic
pain, insomnia, irritable bowel syndrome or
hypertension, just to name a few adverse consequences of
longstanding
stress and discomfort.
I like to frequently remind my patients that our body
is not cut off at the neck; such that what is in our mind
does affect our
body, and what is happening in our body does affect our mind. So, why not make
use of a
healing modality that seems to treat both our mind and
body?
Ultimately, if you have to put in some leg work on your end to figure
out an affordable way to achieve
regular manual or massage therapy, either
through your physical therapy coverage or an affordable massage
clinic in
your neighborhood, in the long run, your mind and body will both be better off
for it.
For more by Julie Chen, M.D., click here.For more on personal
health, click here.
Flickr photo by Nick WebbReferences:
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Cutshall SM. Massage therapy: a comfort intervention for cardiac surgery
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Furlan AD, Imamura M, Dryden T, Irvin E. Massage for low-back pain.
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Zartarian M. Use of a mechanical massage technique in the treatment of
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Kutner JS, Smith
MC, Corbin L, Hemphill L, Benton K, Mellis BK, Beaty B, Felton S, Yamashita TE,
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Orem
Rehabilitation & Skilled Nursing - Daily Herald –
State-of-the-Art
Therapy A Passion for the Art of Caring The Orem Rehabilitation & Skilled
Nursing
therapy team is passionate about bringing the latest techniques and
programs to our patients. Through
continuing education, our physical and
occupational therapists apply the latest research to improve balance
and
reduce fall-risk. They also utilize therapeutic modalities combined with a
comprehensive therapy
program for strengthening, balance training, pain
reduction, wound-healing, urinary incontinence, and
increasing range of
motion. In addition, we have therapists certified in specialty areas of
practice such as: •
Wound Care • Neurological Conditions • Electrical
Stimulation For Swallowing Dysfunction • Lymphedema
• Pulmonary Programs Our
speech-language pathologists incorporate research-based swallowing, language
and cognitive procedures to address the needs of our patients. At the heart
of our therapy programs is a
deep appreciation for, and understanding of,
the special needs of our more mature patients. This goes
beyond the science
and research in order to tap into the art of caring for these unique
needs.
January 14, 2012
Nursing with empathy: Childhood cancer survivor
beats odds, helps others - Glens Falls Post-Star – by
Meg
Hargarty
Although the odds were stacked against her that she would survive
cancer as a 3-year-old, Joanna Burgess
never let her illness stand in the
way of realizing her dream of helping others.
Now, at 49, the former South
Glens Falls resident is a wound, ostomy and continence nurse in North
Carolina.
Joanna recently received the Great Comebacks Regional Award
for rebounding from her bladder cancer
and making a difference in the lives
of her patients.
"Seeing the transformation when a patient goes from being
withdrawn to, ‘OK, I can learn to take care of
(an ostomy bag),' is
rewarding," she said. "(Winning the award) will globally and extensively get my
story
out."
Great Comebacks is sponsored by ConvaTec, a developer and
marketer of medical technologies for
community and hospital care, in
partnership with the Crohn's and Colitis Foundation; the United Ostomy
Associations of America; the Intestinal Disease Education and Awareness
Society; the Wound, Ostomy and
Continence Nurses Society; and the American
Society of Colon and Rectal Surgeons.
Joanna developed rhabdomyosarcoma, a
type of bladder cancer, when she was little more than a toddler.
Her
father, South Glens Falls retired pastor Clayton Burgess, recalled local
surgeon Harry "Mac" DePan
delivering the grim diagnosis to him and Joanna's
mother, Shirley.
"He didn't hide anything. He came out and said, ‘Children
don't survive this cancer," Clayton said.
Given a 10 percent chance of
survival, Joanna was immediately transferred to a Boston hospital, where she
underwent a urostomy to replace her bladder. Ironically, the massive doses
of chemotherapy and cobalt
radiation meant to spare her life would cause
her body to break down in the future.
The most outward effects of the harsh
treatment are Joanna's small stature - she never grew past 4 feet 11
inches
- and a noticeable limp.
The 1981 graduate of South High said she was
thought of as the "mystery girl" at school.
"I walked a little differently.
I think a lot of kids thought I had polio," she recalled. "I didn't know they
thought that. Later on my friends told me."
Joanna graduated from
college and was a nurse for five years when her body began to show signs of the
damaging effects of the cobalt radiation treatments given to her as a
child. She endured a series of
operations, including plastic surgery for
burns on her back, two hip replacements, bypass grafts on her legs
to
improve circulation and an elective colostomy to eliminate the pain of
radiation-induced colitis.
Her life was put on hold for about 20
years.
"Basically they had to re-create my body," Joanna said.
Today she
still wears the colostomy and ostomy bags, uses support hose for lymphedema and
has limited
mobility. The hip replacements won't last forever, she said,
and she thinks she'll need more surgery in the
future.
Despite
everything Joanna endured, she remained grateful to be alive and made the most
of the years spent
recovering from her operations. She volunteered at a
clinic in Honduras, explored the field of holistic nursing
and aided in the
launch of a clinic devoted to those suffering from lymphedema.
Joanna loved
pediatrics and wanted to work with ostomy patients. She had a "synchronistic
opportunity" to
work with a 3-year-old boy diagnosed with rhabdomyosarcoma
and decided to begin coursework to
become a WOCN.
"Now I was able to
witness what a parent goes through when their child gets this diagnosis. It's
still a terrible
diagnosis and still very life threatening," she
said.
At the point when Joanna was finding the most fulfillment both in her
personal life - she met the man who
would become her husband- and
professionally by pursuing her WOCN certification, her doctors advised
her
not to go back to work, fearing her physical condition was too
"fragile."
Joanna decided to follow her own path and has been a WOCN at
WakeMed Cary Hospital in North
Carolina for three years. She brings a type
of empathy to her patients other nurses who haven't walked her
path can't
provide.
"When a person has to have an ostomy, people cannot imagine what it
is going to be like and there is a lot of
shame associated with it. People
don't talk about it because it has to do with something you don't talk about
in society," Joanna said. "I tell them I have an ostomy, and they can't
believe it. They immediately feel hope,
and if I can teach them a way to
change their perception, it can make all the difference."
As the southeast
regional winner of the Great Comebacks award, Joanna said she is now able to
raise
awareness of ostomy issues on a broader level through
workshops
and conferences and by telling her own journey through
illness.
She hopes to help start an outpatient ostomy clinic at WakeMed, but
most importantly, she wants to
continue to be an empathetic resource to her
patients and their families.
"Your story touches something in someone else
whether they have the same thing or not. We're all dealing
with something
difficult, and it's a way to connect with each other," she said.
January 15,
2012
This next one is some kind of blog about printers, I never found
anything referencing lympheema there:
hp photosmart c4280 all-in-one driver
download - Kashmir Observer –
mphedema, a frequent cause of leg edema and
often included in the differential diagnosis of venous disease,
is also
discussed. ...
December 16, 2011
Mohawk College Offers Lymphedema
Program - Wire Service Canada (press release) –
Hamilton, Ontario -
Lymphedema is one of the most feared and least understood complications of
breast
cancer treatment. Mohawk College in Hamilton, Ontario, is offering a
day-long overview that will prepare
the student to understand the causes of
lymphedema as well as receive an introduction to its treatment and
management.
John Mulligan, RMT/CLT-LANA will present an Overview of
Lymphology and Lymphedema Management
at Mohawk College at the
Mohawk/McMaster Institute of Applied Health Sciences Hamilton Campus in
the
Applied Health Sciences building, on Saturday February 4th, 2012, 9:00 a.m. to
4:30 p.m.
This unique one day workshop will explore the different types and
stages of lymphedema, clinical pathways
for treatment and the need for
skilled care. Topics include basic lymphology, differentiating among different
types of edema, the role and mechanics of compression, manual lymph
drainage and complex decongestive
therapy. We will also discuss the
International Lymphedema Framework Movement, research resources
and
educational opportunities in the field of lymphology.
This one-day
introduction to the basics of lymphedema and lymphedema management will
immediately give
the attendees a solid base of knowledge of the lymphatic
system and disorders of the lymphatic system.
For more information visit
www.LymphedemaDepot.comand click on EVENTS in the left-side menu. This
will
bring you to the Mohawk online course catalogue where you can register for the
daylong overview. To
locate the course listing, simply go to page 53 of the
catalogue. To register, click on Registration Information.
For further
assistance contact John Mulligan directly at
[email protected].
Contact Mohawk College here:
http://www.mohawkcollege.ca/continuing-education.
For more information about
Mr. Mulligan and his practice, please visit
www.LymphedemaTherapist.com.
December 17, 2011
New registry will
track lymphedema among breast cancer patients - HealthCanal.com - BY TRACIE
WHITE
More and more woman are surviving breast cancer, but
lifesaving surgical and radiation therapies can cause
a grave side effect:
an incurable chronic condition called lymphedema that involves swelling of the
arms and
often debilitating pain and discomfort.
While this disorder
frequently has been ignored, misdiagnosed and untreated in breast-cancer
survivors, that’
s beginning to change.
In an effort to find better
treatment and preventive strategies for lymphedema, researchers at the
Stanford
University School of Medicine are launching a patient registry to
study breast-cancer-related lymphedema.
The information and records of
breast cancer survivors gathered in the registry will be used in a study to
determine whether early diagnosis of lymphedema can help treat and,
possibly, prevent it.
“There is early evidence to suggest that prompt
diagnosis may reduce the severity or eliminate this problem,”
said Stanley
Rockson, MD, the Allan and Tina Neill Professor of Lymphatic Research and
Medicine, the
lead investigator of the study. “If you take a wait-and-see
treatment approach, by the time the lymphedema
becomes noticeable, it can
be quite advanced. Caught earlier, it may be more manageable, or even
reversible.
“Oncologists and surgeons are becoming more aware of the
need, and there are new technologies that help
with early diagnosis.”
A
leading expert in lymphatic diseases, Rockson, who directs the Center for
Lymphatic and Venous
Disorders at Stanford, helped establish the first
patient registry and tissue bank for patients with lymphatic
disorders in
2009.
For this new study, Stanford researchers hope to recruit an estimated
1,000 breast-cancer survivors for the
Stanford National Breast Cancer
Lymphedema Registry.
“Members of the American Society of Breast Surgeons
will have the opportunity to collaborate in this
project,” according to a
statement from the society. “Member surgeons can choose to help Stanford in
the
identification of patients to be enrolled in the registry and will
facilitate participation through the society's
web-based quality reporting
initiative.”
Participants will periodically update information about any
symptoms, test results or treatments in 15-minute
online sessions. They’ll
give approval for their surgeons to provide their treatment information to the
registry.
Identifying information will be removed.
Currently, there is
no cure for lymphedema, a disorder that arises in 15-60 percent of breast
cancer
survivors. A lifelong problem of disrupted lymph circulation
characterized by fatigue, limb swelling and loss
of the integrity of the
skin, the condition’s severity can range from mild discomfort to disabling
disfigurement,
pain and loss of function.
When lymph circulation is
delayed or interrupted, swelling and inflammation can result from a traffic jam
of
lymph that builds up in the limbs. There are multiple sources of
blockages but often they are caused by
tumor removal surgery, radiation
treatment or lymph node biopsy. The only available treatments are physical
therapies, including skin massage, drainage and pressure bandages, though
the long-term effectiveness of
these therapies has not been carefully
studied.
Patients interested in enrolling can log into the Stanford National
Breast Cancer Lymphedema Registry
website at: http://breastcancer-lymphedema.stanford.edu.
For more information, patients can call (650) 723-
1396 or email [email protected].
Stanford
University Medical Center integrates research, medical education and patient
care at its three
institutions - Stanford University School of Medicine,
Stanford Hospital & Clinics and Lucile Packard
Children's Hospital. For
more information, please visit the Office of Communication & Public Affairs
site at
January 16, 2012
i earns highest level certification -
bcrnews.com –
PERU — Sonnie (Ryba) Blocki, PT, MS and certified lymphedema
therapist of United Physical Therapy
LLC in Peru, attended a three-day
continuing education training in Estes Park, Colo. The conference was
hosted by Klose Training and Consulting LLC.
The conference brought
together lymphedema therapists, physicians, researchers, and world-renowned
experts to share research, experiences, and resources in order to advance
the treatment of lymphedema and
improve the quality of life of cancer
survivors.
Lymphedema is a condition that is most associated with the
swelling of a limb following breast cancer.
However, it can also occur due
to a condition from birth, cancer treatment, or other injury. It is estimated
there are currently 5 million people in the U.S. who suffer with
lymphedema, and they often go undiagnosed,
untreated and mistreated.
As
a LANA-certified therapist, Blocki consults with physicians in the diagnosis
and treatment of
lymphedema.
Big Spike in Knee Surgeries Calls for
Compression Therapy Devices to Lessen Risk of Blood Clots –
SBWire
–
Tampa, FL -- (SBWIRE) -- 01/16/2012 -- New statistics show a big increase
in knee replacement surgery
since the late 1990s. From 1997 to 2009, knee
surgery increased for women ages 45 to 64 by 157 percent
and men in the
same range by 144 percent. The Agency for Healthcare Research and Quality
attributes this
to advances in knee surgery, better implants, and obesity
that can cause the joints to be more compromised.
Right after knee surgery,
patients must be mindful of preventing blood clots as they are immobile while
they
initially heal.
“Sequential compression devices can be great
for many patients who cannot walk or get around much in the
first few
weeks,” said Greg Grambor, president of Vascular PRN, which helps healthcare
professionals
nationwide fill prescriptions for SCDs and IPCs. “Patients
should talk to their doctor about their risk for a
blood clot, find out if
mechanical compression is good for them, and be proactive before the day of
the
surgery.”
The American Journal of Surgery notes that compression
therapy devices can lessen the chances of DVT
post-surgery by 60 percent.
Many patients get mechanical compression therapy devices along with medicine
to help prevent blood clots. Knee and hip surgery carry a higher risk of
blood clots, so patients should be
prepared when they have these types of
surgeries to address any concerns ahead of time.
“Blood vessels can get
damaged during surgery and when you are restricted to bed rest, SCDs can help
blood flow from the superficial veins to the deep veins,” said Grambor. “The
devices are comfortable and
there are some choices depending on how
portable you want the compression therapy system to be.”
Vascular PRN is
known for its full line of sequential mechanical compression devices for the
full leg, calf,
and foot. To learn more about renting or buying a
Sequential Compression Device, SCD boots, or
Lymphedema boots visit
http://www.vascularprn.com/ or call 800.886.4331.
January 16,
2012
Visiting Sloth City? Exercise your options - The Grand Rapids Press -
MLive.com – by Sue Schroder
My inner sloth has been having its way with
me.
My recent failure to exercise is a combination of my own inertia coupled
with bronchitis followed by the cold
from hell. My maintenance therapy gets
only minuscule blame.
Those in active chemo may face limited exercise
options as I did when the chemical warfare did heavy
collateral damage to
my energy and strength, drastically lowered my white blood count and left me
susceptible to infection.
Once outside the treatment-dictated shalt-nots
of human contact, is exercise really worth the effort we’d
have to put into
it?
If you care about reducing the risk and/or recurrence of some cancers
and actually increasing the energy
levels chemo knocks out of us, the
answer is a resounding yes.
Reduce your riskThe National Cancer Institute
reports “strong evidence” that physical activity is associated
with reduced
risk of colon and breast cancers. It also cites several studies reporting links
between physical
activity and reduced risk of endometrial, lung and
prostate cancers.
So how do those of us with a near-mortal fear of Spandex
go about rebuilding our bodies and regaining our
strength?
Consider
exercise programs designed specifically for cancer survivors.
One of the
longest-running is Cancer Well-fit. The program has been offered for more than
10 years at the
Michigan Athletic Club (the MAC) and the East Hills
Athletic Club through the Lacks Cancer Center of
Saint Mary’s Health
Care.
“We don’t have much control over cancer, and people who’ve gone
through our program tell us they feel
they gain some control in their
lives. We know the classes actually reduce fatigue and increase energy
levels,” said Kristi Tuck, fitness director of the MAC and East Hills, and
the woman in charge of the Cancer
Well-fit program.
Certified
programCancer Well-fit is a 14-week program that includes 10 weeks of sessions
conducted by
the only nationally recognized certified cancer exercise
trainers in Michigan, according to the Lacks Cancer
Center website. It also
includes an additional four weeks of open membership.
Classes for 8-10
people are focused on strength training through weight training, Tuck said.
Balance and
stability, flexibility and core strength training are part of
the program.
Open to patients who have recently been or are currently being
treated for cancer and are referred by their
doctors, classes are geared to
people dealing with the effects of treatment, whatever the cancer.
Cost: $50
for patients of The Lacks Cancer Center (support partner included) or $150 for
participants who
are not patients at the Lacks Cancer Center (support
partner included.)
For more information, visit lackscancercenter.org; to
register, call the Lacks Cancer at Saint Mary’s, 685-
5222.
Gilda’s Club
Grand Rapids and Gilda’s Club Lowell both offer fitness and wellness classes
free to Gilda’s
members and open to supporting family and friends.
“In
most cases, the type and level of exercise for someone on a cancer journey will
be dependent on their
current health status and/or treatment plan,” said
Wendy Wigger, vice president of community relations and
program
development.
Here is a small sample of Gilda’s monthly classes:
(Visit
gildasclubgr.org for information on all classes and membership
information.)
Fitness & Movement Taught by a certified physical
therapist, this variety fitness class offers a combined
exercise of core
strength, Tai Chi, meditation and gentle strength training.
Movement &
LymphedemaThis program combines dance with gentle exercise and lymphedema
awareness,
and is designed to increase range of motion and to decrease
lymphedema.
A brochure from the University of Colorado Cancer Center also
can help with planning and monitoring post-
cancer exercise.
Cancer
survivors can download the brochure.
Editor’s note: Sue Schroder, former
features editor for The Grand Rapids Press, was diagnosed with
non-
Hodgkin’s lymphoma in late 2009. Email her at
[email protected].
January 17, 2012
Sports Medicine, Life Therapies
opens in Dickson - The Tennessean –
Baptist Sports Medicine and Life
Therapies recently opened a new outpatient rehabilitation clinic at 10250
Ramsey Way in Dickson.
The clinic offers orthopedic physical therapy,
sports medicine and lymphedema therapy and is led by
physical therapists
Bill Rion and Celeste Crider.
“We are pleased to now have a presence here,
as well as a facility to offer our services to the Dickson
community,” said
Rion in a press release. “We are so grateful for the outreach and support we
have
received thus far and are excited to establish lasting relationships
with the people of Dickson.”
The opening of this clinic marks the 20th
Baptist Sports Medicine and Life Therapies facility in Middle
Tennessee and
the first in Dickson. The clinic is located in the Crestview Office Park
directly across from
Dickson Medical Associates.
For more information,
call (615) 441-2707.
SJH Sports RebahCare debuts Harrison Township location
- Gloucester County Times - NJ.com – By
John Barna -
HARRISON TWP. — SJH
Sports RehabCare has opened its newest location in Mullica Hill at SJH
Tomlin Station Park.
Located at 201 Tomlin Station Road, Suite D, the
facility offers sports and orthopedic physical therapy,
occupational
therapy, spine care, worker's compensation services including FCE and Pre-Work
Screens
and lymphedema services.
In highlighting the opening of this new
location, SJH Sports RehabCare Tomlin Station Park would like to
introduce
two new staff members to the Gloucester County community.
Kristy Meade, who
has over 10 years clinical experience, will oversee SJH Sports RehabCare at
Tomlin
Station Park site. Meade graduated with a Masters Degree in Physical
Therapy from Sacred Heart
University in Fairfield, Conn. She is also a
Certified Athletic Trainer. Kristy's special interests include
post-
surgical patients, athletic injuries, body mechanics and postural
education with a specialty focus on trends in
ACL
rehabilitation.
Victoria Rink, is the OT clinical coordinator for all SJH
RehabCare inpatient and outpatient facilities and
SJH Sports RehabCare
locations. Rink is a Certified Hand Therapist with over 17 years of experience
treating upper extremity disorders. She is a graduate of Thomas Jefferson
University's Honors Program. Her
specialty is in treating complex
post-surgical cases and trauma, including nerve injury, hand replant and hand
transplantation rehabilitation.
For more information, call 856-241-2533
or by email [email protected].
January 17, 2012
Breast Cancer Survivor from
Cortlandt Publishes Book on Mastectomy - Patch.com – ByJessie Jafet –
The
authors provide comprehensive information on mastectomy and breast
reconstruction surgery in their
book released today.
Though there is
plenty of information online about mastectomy, Amy Curran Baker thought it
would be
helpful to many women if she wrote a single-resource guide that
explains the recovery process from
beginning to end.
A breast cancer
survivor herself, the 43-year-old Baker has authored “Now What? A Guide to
Recovery
After Mastectomy,” officially released today, Jan. 17 (the book
has been available online since Dec. 31).
She hopes that women who are
searching for answers about their own journey with mastectomy will find
them in her book.
Baker, a Cortlandt resident, was 39 years old with two
young daughters when she was diagnosed with the
disease in 2008. Even with
significant family experience with breast cancer—her mother, maternal
grandmother, and her maternal aunt had all been diagnosed—she still had
many questions about the
procedure she opted for: bilateral mastectomy with
“direct to implant reconstruction.”
Copious research, along with her daily
work as an occupational therapist, gave her an unique perspective to
write
the book.
“Being an OT I realized that there were a lot of basic recovery
and rehabilitation issues that women might
never be told about after
mastectomy,” Baker said.
“Things like how to manage activities such as
dressing and bathing, getting a good night’s sleep, caring for
children,
home management, and returning to work.” She added that the book is full of
suggestions from
other women who have “been there” and who offer their
advice on what works and what doesn’t in the
recovery process.
The book
is geared toward anyone who has been diagnosed with breast cancer and is
contemplating
mastectomy with or without breast reconstruction—in addition
to those with a hereditary predisposition to
breast cancer who may be
contemplating prophylactic mastectomy. Reconstruction, she emphasized, should
be a personal choice.
“Sometimes I hear people say that women need
breast reconstruction after a mastectomy in order to feel
“whole again” and
that bothers me a little bit,” Baker said—explaining that it was her personal
decision to
reconstruct. She does not like to think of a particular part of
the body as defining the “wholeness” of a
person or a woman.
With her
co-authors, who are her sisters (nurses themselves), she covers other topics
including range of
motion exercises, post-surgical drain care, lymphedema
prevention, breast prostheses, and what to look for
in terms of
complications with healing, wound management, scar massage, emotional recovery,
and more.
Baker also wants readers to know that mastectomy is not what it
used to be. “Techniques for breast
reconstruction have come a long way in
recent years and options are available,” she said.
“And many women don’t
know that there is a federal law called the Women’s Health and Cancer Rights
Act that requires group health insurers that cover mastectomy to also cover
breast reconstruction, breast
prostheses, and treatment for physical
complications like lymphedema that may result from mastectomy.”
This
comprehensive book not only benefits those looking for information: portions of
the proceeds will go to
two breast cancer support organizations that have
been “near and dear” to Baker: Support Connection in
Yorktown and FORCE
(Facing Our Risk of Cancer Empowered) a national hereditary cancer support
organization.
Baker said she is happy to share all that she has learned.
“I feel fortunate that I had access to really great
physicians who were
doing cutting edge work in the areas of mastectomy and breast
reconstruction.”
January 19, 2012
Health Calendar - Santa Maria Times
–
Lymphedema Prevention Exercise Class: 9 a.m. Tuesdays, Marian Health and
Wellness Center, 1207 E.
Main St., Santa Maria. This is a fun, therapeutic
program for cancer survivors and others with chronic
conditions of all ages
and fitness levels to increase range of motion and reduce the risk of
lymphedema. Info
and to make a reservation: 739-3780.
January 20,
2012
Health Matters: Flying with a medical condition - WZVN-TV –
FORT
MYERS, FL -
Every year is a victory for breast cancer survivor Carol
Thisted.
"I just turned 71 and I'm so happy I had another birthday."
She
enjoys life, family and traveling despite suffering from lymphedema. An after
effect from her cancer
surgery, the removal of lymph nodes led to chronic
fluid retention and swelling. It first appeared after a flight
last
year.
"I went on vacation in August and flew in an airplane and came home
and I said to my doctor ‘my ankles are
rather swollen and my arm is a
little swollen too'," says Thisted.
Carol manages her condition with daily
wraps and compression garments, something she has to consider
when taking
flight. Health conditions can spike at 30,000 feet.
"The pressures when
you're flying are less, atmospheric pressure is less so you tend to swell more
when
you're flying," says Jackie Speas, a lymphedema therapist with Lee
Memorial Health System.
"I'd be sure to wear my arm compression stocking and
I would probably even wear some compression
socks on my ankles and my feet
cause they do swell also," says Thisted.
People with vascular conditions
also need to consider their medical condition, especially when you consider
sitting in cramped quarters for long stretches of time.
"I'm on blood
thinners because of blood clots and we want to avoid those so when I fly I make
sure that I
have a layover to get off of the plane after two or three
hours," says Pamela Cupp, a frequent flyer.
Travelers who take long flights,
more than four hours, face a two to three fold risk of developing a clot. So
it's important to move around even in a tight space.
"You have the
change of getting blood clots because of lack of circulation. So you do want to
move your
legs and pump your ankles up and down, so you get that blood flow
back up," says Heather Parker, an
exercise specialist with Lee Memorial
Health System.
Before any trip, confer with your doctor about any medical
conditions, because keeping up with your health
doesn't take a
vacation.
December 20, 2011
Exercise Benefits Breast
Cancer Survivors: Research – EmpowHer - By Mamta Singh
Researchers at
the University of Missouri suggest that exercises will not aggravate the
condition of breast
cancer survivors who suffer from post-treatment
lymphedema. Lymphedema is a condition where the
breasts of the person
undergo swelling because of the removal or radiation of lymph nodes as part of
the
treatment process. It is estimated that more than 6.8 million Americans
either suffer from lymphedema or are
at a risk of developing it.
(1)
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The study reviewed some older
literature on breast cancer survivors that suggested that exercise could
worsen the lymphedema patient’s agony and that they are recommended to lead
a sedate life. After the
review the researchers say that the benefits to be
had by both the breast cancer survivors and those with
lymphedema are far
more than the risks of aggravating their condition especially if they are
closely
monitored. (2)
As per the author of the study, Jane Armer, PhD,
RN, FAAN at the University of Missouri, “Exercise can
be beneficial and not
harmful for breast cancer survivors. Each individual should balance the pros
and cons
of the activity she chooses, but keep in mind that being sedentary
has risks and being active is beneficial in
many ways, including possibly
reducing the risk of cancer recurrence.” (3)
The researchers after executing
a systematic review of contemporary literature said that of specific benefit
would be doing weight workouts or any other workouts that provided
resistance to the patient’s musculature
and skeletal system. Advantages are
to be had through carefully increasing the number of repetitions done in
such exercise programs. However, what needed t be seen is whether such a
program will altogether prevent
the breast cancer condition from
occurring.
As was the cases earlier, patients of lymphedema were recommended
to undergo surgery to ‘fix’ the
swelling yet the swelling at best, could
only be reduced and not done away with. For this reason, a lot of
patients
took to wearing traditional compression garments. Other patients undergo
traditional therapy using
specialized massage and compression garments and
bandages to reduce fluid and swelling before
considering surgery
Update
on Lymphedema: Exercise After Breast Cancer Treatment Is OK - hcp.obgyn.net
–
Lymphedema, swelling caused by a blockage in the lymphatic system, can
occur as a result of surgical or
radiation therapy associated with breast
cancer treatment. Since some research has shown that exercise
after breast
cancer treatment has been associated with developing lymphedema, clinicians
often advise
patients to avoid exercising. But is this truly
necessary?
To better understand the actual risk, Dr Marilyn L. Kwan,
research scientist at the Kaiser Permanente
Northern California Division of
Research, and colleagues conducted a systematic literature review of
contemporary studies. After applying exclusion criteria, Kwan et al.
identified 19 articles for review and
synthesis. The researchers rated the
evidence in the studies utilizing the Oncology Nursing Society Putting
Evidence into Practice Weight-of-Evidence Classification.
Of the
included studies, seven examined the effects of resistance exercises, seven
examined regimens
including aerobic and resistance exercises, and the
remaining five studies looked at other exercise modalities.
Kwan et al.
found that slowly progressive exercise of varying modalities was not associated
either
developing or exacerbating lymphedema associated with breast cancer.
Further, the studies indicated that,
with careful supervision, patients
should be allowed to participate in such exercise regimens. However, data
from the studies examining combined aerobic and resistance exercise did not
yield as conclusive results or
recommendations. While the studies showed
that these exercise regimens appeared to be safe, confirmation
of their
safety requires larger and more rigorous studies.
“Strong evidence is
now available on the safety of resistance exercise without an increase in risk
of
lymphedema for breast cancer patients,” Kwan and colleagues concluded.
“With reasonable precautions, it
is safe for breast cancer survivors to
exercise throughout the trajectory of their cancer experience, including
during treatment.”
“Exercise can be beneficial and not harmful for
breast cancer survivors,” Dr Jane Armer, one of the study’s
co-authors and
director of nursing research at the Ellis Fischel Cancer Center at Sinclair
School of Nursing,
explained in a statement to the press. “Each individual
should balance the pros and cons of the activity she
chooses, but keep in
mind that being sedentary has risks and being active is beneficial in many
ways,
including possibly reducing the risk of cancer
recurrence.”
Mohawk College considers program for condition short of
specialists - Hamilton Spectator –
Mohawk College is considering a program
to train health-care workers how to treat a chronic swelling
condition that
suffers from a shortage of certified therapists.
The college is holding a
one-day workshop in February to gauge interest in learning about lymphedema —
the chronic swelling of limbs or others parts of the body that can be
genetic or caused by trauma or cancer
treatment.
“It could evolve into a
program but we’ve got to see if there’s an interest,” said Donna Dunlop,
program
manager for part-time and graduate studies health sciences. “This
is, from my perspective, one of the cutting
edges that’s emerging as far as
health sciences is concerned.”
There are currently just more than 100
certified lymphedema therapists in Ontario and more than 63,000
patients
with the condition. The Lymphedema Association of Ontario reports some parts of
the province
have little or no access to a therapist.
“I think
health-care practitioners really don’t have a strong knowledge base about
lymphedema and how to
manage it,” said Margaret Forbes, a nurse
practitioner at the Juravinski Cancer Centre who specializes in
lymphedema.
“It’s something that’s under-reported by patients themselves.”
The $95
workshop on Feb. 4 is aimed at health-care workers and students to give them a
background on
the condition that is caused when lymph fluid, which the body
uses to defend against infection, accumulates
because it can’t drain back
into the blood stream. One of the common causes is radiation and surgery for
cancer treatment.
There is no cure, but there are treatments — involving
massage, exercise and compression garments — to
help manage it. The
treatments aren’t covered by OHIP and can cost thousands of dollars.
“It’s
limiting in terms of your activities of daily living to have one limb that’s
quite a bit larger than the other
and it’s also so visible,” said John
Mulligan, a certified therapist who is teaching the workshop. “A lot of
people have had cancer and they’ve been all through the cancer route and
they’ve come out the other side
and then they get stricken with this
lymphedema and they find it difficult to deal with.”
Donna Reise has lived
with lymphedema in her left arm and chest wall for 14 years. She got it one
year after
she was first diagnosed with breast cancer.
“I felt a little
bit like a fullback playing football,” she said. “My arms stood away from my
chest wall. It was
like I was carrying a roll of cotton underneath my
arms.”
Reise, a 62-year-old nurse who lives on the west Mountain, became a
therapist herself after experiencing
firsthand how much the treatment
helped. She now runs a practice on Locke Street.
“It can be quite painful
because of the aching, the swelling causes extra weight and your clothes pinch
because nothing fits properly,” she says. In addition, “it’s a very visual
reminder that you’ve had breast
cancer.”
She feels a workshop such as
the one being held at Mohawk is badly needed.
“There is such a gap in the
training for nurses and physicians,” she says. “Historically, there hasn’t been
a lot
available.”
[email protected] | @JfrketichDecember
21, 2011
Research and Markets: Lymphedema Global Clinical Trials
Review, H2, 2011 - Business Wire (press
release) –
DUBLIN--(BUSINESS
WIRE)--Research and
Markets(http://www.researchandmarkets.
com/research/78850f/lymphedema_global)
has announced the addition of GlobalData 's new report
"Lymphedema Global
Clinical Trials Review, H2, 2011" to their offering.
“Lymphedema Global
Clinical Trials Review, H2, 2011”
GlobalData's clinical trial report,
Lymphedema Global Clinical Trials Review, H2, 2011" provides data on
the
Lymphedema clinical trial scenario. This report provides elemental information
and data relating to the
clinical trials on Lymphedema. It includes an
overview of the trial numbers and their recruitment status as per
the site
of trial conduction across the globe. The databook offers a preliminary
coverage of disease clinical
trials by their phase, trial status,
prominence of the sponsors and also provides briefing pertaining to the
number of trials for the key drugs for treating Lymphedema. This report is
built using data and information
sourced from proprietary databases,
primary and secondary research and in-house analysis by GlobalData's
team
of industry experts.
Scope
•Data on the number of clinical trials
conducted in North America, South and Central America, Europe,
Middle-East
and Africa and Asia-pacific and top five national contributions in each, along
with the clinical
trial scenario in BRIC nations
•Clinical trial
(complete and in progress) data by phase, trial status, subjects recruited and
sponsor type
•Listings of discontinued trials (suspended, withdrawn and
terminated)
Key Topics Covered:•Introduction
•Lymphedema
•Report
Guidance
•Clinical Trials by Region
•Clinical Trials by Country
•Top
Countries Contributing to Clinical Trials in Asia-Pacific
•Top Countries
Contributing to Clinical Trials in Europe
•Top Countries Contributing to
Clinical Trials in North America
•Top Countries Contributing to Clinical
Trials in Central and South America
•Clinical Trials by G7
Nations
•Clinical Trials in G7 Nations by Trial Status
•Clinical Trials
by E7 Nations
•Clinical Trials in E7 Nations by Trial Status
•Clinical
Trials by Phase
•In Progress Trials by Phase
•Clinical Trials by Trial
Status
•Unaccomplished Trials of Lymphedema
•Subjects Recruited Over a
Period of Time
•Prominent Sponsors
•Top Companies Participating in
Lymphedema Therapeutics Clinical Trials
•Clinical Trial
Profiles
•Clinical Trial Overview of Top Companies
•Five Key Clinical
Profiles
•Appendix
•Abbreviations
•Definitions
•Research
Methodology
•Secondary Research
For more information visit http://www.researchandmarkets.com/research/78850f/lymphedema_global
Contacts
Research
and Markets
Laura Wood, Senior Manager,
U.S. Fax: 646-607-1907
Fax
(outside U.S.): +353-1-481-1716
December 23, 2011
Buddycheck23
reducing side effects – WXXA –
When Katie Brophy learned she had breast
cancer, she wasn't surprised.
"I sort of expected it, obviously when you
have a lump, you just assume," she said.
A lumpectomy and radiation took
care of her cancer but left her with the risk of lymphedema, a side effect
of treatment that causes fluid build-up in the limbs. As an interior
designer, that worried her.
"I'm physical. I paint walls. I wallpaper,
refinish wood. The last thing you need to do is have an impaired
arm,"
Katie said.
Mayo Clinic Dr. Andrea Cheville says radiation may destroy
arm-draining lymph nodes. Once they're
damaged, the risk of lymphedema
rises so does the risk of infection.
"It's unattractive and so I think,
socially, it's a very difficult condition for people. Our best hope is to
prevent
people from getting it," Dr. Andrea Cheville said.
To do that,
she's testing a new technique that combines CT scans with spect-imaging. That
powerful combo
pinpoints exact locations of critical lymph
nodes.
"The physicians who are planning a woman's radiation can know
exactly where those critical nodes are and
avoid them, block them from the
radiation field," the doctor said.
Studies show it reduces the number of
critical lymph nodes that receive harmful radiation by more than 55
percent.
"We treated 30 women. None of those women have developed
lymphedema," Dr. Cheville said.
Katie was one of those women.
"At
the moment, I'm very pleased with the result," she said.
December
27, 2011
Lymphedema Following Breast Cancer Surgery May Occur Later -
Patch.com –
Even when lymphedema flares years after breast cancer surgery or
radiation, the pain and swelling can be
treated. There is no rhyme,
reason, or way to predict if a woman will experience lymphedema following
surgery or radiation to treat breast cancer.
Swelling of the arm,
breast, or chest may begin shortly after breast cancer surgery or radiation but
some
women experience lymphedema months -- or years -- later.
While
lymphedema can’t be cured, it can be treated, even when it occurs long after
breast cancer surgery or
radiation.
“The two things that help most are
keeping your weight in a manageable range and light exercise of the arm,”
said Monique Tiffany, R.N., nurse navigator at Los Alamitos Total Care
Breast Center at Los Alamitos
Medical Center.
Doing gentle
weight-bearing exercises with the affected arm helps prevent a sudden
occurrence of swelling
after doing something like reaching for an object on
a top shelf, she says.
“Lightly massaging the arm also helps. Even if one or
two lymph nodes are still there, they can be retrained
to do the job of
draining fluid.”
According to the American Cancer Society, most women who
have had breast cancer do not develop
lymphedema, but those who do can take
steps to manage the swelling and pain, which can range from mild
to
severe.
Lymphedema results when lymph nodes and vessels are removed or
scarred during breast cancer surgery.
With fewer lymph nodes and vessels, it
is more difficult for the upper body to drain lymph fluid. When
excess
lymph fluid builds up, pain and swelling occur.
Radiation for breast cancer
also affects the flow of lymph fluid in the arm, chest, and breast area and can
also cause lymphedema.
“Lymphedema is always a risk when a woman has had
any lymph nodes removed or radiation for breast
cancer,” said
Tiffany.
Tiffany advises women about lymphedema not only as a breast cancer
care nurse, but also as a breast
cancer survivor. She celebrated being
cancer-free for 10 years this month.
Tiffany said she remains aware that
lymphedema can still occur, even after a decade. “I still have to think
about it if I’m going to get on a plane,” she said.
Air travel can cause
lymphedema to flare.
There is no way to prevent lymphedema prior to breast
cancer surgery or radiation.
Tiffany recommends that women get measured for
compression sleeves right after surgery, so they can be
used if
needed.
However, a woman newly diagnosed with breast cancer may find
information about lymphedema
overwhelming on top of everything else she is
dealing with, so not all women will have the measurements
done until
lymphedema becomes an issue.
To manage the pain and swelling immediately
after surgery, women are advised to raise the affected arm
above heart
level two to three times a day for 45 minutes, and to open and close their
fists gently to help
move lymph fluid out of the arm.
Physical therapy
and special exercises can help regain full range of motion in the weeks after
surgery or
radiation. A compression sleeve or special bandaging may be
needed when pain and swelling persist.
Because cuts, burns, or insect bites
on the affected arm make the body respond with extra lymph fluid --
causing
or worsening lymphedema -- it’s important to avoid these injuries.
Wearing
gloves while cleaning or gardening, a mitt while handling hot foods, and a
thimble while sewing can
help prevent cuts and burns. Cuts and scratches on
the affected arm need to be treated right away with
antibiotic
ointment.
Heat can make lymphedema worse, so hot tubs, saunas, or heating
pads are on the list of things to avoid,
along with harsh soaps, which can
dry the skin and make it more prone to cracking.
Lymphedema can seem
particularly onerous when it begins several years after breast surgery or
radiation.
Having to deal with compression sleeves and massaging and
elevating the arm comes as a newly
inconvenient and unwelcome after-effect
of breast cancer treatment.
“Lymphedema can occur at any time,” noted
Barbara Stone, physical therapist at MemorialCare Todd
Cancer Institute at
Long Beach Memorial Medical Center.
Stone sees patients at the outpatient
Lymphedema Program at Memorial, which is part of the MemorialCare
Rehabilitation Institute.
The Lymphedema Program is open to anyone in
the community who needs treatment for lymphedema.
Stone recently encountered
a patient who just developed lymphedema, although her mastectomy was 25
years ago.
“She recently began using a walker, and the extra strain on
that arm may have caused the excess fluid,” she
explained.
In another
case, a breast cancer survivor developed lymphedema three years after her
breast cancer surgery
while caring for her ill husband.
Helping him up
and turning him in bed strained her affected arm, and she developed
lymphedema.
Stone pointed out that water exercise can be very helpful in
managing lymphedema. “When you’re in the
water, it’s like wearing a
compression garment,” she said.
Women who have joint pain that makes walking
or other exercise difficult can get in the water to help
maintain mobility,
she said.
More information on lymphedema is available from the National
Lymphedema Network.
December 28, 2011
Can Massage Help Lymphedema? –
ABCNews –
This is a video at this address with no text to support it:
http://abcnews.go.com/Health/video/massage-
lymphedema-9373495
Helping
others get a leg up during the holidays - Greenwich Citizen – by Beth
DolinarThe leg thing has
become exhausting. It's the first thing on my mind
every morning and the last thing every night. And I think
about it during
the night too, awakening as I do when the special boot I wear to bed starts to
tear at the skin
behind my knee.
Cancer has left me with lymphedema in
my left leg; some lymph nodes were removed during surgery and
then the
radiation killed off most of the rest. And now, my life has become a daily
battle to keep the leg from
getting any bigger. A question mark looms over
every morning: what pants will fit over my swollen thigh?
What shoes can I
wear? There is now such a disparity between my left and right feet I must
either buy two
pairs of shoes -- a 9 and an 11 and you should see my Zappos
bill -- or just go with an 11 and knowing my
normal right foot is going to
flop around inside of it like a penny in a jar.
Of all the challenges I've
faced, this is the worst. Pounding is bad for my foot, so I can no longer run.
I
spend hours of time and hundreds of dollars every week at the physical
therapist, having the leg massaged
back to a somewhat smaller size. And
maybe worst of all, cute shoes are just a memory. And I pine for a
short
dress.
If this sounds like a great big pity party, it is. At some point each
day, usually while stopping to smooth a
wrinkle in the compression garment
I must always wear, I stop and throw the party, dousing myself with the
pathetic confetti of selfish woe. Like I'm the only one with
problems.
It's been time -- for a long time now -- for an attitude
correction. Maybe life can't fix my leg, but it can fix
my head.
And
that's how I ended up serving Thanksgiving dinner to a personal care home. My
family and I served
turkey and stuffing to 18 adults who have mental
disabilities. Some were non-conversant, others chatty but
somehow
withdrawn. All wore the faded expressions of those who have had to dial back
expectations so
far that hope doesn't really factor any more.
The woman
who cares for them said "maybe three" have family who will visit for the
holidays.
After we'd served the meal, I noticed a bag of the little plastic
jelly packets you find on the table at diners -
the cranberry sauce for the
turkey. I ran back into the dining room to hand it out before everyone had
finished the turkey. One lady grinned as I peeled back the lid; she'd been
wondering.
I happen to have been born into a good place, to good people, and
with everything about me working well
enough to propel me into a life that
98 percent of the people on the planet would consider unimaginably
comfortable and easy.
Maybe the exhausting thing is not my leg, but my
constant thinking about the leg. It will be a challenge for as
long as I'm
around. But no matter how big it gets, it's really such a small part of a big
and fortunate life.
I think of the residents of that care home, and how
grateful they were to find there really would be cranberry
sauce for the
turkey. How "maybe three" of them would see family for Christmas. And I thank
my lucky
stars.
Beth Dolinar is a former Riverside resident and
Pittsburgh television reporter who is staying at home to raise
her two
children. She can be reached at [email protected].
New lymphedema group formed
- Beausejour Review –
A Lac du Bonnet woman and her son have yet another
accomplishment to be proud of in their mission to
raise awareness of
lymphedema.
Manitobans will soon be served by a new advocacy group dedicated
to improving services and increasing
awareness of lymphedema. The
Lymphedema Association of Manitoba (LAM) has been incorporated,
developed
its by-laws and is in the process of recruiting members. The first meeting of
members is expected
to be held in January 2012.
Lymphedema is a lifelong
chronic condition. People with lymphedema have various degrees of swollen limbs
or other parts of their body, caused by the inability of the lymphatic
system to drain properly. There is no
known cure and treatment is required
daily. Lymphedema is an accumulation of lymphatic fluids; the
lymphatic
system moves lymph fluid containing white blood cells that help to fight
infection, filter out toxins
and germs.
It's a condition Lac du Bonnet's
Kim Avanthay and son Austin know all too well.
Last year marked significant
progress in her mission for recognition of the disease which is quite common
but
not publicized to any great extent. Many medical professionals have
never heard of lymphedema, which the
World Health Organization estimates
affects more than 250 million people worldwide.
"The more people hear, the
more they will be aware [of lymphedema] and can seek help if they need it,"
Avanthay explained about the importance of making the disease
understood.
Avanthay's efforts are inspired by her young son, Austin, who
suffers from the disease. The Leader first
wrote about Avanthay two years
ago when she graduated from the Lymph Science Advocacy Program in
California. She was there to learn more about the illness that's affected
Austin since shortly after birth.
"Lymphedema is a chronic disease with no
known cure and treatments that for some, are less than
adequate," Avanthay
told the Leader.
"Much work needs to be done in this area as lymphedema
requires daily care."
The disease can become a disability that prevents
those affected by it from continuing in normal daily
activities including
their professions.
Cancer patients who have had surgery and radiation
treatment often suffer from lymphedema and are often
unaware of the causes,
opportunities for prevention or approaches to treatment. While estimates vary,
experts in Canada estimate that up to 25% of cancer patients suffer from
lymphedema. It is a silent
condition; very little is known about it and the
health care system is poorly informed about its role in
prevention and
treatment.
A study by the Canadian Lymphedema Framework found a lack of
standardized care, non-existent or
inadequate provincial health coverage, a
lack of resources for assessment and treatment and inadequate
awareness of
lymphedema prevention and self-management. The impact of lymphedema can be
minimized
by early intervention; the condition requires a highly
specialized treatment known as Manual Lymphatic
Drainage/Combined
Decongestive Therapy and the proper use of compression garments.
The
Lymphedema Association of Manitoba follows similar associations in other
provinces and is linked to
the National Framework and International work in
this area.
For more information, please contact the Lymphedema Association
of Manitoba at lymphmanitoba@yahoo.
ca or write to Box 403, Lac du Bonnet,
MB R0E 1A0.