Kit Easy Talk Manual Lymphatic Drainage
Most arm lymphedema is a secondary condition caused by removal of for, damage to the from radiation or even chemotherapy for breast cancer. Other causes can include burns, various infections, injury or trauma. However, often overlooked and seldom mention is that you can also have primary lymphedema of the arm. The dynamics of arm lymphedema are the same as. A damaged is unable remove lymph fluids adequately and the fluid begins to collect in the interstitial tissues.
This causes of the affected limb. Lymphedema can be devestating emotionally, but I believe that despite lymphedema, you can experience a full and rich life, here's a page that offers some tips For arm Risk Factors for arm lymphedema. 1.) removal for biopsies 2.) Serious that include,. 3.) Deep invasive wounds that might tear, cut or damage the lymphatics 4.) Radiation treatments, especially ones that are focused in areas that might contain “clusters” of 5.) Morbid obesity can cause secondary lymphedema by “crushing” the 6.) Serious burns, even intense sunburn 7.) of the microscopic parasite, though this is more common in tropical countries 8.) For any person who has a family history of unknown swelling of a limb Early Signs and symptoms of arm Lymphedema. If you are an at risk person for arm lymphedema there are early warning signs you should be aware of. If you experience any or several of these symptoms, you should immediately make your physcian aware of them.
Kit Easy Talk Manual Lymphatic Drainage. First Aid International is your one stop shop for all your First Aid needs. We can help you with all of your First Aid. Manual Lymphatic Drainage with Lesley Guilfoyle I recently had one of the most relaxing massages I have ever had. In fact, it was so relaxing I fell asleep, even.
1.) Unexplained aching, hurting or pain in the arm 2.) Experiencing “fleeting lymphedema.” This is where the limb may swell, even slightly, then return to normal. This may be a precursor to full blown arm lymphedema. 3.) Localized of any area. Sometimes lymphedema may start as in one area, for example the hand, or between the elbow and hand.
This is an indication of early malfunction. 4.) Any arm, redness. 5.) You may experience a feeling of tightness, heaviness or weakness of the arm. Complications of arm lymphedema. Infections such as,,.
This is due not only to the large accumulation of fluid, but it is well documented that lymphodemous limbs are localized immunodeficient and the protein rich fluid provides an excellent nuturing invironment for. Draining wounds that leak which is very caustic to surrounding skin tissue and acts as a port of entry for infections. Increased pain as a result of the compression of nerves usually caused by the development of and increased build up of fluids.
Loss of Function due to the and limb changes. Depression - Psychological coping as a result of the disfigurement and debilitating effect of lymphedema. Again as a result of the pressure of the swelling and against the vascular system. Also, can happen as a result of, and infections. See also 7., are possibilities as a result of the infections.
Possible amputation of the limb. May result if the in the abdomen or chest are to overwhelmed to clear the lung cavity of fluids. Complications such as splitting, plaques, susceptibility to and bacterial infections.
Chronic localized. Angiosarcoma, a cancer of the soft tissues 13. Which is a rapidly progressive, non curable cancer of long term lymphedema patients.
14., new research indicates a possibility of this with hereditary lymphedema. I have been diagnosed with two forms of lymphoma. Septic arthritis Stages of arm lymphedema. The for arm lymphedema is much the same as treatment for.
The preferred treatment is decongestive therapy. However, with arm lymphedema, it has been shown that a treatment protocol including sequential pump therapy with manual decongestive therapy has obtained the best results. See also manual lymphatic drainage mld During the course of treatment, the arm will be wrapped in compression bandages after the treatment session. Upon completion of the, sleeves and arm garments will be prescribed. There is one final and critical area pertaining to the treatment, control and management of lymphedema, and that is exercise. Not only is it vital for our over all health, it helps in weight control and is important for the movement of lymph fluid through our body.
No matter the stage of lymphedema, underlying medical conditions or age, everyone of us should have a plan for. Sometimes too, the process we must go through to get our treatment covered is maddening to say the least. You made need to learn to reverse a coverage or treatment denial and you may even have to learn the process with your state commissioner.
No Blood Tests, Blood Pressure, I.V. Or Injections into this Arm!
Perhaps the foremost rationale for NOT allowing the use of needles in an arm with lymphedema is the threat of. Every break of the creates potential entry foci for bacteria. Because of the state of the arm any can and often does escalate quickly into. These infections cause further damage to the, thereby increasing the severity of the lymphedema. (which is the fluid in the arm) is a protein-rich substance that provides excellent nutrition to any that might gain a foot hold in the arm. Once an infection has begun the excess fluid and any of the arm tissue makes it tremendously more difficult to eradicate the bacteria. Injection of Medicines.
The first reason for not allowing an IV is simply the break in the - which would be a continous opening until the removal of the IV. Beyond that and even more important is the simple fact that lymphedema is caused by the inability of the arm to remove even the normal excess fluids of body dynamics.
When you add the fluids that are present in the administration of an IV, you catastrophically overload the arm. It simply is totally unable to rid itself of that extra fluid thereby causing a substantial increase in. Blood Pressure Tests. Because light exercise after breast cancer surgery and removal can help reduce the chances of lymphedema, patients should discuss how and when to begin arm exercises. Some patients find that taking painkillers (analgesics) 30 minutes prior to exercising helps alleviate discomfort, although all medications should be approved by the patient’s physician. The following are suggestions of exercises following breast surgery from the Wessex Cancer Trust, an independent charity that provides information and support to patients with cancer. Each exercise may be performed five times in a row, three times a day (morning, afternoon, evening) with the physician’s approval.
With palms up and elbows straight, stretch arms high above head, linking fingers together. Bend elbows and clasp hands at the back of the neck. Push elbows out as far as possible and then bring them together to touch in front of the body. Place hands behind the back and lace fingers together. Slide hands as far as possible up the body toward the neck. Place hands on shoulders (on the same side of the body) and move elbows up and then down toward the sides of the body.
Place hands on shoulders and make circular movements with the elbows. Circles should be as large as possible.
Change directions periodically. After breast stitches have been removed, stand with one foot in front of the other. Hold on to a chair or table. Lean forward and swing the arm that was involved in the surgery backwards and forwards, and then from side to side as far as it will go. Hold a small weight to gain momentum. Increase movement until arm reaches shoulder height.
Keep elbows straight. Stand with one foot in front of one another.
Hold onto a chair or table for support. Lean forward and swing the arm on the side of the surgery in circles, first clockwise and then counter-clockwise. Keep elbows straight. Face toward a wall. Place hands on the wall and inch fingers up the wall. Try to go higher each day until arms are fully straight over head.
Lymphedema Arm Self Massage. You can do a simplified version of MLD yourself at home, called simple lymphatic drainage (SLD). SLD is done by using your fingers very gently to move the skin in a particular direction. If you find that the skin is red when you have finished, then the movement is too hard. It is often easier if your partner or a friend also learns the technique, so that they can help you in any areas you cannot reach. Your physiotherapist or nurse will be able to show you or your partner the technique. The diagrams and explanations on the following pages should also help.
Massage 1 - for both arm and leg swelling Place your fingers, relaxed, on either side of your neck at position 1. Gently move the skin in a downwards direction, towards the back of your neck. Repeat 10 times at position 1, 2 and 3. At position 4 (on the top of your shoulder) use a gentle inward scooping movement down towards the top of your breast bone (where the collarbones meet) Repeat 5 times.
Massage 2 - for swelling of one arm The aim of this massage is to stimulate the lymph channels on the trunk to clear the way ahead so excess fluid can drain away. The skin is always moved towards the non-swollen side. You will find it easier to start with one hand, and then swap to the other as you move across the body. Starting in the armpit on the non-swollen side (position 1), use light pressure to gently stretch the skin up into the armpit. Your hand should be flat and not slide over the skin. Repeat 10 times. Next, at position 2, use a light push to stretch the skin towards the non-swollen side, with a slow and gentle rhythm.
Repeat 5 times. Repeat the same movements at position 3. Swap hands, and repeat the movements 5 more times at position 3 with your other hand, as this position is very important for lymphatic drainage. This time, the movement with your fingers is a slight pull to move the skin to the non-swollen armpit. Repeat movements 5 times at position 4, then 5. Hand-held massagers Hand-held massagers can be useful for people who have restricted movement of their hands, perhaps due to arthritis.
They are available at most large chemists and some electrical shops. As with all SLD techniques, a light touch is necessary.
Massagers should never be used to press down on the skin. If you do this, you will obstruct your lymphatic channels and so the massage will not help lymph drainage. Hand-held massagers can be quite heavy to hold so try to hold it in the non-swollen hand. You may need your partner or a friend to help you. Talk to your doctor or lymphoedema specialist before using a massager.
It can be used to apply gentle pressure in the same sequence of movements as the exercises on the previous pages. Here are some guidelines for using a hand-held massager: Use it for at least 15 minutes a day. Use the lowest setting and a dimpled head. Do not use oils or creams with the massager. Do not use the heat setting. If possible, get a massager without a heat pad, as these are lighter and easier to use.
Use a gentle, circular movement, following the sequences of movement described earlier. Avoid massaging abnormal or broken skin. Deep breathing exercises Before and after SLD, breathing exercises can help to stimulate lymphatic drainage.
Use the following simple exercises: Sit in a comfortable chair or lie on your bed with your knees slightly bent. Rest your hands on your abdomen.
Take deep breaths to relax. As you breathe in – direct the air down to your abdomen, which you will feel rising under your hands. Breathe out slowly by `sighing' the air out. While breathing out let your abdomen relax in again. Do the deep breathing exercises five times and then have a short rest before getting up.
“One of the truely most comprehensive and best sites I have seen.” **Special Note for Bi-Lateral Mastectomy Patients or Bi-Lateral Surgeries**. At special risk are patients who have gone through a bi-lateral mastectomy or a single mastectomy with surgery also on the opposite side. Remember that both sides of the chest are at risk for lymphedema, so it is important not to move the fluids from one side to the other. Instead, per several lymphedema therapists I asked, the fluid should be directed to the neck and groin lymphatics, as well as the intercostals and abdominals, and away from the left axilla, or right axilla nodes just as part of the “normal” pattern for left upper extremity lymphedema, per the Vodder technique. Thanx Cassie and Carol;-) who are also members of. This is one of my favorite breast cancers sites and they also have a wonderful forums section with one specifically for breast cancers survivors with lymphedema. See also: Exercise and Arm Lymphedema.
Gergich MPT, MLD/CDT Lymphedema Specialist, Penn Therapy and Fitness Posting Date: May 6, 2001 Last Modified: January 3, 2002 Why Should I Exercise? One very important component of a comprehensive treatment plan for -related is exercise. A program consisting of flexibility, strengthening and aerobic exercise is beneficial in reducing lymphedema when administered under the correct conditions. Exercise also allows cancer survivors a more active role in their own lymphedema management. Recent studies have shown no significant increase in the incidence of lymphedema after breast cancer, between women participating in an exercise program when compared to women who did not exercise. What Type of Exercises are Helpful To Someone with Lymphedema?
Flexibility exercises help to maintain joint range of motion and allow for elongation or stretching of tissues. Flexibility exercises also help to prevent joint stiffness and postural changes after cancer surgeries or treatments. Muscle tightness may further complicate lymphedema. Strengthening exercises are also important in reducing lymphedema when done at low intensity levels with the extremity wrapped (see below). These exercises often help increase and venous flow, aiding in the removal of fluid from the involved extremity. Aerobic exercise enhances the lymphatic and venous flow, further reducing swelling in the extremity. Aerobic exercise also combats fatigue, which plagues so many people during and after cancer treatment.
Finally, deep abdominal breathing or diaphragmatic breathing is important with all exercise, but especially so in people with lymphedema. When deep breathing is carried out, the pressure inside the chest and abdomen is altered and creates a pumping activity within the. The central, which carries lymph fluid from the abdomen and legs, travels through the chest cavity. Pumping action around the duct helps to increase lymphatic flow throughout the body. Deep breathing is also important to deliver adequate oxygen supplies to the working muscles so that they may work efficiently. Exercises should be initiated by a physical or occupational therapist that specializes in lymphedema treatment. As with all exercise, you should discuss beginning a program with your physician.
How Much Weight Can I Lift? There has been little research to date regarding the intensity of exercise in people with lymphedema and what is a safe level. Previously, intensive exercise was viewed as contraindicated, or not advisable. Currently, exercise and progressive weight lifting activities are used to assist in the removal of lymphedema from the affected areas. Therapists can guide clients in a weight lifting program that is tailored to their present fitness levels.
How much you can lift depends on the stage of treatment and most importantly, you previous and present fitness levels. It is important to continuously monitor the limb for swelling or redness, which can be an indication that the exercise was too intense.
A weight lifting program should be initiated by a therapist who specializes in the treatment of lymphedema. Should I Wrap My Arm With Exercise? It is recommended that the affected limb (arm or leg) be wrapped with compression bandages during exercise to aide the muscle pump force on the venous and lymphatic systems. Wrapping also prevents further fluid from accumulating in the extremity. The bandages used for lymphedema treatment are short-stretch bandages.
The short stretch bandages used in lymphedema do not stretch much when applied to the arm or leg. When you exercise the wrapped limb, the muscles and the bandages place a force on the lymphatics that help move fluid out of the arm. ACE bandages stretch too much and are ineffective in the treatment of lymphedema. Do NOT USE Ace wraps when wrapping for lymphedema. What Exercises Can I do After Breast Surgery? Following a it is important to maintain range of motion or flexibility in the shoulder. Frequently, women decrease the use of the shoulder and arm on the side of the body where surgery was performed due to pain or fear of hurting the incision.
Protecting the arm may lead to stiffness and tightness in the shoulder which can make it difficult to move the arm. This is often followed by a loss of muscle strength and stability around the shoulder. Since the shoulder and neck are closely related, it is also important to maintain neck mobility to prevent further complications. Ask your doctor or physical therapist if you have questions about which shoulder exercises are right for you. If you have recently undergone a accompanied by a breast reconstruction REFER TO YOUR SURGEON FOR INFORMATION REGARDING SHOULDER EXERCISE.
It is important to discuss beginning an exercise program with your physician. Physical activity for the affected limb and arm lymphedema after breast cancer surgery. A prospective, randomized controlled trial with two years follow-up. Swelling of the arm on the side of your breast surgery can be due to the under the arm being disturbed by surgery and partial removal and also to radiation of the armpit. After an injury anywhere in the body, lymph fluid will rush to the injured site to carry away and any foreign substances. If that injured area is a hand or arm on the side of armpit surgery and radiation, the lymph fluid will have a harder time being absorbed back normally because surgery has removed some of the channels that would have carried the fluid.
Radiation has closed down some of those lymph channels also. Since surgery and radiation were life saving treatments, the focus now should be on preventing injury and stress to the affected hand, shoulder and arm to lessen the chance of lymph fluid causing swelling of the arm.
If you are a person who has had armpit surgery to test for cancer cells, or if you have received radiation to the armpit, you may want to consider ways to prevent arm. Avoid Treat even small injuries/hangnails with care. Wash the injury with soap and water, apply ointment, then cover with a band-aid. Keep of the hand and arm clean and moisturized. Apply moisturizing lotion several times a day. Avoid Injury Do not have blood drawn from the affected arm, unless absolutely necessary. Wear long oven mitts whenever putting hands in an oven.
Have someone else get dishes out of the oven when feasible. Carefully cook foods in oil to avoid splashing of hot grease onto hands.
Use rubber gloves when doing cleaning with harsh cleaners. Wear rubber gloves when doing dishes. Wear canvas gloves while gardening and doing yard work. Wear a thimble while sewing. Shave underarms with an electric razor. Avoid chemical hair removers.
Use insect repellant to protect against bug bites or bee stings. Avoid sunburn by using sunscreen with SPF of at least 15.
Reapply sunscreen after swimming and as directed on the sunscreen label. Don't allow injections, vaccinations on the affected arm. Do not have manicures on the affected hand. Do not cut cuticles or hangnails. Don't hold a cigarette in the affected hand.
Avoid Constriction Avoid clothing with elastic sleeve bands or with tight arms. Don't wear a watch or rings on affected arm.
Avoid carrying a heavy purse or bag with the affected arm. Have blood pressure taken on the unaffected arm, if possible. Underclothing, such as bras, should not leave pressure marks. When traveling in a car or plane for long distances, keep the affected arm above the level of the heart, if at all possible. Avoid Muscle Strain Avoid heavy lifting if your muscles are not used to heavy lifting. Avoid vigorous, repetitive movements such as scrubbing, pulling, hammering. Sports such as tennis, racquetball and golf have the potential to strain muscles because of sudden and forceful strokes.
Begin any new exercise/activity involving the arms gradually and with caution. Prospective evaluation of a prevention protocol for lymphedema following surgery for breast cancer. 2009 Mar Boccardo FM, Ansaldi F, Bellini C, Accogli S, Taddei G, Murdaca G, Campisi CC, Villa G, Icardi G, Durando P, Puppo F, Campisi C. Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, S.
Martino Hospital, University of Genoa, Italy. Lymphedema is a common complication of axillary dissection and thus emphasis should be placed on prevention. Fifty-five women who had breast-conserving surgery or modified radical mastectomy for breast cancer with axillary dissection were randomly assigned to either the preventive protocol (PG) or control group (CG) and assessments were made preoperatively and at 1, 3, 6, 12 and 24 months postoperatively.
Arm volume (VOL) was used as measurement of arm lymphedema. Clinically significant lymphedema was confirmed by an increase of at least 200 ml from the preoperative difference between the two arms. The preventive protocol for the PG women included preoperative upper limb lymphscintigraphy (LS), principles for lymphedema risk minimization, and early management of this condition when it was identified.
Assessments at 2 years postoperatively were completed for 89% of the 55 women who were randomly assigned to either PG or CG. Of the 49 women with unilateral breast cancer surgery who were measured at 24 months, 10 (21%) were identified with secondary lymphedema using VOL with an incidence of 8% in PG women and 33% in CG women. These prophylactic strategies appear to reduce the development of secondary lymphedema and alter its progression in comparison to the CG women. Intermittent pneumatic compression acts synergistically with manual lymphatic drainage in complex decongestive physiotherapy for breast cancer treatment-related lymphedema. 2012 Jun 19 Ancukiewicz M, Miller CL, Skolny MN, O'Toole J, Warren LE, Jammallo LS, Specht MC, Taghian AG. Source Department of Radiation Oncology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. Abstract The purpose of this article is to evaluate arm measurements of breast cancer patients to critically assess absolute change in arm size compared to relative arm volume change as criteria for quantifying breast cancer-related lymphedema (BCRL).
We used pre-operative measurements of 677 patients screened for BCRL before and following treatment of unilateral breast cancer at Massachusetts General Hospital between 2005 and 2008 to model the effect of an absolute change in arm size of 200 mL or 2 cm compared to relative arm volume change. We also used sequential measurements to analyze temporal variation in unaffected arm volume. Pre-operative arm volumes ranged from 1,270 to 6,873 mL and correlated strongly (Kendall's τ = 0.55) with body mass index (BMI). An absolute arm volume change of 200 mL corresponded to relative arm volume changes ranging from 2.9 to 15.7%. In a subset of 45 patients, modeling of a 2-cm change in arm circumference predicted relative arm volume changes ranging from 6.0 to 9.8%.
Sequential measurements of 124 patients with >6 measurements demonstrated remarkable temporal variation in unaffected arm volume (median within-patient change 10.5%). The magnitude of such fluctuations correlated (τ = 0.36, P.05). Absolute changes in arm size used as criteria for BCRL are correlated with pre-operative and temporal changes in body size. Therefore, utilization of absolute volume or circumference change in clinical trials is flawed because specificity depends strongly on patient body size. Relative arm volume change is independent of body size and should thus be used as the standard criterion for diagnosis of BCRL.
Factors associated with the development of arm lymphedema following breast cancer treatment: a match pair case-control study. Johansson K, Ohlsson K, Ingvar C, Albertsson M, Ekdahl C. Department of Physical Therapy, Lund University, Sweden.
Karin.johansson@skane.se We examined factors that may influence the development of arm lymphedema following breast including the specific mode of therapy, patient occupation and life style. Medical record data and a questionnaire were used to collect information after surgery concerning such issues as wound seroma,, adjuvant treatment, vessel string (phlebitis), body mass index, smoking habits and stress. Occupational workload was assessed after surgery whereas housework, exercise, hobbies and body weight were assessed both before and after surgery.
Seventy-one breast cancer treated women with arm lymphedema lasting more than 6 months but less than 2 years were matched to women similarly treated for breast cancer but without arm lymphedema (controls). The matching factors included axillary node status, time after, and age. In the lymphedema group, there was a higher body mass index at time of surgery (p=0.03) as well at time of study (p=0.04). No differences were found in occupational workload (n=38) or housework, but the lymphedema group reduced their spare time activities including exercise after surgery compared with the controls (p. Johansson K, Albertsson M, Ingvar C, Ekdahl C. Department of Physical Therapy, Lund University Hospital, Sweden. We examined the effects of low stretch compression bandaging (CB) alone or in combination with manual lymph drainage (MLD) in 38 female patients with arm lymphedema after treatment for breast cancer.
After CB therapy for 2 weeks (Part I), the patients were allocated to either CB or CB + MLD for 1 week (Part II). Arm volume and subjective assessments of pain, heaviness and tension were measured. The mean lymphedema volume reduction for the total group during Part I was 188 ml (p. Golshan M, Martin WJ, Dowlatshahi K. Department of Surgery, Rush University, Rush Presbyterian St. Luke's Medical Center, Chicago, Illinois, USA.
Arm edema occurs in 20 to 30 per cent of patients who undergo axillary lymph node dissection (ALND) for carcinoma of the breast. Sentinel lymph node biopsy (SLNB) in lieu of ALND for staging of breast cancer significantly lowers this morbidity. We hypothesized that SLNB would have a lower lymphedema rate than conventional axillary dissection. Patients who underwent SLNB were compared with those who underwent level I and II axillary node dissection. A total of 125 patients were evaluated with 77 patients who underwent SLNB and 48 patients who underwent ALND.
The arm circumference 10 cm above and 10 cm below the olecranon process was measured on both arms. In this series a difference in arm circumference greater than 3 cm between the operated and nonoperated side was defined as significant for lymphedema. Lymphedema was seen in two of 77 (2.6%) patients in the SLNB group as compared with 13 of 48 (27%) ALND patients. Given the above data patients who underwent sentinel lymph node biopsy show a significantly lower rate of lymphedema than those who had axillary lymph node dissection. This has an important impact on long-term postoperative management of patients with breast cancer. Publication Types: Case Reports PMID: 12678476 [PubMed - indexed for MEDLINE] Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study.
McKenzie DC, Kalda AL. Division of Sports Medicine and School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada. Kari@interchange.ubc.ca PURPOSE: To examine the effect of a progressive upper-body exercise program on lymphedema secondary to breast cancer treatment. METHODS: Fourteen breast cancer survivors with unilateral upper extremity lymphedema were randomly assigned to an exercise (n = 7) or control group (n = 7). The exercise group followed a progressive, 8-week upper-body exercise program consisting of resistance training plus aerobic exercise using a Monark Rehab Trainer arm ergometer. Lymphedema was assessed by arm circumference and measurement of arm volume by water displacement. Patients were evaluated on five occasions over the experimental period.
The Medical Outcomes Trust Short-Form 36 Survey was used to measure quality of life before and after the intervention. Significance was set at alpha. Ferrandez JC, Serin D, Bouges S. Unite de reeducation main-membre superieur et unite de reeducation vasculaire, Avignon, France. Lymphoedema of the upper limb after breast cancer treated with axillary clearance is a well known sequels. But its real rate is not precise. The retrospective study of 683 patients approaches this reality.
When clinic criteria are selected with centimetric measures, its general rate is 41%; 65% out of them have a difference smaller than 3 cm. We noticed three different kinds of lymphoedemas which occur on the arm, the forearm or the complete upper limb. Their volumes are different, the more voluminous ones occur when the upper limb is touched completely (P = 0.0001).
The different factors which increase the risk of lymphoedema are described. The role of the infection is noticed (x 1.7). The rate is independent of the surgery, of the importance of axillary clearance and of the shoulder joint function. The lymphoedema size is more important when it occurs secondary to mastectomy then conservative treatment (P = 0.0078). Parietal fibrosis increases lymphoedema risk to 54% (P = 0.005) and lymphoedemas are more voluminous (P = 0.009). The Role of Pneumatic Compression Pumps:preliminary results from a current study. Andrzej Szuba, researcher with the Stanford/Aurora Centre for Lymphatic and Venous Disorders, Stanford University School of Medicine, Stanford, CA U.S.A.
Has made a number of presentations documenting this centre's experiences in using pneumatic extremity pumps on patients with post-mastectomy lymphedema. 14-17, 2000 The Role of Pneumatic Compression Pumps, a presentation at the 4th National Lymphedema Network Conference in Orlando, Florida. Szuba suggested that intermittent penumatic compression with single or multi-compression with single or multi-chamber pumps effectively removed access fluid from the extremity. He reported that they were conducting two studies on the application of pneumatic compression in combination with decongestive lymphatic therapy (DLT) in patients with arm lymphedema secondary to breast cancer therapy. Preliminary results of the first study involving 22 women showed an average arm volume reduction of 51% in the group using the compression pump with DLT vs.35% volume reduction in the group treated with DLT alone. The second study of 23 which assessed the usefulness of daily sequential compression for maintenance of arm volume by patients with post mastectomy arm edema also found beneficial effects. 2002 at the Internation Congress of Lymphology, Genoa, Italy, Szuba, R.
Achalu and S.G. Rockson reported on their continued research in this area. They investigated the safety and efficacy of adjunctive intermittent pneumatic compression (IPC) for the acute decongestive therapy of post-mastectomy lymphedema. 23 patients were randomized into two groups: the first which received decongestive lymphatic therapy (DLT) which included manual lymph drainage, bandaging and exercise daily and IP; and the second which received IPC 30 minutes daily at 40-50 mm. In group 1, 11 patients received a 25% acute arm volume reduction; in group II 12 patients received a mean volume of 45.3% mean volume reduction.
Tales Of The Abyss Iso Torrent Download there. These preliminary results appear to show positive affects for some patients which use this form of treatment. EVALUATION OF INTERMITTENT PNEUMATIC COMPRESSION AS ADJUNCTIVE MAINTENANCE THERAPY IN POSTMASTECTORMY LYMPHEDEMA. Rockson Stanford Center for Lymphatic and Venous Disorders, Stanford Univerity School of Medicine, Stanford, CA USA Srockson@cvmed.stanford.edu We studied the safety and efficacy of intermittent pneumatic compression therapy as an adjunct to standard decongestive lymphatic therapy in patients with stable post-mastectomy arm lymphedema.
Conversione File Txt Xml Format. Study design: Randomized, cross-over, 2 month study with 6 month follow-up Patients and methods: 29 patients with postmastectomy arm lymphedema and without evidence of active cancer were enrolled. Patients were randomized into two groups.
Patients assigned to Group I were asked to continue their routine maintenance therapy with use of a Class II compression garment and self–applied manual lymphatic drainage (MLD); patients assigned to Group II were asked to use the intermittent pneumatic compression (IPC) pump for 1 hour daily (40-50mmHg) in addition to conventional therapy (garments + MLD). All patients crossed over to the alternate therapy after one month. Patients who elected to continue chronic use of the pump were evaluated after 6 months. Clinical evaluation was performed at the beginning of the study, after the first and the second month and after six month follow-up.
The evaluation included tank volumetry, skin tonometry, and measurement of range of motion. Results: 27 patients completed the study. Two patients voluntarily withdrew. There was a mean volume reduction of 89.5 ml during the month with IPC and volume increase of 32.7 ml during the month of routine maintenance therapy. The difference was statistically significant (p. The Lymphedema Unit, Department of Plastic and Reconstructive Surgery, Lund University, Malmo University Hospital, Malmo, Sweden. Hakan.brorson@plastsurg.mas.lu.se Breast cancer is the most common disease in women, and up to 38% develop lymphedema of the arm following mastectomy, standard axillary node dissection and postoperative irradiation.
Limb reductions have been reported utilizing various conservative therapies such as manual lymph and pressure therapy. Some patients with long-standing pronounced lymphedema do not respond to these conservative treatments because slow or absent lymph flow causes the formation of excess subcutaneous adipose tissue.
Previous surgical regimes utilizing bridging procedures, total excision with skin grafting or reduction plasty seldom achieved acceptable cosmetic and functional results. Microsurgical reconstruction involving lympho-venous shunts or transplantation of lymph vessels has also been investigated.
Although attractive in concept, the common failure of microsurgery to provide complete reduction is due to the persistence of newly formed subcutaneous adipose tissue, which is not removed in patients with chronic non-pitting lymphedema. Liposuction removes the hypertrophied adipose tissue and is a prerequisite to achieve complete reduction. The new equilibrium is maintained through constant (24-hour) use of compression garments postoperatively.
Long-term follow up (7 years) does not show any recurrence of the edema. Publication Types: Review Review, Tutorial DIAGNOSTIC IMAGES.
Ever experienced puffy ankles, slightly swollen legs at the end of a day or after a flight? Do you sometimes find lymph drainage an issue? Then you’ve experienced the perfectly normal occurrence of oedema. However, over the summer I had a couple of clients come to see me who, whilst not why they had made the appointment, were actually suffering from quite a bit of oedema. Oedema is the accumulation of fluid in the tissues, caused by failure of the lymphatic system to drain properly. The area is swollen, and there may be pain and heaviness. - p76 So here’s the thing.
Our lymphatic system is one of the most incredible mechanisms within our bodies, yet it was only discovered in the seventeenth century (I love proof that our understanding of anatomy is constantly developing). It is our front line in defence, works tirelessly to keep us fit and well, but when we are ‘under the weather’ or really quite unwell, it could do with some support. But as with so much about our own bodies, it’s often confusing to know what we can / can’t / should / ought to do.
So I’ve developed a DIY of self-care for oedema and lymphoedema. Now, I don’t know about your school biology memories, but I don’t remember much talk about the lymphatic system at school, other than something to do with the immune system and white blood cells. So if you’d like more information on the anatomy side of things, I’ve got some a separate article of Lymph 101, including what the fuss is about oedema, the difference between this and lymphoedema, and what to look out for.
Oedema and lymphoedema can be greatly improved and effectively controlled with some simple exercises and ‘lifestyle tips’. However this does come with a major caveat: If you have any of the 'red flags' outlined in the article, or the cause of your swollen limb(s) has not been identified, it is really important that you get yourself checked out by a medical professional before undertaking any further self-care. I don't write this to scare you, but it is more important that if there are any doubts, it's always best to ask your medical team - they and you are the experts on your body. However, once you are given the all clear or the swelling is something you are used to, if you occasionally suffer from puffy ankles, or are fundamentally fit and healthy, and happy just to crack on with helping yourself and your lymphatic system, here you go. Self care Skin Brushing If you do not have sensitive, stretched or taut skin, a brilliant way to stimulate your lymphatic system is with skin brushing.
A, along with a ‘how to’ video has been put together by Sue Hitzmann, Creator of MELT Method®. Exercise Given that our muscles act as pumps for our lymphatic system, moving and exercising is a great way of getting the lymph moving. If you are wanting to undertake some exercise, it’s always a good idea to check with your GP particularly if you have been diagnosed with lymphedema, or any other condition which may put additional pressure on your lymphatic system. Swimming is great place to start because the water will help to support your body weight and will encourage lymphatic drainage (even if you can’t swim, moving in water is hugely beneficial).
Likewise, Yoga, Tai Chi and some Pilates classes will provide a gentle form of exercise with some relaxation - do please talk to the instructor before any class about your condition(s) and any limitations you may feel. Finally, if it hurts, stop and get it checked out by a medical professional. Specific exercises A number of exercises can be done slowly, and gently, mostly while sitting down, so whether you are at home, in bed, in a meeting or on the bus, you know you can be doing something to help. The first thing I would suggest making sure you do though, is to activate your lymphatic system. This is really easy to do and comes back to the system’s role as part of the circulatory system - the primary ducts for returning lymph fluid to the circulatory are just below our collar bones, so by gently placing your fingertips below the middle of your collar bone and either lightly drawing down and in towards your breast plate, or by lightly tapping (think rain drops) on the area, your lymphatic system will be stimulated.
The next step is to slowly use your muscles to start to move your limbs, to pump the lymph back from your extremities to your trunk. Well let's work on the basis that the swollen limb is a hand or wrist. Throughout these exercises, breath slowly and deeply, preferably from your belly, and move slowly and with awareness. • Stimulate your lymph by lightly tapping your breast bone below your collar bones for a few minutes • Moving slowly, circle your shoulders forwards for several rotations, breathing slowly and deeply from your belly as you do this • Moving slowly, circle your shoulders backwards for several rotations, again slowly breathing from the belly • One at a time, pop one hand on the same shoulder and draw small forward circles with your elbow, slowly increasing in size. After a few rotations, change directions • Repeat the elbow circles with the other arm • Slowly bring one hand towards your shoulder then extend it outwards, in time with your breath. Complete this a few times and again swap sides • Gently rotate your wrists, firstly inwards, then outwards • Finally, slowly and gently clench your fist and then stretch it outwards a few times • To finish, place your hands on your abdomen and breathe deeply for a few breaths • Afterwards, if it is possible, keep your swollen limbs slightly elevated, above your heart for a few minutes You can also do something similar with your legs, but I would suggest stimulating the upper body with the above exercise first.
Remember gravity is working against your lymphatic system, so clench your fist from time to time if you are walking, rest your arms on the arms of the chair when sitting for a while, wriggle your toes and practice ‘good toes, naughty toes’ (for those who didn’t do ballet as a tot, point your toes out long for good toes, then push your heels away and lift your toes to the ceiling for naughty toes). General advice • Avoid cuts, grazes, scratches and bites, and if any of these happen, clean the area properly and use an antiseptic solution immediately. • Wear gloves in the garden and when doing the washing up • Use an electric shaver when removing unwanted hair. • Never allow the affected limb(s) to become sunburnt and keep the skin supple and moist - the Lymphedema Society recommend aqueous creams. • Avoid tight clothing or jewellery • Avoid putting heavy strain on the limbs, and if you are doing gentle exercise, such as swimming or yoga, your limb should not ache with tiredness, otherwise you’ve perhaps worked too hard. Finally: Do not exercise or massage any area if you have an infection, cellulitis or a change in the appearance of your oedema or lymphoedema. If in any doubt, please get it checked out by a medical professional.