Understanding Lymphedema Treatment
Arline Kallick: Thank you. Hello everyone. We’re happy to have you with us this evening. Our call will begin tonight with our speaker, followed by a question and answer session, and then end with small group discussions. Please consider, there are many people waiting online to ask a question, so try to limit the question if possible. Please remember, also, this cannot be a private consultation. If we go into the group before you have the opportunity to ask your question, you can address it in the group with our counselors or call the 24-hour Y-ME Hotline at 800-221-2141. Our website is www.y-me.org. Registration for the ShareRing calls can be done online and transcripts of each ShareRing call is available approximately seven days following the call online.
Tonight’s topic is Understanding Lymphedema Treatment and our speaker is Julia Osborne. Julia Osborne has a very diversified physical therapy career for years and has practiced in hospital and outpatient settings in South Africa, England, and the United States. Several years ago Julia became specialized in the areas of oncology rehabilitation, outpatient post breast surgery care, post radiation care, and lymphedema management. She has established and runs one of Denver’s Oncology Rehabilitation Clinics and has recently expanded her care and level of expertise to scar tissue management and post breast reconstruction surgery care. So we have an excellent speaker this evening and we’re so happy to have her back. You probably may all remember that in December our program had to be cancelled because of the terrible blizzard in Denver and we’re happy to be able to reschedule.Welcome Julia.
Julia Osborne: Thank you Arline; and, yes, I’m very happy there’s no blizzard tonight; and thank you for that very nice introduction. Good evening everyone. Thank you for being on this call with me and I really hope to be able to provide you with some valuable and helpful information about the treatment of lymphedema. Some of you on this call might have heard my presentation in August last year on lymphedema prevention and if any of you on this call this evening are hoping to hear and learn about what lymphedema is and how to prevent it, then please be sure to look up my previous talk on the Y-ME website. This presentation tonight is specifically about the management and treatment of lymphedema. However, even if you don’t have lymphedema and you are on this call, it will still be helpful for you to hear what I have to say.
So let’s move on to our topic for this evening, the Treatment of Lymphedema. The first question you might be asking yourself is: Why is it important for us to even talk about this? You might be thinking that surely your healthcare professional treating your lymphedema would know what they are doing. Well, yes, I’m sure they do, but there are many different types of lymphedema treatment forms out there and there are many different types of therapists out there performing these treatment forms. So what I want to do this evening is to empower you with your own knowledge of what to expect and when you are being treated for lymphedema what to look for to insure that you are getting the best possible treatment that you can get. I also wish to enable you to become your own advocate for the best treatment possible. Tonight we will discuss what type of healthcare professional you should seek out to do your treatment, what the hands-on lymph drainage technique is about, how the lymph fluid in your arm is drained and where it is drained to, what to do at home, how to exercise, why bandaging and compression is important, and then a brief discussion about medication.
First, I think we should clarify exactly what lymphedema is. When you go through breast cancer surgery, you mostly in most cases have removal of lymph node; and that may be followed by radiation. Well in both of these cases, the capacity of your lymph system of your arm on the affected side is decreased. In other words, the optimal working of your lymph system in the arm on your infected side is altered and therefore if you overstress your lymphatic system in your arm and it cannot cope with the increased amount that you are placing on it, fluid backup in your arm results. This is essentially what lymphedema is. It is fluid backup in your arm from overstressing the lymphatic system. I want to stress though that if you have lymphedema, it is not your fault. Please don’t blame yourself. It simply results from inadvertently overstressing a structurally damaged system on your affected side and it is somewhat out of your control.
When you are faced with lymphedema, then you are faced with a challenge of finding the best treatment possible for yourself. As with everything these days, you have choices. If you look up lymphedema treatment, you might find several types of options. The best option you should choose is to go to a certified lymphedema therapist. This person is certified in the medical treatment of lymphedema and uses specialized lymph drainage techniques to minimize the volume of swelling in your affected arm. This is not the same as lymphatic massage. Lymphatic massage is a lymph cleansing type of massage and while this is a wonderful and excellent treatment form, this type of work will not specifically treat your medically induced lymphedema; and that’s what I’m trying to emphasize here. Your lymphedema, as a result of breast cancer surgery, is essentially a medical condition. So to have a lymph cleansing type of massage will not really help your medical condition. You need to be treated by a certified lymphedema therapist. Also, a spa type treatment of lymph cleansing, while it is good for you as well, this will not specifically treat and minimize your lymphedema either. So be sure to find yourself a certified lymphedema therapist. Your physician should be able to direct you to the right kind of therapist, but in case they are unable to or cannot find anybody in your area, there is a wonderful website called The Lymphedema Network. On it is a list of certified therapists that you can access. So, again, the website is The Lymphedema Network and it is www.lymphnet.org.
Once you have found your certified manual lymph drainage therapist, what can you expect to happen as you start your treatment? Well the first thing that should take place is that your therapist should take measurements at certain positions along your arm to get a baseline measurement of the volume of fluid in your arm. Then your therapist should proceed with a technique called manual lymph drainage. The idea behind this treatment is to work using our hands from the top of your arm or shoulder down to your hand so as to clear a path for fluid to move up your arm as you are being treated, up your arm and out into your trunk. The fluid gets directed by the hand movements of your therapist into specific pathways that are alternate pathways from the normal ones that are now blocked. So it is really important to have somebody who knows exactly how to do this. You now have certain channels that are blocked and if lymph is pushed into these channels, it can actually make your lymphedema worse. You really want to have somebody who knows how to remove lymph from the blocked channels and redirect it along alternate channels so that your fluid levels in your arm can decrease. Manual lymph drainage is a light touch hand pumping technique that will increase the speed, increase, I’m sorry, speed up the movement of lymph fluid along your lymph vessels in your arm.
