Lymphedema… The unwelcome guest that never leaves!!

imageHaving cancer and going through surgery, chemo and radiation takes its toll but the hope is that after all this life can move on. Imagine however that an unwelcome guest appears after all this, lymphedema. Lymphedema is that dreaded side effect of cancer treatment that remains as a constant reminder of what you have been through. For some people the cancer may return and treatment continues, for them Lymphedema is an added burden that requires their attention 24/7 along with on going treatment. Lymphedema if ignored will flare up and cause even bigger problems such as pain and infection. It effects self-image and impacts on ones quality of life it is also an added financial burden. Lymphedema is the unwelcome guest, post cancer, that never leaves. However we must never forget that some are born with lymphedema which impacts their entire life. However in this story the focus is on lymphedema as a side effect if cancer treatment. Loretta tells us of her experience with Lymphedema after treatment for Ovarian Cancer.

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This is Part 1 of Loretta’s story
“I was diagnosed with Ovarian cancer in March of 2011. I had gone in January to my Gynaecologist for my regular Pap Smear, I received a call to come back as it was irregular. I went back in February and the test was redone this time the results were normal. My Gyn Dr. Daria Klachko said to me she would like to do a cervical and uterine biopsy. That was done sometime in February and that too came back normal. She then told me she wanted me to go for an ultrasound, that was done in March and unfortunately that showed a mass the size of an egg on one of my ovaries. I then went for a CT scan which confirmed the results of the ultrasound. At that point Dr. Klachko referred me to a friend Dr. Mario Leitao who is a gynaecological oncologist at Sloane Kettering hospital in NY. He confirmed by worst nightmare, I had Ovarian Cancer. While we were arranging surgery I said, “please don’t let me get Lymphedema.” I was familiar with Lymphedema, as my older sister had it also from a gynaecological cancer surgery, however I did not at that time appreciate her struggle with it. In June, when I went back to Dr. Leitao, I found out I was indeed very lucky, I had stage 1A clear cell, although clear cell is very aggressive none of the 26 lymph nodes he removed showed any sign of cancer. I had a mix of feelings at this stage, relief that my cancer was caught early and was not in the nodes but some anger too that 26 nodes were removed as I was already having some signs of lymphedema. I told him I was getting some swelling in my left thigh but he attributed it to post op swelling. When I finished with my chemo the swelling was more pronounced and I was diagnosed with Lymphedema. During this time I also had genetic testing done, I tested positive for the BRACA mutation. This was done at Sloane Kettering, they told me that since both my sister’s had cancer and my late father that they had the gene mutation too.

My LE fortunately was very mild at this stage. I was fitted with a 15-20 compression stocking in January of 2012 and went for MLD on a regular basis. I decided not to go to Sloane Kettering for MLD I found a place nearby in New Jersey and a Dr. who was supposed to be a lymphedema specialist.

My husband and I decided to take a trip to France in June, unfortunately we didn’t get a direct flight and by the time I got to Paris my left leg and foot were very swollen. I was frantic, to be away from home and trying to deal with an ever-swelling leg, my low compression stockings were no help at all. I bought new sneakers and tried to elevate and rest as much as I could but I was in Paris!! Then a river cruise on the Rhone, so how much could I elevate? It was at this stage I started to realise the true effects of lymphedema. When I came back I went to the Dr. in NJ and showed her the swelling, which by that time was out of control, the only thing that helped was staying in bed off of my feet. We upped the compression but still nothing helped. This was a miserable and worrying time being unable to control the Lymphedema and the impact it was having on my life. It was at this point I called my surgeon and asked if he could get me into The Sloane Kettering Lymphedema program. At Sloane Kettering I was bandaged but didn’t do well with the compression. The first night I felt like my foot was on fire but kept the bandages on until the next day, when I took them off I had sores behind my toes. Needless to say I didn’t bandage again. However I tried a ready wrap and that worked. At this point I was hoping to find some other help for my Lymphedema as I was having such difficulty controlling it.” Loretta

Thanks Loretta for sharing with us how your lymphedema started in the second part we will hear about Lorreta’s Lymph Node Transfer and her time in hospital… Remember March is Lymphedema Awareness Month and by telling our stories we allow people to understand the impact of Lymphedema on our lives.
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Feel free to share with others. It can be distributed via social media, reblogged or added to websites. Please do not change the original content and provide appropriate credit by including the author’s name and a link to this blog.
https://lymphnodetransplant.wordpress.com/ Thanks

Help with self-care… Videos

These two videos were created at Mt Wilga Rehabilitation Hospital so that people who could not come to the hospital for therapy could benefit from their program…. One video is for lymphoedema of the arm and the other for legs. Some of the video content is duplicated but has individual topics for legs and arms.. The portion which shows self massage is very important for self-care. What I have learnt is the importance of clearing the abdominal area… The “basin” which is the area below the rib cage between the hip bones and pubic bone. Using abdominal breathing and then massaging into this area, to stimulate the many lymph nodes we have in the abdomen, you can actually start to feel the abdomen gurgling when you do this. It is also something you can do several times a day. Remember … Clear the Basin… This is a great help for those with leg lymphoedema as the lymph from the legs can then be cleared upwards and then eliminated from the body. I hope you find these videos helpful..

Feel free to share with others. It can be distributed via social media, reblogged or added to websites. Please do not change the original content and provide appropriate credit by including the author’s name and a link to this blog.
https://lymphnodetransplant.wordpress.com/ Thanks

Primary Lymphoedema Videos

These are two vidoes I found from people living with primary Lymphedema… Both show the importance of assessment and treatment to stop their legs becoming worse and worse.. Every health fund in every country should cover patients for primary and secondary Lymphedema, everyone deserves to have access to treatment. Without treatment people cannot continue with their day-to-day activities.. Lymphedema is no different from any other illness so why is it misunderstood and incorrectly diagnosed. Lymphedema deserves a voice!!

Aquatic exercise for Lymphoedema includes Videos

In my previous post I wrote about returning to the pool and how helpful I have always found this to be. This resulted in a number of questions which I feel are answered in this article from Aqua Lymphatic Therapy. If we can find a group like this or similar it would be great, but I am not going to hold my breath for that!!! I am sure however with this guidance you can put some exercises together yourself.. Tread water, walk in water and use a buoyancy belt or noodle to help….  Join a water aerobics class…. Enjoy

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Water – is it good for lymphedema?
Aqua Lymphatic Therapy
By Dorit Tidhar
Article reprinted from the Spring/Summer 2011 issue of Lymphedema Matters, a publication of the Lymphedema Association of Ontario.

Mrs. G’s birthday is coming up and her husband decided to surprise her with a gift, a day of pampering at a spa. His wife was pleased, yet concerned. She did not know whether a spa would be safe for her lymphedema. She called her therapist for advice. “It seems as if lymphedema does not respond well to high temperatures” said Mrs. G. to her husband. Regrettably, she asked him to return the gift and he decided to buy her a swimming pool membership instead. Was he doing the right thing?

Lymphedema is defined as an abnormal accumulation of a protein-enriched fluid accompanied by chronic inflammation, due to the damage or blockage of lymphatic vessels. People with lymphedema, or at risk of developing lymphedema, should adopt strategies in order to prevent or reduce the exacerbation of lymphedema. These include avoidance of trauma or injury, intact skin preservation, avoidance of constriction, use and exercise of the body, arms and legs. On a similar note, exposure to extreme heat could be of major concern. But why? Exposure to high levels of external temperature (hot water bottles, electric blankets, hot tubs and jacuzzi) causes the capillaries in the skin to dilate; this may lead to an increase in interstitial fluid and can exacerbate existing lymphedema, or trigger the beginning of lymphedema. Therefore it is highly recommended to avoid direct heat applications on the affected area. Sauna or steam rooms do not project direct heat to the skin (heat transfer is much slower in air than in water). Nonetheless, they can cause elevation in body temperature and lead to the worsening or development of lymphedema.

A safe temperature is one that will not elevate body temperature and as a result will not cause the response of vasodilation in the skin. Is there any optimal temperature, or a “safe” temperature? A safe temperature
depends on several factors: The activity that is being performed in the water (whether it is just immersion such as sitting in the tub or swimming), the duration, and the medical condition of the person. Immersion alone is likely to be safe up to 35°C. Consequently, hot baths or jacuzzi are probably hazardous since the temperature is usually above 38°C (100.4°F). When exercising in water, the temperature should be adjusted to lower levels: 29 to 33৹C (84-91.4৹F) is considered to be safe. Importantly, when swimming or exercising in aqua fitness, the temperature of the water needs to be cooler than when one is just walking in the water.

It is important to get physician clearance before participating in any pool activity, and to check the sanitary condition of a pool. Interestingly, the bacteria that causes erysipelas (cellulitis) is not present in pool water, but is actually harbored on the skin. Intact skin preservation is of utmost importance.

Beyond safety concerns, one should ask the question: what types of exercises in water could be of benefit to lymphedema treatment?

Compression garments are generally recommended to treat lymphedema. These garments apply gradient force from higher to lower pressure. Hydrostatic pressure applies its force with an analogous mechanism to compression garments. Importantly, the pressure gradient by water exceeds the pressure gradient by compression garments. Hydrostatic pressure increases directly with the depth of water. When immersing in water, the addition of each centimeter of depth will increase the hydrostatic pressure by 0.73 mmHg (1.85 mmHg/inch). For example, the pressure on feet at a depth of 100 centimetres, would be 73 mmHg (more than a pressure applied by a class 3 compression garment). This pressure is pleasant and imperceptible. In addition, the pressure exerted on a body that is immersed in water is equal from all directions at every depth. This is of utmost importance as some parts of the body (i.e. chest, breast, genitals, ankles, wrist, fingers and toes) often do not experience equalized pressure by compression garment or by bandaging.

Lymphotome is a skin area that drains lymph fluid into regional lymph nodes. For example, the chest lymphotome drains the skin of the arm, front and back chest into the lymph nodes under the armpit. Excess lymph fluid has to pass through healthy lymphotomes and into functional lymph nodes. Immersion in water may be insufficient for treating lymphedema. Hydrostatic pressure lacks the ability to redirect the lymph fluid to healthy lymphotomes. Therefore, there is a need for supplementary exercises such as the Aqua Lymphatic Therapy (ALT) – the Tidhar method©.

ALT is based on the Casley-Smith remedial exercises and uses the same principles, yet in an aquatic environment. The method uses the anatomical principles of the lymphatic system and the force of the water to achieve the goals of lymphedema therapy. The water temperature ranges from 31°C to 33°C (78.8-91.4°F). This temperature enables slow movements in a safe way that will not cause increased swelling. The buoyancy force enables elevating of the limbs and thus performing exercises and self massage with minimal effort. The hydrostatic pressure of water increases lymph and venous flow, thereby protects the limb from swelling and reduces edema. Chronic lymphedema of the limbs can cause muscle weakness. The viscosity of water provides resistance to body movements. ALT uses different ways to minimize water resistance:

• Reducing the surface of progression (for example, in lymphedema of one arm, side walking instead of frontal plane walking)
• Moving through the water in a slow and gentle manner
• Exercising certain movements with flexed instead of stretched extremities
• Over time the resistance will promote strengthening as well.

The sequence of exercises in ALT is important. First, healthy lymphotomes are activated proximally with breathing exercises in order to clear the reservoir. Second, proximal movements of the thorax, abdomen and shoulder girdle are performed in conjunction with self-massage. Lastly, exercises are performed to clear the affected lymphotomes into the healthy ones by performing self-massage and movements that involve distant joints of the limbs (ankle, wrist etc)
ALT is usually performed in a group setting, in which people with similar conditions exercise together. Each session lasts 45 minutes. Once a week, meas- urements of limb circumferences are taken before and after each session to enable the participants to receive immediate feedback on their performance and on their progress between sessions. It is recommended to bandage the limb or to wear a compression garment immediately after an ALT session in order to preserve the volume reducing results of the treatment.

The ALT method was studied in a randomized controlled trial published in 2009, in which 48 women with lymphedema of the arm were divided into study and control groups. The study group participated in a weekly session of ALT and both groups were supposed to keep on performing self management therapy (included self massage, use of compression garment or bandaging and remedial exercises). The women were treated for 3 months and arm volume measurements, quality of life and self-management care were evaluated. Quality of life improved over the 3-month intervention in both psychological and social dimensions in the ALT group while the control group saw a decrease in quality of life over time.

There was a mean volume reduction of 54 ml after the first ALT session and a mean reduction of 98 ml after the last session. These differences were statistically and clinically significant. However, these reductions were not maintained over the study period. This could be due to low adherence (28%) with compression sleeve wearing. ALT was found to be safe as no woman experienced infection during the intervention period. On a similar note, ALT was found to improve strength, shoulder range of motion, pain and disability in a second randomized control pilot study (unpublished data; 2007).

Mrs. S had lymphedema of the left leg due to removal of inguinal lymph nodes and radiation after gynecological cancer surgery. She suffered from 23% volume increase in her lymphedematous leg as compared to her healthy right leg. After an intensive therapy of Complex Lymphatic Therapy (CLT) her lymphedema reduced to 3% volume difference and was maintained for 6 months. Following an allergy attack and a second tumor removal from her genitals, her lymphedema worsened and reached 17% compared with her healthy leg. Swimming 3 times a week and wearing the compression garment did not stop the exacerbation. She could not afford to take time off from her work once more for intensive CLT. Fortunately, 2.5 years later, an ALT program was launched close to her home. She attended the group sessions once weekly for 18 months. Furthermore, she wore a compression garment during the daytime between sessions and continued swimming twice weekly. In 4 months she reduced her swelling from 17% to 2% (-88%change) and maintained that for the rest of the year.

In summary, an aquatic environment is safe as long as it is being used in accordance with the principles discussed above. ALT is a method that can improve lymphedema and maintain the results of the intensive therapy. When summer comes dive in and take the pressure off your limbs!

Dorit Tidhar was trained in lymphedema therapy by Prof. Judith Casley-Smith in 1999 and was certified by her as a teacher in Self Management and Exercise for Lymphedema in 2003. Dorit designed a program of Aqua Lymphatic Therapy to help people who suffer from lymphedema maintain and improve results of conventional treatment. She is an active member of the steering committee of the Israel Lymphatic Interest Group of Physiotherapists. She has published five articles in scientific journals. She is now working at the McGill University Health Centre’s Lymphedema Clinic in Montreal as a clinician and instructor. She is coordinator of the educational program for lymphedema therapists and nurses in various subjects related to lymphedema.

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Thank you for this article Aqua Lymphatic Therapy ALT and Dorit  Tidhar  http://www.aqua-lymphatic-therapy.com/ If you wish to know more please click on this link…

Breathing before starting the exercises

Self massage in the water

Video to show an Aquatic exercise for Lymphedema of the legs.

Video to show Aquatic exercise for the arm.

Learning to Live with Lymphedema

When ever I see post of people’s experience with Lymphedema I feel it is so important to share by reblogging.. Everyone’s story is personal and different but people need to understand what it is like to live with Lymphedema and the change it makes to people’s lives… Thank you Denise for opening a window to your Life with Lymphedema…. Helen

denise4health & hello COURAGE

LymphedivablogWhen the title of this Blog Post entered your Inbox, let’s face it, your heart did not go pitter patter with excitement.  Please try to stick it out!!!  You will learn something and I will attempt to give you a few laughs along the way!   You and your Lymphatic System have something in common–   misunderstood and under appreciated. There are 500 to 700 lymph nodes in the body. Who would think if you have one or a few of those removed, in my case 14, it could cause so much trouble?

My Lymphedema was under control until I picked up those 3 plastic bags of groceries with my impacted arm and then my POOF of Lymphedema came back with a vengeance. Now you cannot yell at me because admit it, you have done it and later regretted it even if you have no chance of Lymphedema.  Who wants to…

View original post 1,328 more words

The Daily Routine… Self massage videos

I get very bored with the daily routine, so I like to have a variety of videos that I can use so that I can mix it up a bit!!! Every video gives you a slightly different regime and method, or though the basics are the same. I often find it easier to follow a video while I work on myself so that I do not cheat and skip bits!! Some days I skip the MLD and do plenty of breathing and exercises to stimulate the lymphatics, other days I use MLD either in the morning or evening. However as we all know it takes time and effort to do all this, but if we do not our limbs get worse! If we can make it interesting it helps…

I found the following videos from Michigan State University Rehabilitation, the therapist is Heidi Roe. I like them as they give clear instructions as to how you should use your hands while doing the MLD, it is a cupping motion. I also like the knee work she demonstrates as my main swelling is in the middle of the leg. I hope you find them useful too.

Video of upper body self massage for Lymphedema by Heidi Roe

Video of lower body self massage for Lymphedema by Heidi Roe
This one helped me as it shows massaging around the knee area.

Video of self massage for lower leg and ankle by Heidi Roe
This is a great video as many people experience their worst swelling in the lower leg and ankle so this is really helpful.

Exciting news from New York… Nodes are growing!!!!

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Lymph node showing Lymph Vessels Google images

Imagine my excitement this morning when I got an email from Jennifer in the USA. Jennifer had a Lymph node Transplant two years ago in New York, her surgeons were Dr Corrine Becker, Dr J. Levine and Dr Julie Vasile. The first part of her story is posted in “Two years after Lymph Node Transfer In New York“. She had some fantastic news which I will post in her own words.

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Showing Lymphatic vessels and the valves that stop the back flow in the vessels.. Google images

“Follow up visit – 2 years post surgery:
Last year, in April, 1 year after my actual lymph node surgery, I had an MRI that showed the 3 nodes implanted and the very beginning of the lymph vessel growing. They referred to the nodes as small. But my surgeon explained that all nodes are small…
I had a 2nd MRI in March of this year and received results in May at my follow-up appointment. The news was very good! The nodes are visualized, there are actually 5 on the right side (including the 3 newly transplanted ones) and 2 lymphatic vessels connected and growing. From what I understand, a lymph vessel has reached half way down to my knee, and it is 1 millimeter in diameter. When I asked if that was a good sized diameter the Dr. responded, “That’s like a Highway!”
So, I left the appointment with a lot of hope. I was told that my leg was continuing to do well, the tissue feels very soft and moveable.
The reality though is I still wear a compression stocking during the day and a tribute sleeve at night. It was suggested that I try going without the stocking during the day at times when I am active, as in walking around, moving about, no long time standing/sitting in other words. Hard to do!! I am complying by not putting the stocking on first thing when I get up. I do morning routine stuff for about 1 hour. I am leery of this because I am so conditioned not to let any additional swelling take hold. I might take a bike ride without a stocking, and see what happens. Oh the freedom of not being encased!
In comparison between 2 years ago, pre-surgery and today: I can do so much more physical activity without ‘feeling’ the fatigue, achiness, swelling, etc. I forget what it was like. I just realized this last night, as it had been beastly hot here, and I am doing really well! Don’t get me wrong, it’s still there, the swelling, but it is definitely getting better. My shoes fit better, my toes aren’t sausages, the top of my foot has lost the camel hump (though edema is still trapped there) I see more definition to my knee, I see some muscle definition when I flex my leg (I have to flex pretty hard, but nonetheless!).

We are talking about a second lymph node transfer to the ankle region as well as some “mini lipo” to the outside of the leg where fat has deposited that doesn’t’ belong. This scares me, but I had a consensus of three wonderful doctors who agreed with it. No need to wear permanent stockings afterward, because this is not the ‘debulking’ method, but judiciously removing a little fat from the problem areas. I have an ugly lump where my thigh high stocking ends. It looks like a have a bagel around my leg….Ughh…
The MRI is a super valuable exam as it shows where the fluid is trapped and how much, as well as visualizing the lymph nodes and vessels. Also, it’s valuable for the lymphedema therapist to know this information as well, as they then know exactly where to send fluid for better results.
This is a specialized Lymph MRI I had done at Weill-Cornell in NYC.

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Google images

So, all in all, I feel encouraged and I hope that you will feel encouraged and hopeful as well. We may never have what we had prior to Lymphedema but at least the worst of the nightmare is hopefully coming to an end”…. Jennifer

So it is true they really do grow!!! All of us who are waiting for things to happen Jennifer says, “If you can, to have as much lymphatic massage as possible. In the first few months of the transplant it’s very important. Even if you can self massage as best you can. You want to ‘wake up’ those newly transplanted nodes and get them working full time.”

Thank you so much Jennifer for sharing, it is so helpful to hear other’s progress. Anyone else who would like to share their experience please email me at helenbrd@bigpond.net.au I will change your name if you wish to retain your privacy.
Thanks Helen

Complex Bandaging…. Includes videos..

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My bandages etc…. Photo Helensamia

Self Compression Bandaging for the arm..
Complex bandaging for half leg
Complex bandaging for the leg
Why use foam as part of the bandaging

COMPLEX BANDAGING
The above picture shows my complex bandaging “kit” and the links to the above videos show how the bandaging is done. Please click on the links to view.

Prior to the bandaging a Manual Lymph Drainage is completed to give the limb the best chance of reducing. This procedure can be completed by a qualified Lymphatic therapist, it can be taught to family and friends and can be self administered where possible. There are many other videos on You tube that teach you how. This is especially helpful if local resources are unavailable or there is a lack of health cover for treatment.

“Bandaging consists of four layers: stockinette, cotton wool bandages, foam padding and low stretch bandages, applied in that order.Stockinette protects the skin and absorbs perspiration. Cotton wool bandages also protect the skin and help to produce a regular cylindrical shape to the limb by reducing shape distortions and deep skin folds. Low density foam pads protect potential pressure areas, reduce shape distortions and soften areas of fibrosis. High density foam is used to soften and reshape fibrotic areas. Low stretch bandages are used to apply necessary compression to the limb. They have a high working pressure and a low resting pressure providing a firm but flexible support to the limb, causing tissue pressure variations as the muscles contract and relax against the resistance of the bandages, thereby stimulating the muscle pump. These bandages are applied according to the Law of Laplace in order to provide greater pressure at the distal end of the limb than at the proximal end. Pressure in the tissues is thereby increased, assisting the passage of oedema fluid from the tissues into the lymphatic vessels via the lymphatic capillaries, and lymph flow through the lymphatic vessels to assist drainage. In addition, bandaging helps to soften fibrosis, restore elasticity to the over-stretched skin and re-shape the limb.” Ref.The Adelaide  Lymphoedema. Clinic

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Leg bandaging.. Photo Adelaide Lymphoedema clinic

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Lower leg bandaging.. Adelaide Lymphoedema clinic photo

When I was first diagnosed with Lymphoedema, after much searching, I found a Lymphoedema unit at the Mt Wilga rehabilitation hospital in Hornsby NSW. I spent five weeks driving backwards and forwards everyday, an hour each way, while treatment was done to reduce my Lymphoedema prior to a compression garment being fitted. When I arrived each day at the hospital the bandages were removed and I would have a shower. The therapist then performed MLD prior to replacing all the layers of bandages. I used to feel as if I had a plaster cast on but as the day progressed there would be a little movement possible. On the weekends I bandaged myself, otherwise the bandages were on 24/7 for five weeks. At the end of this time I was measured for a compression garment as it was felt that the leg had reduced as much as possible. I have to say I was very lucky at that time to live in Sydney and to have the help available, also that we had always paid a private health fund as Medicare did not cover this treatment. It is now possible to get five sessions a year covered by Medicare with a special referral from your GP. The importance of the bandaging is to reduce the limb as much as possible, it can be used on a regular basis or when the Lymphoedema flares up due to infection or hot weather etc. I will bandage myself if I am having  a problem but I did return to Mt Wilga for a week in 2009 when I had a bad fungal infection that affected the skin. When you have Lymphoedema you are so vulnerable to infections, so it is important to look after the integrity of the skin and the condition if the limb.

The bandaging works by putting pressure on the muscles which creates a stronger pumping of the lymphatics, it also pushes the lymph into the deeper lymphatic vessels rather than those nearer the surface. The bandages are tighter at the bottom than the top therefore pushing the lymph up the limb towards the torso. Having them on 24/7 ensures this process continues day and night and does not swell again during treatment.

Bandage

Bandage.. Wikipedia

The magic touch!

Beautiful Pink Flowers..... Photo Helensamia

Beautiful Pink Flowers….. Photo Helensamia

Today was my second visit to the physiotherapist, as she wanted to check that the Manual Lymph Drainage and compression stocking were doing their job. I have been very vigilant with my MLD, doing it twice a day and when ever I think about it taking deep breaths and pushing the abdomen in, to stimulate the abdominal lymph nodes. I have noticed that when I do the MLD in the morning I feel a little nauseous after and a slight headache. I think that this is due to the detoxing affect of the MLD and the movement of stagnant lymph around the body. Today the physio did not do a measure but she felt my leg was much softer, the skin not so taunt, abdomen less bloated and the ankle looked far better. The area around the incision in my knee and under my knee felt much softer, though the area of the transplant is quite hard, this may stay as such for a long time. The area looks a little bruised and very swollen still but otherwise shows no sign of infection, as the scar continues to heal. The physio then did MLD, which is so good when someone else does it for you, as I once had a disaster and gave myself mastitis from bringing the lymph up into my breast instead of under the arm. (Always look on the bright side of life). I was pleased to learn I could continue with my compression stocking so long as the leg keeps improving. I never thought I would say I am happy to wear a compression garment!! I did realise after four weeks of not being able to wear it, what a good job they do.

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Compression reduces up the leg which pushes the lymph up towards the abdomen. There are various levels of compression dependent on what is needed. I wear 20-30mmHg.. Google images

Next Monday I am to visit the physio again, this time she will take measurements ready for when I see the doctor on Friday. I am sure he will then give me a new set of instructions to follow! In the meantime I will continue the magic touch of MLD and hope the leg continues to improve.  I can also now bend my leg to 90 degrees and can step normally on the stairs, with strong grip on the banister!

Deep lymph nodes and vessels of the thorax and...

Deep lymph nodes and vessels of the thorax and abdomen. (Photo credit: Wikipedia)

Self massage for Lymph drainage…. MLD …. Six videos

Videos of self massage to help with lymphatic drainage…. Manual Lymph Drainage

 I thought that this set of videos would be very helpful to learn self massage to help with lymphatic congestion. They are created by Heather Wibbels and are very clear and informative. They are available on You Tube and I have given the link to all six videos.. I have not mastered the art of embedding videos yet, at least not from an iPad! Please just click on the underlined links to view. I hope you will find them helpful and remember that if you have had lymph nodes removed, but do not have Lymphoedema, it is still important to self massage, it is very good for building the immune system and  for general good health.

Deep lymph nodes and vessels of the thorax and...

Deep lymph nodes and vessels of the thorax and abdomen.. Photo Wikipedia

The superficial lymph glands and lymphatic ves...

The superficial lymph glands and lymphatic vessels of the upper extremity… Wikipedia photo credit

Thanks to Heather Wibbels for creating these videos and her generous giving of time in the making of them… Thank you

Lymphatics of the axillary region

The American Cancer Socity also suggested I share this link to there web site… It gives information on Lymphoedema after cancer surgery.. Please click on this link
American Cancer Society Lymphoedema… Thanks

American Cancer Society