Newsletter 13

JM Remedial Therapy & Lymphoedema Clinic
5-7 Albany Forest Drive
Albany Creek Q. 4035
Ph: 07 3264 6698

Newsletter Issue number 13

Points of interests

From the desk
Our special – 20%off stockings
Gynecological cancer and massage
Lymphoedema following hysterectomy
If it is to be – It is up to me!

Message from The Lymphoedema Association of Queensland (LAQ)
Snippets about Lymphoedema

Enjoy a light hearted salmon receipe

From the desk

Dear Friend and Client,

It has been some time since my last newsletter. Many changes have occurred with the running of the clinic. I am working on my own at the present time and find it quite consuming to practice massage and the Complex Lymphatic Therapy as well as looking after reception and bookkeeping.

I have also been involved more with lymphoedema awareness. Dr Jane Turner from the University of Queensland stated in the latest Node News on the subject of lymphoedema that: "Information allows us to feel more in control. Lack of information leads people to imagine the worst, to become more anxious, depressed and uncertain." 

It is recognised in many studies regarding quality of life for people suffering from lymphoedema that there is a general lack of action regarding seeking treatment for lymphoedema maybe because it is not well diagnosed. It is important to be aware that there is no cure for lymphoedema but a good management program can restore faith in someone's ability to enjoy life without the heavy burden of uncertainty.

I have also spent some time writing to the Australian Taxation Office to have my massage and Complex Lymphatic Therapy accepted as GST-free services for clients visiting the clinic with a referral from their doctor. Unfortunately I was unsuccessful in this endeavor. I have been researching cheaper options for garments with suppliers. It all takes time and effort and I can only move forward slowly. The good news is that there is a garment on the market for approximately half the price of the existing ones. Please enquire at the clinic.

I have a special for this end of the financial year until 15th July for the quality knee high cotton compression stockings black and beige. The normal price is $97.30, and they are now reduced to $77.60. This is 20% off the RRP. The stockings offer great support for extra long days, relief from tired and aching legs. In addition they are great for prevention of venous disease particularly when flying. They look fashionable and professional for men and women

I hope that you will find this newsletter interesting. Please send me an email some time and let me know if you like it and if you would be interested in other topics.

Meanwhile enjoy it!

Best regards
Jeanine

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20% off
Quality knee high cotton compression stockings black and beige
Until July 15th

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Gynecological cancer and massage

The diagnosis of cancer has an incredible impact on people. The biggest emotion is fear followed by anxiety and stress, which can worsen the symptoms, especially pain. A few studies have been conducted to assess the psychological effects that may develop in women following hysterectomy. Depression is the most common risk mentioned. The loss of the uterus and scarring after surgery may result in impairment of body image, which includes the perception of a loss of femininity and vitality (1).

Massage cannot treat cancer as such, but it can reduce some of the symptoms such as pain, muscular tension and swelling. Relaxation massage is often recommended to patients as a coping strategy to promote psychological wellness. Studies indicate that regular massages produce marked reductions in stress levels, anxiety and depression as well as an improved mood and sleep patterns. There is evidence that patients having massage before undergoing chemotherapy fare better and report less anxiety (2). While there are instances when massage is not advised, sometimes all that is required is a technique adjustment.

Massage is a very effective tool to improve coping ability with cancer treatment relieving anxiety and depression symptoms and reducing pain. It has been stated that when you are free from stress great success and abundance will naturally flow to you.

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Lymphoedema following hysterectomy

The management for gynecological cancer can include surgical removal of the ovaries, fallopian tubes, uterus, cervix and lymph nodes in the pelvic area. When lymph nodes are removed the lymphatic drainage is compromised and women are at risk of developing lymphoedema.

Lymphoedema means swelling of an area of the body usually accompanied with a feeling of fullness, aching, weakness and decrease in range of movement. In this instance, the abdomen, one or both legs and feet may mildly or significantly increase in size. There is no cure for this condition but prevention and good management should keep it under control.

The Complex Lymphatic Therapy (CLT) is lymphoedema's best choice of treatment. It includes exercise to help restore strength, flexibly and pump the lymphatic system, lymphatic drainage massage and bandaging to remove fluid from the tissue and reduce the limb size. After a reduction of swelling, it is advised to wear a compression garment and bandaging or compression night wear to maintain the results. 

Early detection and management of lymphoedema is crucial, as it prevents symptoms development and the financial burden attached to the intensive treatment. Do not wait until the limb is excessively swollen or deformed. Often, all that is needed is to wear a pair of compression stockings regularly as soon as the first symptoms appear.

Prevention is also better than cure. Studies have shown that cancer patients who have a good skin care routine and exercise regularly after surgery are less likely to develop lymphoedema.


 Photos copyright JM Remedial Therapy & Lymphoedema Clinic, June 2011

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"If it is to be, it is up to me!" 

The biggest problem with lymphoedema is complacency – doing nothing because it may just go away. Lymphoedema is not like that. Swelling may first be due to surgery or as a side effect of medication and resolve itself in due course. However the swelling due to a problem with the lymphatic system generally does not go away.

Many people are frightened when learning that there is no cure for lymphoedema and the thought of wearing a stocking or armsleeve for the rest of their life daunting very understandably.

The longer you wait, the more expensive is the treatment. Once the limb is deformed or grossly swollen, you need to wear a custom-made garment, which is twice the price of a ready-to-wear (RTW) garment. You may need bandaging prior to wearing a compression garment, which accounts for 7 to 10 days one to two hours of treatment to obtain a reduction in swelling. The bandages are expensive and cumbersome to wear and you may want to take some days off work.

The initial visit is for one hour and half and includes going through your medical history, taking your measurement, BioImpedance Analysis to establish your lymphoedema Index, and 30 minutes lymphatic drainage. Basically I am gathering data for the next step and establishing a base line to monitor improvement and any hanges in lymphoedema. Depending on the amount of swelling, I may even take your measurement for the garment. Most likely, I would like to see you for a second one hour visit for another lymphatic drainage and then measure for the garment. Depending on the type of garment you choose, if it is ready-to-wear or custom-made, and if it is in

stock at the clinic, you may be well on your way to manage your lymphoedema. I may only see you for a follow-up session after a week and in six months for a review

of your garment. Ideally, you must be able to manage your condition with a self-management program, which I teach you during the treatment.

Of course no two people are the same. The lymphoedema treatment above mentioned concerns an early detection and early treatment of lymphoedema. So "If it is to be – It is up to me!"

                                          

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Message from the Lymphoedema Association of Queensland (LAQ)

Is the cost of Lymphoedema treatment prohibitive for you?

The Lymphoedema Association of Queensland has a supply of good quality used bandages to assist their members in reducing the cost of their Complex Lymphatic Therapy and ongoing maintenance.

Please contact the Association on 07 3269 1498 to enquire about Membership

 

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Snippets about Lymphoedema

Snippet 1
Women seeking help after treatment for gynecological cancer and receiving inappropriate advice with as many as three assessments prior to referral to lymphoedema specialists…
Women at risk need to know early signs and symptoms and where to seek early care.

Mary Ryan, RN, BN(Hon)1, Colleen M. Stainton, RN, BSN, MN, DSN2, Carmel Jaconelli, RN, DipApplScience(Nurs), GradDip(MedSurgNurs)2, Sally Watts, RN2, Patricia MacKenzie, RN, BA2, Tamar Mansberg, 

Snippet 2
Women most at risk for developing lower leg lymphoedema are those who had treatment for vulvar cancer with removal of lymph nodes and follow up radiotherapy.  
The finding that lower leg lymphoedema occurs within the first year is earlier than hitherto generally believed. It is therefore imperative for all health professionals to include care and assessment of the legs particularly during the immediate pre- and postoperative period. 

Aetiology and prevalence of lower limb lymphoedema following treatment for gynaecological cancer
Aust N Z J Obstet Gynaecol. 2003 Apr Ryan M, Stainton MC, Slaytor EK, Jaconelli C, Watts S, Mackenzie
 

Snippet 3
Patients who had 10 or more regional lymph nodes removed at initial surgery appeared to be at higher risk for developing new symptomatic leg lymphoedema. Patients 
undergoing surgery with lymphadenectomy for uterine corpus malignancy should be informed about the possibility of postoperative new symptomatic leg lymphoedema.

The incidence of symptomatic lower-extremity lymphoedema following treatment of uterine corpus malignancies: a 12-year experience at Memorial Sloan-Kettering

Gynecol Oncol. 2006 Nov
Abu-Rustum NR, Alektiar K, Iasonos A, Lev G, Sonoda Y, Aghajanian C, Chi DS, Barakat RR. Gynecology Service, Department of Surgery, Memorial

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Receipe

Light salmon dinner

Ingredients
4 pieces salmon fillet 
1 bunch baby pak choy
1 tablespoon vegetable oil
2 tablespoons light soy sauce
Juice of 1 lime
2 tablespoons chopped coriander leaves or dill
sea salt and cracked black pepper

Method
Preheat the oven to 200°C . Line a baking tray with baking paper and place the salmon on the tray, skin side down. Season and roast for 10-13 minutes, until cooked to taste.

Meanwhile, blanche the pak choy in a saucepan of boiling water for 2 minutes and drain.

Combine remaining ingredients and pour over salmon. Serve with the pak choy.

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Reference:
1. Risk Factors for Major Depressive Disorder and the Psychological Impact of Hysterectomy: A Prospective Investigation
Ju-Yu Yen, M.D., Yung-Hung Chen, M.D., Cheng-Yu Long, M.D., Yu Chang, M.D., Cheng-Fang Yen, M.D., Ph.D., Cheng-Chung Chen, M.D., Ph.D., and 
Chih-Hung Ko, M.D.
Psychosomatics 49:137-142, March-April 2008
doi: 10.1176/appi.psy.49.2.137
© 2008 Academy of Psychosomatic Medicine

2. Tiffany Fields, at the Touch Research Institute at the University of Miami School of Medicine in the USA

 

JM Remedial Therapy & Lymphoedema Clinic
5-7 Albany Forest Drive
Albany Creek Q. 4035
Ph: 07 3264 6698

Newsletter Issue number 13
 

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