April 2006 No Excuses - Cut the Fat! Mercy Hosts "Reach to Recovery" Volunteer Training Living With Lymphedema

Healthy Living Newsletter

Living with Lymphedema

A 10-year breast cancer survivor, Anna Deni of Port Huron knows a little about living with Lymphedema. She began contending with the condition directly after she received breast cancer surgery to remove her left breast and lymph nodes.

The body has a network of lymph nodes and lymph vessels that carry and remove lymph fluid from the tissues back to the circulatory system.

Lymphedema is the build up of lymph fluid in tissue that results in swelling usually of the arms or legs.
Lymphedema can occur because lymph nodes or vessels are missing or are not working properly. Known as Primary lymphedema, it is not very common.

Anna Deni of Port Huron compares the swelling in her left hand and arm to her right. Anna has contended with lymphedema for 10 years after she received cancer surgery to remove her left breast and lymph nodes. She is smiling because she plans on contacting her doctor as soon as possible to obtain a referral for certified lymphedema treatment now available through Mercy FITRAC in Marysville.

What is more common is Secondary lymphedema which usually occurs as a result of a surgical removal of lymph nodes, most often occurring with cancer surgery. For example, during cancer surgery, the doctor may remove some of the lymph nodes to determine if the cancer has spread. For others, such as Anna, the lymph nodes may be removed entirely to reduce increased risk of further cancer.

Taking out lymph nodes changes the way the lymph fluid flows in that part of the body, making it more difficult for lymph fluid in the arms or legs to circulate to other parts of the body. If the remaining lymph vessels cannot remove enough of the fluid in the area, the excess fluid builds up, causing swelling.
Anna’s left arm often swells, usually as a result of over use.

Radiation therapy treatment can effect the function of the lymph nodes as well.

Early on, lymphedema may be relieved by elevating the affected limb. The skin will remain soft. If the problem persists, the limb may become hot and red, and the skin hard and stiff.

Lymphedema can occur in other areas of the body as well. It is most often the result of breast and prostate cancers, pelvic area cancers, lymphoma or melanoma.

The symptoms of lymphedema include:
- a full or heavy feeling in an arm or leg;
- a tight feeling in the skin on the arm or leg;
- less movement or flexibility in the hand, wrist, or ankle;
- difficulty fitting into clothing in one specific area such as the sleeve of a jacket or sock;
- a tight feeling around rings, watches or bracelets without having gained any weight.

In addition to contending with swelling, those with lymphedema must work hard to avoid infections, burns and injuries. “I’ve learned,” says Anna, “to avoid hurting my left arm at all costs. In addition, when I have blood work done, vaccinations or need an IV, I have my health care provider use my right arm for injections. If I don’t do this, I know my arm won’t simply swell; it will balloon up or even become infected. You just learn to become cautious, and it helps.”

Anna also knows it’s important to continue to use her affected arm in everyday activities; this helps the arm heal and regain strength. Overuse and strain, however, can result in discomfort, a burning sensation and swelling, so Anna finds balance in her daily life to help reduce her risk.

When Anna’s arm becomes swollen, she elevates it to allow the fluid to return to the main part of her body where her active lymph system picks up the lymphatic fluid and passes it naturally. In addition, Anna used to visit a massage therapist who helped push the fluid back to the main part of her body. Today, she has a machine she uses at home; but the home treatment is time consuming, taking up to three hours to be effective.

Other treatments are also available for those diagnosed with lymphedema. These are generally prescribed by a physician and help to reduce the swelling, prevent it from getting worse, and limit the risk of infection.

Mary Ann Herrmann, MPT, CLT, Mercy FITRAC Center

Although Anna chose to use a massage therapist in the past to help reduce the swelling in her arm, lymphedema should be treated by a health care professional who has gone through special training. It is generally recommended that this treatment be provided by a certified lymphedema therapist, such as Mary Ann Herrmann, MPT, CLT, at Mercy FITRAC. Mary Ann is one of only a few certified lymphedema therapists in the region. She completed her training through the Academy of Lymphatic Studies and is now offering this service to area patients.

This was great news for Anna. “I’m just so excited that I can have my treatments performed by a trained specialist,” says Anna. “This will really help in reducing my symptoms.”

Mary Ann has been a physical therapist for 18 years. She has provided care to area patients through Mercy’s outpatient physical therapy program at one of the three Mercy FITRAC Centers. Lymphedema treatments will be provided through the FITRAC Center, located at 782 Huron Boulevard, in Marysville.

“The lymph fluid that collects in the tissues can be very uncomfortable,” explains Mary Ann. “It can reduce the amount of nutrients that gets to the cells, causing infection and interfering with wound healing. When infection or wound issues occur, patients often are hospitalized. Lymphedema is a long-term condition, but there are therapies that can treat it.”

Mary Ann will utilize her skills as a physical therapist coupled with her training, known as Complete Decongestive Therapy (CDT) to offer treatments including: skin care, massage, special bandaging, exercise, and fitting the patient for a compression sleeve. Utilizing the expertise of a trained therapist, should lead to a shorter course of treatment, and help in reducing hospitalization.

“Lymphedema is a lifelong disorder,” continues Mary Ann. “It is our goal to provide treatment to keep the condition under control. Treatments generally last two to four weeks.”

Lymphedema treatment is covered by most insurance. “As a matter of fact,” explains Mary Ann, “Medicare generally has therapy caps; lymphedema treatment is one of the cap exceptions.”

Like Anna, many area cancer patients and survivors may find comfort in knowing lymphedema treatment is now available locally.

“For those undergoing a total mastectomy for breast cancer,” concludes Mary Ann, “42 percent will suffer from lymphedema in the first year; and 50 percent to 70 percent will see it occur in the following five years. It’s a chronic problem, but is one that can be professionally treated in the area.”

For treatment information, speak to your doctor and request a referral to Mercy’s Certified Lymphedema Therapist at the Marysville Mercy FITRAC Center. To contact Mary Ann Herrmann, MPT, CLT, directly, please call (810) 364-9801.

To find out more about lymphedema and cancer, visit the American Cancer Society at www.cancer.org.

Mercy Regional Cancer Center was recently named “best in cancer care” by the Commission on Cancer of the American College of Surgeons. To find out more about Mercy’s continually expanding array of cancer prevention, screening, treatment and aftercare programs, call (810) 985-1603 to receive the Mercy Cancer Care Annual Report and FREE cancer screening guidelines.

HEALTH TIP
Exercise cures the blues. Stroke survivors frequently experience depression, but a recent study found that patients who exercised were less likely to have persistent symptoms. One hundred stroke survivors were placed randomly in two groups: usual care or an exercise program. After nine months, 25 percent of those getting usual care, but only 7.5 percent in the exercise group had symptoms of depression.