March 6th is Lymphedema Awareness Day!

lymphedema

Victoria LaManna PT, DPT, CLT

March 6th is Lymphedema Awareness Day! The lymph system carries the body’s waste products, dead pathogens, and water. Eventually these substances are cleared by the body. Problems can occur if the lymph system gets blocked and cannot clear these substances. Problems with the lymphatic system can cause swelling in affected limbs, and sometimes pain, as well as fibrotic changes in the skin.

You can be born with issues in your lymph system which can cause primary lymphedema or you can have damage to your lymph system because of surgery or radiation treatments, especially for breast cancer.

If you are living with lymphedema, try these tips from the Mayo Clinic to keep your limbs as healthy as possible:

  • Avoid injections, vaccinations, blood pressure monitoring, or IV’s on the affected limb
  • Don’t wear tight fitting clothing or jewelry
  • Avoid exposure to extreme temperatures, like hot baths, or saunas
  • Monitor your affected limb for signs of infection, and go to the doctor if you suspect infection

 

You can also check out our list of Self Care Tips 

Physical therapy can help manage lymphedema, which requires a very specialized lymphedema certified therapist.  At Beyond Basics Physical Therapy, we are lucky to offer lymphedema treatment with our own Certified Lymphedema Therapist, Victoria LaManna, PT, DPT, CLT . If you are interested in starting your lymphedema treatment journey, call and make an appointment with Victoria today!

For more reading on lymphedema, check out our previous blogs:

Lymph Drainage  Therapy for Breast Health at Beyond Basics Physical Therapy

Beyond Basics’, Victoria LaManna Receives Lymphatic Drainage Therapy Certification

 

Sources
Ness S. Living with lymphedema: Take precautions, get support. 2011. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/cancer/expert-blog/lymphedema-management/bgp-20056387. Accessed February 10, 2017

Lymph Drainage Therapy for Breast Health at Beyond Basics Physical Therapy

Victoria LaManna, PT, DPT, CLT

lymphAs Breast Cancer Awareness Month comes to an end, we at Beyond Basics are working hard to help spread the word on the importance of regular self-examination and early detection. For further review, please see our blog post from earlier this month.

In addition to regular self-examination, regular breast massage is shown to help increase the circulation in your breasts. Therapeutic breast massage can also lessen discomfort associated with breast cancer treatments, help relieve post-surgical symptoms, and reduce discomfort during pregnancy, breastfeeding and weaning. Breast massage also contributes to improved skin tone while promoting relaxation and balancing your energy.
With regular massage, you will help diminish benign breast cysts while helping to flush lymph nodes and stimulating your glandular system. The breasts are soft tissue and do not have muscles to help them move, therefore they require assistance for improved circulation and lymph flow.
If you have been diagnosed with breast cancer and have undergone lymph node removal, mastectomy and/or radiation, you may experience lymphedema. About 15-20% of women who have axillary lymph nodes removed during breast cancer surgery will develop lymphedema. Working closely with your medical team to manage lymphedema is key! A Certified Lymphatic Therapist (CLT) can effectively apply gentle hands-on techniques to help enhance circulation and drainage.
Lymphedema is an accumulation of protein-rich lymphatic fluid in the tissues that contributes to swelling secondary to blockage in lymphatic flow when nodes or vessels are damaged. Individuals who have lymphedema may complain of discomfort in the affected limb, feeling of fullness in the limb, fatigue, or decreased flexibility. They may also complain of breast pain, tight-feeling skin, difficulty fitting into clothes, or tightness when wearing rings, bracelets, or watches. Venous insufficiency and obesity can contribute to lymphedema.

Complete Decongestive Therapy (CDT) consists of Manual Lymphatic Drainage (MLD) that aids in the circulation of body fluids, drains toxins from the body, stimulates the immune system and the parasympathetic system, reduces pain and/or muscle spasms, increases ROM, and decreases swelling. CDT can be used to treat conditions such as post-surgery and scars, fibromyalgia, chronic fatigue syndrome, infertility, painful periods, constipation, and irritable bowel syndrome. In conjunction, it is important to have an exercise program of stretching and strengthening to get the maximum benefits of CDT. After treatment, the patient may experience increased urinary frequency or increased amount of urine, increased sleep time or better quality of sleep, tension release and/or emotional release, or improved senses.

If you are seeking treatment, you need to see a licensed healthcare provider that is trained in Lymphedema Drainage Therapy. To find a specialist in your area, go to www.apta.org and click on “Find a PT”, specializing in LDT. Alternatively, you can search through the National Lymphedema Network or the Lymphatic Association of North America (LANA).

victoria2016Victoria LaManna, DPT, CLT, is our lymphedema expert. If you have had a mastectomy and are unsure about lymphedema care, she is an excellent resource. She will be able to instruct you in self- care and lymphedema prevention measures. Physical therapy can also help to release scar tissue in the breast and upper arm area, regain strength in the arm, and ultimately improve your function. Visit us, and read up on Victoria’s bio here, as well as on our website at: www.beyondbasicspt.com/lymphedema.

Breast Cancer Awareness Month

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Fiona McMahon, DPT

Have you noticed an increase in the amount of pink on just about everything the last couple days? The increase of pink everything is because October is Breast Cancer Awareness Month.  Breast Cancer is an extremely common cancer. According to the Nation Breast Cancer Foundation, 1 in 8 women will be diagnosed with breast cancer in their lifetime. Men can also get breast cancer, however it is much more rare for men to develop breast cancer. Luckily with early detection and treatment of early stage and localized cancer, the 5 year relative survival rate is 100%. That being said, early detection is crucial and it is important to catch breast cancer early to ensure the best possible outcome. Let’s take some time to review the signs of breast cancer and recommended screening protocols.

Signs and Symptoms of Breast Cancer

  • Change of Sensation/ texture of the Breast or Nipples
    • Lumps, change in texture in the breast, nipple, or underarm area
  • Change in appearance of Breast or Nipple
    • Swelling
    • Shrinkage
    • Dimpling
    • Change of nipple orientation
  • Discharge from nipple

Detection

bfab76550709826284e190dd6efc1a76Self Exam

  • Recommend for women of all ages
  • Should be performed every 12 months
  • Check in the shower: move the pads of your fingers over your breasts in a circular motion. If you find any lumps or skin abnormalities, visit your healthcare provider.
  • Visual exam: examine your breasts in the mirror. if you note any changes in your breasts such as bumps, skin changes, nipple orientation, dimpling, shrinkage, or swelling, visit your healthcare provider
  • Lying down: moving the pads of your fingers, check for breast abnormalities. Squeeze nipples to check for discharge. If you find any lumps or skin abnormalities, visit your healthcare provider.

 

Recommended Screening:

Mammogrammammogram-ultrasound-equally-effective-to-detect-breast-cancer

  • Recommended every 1-2 years for women who are 40 years old or older.
  • May be recommended for women who are under 40, but have increased risk of breast cancer.

 

Genetic Testing

brca12For some types of breast cancer, there is a very specific link to a person’s genes and her or his risk of developing breast cancer. BRCA1 and BRCA2 are genes that are responsible for the production of certain tumor suppressing proteins. In some populations there are mutations in these genes that disable their tumor fighting properties. These gene mutations are relatively rare and currently screening is recommended just for individuals with increased risk of harboring these mutations. According to the National Cancer Institute, individuals who are at higher risk and should consider genetic testing are:

  • Individuals who have a male relative who has developed breast cancer
  • History of BRCA related cancers within family history
  • People of Ashkenazi (Eastern European) Jewish ancestry
  • Breast Cancer diagnosed before age 50 in family
  • Multiple cases of breast cancer in family

Individuals that test positive for BRCA mutations may consider increased screening, prophylactic surgery or chemoprevention.

Mastectomy and Physical Therapy

Mastectomy, removal of the breast is currently the most common treatment for breast cancer. Some women chose to have their breasts reconstructed after their mastectomy and others do not. It is obviously a very personal choice.  Like any surgery, mastectomies require close postoperative care to ensure maximal function and recovery.

You may have read the last sentence, and thought, “What is the function of the breast, besides breast feeding and for sexual pleasure?” The breast lies in an important intersection in the body. The armpit (axilla) contains bundles of nerves, blood vessels, and lymph vessels that course through it, serving the arm down to the fingers. After mastectomy, their course can be interrupted by scar tissue, radiation damage (if your treatment included radiation), causing painful conditions such as nerve entrapments, frozen shoulder, and lymphedema, ( a backup of lymph fluid, if left unchecked can cause permanent damage and deformation of the arm).

victoria2016Victoria LaManna, DPT, CLT, is our lymphedema expert. If you have had a mastectomy and are unsure about lymphedema care, she is an excellent resource. She will be able to instruct you in self- care and lymphedema prevention measures. Physical therapy can also help to release scar tissue in the breast and upper arm area, regain strength in the arm, and ultimately improve your function. Visit us, and read up on Victoria’s bio here, as well ask on our website at:  www.beyondbasicspt.com/lymphedema

 

Breast cancer is extremely common, but luckily outcomes continue to improve, but early detection is key.  This October, let’s stand together to commit to regular self exams and educate the women in our lives to screen themselves as well. Let’s reduce the impact of breast cancer, one step at a time.

Sources:

http://www.nationalbreastcancer.org/. Accessed: September 24, 2016

National Cancer Institute. BRCA1 and BRCA2: Cancer Risk and Genetic Testing. https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#q1. Accessed September 25,2016

http://www.beyondbasicspt.com/lymphedema

Node Knowledge

By Riva Preil

Breast cancer awareness is sweeping the nation this October!  In honor of the many inspirational survivors who have undergone mastectomies, I have decided to blog about rehabilitation post mastectomy.  In western societies, breast cancer is the most commonly diagnosed tumor amongst women.  In fact, 27% of tumors diagnosed amongst females are breast tumors.  Fortunately, recent research has helped develop minimally invasive surgeries (including sentinel or axillary lymph node dissection) that allow for faster healing.  However, as with any surgical procedure, internal scarring may occur after the surgery which may affect upper extremity joint and muscle function.  Furthermore, removal of lymph nodes may result in dysfunctional drainage of the lymphatic system into the venous system, a condition called upper extremity lymphedema (associated with swelling and heaviness in the affected limb).  This may lead to impairments in functional abilities, including carrying heavy objects and overhead reaching.

A recent study in “European Journal of Physical and Rehabilitation Medicine” (2012, vol 8, No. 4) explored the benefits of early rehabilitation following surgery.  Of the 83 participants in the study, 25 were in the control group (no physical therapy until after discharge from the hospital) and 58 were in the experimental group (physical therapy beginning the day after surgery until discharge from the hospital).  The physical therapy interventions including exercises to maintain shoulder muscle flexibility, decrease pain, improve lymphatic circulation through the affected upper extremity, and breathing exercises to maintain proper pulmonary function.  Each P.T. session was 30-40 minutes during hospitalization, and they were educated on appropriate home exercises for post discharge.

Follow up was performed with both groups 6 months after surgery.  There was a statistically significant difference between the groups regarding the presence of lymphedema- those who had participated in early post-op intervention were less affected than those who had not.  Furthermore, those who had participated in physical therapy earlier on were more flexible and capable of greater function.  Once again, research has proven that physical therapy, including lymphedema treatment, is very beneficial post-surgery, and women are encouraged to use their arms freely post-surgery rather than “taking it easy” in attempt to heal.  Fortunately, we here at Beyond Basics Physical Therapy offer lymphedema treatment!  Our skilled physical therapist, Roseanne Cruz Schoen, is a Certified Lymphedema Therapist.  If you or someone you know may benefit from lymphedema treatment, please contact us- we would love to help!

Promote Pink!

By Riva Preil

October marks National Breast Cancer Awareness Month (NBCAM).  NBCAM was established in 1985 as a partnership between the American Cancer Society and a sub-division of Imperial Chemical Industries with the goal of promoting routine mammographies as the best tool to detect and combat the disease.  In 1993, Evelyn Lauder, Senior Corporate Vice President of the Estee Lauder cosmetics company established The Breast Cancer Research Foundation and the popular pink ribbon as its symbol.  The National Race for the Cure was established in October 1983 to raise funds for breast cancer research.  The first race was held in Dallas, Texas, and there were 800 participants.  By 2002, within a mere decade, the event had exploded into 1.3 million participants in over one hundred U.S. cities!

Fortunately, breast cancer awareness and research has helped with earlier detection and treatment than ever before.  Furthermore, prophylactic measures have become a viable option for women with increased risk of developing the disease.  October is a great time to review the proper way to perform a breast self-examination.  Please refer to the link here to ensure that you are properly performing a BSE monthly.

 

Think Pink!

By Riva Preil

October marks National Breast Cancer Awareness Month, and this is an appropriate time for us to review important health care information.  In my opinion, an ounce of prevention is worth more than a pound of cure, and fortunately, the American Cancer Society has established guidelines for us to follow.  Women over 40 years of age should have annual mammograms and clinical breast exams (CBE).  Women in their 20s and 30s should also have CBEs every three years.  All women should perform a monthly breast self-exam (BSE)- refer to attached link for further details.

Furthermore, starting at age 50, both men and women should participate in colorectal cancer and polyp tests, including flexible sigmoidoscopy every five years, colonoscopy every ten years, double contrast barium enema every five years, or CT colonography (also called virtual colonoscopy) every five years.  Endometrial (uterine) cancer and prostate cancer should also be screened appropriately. Please speak with your primary care physician regarding further details.

Prevention also includes maintaining proper general health care.  This includes avoiding cigarettes, limiting alcohol consumption, maintaining a healthy weight, participating in regular exercises, eating healthy foods (ex. fruits and vegetables), and regular medical check-ups.  May we all celebrate this year’s National Breast Cancer Awareness Month in the best of health!

Click here for even more information from Cancer.org.