COPD and Other Stuff

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New Inhaler for COPDers – a miracle? PATHOS Study

March 19th, 2013 by Sharon O'Hara

Ask your doctor…and look for a miracle inhaler for some COPDers.  The PATHOS study published in the Journal of Internal Medicine shows that SYMBICORTR TurbuhalerR (budesonide/formoterol) must be some kind of miracle inhaler for chronic obstructive pulmonary disease (COPD) patients. 

Among other advantages, the PATHOS study showed a 26% decrease in exacerbations for moderate – severe COPD!  The Symbicort    SYMBICORTR TurbuhalerR            inhaler has to be bliss for those COPDers able to use it.   

I’ve used Foradil Aerolizer (Formoterol Fumarate Inhalation Powder) for years.  The Fulmarate ingredient seems to make it a relative of Symbicort        SYMBICORTR TurbuhalerR                and it is the single inhaler I take (of three) that noticeably helps me breathe easier.

Best of all is the promise shown in the PATHOS study:

Dr. Kjell Larsson, Professor of Respiratory Medicine at the Karolinska

Institute in Stockholm said: “So called ‘real world’ studies, such as

PATHOS, together with randomised prospective studies, play an important role

in answering questions about the value of medicines in delivering better,

cost-effective healthcare to patients. These findings can help physicians

and the healthcare community to understand disease patterns and create a

fuller picture of treatment effects and what patients are experiencing.”

The only side-affect/warning I can find  might be for asthma patients.

http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=77788

http://www.4-traders.com/ASTRAZENECA-PLC-4000930/news/AstraZeneca-plc-Real-w

orld-study-comparing-commonly-prescribed-COPD-medicines-shows-choice-of-trea

-16558063/ …thanks to Linda W EFFORTS <www.emphysema.net> 

 

Thanks for listening … Sharon O’Hara < familien1@comcast.net

Spring 2013

p class=”MsoNormal”


Lymphedema = Pain = More Pain = Avoidance = Get Educated = Get Fit

March 12th, 2013 by Sharon O'Hara

 

Lymphedema = Pain = More Pain = Avoidance = Get Educated = Get Fit  

National Lymphedema Network – Educating Patients Online 

Part 3b of 3b 

Exercise and Compression Garments:

Lymphedema Remedial Exercise as a part of CDT requires compression garments or bandages.3-5 There are no studies on the use of compression garments when performing stretching or flexibility exercise alone.

Our visiting young cousin from Norway rode her first recumbent trike in Silverdale and wore "What is COPD" tee shirt while she was here.

Our visiting young cousin from Norway rode her first recumbent trike in Silverdale and wore “What is COPD” tee shirt while she was here.

My young cousin, Malin from Norway is included here because COPD (Chronic Obstructive Pulmonary Disease) began in 1997 for me and led into my long ride into medical conditions – one after the other and my gathering weight attracted lymphedema as surely as fresh bread and butter sticks to peanut butter and strawberry jam. 

“The NLN Medical Advisory Committee (MAC) recommends using the guidelines for aerobic and resistance exercise to guide use of compression during flexibility exercise since flexibility exercises may be combined with other forms of exercise. 

The amount and type of compression for exercise should be decided with input from a professional knowledgeable about lymphedema. There is no strong evidence basis for the use of compression garments during exercise; however, most experts in the field of lymphedema advise the use of compression during vigorous exercise for people with a confirmed diagnosis of lymphedema.

Melissa showing me the latest fast, protective lower leg support

Melissa showing me the latest fast, protective lower leg support

Melissa Mercogliano, Center for Orthopedic & Lymphatic Physical Therapy in Port Orchard, WA. recently showed me a new and easy way to add support stockings…easy except for we Tub’ettes.

“One study suggested that individuals with lymphedema who do resistance exercise without compression may increase swelling. 

20 Resistance exercise may reduce limb volume when used as an adjunct to compression therapy in people with confirmed lymphedema.

8 One study showed that aerobic and weight-lifting exercise was safely performed without compression in women at risk for breast cancer-related lymphedema.

9 That study showed patients who developed lymphedema could continue to exercise with compression garments. Compression garments should be measured by an individual trained and experienced in fitting compression garments for lymphedema and should be at least Class I compression for upper extremity. Higher classes may be required for more severe lymphedema and for lower extremity lymphedema.

 1-IMG_29033-IMG_29074-IMG_2909

Custom sized, each leg. This pair is old...notice the crinkles below the rubber dotted band. The replacement compression stockings are black.This pair is about one year old.

Custom sized, each leg. This pair is old…notice the crinkles below the rubber dotted band. The replacement compression stockings are black.
This pair is about one year old.

I throw the stockings in a little zippered mesh cloth bag and into the washer on a short cycle, regular soap, extra rinse – cold water and smooth out and let them hang to dry.

I prefer the toe less stocking so my toes don’t get scrunched up and have two different kinds. The little rubbery tips around the tops of both help them from sliding on down my leg and cutting off circulation.  Ask your doctor. 

“A hand piece (gauntlet or glove) is recommended when exercising with a sleeve to avoid causing or exacerbating hand swelling. 

Definition of Individuals At Risk for Lymphedema:

Individuals at risk for lymphedema have not displayed signs and symptoms of lymphedema but may have sustained damage to their lymphatic systems through surgical lymph node removal or radiation therapy.

Additionally, individuals at risk may have surgical incisions in the vicinity of lymph transport vessels.

Individuals who have family members with hereditary lymphedema may also be at risk.

An individual’s risk of lymphedema may change over time depending on factors such as weight gain, age, and changes in medical condition. 

It is the position of the NLN that:

Exercise is a part of a healthy lifestyle and is essential for effective lymphedema management

Before starting any exercise program, individuals should be cleared for the program of activity by their physician.

Lymphedema Exercises (also known as Remedial Exercises) are specific rhythmic muscle and breathing exercises used as a part of lymphedema treatment in Phase I and Phase II

Complete Decongestive Therapy (see the NLN Position Paper on Diagnosis and Treatment). http://www.lymphnet.org/pdfDocs/nlntreatment.pdf 

In Phase II lymphedema maintenance, these exercises can be combined with or integrated into a regular exercise program.

After intensive treatment with CDT, the person with lymphedema should work with the certified lymphedema therapist or qualified lymphedema specialist provider (MD, NP) to adapt their remedial exercises into their fitness and weight management program at the time they are moving from Phase I (treatment phase) to Phase II (self-management).

Individuals with or at risk for lymphedema can and should perform aerobic and resistance exercise in a safe manner.

The individual with or at risk for lymphedema may benefit from working with an Exercise Physiologist and/or Personal Trainer. The person with lymphedema should inquire if the trainer or exercise physiologist has experience working with lymphedema and other medical conditions. Certification for personal trainers varies. Patients who are unsure of about the qualifications of a community exercise practitioner should work with a certified lymphedema therapist or health care provider to assist them in finding a community exercise program or professional.

In general, individuals with a confirmed diagnosis of lymphedema should utilize compression garments or compression bandages during exercise.

Individuals at risk for lymphedema may or may not utilize compression garments during exercise; this is an individual decision to be made with guidance from a care provider and/or therapist based on risk, activity, and conditioning level.

Individuals at risk for lymphedema will benefit from most forms of exercise tailored to their individual needs.

Individuals at risk for or with a confirmed diagnosis of lymphedema should avoid repetitive overuse of the affected part. Sudden increase in an individual’s usual exercise duration or intensity may trigger or worsen lymphedema. It is likely that a program of slowly progressive exercise for the affected body part will decrease the potential for common daily activities to result in overuse.

Exercise should be started gradually, increased cautiously, and stopped for pain, increased swelling, or discomfort.

The risks of exercise for the individual with or at risk for lymphedema must be balanced against the risks of deconditioning that undoubtedly results from not exercising. A deconditioned body part with or at risk for lymphedema can do progressively less without risk of overuse. As a result, exercise is recommended for those with and at risk for lymphedema.

The NLN cannot specifically determine the safety of exercise for any individual. The guidelines in this Position Paper provide general principles, but do not substitute for medical evaluation and recommendations from a health care professional. It is the responsibility of all individuals with or at risk for lymphedema to consult with their health care provider regarding their own specific needs. 

References:

1. Tidhar D, Katz-Leurer M. Aqua lymphatic therapy in women who suffer from breast cancer treatment related lymphedema: a randomized controlled study. Support Care Cancer. 2010;18(3):383-392.

 2.Moseley AL, Piller NB, Carati CJ. The effect of gentle arm exercise and deep breathing on secondary arm lymphedema.Lymphol. 2005;38(3):136-145.

3.Boris M, Weindorf S, Lasinski B, Boris G. Lymphedema reduction by noninvasive complex lymphedema therapy. Oncol (Williston Park). 1994;8(9):95-106; discussion 109-110.

4.Földi E, Földi M, Weissleder H. Conservative treatment of lymphoedema of the limbs. Angiol. 1985;36(3):171-180.

5.Földi M, Földi E, eds-in-chief. Foldi’s Textbook of Lymphology for Physicians and Lymphedema Therapists, 2nd ed. Munchen, Germany:Urban & Fischer; 2006.

6.Bergmann A, Mendes VV, de Almeida Dias R, do Amaral E Silva B, da Costa Leite Ferreira MG, Fabro EA. 

Incidence and risk factors for axillary web syndrome after breast cancer surgery [published online ahead of print October 17, 2011].

Breast Cancer Res Treat. doi:10.1007/s10549-011-1805-7.

7.Fourie W, Rob KA. Physiotherapy management of axillary web syndrome following breast cancer treatment: discussing the use of soft tissue techniques. 

Physiotherapy. 2009;95(4):314-320. 

 

NLN • 116 New Montgomery Street, Suite 235 • San Francisco, CA 94105

Tel: 415-908-3681 • Fax: 415-908-3813

Infoline: 1-800-541-3259 • Email: nln@lymphnet.org •

Online: www.lymphnet.org 

Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx 

Several years ago, I called Harrison Medical Center and asked if non-cancer patients with lymphedema could attend their support group meetings.  At that time, it was limited to cancer patients.

Yesterday I called the following number to be certain it was still up to date.  It is and the closest Lymphedema Support Group I know about.

If anyone knows of more, let me know – I can post it here.

 

Kitsap County Closest Support Group 

Northwest Lymphedema Center

Kent, WA (24.11 miles * Meeting times: Date varies  Phone: (206) 575-7775 

 

Tub’etts! 

I’d like to be part of a support group of fatties who NEED to lose weight for their health’s sake – with or without current medical issues. No dues – a scale and occasionally health professionals willing to talk to us – to educate us – to motivate us – guest speakers. 

I have been told that I’m not a good candidate for bariatric surgery…so, before I push that particular button – is there anyone beside me, who wants to be part of an obese/tubby support group to work together for weight loss and good health? 

To lose weight through good nutrition and exercise is my goal. 

We are dying of too much fat, fellow Tubby Ones.

Will you join me in our battle to shed the fat and live healthy?  Let me know…

 

Thanks for reading… Sharon O’Hara familien1@comcast.net

Kitsap County Library System has educational Lymphedema books for the layperson – just ask.


Lymphedema Tied to Obesity? Exercise helpful too it seems

March 11th, 2013 by Sharon O'Hara

Greetings…  Part 3a of 3b.

Dr. Halligan, surgeon, Doctor’s Clinic Silverdale, saved my life/legs when he checked to see if the deep lesions on my left leg could be treated without surgery….and wanted a daily cleaning –debriding – and rewrapping of the leg. The doctor ultimately did it himself – everyday in the hospital.

Back home my husband, trained by Doctor’s Clinic Silverdale took over the leg lymphedema wrap.

Restless Leg Syndrome (RLS) – now called

Willis-Ekbom Disease (WED) Foundation www.willis-ekbom.org – was my biggest hindrance to healing.

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“Lymphedema Tied to Obesity 

By Todd Neale, Senior Staff Writer, MedPage TodayPublished: May 30, 2012 

 

Obesity may contribute to the development of lymphedema, a small study showed.

 

Among 15 obese patients with enlargement of the legs, the average body mass index was significantly greater for those with confirmed lymphedema (70.1 versus 42.0 kg/m2, P<0.001), according to Arin Greene, MD, of Children’s Hospital Boston, and colleagues.

 

“Our findings suggest that obesity … may be a cause of lower-extremity lymphedema,” they wrote in a letter to the editor in the New England Journal of Medicine.

 

“As the amount of adipose tissue increases in the lower extremity, lymphatic vessels may become dysfunctional (possibly because of compression or inflammation), thereby reducing proximal lymphatic flow,” they explained.

 

“Alternatively, elevated production of lymph from an enlarging limb may overwhelm the capacity of a normal lymphatic system to remove the fluid from the extremity,” they continued. “Although lymphedema is typically progressive, we speculate that 

http://www.medpagetoday.com/Endocrinology/Obesity/32986

 

Steven Gardner, political reporter at the Kitsap Sun, will have Bariatric surgery at Swedish Hospital in Seattle probably in the April time frame.  Steven tells his story here: http://fieldofsteve.com/

 

“Obesity is known to be a major lymphedema risk factor” Part 3a of 3b

 

Fitness and Exercise:

It is very important for individuals with lymphedema to be physically fit and maintain a healthy weight. A safe form of exercise is an essential part of a fitness program for people with lymphedema. Fitness and exercise are not the same. Exercise includes many different types of physical movement. The three main types of exercise are: aerobic, strength, and flexibility.

 

These three types of exercise, along with Lymphedema Remedial Exercises, are addressed

in this paper. There are many other types of exercise that have health benefits such as Pilates, yoga, Tai Chi, Qigong, aquatic exercise,1trampoline rebounding, breathing exercises, and relaxation exercise that have not been adequately studied in people with lymphedema. However, the person with lymphedema can use the benefits of any system of exercise if he/she follows the general safety principles of exercise with lymphedema, seeks medical guidance, and uses caution in starting any new exercise program.

 

Exercise and types of lymphedema:

 

Lymphedema has many causes. The type of exercise that is best for an individual depends upon the severity and cause of lymphedema and other co-existing medical conditions (e.g. heart disease, diabetes, arthritis, etc).

Exercise for breast cancer-related lymphedema is the most studied lymphedema condition. Many conclusions about exercise and lymphedema are based on studies of breast cancer survivors that may or may not apply to other forms of lymphedema.

 

Lymphedema Remedial Exercise:

Lymphedema Remedial Exercise is a part of treatment for lymphedema when reduction of size of a limb is necessary. Lymphedema Remedial Exercise involves active, repetitive, non-resistive motion of the involved body part.

 

Exercise in Phase I and Phase II Complete Decongestive Therapy (CDT) (see Position Paper “Diagnosis and Treatment of Lymphedema” http://www.lymphnet.org/pdfDocs/nlntreatment.pdf) is performed with compression as an essential part of the total (complete) reductive phase of lymphedema therapy.

3-5

Lymphedema exercises, used with compression, help the body’s natural muscle pump to increase venous and lymphatic fluid return to the circulatory system and out of the swollen areas. Remedial Exercises for lymphedema are similar to some movements of low impact Tai Chi and Qigong, but are different in that lymphedema Remedial Exercise is used with Phase

I treatment of lymphedema to reduce size of the body part.

 

Lymphedema Remedial Exercise has been studied and shown to reduce limb swelling.3-5

 

It is unknown whether Lymphedema Remedial Exercise alone can prevent

lymphedema in at-risk individuals, or whether they can maintain reduction of swelling without compression.

 

Flexibility or Stretching Exercises:

Flexibility exercises include a wide range of activities that stretch muscle and connective tissues to increase and/or preserve range of motion. Flexibility exercises can minimize skin scarring and joint contractures that may lessen lymph flow. Flexibility exercises should be performed slowly and progressed gradually. Flexibility exercises are not a treatment for lymphedema, but are a part of optimal lifestyle management for reducing the complications of lymphedema. Lymphedema has a tendency to restrict motion of muscles and joints.

 

Optimal lymphatic function requires full mobility of muscles and joints. Lymphedema from cancer treatment can be associated with tight muscles and connective tissues due to fibrous adhesions from surgery or radiation. Tight muscles and scars from surgery or radiation may require Physical or Occupational Therapy to treat before attempting to do self-stretching.

Specific stretching exercises for cancer treatment-related scars and joint restrictions in an area at risk of lymphedema should be prescribed by a provider familiar with the management of lymphedema. A specialized form of stretching exercise may be required for Axillary Web Syndrome (AWS) or axillary cording, a condition that can occur in cancer survivors who have had axillary (armpit) lymph nodes removed.6

 

AWS may benefit from treatment by a certified lymphedema therapist and specific home stretches taught by a therapist.7

 

Resistance or Weight-Lifting Exercise:

Resistance exercises are usually thought of as weight-lifting. Resistance exercises may involve lifting body weight (such as push-ups) or lifting objects (such as dumbbells, weight machines, etc).

Resistance exercises can be performed without moving a joint (isometric) or by moving the joint through a range of motion (isotonic). All of these types of resistance exercise may be utilized by individuals with lymphedema, but should be done cautiously, starting with low weights, low repetitions, and gradual progression. Resistance exercises are performed against an opposing load to enhance muscle power, stamina, and tone. Resistance exercise may reduce limb volume when used as an adjunct to compression therapy8 

One study showed that guided participation in resistance exercise, as a part of a total fitness program, did not increase the risk of developing lymphedema in breast cancer patients at risk over the group who did not exercise.9

 

Lymphedema did occur in both groups. No increase in lymphedema development was noted between the exercise and the non-exercise group. There have been many studies on resistance exercise in breast cancer-related lymphedema that show no harmful effect on lymphedema and beneficial effects for overall health.10-20

 

Aerobic Conditioning or Cardiopulmonary Exercise:

 

Aerobic conditioning exercise is often referred to as “cardio” exercise. Aerobic exercise involves activity that uses large muscle groups to increase the heart rate to 60-70% of an individual’s maximum heart rate. This type of exercise, when progressed gradually, increases the heart and lung capacity while also improving muscle conditioning.

Aerobic conditioning enhances cardiovascular fitness, effective weight management, and overall health and well-being, all of which are very beneficial to people with lymphedema from all causes.10-21

 

Walking, jogging, cycling, and swimming are examples of aerobic conditioning exercise. Aerobic conditioning has not been studied formally as a treatment for lymphedema. One study showed no adverse effect on lymphedema from aerobic exercise.17

 

Resistance Exercise plus Aerobic Exercise:

Studies of combined resistance and aerobic exercise have shown no adverse effects on lymphedema.21

 

No studies have specifically evaluated resistance plus aerobic exercise as a stand-alone treatment for lymphedema. One study in breast cancer-related lymphedema showed that the individuals who performed aerobic conditioning and weight lifting had better control of their lymphedema and had fewer flares of lymphedema than those who did not exercise. However, individuals with lymphedema still had to utilize standard lymphedema therapy techniques for flares.

 

Another study about women at risk for breast cancer-related lymphedema showed that aerobic conditioning and weight-lifting reduced the risk of developing lymphedema.

 

Considerations for Designing an Exercise Program:

A number of studies have shown that aerobic and resistance exercises are safe and beneficial for people with lymphedema or at risk of lymphedema if they follow the guidelines for progressing slowly, use recommended compression, and report any adverse effects to a professional who can help them adapt their exercise regimen.9,16-21

 

Most studies on lymphedema and exercise have been done on breast cancer survivors, but the principles may guide exercise in other forms of lymphedema. Individuals with or at risk of lymphedema must report other health conditions that need to be considered in developing a personal exercise regimen (diabetes, heart disease, neuropathy, arthritis, etc).

 

Modifications of aerobic and resistance exercise that are commonly recommended for individuals with lymphedema are:

 

1) Allowing adequate rest intervals between sets; 2) Avoiding weights that wrap tightly around an extremity or clothing that cause constriction; 3) Wearing compression sleeves or bandages during exercise; 4) Maintaining hydration; 5) Avoiding extreme heat or overheating; 6) Exercising in a circuit that alters the type of exercise and body part within the exercise session.

 

Exercise and Compression Garments:

Lymphedema Remedial Exercise as a part of CDT requires compression garments or bandages.3-5 There are no studies on the use of compression garments when performing stretching or flexibility exercise alone.

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Thanks for reading… Sharon O’Hara

Continued…in Part 3b

/p


Lymphedema Risk Reduction Practices Part 2 of 3

March 8th, 2013 by Sharon O'Hara

  Greetings!  Part 2 of 3 is the, “Summary of Lymphedema Risk Reduction Practices”

Note that “Obesity” is mentioned as a risk and I’ll have more to say about it in part 3. 

A reminder to ask your doctor – I’m a patient who believes in patient education.  Talk to your doctor.

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“Summary of Lymphedema Risk Reduction Practices

Please refer to the complete Risk Reduction document for details.

 

I. Skin Care – Avoid trauma / injury to reduce infection risk

Keep extremity clean and dry.

Apply moisturizer daily to prevent chapping/chafing of skin.

Attention to nail care; do not cut cuticles.

Protect exposed skin with sunscreen and insect repellent.

Use care with razors to avoid nicks and skin irritation.

If possible, avoid punctures such as injections and blood draws.

Wear gloves while doing activities that may cause skin injury (e.g. washing dishes, gardening, working with tools, using chemicals such as detergent).

If scratches/punctures to skin occur, wash with soap and water, apply antibiotics, and observe for signs of infection (i.e. redness).

If a rash, itching, redness, pain, increased skin temperature, increased swelling, fever or flu-like symptoms occur, contact your physician immediately for early treatment of possible infection.

II.

Activity / Lifestyle

Gradually build up the duration and intensity of any activity or exercise. Review the Exercise Position Paper.

Take frequent rest periods during activity to allow for limb recovery.

Monitor the extremity during and after activity for any change in size, shape, tissue, texture, soreness, heaviness or firmness.

Maintain optimal weight. Obesity is known to be a major lymphedema risk factor.

 

III. Avoid Limb Constriction

If possible, avoid having blood pressure taken on the at-risk extremity, especially repetitive pumping.

Wear non-constrictive jewelry and clothing.

Avoid carrying a heavy bag or purse over the at risk or lymphedematous extremity.

IV. Compression Garments should be well-fitting.

Support the at-risk limb with a compression garment for strenuous activity (i.e. weight lifting, prolonged standing, and running) except in patients with open wounds or with poor circulation in the at-risk limb.

Patients with lymphedema should consider wearing a well-fitting compression garment for air travel. The NLN cannot specifically recommend compression garments for prophylaxis in at-risk patients.”

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In part 3,  I’ll show you the two kinds of leg support stockings I use and why I like them.  There are many other support stockings out there – ask your doctor what she/he recommends.   Also, I’ll show you several tools that aid in putting them on.

Thanks for reading… Sharon O’Hara, familien1@comcast.net


Screening and Measurement for Early Detection of Breast Cancer Related Lymphedema Part 1 of 3

March 8th, 2013 by Sharon O'Hara

Greeting!  Following is Screening and Measurement for Early Detection of Breast

Cancer Related Lymphedema by the National Lymphedema Network. 

Lymphedema and Cellulitis might well disappear one day – I hope! – if we are diligent and research continues.  It is a nasty disease … 

I am reprinting here in three parts only a smattering of information from the NLN website. 

In addition a reminder that I write here as a patient with diseases – one of them lymphedema.

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Part 1 of 3 

Position Statement of the

National Lymphedema Network

By: NLN Medical Advisory Committee

Updated April 2011

TOPIC: Screening and Measurement for Early Detection of Breast

Cancer Related Lymphedema 

Breast cancer treatment places individuals at lifelong risk for the development of lymphedema. Early identification of lymphedema is believed to yield better patient outcomes. Patient education regarding the signs and symptoms of developing lymphedema and objective measurement of arms are needed to promote early identification and to improve patient outcomes.

 

• Patient education:

 

Patients should be made aware of the need to contact a healthcare provider immediately if they begin to experience feelings of heaviness or tightness in at-risk arms; if they notice swelling in the affected area; or if the arm and/or at risk chest or truncal areas becomes hot or red.

 

• Objective measurement:

 

Pre-treatment baseline measurement of arms is essential, as this serves as the base-lined at which subsequent measurements can be compared.

 

See http://www.lymphnet.org/pdfDocs/nlnBCLE.pdf

www.lymphnet.org

 

Thanks for reading … Sharon O’Hara <familien1@comcast.net>


National Lymphedema Network urges the American College of Surgeons to …

March 3rd, 2013 by Sharon O'Hara

Greetings… Following is a copy of an email plea from the National Lymphedema Network to the Journal Of American College of Surgeons.

I’ve produced it here almost verbatim because I have leg lymphedema and it is one of the most painful difficult to live with diseases I have.  Last year it flared again and oozed, taking  about 10 months to heal, including a month in Harrison, a month at Martha and Mary Rehab Center, and months of my husband daily cleaning and re-wrapping my lower legs and feet.

Breast cancer survivors need to be educated to the risks of getting lymphedema.  I can promise – as a patient with lower leg lymphedema – nobody should get this disease if it can be avoided.

Patients, please talk to your doctor about lymphedema.  If she/he will not discuss it, find a doctor who will.

 

“National Lymphedema Network

In response to an article published in the March issue of the Journal Of American College of Surgeons (http://www.journalacs.org/article/S1072-7515(12)01312-9/abstract) the NLN Medical Advisory Committee is responding to a Press Release released on February 25, 2013 (http://www.facs.org/news/jacs/lymphedema0313.html)  in the Journal of American College of Surgeons, “Breast Cancer Patients Fear for Developing Lymphedema Far Exceeds the Risk

Respectfully:

Saskia R.J. Thiadens RN

Executive Director

 

“March 1, 2013

On 2/25/2013 the Journal of American College of Surgeons released a statement entitled, “Breast Cancer Patients’ Fear of Developing Lymphedema Far Exceeds the Risk.” The press release was in response to findings from a single-site study published in the March issue of the Journal of the American College of Surgeons noting that some breast cancer survivors take extraordinary measures to try to prevent lymphedema that may not be necessary. The rate of development of lymphedema in the limbs of the study patients (N=120, followed to 12 months) was similar to reported incidence in the medical literature. Three percent of patients having a sentinel lymph node biopsy developed lymphedema and 19% of patients having an axillary lymph node dissection developed lymphedema. The study indicated that patients with sentinel lymph node biopsy worried and took precautions as much as those who had axillary node dissections.

The National Lymphedema Network agrees with the statement in the press release that “future research should be aimed at better predicting which women will develop lymphedema, thus allowing for targeted prevention and intervention strategies and individualized plans for risk-reducing behaviors for each woman during and after her breast cancer treatment.” However, since this type of risk stratification and broad education does not currently exist, it is important for patients to be given accurate information by their doctors and oncology care providers on reasonable approaches to reducing the risk of developing lymphedema.

The American Cancer Society estimates that in 2013 there will be about 232, 340 new cases of breast cancer in the US and there are approximately 2.9 million breast cancer survivors in the US. If 20% of those who have axillary dissections, and, conservatively, 3% with sentinel lymph node biopsies, are at risk of developing lymphedema, this is still a very large number of women who have reason to be concerned about their risk of developing lymphedema.

Lymphedema is a progressive, debilitating condition that is not merely swelling, but an immune system dysfunction. When recognized late in its course, or inadequately treated, lymphedema leads to chronic infection and progressive disability. Women who are at risk for lymphedema have reason to be concerned and these concerns should not be minimized.

The National Lymphedema Network advocates a reasonable approach to risk reduction guidelines, given that a large population of women is still at significant risk of developing lymphedema. In the NLN Position Paper on Risk Reduction, revised in 2012 and available at www.lymphnet.org , a risk stratification approach is detailed so patients can take appropriate precautions according to their medical situation. Every breast cancer survivor deserves accurate information about her or his risk of developing lymphedema and reasonable precautions based on the available scientific evidence.

The American College of Surgeons, and all providers of care to breast cancer patients, are encouraged to provide every breast cancer patient with accurate information about lymphedema, so patients can make informed choices. Given the imperfect state of the science on risk reduction for lymphedema, there are many reasonable, healthy suggestions for patients at risk of lymphedema to reduce their risk, such as weight management and exercise. The Position Papers on the NLN website on Exercise, Risk Reduction and Screening for Breast Cancer Related Lymphedema were written by a panel of medical experts in the field of lymphology and lymphedema treatment.

The National Lymphedema Network urges the American College of Surgeons to endorse the NLN Position papers, provide them to their members, and acknowledge that a large number of breast cancer survivors are at risk of or currently have lymphedema. These patients need education and information that will allow them to take precautions that are reasonable and not excessive.  Education is the key and then what each one does with that information is a personal choice and a part of personalized health care.”

…NLN Medical Advisory Committee  *  Hotline: 1.800.541.3259

National Lymphedema Network | 116 New Montgomery St. | Suite 235 | San Francisco | CA | 94105

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Best wishes and thanks for reading …   Sharon O’Hara <familien1@comcast.net>


Happy Martin Luther King Day 2013! NAACP’s Health Fair in photos – a little late

January 21st, 2013 by Sharon O'Hara

Happy Martin Luther King Day!

The recent NAACP Health Fair at Olympic College was fun, a day full of record rainfall, a little snow, great speakers and booths crammed with information.

The program included a delightful parade of kids –  tots to teens modeling the latest fashions and we were later served a delicious box lunch.

Thanks to the NAACP Health Fair, I had the opportunity to show and tell about COPD (Chronic Obstructive Pulmonary Disease) and what it can lead to…not good stuff.  It was my pleasure, thanks for asking.

Harrison Medical Center was not able to attend to offer early detection COPD Spirometry testing – this time.

A quick glance around when I arrived showed a who’s who of Kitsap County, including Bremerton’s Mayor, Patty Lent.

18-IMG_3018 17-IMG_3016 16-IMG_3013 15-IMG_3010 14-IMG_3007 13-IMG_3005 12-IMG_3004 11-IMG_3000 10-IMG_2998 09-IMG_2990 08-IMG_2989 07-IMG_2986 06-IMG_2983 05-IMG_2979 04-IMG_2976 28-IMG_2969 27-IMG_2967 26-IMG_3029 25-IMG_3026 24-IMG_3024 23-IMG_3023 22-IMG_3022 21-IMG_3021 20-IMG_3020 19-IMG_3019 03-IMG_2994  Hey, mom – I found you! 01-IMG_2997

Let’s go THIS way – there is my mom!

Our lives begin to end the day we become silent about things that matter.

Martin Luther King, Jr.

 

Thanks for reading… Sharon O’Hara (familien1@comcast.net)

Martin Luther King, Jr. DayWikipedia: Martin Luther King, Jr. Day is a United States federal holiday marking the birthday of Rev.


NAACP Health Fair TOMORROW Olympic College

December 14th, 2012 by Sharon O'Hara

What do the NAACP Community Health Fair, Harrison Medical Center, and Olympic Community College have in common?

 

Easy – they all have an interest in health care and patient education.

When:            Saturday, December 15, 2012

Where:           Olympic Community College – at the Student Center next to the Book Store

Time:              11:00 AM to 4:00 PM

For info:         360. 434.1754 or email: hjs52@hotmail.co

Community Resource Informational Booths

 Project HELP

 Entertainment

Fashion Show

Testimonials

Food

There will be free Snacks, Youth Fashion Show, Free Massages, Informational Health Material, Information on Affordable Health Insurance, Blood Pressure Readings and lots more!


Robin from Harrison Respiratory was kind enough to bring me a wonderful array of helpful information to hand out at the fair.  I have them packed to take tomorrow.  Thank you Harrison Medical Center!

Ask me about COPD – anything.  I will be the short, really round woman huffing and puffing behind a walker and pushing a case on wheels chock full of free helpful information for you. 

Thanks for reading. 

Hope to see you tomorrow …. Sharon O’Hara


Reduce risk of developing some forms of cancer – drop to a healthy weight

December 5th, 2012 by Sharon O'Hara

Tubby’etes … Somehow I’ve seriously packed on an excess of thirty pounds or so since my tumor operation and I’m back to seriously climbing stairs.  I began again this morning. The possibility that obesity increases the risk of ‘developing some form of cancer’ is a call to cut obesity loose and off this short frame.

Poulsbo women, if any of you are 100 or more pounds overweight, you are welcome to join me in a health quest of diet and exercise.

*****************

 

  • From: National Heart Lung and Blood Institute.

“ Your weight may be affecting you more than you may think.

Even a few extra pounds each year can affect your quality of life.

There are many benefits to achieving and maintaining a healthy weight that will improve your health and life in the short-term. These include:

If you are overweight or obese, losing weight and being physically active can help you control your blood sugar levels.

Weight loss of at least 5 percent of your body weight may decrease stress on your knees, hips, and lower back.

Weight loss often improves sleep apnea.

Not only can extra weight cause joint pain, it can lead to serious chronic diseases. If you are overweight or obese, losing just 5 to 10 percent of your weight can lower your chances of developing heart disease, type 2 diabetes, or having a stroke. Other long-term health benefits of having a healthy weight include:

 

    Reducing your risk of developing some forms of cancer.

    Lowering your risk for developing gallstones and fatty liver disease.”

http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/onepound.htm

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Thanks for reading …. Sharon O’Hara <familien1@comcast.net>

 


Apology to the Podiatry Professionals

December 5th, 2012 by Sharon O'Hara

I have an apology to the Podiatry profession.

When I wrote about Podiatrists cutting toes as well as toenails, my focus was on patients and their loved ones being aware. …not to cast aspirations on all podiatrists or the profession of podiatry.

Following is my comment to Sally Santana’s question to my original post concerning the name of the podiatrist I encountered.

*****************************

“Sorry I don’t remember his name Sally – Only that he said his office was close by in Poulsbo. Moreover, he does toenails there every two months. Martha & Mary know his name.

Dr Gent was recommended to me One of two Podiatrists recommended to me..

At the same time I posted this I sent the URL and a complaint to the state director of Podiatrists … Something I should have done immediately after this happened. I expect that M & M took direct action and handled the situation… I told this story several times to different people there at the time..

M&M is a place if need be I would want to return.. It’s a stellar place for patients to recover.

That said, if incompetent toenail cutters can happen in a quality place like Martha & Mary – I worry about what’s going on with patients at lessor places… Who is watching?”

The fact is I do not remember his name, only that he told me when I asked that he has an office in Poulsbo.  I’ve called M & M to get the name of the podiatrist who did toenails there last February – something I should have done first.

My sincere apology to the dedicated podiatrist professionals.  I did not intend to cast a smear on your profession.

… Sharon O’Hara


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About This Blog

This is a patient to patient blog to exchange information and resources...from COPD (Chronic Obstructive Pulmonary Disease) to Arthritis to Cellulites to Sarcoidosis to Sleep Apnea to RLS to Psoriasis to Support Groups to Caregivers and all points in between. Written by Sharon O'Hara.

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