Lymphadema and Nutrition

Another great post

There is no special diet that will prevent or control lymphedema; however, good nutrition promotes good health and this helps the body manage with the stresses related to lymphedema. The main recommendations are eat a low sodium diet and keep hydrated.

Eating a Balanced Diet

Eating a well-balanced diet that includes a variety of fruits and vegetables is recommended for maintaining good general health. It also aids the body in coping with the added stress caused by lymphedema.

High salt foods, which encourage the body to retain fluids, are not part of a recommended healthy diet. High sodium foods cause the body to retain fluid in general, and will make the lymphedema swelling worse.

Staying Hydrated

The term hydrated describes the state of having adequate fluids in the body. Maintaining this state helps the body remove impurities from the blood and this is important to good health.

Drinking plenty of fluids, particularly water, is essential to maintaining this balance within the body. Cutting back on fluid intake in an effort to reduce the swelling of lymphedema doesn’t work! Instead of the desired effect, the protein-rich lymph of lymphedema attracts more fluid from the other parts of the body. This can cause increased swelling in the affected area.

Drinking eight 8-ounce glasses of water a day is recommended to maintain good health; however this need increases in hot weather, or in very dry conditions, when the body looses fluids more rapidly.

Being well hydrated, by drinking plenty of water, is particularly important after an MLD or pump treatment because it is necessary to flush out the impurities that were moved during treatment.

Caffeine, which is a mild diuretic, reduces the level of body fluids by encouraging the kidneys to excrete more urine. For this reason caffeine containing substances (coffee, tea, chocolate and many soft drinks) should be consumed only in moderation.

Alcohol also has a diuretic effect that stimulates the kidneys to excrete more water and thereby increasing dehydration.

Sonja M. Maul PT, CLT-LANA

National Board Certified Lymphedema Therapist

Basic Lymphadema Care Tips

Here's a great article about a couple basic things you can do to help with your lymphadema.

The first time I see a patient is for the evaluation. At the end of the evaluation I give my patients a packet of information to take home and read, instruct them in the Anatomy and Physiology of the Lymph System, and give them two things to get a head start on before we initiate our treatments. These two things are:

1. Any time you wash, dry, or lotion the swollen arm/leg, always rub up towards the body/heart. What we generally do is rub up and down. The lymph system is very close to the surface and the normal pressure we use to do these every day activities of washing, drying and putting on lotion is enough to stimulate that lymph system, so move the direction we want the fluid to go.

2. Deep Abdominal Breathing: The last tube of the Lymphatic system goes up through the chest passing through the Diaphragm. As we breathe the Diaphragm moves up and down massaging the lymph fluid up and into the Blood Circulatory System. Thus, by doing Deep Abdominal Breathing it creates a “wicking” effect, drawing the lymph fluid from the limbs and body.

• Deep Abdominal Breathing: Place one hand on your chest, the other hand on your stomach just below the ribs. Breath in slowly through your nose – your chest should stay still while your stomach expands out. Then blow the air out through your mouth as if blowing out 50 birthday candles – your stomach should pull in. Your exhale should be twice as long as your inhale. Do 10 of these breaths as often as you can recall throughout the day. (If you start to feel light headed stop and breath normal. To not get light headed, pause for 2 seconds at the end of each inhale and each exhale.)

With these two activities I often see patients return to start treatment with some decrease in their swelling.

Sonja M. Maul PT, CLT-LANA

National Board Certified Lymphedema Therapist

2008 Horizon of Hope

Longaberger Horizon of Hope to Raise Money for American Cancer Society Breast Cancer Initiatives

Horizon of Hope Products Available at 20 Percent Off for Limited Time

NEWARK, Ohio--The Longaberger Company is kicking off its 2008 Horizon of Hope campaign with a special offer that will enable customers to buy Horizon of Hope products at a 20 percent discount while also supporting American Cancer Society breast cancer research and education initiatives.

The campaign features a Horizon of Hope Basket and other products that Longaberger designs exclusively for the fundraising effort. Proceeds ($2 from each Horizon of Hope Basket, accessory set or set of travel mugs) go to the American Cancer Society.

The campaign is from July 1 through August 31, with the discount on Horizon of Hope products available from July 1 through July 16.

“It is our hope that we not only spur more awareness of this program that is bringing results in the fight against breast cancer, but that this promotional offer also acts as a catalyst to raise more money for the American Cancer Society,” said Julie Moorehead, Longaberger’s national executive director of sales.

Longaberger products can be purchased through independent Home Consultants nationwide or at www.longaberger.com. Since Horizon of Hope’s inception in 1995, Longaberger, its Home Consultants and the American Cancer Society have raised approximately $13 million and reached an estimated 19 million women with potentially life-saving information.

“Our company and our Home Consultants are passionate about Horizon of Hope because we’ve seen first-hand how we are together making a difference,” Moorehead said. “We’re proud to support the American Cancer Society.”

Horizon of Hope supports American Cancer Society programs aimed at improving the quality of and access to mammography services, breast imaging quality standards, the quality of clinical breast examinations, and the quality of life for young survivors and women with breast cancer recurrence. It also supports research into lymphedema, a debilitating swelling of the arms that can be a side effect of breast cancer treatment. To learn more, visit www.HorizonOfHope.com.

Founded in 1973, The Longaberger Company is America’s premier maker of handcrafted baskets and offers a variety of home and lifestyle products, including pottery, wrought iron and fabric accessories. There are approximately 45,000 independent Home Consultants in all U.S. states who sell Longaberger products directly to customers.

Contacts

The Longaberger Company
Tom Matthews, 740-322-5157
tom.matthews@longaberger.com

The first time I see a patient is for the evaluation. At the end of the evaluation I give my patients a packet of information to take home and read, instruct them in the Anatomy and Physiology of the Lymph System, and give them two things to get a head start on before we initiate our treatments. These two things are:

1. Any time you wash, dry, or lotion the swollen arm/leg, always rub up towards the body/heart. What we generally do is rub up and down. The lymph system is very close to the surface and the normal pressure we use to do these every day activities of washing, drying and putting on lotion is enough to stimulate that lymph system, so move the direction we want the fluid to go.

2. Deep Abdominal Breathing: The last tube of the Lymphatic system goes up through the chest passing through the Diaphragm. As we breathe the Diaphragm moves up and down massaging the lymph fluid up and into the Blood Circulatory System. Thus, by doing Deep Abdominal Breathing it creates a “wicking” effect, drawing the lymph fluid from the limbs and body.
• Deep Abdominal Breathing: Place one hand on your chest, the other hand on your stomach just below the ribs. Breath in slowly through your nose – your chest should stay still while your stomach expands out. Then blow the air out through your mouth as if blowing out 50 birthday candles – your stomach should pull in. Your exhale should be twice as long as your inhale. Do 10 of these breaths as often as you can recall throughout the day. (If you start to feel light headed stop and breath normal. To not get light headed, pause for 2 seconds at the end of each inhale and each exhale.)

With these two activities I often see patients return to start treatment with some decrease in their swelling.

Sonja M. Maul PT, CLT-LANA

National Board Certified Lymphedema Therapist

Healthy Skin Maintainance

Another Great Article:

Maintaining healthy skin is essential for those with lymphedema because intact skin, with no scrapes or cuts, prevents bacteria from entering and causing infection.

The swelling of lymphedema stretches the skin and disrupts the skin’s basic protective mechanisms. Also, as lymphedema increases in severity the skin loses its elasticity, becomes thicker and scaly, and is increasingly at risk.

Avoid Smoking

Smoking causes narrowing of the blood vessels in the outermost layers of skin. This decreases blood flow, which depletes the skin of oxygen and nutrients (such as vitamin A) that are important to skin health.

These factors increase damage to the elastic fibers (elastin) and collagen, which give your skin strength and elasticity. When skin is already challenged by the damage of lymphedema, these additional stresses make the condition worse.

Sonja M. Maul PT, CLT-LANA

National Board Certified Lymphedema Therapist

Lymphadema and Infections

Skin infections are something that people with Lymphadema deal with on a regular basis. Here is a good article with information about infections, and especially cellulitis which can become life threatening if left untreated.

Infections that can develop within the affected tissues are a serious complication associated with lymphedema. The risk of infection increases when lymphedema is not controlled by proper treatment and appropriate precautions.

The risks of lymphedema related infections are due to:

• The swelling of lymphedema compromises the health of the skin.
• Protein-rich stagnant lymph within these swollen tissues creates an environment that pathogens love!
• The deep skin folds resulting from the lymphedema are an ideal breeding ground for fungal infections.

Cellulitis

Cellulitis (sell-you-LYE-tis) is an infection that spreads freely, and quickly within the deeper tissues of the skin. Cellulitis becomes a life-threatening emergency when it spreads through the lymphatic or circulatory systems and can reach vital organs and other body parts.

Cellulitis is usually caused by the bacteria staphylococcus aureus that normally live on the skin. Any break in the skin, no matter how small, provides an opening for them to march in, multiply, and thrive. Even a simple act such as shaving a swollen leg could be an invitation to infection.

Symptoms of Cellulitis

• Malaise (a general sense of not feeling well)
• Flu-like symptoms
• Chills and fever
• Discoloration (redness, or streaky red lines)
• Rash
• Tissues that feel hot and tender
• Sudden swelling
• Itching
• Pain

This type of infection requires prompt treatment with antibiotics. See a Physician immediately if you think you may have a Cellulitis infection in a Lymphatic limb!!

Sonja M. Maul PT, CLT-LANA

Article on Swelling

This article was featured at "The Hook." I thought some of you might be interested in it. There is also some interesting issues and questions being raised in the comments section. It would be worth checking out.

DR. HOOK- Big head: Swelling of parts has many causes

by JOHN HONG, MD, published April 10, 2008

Ex-Governor Eliot Spitzer must have had a pretty big ego to think he could hire prostitutes and not get caught. Hello! But then again, it seems most powerful people get a swollen head and feel untouchable-- until they get a swollen lip when they get caught. Perhaps if the head did visibly swell up, it would keep people "in check" because it would be pretty unattractive.

Swelling, in medical terms, is called edema and occurs when fluid from the blood vessels leak into the soft tissues, such as into the legs, arms, lungs, and belly. Not sure what edema is like? Talk to a woman with PMS who's puffy all over-- and be sure to give her flowers.

Legs are the most likely place to have edema. People often complain their socks leave dents in their shins and calves, like a Tempur-Pedic mattress, a condition called "pitting edema." The edema can be uncomfortable from the tension. If the edema goes into the feet, wearing shoes can become difficult (yes, Imelda Marcos).

There are many causes of edema, but a big ego is not one of them. For the legs, poorly working veins are often the issue. If the blood doesn't go up the veins, the blood will pool in the legs and start to leak fluid. That's why folks with leg swelling often start the morning with thin legs-- lying in bed reduces the blood in the legs. Then being upright all day, gravity keeps blood down in the legs, and they begin to swell. In a worse-case scenario, a blood clot (DVT: deep venous thrombosis) backs up the pipes. A DVT usually causes fast edema and on one leg, and this requires immediate medical attention.

Poor lymphatics can lead to lymphedema. For example, a mastectomy with lymph node exploration can lead to permanent arm edema. Lymphedema (as well as edema due to thyroid disease) doesn't cause a pitting edema. (It's more of a Serta mattress.)

Salt! We all hear too much sodium (found in table salt) isn't good for us, and this is especially true for those with edema. If the kidneys can't excrete enough sodium, the pressure in the blood vessels pushes fluid into the soft tissue. It's like when I eat too many salty French fries on a hot day at an amusement park and my fingers swell up. Fluid depletion, like on a hot day in the park, can make the kidneys retain salt and water to worsen edema. Good working kidneys are important to prevent the body from swelling up like a sumo wrestler.

The heart pumps blood through the body-- and in particular to the kidneys-- for proper filtration. People with a weak heart, such as in congestive heart failure, can experience edema. If pulmonary edema occurs, the fluid in the lungs makes it hard to breathe, in particular when lying down, because blood pools in the lungs and they leak fluid. If it's bad enough, the person may have to sleep sitting up in a chair.

Cirrhosis of the liver can cause terrible edema throughout the body, but in particular the belly (ascites). The ascites often requires drainage via a needle. Also, protein levels can drop with cirrhosis, which leads to more edema.

Treatment for edema can be tricky. Compression stockings, exercise, and elevation of the legs might not create Betty Grable gams, but they can be pretty effective. Vascular surgeons can treat poorly working veins. Diuretics can help but also worsen edema depending on the underlying problem, so it's a balancing act.

For politicians with a big head, a little humble pie (minus any salt) might be the best treatment of all. Wouldn't that be swell?

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.