Sunday, May 27, 2007

Lighthouse Lymphedema Network Lymphedema Education & Awareness Program Schedule

Lighthouse Lymphedema Network Lymphedema Education & Awareness Program


Friday, October 5, 2007

1:00-4:00 PM Pre-conference Tour of garment manufacturing plant sponsored by Sigvaris, Inc. Limited to the first 30 who sign up.

5:00-7:00 PM Kick Off Party - includes Style Show and Silent Auction Registration/Check-in * Exhibits

Saturday, October 6, 2007

7:00-7:40 AM Late Registration * Continental Breakfast * Exhibits

7:45-8:30 AM Welcome: Joan White Keynote Speaker: Elizabeth McMahon, PhD

8:30-10:15 AM Plenary Session - Moderator: Nicole Gergich, PT, CLT- LANA

* Exercise Shelley Smith, PT, CSLT Bernice Cohen, PT, CLST

* Overview of the Lymphatic System Paul Stewart, MD, CLT-LANA

* Differential Diagnosis Kathleen Francis, MD

* Diagnosis of Lymphedema through Lymphoscintigraphy Sabah Tumeh, MD

* Imaging - MRI - CAT - Ultra Sound

10:15- 10:45 AM Break

10:34-12:30 PM Plenary Session - Moderator: Elaine Gunter, BS MT (ASCP)

* Exercise Shelley Smith, PT, CSLT Bernice Cohen, PT, CSLT

* Parent, her Story on How Her Son was Diagnosed with Lymphedema Debbie Miles

* Cause of Primary Lymphedema - VEGF Research on Generating Lymphatics David Finegold, MD

* What a Genetic Counselor ddoes and how to find one. Nikki Justice, MS CGC

* How to Evaluate Research Dolores Bradley, PhD

* Lymphatic Research Foundation (LRF) Wendy Chaite, JD, Founder

12:30 - 2:00 PM Lunch * Exhibits

2:00 - 3:30 PM Instructional Sessions

(1) Manual Lymphatic Drainage for the Person with newly Diagnosed Lymphedema Carmelita Rifkin, PT, CLT-LANA

(2) History and Science of Manual Lymphatic Drainage DeCourcy Squire, PT, CLT-LANA Kathryn Thrift, BS, CLT-LANA

(3) Insurance/Medicare Issues Robert Weiss; Cheri Hoskins, CCT

(4) Expert Panel Discussion David Finegold, MD Elizabeth McMahon, PhD

(5) * Professional Session Kathleen Francis, MD

3:30 - 4:00 Break * Exhibits

4:00 - 5:00 PM Instructional Sessions

(6) Lymphedema Advocacy and Awareness Joan White Cheri Hoskins, CCT Pat O'Connor

(7) Exercise Lebed Method: Sherry LeBed Davis Pilates: Maria Elena Grogan, PT Yoga: Neely Sullivan, MPT, CLT

(8) Teen Networking Nicole Gergich, PT, CLT-LANA

(9) * Professional Session: Reducing pereioperative complications in patients with Lymphedema Wade Farrow, MD, CWS, FCCWS

Pain Management Paula Stewart, MD, CLT-LANA

Sunday, October 7, 2007

7:30 9:00 AM Early Morning Breakout Sessions:

Special interest topics - Signup when submitting form. Attendees may also sign-up on site:

* Head and Face Lymphedema - DeCourcy Squire, PT, CLT-LANA
* Genital Lymphedema, Men - Pat O'Connor
* Genital Lymphedema, Women - Shelley Smith, PT, CSLT
* Truncal Lymphedema - Nicole Gergicj, PT, CLT-LANA
* Parent to Parent Networking - Jennifer Fortener

7:30 - 9:00 AM Continental Breakfast * Exhibits

9:00 - 10:30 AM Instructional Sessions

(10) Basic Lymphedema Exercise - Pool Exercises
Janet Wolfson, PT, CSLT Gwen Forbes Kirby, PT, CLT-LANA

(11) Compression Physiology Basics, Bandaging for arms and legs Barry Creighton, DPM, FCCWS, APWCA, CHT Janie Smith, PT, CLT Kim Mainer, OTR/L, CLT-LANA

(12) Expert Panel Discussion Kathleen Francis, MD Paujla Stewart, MD, CLT-LANA

(13) Alternative Treatments: Do they really work? DeCourcy Squire, PT, CLT-LANA Dolores Bradley, PhD

10:30 - 11:00 Break * Exhibits

11:00 - 12:00 PM Instructional Sessions

(14) Obesity and Lymphedema: Difference between Obesity and Lipedema, Bariatric Surgery, Nutritionist Kathryn Thrift, BS, CLT-LANA Christopher J. Hart, MD, FACS Neely Sullivan, MPT, CLT

(15) Compression Garment Problem Solving DeCourcy Squire, PT, CLT-LANA Laura Hoffman; Tammy Malone

(16) Self-Care Arm and Leg Lymphedema Carmelita Rifkin, PT, CLT-LANA

(17) Treatment for Newborns and Children Kathy Kearse, PT, CLT-LANA

12:30 - 2:00 PM Lunch * Exhibits

* Exercise - Janet Wolfson, PT, CSLT; Neely Sullivan, MPT, CLT
* Wound Care and Lymphedema Wade Farrow, MD, CWS, FCCWS
* Foot and Nail Care Barry Creightonm, DPM< FCCWS, APWCA, CHT
* Living Well with Lymphedema Elizabeth McMahon, PhD


On Saturday morning during the Plenary Session, physicians will discussthe lymphatic system, the differential diagnoses and the various diagnostic tools. Foot and Nail Care and patient Issues.


(1) For participants with little knowledge of Complete Decongestive Therapy, learn about Manual Lymphatic Draingage, breathing, strokes, explaination of watershed and much more.

(2) For participants who have knowledge of the treatment protocol called Complete Decongestive Therapay: learn about the history and science of Manual lymphatic Drainage

(3) Learn from the nation's leading lymphedema experts what is going on nationally and locally with medicare and state lymphedema bills and how you can become involved.

(4) Expert Panel Discussion: A question and answer time from patient to physician or therapist.

(5) * Professional Session

(6) Starting a lymphedema support group in your community: how to sponsor educational.awareness event; legislation; finding lymphedema on the web; tips for success.

(7) Exercise Techniques: Lebed Method, Pilates, Yoga

{8} Teen networking.

(9) *Professional Session: In depth discussion of wound care, avoiding infections, cellulitis, pre-signs to look for in organ failure. Pain Managment techniques.

(10) basic lymphedema exercise/pool exercises via closed circuit TV.

(11) Importance of short stretch bandages: bandaging for both upper and lower extremity lymphedema.

(12) Expert Panel Discussion: Another opportunity to ask questions of the professionals.

(13) Accessing a new product: Could it help your lymphedema?

(14) Weight Control: Why it is important not to be overweight. Discussion will include bariatric surgery, nutrition and lipedema.

(15) What to look for in a garment.

(16) The precautions, skin inspection/skin care, and other self-care techniques for the arm and leg.

(17) Treatment for newborns and children.

Lighthouse Lymphedema Netowrk Lymphedema Education & Awareness Program




“Lymphedema: Empowerment through Knowledge"

October 5-7, 2007

Renaissance Waverly Hotel
2450 Galleria Parkway
Atlanta GA 30339

The Lighthouse Lymphedema Network is pleased to invite you to an outstanding educational and awareness conference this fall! Continuing our annual efforts to increase awareness about lymphedema, we have assembled a terrific group of speakers to provide information on a wide variety of topics for patients, family, caregivers, and professionals. We will also have a large number of our excellent vendor associates present to demonstrate current products for lymphedema care and treatment.

Whether you are newly-diagnosed with lymphedema and eager to get more information about what it is and how it can be treated, or perhaps you are interested in learning what the latest research in this field promises, attendance at our program will definitely be beneficial. [Professionals, remember LLN offers CEUs for attendance.]

Our program starts Friday afternoon, October 5, with a pre-conference tour of Sigvaris’ garment manufacturing plant here in Atlanta, and will be followed by a Kick-Off Party from 5:00-7:00 PM. Saturday and Sunday are full of plenary sessions open to everyone, with instructional sessions for both professionals and all other conference attendees.

Lighthouse Information Page

Schedule and Registration Brochure

Information Forum on Lymphedema People

Saturday, May 19, 2007

Benzo-pyrones for reducing and controlling lymphoedema of the limbs.

We hear so much in the lymphedema world ab out benzo-pyrones (flavanoids) and how they help reduce and/or control lymphedema. Sometimes, we are even told taht there have been studies done that verify their effectiveness. I ran across this study in 2004 that reviewed numerous some of these studies and the validity of the info from them. One of the reviewing participants was Dr. Peter Mortimer, th well respected lymphedema doctor in the UK. Interesting.


Benzo-pyrones for reducing and controlling lymphoedema of the limbs.

Cochrane Database Syst Rev. 2004

BACKGROUND: Lymphoedema is the accumulation of excess fluid in the body caused by obstruction of the lymphatic drainage mechanisms. It can be caused by a number of factors, including congenital predisposition, parasitic infection or surgery. Lymphoedema is chronic and progressive and affects a significant proportion of the population. The standard treatment regimes include compression hosiery, skin care and exercise. The use of drugs in treatment, particularly benzo-pyrones, has gained favour over the last ten years. Benzo-pyrones, originally developed for use in vascular medicine, are prescribed to reduce vascular permeability and thus the amount of fluid forming in the subcutaneous tissues. Advocates for this treatment method believe that, as a result of reducing filtration, the drugs have some beneficial effect on pain and discomfort in the swollen areas. Proponents also claim that these drugs increase macrophage activity, encouraging the lysis of protein, which in turn reduces the formation of fibrotic tissue in the lymphoedematous limb.

OBJECTIVES: To assess the effectiveness of benzo-pyrones compared to placebo or to different benzo-pyrones in reducing limb volume, pain and discomfort in lymphoedematous limbs. To assess the effect of benzo- pyrones on the quality of affected tissues and on the patient's quality of life and, finally, to establish the incidence of adverse effects.

SEARCH STRATEGY: We searched the Cochrane Breast Cancer Group register (September 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 4,2003), MEDLINE, EMBASE, CINAHL, UnCover, PASCAL, SIGLE, reference lists produced by The British Lymphology Society, the National Research Register (NRR) and The International Society of Lymphology congress proceedings.

SELECTION CRITERIA: Types of studies considered for review were randomised controlled trials testing Paroven, coumarin, Venastat, Cyclo 3 Fort or Daflon versus placebo (with both groups having or not having standard physical treatment DATA COLLECTION AND ANALYSIS: Eligibility for inclusion was confirmed by two blinded reviewers who screened the papers independently using a checklist of criteria relating to the randomisation and blinding of the trial. Both reviewers extracted data from the eligible studies using a data extraction form.

MAIN RESULTS: Overall, 15 trials were included that evaluated the role of benzo-pyrones. Three trials of oxerutin were found. Each tested the drug over 6 months using the same dose of drug against placebo. Two were crossover trials and one a parallel group trial with a total number of 127 participants and data available for only 81 of them. There were insufficient data provided in any of the trials to calculate the per cent reduction or increase in baseline excess limb volume. Standard deviations or confidence intervals and the numbers in the groups at the different stages of the trial were missing for all the data in two of the reports and for much of the data in the third, making any attempt at meta-analysis impossible.One trial testing Cyclo 3 Fort (approved name) over 3 months was found and involved 57 patients but provided insufficient data to allow a proper analysis of its findings. A single trial of Daflon (approved name) was found, lasting 6 months and involving 104 participants; once again there was insufficient information provided in the report to reach a conclusion about the effectiveness of the drug.

Three trials of coumarin combined with troxerutin were found and tested two different doses of the drug against each other with no placebo, however, numbers of participants in the trial groups and baseline data were not provided. Eight trials of coumarin were identified. Two of the reports were confirmed as reporting the same trial and a further trial potentially also referred to the same trial but this was unconfirmed. A further two papers appeared to refer to the same trial but this was not confirmed. Three trials involved the same researcher. Five studies were conducted in India or China and they added anti-filarial dia or China and they added anti-filarial drugs to the interventions tested. The numbers of participants withdrawn and the numbers included in the analyses in all these trials were not extractable; the reporting of outcome measures in most of the trials was not clear.

Loprinzi's 1999 trial in the USA reported the conduct of the trial and its findings with more detail, however, its conclusions were very much at odds with the findings of the other trials, finding that no difference was observed between those on the active preparation (coumarin) and placebo in any of the outcomes under investigation. This trial also reported a case of hepato-toxicity in a patient receiving the active preparation.

REVIEWERS' CONCLUSIONS: Meta-analysis was not performed due to the poor quality of the trials. It is not possible to draw conclusions about the effectiveness of Benzopyrones in reducing limb volume, pain, or discomfort in lymphoedematous limbs from these trials.

Plain language summary

Currently there is not enough evidence from research to show that benzo-pyrones are either beneficial or unhelpful in reducing lymphoedema.

Lymphoedema is an accumulation of excess fluid, mainly in the arms and legs. It can occur in several ways: from birth; as a result of a parasitic infection; or as a complication of cancer surgery. The most common treatments are compression hosiery (e.g. bandaging, sleeves, etc.), skin care and exercise. The drugs commonly known as benzo- pyrones have been prescribed to prevent the fluid leakage and collection which characterises lymphoedema.

This review found that there was not enough good quality evidence to draw conclusions about whether benzo-pyrones are useful either in reducing lymphoedema or the pain and discomfort associated with it.

The Cochrane Library

Friday, May 11, 2007

Lymphedema Affects Quality Of Life

Lymphedema Affects Quality Of Life

May 10, 2007


Almost one-third of young breast cancer survivors surveyed by researchers at the Ohio State University Comprehensive Cancer said their quality of life suffered because they experienced lymphedema, an often debilitating consequence of breast cancer treatment.

The findings are significant because they point to the need for preventive education, says principal investigator Electra Paskett, associate director of population sciences at Ohio State's Comprehensive Cancer Center.

"This is the first study in the United States to look at the incidence, prevalence and persistence of lymphedema among young breast cancer survivors, and how having lymphedema negatively affects their quality of life," says Paskett. "We found that the women who reported persistent swelling of their arms or hands after surgery or radiation were more likely to report poorer quality of life."

The research involved 622 breast cancer survivors who were 45 years or younger at diagnosis. They were monitored with semiannual questionnaires for 36 months after breast cancer surgery to determine the incidence of lymphedema, prevalence of swelling, factors associated with each and quality of life.

The study is published in the April issue of the Journal of Cancer Epidemiology Biomarkers & Prevention.

Lymphedema is a common complication of cancer therapy and is characterized by an accumulation of lymphatic fluid, which causes swelling, most often in the arms or legs. Lymphedema can occur anywhere lymph nodes have been surgically removed or lymph flow has been disturbed.

The study found that 54 percent of participants reported at least one incidence of swelling of the arm or hand within 36 months after surgery, with 32 percent reporting persistent swelling. Swelling was reported to in the upper arm by 43 percent of the women; in the hand only by 34 percent; and in both arm and hand in 22 percent of participants.

Factors associated with an increased risk of developing swelling included having a greater number of lymph nodes removed, receiving chemotherapy and being obese. Factors associated with persistent swelling included having more lymph nodes removed and being obese. Weight management may be a potential intervention for those at greatest risk of lymphedema to maintain optimal health-related quality of life among survivors, Paskett says.

Women who reported swelling had significantly lower quality of life compared to women without swelling, Paskett says.

"These are the women we are most concerned about," says Paskett, a two- time breast cancer survivor who struggles with a mild case of lymphedema. She does daily exercises and occasionally wears a pressure sleeve and glove to control her swelling.

"If we can identify women who are at greatest risk of developing lymphedema, then we can educate them about the problem, so they can watch for symptoms and seek early treatment," Paskett says.

The majority of women in the study reported mild swelling. But even that can interfere with daily activities and negatively affect quality of life, she says.

"Some women must buy larger clothing because of the swelling, while others can't wear rings or button their blouses because their fingers are swollen," Paskett says. "For many, lymphedema is a constant reminder that they had cancer."

Paskett also is the principal investigator of a major, multicenter clinical trial that will enroll 500 women nationwide in the Lymphedema and Education Awareness Program. The ongoing study will test a program to prevent lymphedema in women who have been treated for breast cancer.
There is always a risk of developing lymphedema after the removal of lymph nodes during breast cancer surgery, and the condition can develop immediately, in months or even years later, Paskett says.

"It is important for women to recognize the signs and symptoms of lymphedema and seek treatment immediately to lessen the severity," Paskett says.

Saturday, May 05, 2007

Microsurgery for treatment of peripheral lymphedema: Long-term outcome and future perspectives.

Microsurgery for treatment of peripheral lymphedema: Long-term outcome and future perspectives.

Microsurgery. 2007 May 3

Campisi C,
Eretta C,
Pertile D,
Da Rin E,
Campisi C,
Maccio A,
Campisi M,
Accogli S,
Bellini C,
Bonioli E,
Boccardo F.
Department of Surgery, Unit of Lymphatic Surgery and Microsurgery, San Martino Hospital, University of Genoa, Genoa, Italy.

Authors report over 30 years of their own clinical experience in the treatment of chronic peripheral lymphedemas by microsurgical techniques performed at the Center of Lymphatic Surgery of the University of Genoa, Italy. Over 1,500 lymphedema patients were treated with microsurgical techniques. Derivative lymphatic-venous techniques were most often used. For those cases where a venous disease was associated to lymphedema, reconstructive lymphatic microsurgery techniques were performed (lymphatic-venous-lymphatic-plasty).

Objective assessment was undertaken by water volumetry and lymphoscintigraphy. Volume changes showed a significant improvement in over 83%, with an average follow-up of more than 10 years. There was an 87% reduction in the incidence of cellulitic attacks after microsurgery.

Microsurgical lymphatic-venous anastomoses have a place in the treatment of peripheral lymphedema and should be the therapy of choice in patients who are not sufficiently responsive to nonoperative treatment. Improved results can be expected with operations performed at earlier lymphedema stages. (c) 2007 Wiley-Liss, Inc. Microsurgery 2007.

PMID: 17477420 [PubMed - as supplied by publisher]