myths & tips for preventing / living with lymphoedema
TRANSCRIPT
Myths & Tips for Preventing / Living with Lymphoedema
Louise Koelmeyer, BAppSc(OT), PhD
Director, ALERT Program
Faculty Medicine, Health & Human Sciences
Macquarie University
Sydney, Australia
• Introducing ALERT
• Lymphoedema and survivorship
• Risk factors & early warning signs
• Signs & symptoms
• Risk minimisation education
• Lymphoedema management
• Debunking the myths
• Finding a qualified lymphoedema therapist
Presentation outline
ALERT - AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT
ALERT
ALERT is a multi-disciplinary national and international flagship program at Macquarie University
providing:
ALERT - AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT 3
The ALERT Mission - Delivering high-standard personalised clinical care, evidence-
based education and innovative research in the field of lymphoedema and lipedema.
AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT
Education
CPD programs for health
professionals and teaching to
MQ students
Research
into the causes of
lymphoedema and strategies
for its effective management
Treatment
conservative and surgical
management strategies for at
risk or living with
lymphoedema
The ALERT Team
ALERT - AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT
Lymphoedema and Survivorship
ALERT – AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT
• Lymphoedema is a survivorship issue
following breast cancer treatment
• It is often the daily reminder of having
survived cancer treatment
PHYSICAL
PSYCHOLOGICAL
FUNCTIONAL
ECONOMICAL
• Extent of surgery and whether lymph node dissection is
performed (ALND = 20%; SNB = <5%)
• Radiation therapy to axilla (30%)
• Trauma
• Infection
• Body mass index (BMI)
• Immobility
• Effects of taxanes? – 6 x risk of increased transient swelling
• Educate women according to risk stratification – high vs low
Key risk factors
ALERT - AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT
May be vague and intermittent and include:
• Feelings of heaviness
• Aching, pain or tension
• Tightness or fullness
• Clothing or jewellery feeling tighter
• Transient swelling
• Pitting oedema “soft indentations”
Early detection and effective management can reduce symptom severity and
improve quality of life. It is the key to SUCCESS in gaining long term CONTROL
Early warning signs
ALERT - AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT
• Use affected arm NORMALLY for daily activities at home, work and during
leisure time.
• Become in tune and aware of own body signs / symptoms
• Maintain a healthy weight with regular exercise
• Use moisturising cream to keep the skin moist and reduce risk of infection (upwards)
• Meticulous skin and nail hygiene (minimise risk of infection /
cellulitis)
Risk minimisation educationHOW DO I LOOK AFTER MY ARM?
ALERT - AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT
• Regular exercise of the affected arm including resistive training exercises will help
circulation and pumping of lymph fluid (swimming / aqua aerobics / gym program / weights).
• Discuss options for wearing a compression sleeve with your medical specialist or
lymphoedema therapist.
Risk minimisation educationHOW DO I LOOK AFTER MY ARM?
ALERT - AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT
• Prospective surveillance aims to detect stage 0 Lymphoedema (subclinical)
• Not visible and with no associated volume change
• Monitoring using Bioimpedence Spectroscopy (BIS) or Tape measure
• Is more easily managed than later stage lymphoedema and potentially reversible
• All women at risk of lymphoedema should have access to early intervention
using compression therapy, exercise and skin care.
Breast Cancer Rehabilitation
ALERT - AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT
PROSPECTIVE SURVEILLANCE & EARLY INTERVENTION MODEL OF CARE
Pre-breast cancer treatment Ax,
Measurement & education
Ongoing education,
rehabilitation, support and monitoring
Early intervention as
appropriate using CLT
Lymphoedema Tool Kit
ALERT - AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT
ALERT - AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH & TREATMENT
Personalising managementICG LYMPHOGRAPHY
Mapping Chart
• Nothing can be done for lymphoedema – NOT TRUE
• Having a blood test or blood pressure taken on same limb causes lymphoedema
- NOT TRUE
• I’ve got lymphoedema in my arm, I am not allowed to use it anymore – NOT TRUE
• I’m at HIGH risk of developing lymphoedema after I had two sentinel lymph nodes
removed – NOT TRUE
• Aeroplane flights trigger lymphoedema – NOT TRUE
• Diuretic medications lessen lymphoedema – NOT TRUE
• I’ve been told I shouldn’t lift heavy weights, handbag or shopping bags – NOT TRUE
Myth debunking
ALERT - AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT
Find a qualified lymphoedema
therapist
www.lymphoedema.org.au
ALERT - AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT
Thank You and Questions
www.mqhealth.org.au/[email protected]
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ALERT – AUSTRALIAN LYMPHOEDEMA EDUCATION, RESEARCH AND TREATMENT