Lymphedemaville

5:59:09 AM EDT

Lymphedema People

Public Notice

Statement of Ownership

The website Lymphedema People also referred hereafter as
lymphedemapeople.com is a distinct separate entity from the domain registered as http://lymphedemapeople.com and should not be construed to be one in the same.

The website Lymphedema People (commonly referred to as
lymphedemapeople.com) predates the domain registration as the website as established in 2003 and the aforementioned internet domain was established in 2006.

Ads placed on the website and donations are the responsibility of the domain and are to be used to provide financial reimbursement to the domain for the expenses it incurs as hosting the website.  Responsibility for those ads and questions concerning the ads rests with the domain and not the website.  Users of the website agree to a hold harmless agreement regarding the ads and donations.

Under the terms of intellectual property, established by legal precedent and law, the website Lymphedema People
(lymphedemapeople.com) is the creative, intellectual and personal property of Pat O’Connor (Charles P. O'Connor, II).

The website name Lymphedema People both as a trademark and a website name is the sole property of Pat O’Connor. Use of that name is prohibited by any other agency, person group or entity.

All online support groups, blogs and entities so identified as being sponsored by Lymphedema People are the sole personal property of Pat O’Connor and are governed by the hosting agency.  These agencies include, but are not restricted to Yahoo, Google, AOL, Lycos and MSN.

These groups are listed as sponsored as defined by the website Lymphedema People and not the domain.

Pat O’Connor

August 14, 2008

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5:14:46 AM EDT
Ann Surg. 2008 Aug

Sydney Melanoma Unit at the Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia. andrew.spillane@smu.org.au

OBJECTIVE: This study aims to objectively define the criteria for assessing the presence of lymphedema and to report the prevalence of lymphedema after inguinal and ilio-inguinal (inguinal and pelvic) lymph node dissection for metastatic melanoma.

SUMMARY BACKGROUND DATA: Lymphedema of the lower limb is a common problem after inguinal and ilio-inguinal dissection for melanoma. The problem is variably perceived by both patients and clinicians. Adding to the confusion is a lack of a clear definition or criteria that allow a diagnosis of lymphedema to be made using the various subjective and objective diagnostic techniques available.

METHODS: Lymphedema was assessed in 66 patients who had undergone inguinal or ilio-inguinal dissection. Nine patients received postoperative radiotherapy. Assessment was performed by limb circumference measurements at standardized intervals, volume displacement measurements, and volumetric assessment calculated using an infrared optoelectronic perometer technique.

Comparisons were made with the contralateral untreated limb. Patient assessment of the severity of lymphedema was compared with objective measures of volume discrepancy.

Classification and regression tree analysis was used to determine a threshold fractional leg volume or circumference increase above which patients could self-detect volume changes that they reliably considered to indicate lymphedema.

RESULTS: Based on classification and regression tree analysis, both the whole limb perometer volume percentage change > or = 15% and the sum of circumferences (of 6 defined sites along the limb) percentage change > or = 7% performed well overall in predicting moderate or severe perceived swelling (defined as "lymphedema"). Both definitions predicted lymphedema in approximately the same fraction of patients with misclassification rates of 16% and 15%, sensitivity 56% and 50%, specificity 95% and 100%, respectively. Using > or = 15% of whole perometer volume percentage change, 12% of patients with inguinal dissection had lymphedema compared with 23% of patients with ilio-inguinal dissection. Combining both groups, 18% of patients had lymphedema, positive and negative predictive values 82% and 84%. Using the definition > or = 7% of the sum of circumferences percent change, 7% of patients with inguinal dissection had lymphedema compared with 19% of patients with ilio-inguinal dissection (overall 14% had lymphedema, positive and negative predictive values 100% and 82%, respectively). Of the variables assessed, only radiotherapy was significantly associated with predicted lymphedema (OR 12.6; 95% CI 1.7 to > 100; P = 0.001 using whole perometer change > or = 15%; and OR 13.0; 95%CI 1.4 to > 100; P = 0.021 using sum circumference change > or = 7%).

CONCLUSIONS: A whole limb perometer volume percentage change of > or = 15% and increase in the sum of circumferences of the defined points along the limb > or = 7% provide robust definitions of lower limb lymphedema.

Lippincott, Williams & Wilkins

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12:09:49 PM EDT

Meet the Therapist – new forum on Lymphedema People

Have you ever needed to or wished that you could ask a therapist a quickie question about your treatment program, bandaging tips,garment problems?

Well, now you can!!!!

Announcing our new forum:

MEET THE THERAPIST

Managed by Tom Kinchloe, Certified Lymphedema Therapist

Go to:

Lymphedema People

http://www.lymphedemapeople.com/

Click on:

Forums

Scroll down until you see the forum - and ask away :-)

If any of our membes are also therapists, you are most welcome to join in and help.

Tom is a member of our Yahoo group:

Advocates for Lymphedema

not only is he a top notch lymphedema therapist, but has a caring and compassionent heart for those he serves. 

I am very excited about this new forum and look forward to seeing everyone's participation.

A half million people have visited Lymphedema People so far in 2008, come and be a part of the most popular website in the world for lymphedema and lymphatic conditions. 

Pat O’Connor
Founder and Director

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1:34:24 AM EDT

Cystic lymphangioma: An unusual cause of lower limb lymphedema

J Mal Vasc. 2008 Jul 3

Hadj-Henni A, Ladan-Marcus V, Javerliat I, Bouhzam N, Fouilhe L, Marcus C, Long A.

Unité de médecine vasculaire, hôpital Robert-Debré, CHU de Reims, rue du Professeur-Kochman, 51100 Reims, France.

We report an unusual cause of unilateral lymphedema of the right limb rapidly increasing in a young woman. Ultrasonography ruled out the diagnosis of iliac deep venous thrombosis or extrinsic compression: the B mode scan revealed a mass located below the aortic bifurcation and along the iliac vessels, without any compressive effect. The lesion was heterogeneous associating both tissular and cystic aspects. The lower limb lymphoscintigraphy showed an interruption of the colloid circulation at the right iliac level. Computed tomography did not give any additional information. Magnetic resonance imaging before then after gadolinium showed typical aspects of cystic lymphangioma and confirmed the ultrasonography hypothesis. Considering that this tumor is benign, that surgery would be difficult because of the anatomic situation of the mass, and that post-operative involution of the edema is uncertain, the treatment was based on compressive stockings and regular follow up.

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5:52:41 AM EDT

===============================================

Join us as we work for lymphedema patients everywhere:

Advocates for Lymphedema

Dedicated to be an advocacy group for lymphedema patients. Working towards education, legal reform, changing insurance practices, promoting research, reaching for a cure.

http://health.groups.yahoo.com/group/AdvocatesforLymphedema/

To Subscribe

AdvocatesforLymphedema-subscribe@yahoogroups.com Join us today to learn about, for daily discussions and for advocacy on behalf of lymphedema.

Pat O'Connor

Lymphedema People / Advocates for Lymphedema

==============================================

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12:47:47 AM EDT
11th Annual Lymphedema Education & Awareness Program

An educational and awareness conference for patients, caregivers and professionals!

at Piedmont Hospital

Richard H. Rich Auditorium

1968 Peachtree Road, NW, Building 77

Atlanta, Georgia

Saturday, October 18, 2008

7:30 am - 5:30 pm

Program includes:

What to expect of tissue after radiation? What is the physiology response of radiation? What does radiation do to the lymph nodes? - Peter Rossi, MD

How does vascular flow affect the lymphatics? - Ken Harper, MD

Expectations of surgery. - Christopher Hart, MD, FACS

The Lymphatic System, Wound Care, Infections and Treatment - Paula Stewart, MD

Parent Networking

Aquatic Exercises

The Connection of obesity and increased swelling in people with lymphedema and lipedema.

and more.

Additional information and registration form:

http://images.acswebnetworks.com/1/187/ ... rogram.pdf

Lighthouse Lymphedema Network

http://www.lymphedemalighthouse.org/

See you there


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8:42:09 AM EDT

Home-based lymphedema treatment in patients with cancer-related lymphedema or noncancer-related lymphedema.

Oncol Nurs Forum. 2008 Jul

Ridner SH, McMahon E, Dietrich MS, Hoy S.

School of Nursing, Vanderbilt University, Nashville, TN, USA. sheila.ridner@vanderbilt.edu

PURPOSE/OBJECTIVES: To compare treatment protocol adherence, satisfaction, and perceived changes in emotional and functional status between patients with lymphedema with and without cancer using the home-based Flexitouch (Tactile Systems Technology, Inc.) system for lymphedema self-care.

DESIGN: Quasi-experimental, pre- and post-test design.

SETTING: Private homes in the continental United States and Alaska.

SAMPLE: 155 community-dwelling individuals with lymphedema: 93 with cancer-related lymphedema and 62 with noncancer-related lymphedema.

METHODS: A survey was completed before use of the Flexitouch system. Participants received in-home education about device use, safety precautions, and the two-phase therapy protocol. A post-therapy survey was completed during the maintenance phase of the protocol.

MAIN RESEARCH VARIABLES: Use of the Flexitouch system, treatment protocol adherence, participant satisfaction, and emotional and functional status.

FINDINGS: Participants without cancer were more adherent to the prescribed protocol. Both groups were satisfied with the system, perceived it to be effective, and reported improvement in physical and emotional status. Participants' use of professional manual lymphatic drainage (MLD) therapy, self-MLD, and bandaging declined after they initiated use of the Flexitouch system.

CONCLUSIONS: Patients using the Flexitouch system were satisfied with the device and perceived it to be beneficial in management of their lymphedema.

IMPLICATIONS FOR NURSING: Patients using the Flexitouch system should be assessed for adherence to the prescribed treatment protocol and use of other self-care treatments. Healthcare professionals should facilitate communication among members of the lymphedema treatment team and the patient when problems are noted.

PubMed

 

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8:38:35 AM EDT

Important changes on Lymphedema People

Happy Fourth of July

I did want to advise everyone on some important changes on Lymphedema People.

I have put out a number of new Wiki pages in the last week. There is a page you can go to to see any new or revised articles:

New Articles and Updates

You can also "subscribe" to this page and automatically be advised when new articles and updates are posted. When you go to the page, scroll way down and click on the "RSS/XHL Feed" on the left bottom corner. 

That takes you to a page where at the top in a yellow background panel you can subscribe to that page. Click on
the "Subscribe to the feed" line.

On the new website entry page:

http://www.lymphedemapeople.com/

Search

We now have a search line that finally brings together the ability to search all HTML articles; Wiki pages and the Forums. When you enter a term on that lines, now no matter where on the entire site a subject is, you will finally be able to find it.

Translate

While translation technology still has a long way to go, Google has the best tool available. Below the search line is a new translation device. We literally have several thousand people a week visiting the website from around 130 countries. This translation device will translate 24 languages other then English When a language is chosen, the website will change and come back up in the chosen language.

I am excited about this as it helps so many people have access to lymphedema information in their native language.

This is what it is all about folks.

I hope you enjoy the new features.

Pat

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7:23:15 AM EDT
Targeted treatment for lymphedema and lymphatic metastasis.

Ann N Y Acad Sci. 2008

Tervala T, Suominen E, Saaristo A.

Department of Plastic Surgery, Turku University Central Hospital, Turku, Finland.

The presence of lymphatic vessels has been known for centuries, but the key players regulating the lymphatic vessel growth and function have only been discovered during the recent decade. The lymphatic vasculature is essential for maintenance of normal fluid balance and for the immune response. Hypoplasia or dysfunction of the lymphatic vessels can lead to lymphedema. Currently, lymphedema is treated primarily by physiotherapy, compression garments, and occasionally by surgery, but the means to reconstitute the collecting lymphatic vessels and cure the condition are limited. Specific growth factor therapy has been used in experimental models to regenerate lymphatic capillaries and collecting vessels after surgical damage.

Recent results provide a new concept of combining growth factor therapy with lymph node transplantation as a rationale for treating secondary lymphedema. Lymphatic vessels are also involved in lymph node and systemic metastasis of cancer cells; our understanding of mechanisms of lymphatic metastasis has increased remarkably.

Annals of the New York Academy of Sciences

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10:26:02 PM EDT

Localized lymphedema (elephantiasis): a case series and review of the literature

J Cutan Pathol. 2008 Jun 17

Lu S, Tran TA, Jones DM, Meyer DR, Ross JS, Fisher HA, Carlson JA.

Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, NY, USA.

Background: Lymphedema typically affects a whole limb. Rarely, lymphedema can present as a circumscribed plaque or an isolated skin tumor.

Objective: To describe the clinical and pathologic characteristics and etiologic factors of localized lymphedema.

Methods: Case-control study of skin biopsy and excision specimens histologically diagnosed with lymphedema and presenting as a localized skin tumor identified during a 4-year period.

Results: We identified 24 cases of localized lymphedema presenting as solitary large polyps (11), solid or papillomatous plaques (7), pendulous swellings (4), or tumors mimicking sarcoma (2). Patients were 18 females and 6 males with a mean age of 41 years (range 16-74).

Anogenital involvement was most frequent (75%) - mostly vulva (58%), followed by eyelid (13%), thigh (8%) and breast (4%). Causative factors included injury due to trauma, surgery or childbirth (54%), chronic inflammatory disease (rosacea, Crohn's disease) (8%), and bacterial cellulitis (12%). Eighty-five percent of these patients were either overweight (50%) or obese (35%). Compared with a series of 80 patients with diffuse lymphedema, localized lymphedema patients were significantly younger (41 vs. 62 years old, p = 0.0001), had no history of cancer treatment (0% vs. 18%, p = 0.03), and had an injury to the affected site (54% vs. 6%, p = 0.0001).

Histologically, all cases exhibited dermal edema, fibroplasia, dilated lymphatic vessels, uniformly distributed stromal cells and varying degrees of papillated epidermal hyperplasia, inflammatory infiltrates and hyperkeratosis.

Tumor size significantly and positively correlated with history of cellulitis, obesity, dense inflammatory infiltrates containing abundant plasma cells, and lymphoid follicles (p < 0.05). A history of cellulitis, morbid obesity, lymphoid follicles and follicular cysts predicted recurrent or progressive swelling despite excision (p < 0.05).

Conclusions: Localized lymphedema should be considered in the etiology of skin tumors when assessing a polyp, plaque, swelling or mass showing dermal edema, fibrosis and dilated lymphatics on biopsy. A combination of lymph stasis promoting factors (trauma, obesity, infection and/or inflammatory disorders) produces localized elephantiasis.

Blackwell Synergy

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