When my sister, Phyllis Tubbs-Gingerich, asked me to write an article for this newsletter, I agreed because it seemed like a good chance to make a contribution. I could share my knowledge and expertise and help others at the same time. You see, I have had a private counseling practice for more than 20 years and have taught in higher education for almost as long. As I thought about the topic for this article, I realized that even though I might be a "subject matter expert" in psychology and mental health, I knew relatively little about lymphedema. One thing seemed apparent, namely, that grief and loss are a pervading theme. I wondered how I would "attack" this subject? Phyllis, who heads up the Gin-ger-K Center in Morgan Hill, CA. sug-gested that my background makes me "expert" enough. I wanted to know how much grief and loss the victims and their families of this problem suffer . I also wondered how the caregivers deal with grief and loss on a daily basis, not only in their patients, but also within them-selves. These questions took me to the Chi-cago 2004 Lymphedema International Conference. As I networked with con-ference attendees and exhibitors, I quickly discovered that the medical as-pects of lymphedema are still being de-fined and little consideration has been given to the psychological effects of this

disease. It is my hope that this article on grief and loss may serve as a catalyst for further discussion. What has been lost by lymphedema patients and their families? Loss of wholeness and health, loss of function-ing, loss of perceived normalcy, loss of freedom and financial loss, to name a few. According to Dr. Elisabeth Kübler-Ross, author of “On Death and Dying” and founder of the hospice movement, whenever we lose something of value, we go through a fairly predictable pro-cess of grief. Our first reaction is SHOCK: “I can't believe this is happen-ing." Our whole body and mind take a sharp breath. We then go into a process called "grief work" which may last only a short time or may be quite prolonged. Kübler-Ross describes five stages of grieving as normal for every loss, no matter how large or small: denial, bar-gaining, depression, anger and ac-ceptance. We go through these five stag-es in no particular order and for as long as it takes us, often repeating them as we try to come to terms with the pain. Denial: “This doesn't happen to me or to my family. The doctor must be wrong.” Bargaining: "Please give me a pill to take to cure it. God, if you heal me, I’ll...”

Continued on page 13.

Grief, Loss, and Lymphedema by Dr. Bill King, therapist and educator

L y m p h e d e m a I n f o r m a t i o n L y m p h e d e m a I n f o r m a t i o n L y m p h e d e m a I n f o r m a t i o n L y m p h e d e m a I n f o r m a t i o n S u p p o r t G r o u pS u p p o r t G r o u pS u p p o r t G r o u pS u p p o r t G r o u p

I ns i de t h i s i ssue :

Vo lume 4 , Issue 1 Win te r 201 4

Feature Article

Front Cover

First Hand--A Patient’s Perspective

2-3

A Pedorthist 4-5

Gradient Compression Garments

6-7

Two Interns’ Views

8-9

Dietary Corner

10

Upcoming Event

11

Exercise 12-13

LISG Contribution Form

14-15

Upco ming Ev ent :

Healthy Feet and Legs Expo

Saturday, April 26

10 AM - 3PM

Morgan Hill

Centennial Recreation Center

See page - 11

LISG

My Persona l Exper ience w i th Lymphedema By Dawn Sudmeie r

My experience with lymphedema dates back to a breast biopsy in 2000. Shortly after my surgery, I needed follow-up care for inflammation and swelling in my breast. This led to needle extraction and treatment with antibiotics. No one even considered lymphedema as the source of my trouble. After all, it had just been a biopsy and not anywhere near a lymph node.

Fortunately, fate intervened, and that led to my treatment with Phyllis Tubbs-Gingrich. My condition was mild but ex-acerbated by weekly airplane trips and high level of stress. My condition is now stable, with little or no swelling. When I was diagnosed, I was so frightened of losing my quality of life.

My research and experience resulted in a few tips that I'd like to share. But to understand my process of healing, I need to explain that I envision the lymph fluid in my body as a flowing river. When the fluid is thick, it builds up and congests. When I do the right things, it is thin and flowing. I’ve followed the conventional wisdom of treatment but have also ex-plored herbal supplements and non-traditional treatments as well.

First, a word about the traditional rec-ommendations. The "food enemies" for me are salt and alcohol. Both are dehy-drating and the lymph fluid seems to col-lect more. Drinking lots of water keeps the fluid flowing.

Heat and sun are a major problem. Anytime the temperature is more than 80 degrees, pain and swelling begin. So I avoid being in temperatures over that. That has made me a shut-in during much of the summer. So we're planning a move to the Oregon coast to live in a more

temperate climate. Losing weight has helped. My sports bra, with a wide-band bottom and padded shoulder straps, is my everyday bra. This allows the fluid to flow past the straps and band.

I began swimming three times a week and saw dramatic improvements. The movement and the water pressure on the arm and breast helped to get the fluid moving. Ironically, the breast stroke was like a miracle to relieve the congestion. Even if you can’t swim, just standing in deep water and moving the arms in cir-cles and swinging them from side to side will work. Water walking or aqua aero-bics are also great but, keep your arm underwater as much as possible.

Now for the more unconventional treatments that I feel really made a major contribution. I found an herbal extract that really helps to keep the fluid flow-ing. It's called Lymph Tonic from Danc-ing Willow Herbs in Durango, CO. (970-247-1654). It's a blend of Red Root, Echinacea, Burdock and Poke Root. I took it 3 times a day in a glass of water, every day for about a year. Now I use it when I'm feeling like I need some extra help. These herbs are cleansers and im-mune-system boosters and I had no side effects at all.

I also took Horse Chestnut capsules. It's a "thinner" and is used for varicose veins. I heard that The Scripps Research Institute is using it in their lymphedema treatment program. It really made a dif-ference. I followed the label directions and took it for about six months. I don't take it now unless I'm having trouble. Be careful not to overdose because it thins the blood. If you see more bruising, back off on the dosage.

L I S G P a g e 2

No one even

considered

lymphedema as the

source of my trouble..

First Hand A Patient's Perspective

P a g e 3

First Hand First Hand First Hand First Hand — the personal views of those affected by lymphedema, “first hand.”

Fo r pat ien ts and fami l y members

who wan t to share a persona l s to ry abou t the i r wa l k

wi th l ymphedema, p lease send to :

L ISG c /o Phyl l i s Tubbs-Ginger i ch 16130 Juan Hernandez Dr ive

Su i te 108 Morgan H i l l , CA 95037-5527

-o r -

emai l : phyl l i s@gingerkcen te r .com

I also have chronic candidiasis (yeast) that has affected the lymphede-ma by thickening the sinus mucus and intestinal fluids It stands to reason that it also thick-ens lymph fluid. Prior to my breast sur-gery, I had swelling in my face and neck, especially in the lymph drainage area by my collarbone. I now know that this was a backup of lymph fluid. I've never read about any connection be-tween candida and lymph, but I KNOW it's there. With pre-existing conditions like I had, I’m not really surprised that lymphedema developed from a simple biopsy. Most physicians don’t understand chronic candida. Symptoms include si-nusitis, irritable bowel, muscle fatigue, ringing in the ears, vaginal yeast infec-tions, even depression, memory loss, and “brain fog.” It’s usually caused by frequent use of broad-spectrum antibiot-ics like Keflex and Tetracycline. A new drug called Zitromax put me in the hos-pital, with no muscle strength on my left side. Use of steroids can also cause can-dida. I'd recommend that you check out two books on yeast problems: Chronic Candidiasis by Dr. Michael Murray and The Yeast Connection Handbook by Dr. William Crook. Both books contain a simple test to determine whether you have candida. Osteopaths and naturopaths are more aware of treatment options than MD’s. If you have an expert in your local health food store, discuss it with them. The treatments that I use for my candida are a supplement from Pure Essence Labs called Candex and Oil of Oregano. Both kill the fungus in your system and allow the lymph fluid to thin out and flow more easily. You should follow a low carbohydrate diet with no sugar, no fermented foods like yeast and vinegar, no alcohol, no moldy foods like cheese,

Sugges ted Read ing

One Answer to Ca ncer- -W i l l iam Do na ld Ke l l y ,

M.D. W ww.drke l ley .co m/CANLIVER55.h tml

____________

Nature ’s Med ic ines- -Gale Ma leskey and the ed i to rs o f P revent ion

Hea l th Books

____________

The Hea l ing Foods- -Pat r ic ia Hausman and

Jud i th Hur ley _______________

Books by Dr . W i l l iam G.

Crook:

The Yeast Connec t ion : A Med ica l B reak th rough

The Yeast Connec t ion and

Women ’s Hea l th

The Yeast Connec t ion Handbook: How Yeasts

Can Make You Fee l ‘S ick A l l Over ’ . . .

and no fungi like mushrooms. And yes, you can cheat a little and will have more tolerance once the yeast is under control. I’m living a really normal life at this point, except for the intol-erance to heat. I’m happy and no longer stressed out about my condition. I hope that these tips help others to improve their lives as well. If you’d like more details about alternative treatments and formulas used to control lymphedema and Candida, Dawn Sudmeier invites you to contact her at:

dawnsud@tds.net

W in ter 2014, Vo lume 4 Issue 1

When was the

l a s t t ime you had your f ee t

checked?

Pedor th i cs : The Who , Wha t , Whe n , Where , and Why

by Ju l i a Sa l zano C .ped , CMA, CBCS

Myjourneyintothehealthcare�ieldbeganin2004whenIwashired

at a small specialty store that sold fashion friendly orthopedic shoes.

WhenI�irstappliedforthejob,Ihadneverheardofpedorthics.Ididn’t

knowanythingaboutshoesotherthanwhatanormal17-yearoldgirl

would know. After applying and being hired, it took only a fewdays

beforeIrealizedIwasinformorethanjustsellingshoespart-time. Myboss,theownerofthestoreandtheon-staffcerti�iedpedorthist,

beganmy training immediately.Hestartedby introducingme to foot-

wearlinesandwhatstylesuitedwhattypeoffeet.Next,wefocusedon

designingcustommadeorthotics,andlastly, I learnedaboutmodi�ica-

tions.

Iwatchedmanytimesashewouldcutashoeinhalf,ripitopen,cut

pieces out, andbymanyde�initions, destroy it.However, thedestruc-

tion lead to the reconstruction of the shoes which were crafted and

modi�iedtospeci�ically�itthepatient’scondition.

Whetherweexcavatedashoeforulcers,wideneditforbunions,or

cutitopentochangethelast(theshapeinwhichtheshoeismade),all

theseprocessesexcitedmeaboutpedorthicsandinspiredmetogofor-

wardintheprofessionandobtainboardcerti�ication.

Oneof themostcommonquestions Ihavereceived inmyworking

experienceis,“Whatispedorthics?”

Pedorthics de�ined byWayneDecker in “ContemporaryPedorthics”

is, “the practice, pursuant to a written order/prescription when ad-

dressing amedical condition of: evaluation, treatment, planning, pa-

tient managing, measuring, designing, fabricating, assembling, �itting,

adjusting,orservicing,necessarytoaccomplishtheapplicationofa

pedorthicdevice for thepreventionorameliorationofpainfuland/or

disablingconditionsofthefootandankle.”

Or in lay person’s terms,apedorthististrainedinthe�ittingof

footwear,orthotics,devices,andmodi�icationstohelprelieveand

alleviatefootpainandshoediscomfort.

Another frequently askedquestion is, “Whyaretherebene�itsin

seeingacerti�iedpedorthist(C.Ped)?”

The average person spends a signi�icant amount of time on their

feet.Whetheryouareatwork,runningerrandsorstayingactive,walk-

ingandbeinginaweightbearingposition(standingupright)isanatu-

ralpartoflife.Alloftheseactivitiescanleadtotiredandachyfeetfrom

alongorbusyday,andcanbeexacerbatedbywearingimpropershoes.

Atthispointyoumaybeaskingyourself,“Whenwouldbethetime

toseeaC.Ped?”

Continued on next page.

P a g e 4 L I S G

Theanswerisnow!AC.Pedisnotjusttrainedinhelpingproblematic

feet,theycanalsoguideinselectingtheshoesrightforyou,helpeaseeveryday

commonfootpain,andpreventanydebilitatingcomplicationsthatmayoccur

withinadequateshoesorfootcare.

Whenwasthelasttimeyouhadyourfeetmeasured?

Didyouknowaging,weightgain,accidentsorinjury,andpregnancycanall

affectyourfeetandshoesize?Or,thatwearinganimpropershoesizecanlead

tohangnails,bunions,blisters,andcallouses.Forthesereasons,acerti�ied

pedorthistiseducated,skilled,andtrainedto:

·Assistin�indingthepropershoesizebymeasuringyourfeetfor:

-Footlength

-Archlength/Archtypeex:�lat,medium,high

-Widthandshapeex:narrow,medium,wideandsquare,

round,orpointy;

·Guideinpropershoeselection,whethertolookfor:

-Flatorcontouredshoe

-MedialorLateralsupport

-Highcushionandshockabsorptionorstructureandrigidity

-Styleofshoeex:boot,walking,running,opentoeorVelcro;

Withadoctor’sreferralorphysician’sprescription,acerti�iedpedorthist

canhelpprevent,treat,andalleviatepainassociatedorcausedby:

-Hammertoes

-Clawtoes

-PlantarFasciitis

-Metatarsalgia

-Bonespurs

-Bunions

-Andmanymoresimpletocomplexailmentsthatcan

ariseinthefoot,ankle,andlowerextremities.

The�inalquestionI’mfrequentlyaskedis,“Whocanguidemein�indinga

certi�iedpedorthistandwherecanIlocateone?”

Anypodiatrist,orthopedicof�ice,andmanydoctor’sof�iceswillbeableto

referyoutoacerti�iedpedorthistortrustedhealthcareproviderwhereyour

questionscanbeanswered.

Ifyoudonothavehealthinsuranceorahealthcareteamtoconsult,there

arespecialtystoreswhereemployeesarecerti�iedshoe�itters,certi�ied

pedorthists,orskilledindividualswhocanmeasureyourfeet.

Theycanalsohelpprovideyouwithappropriateshoesuggestions,andas-

sistyouinmakingeducatedchoicesforyourfeet.

Ifyouhaveanyquestions,youmaycontactJuliaat:

juliarsalzano@gmail.com

P a g e 5 Winter 2014, Vo lume 4 Issue 1

Grad ien t Compress ion Garments By Phyl l i s Tubbs-Ginger i ch , RN, BSN, CLT-

Lymphedema Spec ia l is t , LANA/Vodder

P a g e 6

“These are not

the garments

grandmother

wore.”

L I S G

the knee, to the groin or pantyhose. Custom garments are made according to the patient's needs as outlined by the lymphedema specialist or the pa-tient's physician.

Custom gradient compression garments can be designed for the whole body. For example, stockings, sleeves, pants, bras, gloves, vests, body suits, socks and variations there-of can be tailored to each patient's needs.

Despite all the advancements in fabrics, colors and styles, the difficul-ty in applying stockings is getting them over the heel.

The secret in pulling up any gra-dient compression garment is pa-tience, a pair of rubber gloves, good skin care, and donning aids such as ALPS Silicon Skin Lotion.

Other useful tools can be utilized according to individual needs.

A qualified lymphedema special-ist will give instructions in application of gradient compression garments and skin care during the fitting.

Pre-schedule fittings with your lymphedema specialist to allow suffi-cient time for necessary measure-ments, instructions, and questions.

Complete information and details about compression garments can be found in the Lymphedema Self-Care Manual. More information about pur-chasing the manual can be found on page 7. Continued on page 9.

Gradient compression garments assist the body's natural mechanism for venous and lymph return from the extremity. They ensure that counter pressure is greatest at the most dis-tant part of the limb with gradual de-creasing pressure toward the nearest part of the affected area or body.

Any gradient compression gar-m en t m o re t h an 2 0 m m H g (millimeters of mercury pressure) is designated a "medical compression garment" and requires an order from a medical doctor for fitting.

Garments can be purchased over-the-counter as "ready made" if measurements of the affected area adapt to a standard size range.

When the affected area is over-sized or not within the standard size range, a custom garment, made to specific limb or area measurements, is ordered. Delivery usually requires 3-4 weeks'.

The notion of unflattering gar-ments should be dispelled. Colors such as: mocha, champagne, barely black, pearl, mink, navy, silky beige and the classics - black and white - make wearing compression garments more stylish than ever before. Fab-rics are much lighter weight and sheer enough for skin to be seen. These are not the garments grand-mother wore .

A variety of styles are also avail-able to suit all sizes and compression needs.

Ready-made stockings are avail-able in open-or -closed-toe styles, to

P a g e 7

The bes t way to t rea t l ym phedem a i s to :

• Get as much in fo rmat ion as poss ib le about l ymphedema

• Seek proper care

and ins t ruc t ions f rom a bona f ide l ymphedema spec ia l i s t

• Secure mater ia l s

and supp l ies necessary to p roper l y ma in ta in l ymphedema.

Th is book is no t in tended to be a med ica l manua l o r to rep lace your phys i c ian 's care and adv ice , bu t ra ther as a gu ide to a id in se l f c a r e a n d m a i n t e n a n c e o f l ymphedema, sk in and wound care . I t i s the cu lminat i on o f 30 years ' exper ience in the f ie ld o f cancer , l ymphedema, sk in and wound care . Se l f care sugges t ions in th is book are the d i rec t resu l t o f pa t i en t ' s s ub j ec t i ve co m m en t s , w h i ch h av e p rom p t ed u s t o r e s e a r c h b e t t e r m e t h o d s o f t rea tment . Over the years , these fo rmu las have been used i n t rea t ing our pa t ien ts and have no t on l y become par t o f our c l in ic 's p ro toco l fo r therapy bu t have p roven to be a v i ta l too l fo r educa t ion o f pa t ien ts in se l f care and ma in tenance. Th is cons tan t exchange o f in fo rmat ion between pa t ien t and l ymphedema spec ia l i s t con t inues to be the bas is fo r ind iv idua l i zed pat ien t care a t our c l in ic .

Name: ____________________________________________ Address : __________________________________________ C i t y: ____________________ S ta te : _____ Z ip : ________ Phone: ___________________ Emai l :____________________________________________ Pay b y: ( c i rc l e one) CHECK CREDIT CARD CC # : _________________________________CVV:______ Exp. Date : ___________ (c i rc l e one) V ISA MC S ignature :_________________________________________

Order you r cop y o f the Lymphedema Se l f -Care Manua l $39 .68

( $32 .00+ $2 .68 Tax + $5 .00 Sh ipp ing) "c l ip and fax " o r "c l ip and mai l "

The need fo r a deta i led resou rce gu ide fo r l ymphedema se l f -c a r e p r o m p t e d t h e p u b l i c a t i o n o f t h i s "eas y- to -car r y" manua l . We hope ou r 1s t e d i t i o n w i l l a n s w e r q u e s t i o n s y o u h a v e about l ymphedema and gu ide you th rough a bet te r unders tand ing o f se l f ca re .

Win ter 2014, Vo lume 4 Issue 1

An In te rn ’s View By E lyse Wa l lash

sparked a fire inside me to further my own education. I loved teaching, but I was look-ing for a way to build on what I learned in my undergraduate studies. After making lists and lists, and truly thinking about the qualities I want in a career, I decided nurs-ing would be a perfect fit for me. My path to finding a career has been far from direct, but I am loving the journey! By living in a foreign country and teach-ing English, I was able to learn invaluable life lessons and gain a new perspective on culture that I could have never learned with-in the confines of California. I hope to use my newfound perspective to approach nurs-ing with a new and unique point of view. I know that wrapping up the prerequisites, completing an accelerated program, and ac-tually being a nurse will be far from easy, but I do feel it will be worth it. With the support of Phyllis, my family and friends, I am more confident than ever that I will real-ly be able to make a difference as a nurse.

Until then, I hope to see you at the Ginger-K Center!

Hello everyone! My name is Elyse and I started interning at the Ginger-K Center in September 2013. Since then, I’ve learned a lot about the cause and treatment of lymphedema through work-ing with patients. Thanks to Founder Phyllis Tubbs-Gingerich, I have been able to learn a lot about the medical field, and I am excited about the pro-spect of learning so much more. I started interning to get exposure in the health-care field as I prepare to apply for an accelerated second bachelor’s de-gree a nursing program. After graduating from UC Davis with a double major in biology and psycholo-gy, I made the decision to move to Ko-rea to take a job teaching English. I had always wanted to live abroad and im-merse myself in a foreign culture, and I jumped at the opportunity to fly across the world and embark on a new adven-ture. I packed my bags and hopped on the plane bound for Seoul, South Korea - stepping about as far out of my comfort zone as possible. As I stepped out of the airport, my eyes were wide and my heart was open as I tried to absorb each and every new experience Korea had to offer. I was able to learn to read (and speak a little) Korean, travel around Asia and teach some of the brightest and sweetest chil-dren I have ever met. I had first intended to move to Korea and change the lives of my students and instill in them a love for learning, but in the process, I was also extremely in-spired by my students. Over the course of two and half years of teaching at the same school, the students’ dedication to learning and propensity to ask questions

P a g e 8

Changes in my

life are giving

me a new

perspective on

the path I want to

take.

L I S G

See us for custom orthotics, diabetic, and corrective shoes. Ginger K Center, 16130 Juan Hernandez Drive, Suite 108, Morgan Hill, CA. Call for fitting: 408-782-1028

P a g e 9 Winter 2014, Vo lume 4 Issue 1

An In te rn ’s View By V idyun Ba is

Working at the Ginger-K Lymphedema & Cancer Care Center has been a life altering experience. For years I have concentrated my studies on theories and speculation, more so than practical application. Surgery was always cold, unreachable, and precise. However, working at the center has helped me to understand and better evaluate the tangible aspects of surgery. I now have a greater reali-zation of its aftereffects. Also being at the center has changed my frame of mind in the sense that I now more fully realize that every small action has an effect. For example, even though a person might seem exactly the same as before surgery, every suture, stitch, and minuscule wound has an effect on the body. In light of how sensitive the human body is, I will, in the future, think more carefully about every action I take. I am also more aware that a smile might often brighten a person’s day and it becomes a ripple effect in everyday life. ______________________________________________________________

Gradient Compression Garments continued from page 6

There are a variety of indications of uses for compression garments. These include: • Varicose veins • Chronic venous insufficiency • Varicosities associated with pregnancy • Post-facial surgery • Burns • Arm lymphedema following breast surgery • Support post-abdominal surgery • Venous ulcers • Post liposuction or sclerotherapy • Inflammation or swelling during or post radiation • Any "frequent flyer" who is airborne longer than 2 hours • Anyone that stands or sits for long periods of time Most of us will experience some form of venous disease in our lifetime. Venous disease can range from a milder form such as superficial varicosities to severe unsightly leg ulcers. The majority of "leg complaints" are directly related to venous dysfunction. Complete information and details about compression garments can be found in the Lymphedema Self-Care Manual. Please see page 7 if you would like to order a copy of the manual.

These t i ny s eeds a re j am-packed wi th nu tr i t ion .

This is a new favorite of mine! It's a delicious and healthy breakfast option, as well as a perfectly sweet treat in the evening. It takes less than five minutes of active preparation, and then it simply sits in the refrigerator overnight. After the chia seeds sit in the yogurt and almond milk, they plump up and have the soft consistency of tapioca. Chia seeds are high in omerga-3 fatty acids as well as fi-ber and they provide an extraordinary amount of nutrition for their size. Don't for-get to top off this healthy meal option with your favorite fruit to make it just a little sweeter!

Ingredients: - 1 cup vanilla-flavored un- sweetened almond milk - 1 cup plain low-fat Greek yogurt - 2 tablespoons pure maple syrup, plus 4 teaspoons for serving - 1 teaspoon vanilla extract - 1/8 teaspoon kosher salt - ¼ cup chia seeds - 1 pint of fresh seasonal berries - ¼ cup sliced toasted almonds

P a g e 1 0

Dietary Corner Chia Seed Yogurt Recipe - by Elyse Wallash

Directions: In a medium bowl, whisk the yo-gurt, almond milk, 2 tablespoons of maple syrup, salt and vanilla until blended. Add the chia seeds and whisk. Let the mixture stand for 30 minutes. Stir again to distribute the seeds, cover the bowl and refrigerate it over-night. The next day, in a medium bowl, toss the ber-ries with the remaining 4 tablespoons maple syrup and mix in the almonds. Then, spoon the pudding into 4 bowls, mound the berry mixture on top, and enjoy!

LISG

Winter 2014, Vo lume 4 Issue 1 P a g e 1 1

Healthy Feet &

Legs Expo

Morgan Hill Centennial Rec. Center 171 Edmundson Ave.

Morgan Hill, CA 95037

Saturday April 26, 2014 10a.m. - 3p.m.

Free Admission

“Healthy feet are the foundation for a healthy life.” -Gandhi

More than 30 medical and professional specialists will be exhibiting, educating and evaluating:

• Podiatrists • Shoes - custom & ready-made • Gradient Compression Garments • Pedorthist • Chiropractor • Exercise & Water Aerobics • Nutritionist • Physical Therapy • Healthy Foods and Drinks • Orthotics & Sports Injury Devices • Lymphedema/edema Specialist • Specialized Skin Care Products • Many handouts and free samples

During Combined Decongestive Therapy - CDT, each patient while bandaged, is instructed in lymphedema specific exercises. Following CDT, a lymphedema specialist should be consulted be-fore commencing a weight-lifting regimen. Most generally, lifting anything over 10 lbs. may cause negative effects on an affected area. When performing any task or exercise, use the “ cause and effect” rule – whatever you do, check the results on the affected area. This is a good guideline to monitor lymphedema. Each lymphedema case is different and each person affected will react differ-ently. If the lymphedema condition worsens after performing a task or a certain exercise, re-assess what you’re doing and how it is being done. Moderation is the key. The weight you’re carrying may be too heavy or the task may be too strenuous. Consult with a lymphedema specialist for guid-ance and direction concerning your individual routine. Swimming is one of the best all-around exercises. The water automatically gives gradient pres-sure as long as the affected limb is totally submerged while swimming. If you were to stand in wa-ter to just above your waist, you’d receive approximately 35-mmHg pressure at your knees – that’s class 2 compression (30-40mmHg pressure). Therefore, swimming does not require compression. However, following swimming, it is important to wash the affected area, apply lotions and then ap-ply a clean gradient compression garment to the affected area. Walking is the ultimate-weapon exercise since it uses almost all of the 650 muscles and 206 bones without stressing the body. Also, those bones and muscles are used in a more balanced way than in any other exercise. It is the most effective exercise for weight control because it can be per-formed every day, by every “body,” for long periods of time throughout one’s life. Walking, as well as any other exercise, requires proper shoes and equipment before commencing. Yoga is also very good. It strengthens muscles and joints, reduces tension, and relaxes the whole body. It is best to begin slowly and build your regimen as the body can tolerate. Always re-member the “cause and effect” rule. Whatever you do, monitor the effects. If the effects are good, keep doing what you’re doing. If the effects are not good, either slightly alter what you’re doing or stop. Abdominal diaphragm breathing, also referred to as deep breathing, is the practice of pushing air into your “belly” or abdomen. When you breathe in, count to 7 while inhaling, hold your breath to the count of 7, then to the count of 7 slowly release your breath while the abdomen flattens. Re-peat this 10 times until you can build to 25 or more times/day. This is very relaxing before bedtime and usually sleep comes before completing the exercise. Deep breathing also clears the lungs and brings oxygen to all the tissues. Continued on next page.

Exercise

LISG P a g e 12

To Rea l i ze :

- the value of a sister, ask someone who doesn't have one. - the value of 10 years, ask a newly divorced couple.- - the value of 4 years, ask a graduate. - the value of 1 year, ask a student who has failed a final exam. - the value of 1 month, ask a mother who has given birth to a premature baby. - the value of 1 week, ask an editor of a weekly newspaper. - the value of 1 hour, ask the lovers who are waiting to meet. - the value of 1 minute, ask a person who has missed the train, bus, plane. - the value of 1 second, ask a person who has survived an accident. - the value of 1 millisecond, ask the person who has won a silver medal in the Olympics. Time waits for no one. Treasure every moment you have .

Exercise is the “indispensable ingredient” for a positive correlation between doing better and feeling bet-ter. Through the ages man has recognized that physical condition and emotional well-being are linked. It takes about one hour each day for a good exercise program and the only way to work exercise into your life is to remove some “dead weight” from your schedule. Make a commitment to exercise. Try a “FIT” program = elements of an exercise program: F=frequency (how often); I=intensity (how hard); T=time (how long). The only way to fail is not to partici-pate. Any exercise, with the exception of swimming, requires compression for lymphedema. Muscular action with compression moves fluids more efficiently. Without compression the affected part will become more swollen. ______________________________________________________________________________

Continued from Front Cover - Grief, Loss and Lymphedema Depression: “Is this awful feeling I have normal?” Anger: "Why did this have to happen to me?!" Acceptance is won only when we begin to realize that we can go forward with life and that our pain and loss have not destroyed us. We also realize that we may never be free of the pain and accept it as part of who we are now. As a therapist, I help people walk through their grief and am amazed at their struggle and their resiliency. I also see people crushed by it. This humbles me. We are all in pain over something. Exploring this pervading theme of grief and loss for the lymphede-ma patient and their caregivers, gives me greater understanding and compassion.

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Winter 2014, Vo lume 4 Issue 1 Page 13

L I SGL I SGL I SGL I SG Support the

Lymphedema Information Support Group©

LISG is a non-profit organization and we depend upon your support. Yes I’d like to be a Contributor and receive: � Quarterly newsletters � Calendar of upcoming events � Information regarding current treatment for lymphedema � Other helpful information

The level of my gift is: Supporter $ 50 Friendship $ 100 Patron $ 250 Benefactor $ 500 Gold Medal Contributor $1,000 My Company will match my gift $____

For additional tax deductible donations to the LISG, enter the amount on the following line. _____________________________ For donations in honor of a loved one, please fill in the amount and indicate in whose memory the contribution is being made. _________________________________________ Your Name ________________________________________________________ Address ________________________ City __________________ Zip _________ Cell phone: __________________ Home or Work Phone:____________________ Check: Y/N OR Credit Card #______________________ Exp. Date__________

CVV# - (3 digits on back of card) ___________________

Signature _______________________________________ I would like to pledge $________ One Time Monthly Quarterly Biannually Other

Please make check payable to: LISG - Lymphedema Information Support Group

We appreciate your support. Sincerely, Phyllis Tubbs-Gingerich RN, Founder LISG

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16130 Juan Hernandez Drive, Suite 108, Morgan Hill CA 95037-5527

Phone: 408-782-1028 Fax: 408-782-1061

Web: www.gingerkcenter.com

Email: phyllis@gingerkcenter.com

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We are grateful to those who helped create

this newsletter:

Elyse, Kim, Bill, and Vidyun

LISG Lymphedema Information Support Group