Transcription:

Melanie Cole (Host):  There are many types of therapy that may help to reduce the swelling and discomfort of lymphedema for breast cancer patients. My guest to tell us about this today is Brandon Meister. He’s a Physical Therapist and a Lymphedema Specialist with Palmdale Regional Medical Center. Brandon I’m so glad to have you with us as so many women experience that swelling and discomfort when they do develop lymphedema. Tell us what it is and where on the body does it typically occur?

Brandon Meister (Guest):  Well lymphedema is a protein which swelling that can occur typically in a single arm or leg. Most often we see it postoperatively in a post breast cancer mastectomy patient. But it really can occur anywhere on the body that has had any kind of surgical disruption or trauma disruption to the soft tissue.

Host:  So, then why, if there has been surgical disruption whether it’s from breast cancer surgery or lymph node removal; what is the reason that this happens?

Brandon:  Well directly underneath our skin is where our lymphatic system resides. It is a counterpoint to our normal vascular system and basically reabsorbs fluid; out white blood cells, cellular debris and helps our body process it out and remove any sorts of contaminants or infection. And it basically sits between our outer dermal layers which is our skin and the deeper fascial and muscle layers underneath.

Host:  So, does every woman that’s had surgery or surgical interruption in that area get lymphedema and are there certain people that are going to be at higher risk for it?

Brandon:  Not everybody gets it. But definitely anybody who has had surgery is going to be a risk for it. There is no rhyme or reason as to why some people develop it or others. But we do know certain things are definitely going to increase your likelihood if you’ve had surgery, if you’ve had radiation, or lymph node removal; those definitely increase your likelihood.

Host:  Then are there some complications that can arise from this buildup of fluid?

Brandon:  Well I mean we can definitely take steps to potentially prevent it but there’s no hard guarantee that it’s not going to happen. Going into surgery, we want to make sure that we have as much range of motion as possible. That kind of stands true for anybody who is going into surgery. As well as keeping up our cardiovascular general health, that kind of helps keep our lymphatic system flowing and our normal circulatory patterns working. Preventively wise, I mean we don’t expect or don’t want to put anybody into like a compression garment to prevent it from happening because that compression garment can also cut off blood flow and cause lymphedema.

Host:  Wow and as I’ve seen so many women that really develop this; tell us about the treatments that you might use. What are some exercises that are important for lymphedema? What kind of treatment modalities do you use Brandon?

Brandon:  Well depending on the severity or the stage there are two phases to the traditional, the gold standard of lymphedema therapy. There is the intensive stage of therapy which comprises compressive bandaging and lymphatic massage followed by more of a maintenance phase and kind of general exercise phase. If we are in the initial stages or stage zero or stage one of lymphedema, our swelling is very mild. You may not even be able to tell that you are swollen. It might just be a feeling of heaviness or tightness to the skin. In which case, with rest and elevation, the swelling goes down and it’s not really apparent. When we get to more like the stage one to two or three; we are looking at much larger volumes of fluid. You are able to easily tell just by looking at the arm. It’s much larger than the other one or much different shape because of where the fluid is retained.

So, in which case, we are doing lymphatic massage to the surface layers of the skin to increase the circulatory process and then right afterwards we are wrapping for compression to help maintain the reduced volume. And then we are actually doing exercise once you are wrapped up and that’s really actually the most important phase of therapy is getting you into compression and then performing light aerobic exercises to boost your circulatory process.

Host:  Tell us about those light aerobic exercises. Women have heard Reach for Recovery, but you’re talking about a little bit more than that. Give us an example.

Brandon:  You know the Reach for Recovery and the crawling up the wall, that’s purely just a normal range of motion stretching that we do for any postoperative shoulder patient. For the circulatory process for a lymphatic patient, what we are really looking at is getting the muscle to pump whether that’s through an isometric contraction where you are just squeezing a stress ball or you’re doing circular motions or cardio kick boxing kind of activities where you are moving your muscles, getting them to work and it doesn’t matter which direction you move it in so long as your muscles are active.

Host:  True that’s really great information. So, what would you like women to know that may have been diagnosed with breast cancer, are expecting to go through surgery; what would you like them to know as we wrap up about lymphedema, about the therapy options that are available and even possibly trying to prevent it in the first place?

Brandon:  I think the most important thing is to be self-aware. Pay attention to what your body is telling you. If it feels off, if it feels heavy, if it feels like it’s getting tight or if it’s feeling stiff. The earlier you can get to intervention, the less likely that the problem is going to arise and impact your quality of life. And that’s the big one. The earlier we can treat you; the less likely your life is going to be disrupted.

Host:  It’s really great information and so important for women to hear that they don’t have to suffer with the discomfort of the swelling that comes with lymphedema. Thank you for joining us. And that wraps up another episode of Palmdale Regional Radio with Palmdale Regional Medical Center. You can head on over to our website at www.palmdaleregional.com for more information and to get connected with one of our providers.

If you found this podcast informative, please share on your social media, share with other women that you know that might be going through this. That way we can all learn from the experts at Palmdale together. And don’t miss all the other interesting podcasts in the Palmdale library. Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. Until next time, this is Melanie Cole.