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CRA's Upcoming Workshops
Acupressure and Cancer Recovery: Points to Help You Heal
A hands on workshop for patients and their caregivers! In this powerful presentation, you will walk away with specific acupressure points to use while recovering from conventional treatments. Conditions covered will include: hot flashes, fatigue and pain (including neuropathy).

When: November 18th 2:00-3:30 pm
Where: Cancer Rehab Austin

Agnes Nowakowski L.Ac, (TX), AP, DOM (FL) is the acupuncturist at Cancer Rehab Austin.
This interactive workshop will discuss essential oils and how they can contribute to balancing the mind, body and soul. This will be followed by a guided meditation using essential oils. There will also be time for a Q&A with leading wellness practitioners in the Austin community.

When: December 16th 2:00-3:30 pm
Where: Cancer Rehab Austin

Presenters: Eden Lackey, Catherine Winslow and Nathan Elias Jimerson
Create your Dreams: A Vision Board Workshop
Vision boards are a powerful and creative way to harness the power of your dreams to manifest then into reality. In this workshop we will practice visualization techniques, set goals, make them tangible, have fun, and manifest the life you dream of! 

When: January 13th 2:00-3:30 pm
Where: Cancer Rehab Austin

Nanette Labastida is a yoga teacher and transformation coach, empowering women who have been touched by cancer. She has been a yoga student for over 20 years, but after dealing with breast cancer in 2010 she was called to teach. Changes in her body & spirit challenged her to approach yoga from a new perspective. This rebirth of yoga launched a journey into deep self love and self care, enabling her to grow even stronger in body & spirit than before being ill. She teaches this enlightenment to fellow survivors and women over 45 through her yoga teachings and coaching programs. 
What is Lymphedema?

Your lymphatic system works closely with your circulatory system to move fluid through your body and is vital for immune function. When your lymphatic system is not working properly fluid can accumulate causing a blockage of the system. This is called Lymphedema. A person's lymphatic system can be compromised by trauma/injury, cancer treatment, or be from a congenital defect.

The lymphatic vessels are the transportation system that moves fluid, proteins, cellular waste, and bacteria out of the tissues. The lymphatic system also contains white blood cells that aid in immune function. When the lymphatic system cannot perform its job effectively, fluid can accumulate in the tissues leading to swelling. This abnormal accumulation of fluid and swelling in the tissues is called lymphedema.

The warning signs of lymphedema may include the following symptoms in the areas of and around where you were treated for cancer:
  • A heavy or achy feeling
  • A tightness or decreased flexibility in the joints and surrounding tissues
  • Noticeable swelling 
  • Pain, numbness or tingling

To date, there is no cure for lymphedema, however, the amount of swelling can be reduced and the tissue quality improved in order to increase comfort, mobility and quality of life as well as prevent progression of the disease. The gold standard for lymphedema treatment is called Complete Decongestive Therapy (CDT). CDT is a safe, reliable and non-invasive treatment that is performed by a certified lymphedema therapist. 

Complete Decongestive Therapy consists of:
  • Manual Lymphatic Drainage: A manual technique that re-routes fluid to areas in which the lymphatic system has not been compromised and can be eliminated more effectively.
  • Compression bandaging or compression garments: Techniques that help eliminate fluid and soften fibrotic tissue.
  • Therapeutic Exercise: Promotion of lymphatic circulation.
  • Education on precautions and skin care

Highlights from the National Lymphedema Network Conference 2017
Nutrition Should be a Pillar in Lymphedema Treatment
" Nutrition and exercise can help in managing lymphedema symptoms by following these simple strategies:
  • Consume healthy, well-balanced meals focused on a variety of fruits, vegetables, whole grains, beans, nuts, lean protein, and low fat dairy foods.
  • Achieve and maintain a healthy weight.
-Jessica Iannotta MS, RD, CSO, CDN-

Chuck Erlich with Lymphnotes recommends eating whole foods, minimizing sugar intake and decreasing your consumption of animal products. 

Advancements in Imaging Can Help Individualize Lymphatic Treatment
"Near infrared Fluoroscopy Lymphatic Imaging is helping in understanding the variations in every individuals lymphatic pathways and has long term potential to create a more individualized treatment plan." -Jane Wigg

This is a technique in which advanced imaging called Fluoroscopy is used at the same time as manual lymphatic drainage to allow the lymphedema therapist to actually adjust their technique and pathways based on the patients unique lymphatic injury and move fluid away from areas of blockage.

This new technique requires advanced training and many lymphedema practitioners in the UK are starting to use this technique. In the future therapists in the USA will be trained and this technique will become available in treatment centers around the US.

What the Current Research Says About Lymphedema Risk
The strongest evidence for reducing your risk of lymphedema through lifestyle choices include:
  • Maintaining a healthy body weight
  • Increasing physical activity

Well documented factors in the literature that impact your risk of acquiring lymphedema include:
  • Number of lymph nodes removed
  • Location of radiation treatment
  • Obesity
  • Infection.

Current Lymphedema Clinical Trials
A New Compression Pump for Head and Neck Lymphedema
  • There is a new compression pump for head and neck lymphedema by Flexitouch. They are currently seeking participants for a study on the new device.
  • In previous studies for the arm and leg pump with the Flexitouch device a reduction in swelling, fibrosis, and decreased incidence of cellulitis have been reported.
  • This new product specific to head and neck swelling is now available and may be a promising modality to use in conjunction with treatment by a lymphedema therapist.

A New Drug Therapy for Lymphedema
 At Stanford they are currently performing a phase II trial with the anti-inflammatory drug called Ubenimex on lower extremity lymphedema. This drug has a very specific inflammatory pathway that differs from over the counter medications like Motrin and Aleve. This drug blocks Leukotriene B4 (a molecule linked to inflammation.) Previous studies reveal a reduction in edema, reduced skin thickness, and less vessel dilation. If you would like to be a part of this clinical trial here is more info. 

New Technology and Techniques
New Technology for Measuring and Diagnosing Lymphedema
  • LymphaTech is a handheld 3D scanning device with increased accuracy in measuring and tracking limb volume. LymphaTech's 3-D scanner allows clinicians to diagnose lymphedema with highly accurate measurements of both volume and circumference compared to gold standard measuring tape and water displacement treatment.

Technology Assisting in Lymph Node Transplants
A Biobridge scaffold is a scaffold made of Fibralin that is surgically placed next to a transplanted lymph node to promote vascular and lymphatic regeneration. The FDA has given clearance to conduct stage II clinical trials in humans and the 1st surgery has been performed at Stanford on June 2017.

LYMPHA (Lymphatic Microsurgical Preventive Health Approach) 
"Early data from a NewYork-Presbyterian/Columbia pilot study may suggests that an innovative microsurgery technique helps prevent lymphedema in breast cancer patients. Results from the study have been published in the Annals of Surgical Oncology. The study of the lymphatic microsurgical preventive healing approach, or LYMPHA, was the first conducted outside of the University of Genoa in Italy, where the technique was developed. LYMPHA was designed to help prevent lymphedema by creating a bypass to restore lymphatic flow by connecting lymph vessels to a branch of the axillary vein, a pathway normally severed by node removal. This preventative bypass is performed immediately after lymph node removal so that the normal lymphatic flow is maintained. " -Columbia Technology Ventures-

New Product From a Local Austin Inventor!
Protect Yourself From Mosquitos and Other Bugs Without Toxic Chemicals With Meshed.
MESHED is a lightweight, breathable, non-toxic and attractive jumpsuit that hinders mosquitoes, ticks and other bugs from making contact with your skin. Those with lymphedema have to be cautious about bug bites due to risk of infection or increased swelling. MESHED is a natural bug repellent option.

Lesley's Journey with Lymphedema
Val's Journey with Lymphedema

"I eagerly crossed the days off of my calendar in 2011-2012. Not one to typically rush time, the end of breast cancer treatment couldn’t come soon enough. Naively, I assumed that everything would go back to normal on the magical day I’d circled. You know, that I’d pick up right where I’d left off. On March 12, 2012, I retired my countdown highlighter, ripped the calendar from my fridge, and moved on. But I’d soon realize it was not over.

My surgeon warned me about Lymphedema immediately after my first surgery, but that was months before, and after waiting for the symptoms, they never materialized. I figured I was in the clear. Six weeks later, after radiation, I had intense pain in my armpit and swelling in my arm. I couldn’t reach
for cupboards, pick up dishes or do household chores without pain. Something was terribly wrong.

After a few survivor friends mentioned that I might be suffering from Lymphedema, I made an appointment with Angela and began my road to recovery. It turns out that the radiation - more or less - fried my lymphatic system in the upper quadrant of my body. With the Manual Lymph Drainage massage method, she helped me regain use of my arm. She taught my husband, Jack, to perform it as well, and for many months, he helped me keep the swelling in check. She also sent me home with rehab exercises after my initial visit, and I got fitted for compression. Armed with these tools, I was able to get it under control. 

I was still worried about my weightlifting, though. An avid exerciser, I had competition ambition. I wanted to bodybuild, but I assumed that I couldn’t fulfill that dream now that my arm was not 100%. Angela supported me and helped me ease back into that environment, and together we used bodybuilding to strengthen my arm. In fact, I attribute weightlifting exercises with keeping my lymphatic system in check. Under her careful supervision, and after following her directions, I’ve only had 2 noticeable flares, and both were prior to my return to training. Today, 6 years later, I maintain a healthy arm and have successfully competed for three seasons. I continue with monthly MLD maintenance, wear compression when exercising or flying, and pay attention to my body. Lymphedema has not slowed me down and, at times, it is hardly noticeable.

True, with a cancer diagnosis, I have learned that it’s never really “over.” I don’t mean that in a cynical way, but just that I do have to be vigilant and proactive. However, I am able to do the things I did prior to cancer and actually more - even with Lymphedema. My quality of life has not suffered, and I look forward to increasing my strength in the gym on a weekly basis. This summer I will be competing in my 5th fitness show, and I plan to bring my best package to date. If you’re struggling Lymphedema, I highly recommend meeting with a specialist like Angela to develop a plan of action. She has been a key player in my recovery, and seeking her medical expertise was the best thing I ever did."

Services Offered at CRA
Oncology Physical Therapy

Contact our oncology rehab physical therapist Dr. Angela Wicker-Ramos PT, CLT-LANA to schedule a session.  (Click here for more info)

(512) 524-0964

Lymphedema Treatment

Contact our certified lymphedema therapist Dr. Angela Wicker-Ramos PT, CLT-LANA to schedule treatment.  (Click here for more info)

(512) 524-0964

Dr. Agnes Nowakowski L.AC (TX), MACOM, DIPLOM, DOM (FL) is CRA's acupuncturist.  (Click here for more info)
Contact Agnes to schedule an appointment:
(512) 731-2462
Massage Therapy

Our massage therapy team consists of:
Geri Ruane LMT, OMT, CLT and Ashley Hiatt LMT, OMT, CMLDT.  (Click here for more info)
Yoga Therapy

CRA offers private yoga sessions taught by Kimberly Wharton. 

Schedule today with Kimberly:
(323) 363-3050
Free Nutritional Consults

Free nutrition consultations are offered at by Dr. Krystle Zuniga Phd, RD.  (Click here for more info)

For more information or to set up an appointment, contact Krystle Zuniga at: kezuniga@gmail.com.
Cancer Rehab Austin | Phone: 512-524-0964 | Fax: 512-524-0936 
email: angela@cancerrehabaustin.com| Website: www.cancerrehabaustin.com