viha 7th annual rehab forum - Lymphedema Association of

Transcription

WINTER 2012
the BC Lymphedema Association insert
V I H A 7 T H A N N UA L R E H A B F O R U M
by Lynn Holloway, Parksville, BC
A few months ago, I heard that the
Vancouver Island Health Authority
(VIHA) was holding their 7th Annual
Island Rehabilitation Forum in my
hometown – Parksville. I contacted
the organizers to see if BCLA might
be able to have an information
table and they were pleased to
invite us. In addition to BCLA having a presence, BCLA member,
Noreen
Campbell,
RN/retired
wound clinician from Victoria, was
going to be presenting on lymphedema!
I asked all the Vodder therapists on
Vancouver Island if they would like
to participate with me to help field
questions about lymphedema and
its care. Sonia Brown, a new RMT
from Parksville, jumped at the
chance to support me in this endeavour. Robert Harris, Director of
the Dr Vodder School sent me
informative handouts of where BC
therapists are located and what
upcoming trainings they are having
to include as handouts on our table.
Throughout the day, we were visited by interested participants. We
asked how often they came across
IN THE FLOW - BCLA WINTER 2012
lymphedema in their practice and
the usual answer was ‘not very
often’. But, when they did, they did
not feel adequately equipped to
help their patients. Many of them
who worked in hospital settings
and had access to a pneumatic
pump were aware that they may
run the risk of further damaging the
delicate lymphatic system OR that
although effective at the time of
treatment, had no lasting effect
given compression was not applied
immediately afterwards. Many had
a keen interest in learning wrapping
techniques and I have forwarded
that request to Robert Harris.
Noreen gave a great presentation!
It had a good balance of technical
information, pictures, and humour.
(How many boring presentations
have we all sat through with people
reading off a PowerPoint presentation?!) The participants seemed
engaged and genuinely interested
in the topic as the room was full
and we kept having to bring in
more chairs!
I had the opportunity to meet and
talk briefly with Dr Timothy
Deutscher, a Nanaimo Physiatrist
who was presenting at this forum. I
asked his opinion on whether he
believed lymphedema belonged
under the care of Physiatry and he
was in agreement. One of the
areas we need to advocate for is for
an area of medicine to take
‘ownership’ of this condition.
A bonus to attending that I hadn’t
considered was also learning from
other exhibitors! Beside us was the
University of Victoria Self-
Management Programs. I had been
in contact with the Program Director a few years back as they have a
four-day Leader Training Series for
people to become trained to facilitate self-help/support groups in
their home area. This training is
offered on a regular basis throughout BC.
Their representatives
shared a brochure of theirs entitled
Living A Healthy Life With Chronic
Conditions. I believe this group is a
worthwhile follow-up for BCLA to
see how our needs and what they
offer could dovetail. If anyone
wants to have a look at what they
offer,
their
website
is
www.selfmanagementbc.ca.
On the other side of us was the Port
Alberni Integrated Health Network
(IHN). VIHA has created these as a
Chronic Disease Management project to provide support and education to people living with chronic
health conditions. The IHNs are an
innovative way of providing health
care services that relies on patients
to be partners in managing their
health. Each IHN offers a variety of
self-management group sessions
aimed at improving health and wellbeing. As an example, given swimming is one of the best exercises for
lymphedema, I could get help
through the IHN connecting me
with our local pool office to help me
gain access should I find the cost
prohibitive. I always think of myself
as pretty knowledgeable about
health provision in my community,
but I didn’t know about this.
The Nurse Next Door (NND) was
another surprise for me. Although I
knew about their services, I had
never equated it to how I might
make use of their services. I always
considered them as a resource for
the elderly. They design customized
care plans specific to ones needs.
We talked about my frequency of
cellulitis and how I hate having to
be admitted to the hospital. After
an IV drip with some antibiotics, I’m
feeling myself again. Home IV can
take many days to arrange. I could
setup a plan with NND to meet me
at my local ER and they will work
out a plan with the hospital staff
and myself to have my IV done at
home. With the high cost to the
province for hospital admissions
(not to even mention often the lack
of beds!), I would think they’d be
glad to have me go home knowing I
was going to be in the safe care of
an RN. The one hitch, I would be
paying this person a high hourly
rate ($65/hr) for this care vs. having
the province pay. However, for the
joy of being at home – I think I’d pay
the bill!
A couple of years ago we were
granted funds to be able to create
promotional items so that we could
participate in health awareness
events such as this. BCLA has a
portable tabletop display, a foldaway banner, brochures, and business cards all sporting our new logo.
If you have an event in your area
where you’d like to promote awareness and offer education about
lymphedema and BCLA, these items
can be shipped to you. YOUR presence and voice is the way greater
awareness and education for the
condition is going to happen, as well
as support and advocacy. 
Page 1
The Good, The Bad and the Not So Ugly: Lymphedema Care in BC
by Dr. Elliott Weiss
in the flow
Is published by the
BC Lymphedema Association
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Feb 08/13
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August 9/13
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will be subject to editing and
available space.
ADVERTISING
Contact us for rates and sizes
for this insert if you are a BC
advertiser. National advertisers contact Anna Kennedy at
[email protected] or 1877-723-0033
DISCLAIMER
The BCLA does not guarantee,
warrant or endorse any products or services advertised in
this publication. The views
expressed do not necessarily
represent the views of the
BCLA, its Board of Directors or
advertisers.
BC LYMPHEDEMA ASSN
Mailing Address:
#215 - 5589 Byrne Rd
Burnaby, BC V5J 3J1
1-866-991-2252
[email protected]
www.bclymph.org
Are you living with lymphedema? If so, are you young, or
once were young? Is your condition one you were born with
or associated with another condition, perhaps cancer?
What if you are a provider of
care? Do you possess unique
skills or knowledge? What is
your training? Or perhaps you
provide other services, such as
a fitter of compression garments or supplies.
To all of us, the ‘good’ is our
interest in improving care for
ourselves, our friends and family, and our patients. Professional and patient interest in
lymphedema is increasing and
we are slowly seeing improvements in care and outcomes.
The ‘bad’ is access to quality
lymphedema care, which is
limited, piece-meal and episodic. In many locales, services
do not yet exist, or locales that
do, may not be optimal. This is
true for urban, suburban and
rural communities.
So, what is the ‘not so ugly’?
Over the past decade we have
seen the establishment of the
BCLA and similar organizations
across Canada; increased interest amongst therapists and
nurses within our health regions; studies, research and
clinical experience are changing our knowledge and understanding of this condition; and
finally, sharing of knowledge
including with those interested
and those that should be interested in improving the lives of
those living with lymphedema.
So, where do we go now? For
primary lymphedema, early
recognition/diagnosis is critical.
Starting care in the early stages
is an essential way to prevent
or reduce the serious complications of this condition, always
maintaining a bio-psycho-social
perspective.
For secondary lymphedema,
we probably need to consider
two separate patient populations. For cancer-associated
lymphedema, surveillance is
key and critical, and the development of accessible and reliable diagnostic tools to moni-
tor for lymphedema should
make this fairly straightforward.
We need to be mindful that
not all cases of secondary lymphedema are cancer-related.
Consider patients living with
lipedema, chronic venous disease and other vascular disorders. After limb trauma and
chronic infections patients are
also at a much increased risk
for lymphatic dysfunction.
Surveillance and early recognition/detection are equally critical, although harder to achieve
for non-malignancy related
conditions. Management likely
parallels the approach with the
primary lymphedema population.
In addition, a better understanding of the emotional challenges lymphedema patients
experience can go a long way
in improving one’s quality of
life. Historically, addressing
aesthetics has been overlooked
and needs to be considered,
especially with single limb disease.
cont’d on page 3
Phone: 604-888-8811
Toll-free: 1-888-988-5882
Fax: 778-355-1185
www.bcmedequip.com
2 locations to serve you - Coquitlam & Burnaby - call for an appt.
For exceptional service and experience for ALL
your compression and lymphedema needs





Compression garments - off the shelf & custom made
Lymphedema day and night-time garments
Mastectomy supplies, specialty bras
Lymphapress - sales, rental, onsite pump therapy
Full line of home health care products
Patricia Montagano, RN, BSN
Certified Lymphedema Consultant, Expert Garment Fitter
[email protected]
Page 2
cont’d from page 2
Lack of knowledge and skill amongst healthcare providers is the real root of the problem. Our knowledge of the anatomy and
function of the lymphatic system needs to be
enhanced amongst all healthcare providers.
Without standardization of care, including
diagnosis and management, how can we
improve outcomes? We will know we are
"there" when lymphedema care is as standardized as cardiac care. 
Dr Weiss is a Physiatrist with Providence
Health Care and is the main physician seeing
lymphedema patients in BC. He has also
been a Board member since the inception of
BCLA.
10
1.
2.
3.
Easy Steps to Improved
Lymphedema Care
Dr. E. Wiess
Patient awareness and education
via books/articles, internet resources, conferences, and support
groups.
The early introduction of lymphatic
disorders in undergraduate healthcare education.
Improved dissemination of knowledge to healthcare providers
through presentations, publications, and conferences.
4.
Regional awareness: rounds, presentations for clinicians providing
lymphedema care , and those working in high risk populations.
5.
BC Cancer Agency (BCCA) surveillance in target populations.
6.
An enhanced BCLA, including more
support and advocacy.
7.
Introduction and promotion of
improvements in lymphedema care
in all regions of BC, including access
to providers.
8.
Improved financial access to lymphedema supplies and evidencebased interventions.
9.
Dissemination of evidence-based
skills and clinical pathways for lymphedema care.
BC EVENTS
INSPIREHEALTH - VANCOUVER
604-734-7125
Free lymphedema information
sessions for people with cancer
INSPIREHEALTH - VICTORIA
250-595-7125
Last Wed
of month
Feb 1517/13
21st Wellness Show
Vancouver Convention Center
Come visit the BCLA booth!
BCLA BOARD
PRESIDENT
Lucette Wesley
VICEPRESIDENT
VACANT
SECRETARY
VACANT
TREASURER
Michelle Kinakin
DIRECTORS
Lene Tonnisen
Leona Towers
FUNDRAISING
Thank you to the following people who have so
kindly donated to BCLA since our last newsletter.
Aboud/Del Balso
Family
Isabelle Green
Eileen Holloway
Booth costs for 21st Wellness Show
$100
$10/mo
Monthly gift in memory of
Lorraine Warnock, Lynn
Holloway’s mother.
MEMBERSHIP
Welcome new members!
I = Individual P = Professional C = Corporate
P Irina Alexandrov, RMT
P Jeanne Brummond, RF
P Leah Cameron, RN, LT
Surrey
Penticton
Salmon Arm
I Isabelle Green
Langley
Elliott Weiss
OTHER VOLUNTEERS
FUNDRAISING
VACANT
MEMBERSHIP
VACANT
Membership is temporarily being
managed by Lynn Holloway
NEWSLETTER
Wendy Bowles
WEBSITE
Lene Tonnisen
Cyndi Cassidy
BCLA is always looking for more personal
interest stories to include in “In The Flow”.
We would be happy to write the article if
the “teller” is not confident. Contact us
through [email protected]. Let us know if
you have a story to tell ! 
10. Quality research will translate into
improved care and outcomes.
We are on our way, but we
are certainly not there yet!
Page 3
PROFESSIONAL DIRECTORY
CORPORATE MEMBERS
PROFESSIONAL MEMBERS
BACK ON TRACK FITNESS - MOVING BEYOND CANCER
Joanne Morgan, 731 W 16th Ave, Vancouver
Tel: 604-787-1494 / [email protected]
Website: www.backontrackfitness.ca
IRINA ALEXANDROV, RMT
North Surrey Massage Therapy Clinic/Vida Wellness Spa
Tel: 604-518-2679
[email protected]
BC CANCER AGENCY - LIBRARIES
Covering all five health authorities
Tel: 604-675-8004 / Fax: 604-675-8009
[email protected] / www.bccancer.bc.ca
MARLENE ALLEN , Shoppers Home Health Care
709-1301 Main St, Penticton
Tel: 250-492-7592
[email protected]
BC MEDEQUIP HOME HEALTH CARE LTD
2230 Springer Ave, Burnaby, BC V5B 3M7
Tel: 604-888-8811 / Toll-Free: 1-888-988-5882
[email protected] / www.bcmedequip.com
CAROL ARMSTRONG, BA, RMT, EGF-Garment Fitter
Fairfield area, Victoria
Tel: 250-598-8004 / Fax: 250-598-8044
[email protected]
DR VODDER SCHOOL™ INTERNATIONAL
PO Box 5121, Victoria
Tel: 250-598-9862 / Fax: 250-598-9841
[email protected] / www.vodderschool.com
KYLA BECK, RMT
Grandview Massage Therapy Clinic
#303 - 2730 Commercial Dr, Vancouver
LIFECARE MEDICAL
Tara Hashemi - Garment Fitter
#130 - 3030 Lincoln Ave, Coquitlam, Tel: 604-941-5433
[email protected] / www.lifecare1.ca
KOBY (Linda) BLANCHFIELD, RMT
Cedar Hills Lymphatic & Massage Therapy Clinic
9474 - 126th St, Bsmt, Surrey
LYMPHEDEMA DEPOT LTD
12 - 111 Fourth Ave, Ste 347, St Catharines, ON
www.lymphedemadepot.com
SHAWNA BOND, Breast Health Navigator
Breast Health Centre - Victoria General Hospital
1 Hospital Way, Victoria
MACDONALD’S PRESCRIPTIONS LTD - #3
2188 W Broadway, Vancouver
Tel: 604-738-0733
[email protected] / www.unipharm.com
MELANIE BRANCATO, RMT
4560 Waldy Rd, Cowichan Bay
Tel: 250-748-3351
[email protected]
MACDONALD’S PRESCRIPTIONS LTD
746 W Broadway, Vancouver
Tel: 604-872-5496
[email protected] / www.unipharm.com
JEANNE BRUMMOND, RF
Health Source Specialty Medical Supplies
333 Martin St, Penticton
MEDICAL TOWER DRUGS
#6 - 2151 McCallum Rd, Abbotsford
Tel: 604-859-7651
[email protected]
LEAH CAMERON, RN, LT
Leah’s Therapeutic Lymphatic Care (TLC)
2251 21st St, NE, Salmon Arm
MASTECTOMY SHOP, The
Cindy Loftus, RPN, Garment Fitter
#5 - 13665 96th Ave, Surrey
ELIZABETH CARTER, RMT
239 East Valley Dr, SE, Marietta, GA, USA
Tel: 770-565-1608
[email protected]
SHOPPERS HOME HEALTH CARE
#202 - 370 E Broadway, Vancouver
Tel: 604-876-4186
[email protected]
C JULIE CHATELAIN, RMT
Massage Therapy Group
#201 - 821 Burdett Ave, Victoria
Pathways includes a “Hints & Tips” section, so please share the things you’ve
learned along the way that might help
others who read the magazine. Your assistance in keeping this area of the magazine
vibrant will be appreciated.

We would like to thank Michael Del Balso,
one of our members whose teenage son
has primary lymphedema. He is donating
registration for a BCLA booth at the 21st
Annual Wellness Show in Vancouver.
Page 4
JESSICA DECKER, RMT
Jessica Decker Massage Therapy Clinic
#313 - 1095 McKenzie Ave, Victoria
GRACE DEDINSKY-RUTHERFORD, RMT
North Shore Lymphedema Clinic
1372 Marine Dr, North Vancouver
Tel: -551-8202 / [email protected]
CATHERINE DICECCA, RMT
Millstone Massage Therapy
402 Millstone Ave, Nanaimo
DENISE DRISDELLE, RMT
Tel: 604-872-1675
[email protected] / www.manuallymphdrainage.ca
GABRIELLA FRIESEN, RMT
Grandview Massage Therapy
HELEN GARFIELD, Garment Fitter
Healthy Life Garments
5864 Gardi Rd, Kamloops
SARA HODSON
Live Well Exercise Clinic Inc
306-1676 Martin Dr, Surrey
DIANE LJULJOVIC, RMT
Northview Massage Therapy Clinic
#300 - 124 Lonsdale Ave, North Vancouver
CHRISTINE MILLER, RMT
Motion Massage Therapy
#210 - 1001 Gibsons Way, Gibsons
SONJA REDDEN, PT
Healing Rivers Physiotherapy
#206 - 1811 Victoria St, Prince George
EVA SHAM, RN
Vancouver Coastal Health Authority
3425 Crowley Dr, Vancouver
BYRON SHIER, MBA, BSc, OT, CLT-LANA, CHE
Canadian Lymphedema & Rehabilitation Services, Inc.
Tel: 604-566-0824 / Fax: 604-566-0859
www.canadianlymphedema.com
DAWN SPARKS, RMT
Cross Roads Physio & Massage Therapy
#350 - 507 W Broadway, Vancouver
JANET SPRAGUE, BHScPT/LANA
Keary Physiotherapy Clinic
413 E Columbia St, New Westminster
COLETTE SWAIN, RMT
#6D - 530 Horse Lake Rd, 100 Mile House
Tel: 250-706-8765
[email protected]
LENE TONNISEN, BA (Hon) PE, RMT
Certified CDT Therapist & JoViPak Fitter
9474 - 126th St, Surrey
GWEN VALENTIC-MORRISON, RMT
Ascension Massage Therapy
14939 71st Ave, Surrey
LESLIE WILLIAMS, RMT
Serenity Wellness Clinic
#201 - 636 W Broadway, Vancouver
Lymphedema
ASSOCIATION
OF SASKATCHEWAN INC.
Winter 2013
President’s Message
I am pleased to report that the first meeting of the Ministry of Health’s Lymphedema
Working Group on Implementation was held on November 7th, 2012. This new
group was initiated to advise the Ministry of Health on how to best implement the
recommendations selected for funding from the Lymphedema Working Group
2011-12 Summary Report. The current Working Group consists of representatives
from the Ministry of Health, Regional Health Authorities, agencies and individuals
that provide lymphedema services, supports and education as well as lymphedema
patients who have recently accessed the system to receive lymphedema treatment
in Saskatchewan. Several members of the previous working group were asked to
serve on this new one. Elaine Arnusch and I were asked to represent LAS. Sylvia
Krueger, LAS member and private lymphedema therapist, was asked to serve, as was
LAS Board member Tracy Gardikiotis who is part of the group representing Regina
Qu’appelle Health Region. I am gratified that the Ministry of Health is seeking advice
on the best way to disburse limited resources. The final report is planned for March of
2013, with implementation to follow soon after.
As part of the funding announced by Health Minister Dustin Duncan, 14 therapists
from the various health regions will be trained and certified in CDT to better serve
lymphedema patients across the province.
It has been a slow process, but we have finally been awarded a Charitable Donation
number and will now be able to issue tax receipts for donations. I want to thank
Board member Verna Schneider for wading through the sea of forms and paperwork
required by Canada Revenue Agency, for not missing any of the many deadlines
and for finishing the task initiated by our former Treasurer, Myriam Weibe. Thank you
Myriam and Verna; it was a lot of work, but well worth the effort!
We are seeking stories for Patient Perspective. How did you develop lymphedema?
How long did it take for you to be diagnosed? Who made the diagnosis? How was it
first treated? How do you manage it now? How has living with lymphedema changed
your life? Your story is important and we would love to share it. Email Angela or me
at sasklymph.ca or write us at LAS, Box 28068, Saskatoon SK, S7M 5V8 and we will be
happy to assist you. If you developed lymphedema after cancer or other surgery, or
some other trauma, we would like to include your story in the spring newsletter. The
deadline for submission is February 5th.
We are making plans for Lymphedema Awareness Day on March 6, and for our AGM date and location yet to be determined. Please contact us with your suggestions.
Thank you for supporting Lymphedema Association of Saskatchewan. With your help,
change is on the way!
Glenda Cook, President
LAS Board Executives
President | Glenda Cook (Regina)
Angela Connell-Furi (Saskatoon)
Tracy Gardikiotis (Regina)
Barb Lauterbach (Prince Albert)
Louise Bird (Wawota)
Verna Schneider (Prince Albert)
Betty Stirr (Regina)
Evelyne Tucker (Saskatoon)
Vicki Doell (Prince Albert)
Please contact us at
[email protected]
or visit our website at
www.sasklymph.ca
Volunteers always welcome
Perspective
Patient
This month’s Patient Perspective is
written by Katie Duran, a young
woman from Regina who has lived
with primary lymphedema her entire
life. Thank you Katie, for taking the
time from your very full university
schedule to share your story with us.
(story on page 2)
Perspective
Patient
(continued from page 1)
L
Katie Duran
Living with lymphedema is not easy,
but I have learned to make the best
of it anyway. My name is Katie Duran,
I live in Regina, Saskatchewan, and I
was born with primary lymphedema.
Lymphedema is rare, and for the most
part, unknown. A lot of women have
lymphedema from having breast cancer,
but I am going to talk about what it
is like being born with it. Living with
lymphedema is not easy; it is a challenge
but that is all I have ever known. For
years I have been bullied because I am
obviously a bigger person than most,
but no one ever knew why. Originally, I
did not want my story online or in any
magazine, but I decided that there is
nothing to hide and it is something I
have had to face. I am going to share my
story of what it is like to grow up with
primary lymphedema.
Growing up and living with lymphedema
is hard, but no one ever said it was going
to be easy. I would always ask myself
what I did to deserve such misery all the
time. I have always known I was different
from everyone else, but I never liked
it. No one knew how hard it was living
with a weakened immune system, being
sick all the time, constantly wondering
if you were going to catch some kind of
infection. With getting made fun of for
something I can’t even control, it didn’t
make matters any better. Despite all the
hospital visits I have had, I now live a fairly
normal life. I tell myself that even though
my legs are different than everyone else’s,
at least I have legs and can walk; at least I
am alive. I am very thankful for that.
career path I decide to choose; I would
like to do something where I am making
a difference in someone’s life. Just like
others have made a difference in mine.
Life isn’t fair; we all know that, but I know
I could always have it worse. I have so
much to be thankful for; I know that my
lymphedema can’t get me down because
a person cannot live life unhappy.
“I want to give
back, and have
a career where I
help people just
like others have
helped me....”
When I was little, I wished everyday that
there was a cure for my condition so I
didn’t have to go through the struggles
with it anymore. I have learned to
accept who I am as a person and live life
normally like everyone else. Just because
I’m different doesn’t mean I have to stay
in the shadows because of it. That is why
I am publishing this story for everyone
to see. Whether you have lymphedema
or any other disease, you shouldn’t let it
change who you are. Be true to yourself
and don’t let anything stop you from
fulfilling your full potential.
There have been several times in my life
where I would not be alive today if it was
not for all the doctors and researchers
that have helped me along the way.
Without family, friends, doctors, teachers,
co-workers, and everybody else along the
way, I would not be the person I am today.
I would not be as successful, and I don’t
think I would have as much ambition as
I do today. I want to give back, and have
a career where I help people just like
others have helped me. I know I have
the world ahead of me, with whichever
Lymphedema
I do manage my lymphedema by
wearing compression garments on both
of my legs and taking medication daily
for it. I have seen so much improvement
within myself over the years; I can
only hope that things will continue to
progress for the years to come, and
that one day there will be a cure for
lymphedema.
So many of my family and friends have
given me motivation over the years to
be the best person I can be. If I can give
hope to even just one person reading
this, I know I have done my job. Everyone
has a story if you take the time to listen;
this story is just mine.
Association of Saskatchewan Inc. | 2
If your business is
interested in
advertising with us,
please contact the
Lymphedema Association
of Saskatchewan Inc. at
[email protected]
Volunteers always welcome
Lymphedema
Association of Saskatchewan Inc. | 3
Lymphedema
ASSOCIATION
OF SASKATCHEWAN INC.
We now have a Facebook group for the Association
and all members and potential members are welcome.
Association events will be posted on the page. You can
join and meet other members, ask questions, etc.
Go to the LYMPHEDEMA ASSOCIATION OF
SASKATCHEWAN facebook page to join.
Lymphedema
Association of Saskatchewan Inc.| 4
Winter 2012
Volume 1, Issue 4
Lymphedema
Association of
Manitoba
Swelling
with Emotion
Box 403
Lac du Bonnet
Manitoba
R0E 1A0
Getting Up Close and Personal to your LAM Board
The Lymphedema Association of
Manitoba (LAM) held their first Board
meeting (the organizational meeting) on
June 16, 2012. It was at this meeting
that the officers of the LAM were
appointed; Cindy Elkin (nee Otto) is the
Secretary, Lillian Gehon is the Treasurer,
Kim Avanthay is the President and
Isabelle Thorvardson is the Vice
President. Our other Board members
include Sandy Funk, Dena DavidsonJohnson and Suzanne Paintin. Thank you
to our Board members and to the
individuals that have accepted an
Officer position on the Board. It is very
much appreciated!
Please keep reading to find out more
about who the LAM Board really is.
Kim Avanthay works for the Federal
Government in Pinawa, MB. She is a
Mother, Kookum, co-founder and
President of the Lymphedema Association of Manitoba. Seven years ago, Kim
was enjoying motherhood, unaware of
lymphedema and the impact it would
Kim Avanthay
LAM President
have on her life. It was only a year after
her youngest child was born that she
found out about this condition. This is
where her passion lies; raising awareness of lymphedema in Manitoba so
others don’t have to go through what
she did in trying to get a diagnosis and
treatment for her baby.
In 2008, Kim was accepted to participate
in the National Lymphedema Network’s
(NLN) Lymph Science Advocacy Program
(LSAP). It was at this conference that
she realized there were people out
there working diligently on advancing
the field of lymphology and working on
breakthrough research to help those
suffering from lymphedema.
Kim
returned from that experience with her
eyes open and her future mapped out;
to share her knowledge and raise
awareness of this little known condition.
Since then, Kim has attended numerous
conferences, was Manitoba’s representative on the monthly cross-Canada
provincial association conference calls
(even though Manitoba, at the time,
didn’t have a Provincial association) and
has worked in having local community
newspapers publish articles to raise
lymphedema awareness. Kim has told
her story to the LIVE group at Pinawa
Secondary School and to the delegation
at the Lymphedema Association of
Ontario’s yearly conference in 2009.
Currently Kim sits on the Canadian
Lymphedema Frameworks (CLF)
Advisory Board and is also a member of
the CLF’s Partnership Development and
Fundraising Working Group.
Lymphedema Association of Manitoba—Winter 2012
EMAIL
lymphmanitoba
@yahoo.ca
WEB
www.lymphmanitoba.ca
Inside this issue:
Up Close to your LAM Board 2-5
(continued)
March 6-Lymphedema
Awareness Day
5
A Conversation with Mr.
Ernie Funk
6
Swimming for
Lymphedema
6
Resources
7
LAM Membership Form
8
Since 2009, Kim has been sending
requests to all the Manitoba Municipalities, to proclaim March 6th as Lymphedema Awareness Day. She has had
great success and every year, more
Municipalities are making that
proclamation. She is most proud that
the Province of Manitoba’s Minister of
Health, Theresa Oswald, has also made
that proclamation in 2010, 2011 and
2012; bringing awareness at the
Provincial government level about this
condition.
Page 2
Swelling with Emotion
Up Close to your LAM Board
to their affected side where lymph
nodes had been removed. Cindy looks
back now and thinks that in her own
small way, she was already advocating
for our cause, unknowingly realizing
there was a much bigger picture, and
some day she would stumble into that
“big picture” with other amazing, strong
individuals.
When attending the various conferences around the world, it is evident
that the lymphedema community is very
small. Through these conferences, Kim
has made connections with many
professionals and knowledgeable
people, but isn’t sure who Manitoba’s
experts are. Kim is hopeful that this
community will continue to grow as
others become aware of the condition
called lymphedema.
Cindy Elkin
LAM Secretary
Cindy Elkin is honoured to be participating as the first secretary with the
Lymphedema Association of Manitoba.
She is excited to be part of a movement
this big, bringing information to all
Manitobans and finally putting
Manitoba on the map in regards to
lymphedema care and treatment.
Dena Davidson Johnson
LAM Board member
Dena Davidson Johnson recently retired
from Manitoba Agriculture and brings
with her 22 years of experience as an
Administrative Assistant. Dena was
diagnosed with secondary lymphedema
in 2009, six months following breast
cancer surgery. As a Northern resident
she has experienced compounded
difficulties and is committed to seeing
that everyone diagnosed with lymphedema has equal opportunity for
treatment, support and r e sources. Dena looks forward to the
challenges and opportunities as a Board
Member of the Lymphedema Association of Manitoba.
This Association is near and dear to her
heart, as she was diagnosed in 2004
with cancer which required a lumpectomy and lymph nodes to be
removed. Cindy was one of the lucky
ones as she did receive information
prior to her surgery about the possibilities of lymphedema, what to do, what
not to do. The day after her surgery she
was in absolute horror to see nurses
applying blood pressure cuffs to the
affected arms of other women, who also
had the same surgery as Cindy. She
couldn’t understand why the medical
professionals were doing this and why
the patients were not speaking up. She
remembers educating the other patient
by telling her about the possibility of
lymphedema occurring on the affected
side, and that they shouldn’t have a
blood pressure cuff or needles applied
Currently Cindy is cancer free, but
continues on her journey for a second
round with the infamous “five year”
cancer free goal. She remains confident
and optimistic that her magic number
will be 10 years cancer free; words that
every cancer patient desperately wants
to hear. But in reality, cancer patients
know our struggle continues every day;
we see our battle scars, we deal with
side effects, pain and unfortunately for
many, the struggle with lymphedema.
Cindy works for the Federal Government but has also worked in the private
sector for various companies. She has
owned and operated several successful
businesses for over a decade. Cindy has
just recently re-married, enjoys
travelling, sports, music, movies and
loves creating fresh floral designs.
Throughout her life, Cindy has always
volunteered her time at some type of
level; from donating clothing to families
in need, sending school supplies to
children across the world or donating
food for multiple families and missions.
Cindy also volunteered and held
President, Vice-President and SecretaryTreasurer positions for a local car club,
who each year hosted one of the largest
car shows in eastern Manitoba. The
year Cindy was battling cancer, the car
club decided one of the community
groups to receive a donation would be
the local breast cancer support group.
Being owner/operator of her own
successful businesses has allowed Cindy
to enjoy her creative side and also
Page 3
Volume 1, Issue 4
provided many wonderful opportunities
to meet people from all walks of life.
Cindy is looking forward to this journey
with the LAM and is optimistic that
going forward, lymphedema will be
better understood.
Sandy Funk
LAM Board member
Sandy and Ernie Funk happily celebrated
their 47th anniversary in June. They
worked and raised their two lovely
daughters in Winnipeg. Their children
married brothers and now their family
includes two wonderful son-in-laws, a
grandson, and three granddaughters.
The Funks had a cottage in the RM of
Lac Du Bonnet for 20 years. Seven years
ago, they converted it into a permanent
residence and moved there. They are
on the Lee River and feel blessed to live
in “their little piece of paradise”,
especially now that they are both
retired.
Sandy worked in a small boutique in
town for a couple of years and Ernie
commuted to Winnipeg to work until
last October. 2009 was Sandy’s breast
cancer year. In 2005, when they were
considering moving to Lac du Bonnet,
getting a major illness had ranked near
the top of their con-list. Surprisingly,
living in rural Manitoba was a good
thing. Sandy had her chemo at Pinawa
Cancer Care; from her health care
provider, to the pharmacist, the chemo
nurses, the home care nurses, and the
doctors, Sandy’s care was very personal.
It is a small community and she belongs
to them. She had radiation at the
Health Science Center in Winnipeg.
Every staff person was terrific yet that
part of her journey was lonelier. Sandy
missed the intimacy of her small
community. Having had this experience,
the Funks are very content to stay living
in Lac du Bonnet.
In August of 2010, Sandy had her first
mammogram. Shortly after, she started
feeling some discomfort in her
compromised arm (where she had
lymph node dissection). Sandy was
diagnosed with lymphedema (LE) at the
Breast Health Center.
She came
through her surgeries and cancer
treatments really strong and had no
idea how hard living with this LE lifesentence would be.
Sandy is right handed and the lymph
nodes were removed from her right
armpit. This means that lymphedema
affects everything she does. It is a
debilitating condition. Besides swelling,
lymphedema causes Sandy a myriad of
discomforts ranging from mild to severe
pain, numbness, aching, fullness,
heaviness, tight skin, burning or
shooting pain that happens on and off in
the affected area, and less flexibility.
She has been taught to do manual
lymph drainage and spends ¾ of an hour
to one hour twice a day doing this. She
wears a compression sleeve daily and a
night garment as well. She also uses a
trunk garment. Sandy is stunned at the
cost of these garments and how often
they need replacing. She resents all the
time spent on self-care. She misses the
spontaneity that has been stolen from
her. She wants her life back. The Sandy
she was can never be again. She thought
she just had to get through the cancer
“stuff”. She didn’t expect all this and it
makes her angry and sad. This is a
chronic condition. This is now her life.
Sandy continues to work on her
emotional issues. It may not sound like
it but she does know how fortunate she
is. When she thinks of others, she feels
guilty and ashamed of these thoughts
and feelings. But it is her truth.
Sandy’s LE Therapist told her there was
a support group that had recently
started.
Sandy’s husband Ernie
encouraged her to join so the both of
them attend monthly meetings in
Winnipeg. There they learned about Kim
Avanthay’s efforts in starting the
Sandy and Ernie joined the Association
immediately. Sandy and Ernie were also
excited to attend Saskatchewan’s
symposium and to see all of their
amazing accomplishments.
This Sandy is taking a leap of faith. She
recognizes that with a lot of hard work
and effort, changes can and will be
made in Manitoba. She wants to be a
part of this change and so here she is,
on the LAM Board. The LAM Board is a
passionate group, thinking and
dreaming big, believing and trusting that
we can achieve many improvements for
Manitobans with lymphedema.
Do you have a lymphedema
story to share?
A question to ask?
A helpful suggestion for
others to learn from your
experiences?
If so, please email them to
the LAM.
[email protected]
Page 4
edema are expensive, especially when
you need more than one compression
garment a year and/or night time
garments. Lillian knows that even if you
have private health insurance, those
costs may not be completely covered.
Lillian Gehon
LAM Treasurer
Lillian Gehon was treated for Breast
Cancer in May 2010 and six weeks after
surgery, developed a major infection
which resulted in lymphedema in her
left chest and arm as well as a corded
nerve in the upper arm. She went
through chemo and radiation. Lillian
was referred through Cancer Care
Manitoba to a certified physiotherapist
who did massage treatment for
lymphedema. It was evident that there
wasn’t a lot of literature available about
lymphedema as a side effect of breast
cancer.
After all her cancer treatments, Lillian
found that the lymphedema was worse
and in the summer of 2011 she went
back for more physio. It was at these
appointments that Lillian learned what
she could do to help herself and manage
her lymphedema.
At one of her appointments, Lillian met
another patient who had lymphedema.
This patient contacted Lillian later in the
year to inform her that a breast cancer
lymphedema support group was being
formed. It was at one of the support
group meetings, that Lillian found out
about the Lymphedema Association of
Manitoba and knew that she wanted to
be part of that Association.
Lillian finds that the garments needed to
help with the maintenance of lymph-
Lillian realizes that little is known about
lymphedema in Manitoba, from the
health care professionals to the layman,
about how you get it or how you treat
it. Some just don’t think this affliction is
of any significance. Lillian would like to
see support in financing the garments.
She wants to learn more about
lymphedema and to help spread
awareness. She wants to help people
get the help they need.
family and has many hobbies. Suzanne’s favourite pastime is to be outside
no matter what the weather is like.
Suzanne developed lymphedema in her
right arm, a few months after radiation.
She wears a custom sleeve and gauntlet.
Recently Suzanne changed to a different
style of garment which was considerably
more money.
Luckily she will be
reimbursed 80% through her husband's
group insurance but after paying for the
garments she was angry. Knowing that it
is a medical garment, something she
needs and not simply wants, she feels
that the cost is ridiculous. Especially
given the fact that the garment will only
last three to six months. She feels very
sorry for people that do not have
insurance to cover the cost of the
compression garments. Other provinces
cover two sets of garments in a calendar
year. Suzanne is delighted to be on the
LAM Board of Directors and is hopeful
that the LAM will bring important
changes in the Province of Manitoba.
One of Suzanne’s current goals is to not
let lymphedema change her life
completely.
Suzanne deals with it
everyday, but tries to live and accept
it. Suzanne joined the Chemo Savvy
Dragon Boat Team and finds it very
rewarding.
Suzanne Paintin
LAM Board member
Suzanne Paintin feels blessed to be a
breast cancer survivor. She has a
supportive husband, Rick, a loving
twelve year old daughter, Christina and
a wonderful nine year old son, Malcolm.
Suzanne also feels blessed to have
wonderful family and friends. Her
journey has taught her many things and
she feels that she is a better person
because of it. Suzanne works full time
at Artists Emporium, an art store, and
the people she works with are her
second family. She loves being
physically active, visiting friends and
Isabelle Thorvardson
LAM Vice President
Page 5
Volume 1, Issue 4
Isabelle Thorvardson was born in Saskatchewan on a cold winter day in March
1949. Isabelle spent her early childhood
days on the farm and then moved to
Winnipeg to attend high school and
then university at the University of
Manitoba. Isabelle met Ken and they
were married in June 1970 and today
they have three children and nine
grandchildren.
Isabelle taught school for 20 years and
retired from teaching in June 2004. She
had breast cancer surgery in May of
2003 and was just too exhausted to
keep teaching. It wasn’t until May 2005,
that she experienced her first bout of
cellulitis and has since then developed
lymphedema in her left arm. Over the
years, Isabelle had two more bouts of
cellulitis and consistently needs to wear
compression garments, day and night,
to keep the lymphedema under control.
and teach people how to live with the
effects of lymphedema.
When the opportunity presented itself,
Isabelle was happy to become involved
in the Lymphedema Association of
Manitoba; an organization that would
help other people become aware of the
side effects of lymphedema and learn
how to manage it. She is looking
forward to helping promote, educate
Are we looking for
you?
Contact the LAM if you are a
Manitoba lymphedema stakeholder. Includes, but not limited to,
patients, therapists, physicians,
nurses, researchers, insurance
companies, educators, garment
fitters and industry representatives.
DISCLAIMER:
The views that are expressed throughout “Swelling with Emotion” are those of the authors and not necessarily those of the
March 6—Lymphedema Awareness Day
On March 6th the Lymphedema Association of Manitoba and the lymphedema community nationwide will celebrate Lymphedema
Awareness Day, a special day set aside to honour inspirational lymphedema patients and caregivers; those who have contributed to the community or who have shown great courage in their struggle with this condition.
On this day, we raise our voices together and say: "We are here and we are breaking down the barriers regarding treatment and
support for this condition." On this day we show the world that lymphedema is no longer a rare condition by honouring the
many people living with it today, and the exceptional health care providers who, with dedication and support, have touched
their lives and hearts.
Here's how you can participate:
On Lymphedema Awareness Day you, someone you know, or your favorite health care provider/facility can honour a lymphedema patient for his or her courage in living and coping with lymphedema. This day provides us with a special opportunity to
alert our local media, medical community and neighborhoods about lymphedema; to create awareness about this condition,
who is at risk, and available treatments, so not one more person will be told they just have to live with it, that nothing can be
done.
Once you've chosen your honouree/s be sure to email us at [email protected] and request an official LAM Lymphedema
Awareness Day Certificate for your honouree/s. A list of honourees will be listed on our website, www.lymphmanitoba.ca, and
published in the Summer issue of “Swelling With Emotion”, the LAM’s quarterly newsletter.
To participate, please send the following to the LAM by April 1, 2013:
The patient’s name and age
Type of lymphedema (primary or secondary, arm(s), leg(s), other)
Date honoured and honoured by (your name, facility if any, phone or email address to contact you, if needed)
Where (location in Manitoba)
A brief statement from you about why you chose this particular patient
The patient’s mailing address or email if you would like us to send them acknowledgment
We look forward to celebrating National Lymphedema Awareness Day with you! Recognize and honour a special patient or
caregiver, and let them know you care.
Page 6
A Conversation with Mr. Ernie Funk
Kim Avanthay sat down with Mr. Ernie
Funk to explore what it is like dealing
with lymphedema from a support
person’s perspective. The following is a
summary of that conversation.
Ernie is 65 years of age and retired from
the hazardous waste industry. Ernie
and his wife, Sandy, live in rural Lac du
Bonnet, MB for the past seven years.
Ernie is a member of the Lymphedema
Association of Manitoba even though he
doesn’t have lymphedema. It is his wife
that has had breast cancer, lymph node
removal and radiation. She now has
lymphedema in her right arm.
When asked what kind of support he is
providing his wife regarding her lymph-
edema, Ernie at first had difficulty
articulating it. Sandy offered a few
items to get Ernie started and then the
flood gates opened. Because he felt it
would be good for her, Ernie was the
one to encourage Sandy to go to the
Breast Cancer Lymphedema Support
Group that holds monthly meetings in
Winnipeg. Ernie encourages anyone
with lymphedema to find support
through others going through the same
thing. He has learned a lot from the
support group as they provide support
to a group of women who you can communicate with easily. Ernie had a big
smile on his face when he said how he
enjoys the meetings. Of course Sandy
was happy to add, that it was because
he is with all these women and he likes
all the attention.
Sandy has to massage her arm every
morning for approximately one hour so
while she does this, Ernie is busy making
breakfast and bringing her coffee. Ernie
also assists Sandy in getting on both her
daytime and night-time garments. It
takes both of them to put on the compression garments properly. To support
Sandy, Ernie also had to become a student as he had to learn from the certified lymphedema therapist how to apply the bandage wraps. She needs to do
Swimming for Lymphedema
this sometimes when there is increased
swelling in her arm. Another important
task Ernie does is massaging Sandy’s
side and back area.
Ernie chuckles as he explains to me that
he also looks after the vacuuming. The
story goes that Sandy has a female doctor that is against vacuuming and Sandy
also has a male doctor that says vacuuming is ok. According to Ernie, Sandy
is adamant that she can’t do the vacuuming. Ernie is also Sandy’s chauffeur
(and gofer); taking her to the support
group meetings, medical appointments
and anywhere else she needs to go.
Mostly he just tries to make things easier for her.
The Funks have been on this lymphedema journey now for just over two
years. A message they want to share is
that you never know when it could start.
You might get lymphedema, you might
not, but if you do, it takes over. It
changes your life and the way you do
things. Spontaneity is lost. The Funks
feel that lymphedema is a lifetime sentence for both of them. Ernie emphasises that you should support your partner in every which way possible. A final
message from Ernie is to incorporate
humour daily; and patience, patience,
patience.
by Judy Labossiere
Judy Labossiere participates in a lymphedema swim program and the following are her thoughts about it: Swimming is an
excellent exercise for those with lymphedema. The relationship between exercise and lymphedema is not simple. People with
lymphedema are encouraged to exercise but they need to take rests during activity to avoid overuse and gradually build up
duration and intensity. A compression garment is not needed in the water as the pressure of the water on the limb acts like a
compression sleeve but some do choose to wear an older garment in the water. It is perfect pressure around every body part
and it is good exercise for upper and lower lymphedema. Diana Oakley is a certified aquatic instructor at the Misericordia Health
Centre Pool. She teaches a lymphedema aquasize program once a week on Thursday afternoons from 2 to 3 p.m. An evening
program is planned to begin in January. The pool is in the basement on the Wolseley side of the building where there are two
doors that you can enter. The elevator is in between the cafe and auditorium. Once Diana gets everyone into the warm pool
they are hooked. The class is an hour long that includes warm up, stretching and body exercises. There is a balance beam, a
water bicycle and two underwater steppers. There is a lot of talking and laughter. The group has a time of relaxation in the last
15 minutes of the class, with the slow gliding movements of Aqua I-Chi. We all leave the pool with a sense of calm, weariness
and a new found energy (after a few hours for some). Water does the majority of work for lymphedema and once you get there,
it is fun. No one worries about how they look in a bathing suit. The water helps to overcome lymphedema issues and the gentle
waves are soothing. I encourage everyone to come and try it. For more information contact Diana Oakley at 204-489-1948 or
email [email protected].
Page 7
Volume 1, Issue 4
Resource Guide
DISCLAIMER
Businesses and service providers pay a fee to be listed. At no time is the Lymphedema Association of Manitoba responsible
for quality of service or rates charged.
SUSAN ZWARICH, RMT, CLT/CDT
Breast Cancer Lymphedema Support Group
Sturgeon Creek Chiropractic Centre
Meets in Winnipeg at 6:30 p.m.
Registered Massage Therapist
Certified Lymphatic Therapist
On the third Tuesday of the month
1-2565 PORTAGE AVENUE
WINNIPEG, MB R3J 0P4
phone: 204 831-1122 fax: 204 885-3672
Email: [email protected]
You can also find them on Facebook
Page 8
Lymphedema
Association of
Manitoba
Yes, you can count on me to support the LAM!
LYMPHEDEMA ASSOCIATION OF MANITOBA
MEMBERSHIP APPLICATION
The Lymphedema Association of Manitoba is in pursuit of the provision of resources, information, education,
awareness and support to those affected with or at risk of primary or secondary lymphedema;
their families, healthcare professionals and the general public.
1.
Member Information
Professional Association (if applicable)
NAME:
ADDRESS:
CITY:
PROVINCE:
POSTAL CODE:
PHONE NUMBER:
EMAIL ADDRESS:
2.
Membership Fees
Regular Memberships and Renewals
$ 45.00
Individual 1 Year
$ 60.00
Family 1 Year
$130.00
Professional 1 Year
$ 85.00
$110.00
$240.00
Individual 2 Year
Family 2 Year
Professional 2 Year
Individual and family memberships include an annual subscription to the LAM provincial newsletter, in addition to a complimentary
subscription to PATHWAYS, Canada’s Lymphedema Magazine. Also included are membership discounts to conferences and a
single vote per adult at the Annual General Meeting.
Professional memberships are for those working in the lymphedema community, independently or in a hospital or corporate setting;
including therapists, hospital clinicians, fitters, vendors and nonprofit organizations. Membership includes 5 copies of each issue of
the LAM provincial newsletter and PATHWAYS, Canada’s Lymphedema Magazine, discounts to conferences and notification of
the Annual General Meeting; non-voting member.
3.
Additional Donation (Optional)
I would like to make an additional donation of $_________________.
In honor of:
Mr.
Mrs.
Ms.
HONOREE’S NAME:
HONOREE’S ADDRESS:
CITY, PROVINCE, CODE:
Please do not send acknowledgement to my honoree.
4.
5.
Total Enclosed $_______________
Volunteer Opportunities with the Lymphedema Association of Manitoba.
YES, please contact me. I am interested in learning more about volunteer opportunities.
6. Comments (Optional)
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
Please complete this form and mail with cheque or money order to:
Lymphedema Association of Manitoba, Box 403, Lac du Bonnet, MB R0E 1A0
Lymphedema
Matters
A publication of the Lymphedema Association of Ontario
Winter 2013
Volume 16 Issue 1
Lymphedema Conference a Success
Draws Record Number of Attendees
What do 250 conference attendees including exhibitors, sponsors, speakers, health professionals and
people living with lymphedema, all have in common?
A passion to further education for lymphedema!
The 16th Annual Lymphedema Conference, presented
by the Lymphedema Association of Ontario (LAO) was
held on October 27, 2012 in downtown Toronto, and
was another success. Attendees and speakers from
Alberta, Saskatchewan, Quebec and Atlantic Canada
joined delegates from across Ontario for this annual
educational and awareness event.
Thank you to the sponsors who made the conference
possible: The Canadian Breast Cancer Foundation (Lead
sponsor), Valco/Mediven (Gold sponsor), 3M Canada
(Silver sponsor), BSN Medical and Pascoe Canada
(Bronze sponsors).
The Canadian Breast Cancer Foundation (CBCF)
kindly sponsored the luncheon speaker, Professor Miles
Johnston, who shared his current research focused on
studying the impact of radiation on lymphedema. CBCF
also provided bursary support to a number of qualifying
patient delegates, who may not have otherwise been
able to attend the conference.
The conference opened with an introduction to the
host of the event, the LAO. The services this organization has provided to
the community have
been instrumental in
raising awareness for
lymphedema in
Ontario.
The LAO is proud of
its affiliation with the
Canadian Lymphedema
*based on post conference evaluations Framework and the
Winter 2013
From left to right, Sandra Palmaro (Canadian Breast Cancer
Foundation), Anna Kennedy and Professor Miles Johnston.
International Lymphoedema Framework. As such, it
was appropriate to bring some context to lymphedema
care in Ontario by having the opening session feature
the evolution of lymphedema care models around the
world. Speakers showcased models in the USA, new
initiatives from Alberta Health Care, in-patient care
examples in Austria as well as
Continued on page 7
Lymphedema Matters
Lymphedema
Association
of Ontario
Committed to improving
the lives of people
living with lymphedema
MEDICAL ADVISORY BOARD
Miles Johnson PhD
Toronto Sunnybrook Centre
Ian Dayes MD
Hamilton Juravinski Centre
Robert Harris RMT CDT
Vodder International School
Donna Lue Reise RN CDT
Talspar Nursing Services
Martina Reddick RN CDT
Eastern Health Services
Anne Blair RN
Odette Cancer Centre
International
Saskia Thiadens RN CDT
United States-NLN
Shetty Lee MD
Austria-Wittlinger Clinic
Neil Piller PhD
Australia-Flinders University
BOARD OF DIRECTORS
Kim Gagan President
Leona DiCasmirro
Vice-President
Janice Goldberg Secretary
Fran Suran Acting Treasurer
Ruby Kreindler
STAFF
Anna Kennedy
Executive Director
Shannon Moore
Outreach and Event Planner
Honorary Patron
Honourable David C. Onley
Lieutenant Governor of Ontario
Charitable Registration number
87165 5049 RR0001
4161 Dundas Street West
Toronto, Ontario M8X 1Y2
Toll Free: 1-877-723-0033
Fax: (416) 236-7604
[email protected]
www.lymphontario.ca
Winter 2013
Executive Director’s Report
By Anna Kennedy
To say we have been busy this
fall would be an understatement.
Although the majority of our efforts
were focused on preparing for our
annual lymphedema conference, we
also made time for other important
awareness and advocacy efforts.
September - I was fortunate to
attend the National Lymphedema
Network conference in Dallas as a
graduate of the Lymph Science Advocacy Program. It is always inspiring to meet with neighbouring
American patient advocates and
share the efforts each of us are
making on both sides of the border.
October - Our fundraising efforts in
our 5th annual Charity Challenge
5km-marathon event was another
success. In addition to Team
Lymphedema Toronto, we had
teams in Thunder Bay, Niagara, and
Kitchener, with participants raising
pledges and sponsorships totalling
just over $23,000.
I was invited to sit as an advisor
on a panel of the North York General Hospital who is looking at developing a Best in Class lymphedema clinic. We were very proud
to be invited to the table to share
our knowledge of other hospital
models of lymphedema care and
also provide input into what lymphedema patients in Ontario need.
November - The LAO was represented at the Canadian Association
of Wound Care Conference in London, Ontario where I was invited to
co-present a session with Dr. John
Macdonald, entitled “The Social and
Economic Impact of Lymphedema
in Both Developing and Developed
Countries”. The audience consisted
primarily of nurses and doctors who
were keenly interested in learning
more about their role in lymphedema care.
We were honoured to have the
Honourable Bernard Trottier, MP for
Etobicoke-Lakeshore, pay a visit to
the Lymphedema Association of
Ontario office to officially congratu-
The Honourable Bernard Trottier MP,
Anna Kennedy and Shannon Moore (LAO).
late me on my recent Queen’s
Diamond Jubilee Award and to learn
more about lymphedema and the
services our organization provides
to the community. We proudly
showcased the results of our recent
conference as well as the partnership the LAO has with the Canadian
Lymphedema Framework - in leading the Editorial process and production of the new CLF national
magazine - Pathways.
Educating more government officials about the needs of those living
with lymphedema will raise awareness of lymphedema among those
who can help make a difference.
We encourage our members
to plan awareness activities for
March - Lymphedema Awareness month. Whether it is contacting your local MP to establish
lymphedema awareness day in your
city, recognizing a health professional or patient who you think embodies the spirit of advancing lymphedema awareness or organizing
your own fundraising activity in
your city - we hope you will use the
month of March to give your personal contribution - both time and
money, to the cause.
Call us for form letters and templates to help you. Then send us
your pictures and accounts of your
event and we will feature them in
our next issue of PathwaysLymphedema Matters.
Lymphedema Matters
3
Ontario Lymphedema Certified Therapists
Barrie/Orillia
Lana Boudreau RMT
705-716-0758
[email protected]
Cathy Petzoldt PT
705-794-3772
[email protected]
Beaverton
Phyllis Christian RMT
905-721-3828
Mobile Therapist (Durham Region)
Janet Millward RMT
Ayr, Ontario 519-632-9991
[email protected]
Etobicoke/West Toronto
Crystal Sivill RMT
519-772-1010
[email protected]
Alison Glasbey RPT
416-251-2300
[email protected]
Sarah Cowley RN RMT
705-426-2894
Violetta Soffe RMT
Mobile 416-727-0020
[email protected]
Beamsville
Guelph
Vivian Dim OT Reg (Ont) LLCC
289-897-8707
[email protected]
Renata DeForest RMT
519-993-2736 (cell)
[email protected]
Brampton
Kieu-Oanh Nguyen
519-837-2020/ 519-829-0282 (clinic)
www.guelphsportsmassage.com
Angela Hunt RMT LLCC ALT
905-495-7308
www.lymphedemawellnesscentre.com
Brantford
Pamela Monarch RMT
519-751-7096 ext.3414
www.pammonarchrmt.com
Burlington
Kimberly Boersen-Gladman RMT
905-332-6542
www.headtofootoasis.ca
Ramona Herman RMT ALT
905-319-2454
[email protected]
Carlos Ospina, D. Ac. MLD
647-705-8995 info@
carlosospinahealthsolutions.com
Durham Region
Jason Mandalentsis RMT ALT
289-388-6080
[email protected]
Hamilton
Donna Lue Reise RN LANA
905-385-3176 or 905-523-4999
[email protected]
Maureen Sawyer RPT
905-389-0869
www.msphysio.ca
Kingston/Brockville
Lynette MacKinnon RMT
613-507-3344
www.westendmassagetherapy.com
Jennifer Phillips RMT
Kingston 613-340-0306
Brockville 613-342-3333
Kitchener
Louise Danieli RMT
519-569-8555
[email protected]
Swelling Solutions
519-749-0102 www.lymphcare.com
Catherine Burt RN RMT ALT
Melody Southgate RMT
Rachelle Wright RMT CK ALT
London
Helen Murray RN London Lymphcare
Centre 519-913-0181
[email protected]
Midland/Penetang
Eryn Lorriman RMT
705-549-1700
www.georgianbaymassagetherapy.ca
Markham
Reshmi Cain RMT
905-471-5311
www.villagewellnessclinic.com
Ann DiMenna PT
Mobile-Toronto and Area 647-500-4771
www.anndimennaphysio.com
Milton
Rae Baron RMT
905-878-9041
[email protected]
Mississauga
Nancy Scagnetti RN RMT ALT
Mobile Therapist 905-607-8422
www.lymphedemawellnesscentre.com
Kimberly Tweedie RMT
416-569-5349
[email protected]
Legend
All therapists listed have all been trained in a LANA approved school where they received a minimum of 135
hours of post graduate training before obtaining their certification. The therapists are either Registered Nurses
(RN), Physiotherapists (PT), Occupational Therapists (OT) or Registered Massage Therapists (RMT) and have provided proof of certification. Those who have certified in Aqua Lymphatic Therapy are indicated with ALT.
Disclaimer
Therapists pay a fee for listing their services. The LAO is not responsible for the services performed or rates
charged.
Fees
Hourly rates for lymphedema therapy can range from $70 to $140. Insurance plans will reimburse only to the
standard provincial rates of therapy that MLD is billed under. As an example, the Registered Massage Therapists
Association of Ontario’s standard rate since 2010 has been $93 for 60 minutes of treatment (including HST).
4 Lymphedema Matters
Winter 2013
Newmarket
Pickering
Rebecca Wilkinson RMT ADP ALT
905-830-9700
www.rebeccawilkinsonrmt.com
Anne-Marie Craigen RMT
416-616-8672
[email protected]
North Bay
Richmond Hill
Susan Woodman RMT LANA
705-497-0683
[email protected]
Sophia Finkel HD RMT
416-318-4135 Toronto & Richmond Hill
267 Finch Ave & 8905 Bathurst St
Oakville
St.Catharines
Caroline Bieze RMT LLCC
Oakville/Mississauga 905-339-3950
www.lymphatictherapist.ca
John Mulligan RMT LANA
905-687-1828
www.lymphedematherapist.com
Nancy Shoemaker RN RMT LLCC
905-465-2929
[email protected]
Cindy Schultz RMT
Port Health Clinic 905-684-6066
[email protected]
Ray Vickers RMT CK
Oakville/Milton 905-699-3451
[email protected]
Sudbury
Orillia
Anne Dockendorff RMT
705-327-0457
[email protected]
Oshawa/Port Perry
Heather Cirone PT
Park Road Physio 905-438–1500
[email protected]
Darlene Spence RMT
905-244-7223
www.burketonmassagetherapy.com
Esther Epp-Kaethler RN ALT
519-599-6597
[email protected]
Tillsonberg
Jeanne Magashazi RMT
519-842-3702
[email protected]
Toronto
Marnie Gallant RMT
416-732-5218 or 416-482-4476
[email protected] (Mobile)
Sasha Goudriaan RMT
416-523-8364
[email protected]
Owen Sound
Pam Hammond RMT
416-928-9650 Spadina & Bloor
Massage Therapy Clinic
Danuta Valleau PT
519-534-1788
[email protected]
Veronica Lelchuk RMT
416-315-0640
[email protected]
Sharon Evans ALT
Kinexions 519-371-8314
[email protected]
Nadine Maraj-Nyiri RMT
Mobile Therapist 416-569-2280
[email protected]
Peterborough
Petra Norris RN
416-841-3119 Toronto and Etobicoke
[email protected]
Winter 2013
Toronto Lymphocare Centre
416-531-7612 or 705-458-2156
www.torontolymphocare.com
Niki Travers PT
647-701-5582 Spadina & Bloor
Massage Therapy Clinic
Akari Yokokawa RMT
416-792-4400 www.careforlymph.com
www.mahayaforesthill.com
Lindsay Davey PT
Toronto Physio 416-792-5115
www.torontophysiotherapy.ca
Janice Simmonds RMT
Ashburnham Massage
705-876-8561
Lucy Romano RMT
647-342-1801
[email protected]
Thornbury
Ottawa
Louise Killens RPT
Mary Hutton RN
[email protected]
Ly Raha RMT
416-446-5911
Shanna Yee RMT
BayviewSheppard RMT 416-222-3768
[email protected]
Sylvia Crowhurst RMT
416-537-3555
www.lymphaticdrainage.ca
Haley Rehab Clinic
613-422-5061 two locations
www.haleyrehab.ca
Jo-Anne Racette RMT
416-465-8179
www.massageondanforth.com
Chrystal Prosperi PT ADP
705-522-0770
www.progressivetherapy.ca
Susan Sweetapple RMT
905-903-3850
[email protected]
Catherine Croteau RMT
613-297-9325
www.croteaurmt.ca
Catherine Paterson RMT
[email protected]
647-351-2222 Yonge/Eglinton
Unionville
Monica McCarron RMT ALT
905-305-1411
www.labalaba.ca
Waterloo
Janmari Baas Ross RMT
519-884-4848
[email protected]
Bernadette Tallon RMT
519-884-4848 [email protected]
New Hamburg 519-662-9331
Lymphedema
Matters
is the official publication of the
Lymphedema Association of Ontario
(LAO).
Advertising
Queries about rates and deadlines for
advertising should be directed to the
LAO office.
Disclaimer
The LAO does not guarantee, warrant
or endorse any product or service
advertised in this publication.
Lymphedema Matters
5
Corporate Members - Local Resources
Authorized Fitters
Suppliers/Distributors and Educators
Coulter’s Pharmacy London
www.coulterspharmacy.com
3M Canada
www.3m.com
Lymphedema Depot
www.lymphedemadepot.com
Dell Pharmacy
www.dellpharmacy.com
Academy of Lymphatic Studies
www.acols.com
LympheDIVAs
www.lymphedivas.com
Fran's Boutique Cambridge
www.fransmastectomyboutique.ca
Bauerfeind
www.bauerfeind.com
Mansueta Medical Garments
Toronto 416-591-0006
BSN Medical - Jobst Inc.
www.jobst.com
Norton School of
Lymphatic Therapy
www.nortonschool.com
McNiece T.E.N.S. Inc. SW Ontario
www.mcniecetens.ca
Canadian Bandage Shoppe
www.cdnbandageshop.com
Renaissance Woman Georgetown
www.youngspharmacy.com
CertiCare
613-845-0168
Shoppers Home Health Care
www.shoppershomehealthcare.com
Dr. Vodder School
International
www.vodderschool.com
The Nu Me Boutique Kitchener
www.numeboutique.com
Yurek Home Health London
www.yurekpharmacy.com
Contact us today to be listed in
the Lymphedema Matters insert
1-877-723-0033
Paradigm Medical Inc.
www.paradigmmed.com
Pascoe Canada
www.pascoecanada.com
Peninsula
www.noblemed.com
Sigvaris
www.sigvaris.ca
JoViPak
www.jovipak.com
Valco/Mediven
www.valco.ca
Juzo
www.juzousa.com
Venosan
www.venosan.ca
Linotrade Ltd.
www.lympholino.com
Wearease
www.wearease.com
Support Groups
BRANTFORD - every second Tuesday of the month By registration only. Contact Pam Monarch at
519-751-7096 x 3414
KINGSTON - 5 times per year - last Wednesday of a
month. Contact Sue Davies, Breast Cancer Action
Kingston at 613-531-7912
WATERLOO REGION - last Tuesday of each month at
7pm. Call Melody Southgate at 519-749-0102
Aqua Therapy Classes
Classes for arm and leg lymphedema
Tuesday evenings, downtown Toronto
Sylvia Crowhurst RMT/CDT
www.lymphaticdrainage.ca
416-537-3555
“I found it tremendously helpful with my arm and chest and back mobility in general.”
Pascoe Canada makers of
NORTH BAY - Lymphedema Educational Workshop once a season. To register please call Susan
Woodman at 705-497-0683
OSHAWA - every third Thursday evening of the
month, 7 p.m. to 9 p.m. For more information or to
register, call Hearth Place at 905-579-4833
OTTAWA - Both information sessions and exercise
programs. To register please call Breast Cancer
Action Ottawa at 613-736-5921 or visit
www.bcaott.ca for information.
TORONTO - second Thursday of the month, 10:00
am and 12:00 pm at Wellspring/Sunnybrook Hospital
in Toronto. To register, please call the LAO at
416-410-2250 or 877-723-0033 toll free.
6 Lymphedema Matters
Winter 2013
Conference Review - Delegate Perspective
by Nancy Rogers
The Lymphedema Association of Ontario has hosted
a conference in Toronto for 16 years. Having been a
member of the association for three years, I have now
attended two conferences. “Why?” you may ask.
Without knowing it, my 19-year old son has lived
with primary lymphedema in his left leg since the age
of nine. By the age of thirteen and many doctors later,
we happened to ‘stumble’ upon what it is he suffers
from, but were told there was not much we could do.
After months of research on my own and then finding an amazing massage therapist that performs Manual Lymph Drainage (MLD), I noticed a copy of
Lymphedema Matters in her waiting room and asked if
I could take a copy. Having dealt with and assisted my
son in managing his lymphedema over the years, I felt
I knew it all. At a younger age, my son had obliged to
the compression wrapping, MLD therapy and compression garments (with excellent results). As a teenager,
it became more difficult to enforce his compliance to
the treatment program and this has become a very
tender subject in our household.
I invited him to attend the conference with me this
year (well, really he was dragged), because I thought
it would be a good venue for him to realize the severity of his condition, the importance of compliance and
different ways he could deal with lymphedema that he
felt comfortable about. I believe my theory did work,
if only for the fact that he was immersed in lymphedema education for the day and hopefully absorbed
information through osmosis.
I, on the other hand, left the conference, with new
hopes and contacts. Having spoken to Anna Kennedy
(LAO`s Executive Director) about my predicament
earlier, she put me in contact with another mother,
whose son suffers from lymphedema and is close to my
son’s age. While chatting and comparing notes with her
at the conference, yet another woman, who has two
younger sons with lymphedema, joined our discussion!
All I could think was, “Wow, there really are others with
this problem!” By problem, I am referring more to how
our boys were handling their condition, rather than the
lymphedema itself.
I love the education the conference offers: the workshops on what lymphedema is all about; treatment and
the different exercise; what products are available. But
what stood out for me the most this year were the peo-
This introduced me to the LAO and
their annual conferences, which has
provided me with an education I could
never have found on my own.
ple; the exhibitors, the educators and most of all, the
other attendees. The more people I talked to, the more
I realized we are all dealing with the same issues. To
realize that my son is not alone in his day-to-day struggle was so enlightening. Yes, we (he) will always need
to manage this condition, but to know we will hopefully
not always be arguing about it was such a relief for me.
The conference theme this year was “Empowering
Patients and Professionals”. I am pleased to tell you
that you have empowered parents as well this year,
LAO, and I thank you!
Conference Results
continued from page 7
lymphedema care models within the developing world.
Workshop selections were categorized into various
learning streams. For those new in their learning journey - choices included Lymphedema Basics (R. Harris), Practical Exercises (R. Herman, R. Wright and C.
Burt), and Self-Care Management (J. Yurick).
Heath professionals’ sessions included The Science
of Compression (D. Keast), How to Present Cases (A.
Towers), and Lymphedema Hospital-Based Programs
(J. Millward).
Sessions that catered to both health professionals
and the experienced lymphedema patient were Lymph
-edema Early Surveillance Model (J. Binkley), Additional Treatment Options (A. Wittlinger) and Exercise
Prescriptions (M. McNeely).
All delegates met up again at the end of the day for
a unique Ethnodrama - a reality based drama preWinter 2013
sented by breast
cancer survivors of
their experiences
with lymphedema.
A Q&A session with
the medical experts concluded
the day.
Thank you to all
the speakers who
contributed to this event. Your knowledge and continued research is vital to the empowerment of the lymphedema community - both patients and professionals! It is because of you that 98% of conference delegates rated our conference as a worthwhile investment of their time and money.
Finally, thank you to all our delegates for taking the
time to attend our conference.
Get ready for an extended conference - October 2013!
Lymphedema Matters
7
Thank You!
...for your generosity and
support throughout the 2012
year. We hope that you will
continue to support the
Lymphedema Association of Ontario in
2013 and our commitment to improve the
lives of people living with lymphedema.
The Lymphedema Association of Ontario could not operate without the
generosity of our supporters.
Because of you - we have increased the number of people we were able to
help through our telephone and email support lines.
Because of you - we were able to grow our lymphedema education and
awareness events.
Because of you - we have extended our outreach within the health
community and government relationships. Lymphedema information
pamphlets are now distributed to every oncology clinic within Ontario.
We wish you a wonderful holiday season and all
the best in the new year!
- LAO Staff and
Board Directors
Association québécoise du lymphœdème
Lymphedema Association
of Quebec
L hiver 2012
LE TRAITEMENT CHIRURGICAL DU LYMPHOEDEME AUJOURD’HUI
D re Janice N. C ormier, M D M PH & Kate D . C romwell, M S
Veuillez vous reporter
à la version anglaise de cet
article dans la révue principale pour les tableaux
et schemas numerotes.
Le traitement chirurgical du lymphoedème est de nos
jours un sujet populaire parmi les patients et les
professionnels de la santé. Tandis qu’il est vrai que les
interventions chirurgicales offrent des possibilités
prometteuses dans les cas où les traitements
traditionnels sont restés sans effet, les patientes ne
comprennent pas toujours que le traitement chirurgical
apporte rarement la guérison et que la plupart doivent
continuer à porter des vêtements de compression à vie.
On peut regrouper les procédures chirurgicales en 4
grandes
catégories:
excision,
liposuccion,
reconstruction lymphatique et transfert de tissu.
Chaque catégorie présente des avantages et des
inconvénients. La réduction de volume signalée pour
chaque
type
de
procédure
varie
grandement.
L’American Lymphedema Framework a fait une revue
systématique de la recherche (Tableau 1) à partir de
laquelle l’International Lymphoedema
Framework à
élaboré son document de positionnement.
L’excision
L’excision et la chirurgie de réduction du lymphoedème
sont les interventions les plus lourdes. Ces opérations
consistent à retirer la masse de tissu sous-cutané ainsi
que la peau des membres affectés pour se poursuivre
par une greffe cutanée assez étendue. Avec l’évolution
de la procédure on peut maintenant conserver les
lambeaux de peau pour préserver la circulation
sanguine et faciliter la guérison.
Dix publications,
revues par les pairs, signalent des réductions allant de
16% à 21% dans la taille du bras ou de la jambe après
excision.
Parmi les complications post-chirurgicales
documentées on retrouve des cas d’infection, de retard
cicatriciel, de thrombose des veines profondes, de
problèmes esthétiques, de destruction
des voies
lymphatiques restantes, de perte de fonction du bras ou
de la jambe, et de retour de l’enflure.
Encart de l'Association Québécoise du Lymphoedème
La liposuccion
Le Dr Brorson a été le pionnier de la technique
contemporaine de liposuccion. Les candidates à la
liposuccion sont d’abord traitées par TDC jusqu’à ce
qu’il n’y ait plus de signe du godet. La liposuccion
se fait à l’aide de 15 à 20 petites incisions pour
retirer
le
tissu
adipeux
sous-cutané.
Immédiatement après l’intervention, on applique
des vêtements de compression pour lesquels on
aura pris les mesures avant l’opération sur le
membre non affecté. Ces vêtements doivent être
remplacés tous les 3 mois. Sept articles de la série
avec revue systématique signalent une réduction
entre 18% et 118%.
Parmi les complications
associées à la liposuccion on retrouve des cas de
saignement, d’infection, de perte de peau, de
sensation de brûlure ou d’engourdissement de la
peau. Brorson et ses collègues insistent sur le fait
que les patientes doivent continuer à porter des
vêtements compressifs pour le restant de leur vie. Reconstruction lymphatique
La reconstruction lymphatique crée de nouvelles
connexions
entre
les
voies
lymphatiques
endommagées et les autres canaux lymphatiques.
La technique la plus courante est la dérivation
lympho-veineuse qui établit des connexions micro
chirurgicales à partir des canaux normaux ou dilatés
vers les veines. Ces techniques sont hautement
spécialisées et habituellement réalisées par des
chirurgiens plasticiens. Neuf études traitent de la
reconstruction lymphatique et font état d’une
réduction de volume de 2% à 52%. Parmi les
complications signalées on note la
défaillance
rapide des connections et une récurrence du
lymphoedème. On a eu recours, plus récemment, à
l’imagerie lymphatique au vert d’indocyanine pour
mieux visualiser les canaux lymphatiques. Une étude
récente de Boccardo et al. a signalé la création de
Voir page de
Q2 la
dérivations lympho-veineuses au moment
résection
du
ganglion
lymphatique
pour le
page Q1 traitement du cancer du sein afin de prévenir la
formation de
LE TR AITEM ENT CHIR UR GICAL
cont. de page Q1
récente de Boccardo et al. a signalé la création de
dérivations lympho-veineuses au moment de la
résection du ganglion lymphatique pour le traitement
du cancer du sein afin de prévenir la formation de
lymphoedème.
Transfert de tissu
On a utilisé différents
types de tissu (muscles,
ganglions lymphatiques, etc.) pour essayer d’améliorer
le drainage lymphatique. Les techniques qui consistent
à récolter des ganglions lymphatiques sains à partir
d’une région non affectée pour les implanter ensuite
dans la région où se trouve le gonflement sont celles
qui ont fait l’objet du plus grand nombre de rapports.
La mise à jour de la revue systématique a permis
d’identifier 8 études qui signalaient des changements
allant d’une réduction de 81% à une augmentation de
13 % dans le volume du membre lymphoedémateux
après intervention. Une autre étude rapporte que 60%
des patients ont présenté des changements notables
des fonctions lymphatiques au site du prélèvement
tissulaire
mais
aucun
changement
dans
la
circonférence du membre n’a été observé pendant la
période de suivi (8 à 56 mois). Les procédures de
transplantation de ganglions lymphatiques sont
toujours à l’étude. Des complications peuvent
Devenez membre
l'Association québécoise
du avec
accompagner
ces detechniques,
notamment
lymphoedème
et
recevez
votre
abonnement
de
l’apparition de lymphoedème au site donneur et la
Pathways gratuitement
récidive du lymphoedème
au site affecté.
[email protected] ou 514-979-2463
•Become a member of the Lymphedema
Association of Quebec and receive a free
Pathways subscription
[email protected] or 514-979-2463
transplantation de ganglions lymphatiques sont
toujours à l’étude. Des complications peuvent
accompagner ces techniques,
notamment avec
l’apparition de lymphoedème au site donneur et la
récidive du lymphoedème au site affecté.
Discussion
Différentes procédures ont été proposées pour le
traitement du lymphoedème dont un grand nombre ont
donné des résultats prometteurs pour un groupe choisi
de patients et patientes; la plupart des cas se sont
accompagnés d’une réduction significative du volume
du bras ou de la jambe. Peu d’études, toutefois, nous
informent sur l’incidence des complications possibles.
Le port continu de vêtements de compression reste
généralement recommandé après le traitement
chirurgical du lymphoedème. Aucune de ces techniques
n’a fait l’objet d’études aléatoires contrôlées portant
sur une grande population et sur une longue période.
Il existe une variabilité marquée dans les réductions de
volume rapportées et, à part pour la liposuccion, on
n’as pas défini quelle serait la population optimale pour
ces procédures. C’est lorsqu’il s’inscrit dans une prise
en charge globale du lymphoedème qui fait place au
traitement traditionnel que le traitement chirurgical du
lymphoedème peut le plus réussir.
Traduction : Taous Selhi
BIEN VIVRE AVEC LE LYMPHOEDÈME
Groupes d’éducation et d’entraide
Pour les personnes avec le lymphoedème
ou étant à risque
4/2/2013 Demandez à l’expert (FR) 4/3/2013 8/4/2013 Ask the expert (EN) Lymphoedème 101 : prinicipes de base
du lymphoedème (FR) Lymphedema 101 : Lymphedema basics
(EN) Exercices et le lympohoedème : On
bouge! (FR) Compression and Lymphedema (EN) Compression et le lymphoedème (FR) Exercises and lymphodema : let’s go!
(EN) 6/5/2013 3/6/2013 9/9/2013 7/10/2013 4/11/2013 HEURE/TIME: De 18:30 à 20:30
PLACE: Clinique du lymphoedème du CUSM, 5252 de
Maisonneuve ouest, #105b, NDG, Montréal
Toutes les sessions sont sujets à changement. RSVP est requise.
All sesssions are subject to changes. RSVP is required
Pour plus d’information ou l’inscription veuillez visiter
www.infolympho.ca ou contactez l’AQL au Tél. : 514-979-2463
page Q2 « SUCCÈS FACE AU LYMPHOEDÈME : PLEINS FEUX SUR LA COMPRESSION, LA GESTION
ET LE TRAVAIL D’ÉQUIPE »
La neuvième conférence annuelle de l’AQL
Le 23 août dernier, l’Association québécoise du
lymphoedème (AQL), en collaboration avec le
programme de recherche de McGill sur le
lymphoedème,
a
tenu
une
conférence
d’enseignement bilingue.
Plus de 200 personnes étaient présentes, y compris
des professionnels de la santé, des thérapeutes en
lymphoedème, des orthésistes et des gens atteints
de lymphoedème accompagnés de leur famille.
Les points clés de la conférence étaient :
•
Le guide des meilleures pratiques pour la
compression Dre Anna Towers, directrice de la
Clinique du lymphoedème au CUSM a fait état de la
dernière publication du Partenariat international sur
le lymphoedème.
•
La compression dans le traitement du
lymphoedème Mme
Angela
Vollmer,
MSc,
spécialiste allemande en orthopédie et sommité
mondiale
en
ajustement
de
vêtement
de
compression a expliqué les défis et les bénéfices de
la compression.
portant sur la gestion des risques en lymphoedème,
des techniques de bandages innovatrices ainsi que
des études de cas de mesure.
Un des faits saillants de la conférence a été une
performance dramatique sur La nouvelle norme : Vivre
avec le lymphoedème suite à un cancer du sein. Cet
ethno-drame, créé par des patients en interaction avec
une équipe de recherche multidisciplinaire dirigée par Dre
Roanne Thomas-MacLean, a exploré les expériences
souvent compliquées, frustrantes et positives des
survivantes du cancer du sein vivant avec le
lymphoedème.
Une équipe de tournage des nouvelles de CTV
(commanditée par une subvention éducative de BSN
Médical) a été présente pendant la conférence. Le court
métrage réalisé met en vedette Dre Anna Towers ainsi
que Babara Meimari, une patiente/bénévole de l’AQL, et
nous parle du lymphoedème, ces défis et l’autogestion.
Ce film peut être vu au
www.infolympho.ca/en/index.en.htm.
•
Maximiser le traitement et l’autogestion
du lymphoedème : l’adaptation, faire face et
l’approche d’équipe Mme Johane De Montigny,
psychologue montréalaise, a abordé un sujet
souvent négligé : la résilience du patient et l’automotivation dans la gestion d’une condition
chronique.
Les
patients
et
thérapeutes ont pu
assister à une grande
variété de conférences
et d’ateliers portant
sur
la
théorie
du
bandage, l’autogestion
ainsi que les conseils
sur les vêtements de
compression.
Toutes
ces séances ont mis
l’emphase
sur
l’importance
de
l’implication du patient dansl’implication
l’autogestion
dudans
patient
le
l’autogestion
traitement du lymphoedème.dans
Les thérapeutes
et les
dansont
le traitement
du
professionnels de la santé
bénéficié de
lymphoedème.
Les
formation continue en assistant
à des ateliers
et
les
portant sur la gestion thérapeutes
des risques
en
professionnels
de
la
lymphoedème,
des
techniques
de
bandages
santé
ont
bénéficié
de
innovatrices ainsi que des études de cas de
formation continue en
mesure. assistant à des ateliers
portant sur la gestion
Le financement de la part du gouvernement pour les
vêtements de compression est toujours en suspend.
Nous devons attendre l’annonce qui sera faite par le
nouveau parti au pouvoir, le Parti Québécois.
En plus des rencontres mensuelles du groupe de soutien,
ces importantes conférences permettent aux gens
intéressés par le lymphoedème de se rencontrer,
d’apprendre et de partager des expériences avec les
autres ainsi que de faire la promotion d’une meilleure
sensibilisation et traitement du lymphoedème.
C asi S hay, PT,
C oordonatrice des événements spéciaux, AQL
page Q3 Encart de l'Association Québécoise du Lymphoedème
page Q4 M AXIM ISER LE TR AITEM ENT ET L’AUTOGESTION : L’APPR OCHE D’ÉQUIPE
Point de vue psychologique
Par Johanne de Montigny,
psychologue, Unité de soins palliatifs, Centre
universitaire de santé McGill, Hôpital général de
Montréal, et pratique privée
Je me sens à la fois
honorée et audacieuse
d’aborder le volet
psychologique associé
au lymphoedème. En
explorant l’apport du
système lymphatique
chez l’être humain, j’ai compris à quel point une
équipe de soignants pluridisciplinaires bien formés
pouvait éventuellement influencer et stimuler
l’autonomie des personnes atteintes, développer avec
elles l’art de drainer les blocages lymphatiques et les
aider à dépasser les contrecoups psychologiques. Je
suis convaincue de l’importance d’un bon plan de
soins en vue d’une prise en charge personnelle au
quotidien.
L’autogestion
du
lymphoedème
(drainages
lymphatiques manuels quotidiens ou rapprochés;
pose de bandages réducteurs; gymnastique sous
bandages…) exige une discipline constante, une
grande détermination et, par-dessous tout, le goût de
vivre. Quand le corps est tuméfié par les
complications de la lymphe, l’identité en prend un
coup et c’est l’esprit qui viendra à sa rescousse. En
faisant l’expérience de sa vulnérabilité, l’être humain
découvre les forces tapies au fond de lui qui le
propulse dans une réorganisation de ses priorités et
une redéfinition de ses choix de vie.
La perception de soi est un phénomène étrange, c’est
bien connu, on est plus indulgent pour les autres
qu’envers soi-même. Mais le corps ne révèle qu’une
partie de soi. L’approche psycho-spirituelle nous aide
à comprendre que le regard sur soi évolue à partir de
nos expériences, de nos valeurs, de nos rencontres
et des représentations que nous nous faisons du
bonheur, du malheur, de la souffrance et de la joie
profonde.
Dans un premier temps, la personne durement
éprouvée peut sombrer dans la détresse, le
découragement, et dans le refus d’une souffrance
dont l’intensité et la durée varient pour chacun. Il
importe
de savoir que
l’un des obstacles
majeurs à
Encart
de l'Association
Québécoise
du Lymphoedème
tout cheminement provient du désir impossible de
redevenir comme avant. Les professionnels de la
santé sont sur la ligne de front pour guider l’éprouvé
à la croisée des chemins entre ce qui n’est plus
dont l’intensité et la durée varient pour chacun. Il
importe de savoir que l’un des obstacles majeurs à
tout cheminement provient du désir impossible de
redevenir comme avant. Les professionnels de la
santé sont sur la ligne de front pour guider l’éprouvé
à la croisée des chemins entre ce qui n’est plus
possible et ce qui se dessinera autrement.
Afin d’atteindre le but des traitements (retrouver sa
mobilité, stabiliser le volume du membre, empêcher
les complications, éviter les récidives, retrouver
l’esthétique et une fonction normale du membre),
l’implication et la contribution initiales de l’équipe de
soignants (médecins infirmières, physiothérapeutes,
psychologues, ou autres) permettront de stimuler la
prise en charge individuelle tout en assurant une
collaboration efficace. Les changements qui lui sont
imposés obligent l’être humain à basculer au plus
profond et à sonder l’envers de son corps. La
rencontre avec son for intérieur est percutante; elle
lui permet de revoir sa façon de composer avec les
éléments extérieurs. C’est la capacité d’être en
relation avec une équipe de soignants qui ouvrira la
voie à la capacité éventuelle d’être seul et
d’entreprendre sa propre discipline. Une bonne
alliance avec les soignants permettra d’aller de
l’avant.
Surmonter l’épreuve du lymphoedème consiste donc
en l’acceptation de ce qui est. Cette attitude est
cruciale et facilite l’adoption d’un nouveau régime de
vie. Au contraire, le refus de sa situation agit comme
un blocage psychologique et se confond avec le
blocage de la lymphe.
« Devenir autonome nous dit le philosophe Alexandre
Jollien, ne consiste pas dans la capacité de se passer
des autres, mais plutôt dans la hardiesse de
demander de l’aide. » La résilience est tributaire
d’une structure cognitive déjà solide ou d’une
restructuration de ses pensées, de relations affectives
fiables, de ressources personnelles comme la
débrouillardise,
la
détermination,
la
capacité
d’élaborer un nouveau sens à sa vie, d’y donner une
autre direction, et de consentir à ce qui a changé en
soi et autour de soi.
Je suis consciente que plusieurs aspects reliés au
lymphoedème n’ont pas été abordés dans cet article.
Je pense entre autres aux personnes génétiquement
prédisposées au lymphoedème qui se se démarque
par sa durée, par ses coûts financiers Voir
exorbitants
page Q6et
par le sentiment de culpabilité lors de la transmission
Q5 héréditaire. Le témoignage d’une femme qui sepage
débat
avec sa situation depuis 50 ans m’a éveillée sur ce
que signifie la discipline personnelle quand le corps
tout entier exige un soin continu de la peau, un
drainage lymphatique régulier et des bandages
POINT D E VUE PS YC HOLOGIQUE
cont. de page Q5
par sa durée, par ses coûts financiers exorbitants et par le
sentiment de culpabilité lors de la transmission héréditaire.
Le témoignage d’une femme qui se débat avec sa situation
depuis 50 ans m’a éveillée sur ce que signifie la discipline
personnelle quand le corps tout entier exige un soin continu
de la peau, un drainage lymphatique régulier et des
bandages multiples. Mais cette mère souffre davantage
d’avoir légué bien malgré elle le lymphoedème à son fils qui,
dans la trentaine, compte déjà plusieurs hospitalisations,
souffre d’isolement social et entraîne d’énormes coûts
financiers relatifs à sa santé. Le soutien du père s’avère
essentiel pour que mère et enfant puissent envisager la vie
de famille avec courage et espoir.
En terminant, je demeure convaincue que l’humain est
capable de faire face à ce qui lui arrive, de se relever après
avoir eu peur d’échouer et de transmettre des messages
dont la portée peut se décupler. Je souhaite à toute
personne éprouvée de rencontrer des soignants qui, dans
leur regard, poseront sur elle le coup d’envol pour
surmonter la souffrance et réorienter le sens de sa vie.
Notre passion : votre mieux-être !
Our passion : your well-being !
Vêtements compressifs
Compression garment
Système intermittent et séquentiel
Intermittent & sequential system
Bandages élastiques
Elastic bandages
Chaussures médicales et de confort
Medical & comfort shoes
112012
[email protected]
1 866 525 3757
page Q6 DEMANDEZ À L’EXPERT :
Q – Il semble que j’ai des infections de
Translator
Marie-Ève Letellier
cellulite
récurrentes
et je ne sais pas quoi
faire pour minimiser la fréquence et la
sévérité des cellulites.
David Keast
crème antibiotique et couvrez-les pour les
protéger. Finalement, vous devez maximiser
l’habileté de votre corps de combattre les infections
en mangeant une diète saine et équilibrée et en
faisant de l’exercice régulièrement.
La cellulite, ou érysipèle, est une complication
Malgré tous vos efforts, vous allez peut-être avoir
commune du lymphoedème. C’est une infection de
un épisode ou plus de cellulite par année. Si vous
la peau et des tissus sous la peau. La peau normale
avez plus de deux épisodes par année, l’usage d’un
agit comme une barrière très efficace contre
antibiotique prophylactique quotidien peut être
l’invasion de bactéries, de virus ou de champignons.
considéré. Le guide des meilleures pratiques du
L’enflure chronique du lymphoedème affecte
Partenariat
international
du
lymphoedème
l’habileté de la peau de protéger contre cette
recommande l’usage d’une faible dose quotidienne
invasion. Les bactéries peuvent pénétrer par de
d’érythromycine ou de clindamycine pendant deux
petites fissures, des zones d’eczéma ou d’infection
ans. S’il n’y a pas de récidive, les antibiotiques
fongique. Afin de prévenir une cellulite, vous devez
peuvent être arretés. Par contre, si une cellulite
maximiser cette fonction de barrière de votre peau.
survient
de
nouveau,
une
médication
Le plus important est de contrôler l’enflure de votre
prophylactique
à
vie
devrait
être
envisagée.
membre affecté avec vos stratégies habituelles de
Finalement,
si
vous
avez
eu
des
problèmes
traitement et l’usage consistant de votre vêtement
récidivants de cellulite, vous pouvez envisager eu
de compression. La peau doit être maintenue douce
des problèmes récidivants de cellulite, vous pouvez
et souple par l’entremise d’un nettoyage efficace
envisager d’avoir une prescription d’antibiotiques
fait avec un savon doux au pH équilibré. Après le
d’urgence si vous voyager loin de la maison.
nettoyage, la peau doit être complètement séchée,
incluant entre les doigts, les orteils et toutes
Q – Quels sont les signes et symptômes d’une
crevasses ou plis de peau. Une crème hydradante
infection ?
hypoallergène et non-parfumée peut ensuite être
appliquée. Consultez un médecin pour des
Les symptômes d’une infection peuvent être
infections fongiques ou des zones d’eczéma. Utilisez
variables. Certains épisodes peuvent apparaître
des vêtements appropriés pour protéger votre
très rapidement, à l’intérieur de quelques heures.
peau, incluant des gants lorsque vous lavez la
Dans d’autres cas, les symptômes peuvent
vaisselle ou travaillez dans le jardin. Des coupures
s’étendre sur plusieurs semaines. Vous pouvez
mineures et éraflures doivent être nettoyées
juste vous sentir mal sans raison claire. Douleur,
immédiatement avec de l’eau propre, appliquez une
rougeur, chaleur et enflure sont lesVoir
symptômes
page Q8
crème antibiotique et couvrez-les pour les protéger.
habituels qui peuvent vous alerter que vous
Finalement, vous devez maximiser l’habileté de
développer une cellulite. Vous pouvez développer
votre corps de combattre les infections
en
Les expériences d’un lymphoedème et les des stries
rouges le longsecondaire de votre bras
ouactivités de votre
mangeant une diète saine et équilibrée et en faisant
de jambe
la vie q(lymphangite)
uotidienne: Une Photovoix enflés dans
ouétude des ganglions
de l’exercice régulièrement.
votre aine ou votre aisselle. Des cloques sont
Une invitation participer la recherche, parfois àvisibles.
Si àvous
avez deen laanglais, fièvre, des
sur les e
xpériences d
’un l
ymphoedème s
econdaire
frissons, des maux de tête ou que vous vomissez,
ces symptômes indiquent une infection grave
nécessitant une attention médicale immédiate à
l’urgence la plus proche.
.
page Q7 Démandez à l’expert… cont de page Q7
rougeur, chaleur et enflure sont les symptômes
habituels qui peuvent vous alerter que vous
développer une cellulite. Vous pouvez développer
des stries rouges le long de votre bras ou de votre
jambe (lymphangite) ou des ganglions enflés dans
votre aine ou votre aisselle. Des cloques sont
parfois visibles. Si vous avez de la fièvre, des
frissons, des maux de tête ou que vous vomissez,
ces symptômes indiquent une infection grave
nécessitant une attention médicale immédiate à
l’urgence la plus proche.
chronique, la zone autour de la plaie peut
développer une réponse inflammatoire chronique.
Ultimement, ceci peut surcharger la capacité des
vaisseaux lymphatiques de gérer cette situation et
la
dysfonction
lymphatique
peut
devenir
permanente. Ceci est particulièrement visible chez
les
personnes
souffrant
d’ulcères
veineux
chroniques, dont plusieurs d’entre eux développent
un lymphoedème
Q – Est-ce que les plaies chroniques peuvent
causer le lymphoedème ?
Traduction : Marie-Ève Letellier Ceci est vraiment une bonne question. Chaque fois
qu’une plaie survient, il y a une réponse
inflammatoire qui se fait et qui initie la guérison.
Ceci sera perçu comme de l’enflure, de la chaleur
et de la rougeur causé par la perte de liquide, de
protéines et de substances inflammatoires dans les
tissus. Dans la zone d‘une plaie aigue, il y aura
une stase lymphatique. Si la guérison se fait, ceci
se résorbe. Par contre, si la plaie devient
chronique, la zone autour de la plaie peut
développer une réponse inflammatoire chronique.
Ultimement, ceci peut surcharger la capacité des
vaisseaux lymphatiques de gérer cette situation et
la
dysfonction
lymphatique
peut
devenir
permanente. Ceci est particulièrement visible chez
les
personnes
souffrant
d’ulcères
veineux
chroniques,
dont
plusieurs
d’entre
eux
développent un lymphoedème
Traduction : Marie-Ève Letellier http://www.healthandfamily.ca/lymphedema
Cette sesion d'éducation présentée sur
la chaîne CTV lors de l'émission "Health
and Family" du Dre Maria Shapiro met
en vedette Dre Anna Towers, MD, CM,
FCFP et directrice de la clinique du
lymphoedème du CUSM.
BÉNÉVOLES DEMANDÉS
Lors de leur conférence
annuelle
le
23
août
dernier,
le
Conseil
administratif
et
les
membres de l'LAQ ont
honoré
Sally
Saskin
pour les
13
ans
de
son dévouement à la cause
de lymphoedème.
At their annual conference
of August 23, 2012 LAQ’s
board of directors and
members honored Sally
Saskin for her 13 years of
dedication
to
the
lymphedema cause.
VOLUNTEERS NEEDED
Joignez-vous à notre équipe.
On a besoin vos talents.
Join our team of wonderful people.
We can use your special skills.
514-979-2643 / [email protected]
page 8 Atlantic Clinical
Lymphedema Network
Winter 2012-13
Ankle Brachial Pressure Index (ABI) before
Lymphedema Treatment?
ABI testing is performed by taking the blood pressure(BP) in the arm and
at the ankle and comparing them. A normal resting ABI is between 1.0
and 1.4 meaning the pressure at the ankle is the same or better than the
arm and there is no significant arterial narrowing or blockage causing
reduced blood supply to the leg. An ABI less than 1 indicates that there
is possible Peripheral Arterial Disease(PAD). An ABI of less than 0.5
indicates that PAD is severe enough that applying compression to the leg
could result in tissue ischemia.
As a physiotherapist who has been treating Lymphedema for over 10
years, I have sent patients at times for ABI testing if I have suspected
PAD. Signs might include numbness or tingling in the feet and legs
associated with Diabetes, pain in the calves when walking, pain when the
legs are elevated, lack of a pulse among other things. All other patients
with chronic edema, I have recommended or provided compression
without hesitation.
Over the past few years I have noted that the community health nurses,
who use alot of compression bandaging for venous ulceration, have
increasingly insisted upon screening all patients with ABI prior to
compression wrapping them. I have always felt that this seemed
excessive until last month.
At the October LAO 2012 Conference, I attended an education session
given by Dermatologist Dr. David Keast titled “The Science of
Compression”. He gave an excellent lecture on Tissue Fluid Dynamics and
the physiology of chronic edema. He recommended doing ABI screening
on every patients for whom we recommend leg compression. He stated
that there would be many patients we see who have mixed venous and
arterial edemas and that we may not identify PAD, despite doing a
thorough subjective and objective assessment. To complicate matters,
many of our patients have calcified arteries (i.e. diabetics), or large
fibrotic limbs that confound the ABI results and require Toe PPG testing
for clarity.
Taking this screening approach as Lymphedema Therapists would mean a
change in practice. Patients would be assessed and then have to be
scheduled for ABI testing. Availability of this testing will be limited in
many areas and lead to delays in treatment. However, having small
portable ABI/PPG testing units in our clinics would be more time efficient
but would cost approximately $3000 per unit. Since the Nurses have this
policy of screening in place, a concern would be if and how it affects our
liability. As a group of concerned professionals, further discussion is
needed to determine if doing ABIs on patients is something we want to
incorporate into routine practice.
Andrea Tilley, PT
Edema Care and Breast Cancer Rehab Services
Horizon Health Network / Réseau de santé Horizon
ACLN - page 1
Atlantic Clinical Lymphedema Network
Winter 2012-13
Lymphedema Support Group
St. John’s, Nl
Challenges of Lymphedema Therapy
in Rural Newfoundland
After a beautiful summer in St. John’s, we are back
to our monthly support group meetings at Daffodil
Place.
Donna Parsons is a full time Nurse Practitioner in
primary health care practicing at LeGrow Health
Center in Port Aux Basques, Newfoundland. In
2009, she was one of three nurses from
Newfoundland and Labrador selected to complete a
lymphedema therapist course at the Steve Norton
School of Lymphatics in New Jersey. This was
possible through a grant supplied through the
CBCF-Atlantic Region. A needs assessment done
through the Lupin Partnership that showed women
with lymphedema were being largely under
serviced. Incorporating this new role into her busy
practice has been challenging due to time
constraints, lack of resources and continuity of
care. “To provide awareness of my role as a
lymphedema therapist, letters were sent to family
physicians in the Port Aux Basques area outlining
my role. An invitation to speak at a wound care
conference also gave me an opportunity to
promote lymphedema awareness and my role
regionally. Since that time, I have received many
referrals.”
We have had 2 meetings this fall. The first focused
on a general over view of lymphedema, both
primary and secondary, its causes and treatments.
Best practice guidelines for the prevention and
treatment of lymphedema were reviewed.
Members of our group were also asked to provide
suggestions for future topics. Many people felt they
would like to repeat sessions we have done in the
past, such as presentations from compression
garment companies, a dietician and a social worker
to present the psychosocial side of lymphedema.
That led perfectly into our second support group
meeting. Bill Hynes, BSW, is a social worker at the
Dr. H. Bliss Murphy Cancer Centre and he spoke to
our group in November. Bill’s presentation focused
on how lymphedema for some individuals can be a
reminder of the disease in which they have gone
through, especially with an oncology diagnosis. For
those who have primary lymphedema, there may
be a level of frustration that the origin of the
edema is unknown or, if caused by a genetic
disorder, how will this effect a family. He listened
to our group verbalize the challenges in accessing
therapy for lymphedema. Cost and replacement of
compression garments were also highlighted.
Overall, the message was clear. As a social worker
and counsellor, it was his opinion that the
psychosocial side of lymphedema cannot be
ignored. Seek out groups, either in your
community or on line, for support. Knowing you
are not alone is comforting. Increase your
knowledge about lymphedema as knowledge is
power. Recognize that it is okay to ask for help or
to need someone to talk to.
Monthly Support Group Meetings are held at
Daffodil Place in St.John’s the first Thursday of
each month at 7pm. Call 777-8713 for information.
Jean Ann Ryan and Janet Montevecchi
Lymphedema Therapists
St. John’s, NL
Need info on the ACLN?
Contact Shannon Andersen
[email protected]
(902) 893-5554 ext 2198
I n i t i a l l y, D o n n a p r o v i d e d C o m p r e h e n s i v e
Decongestive Therapy as well as education in self
management and follow up. However, this was
quite a struggle in an already busy practice.
Unfortunately, she realized that with limited time
and lack of resources, she could no longer provide
Complete Decongestive Therapy. This was a
struggle for some time however she decided that
her role would have to focus on education and
support versus treatment. Now, when assessing a
person with lymphedema, she educates them
about lymphedema, what treatments options are
available, the importance of compression therapy
and good skin care. Recently, Donna attended a 2
day workshop facilitated by Martina Reddick and
Jill Allen on compression bandaging for edema
management. The workshop was an excellent
educational opportunity that demonstrated
application techniques and opportunity for practice
using the 3M Coban 2 Layer compression systems.
The take home tools and access to online forums
will greatly enhance her treatment of people living
with lymphedema. “Participating in workshops,
continuing education and connecting with other
lymphedema therapists is an excellent way to
maintain competencies in lymphedema therapy”.
Donna Parsons is a Nurse Practitioner and a
Certified Lymphedema Therapist that practices in
Port Aux Basque, Newfoundland & Labrador.
ACLN - page 2
Atlantic Clinical Lymphedema Network
Winter 2012-13
Julie Skaling Physiotherapy Clinic
70 Exhibition St. Kentville, NS
902-678-3422
List of Services Include:
Physiotherapy and Massage Therapy
Manual Therapy
Manual Lymphatic Drainage and CDT
Compression Garments
Mastectomy Bra Fittings
Vestibular Rehabilitation (BPPV)
Personalized Exercise Program
Craniosacral Therapy
Acupuncture
8 a.m. - 8 p.m. Monday to Friday
www.skalingphysio.com
ACLN - page 3
Certified Lymphedema Therapists in Atlantic Canada
Nova Scotia
Shannon Andersen PT
Colchester East-Hants, NS
902-893-5554 ext 2198
Natalie Parker PT
Colchester East-Hants, NS
902-893-5520
[email protected]
Natalie.Parker@cehha.
nshealth.ca
Leanne Beaton BSc, OT
Halifax, NS, 902-472-2151
[email protected]
Julie Skaling PT
Kentville, NS, 902-678-3422
[email protected]
Natalie Bourque PT
Yarmouth, NS
902 742-3542 ext.1154
[email protected]
New Brunswick
Tammy Betts PT
Moncton, NB
506-857-5326
[email protected]
Audrey Deveaux PT
Halifax, NS, 902-473-2151
Audrey.deveaux@cdha.
nshealth.ca
Jackie Devoe PT
Sydney, NS
902-567-8000 ext 2196
[email protected]
Danna Harrison RMT
Kentville, NS, 902-687-3422
[email protected]
Christine Johnston PT
Truro, NS
902-893-5554 ext 2210
[email protected]
Amilyn Kearney BSc,RMT
Sydney NS, 902-539-1218
[email protected]
Myrna King BSc, OT
Halifax, NS 902-473-1257
[email protected]
Cynthia Lohnes-Ferrolino BSc,RMT
Chester, NS
902-275-8089
[email protected]
Kimberley Lombard MSc, OT
Shelburne, NS
902-875-4144 ext.284
[email protected]
Heather Lowe MSc, OT
Yarmouth, NS
902 742-3542 ext.1137
[email protected]
Sandra MacDonald RMT
Halifax, NS
902-421-7549
aj244@[email protected]
Sophie Doiron PT
Moncton, NB
506-862-4100
[email protected]
Louise Godin PT
Moncton, NB
506-862-4100
[email protected]
Nathalie Hache PT
Lameque, NB
506-344-3419
[email protected]
Nicole Hache PT
Caraquet, NB
506-726-2275
[email protected]
Winter 2012-13
Linda Savoie PT
Tracadie-Sheila, NB
506-394-3004
[email protected]
PEI
Alanna Saulnier PT
Dept. of Physical Medicine
Charlottetown, PEI
902-894-2062, [email protected]
Newfoundland
Heather Buckle PT, CDT
Health & Performance, Corner Brook, NL
709-632-2266
[email protected]
Beverly Lanning RN, CLT-LANA
Regional Lymphedema Nurse
Central Heath, NL
709-489-4418
[email protected]
Ingrid Lindner RMT, CDT
Labrador Massage Therapy Clinic
Goose Bay, NL, 709-896-3843
[email protected]
Jodi MacPhail PT, CDT
Labrador Health Center
Happy Valley-Goose Bay, NL
709-897-2124
[email protected]
Janet Montevecchi RNBN, CDT
Ramona Kieser BHSc,PT
Sackville, NB, 506-536-8081
[email protected]
Breast Screening Centre, St. John’s, NL
Marie-Andree Legere PT
Minto, NB, 506-327-7821
Donna Parsons RNNP, CDT
Dr. Charles LeGrow Health Centre
Port Aux Basque, NL, 709-695-4500
[email protected]
Laine MacKinley PT
St. John, NB
506-648-7981
[email protected]
Tara Mann PT
Moncton, NB
506-857-5326
[email protected]
Manon Tardif PT
Campbellton, NB, 506-789-5017
[email protected]
Andrea Tilley PT
St. Joseph’s Hospital, St. John, NB
506-632-5510
[email protected]
ACLN - page 4
709-752-3626
[email protected]
Jean Ann Ryan RNBN, CDT
DHBMCC, St. John’s, NL
709-777-8713
[email protected]
Martina Reddick RN, CDT
DHBMCC, St. John’s, NL
709-777-8713
[email protected]
Teresene Walsh Oakley RMT, CDT
Pro Motion Therapeutic Services
St. John’s,NL, 709-747-7766
[email protected]

viha 7th annual rehab forum - Lymphedema Association of

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