E-Newsletter - October 2009
Welcome to our first e-newsletter.
We hope from this small beginning will blossom a communication, educational and discussion forum for all of us who have an interest in lymphoedema, its identification, diagnosis, treatment and management taken in the most holistic sense and encompassing those members from developed and developing countries and communities.
The aim of this newsletter is to inform and encourage discussion and help us all develop relationships with others who have a similar interest. From this we hope that, at the very least, we can all become more aware of what others are doing and that the sharing of ideas and actions will lead to better patient outcomes. Importantly, we hope you will develop new friendships and, from this, develop new research projects at the national and international level.
As an executive member of the International Society of Lymphology (and President of the 2009 International Congress of Lymphology), I can say that JOL has facilitated a significant improvement in communication and awareness among lymphoedema researchers and those in other fields. The journal's new website, www.lymphormation.org, can only serve but to continue this trend and invite opinion at all levels, providing a platform for us all to discuss and debate issues. I urge you to go online, pose questions and engage in what we hope will become a truly international resource.
As an executive member of the International Society of Lymphology (and President of the 2009 International Congress of Lymphology), I can say that JOL has facilitated a significant improvement in communication and awareness among lymphoedema researchers and those in other fields. The journal's new website, www.lymphormation.org, can only serve but to continue this trend and invite opinion at all levels, providing a platform for us all to discuss and debate issues. I urge you to go online, pose questions and engage in what we hope will become a truly international resource.
Another resource you might like to access is the recently published Template for Practice: Compression hosiery in upper body lymphoedema (available to download from www.lymphormation.org). Following the format of its sister publication, Template for Practice: Compression hosiery in lymphoedema, the document offers much needed guidance on this neglected area of lymphoedema management.
For each e-newsletter we hope to present something new to you in visual format. As a start, we have an interesting and informative video of Professor Partsch demonstrating bandaging technique and two animations from my group showing the benefits of variation in tissue pressures brought about by vibration, massage, activity and exercise. These are not for public broadcast but for your information to improve and enhance the clarity of your knowledge.
Click here to view the animations
We will also report on our recent world events in the area of lymphoedema and lymphology, as well as initiate a discussion forum for your input on a range of relevant and current issues confronting all of us who deal with any aspect of lymphoedema.
Report on the 22nd International Congress of Lymphology, Cairns, Sydney and Ayers Rock, September 2009
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Indigenous Welcome to the Country |
27 of our young lymphologists (our future) |
I'm proud to be able to say that this congress was a very successful event with over 160 presenters from 34 countries, over 40 posters, 28 keynote speakers and 20 key representatives from around the world of lymphology.
Outcomes of the congress will be available in the Proceedings to be published early next year.
The meeting's theme was lymphangiogenesis, lymphatics, lymphoedema, life to encompass the breadth of the area of lymphology. Each site had specific themes and areas of presentation, discussion and debate, starting with issues of 'hot and humid' in Cairns and finishing with 'hot and dry' in Ayers Rock.
The meeting was one whose outcome intention was to present the holistic nature of lymphoedemas and to emphasise the importance of a holistic and multidisciplinary information base and care to achieve the best outcome for the patient and the greatest satisfaction for the therapist.
We hope some of the issues of debate and discussion will follow through to future meetings.
Question and discussion area
Some of the important, topical discussion issues we have seen will be explored through the newsletter.
We invite your comment and hope that these become part of an evolving discussion forum and then a debate topic in the Journal of Lymphoedema (JOL). Most importantly, we hope that these discussions will form part of an evolution and improvement in our patient care in the countries we represent and hale from around the world.
Treating lymphoedema when it's hot
It was clear in our discussions at our recent congress that treating lymphoedema in hot and humid and hot and dry areas is very problematic.
Some suggestions have included bandaging or garment use when inside an air-conditioned environment. But what if there is none? What are our options?
One of my personal suggestions was an increased use of kinesio/lymph taping to help lymph flow.
Picture courtesy of Ms J Bosman - Flinders Lymphoedema Assessment Clinic
Well, one of the biggest issues is that of bandaging and garments in hot and humid regions. It is clear that in normal temporate climates bandages are helpful, in fact they may be the best of all the possible treatments, but in a hot and humid climate they are an issue, not only from the point of view of possibly heating up the arm, thus causing more peripheral vasodilation (on top of that which is already occurring as part of the intent of the body to dilate superficial capillaries to help reduce elevated core temperatures), but also from the point of view of compliance.
So, is the solution to continue to use them (if they are so beneficial) and perhaps considering only applying them when the patient is in an air-conditioned environment? But what if there is no air-conditioning, or no cool place to go - what then?
Maybe the solution is in part found in the use of sleeves in hot environments, with the newer wicking type materials which draw fluids away from the skin through the fabric, thus giving the limb a better chance to remain cooler.
But what if it is pretty much 100% humidity - wicking does not work too well then, one has to have a fan or some sort of air movement.
Whatever, it is clear that there are many issues faced in hot and humid environments, and there is simply not enough research done or being done as the recent paper by Gordon et al (2009) has shown.
Your ideas and replies to this question of what to do when it is hot will help us inform and perhaps direct research, so that we can gain better patient outcomes, not only in developed nations, but also the developing ones.
How do you help a patient in these environments?
What would help you do it better?
What do you do when there is no trained therapist around?
Is there anything the patient or partner or carer can do to help?
If you have any comments on any of the above questions, please do feed them back to: furtherinformation@lymphormation.org to enable this discussion forum to evolve and develop….
Written by Professor Neil Piller
Reference:
Gordon S, Sheppard L, Selby A (2009) BCRL questionnaires: climate and indigenous groups. J Lymphoedema 4(2): 44-51
