National Lymphedema Network
 Lymph e-Channel vol. 8August 2013  
In This Issue
· Welcome
· Therapist's Article
· New Product

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Welcome to Lymph e-Channel   


Dear Friends and Colleagues,


Greetings from the NLN Headquarters. First and foremost it is with great pleasure that I introduce you to our two new staff members, Liz Cheng and Kelly Morrell. Both joined the NLN in May and we are thrilled to have them on our team.




Liz Cheng, our Database Manager, came to the NLN in May. She handles all our affiliates and general members, and is thrilled to launch our new affiliate online renewal application process this week.  Liz is also the Exhibitor Liaison for the 2014 NLN Conference and be in charge of registration. You will enjoy working with her. 




Kelly Morrell, our new Outreach and Office Coordinator, joined the NLN shortly after Liz. She manages the NLN Info Line, communicates with patients and handles the shipping of NLN merchandise and information. She is also the Editor of LymphLink and Committee Liaison of the various NLN Committees, as well as Saskia' s right hand, handling numerous administrative tasks. She is a busy person but always available with a big smile.



This issue features the condition of Lipedema, characterized by symmetrical bilateral swelling in the lower extremities. At this point few healthcare professionals have any knowledge, and often it is misdiagnosed. Linda Ann Kahn, a well-known Vodder trained therapist, shares her knowledge and expertise with this patient population. She provides excellent tips for treatment, including nutritional components. Many thanks Linda.


If you have a unique case study or new product you like to share with the LE community at large, please contact the NLN office. We continue to learn from each other and love to hear from patients or therapists alike. Enjoy the remainder of the summer.


Saskia R.J. Thiadens R.N.

Executive director and NLN staff

Integrative Treatment of Lipedema


by: Linda Anne Kahn HHP CLT-LANA CMT  


Lipedema is a chronic inflammatory disease of complex causes, many of which the medical community does not understand. It occurs almost exclusively in females and is characterized by symmetrical flabby swelling of the legs. There is an abnormal accumulation of fatty deposits starting in the hip region and ending at the ankles. The arms and abdomen can also be affected. 

Lipedema is a poorly understood condition, and health professionals and physicians may dismiss the patient and consider this a problem of weight control.


Individuals with this condition are oftentold they are overweight and counseled that they eat too much or are not following their prescribed diets. This uniform approach to the problem can convey a lack of understanding. It can result in anxiety, frustration and a feeling of helplessness on the part of the person who is suffering from lipedema. In fact, this condition is a genetic abnormality and the obesity is not the patient's fault.


The treatment for lipedema is complex. Individuals with a diagnosis of lipedema require a comprehensive plan of care, including physical and psychological support, to help them overcome the many problems that accompany the condition. They should also receive the nutritional guidance that will help decongest the system and assist in minimizing additional weight gain.


Why do I swell?  

  • Swelling occurs when there is interference with the flow of lymph fluid. This interference can produce edema, which is another name for swelling.
  • Excess fatty tissue will impact the lymphatic system by disturbing the normal  flow of lymph fluid.
  • Fat cells can contain toxic material such as dioxins, mercury and other heavy metals that contribute to the inflammation
  • Inactivity further exacerbates the condition as the pumping activity of the muscles to move fluid is reduced, which can result in increased swelling.
  • Typically, lymph fluid is absorbed from the initial lymphatic vessels in the tissues, enters the lymphatic system and is pumped upward. Constriction of the lymphatic vessels by the increased fat deposits restricts absorption and blocks the return flow of the lymphatic vessels.

Treatment of lipedema 

  • Manual lymph drainage (MLD)- This form of massage utilizes gentle, rhythmic pumping movements to stimulate the flow of lymph around blocked areas to healthy vessels, where it can drain into the venous system. This can help to relieve pain and prevent fibrosis (hardening of the soft tissues).
  •  Compression- The use of stretch bandages or custom-fitted panty hose, panties and/or spandex shorts increases tissue pressure in the edematous legs. This can decrease the re-accumulation of fluid and create a significant reduction in adipose tissue
  • Exercise- Regular activity and exercise helps reduce fluid buildup, increases mobility and maintains or improves function. Rebounding, whole body vibration, walking, yoga and swimming should be included.
  • Deep Breathing- Learning how to correctly perform deep breathing exercise helps to move lymph fluid by stimulating the vessels in the abdomen that transport the fluid.   
  • Diet - A diet that includes nuts, seeds and foods high in omega 3 fatty acids is considered to be helpful in controlling inflammation. 

The foods you eat play an important role in how you feel. Junk, processed and fast foods contain too much sugar, salt and white flour which can aggravate inflammation. Avoid red meat, as it contains arachidonic acid, which in excess could make your inflammation worse.


Try to follow a Mediterranean diet as an anti-inflammatory dietary pattern. This diet consists of fruits and vegetables, nuts, olive oil, beans, legumes and fish. It is moderate in alcohol and eliminates processed meat, refined carbohydrates and whole-fat dairy products.


Fish oils are thought to generally decrease sev­eral markers of inflammation. Omega 3 fatty acids are found in high levels in fatty fish, such as mackerel, lake trout, herring, sar­dines, albacore tuna, wild salmon and hali­but.


Dietary sources of the omega 3 fatty acid alpha-linolenic acid include flaxseeds, chia seeds, walnuts, pecans, pumpkin seeds, hemp seeds, soybeans and some dark green leafy vegetables. Omega 3 fatty acids may also reduce the risk of obesity.


Incorporating medium fatty acids (MCT) into the diet can help patients with lipedema. They are easily absorbed and unlike other fats, which are stored in the adipose tissue, MCTs put little strain on the digestive system, provide a feeling of satiety and give a quick source of energy. Animal and human studies have shown that the fast rate of oxidation of MCFA leads to greater energy expenditure (EE), resulting in less body weight gain and decreased size of fat depots after several months of consumption.  Pure virgin cold-pressed coconut oil and Caprylic acid are medium fatty acids



Patients should continue on this multifaceted program to prevent the condition from getting worse, as the disease can progress to lymphedema if left completely untreated. It is important to seek out a qualified and caring therapist to support and encourage treatment. 

JOBST® Elvarex® Soft



As the experts in the field of lymphology, BSN medical developed JOBST® Elvarex® Soft custom-made for lower extremities and for the arm. The unique, knitted fabric of JOBST® Elvarex® Soft is made of soft textured yarn.  This specialized yarn combines skin-protecting softness and excellent breathability. It is particularly well-suited for patients who have sensitive or fragile skin.


Latex-free JOBST® Elvarex® Soft is very comfortable to wear, as well as easy to don.  The inner side of the seam has been designed to be particularly soft, though a new construction using specialized sewing yarns. This makes the inner side of the seam of JOBST® Elvarex® Soft both smooth and gentle on the skin.


Jodi Winicour, PT, CMT, CLT-LANA with Longmont  United Hospital and instructor with Klose Training & Consulting states, "I have used Elvarex soft for my lipedema patients, as well as for my older patients with milder lymphedema who have fragile skin and they love the fabric. They find it to be very comfortable and easy to don and wear. The fabric also transitions nicely from large to smaller regions, or vice versa and is nice and flexible at the knee and elbow."


Now available in Capri and Bermuda!


The combinations of Capri/Knee Highs and Bermuda/Thigh Highs that you love in traditional  JOBST® Elvarex® are now available in JOBST® Elvarex® Soft.  These two piece garments are easier to don for those patients with limited range of motion and help with long-term compliance.



National Lymphedema Network, Inc.
116 New Montgomery Street, Suite 235
San Francisco, CA 94105
Hotline: 1.800.541.3259
Tel: 415.908.3681
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