Lymphedema in the Newspapers

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Lymphedema in the Newspapers

Postby patoco » Sat Jun 17, 2006 4:36 pm

Lymphedema in the Newspapers

Lymphedema People

http://www.lymphedemapeople.com

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Story about Patrick Hornby and lymphedema from the UK

June 17, 2006

Patrick Hornby

DURING a three decade career at the sharp end of the health service, Patrick Hornby helped save an unknown number of lives.

Mr Hornby, from Walton, worked in emergency surgery at the Royal Liverpool, Walton and Fazakerley for 33 years of his 35-year NHS career.

But work was cut suddenly short for Mr Hornby last year when he was struck out of the blue by the condition lymphodema.

The grandfather-of-three said: "The lymph glands in my leg just decided not to work any more.

"I was on duty when it happened and was just going to give a lecture. My leg swelled up and I was taken to casualty. Within 15 minutes I was on two drips and morphine. I was in hospital for five weeks.

"There's no cure for it, and I'll be on antibiotics and pain-killers for the rest of my life."

Mr Hornby, 53, had to give up work, and now needs crutches to get around.

He plans to take his wife Barbara as one of his guests to the Pops.

Son James, who nominated his dad, said: "He has saved so many lives in his time, he needs a night out with mum and now he has the time."

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Options to treat lymphedema

Wed. May 17, 2006

Chronic disease now seen as manageable condition
By BILL RADFORD
The Gazette (Colorado Springs, Colo.)
Just live with it. That often was the advice for people with lymphedema -- assuming it was even diagnosed in the first place.

The body's lymphatic system transports excess fluids from tissues to the blood and also helps fight infection. A buildup of lymph fluid can lead to lymphedema, a chronic condition that involves swelling, most often in a leg or arm. Secondary lymphedema, the most common form, is caused by damage to the lymphatic system, such as that resulting from breast cancer surgery or radiation.

Lymphedema affects millions in the United States, mostly women. But until recently, little attention was paid to the condition. Bobbi Van Riper, a Colorado woman with lymphedema, tells of a fellow breast cancer survivor who suffered in silence for years with lymphedema after her doctor told her, "What do you care? We saved your life."

If doctors in the past didn't appear too concerned, that may have been because they had little to offer patients, says Jean Smith, a lymphedema clinical nurse specialist. "Doctors really felt like there wasn't anything they could do."

Care has improved in the last decade or so to the point that lymphedema is now recognized as a manageable condition. But Smith complains of a tendency to forget the chronic nature of the disease.

Constant reminder of cancer|

Instead of seeing patients once and sending them on their way, healthcare providers should be prepared to deal with the long-term physical and psychological issues stemming from lymphedema, Smith says. It's not simply an annoyance: The swelling can be painful and, if untreated, the affected limb is more prone to infection. For a cancer survivor, lymphedema is a constant reminder of that battle.

The Sinclair School of Nursing at the University of Missouri-Columbia is conducting a study following more than 300 women treated for breast cancer. Two years after surgery, 40 percent showed signs of lymphedema, the study found.

Secondary lymphedema can occur weeks, months or years after damage to the lymphatic system.

"We know that there are 2 million women in this country who are breast cancer survivors," says Jane Armer, a professor at the Sinclair School of Nursing. "That's a whole lot of people who are at risk for lymphedema sometime during their lifetimes."

That risk may be falling with refinements in breast-cancer surgery and more precisely targeted radiation, Armer says. But breast cancer treatment isn't the only culprit. Any surgery that may require removal of lymph nodes, such as surgery for melanoma, colon, prostate or head and neck cancers, can lead to secondary lymphedema. Primary lymphedema, which is less common, is believed to result from a developmental abnormality in the lymphatic system.

Cheri Swann, 52, developed lymphedema in her legs after surgery to remove excess skin -- a reminder of gastric-bypass surgery more than 20 years earlier. She lost more than 180 pounds after the procedure in 1982. "I tell people that I lost a 6-foot-1 man out of my 5-foot-3 body," she says.

For decades, she put up with the excess skin resulting from her dramatic weight loss. But in October 2004, she had the excess skin surgically removed from her arms and legs. In March 2005, she had another surgery to remove excess skin around her abdomen. Four months later, she was diagnosed with lymphedema.

Lymphedema treatments

"I wouldn't wish this on my worst enemy," Swann says. Her legs burn and tingle from the swelling. Instead of showing off her slimmer body, she wears long pants to hide the compression stockings she wears during the day. "You have to pull and tug and stretch, and that's another concern I have is when I get to be an older woman and I can't put these on, who's going to do it for me."

She wears a sturdier compression garment at night and also periodically undergoes manual lymph drainage, a light massage that stimulates lymph vessels and helps the flow of lymph fluid. Drainage therapy and compression garments are the cornerstones of lymphedema treatment. Skin care, to prevent infection, and exercises to promote lymph flow are also typically stressed.

Pneumatic compression pumps can also be used to get lymph fluid moving. Some research points to benefits of the pumps, but other research indicates they may further damage the lymphatic system or cause other problems, Smith says.

She also points to research indicating manual drainage therapy may be of little benefit in treating lymphedema in arms and legs. She stresses compression as the key to managing lymphedema, but says, "A lot of people believe that the drainage therapy is needed."

Armer says the drainage therapy can ease symptoms and help prevent infection by keeping the otherwise-stagnant lymph fluid moving.

http://www.montereyherald.com/mld/monte ... 599142.htm

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Progressive Weight Training Does Not Cause Lymphedema in Breast Cancer Survivors, Study Says

May 19, 2006

Breast cancer survivors who have had their lymph nodes removed and who practiced slow, progressive weight training did not increase the onset of lymphedema -- a buildup of lymphatic fluid under the skin -- according to a study published in the May 15 edition of the Journal of Clinical Oncology, the New York Times reports. Kathryn Schmitz, an assistant professor in epidemiology at the Abramson Cancer Center of the University of Pennsylvania, and colleagues for six months studied 23 breast cancer survivors who had had their lymph nodes removed and underwent weight training twice a week and 22 breast cancer survivors who had had their lymph nodes removed and did not lift weights.

Researchers found there was no difference in arm circumference between the exercise group and the control group, and the exercise group had fewer symptoms of lymphedema than the women in the control group, the Times reports. "While current clinical guidelines say that this type of exercise may be harmful, our research indicates that it is indeed safe," Schmitz said, adding, "More research is needed to know whether exercise prevents lymphedema, but there are physiologic reasons to believe that it might."

Joseph Feldman of the Lymphedema Treatment Center in Illinois said that because the study tracked women for only six months, he would advise his patients to avoid lifting weights heavier than five pounds until a study spanning several years is conducted, the Times reports (Berger, New York Times, 5/18).

http://www.kaisernetwork.org/daily_repo ... R_ID=37365

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Patients learn to live with swollen limbs

Posted on Thu, Jun. 01, 2006

By Jo Ann Mathews
For The Sun News
Katie Bissett of Carolina Shores, N.C., noticed a gradual puffiness above and below the mastectomy scars she had. Her arm, where lymph nodes had been removed, also began to swell.

Mary Jane Shipley of Little River, who had a mastectomy and her lymph nodes removed 40 years ago, also experienced swelling in her arm.

Kathleen Kepenis of North Myrtle Beach said four years ago her right arm swelled to one-and-a-half times the size of her left arm.

"We think it started after I took a 26-hour flight to China," Kepenis said. Last year she traveled to Cambodia, Vietnam and Thailand. In February she went to Antarctica and South America, and her condition worsened.

"The day after Easter my hand was like a 'Hulk' hand, and my arm was like a balloon," she said.

These women knew they had to address the situation, and Shipley felt fortunate to find Laura Flint at Specialty Physical Therapy in Murrells Inlet.

"I have lymphedema," Shipley said. "I blame it on golf, but I don't know for sure. Something triggered it."

"I have truncal lymphedema," Bissett said, who received treatment from Danielle Dailey at Myrtle Beach Physical Therapy in Little River.

Kepenis, who had breast cancer in 1989 and has osteoporosis, osteoarthritis and rheumatoid arthritis, has had treatment for lymphedema from both Flint and Dailey.

"Once I got the arm wrapped, it stopped hurting," she said.

Lymphedema

Information from Dailey explained lymphedema as a "chronic disease process that occurs when the ability of the lymphatic system is compromised due to damage, trauma, surgery or malformation. Protein-rich fluid accumulates in the tissue spaces causing the limb or body part to enlarge."

The accumulation of this fluid may cause bacteria to grow, which may trigger an infection. The body part that is affected may become so enlarged that it is disfigured.

A person can be born with the condition, which is labeled primary lymphedema, but this is rare. It means the lymph nodes or lymphatic vessels are absent or abnormal.

Secondary lymphedema, which occurs as a result of surgery, damage or trauma, especially side effects from radiation therapy, is more common.

Those who have their had lymph nodes removed, especially women who have had breast cancer, and people who have post-surgical scarring or post-radiation burns are often affected.

According to Klose Training and Consulting LLC, which provides lymphedema therapy certification courses, the condition affects 1 percent of the population in the United States. Emedicine.com estimates that 140 to 250 million cases exist worldwide; however, most cases outside of the United States are caused by a parasite in the lymph nodes. Without treatment, the condition may lead to cellulitis, which is the inflammation of cells, indicating an infection.

Symptoms

A person experiences swelling, as Bissett, Shipley and Kepenis did. Bissett and Kepenis experienced pain. Shipley did not. The women had decreased mobility and experienced fatigue.

Aching and tenderness at the affected area and leakage of lymph fluid from the skin are also symptoms.

Dailey said lymphedema doesn't occur immediately after a trauma or oncology treatment.

"From 25 to 35 percent of the people get it two to 20 years down the road," she said. "It appears little by little. The pain comes in slower. It's chronic. Before I became a specialist, I knew patients had it and I knew I had to treat it. Necessity demanded that I do it. Nobody else can help them."

"My problem is strictly in my arm," Shipley said. "My arm gets tired. I can't lift more than 10 to 15 pounds. The swelling has gone down, but it's a continuous battle."

Kepenis' swelling was so severe, she said, "I have a fat arm. I couldn't wear anything."

Treatment

Usually a physician refers a patient to a lymphedema specialist. Both Flint and Dailey have the certification. Flint is also a physical therapist; Dailey is an occupational therapist.

Flint and Dailey use the method referred to as complex decongestive therapy or physiotherapy. The technique includes manual lymph drainage, compression bandaging, remedial exercise and skin care.

This is considered the "gold standard" in medicine for the treatment of lymphedema, Dailey said.

She said that she takes a lengthy history of patients.

"I couldn't treat someone with a deadly infection," she said. "I would be moving that infection through their body. Blood-clot patients don't qualify."

"Treatment is very patient specific," Flint said.

An initial treatment usually takes two hours, but the patient's condition determines the exact number of treatments needed, she said.

"There's a very strong education component," she said. "Lymphedema can be painful. Once the swelling is reduced, the pain abates."

"[Flint] has taught me how to massage my arm every day to move the fluid into my body," Shipley said. "Once she teaches you to manually massage your arm, the compression pushes the fluid out."

Bissett received hourly treatment from Dailey five days a week for four weeks. She did exercises and massaged the affected areas, but she explained that it's not a traditional massage.

"She moves the lymph fluid," she said. "I lost four inches around my waist without dieting. I lost an inch in each arm. My carpal tunnel is gone.

The scar tissue is eased. I take less medication."

She said she also has increased mobility and energy as a result of treatments. "I can almost touch my elbows behind my back," she said.

"It's a lengthy, tedious process for those it affects," Dailey said.

Patients wear compression garments, which contain the swelling, Flint said.

Shipley said she always wears a sleeve, which keeps the fluid down. "It's something you learn to live with," she said.

"It's not hurting any more," Kepenis said. "Once I got the arm wrapped, it stopped hurting. The massaging helps. My arm has to be wrapped every day."

"If I continue the therapy, [Dailey] feels wearing a sleeve all the time will help," she said. "I just want it down because I can't wear anything. I couldn't get one jacket above my elbow. Now it fits, although it's snug."

Awareness

"We need to improve community awareness of lymphedema and what it is," Flint said. "After oncology, 10 years down the road, it may overwhelm the arm."

Patients will need compression sleeves or other garments for the rest of their lives, but they learn to massage and bandage themselves, Dailey said.

Flint explained that despite some reports, diuretics do not relieve lymphedema. Dailey said pumps, often from $3,000 to $5,000, do not prove to reduce swelling. They have shown to injure the superficial lymphatic vessels.

"Swelling isn't necessarily a bad thing, but when it's chronic, you need to clear it out," Dailey said. Drainage by a trained therapist can be effective.

"The community should know, yes, there is someone here who can help you," Flint said.

http://www.myrtlebeachonline.com/mld/my ... 713540.htm

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Sentinel Node Biopsy

Written by Andrea Roane
Created:6/1/2006 9:10:40 AM
Last Updated:6/2/2006 7:22:45 AM

One of the most talked about new surgical techniques to check for the spread of breast cancer is the sentinel node biopsy. Doctors believe this alternative to a standard lymph node biopsy can spare women more invasive surgery and debilitating side effects.

Nothing is more important to Rhonda Luss than her husband and three sons.

"When you're a wife and mother, it was just devastating to think that I wouldn't be there for my children."

Six years ago, on New Year's Day, she found a lump while taking a shower.

"I wasn't overweight. I didn't meet any of the criteria that you normally see in patients with breast cancer."

She had a lumpectomy. But to find out if the cancer had spread, surgeons would also need to remove lymph nodes from under her armpit. Rhonda knew that could cause lymphedema or severe swelling of the arms. But the new standard of care virtually eliminates lymphedema. It's called a sentinel node biopsy.

"The sentinel node is the first node, the first lymph node under the arm the breast cancer will spread to if it was going to spread to any lymph nodes."

Dr. Collette Magnant, a breast surgeon at Sibley Memorial Hospital, has performed more than 1,100 sentinel node procedures over the last two years.

"If that's negative, then the other nodes will be negative basically 98% of the time."

To find the sentinel nodes, patients are first injected with a radioactive tracer. Two hours later during surgery, a blue dye is injected near the tumor site in the breast.

Once Dr. Magnant locates the sentinel node, it's removed through a small incision in the armpit and examined.

"If you have to remove all the lymph nodes from under the arm then the incidence of lymphedema ranges somewhere between 10% to 25%. If you have one or two nodes removed the incidence of developing lymphedema is basically zero. Basically, we're moving towards trying to make the patient happier, more comfortable having a better quality of life."

"I feel outstanding! My long term prognosis is good because I've had my five year check up and it went well. I'm very happy with the outcome."

http://wusa9.com/health/health_article. ... ryid=49868

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For 630-Pound Woman, Few Options Outside Hospital

created: 5/31/2006 5:41:41 PM
updated: 5/31/2006 11:19:55 PM

By Deanne Lane

(KSDK) - Some startling news from Barnes Jewish Hospital: on any given day, one-third to one-half of its patients weigh more than 300 pounds. It's forcing more and more hospitals and their patients to make drastic changes in order to provide the necessary services. But once a severely obese patient is discharged, what are their options?

56-year-old Sharlinda Whitlock is back in the hospital due to complications from her obesity. She weighs 630 pounds. "I don't feel like a woman. I can't do things I used to. I can't go to church," said Whitlock.

56-year-old Sharlinda Whitlock is back in the hospital due to complications from her obesity. She weighs 630 pounds. "I don't feel like a woman. I can't do things I used to. I can't go to church," said Whitlock.

She's been battling an infection and Lymphedema, which has engorged her ankles and feet. But now the hospital says it has done all it can for Sharlinda, and she has nowhere to go. Doctors say she can not return to her two bedroom apartment because of her size and safety. The nurses that have been caring for her are trying to find a first floor special needs building, with expanded doors and other necessities for Sharlinda.

The great-grandmother does not qualify for a nursing facility or habilitation center because most of them in Missouri will not take patients over 300 pounds.

In the meantime she waits for a miracle or an angel. Weight loss guru Richard Simmons has already called Sharlinda three times in the hospital to bolster her spirits. No word if he plans to visit.

http://www.ksdk.com/news/news_article.a ... ryid=97861

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What is Vodder Therapy?

By sonja redden
Healing Rivers Physiotherapy
Jun 07 2006


Extended Medical Plans cover Vodder Therapy, which is a new and growing field in North America.

Dr. Emil Vodder started his manual lymphatic drainage research in the 1930’s, and during the 1950’s practice of Vodder Therapy started to spread throughout Europe.

Anyone who experiences swelling from an injury, cancer treatment, surgery or other causes should look into Vodder Therapy. Even chronic sinus infections can be addressed. Migraines, arthritis, stress, fibromyalgia, skin ulcers, lymphatic enteropathy, speech problems after a stroke, and whiplash may also be aleviated through manual lymphatic drainage.

Prince George has a Registered Physio Therapist who is qualified to treat all of these conditions using Vodder Therapy, and is one of very few communities of its size to offer effective treatment for lymphedema (swelling caused by damage to the lymph system).

To find a Vodder Therapist in your area check the internet at www.vodderschool.com.

Prince George FreePress

http://www.pgfreepress.com/portals-code ... 3967&more=

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Man survives flesh-eating bacteria

Benefit today for Fayal resident having surgery, skin grafts
Linda Tyssen
Mesabi Daily News
Tuesday, June 06th, 2006 10:33:24 PM


EVELETH — Dave Chida went to the emergency room on a Sunday afternoon in April with a mysterious 4-inch-round swelling on his back near his left armpit.

By Sunday night it was the size of a hot dog bun. By Monday afternoon the swelling had spread to his neck, chest, back and hip. That night doctors removed a 20-by-14-inch section of decaying skin and tissue.

And Chida is alive to about it.

The 46-year-old Fayal Township man was diagnosed with the “flesh-eating disease’’ with the strange-sounding name — necrotizing fasciitis, pronounced neck-row-tize-ing fash-e-i-tis. It is a decaying infection of the body’s soft tissue caused by the same bacteria that causes strep throat.

To help defray expenses not covered by health insurance, a benefit is being held today from 3 to 7 p .m. at the Range Recreation Civic Center in Eveleth. The benefit includes rigatoni dinner, silent auction and entertainment. The cost is $6. Contributions can also be sent to the Dave Chida Benefit Fund at Miners National Bank in Eveleth.

Chida even jokes about it now, but for 37 days he hung between life and death, amazing even the staff at St. Mary’s Medical Center in Duluth. “The moral of the story is don’t get necrotizing fasciitis. If you get a choice between a trip to Europe and the disease, take the trip,’’ he said with a smile.

That’s almost what happened. Chida and his sisters were planning a trip to Ireland, but his plans changed and he’s glad they did. The disease came on “out of the blue.’’

Doctors think it might be related to Chida cutting his thumb opening a can of water chestnuts. It was a deep cut, but he didn’t get stitches and the bacteria may have entered his system through the open wound. A short while later he tore the rotator cuff muscles on his left shoulder, and that “provided a location inside for the host bacteria’’ to do their work.

His teenage son saw the swollen area and asked his father about it. Soon Chida and wife Katie were at the Virginia Regional Medical Center emergency room. His blood pressure had plummeted and his heart was racing. Doctors planned an MRI for Monday morning, but conditions worsened and Dr. Robert Rutka recommended a transfer to St. Mary’s, where he was diagnosed that same day. “Dr. Rutka was superb, at St. Mary’s they were top-notch. They’re the reason I pulled through.’’

Chida would spend the next four weeks in intensive care in an induced coma, with at least 20 intravenous bags, including medications to produce amnesia to help him through the pain. “They were surprised I even made it to Duluth, my blood pressure was so low,’’ Chida said. But he remembers everything about the trip down Highway 53, which he had driven every day to his civil engineering job in Superior, Wis. He remembers the ambulance crew chief telling the dispatcher his blood pressure was 70/30 and the dispatcher expressing disbelief.

“They were surprised he made it through surgery,’’ said his wife.

“The nurse said five times he thought I was going to check out,’’ said Chida. “All in all, it was not really a great spring for me.’’

He had three surgeries in all. The first was to remove the dying flesh and bandage the incision in such a way to allow healing from the inside out. “They didn’t know if they were going to take more off, it grows so fast,’’ Chida said.

The second surgery was to remove damaged muscle from his back. The third was skin grafting. Doctors peeled a thin layer of skin from his left thigh, slit it to allow it to stretch and placed it over the open wound under his left arm, attaching it with more than 100 staples.

“I was one of the lighter ones,’’ Chida said, because he survived with limbs intact — and with his life. “A lot will have arms and legs cut off.’’ Another man with the same disease died while Chida was in the hospital. Chida praised his family for staying by his side through the ordeal. He thanked doctors and nurses, family and friends. “All I did was lay in bed and not die.’’

The pain is lessening each day as the wound heals and as wife Katie, a physical therapist, cares for him. “She found a couple staples they missed,’’ he joked.

There are after-effects, including lymphedema (swelling) in his left arm, much as one might experience after a mastectomy. He sleeps much of the day and can’t drive because of the pain medication. He says he’s making a fashion statement with the loose-fitting hospital pajama pants and sandals he swore he’d never wear. Doctors told him he would experience the stages one goes through after a death in the family because he has lost his health. And now instead of being in the hospital, “I’m cooped up at home with three crazy kids,’’ he said with a laugh.

“There’s nothing you can do’’ about necrotizing fasciitis, Chida said. “It (Strep A bacteria) is all over. The stars are lined up against you.’’ The disease is not contagious. It is fast-moving and it is often misdiagnosed as the flu and then it’s too late.

Chida was one of the lucky ones. “I tell people every day is better than the last

http://www.virginiamn.com/mdn/index.php ... _id=206411

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Postby patoco » Mon Sep 25, 2006 8:34 pm

Posted on Tue, Sep. 19, 2006

Sharks assistant coach Strelow returns after kidney transplant, lymphedema

By David Pollak

San Jose Mercury News

(MCT)

SAN JOSE, Calif. - There were times during the past three years when Sharks goalies coach Warren Strelow - labeled by ESPN the Magazine as the best in the world at what he does - thought his days teaching the fine art of puck-stopping were over.

With good reason. An August 2003 kidney transplant began a downward spiral of problems that read like a medical textbook's worst-case scenario: Multiple infections. Gall-bladder surgery during which a laser nicked his liver. Lymphedema. A drop in blood pressure. A fall that broke his leg in three places.

"They had me not living through the night three different times," said Strelow, 71. "It was pretty touch and go."

But now Strelow is taking part in his first training camp in four years.

And although his health problems have limited his mobility - Strelow uses a motorized scooter on the ice, for example - they have not damaged what goaltender Evgeni Nabokov calls his "gifted eye."

Strelow, Nabokov said, "can see little things that you do wrong, and he can tell you this or this. Maybe you put your glove down too much. He always sees something...he always tries to correct you."

Monday, Strelow was doing just that during a 90-minute goalies practice as he orchestrated a series of drills that had six shooters fire puck after puck from precise areas on the ice. "Learning is repetition," he preaches.

If Nabokov was in net, Strelow would watch him while talking with Vesa Toskala about his stint minutes earlier. Watching Toskala in net, Strelow chatted with Nabokov.

About what? "Little fundamental things - you overslid too soon on this shot, or whatever," Strelow said.

Both goalies say they welcome the on-the-spot critique.

"It's amazing what kind of hockey sense he has," Toskala said.

Strelow's return comes at a time when some around the NHL say the Sharks have a problem in goal - too much of a good thing. Outsiders predict friction because both Nabokov and Toskala rightfully see themselves as the starter.

Strelow, like General Manager Doug Wilson and Coach Ron Wilson, doesn't see a problem, just two very good goalies. And Strelow doesn't expect to spend time talking about the issue or soothing egos.

"I don't worry about that at all," Strelow said. He added, "They know that I don't care about who plays goal, just that whoever plays, plays well."

Strelow became the Sharks' full-time goaltending coach in July 2000, after serving as a consultant for three years. He came with impressive credentials: goalies coach for the late Herb Brooks on the 1980 U.S. Olympic "Miracle on Ice" gold-medal team, three NCAA championships with Brooks at the University of Minnesota, NHL experience in Washington and New Jersey.

Even while recuperating at his home in St. Paul, Minn., Strelow stayed in touch with his goalies, watching games on satellite TV. He shared his thoughts daily with assistant general manager Wayne Thomas, a former goalies coach, and talked weekly with Nabokov and Toskala.

But being here, Strelow says, has a big advantage.

"Eye contact," he said. "I can look at you and I can feel if you're receptive or if there's any trouble communicating."

Coming to San Jose also allows Strelow to work with the Sharks' goalie prospects. During a weekend scrimmage at Logitech Ice, he sat in the media room overlooking the rink with Taylor Dakers and Thomas Greiss.

Strelow philosophized. "Negative body language - you don't want that." And there were pop quizzes from the man who was a high school teacher for 18 years. "What do you think? What would you have done better on that goal?"

Strelow says he will stay with the Sharks as long as his health allows. For now, his son, Ingo, has come up from Los Angeles to help his father get around.

Medical issues remain. A regular blood test is part of Strelow's regimen. He hurt his back in rehab. He has put on 35 to 40 pounds, fluid retention caused by the lymphedema.

But he can joke about some of his limitations, such as the four-wheel scooter that gets him around the ice.

"It's a lot safer," Strelow said. "People can't run you from behind. And I'm not going to demonstrate the butterfly at my age."

Sharks players and the front office say its great to have Strelow around again, not only because of his goaltending knowledge, but also because it's a sign how much his health has improved. Ron Wilson even turned Strelow's return into a motivational moment at a team dinner last week.

"I told everybody he was cryogenically frozen for three years until we were ready to win the Cup," Wilson said. "And that's why he's back."

Strelow looks at his survival similarly.

"I think maybe it wasn't my time because I hadn't won a Stanley Cup. That's the goal. I've won Olympic medals and I've got NCAA championship rings. I want a Stanley Cup ring, and I'm not getting any younger."

---

© 2006, San Jose Mercury News (San Jose, Calif.).

Visit MercuryNews.com, the World Wide Web site of the Mercury News, at http://www.mercurynews.com.

Distributed by McClatchy-Tribune Information Services.

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Related story

No New Jersey For Domi, Retires From Leafs

September 20, 2006

Combined Wire Services Saying he just "couldn't put on another jersey," longtime Toronto Maple Leafs enforcer Tie Domi retired Tuesday.

"I love hockey, I love the Toronto Maple Leafs, this is my home," Domi said during a packed press conference at the Air Canada Centre in Toronto. "There were other interests, but I couldn't see myself wearing another jersey other than the blue and white."

Domi said he has taken a job with The Sports Network, Canada's version of ESPN.

The Leafs bought out the remaining year of his contract. They are paying him $833,000 over two years, two-thirds of the $1.25 million he was owed.

Domi, 36, spent the final 11 seasons of his career in Toronto. He's fourth all-time in NHL penalty minutes with a little more than 3,500.

He played 1,020 games with the Leafs, Rangers and Jets.

Strelow returns: There were times during the past three years when Sharks goalies coach Warren Strelow thought his days teaching the fine art of puck-stopping were over.

With good reason. An August 2003 kidney transplant began a downward spiral of problems that read like a medical textbook's worst-case scenario: multiple infections; gall-bladder surgery during which a laser nicked his liver; lymphedema; a drop in blood pressure; a fall that broke his leg in three places.

"They had me not living through the night three different times," said Strelow, 71. "It was pretty touch-and-go."

But now Strelow is taking part in his first training camp in four years.

http://www.courant.com/sports/hockey/hc ... nes-hockey

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Survivor on the ride of her life
Cancer behind her, she'll bike to Texas for charity rides


BY RHODA FUKUSHIMA
Pioneer Press

Sept. 18, 2006

Today, Annemiek Sistermans will mark five years of surviving cancer by riding her bike to Texas.

About 8:30 a.m., Sistermans will leave the Capitol steps to begin an 1,100-mile trek to Austin, where she will later ride in two of Lance Armstrong's 100-mile charity rides. Armstrong is a cancer survivor and seven-time Tour de France champion.

"I thought it would be a cool thing to do," said Sistermans, who grew up biking in the Netherlands and was diagnosed with breast cancer in 2001.

The 19-day trip will take Sistermans through Iowa, Missouri, Kansas, Oklahoma and Texas. She expects to reach Austin on Oct. 7. She will average 60 to 70 miles a day.

Sistermans, a 38-year-old physical therapist from Minneapolis, will have biking buddies and a support crew will follow her. The day after she arrives in Austin, she plans to ride the 100-mile option of the LiveStrong Challenge. The following weekend, she'll do the 100-mile option of the Ride for the Roses.

"Oftentimes, I think people overextend themselves," says Jim Owens, an Edina cancer survivor active in the Cyclists Combating Cancer group. "But I think she's capable of doing it. She's in good shape. She's an experienced cyclist. She's thought it through."

Sistermans was diagnosed with breast cancer at age 33 in May 2001. She found a lump during a self-exam, just nine months after her mother's own breast cancer diagnosis. It had spread to her lymph nodes.

Sistermans was diagnosed with hormone-sensitive breast cancer and underwent surgery, 37 radiation treatments, four sessions of chemotherapy and hormone therapy, which ends in December. The treatments have left her chemically in menopause, her fertility a question mark.

"It's always been a dream of mine to have kids," she says. "I'll just have to wait and see."

During her recovery, Sistermans read Armstrong's book — "It's Not About the Bike: My Journey Back to Life" — and was heartened by his fighting spirit. She thought she'd like to do his charity ride — someday.

"I played with the idea," she says. "I wasn't ready to plan what I was going to have for dinner, let alone a 100-mile bike ride."

In 2004, she got serious about it. To ride in the LiveStrong Challenge, one of five national events, she had to raise $500. To participate in Ride for the Roses, she had to raise $15,000. That's one reason for the ride from St. Paul to Austin.

"I started to think, 'How could I make this a challenge?' " she says. "If I made it a bigger challenge, I figured people would be more willing to give."

They did. Sistermans worked friends and family on both sides of the Atlantic. She started a blog to keep loved ones up to date (http://sisfiets.blogspot.com/). They had silent auctions, garage sales, bike rides and a knitting project. As of Thursday, they'd raised $15,605, with one more fundraiser to go. Her parents and brother, who live in the Netherlands, plan to fly out and ride with her.

"She really approaches these types of goals, which seem very large, as an attainable goal," says friend and training partner Kharmen Roman, of Minneapolis. "She really doesn't stress out over it. She takes it as a challenge."

Sistermans has been putting 200 to 300 miles on her bike each week. She cross-trained by running, lifting weights and doing yoga. In July, she did a triathlon in Wisconsin. Most days, she commuted by bike from her home in Minneapolis to her office in St. Louis Park, taking the "long way home" to rack up extra miles.

She worked with a coach from the Lance Armstrong Foundation and consulted local cyclists, like Owens, who had done Armstrong's national Tour of Hope in 2004.

"Getting out on the bike is both a celebration and a gift," Owens says. "It keeps us sane at times when we face fear or don't feel well."

For her part, Sistermans has had to monitor occasional lymphedema in her right arm. In May, an MRI showed that she was free of cancer.

"Breast cancer was never a death sentence," she says.

Rhoda Fukushima can be reached at 651-228-5444 or rgfukushima@pioneerpress.com.

To prepare for her ride to Texas, Annemiek Sistermans biked 200 to 300 miles a week. She cross-trained by running, lifting weights and doing yoga.

Sistermans, left, and Nia Wronski bike along a path between Lake Calhoun and Lake Harriet in Minneapolis. While battling breast cancer, Sistermans was inspired by Lance Armstrong and wanted to take part in one of his charity rides. After first biking to Austin, Texas, she'll participate in the LiveStrong Challenge. On a bike path near the lakes in south Minneapolis, Annemiek Sistermans prepares for a ride to Austin, Texas. Five years ago, she was diagnosed with breast cancer.

http://www.twincities.com/mld/pioneerpr ... 545611.htm

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Exercise can pump muscle into treatment

Saturday, September 09, 2006

NANCY DOW

A breast cancer diagnosis wouldn't send most people running to the gym, but exercise may be a valuable tool in fighting and coping with the disease.

Andrea Bruno, founder of the Cancer Exercise Training Institute, says the concept is "still on the cusp of being really respected." Bruno, 40, is a personal trainer who travels nationwide teaching trainers to work with people with any of 24 types of cancer. She sees patients -- mainly breast cancer patients -- part time in her home studio in West Linn.

Bruno is co-author, with Amy Halverstadt, of "Essential Exercises for Breast Cancer Survivors," written under her maiden name of Andrea Leonard.

"Lots of women," Bruno says, "just accept where they are because they're happy to be alive. And some say, 'Why start now?' " But Bruno thinks exercise can

address muscle imbalance, weakness and posture changes as well as other treatment effects. "Three of the long-term side effects of chemotherapy and radiation are diabetes, osteoporosis and heart/lung damage," she says. "All can be prevented or minimized by exercise. And if you have the fortitude to exercise during treatment, it will help counter fatigue and nausea, especially if you've been exercising all along."

Bruno suggests taking it slowly. Strength exercises to prevent osteoporosis are important, but light weights should be used at first, and patients should watch for swelling. Cardio exercise should be approached with caution because of the risk of lymphedema, but stretching should be done "for the rest of their lives."

The mental benefits of working out can be doubly important, she says. Exercise can bring a much needed feeling of well-being, boost self-esteem and help hedge against recurrence.

Kerri Winters-Stone, assistant professor and associate scientist at Oregon Health & Science University's School of Nursing, agrees. "Exercise should be part of the care plan at diagnosis. As little as 10 minutes a day of walking can make a difference. The key is to not be completely sedentary. Even walking around the block can help."

The old thinking was that cancer patients should rest during treatment. Now, says Winters-Stone, the American Cancer Society encourages physical activity. Even those who weren't active before their diagnosis can begin a low- to moderate-intensity exercise program as long as they listen to their bodies and their doctors.

Most studies have focused on the effects of strength training in reducing fatigue and improving quality of life. Winters-Stone is beginning to see data showing that exercise also may reduce the risk of recurrence. "Exactly how it works is unclear, but it gives us a lot of encouragement."

More studies are needed, and recent grants from the Lance Armstrong Foundation, the Susan G. Komen Breast Cancer Foundation and the American Cancer Society are paving the way. Recruitment of study participants by OHSU will coincide with this month's Race for the Cure.

"We don't know the effects of different types of exercise or the specific exercise prescription," Winters-Stone says. "What's the minimum needed for benefits? Is there a point at which increased activity doesn't bring benefits any longer and may actually be detrimental? It may be that women need a combination of aerobic and strength training. We need to develop guidelines."

In the meantime, Winters-Stone says she routinely hears from women, especially younger women, who say they couldn't have made it through treatment without exercise.

"In addition to the physical benefits," she says, "it's about having a little bit of control in a situation where you have so little."

Nancy Dow: 503-294-5036; nancydow@news.oregonian.com

http://www.oregonlive.com/news/oregonia ... 7#continue

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Parkway Lymphedema Patient Hopes For New Lease On Life

by Rick Archer, Assistant Editor

08/10/2006

Thinking back to his Brooklyn childhood, Kevin Crumpton remembers a man he knew by the nickname "Tiny." Tiny weighed about 600 pounds and Crumpton remembered that he would often tease Tiny over his weight. Sometimes he would even throw things at him as he went by.

As Crumpton sat in a bed in New Parkway Hospital in Forest Hills on
Saturday-weighing 544 pounds and awaiting treatment for a condition
that has left one of his legs grotesquely swollen-Crumpton said he
often thinks of Tiny these days. "God is a good god, but he also has
a sense of humor," he said.

Outside the room, the camera crew that has been documenting his
treatment at the hospital was interviewing one of the specialists who
had been brought in to determine what to do about his condition.

Ten years ago, Crumpton suffered an injury to his right leg that
developed into cellulitis, then lymphedema, a rare disorder where fluid
buildup causes massive swelling in the head or limbs. The condition
helped drive his weight up to 701 pounds at its peak. For the past
three years, he has been living at Brookhaven Health Rehabilitation
Center, a Far Rockaway nursing home that specializes in treating the
morbidly obese.

Despite having one leg that he estimates weighs 200 pounds, Crumpton
can still walk, albeit not far. He can manage about two blocks at a
stretch, coincidentally the distance between his home and the beach.

Since January, he and other residents at Brookhaven have been under
the cameras of the film crew, which is putting together a still
untitled documentary for the Discovery Channel. The documentary, set to
air sometime next year, will chronicle the lives of several of the
home's morbidly obese residents over the course of a year.

When Crumpton contracted an infection on his leg last week, those
cameras followed hin to New Parkway for treatment. Since he was going
to be in the hospital anyway, it was decided to use the opportunity to
bring in specialists to evaluate his leg. Because his condition is not
covered by insurance, the specialists are not charging for the
consultations, and hospital officials said that any future treatment at
New Parkway would also be free.

He had previously seen two specialists for his leg. Saturday he saw
a third, gastric bypass surgeon Dr. James Sapala.

Gastric bypass was being considered because Crumpton's doctors
agreed that losing weight would be important to whatever treatment is
selected. Because Crumpton's weight is concentrated in the center of
his body, there is hope that losing some of the weight will take
pressure off his leg and allow some of the fluid to drain.
Even if treatment is impossible and the leg has to be amputated, he
would still need to lose weight if he hopes to stay mobile. "They
don't make prosthetics that can handle 500 pounds," Sapala said.

But even before he can undergo the bypass, Crumpton will have to
lose another 140 pounds. Sapala said this is both to demonstrate he can
make the lifestyle changes he will need to continue to lose weight
after the operation and because his equipment isn't capable of
handling someone as heavy as Crumpton is now.

Despite the prospect of losing the weight and a possible three to
four month wait before the gastric bypass can be performed, Crumpton is
already looking ahead. "Someday, I want to get married. I want to
have children," he said.

This collector of Superman memorabilia said he hopes his struggle
eventually serves as a source of inspiration to his future children.
"I guess I'm kind of a Superman," he added.

Documentary director Debbie Dunnett said that Crumpton's mood has
improved considerably since he checked into Parkway the week before.
"You guys have given him a lot of hope," she told hospital
officials.

http://www.zwire.com/site/news.cfm?news ... AG=461&d...

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