CERTIFIED THERAPIST: Certified
lymphoedema therapist Karie Ann De Gannes wants to educate people about the condition.
Relief for cancer patients
Learning about lymphoedema...
Essiba Small firstname.lastname@example.org
Stage four breast cancer, surgery, lymphoedema—in that order. That’s how it all came down, healthwise, for 37-year-old teacher Michelle* ; the domino effect leaving her with little chance to catch her breath.
Michelle noticed a little swelling in one of her breasts and her arms and immediately went to her doctor to find out what was wrong. Her mammogram came up negative; so did the doppler ultrasound and the biopsy. Finally, an MRI confirmed her fears of breast cancer.
Michelle began chemotheraphy, did a double mastectomy and removed her lymph nodes to rid herself of the cancer cells, only to discover that she had lymphoedema—swelling in the arms or legs which is caused by a blockage to the lymphatic system that prevents lymph fluid from draining.
The condition is mostly a side-effect to the removal of lymph nodes following cancer surgery, according to Mayoclinic.com.
Diabetes, deep-vein thrombosis, trauma, infection, can also increase the risk of developing lymphoedema.
Michelle recalls she was teaching a class when her pupils remarked about her swollen left arm.
“I was looking at my arm and it was like it was getting bigger right in front of my eyes,” the mother of one said.
“My hand just felt so heavy.”
Doctors told Michelle that she would have to live with lymphoedema for the rest of her life and she was sent for treatment.
Michelle tried a compression sleeve and physiotheraphy, both of which did little to bring down the swelling and bring her comfort.
She was desperate for help. Her hand had the weight of three hands, she said, and she was doing routine things that had become difficult.
A meeting with Ms Bra Fit’s Nicole Joseph-Chin led her to Karie Ann De Gannes, a certified lymphoedema therapist. It’s been three weeks since Michelle started going to De Gannes and already she said she is seeing a difference in the size of her arm.
For the last three years, De Gannes has been working out of Maraval attending to patients like Michelle. She got into the field because she had a lot of friends who lost their families to cancer.
From her research and her interactions with patients, she also realised that so few people knew about lymphoedema.
“I have had patients come to me for therapy and tell me that someone (work obeah) on them! Some just didn’t know why their legs and arms were swollen.”
De Gannes added that her intitial field of study was therapeutic massage with a focus on rehab.
“I studied at Florida College of Natural Health and was able to work alongside the Touch Research Institute at the University of Miami.”
“I wanted to do something to help cancer patients so I went to the Academy of Lymphatic Studies in Florida, where I did the Complete Decongestive Therapy.”
De Gannes uses the Dr Vodder method of lymph drainage to treat her patients. The technique was developed in the late 1800s by Danish expert Dr Emil Vodder and involves a massage technique that uses repetitive, circular and spiral-shaped movements with an increase and decrease in pressure.
The change in pressure is said to create a pumping effect which encourages the flow of the lymph fluid and drains out excess fluid from the connective tissue.
Unlike some traditional massages, the Vodder technique does not require oils to be effective.
De Gannes also uses a Multi-Layer Short Stretch Bandaging, according to her patient’s therapy needs (which helps to reduce the pressure), along with remedial exercises. All her patients are then put on a management programme.
“As lymphoedema is lifelong, the only cure is management,” De Gannes said.
“I start seeing patients on a daily basis and then, after about a month—according to their condition—I advise them how to manage themselves. They still have to come in periodically for me to mark their progress.”
Since going to De Gannes, Michelle said her swelling has gone down considerably. She usually wears a compression sleeve on arm and was happy to report that with the decrease in swelling, she is now down a size in her arm sleeve.
De Gannes, originally from Santa Cruz, said she rarely takes patients from off the streets and rather that they are referred to her by physicians.
Swelling, she said, is not limited to the legs and arms, but can also appear in the genitalia and face.
“If someone has a swelling in an area and there is a feeling of heaviness or tightness, go to your doctor to see what’s wrong.”
Symptoms of lymphoedema also include restricted range of motion in the arm or leg, aching or discomfort in the affected area, hardening and thickening of the skin on the affected area.
De Gannes, who has patients from Tobago, and even Grenada, last month established a Lymphoedema Association which she hopes will help connect her to other trained certified lymphoedema therapists.
“As it is, I work constantly, including holidays, to serve the patients I have. I am also the Caribbean distributor for Solaris Medical Products, which sells the compressive sleeves and stockings. I have come to a point where I have to lessen my hours.
“I want to see more CDT come on board so I could create a database. My main drive is awareness of this disease.”
By next month, De Gannes will open an office in St James.
To Michelle, De Gannes is God sent, one whom she is happy to have found right here in Trinidad rather than overseas.
De Gannes is well aware of what her profession means for her patients, whose self-esteem often takes a blow due to the uncontrollable swelling.
“I like being able to help people. I wish I could do more. I wish that the insurance companies would make it possible for patients like Michelle to claim back the money they have spent.
“Treatment material and therapy can become very costly. To date this type of therapy is the most effective way to manage lymphoedema.”
Michelle echoed De Gannes’s sentiment.
“The cost is a lot. I, too, wish that my insurance company would allow me to claim back what I spend. I mean I have to live and treat this condition for the rest of my life.”