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Swelling and tightness in the skin are symptoms that physical
therapy alumna Karen Wingert, looks for when examinging
a lymphedema patient. Gene Royer photo
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Helping the Survivors Survive
By Cheri Ghan
Lymphedema is a swelling of a body part,
usually an arm or leg, often following surgery where lymph nodes
are removed. In the 1970s when Karen Wingert, BHS-PT ’73,
saw a woman with lymphedema, the only treatment was to drain fluid
out of the affected limb and send her back to whatever she was
doing before she came in. Reducing the fluid that causes painful
and noticeable swelling is still a major part of treatment, but
the method has changed and the goal now is long-term control of
the condition that affects one out of every three breast cancer
survivors.
Wingert, a clinical associate professor in
the MU School
of Health Professions, holds a clinical doctorate in physical
therapy. She also is an RN, with a master's degree in counseling.
She's not someone who is content with finding a quick fix to a
chronic problem. That's why she didn't stop at the 135 hours required
to be a certified lymphedema therapist. Wingert has had every
level of training offered in treating the condition and has since
taught others all around the world. Her biggest challenge may
come from the Susan G. Koman Foundation grant she has just received.
The one-year $10,681 award requires Wingert and Vickie Parker,
BHS-OT’94, to teach other health care providers and lay
people in a 13-county mid-Missouri area how to spot lymphedema.
They have until next June to do it.
“Every three minutes another woman
will be diagnosed with breast cancer, which is the number one
cause of lymphedema,” Wingert says. “We must train
them to recognize it and give them a list of certified lymphedema
therapists, so women can get the treatment they need.”
In addition to occurring when the lymph nodes
are removed, lymphedema also can develop when patients undergo
radiation or trauma to a limb. Sometimes it occurs without a known
cause. Most patients are breast cancer survivors, but it affects
females and males in all age groups.
Before treatment, right, a patient's arms and hands have
noticeable swelling and feel heavy. After treatment, left,
of massage, compression bandaging and exercise, the swelling
is greatly reduced. Gene Royer photos
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“One patient noticed it between the
thumb and finger. She said ‘my skin feels tight,’”
Wingert says. “It almost always shows up in the arms. One
woman noticed that her watch felt tight.”
The treatment consists of manual lymphatic
drainage massage; compression bandaging worn for 23 hours a day,
seven days a week; special exercise while wearing the bandage
followed by proper education of how to continue this activity
to prevent reoccurrence.
“Early intervention is crucial,”
Wingert says. “If we can get someone right away, we can
control it. If their skin already feels hard, it takes so much
longer to get it under control.”
Since 2000, Wingert has staffed a clinic
for “my women,” as she calls them. Located in the
Ellis Fischel Cancer Center, the clinic is cheerful and warm.
The women who work there are the same. There is a liveliness about
Wingert herself that is contagious. “Had anybody ever said
I’d be working in oncology I would not have believed them,”
she says. “I'm so high energy that I wondered myself how
I could ever work on an oncology team. Yet, I love it, and these
[patients] are my friends.”
Armed with brochures and a DVD developed
by MU journalism students, Wingert and Parker will hit the highway
this fall to spread their message. Many of the stops will be in
rural Missouri. “Our goal is to make it to as many places
in these counties as we can so all women with lymphedema may be
treated early.”
There is no cure for lymphedema, but there
is hope for a normal life. “Our role is to make it controlled.
It interferes with their self-esteem, self-image and it can even
interfere with their jobs,” Wingert says. “We want
to look at the things that are important to women and those are
the things we want to help them do. I remember an early patient
who told me ‘I want to braid my daughter’s hair.’
I want them to be able to braid their daughters' hair.”
Originally published in the Fall 2007 issue
of The Touchstone, the magazine for alumni of the School
of Health Professions.
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Last Update:
September 3, 2008
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