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Vitamins:
Vitamins are natural substanc-
es found in living things such as
plants. Vitamins must be obtained in
the body from foods or supplements as
they cannot usually be produced by
the body.
Minerals:
Minerals are found in plants.
Plants get their minerals from the soil-
soil gets minerals from water washing
over rocks. For vitamins to do their
job, they require minerals. Minerals
must also be obtained from food or
supplements.
Antioxidants:
Antioxidants are specific vita-
mins or minerals that protect body
cells from damaging effects of Free
Radicals. Free Radicals come from or
are caused by smoking, sunlight,
stress, exercise, etc., and are one of the
primary causes of premature aging,
sickness, and disease.
Supplements:
Supplements are vitamins
and minerals that have been extracted
from a plant or created in a laboratory
and put into a form that can be ingested
and used by the body.
There are effective supplements,
ineffective supplements, and hazardous
supplements.
Uneducated consumers are at
risk from two sides:
1. Consumers know they should sup-
plement but don’t know how to ef-
fectively. Therefore, they waste their
money, time, and health.
2. Consumers are uninformed (or given
bad advice) on the need to supple-
ment and sacrifice their health.
Editor: Manjot Kaur
M a g n e s i u m “ M a i nt a i ns no r m a l b l o o d p res su re ”
L y m p h e d e m a I n f o r m a t i o n S u p p o r t G r o u p
V o l u m e 6 I s s u e 3
I n s i d e t h i s i s s u e :
Minerals (Magnesium)
1-7
Dietary
Corner
8
Sallie’s
Personal
Report
9
Case Study
Knee
Replacement
10-12
A bone fide Lymphedema
Therapist must have/be
13
Complete Lymphedema
Care
14
F u l l S e r v i c e
M a s t e c t o m y
C a r e :
Bras, Prostheses,
Lingerie
By Appointment
(408) 782-1028
LISG
How Do Vitamins and Minerals get in the Body? Vitamins and minerals get into your body when you eat plants such as fruits, vegetables, grains, nuts and spices or when you take a vitamin/mineral supplement. You can also get some vitamins and minerals into your body by eating meat as most animals eat plant food.
Digestive Tract Where do Vitamins/Minerals go in the
Body?
F a l l 2 0 1 6 , V o l u m e 6 I s s u e 3 P a g e 2
Vitamins and minerals go from your stom-ach to your intestines. They then go through a very complex allocation system whereby the body dis-tributes certain vitamins and minerals to parts of your body based on its own priority system. (see image). If a nutrient is needed in a certain organ that the body deems more important, it will take the nutrient from a less important organ, and allo-cate it to a more important organ. Sort of a “rob Peter to pay Paul” action. That’s why it is critical to maintain proper vitamin and mineral levels. Vita-mins and minerals in your body should not be viewed as independent substances, but rather as a cooperative network of nutrients working together. If one nutrient is missing, it throws the entire net-work of nutrients out of balance.
“A deficiency of a vitamin or mineral will cause a body part to malfunction and eventually break down - and, like dominos, other body parts will follow”
-James F. Balch, M.D Prescription for Nutritional Healing
F a l l 2 0 1 6 , V o l u m e 6 I s s u e 3 P a g e 3
Continuation from page 2
How Do Vitamins/Minerals Leave the Body?
Vitamins and minerals are “used” by the
body. As they perform their function, they often use themselves up in the process, which is the case with most of the critical diseases fighting antioxidants.
Even thinking uses vitamins and minerals.
Exercise and stress use a lot of vitamins and minerals; the use of diuretics (substances that increase the discharge of urine) such as drugs, alcohol, coffee, tea and sodas - wash away vitamins and minerals out of the body creating deficien-cies - this can create a major health prob-lem!
Tobacco and alcohol can also inhibit the ab-
sorption of vitamins and minerals, or ac-celerate the loss of them.
Your Health, Your intelligence, Your energy Your appearance are dependent upon you replenishing your vitamins and
minerals every day.
Vitamin & Mineral Supplementation
is necessary for these reasons:
1. Crop nutrient losses - soil has been de-
pleted of nutrients 2. Poor digestion - indigestion reduces ab-
sorption 3. Over-cooking - destroys nutrients 4. Microware cooking - alters structure of
nutrients 5. Food storage - length of time stored and
freezing deplete nutrients 6. Food selection - limiting food selections 7. Food omission - dieting and allergies re-
duce or omit sources of nutrients 8. Environmental factors - herbicides and
pesticides reduce nutritional values 9. Antibiotics - interfere with intake of nutri-
ents 10. Poor Lifestyle - smoking, alcohol and caf-
feine inhibit absorption of nutrients 11. Stress - increases body’s requirements 12. Out of balance - missing nutrients create
an out of balance situation in the body 13. Nutrient variance - some foods have
greater amounts of certain nutrients.
F a l l 2 0 1 6 , V o l u m e 6 I s s u e 3 P a g e 4
Magnesium “Maintains normal blood pressure”
1) Magnesium appears in large amounts in
a wide variety of foods.
2) A constant state of self-induced stress
might be due to magnesium deficiency.
3) Stress has also been shown to play a
role in the SDIHD syndrome-sudden
death ischemic heart disease, or sudden
heart failure. Magnesium specialist
Bella T. Altura, Ph.D., of the State Uni-
versity of New York’s Downstate Medi-
cal Center in Brooklyn has found that
stress indirectly causes the body to ex-
crete magnesium, resulting in a magne-
sium deficiency in the heart muscle.
4) Magnesium is required for dilating
(opening) the blood vessels in the heart
tissues, and calcium is required for
constricting (closing) the vessels. A del-
icate balance of magnesium and calci-
um keeps the heart beating smoothly.
5) SDIHD is highest in areas where the soil
contains only small amounts of magne-
sium.
6) Depleted magnesium levels in both hu-
mans and animals have also been asso-
ciated with elevated blood pressure,
that celebrated prelude to heart dis-
ease.
7) Just as magnesium and calcium compete
to maintain the relaxation/constriction bal-
ance of the heart, they apparently also com-
pete for a place in the kidneys. An optimum
intake of magnesium can prevent a buildup
of calcium deposits and the formation of cal-
cium-based kidney stones.
8) Low levels of magnesium in the blood may
also be an important risk factor in the devel-
opment of a major complication of diabetes
known as diabetic retinopathy, involving tiny
hemorrhages in the retina of the eye that can
lead to total blindness.
9) Patients with the most advanced and se-
vere retinopathy have the lowest magnesium
levels of all compared to nondiabetics and
those who had retinopathy for at least 10
years.
10) Magnesium can also rescue you from two
common-place but embarrassing conditions–
body odor and bad breath. Magnesium when
taken with zinc, PABA, and vitamin B6, can
effectively control offensive body and breath
odor.
11) Recommended allowances for magnesi-
um range from 350 to 450 milligrams a day.
F a l l 2 0 1 6 , V o l u m e 6 I s s u e 3 P a g e 5
Scientists subjected 6 groups
of rats to “noise stress” for 3
months. The stress robbed
their bodies of magnesium-
the louder the noise, the
greater the decrease in
magnesium levels. In tests
on people (who had to listen
to loud traffic noise for 8
hours), results were the
same. That means if you live
or work where it’s noisy,
chances are you need extra
magnesium.
F a l l 2 0 1 6 , V o l u m e 6 I s s u e 3 P a g e 6
F a l l 2 0 1 6 , V o l u m e 6 I s s u e 3 P a g e 7
Dietary Corner
Swiss Chard Chickpea Potato Stew Ingredients 1 pound swiss chard, chopped
3 tablespoons olive oil
1 1/2 pounds potato, peeled,
and sliced 3/4 inch thick
1 sweet onion, chopped 3 cloves garlic, minced 1 teaspoon paprika 1/4 teaspoon turmeric 1/4 teaspoon cayenne Salt to taste 19-ounce can chickpeas,
drained 1 cup water 3 cups canned low-sodium
chicken broth 2 hard-boiled eggs, cut into wedges
Preparation 1. Bring a pot of salted water to a boil, add swiss chard, and cook for 3
minutes.
2. In a dutch oven, heat oil over medium heat, add potatoes and onion,
and sauté.
3. Sauté until potatoes start to brown, about 5 minutes.
4. Add garlic, paprika, turmeric, cayenne, and salt and cook for additional
minute.
5. Add swiss chard, chickpeas, chicken broth, and water to dutch oven.
6. Bring to a simmer and cook until potatoes are tender.
7. Serve stew with hard-cooked eggs.
F a l l 2 0 1 6 , V o l u m e 6 I s s u e 3 P a g e 8
For 13 years before my knee replacement, I believed that any kind of surgery
performed on my affected leg was very, very risky. I remember vividly seeing a man
whose leg had been amputated and being told he was in that condition as a result of
an attempt to surgically eliminate his lymphedema. It made a strong impression on
me, so strong that I had no desire to allow anyone cut into my leg. Only when my
knee began hurting so badly and I rotated between a cane, a walker, and even a
wheelchair, did I decide it was worth the risk. Although I was his first lymphedema
patient, my surgeon was encouraging and willing to discuss my condition with my
lymphedema therapist and listen to her suggested precautions for pre- and post-op
care.
Between the 6 weeks from decision to surgery, I had weekly CDT treatments.
The day following surgery and almost every day of the 10-day hospital/rehab stay, my
lymphedema therapist came to the hospital to treat my leg. When I was finally able to
go to the clinic for CDT therapy, treatments were weekly for 5 weeks, reducing to bi-
weekly, then monthly. Another important part of my success story is the Tribute.
Having worn the directional flow garment nightly since it was invented some 5 years
ago, the thought of being without it was very frightening. Three days after surgery
the modified Tribute was delivered to the hospital which could be applied on my leg
without bending the knee. I wore it until I was able to get back into my regular
Tribute.
Eight months have passed and I haven't taken codeine or vicodin since prior to
surgery. My leg is smaller than it has been in years. I have occasional CDT therapy,
wear a gradient compression stocking daily and a Tribute directional flow garment at
night. Incidentally, learning to "climb into" gradient compression stockings was one
of the most frustrating experiences of the entire operation.
I'll be forever grateful to my surgeon, my lymphedema therapist, and the
Tribute directional flow garment for making my life more comfortable. Adding years
to your life is not as important as adding life to your years. I wish I had done it
sooner.
F a l l 2 0 1 6 , V o l u m e 6 I s s u e 3 P a g e 9
Su c c e s s fu l To ta l K ne e R ep la c em en t
i n a L eg Wi t h S ev e re Ly mp h ed ema
By Sa l l i e Mor ton
The patient first visited our clinic for lymphedema therapy in July 1998.
Having had lymphedema for almost 10 years, secondary to hysterectomy for
cancer followed by radiation of the lower abdomen, she was well acquainted
with bandaging and self-MLD. Her daytime garment was a unilateral CCIII-AG
and her nighttime garment, a custom directional flow Tribute -AG over which
she either applied a pump sleeve and pumped before retiring, or would wrap in
short stretch bandages. Our concerns were: the very dry condition of the skin
and the presence of a large erythematous area on the anterior lower leg; the
increased girth of the lower leg and calf; the knee was very heavy with
lymphedema and becoming increasingly immobile; and there was a ridge of
fibrosis extending posteriorly from the ankle into the popliteal space. Though
the patient stated the area of erythema had always, "been that way and
sometimes worse," we were concerned about the possibility of a chronic
inflammatory process of the lower leg. When the patient repeatedly commented
about the increasing pain and immobility of the affected left knee, we became
concerned about the efficiency of fluid movement through, and away from, the
knee joint.
It appeared that the knee was the "problem" area for the lower leg and
calf. The patient then stated her concerns about possible knee surgery. Our
focus was to reduce and maintain the left affected leg by: concentrating on
intensive skin care to reduce inflammatory processes and increasing CDT
therapy sessions; checking the viability of compression supplies, her present
gradient compression stockings, and the directional flow garment; initiating an
exercise regimen; planning different compression solutions to enhance
reduction; and protecting the unaffected right leg from the possibility of
lymphedema occurrence. Unfortunately, as knee pain and immobility increased,
she continued to have severe back problems, and any amount of exercise
became a real challenge.
1 of 3
F a l l 2 0 1 6 , V o l u m e 6 I s s u e 3 P a g e 1 0
Ca s e S tu d y : Ca re o f a P a t i e n t Wi t h S ev ere
Ly mp h ed e ma P re - a n d P o s t - O p To ta l K n e e
R ep la ce m en t By Phy l l i s Tubbs -Ginge r ich , RN, BSN, LE , CLT -LANA
By January 2002, the patient's posture was worsening - she was stooping
over more severely and any slight rotation of the knee brought on excruciating
pain. She began preparation for knee surgery by scheduling pre-operative CDT
therapy sessions and getting mentally and emotionally prepared. Therapy
sessions included: gradient sequential pumping by applying a full leg pneumatic
appliance over a directional flow garment for 30 minutes while manual lymph
drainage was performed on the torso; intensive manual lymph drainage
continued on the left affected lower leg and calf post pumping; full-leg
circumferential measurements; intensive specialized skin care, especially in the
erythematous areas of the anterior lower leg; and application of an accessory
compression garment to provide a greater degree of compression on the distal
calf.
Post-surgical protocol for therapy was planned, focusing on channeling
lymph medial to lateral left torso and upper leg, including the affected knee, into
ipsilateral collaterals. The directional flow garment was constructed to follow
protocol exactly and designed in 2 pieces: a high body part around the torso and
a separate full leg with Velcro closure tabs laterally. Velcro tabs anterior and
posterior on both garments made it possible to attach them together during
application. Directional flow garments are designed with gradient pressure from
many directional flow angles. Each unit is also constructed with passive
compression to allow movement of lymph fluid along normal lymph pathways.
These 3 ingredients: gradient pressure, directional flow, and passive
compression must work together to be effective. In addition, it is very important
for the therapist to have experience in post-operative care so that protocol for
therapy is correct in order to effectively protect the patient. Post-op care for this
patient meant protecting the knee.
2 of 3
F a l l 2 0 1 6 , V o l u m e 6 I s s u e 3 P a g e 1 1
Ca s e S tu d y : Ca re o f a P a t i e n t Wi t h S ev ere
Ly mp h ed e ma P re - a n d P o s t - O p To ta l K n e e
R ep la ce m en t By Phy l l i s Tubbs -Ginge r ich , RN, BSN, LE , CLT -LANA
After thorough hand washing, MLD was performed according to
protocol, the skin cleansed well and lotions applied and the surgical
incision well protected. The affected left leg was then placed into the
open directional flow garment and using the lateral Velcro tabs, the
garment was lightly tightened from ankle to groin to the patient's
tolerance. The body portion was then fastened around her waist and
attached to the leg portion thus completing directional flow, gradient
pressure and passive compression. Following hospitalization, this
"open garment" was perfect for the patient's home care until the knee
healed sufficiently and her regular directional flow garment could be
applied.
In conclusion: comprehensive care post-operative knee
replacement using CDT and a directional flow garment indicates: Reduction of fluid retention at operative site Inflammatory processes reduced
Earlier mobility of the knee with gradual greater range of motion Reduction in pain Accelerated wound healing Decreased possibility of keloid process Reduced recovery time
Safeguards patient against lymphedema crisis
Patient's satisfaction of overall care
3 of 3
F a l l 2 0 1 6 , V o l u m e 6 I s s u e 3 P a g e 1 2
Ca s e S tu d y : Ca re o f a P a t i e n t Wi t h S ev ere
Ly mp h ed e ma P re - a n d P o s t - O p To ta l K n e e
R ep la ce m en t By Phy l l i s Tubbs -Ginge r ich , RN, BSN, LE , CLT -LANA
A bona fide Lymphedema Therapist must have/be:
1. A medical professional with solid background in anatomy
and physiology of the lymphatic system
2. Completed 140 hrs. of education in the field of
lymphedema with -
3. Approximately 2 x’s that amount of time in practicum
preparation
4. 5 years’ experience in the field of lymphedema treatment
and care
5. Pass the LANA Test to become a Nationally Qualified
Lymphedema Therapist
(Ginger-K Center meets all these criteria)
F a l l 2 0 1 6 , V o l u m e 6 I s s u e 3 P a g e 1 3
Ginger-K Lymphedema & Cancer Care Center
16360 Monterey Road, Suite 270
Morgan Hill, CA 95037-5406
Phone: 408-782-1028
Fax: 408-782-1061
Hours: By Appointment
Tues-Fri 10am-6pm
Sat: 12pm-6pm
phyllis@gingerkcenter.com
www.gingerkcenter.com
Phyllis Tubbs-Gingerich, Director
R.N., B.S.N., L.E., CLT-Lymphedema & Cancer Care Specialist
Skin and Wound Care Specialist
Medical Esthetician
Board Certified Mastectomy & Orthotic Fitter
CA. Licensed DME Fitter & Supplier
Certified Burn & Gradient Compression Garment Fitter & Supplier
Exclusive Medical Wig Fitter for Alopecia
F a l l 2 0 1 6 , V o l u m e 6 I s s u e 3 P a g e 1 4
C o m p l e t e Ly m p h e d e m a C a re
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