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