Lymphoedema toolbox talk

hello and welcome so my name is sally k and before i tell you more about reflexology lymph drainage i would like to thank siobhan harris for inviting me to take part in this event what an inspired idea to start the lymphedema toolbox and hopefully once you've heard more from me you'll agree that rld deserves a place alongside other tools in the box so what is reflexology lymph drainage also known as rld i believe siobhan herself has experienced the benefits of rld after a course of treatments with one of the many reflexologists who have trained with me in this method so before i answer this uh about rld i need to briefly explain a bit more about reflexology for those of you who are not familiar with this ancient complementary therapy reflexology is a non-invasive complementary therapy which has been around for thousands of years its origins date back to the ancient cultures such as the egyptians the greeks the romans and um particularly china is often associated with the you know origins of reflexology um but and this therapy is really only introduced into the west in the early 1900s by a dr william fitzgerald he believed that reflex areas on the feet and hands were linked to other areas and organs of the body within the same zone and then later on in the 1930s eunice ingham further developed a map of the feet um so reflexology is basically it's based on the principle actually let me just change a slide got some slides here okay so reflexology is based on the principle that reflex points on the soles tops and sides of the feet correspond to different areas of the body in this way the feet can be seen as a map of the body known as a foot map and believe me there are many many different foot maps so just swap this here for you to get a better look um so this is just this um here you can see the soles of the feet um with horizontal zones for example the shoulder line here actually here shoulder line here so everything above that would be head and neck and then from between the shoulder and the diaphragm line you've got everything that's in the chest and abdomen and vice versa i think i'll just swap that back so you might get a better view there okay so that gives you a very very basic idea of the principles of reflexology um so yeah this this would be the plant of you so the soles of the feet and um then we can also see in the next image we can see the spine mapped out on the feet so this shows the the spine on the medial edge of the foot as it runs down the center of the body it in the same way as it does on the feet so this would be the medial edge of the spine here so the neck uh would be in the neck the big toe so above the shoulder line and so on the thoracic spine would be um in in next sec next horizontal zone from the shoulder line to the diaphragm line and so on excuse me so a reflexologist would use a variety of techniques to specific reflex points and areas basically using the thumbs fingers knuckles but it's actually a very pleasant treatment it's nice you know generally very nice and relaxing treatment so the aim of the session is to help restore balance in the body naturally and improve clients well general well-being some therapists may work different reflex points on hands ears and face as well however it is the feet that are most commonly treated in reflexology so in my early days as a reflexologist i worked in supportive cancer care i did this for many years and absolutely loved it treating between 20 and 30 patients a week and seeing how this gentle complementary therapy brought so much help and comfort to all not just the patients service users but also to those who are supporting them carers and family members who who that journey affects it affects everybody um so the reflexology sessions at the clinics were time limited due to the number of patients because it was busy there so i used to ask patients what would you most like help with today before deciding how best to proceed with an adaptive and more problem specific reflexology session and this would focus on a specific reflex areas that would be relevant to that individual there are so many different applications of reflexology really more than i could even think about listing um here today so for some um a session could be just a gentle relaxing session to help with high levels of stress and anxiety and are often associated with cancer diagnosis and treatments in addition to these sort of well-documented unpleasant physical effects of cancer treatments such as nausea and fatigue so reflexology is in fact extremely and a bonus compared to other bodywork therapies uh i have to say i'm biased here i am wholeheartedly biased um but compared to other bodywork therapies such as massage there's no need to get undressed for reflexology you only have to remove your shoes and socks um hand jokey aside uh this can be a you know very pleasant way of doing a treatment and also for anybody who has body image which can be affected after surgery or with various diagnosis um to not have to get undressed to have a nice relaxing treatment um for me is a real bonus i think as i said i'm biased however a limitation of reflexology is that despite multiple different theories and philosophies about the mechanism of action as yet we do not understand how it works even though it's been around for thousands of years it's difficult to try and explain but modern day healthcare practices likes to understand and verify the science and sadly there's not enough of this for reflexology to be widely accepted so now you have a better idea of what reflexology involves i'm going to explain rld to you quick slide change so basically to cut a long story short while i was working in supportive cancer care i developed an adaptive reflexology protocol to help patients with breast cancer-related lymphedema it was based on the principle of manual lymph drainage massage which many of you here today may be familiar with sadly you may also be aware that access to this specialized type of treatment mld massage is often limited not everywhere but these services can depend greatly on where you live it's a bit of a postcode lottery sometimes which is such a shame so there was an mld therapist who worked at the clinics where i was working and she was then off for prolonged periods of time patients were saying to me oh i don't suppose you can help you can do anything for my arm can you i've been missing my mld and it's been aching more or you know whatever those sort of examples so although by now i was qualified in advanced massage and all sorts of other aromatherapy all sorts of other um complementary therapies although reflexology is my number one i was not qualified in manual lymph drainage but i understood it having worked closely with colleagues and studied complementary therapies in depth at university now i'm naturally curious um i like the odd what if moment i always like to question things and so it occurred to me that i i did have a what if moment with this so what if i applied the principles of manual lymph drainage which i understood to the reflexes of the feet i'm a reflexologist i could try it so obviously this was done with permission of the patients and they began to report similar benefits that they had felt um during mld something was definitely happening you know clothing was looser or they experienced increased urination after the treatments and as the weeks went on um the effects and benefits of this appeared to be cumulative so the limb was becoming stronger less weaker you know more able to do things that people hadn't been able to do before it was noticeable noticeable more so to them anyway inspired by this the fact that the results are measurable here's what happened next so i did a small research study which was actually part of the final year dissertation for my degree as a very mature student and in this study six women received rld once a week for four consecutive weeks the study was done over a six-week period so week one um could be baseline measurements and no treatment just data collection and week six again no treatment just data collection so it was the four weeks in between where they just had treatment once a week same day same time so these are the data collection tools that i used a limb volume circumference measurement which measures and calculates the volume of the cylinder of the arm some of you may well be familiar with this method it's an objective outcome measure and i also used a secondary outcome measure my core measure yourself concerns and well-being which captures the subjective concerns of the patients or people taking part so to eliminate any bias of daily fluctuations in swelling which as you probably know can get worse throughout the day and depending on many things which affect the swelling such as activities lifestyle weather etc i'm sure you all know about this so appointment times were for the same time of day throughout the six weeks so the first person came at 10 o'clock on week one for baseline measurements but then she came at 10 o'clock right the way through the study and so on second one quarterback 11. so i was always seeing them at the same time participants were measured immediately before and again after each rld treatment as well as a baseline measurement at week one and a follow-up measurement at week six so next slide is going to show you the results so in this graph in fact i think in this graph let's see you get a better view there yes i think you do okay so in this graph you can see that each person lost the most so this is baseline here and then this is the first this is the measurement before the first reflexology treatment here um so there's always a slight fluctuation or but not huge not significant and this can depend on level of activity and all sorts of things as you know so no treatment here and then here is before treatment and then measured again immediately after treatment and you can see on the graph here that each person lost the most during the first treatment and then it went up a little bit week two back down up down up down and then week six here follow up no measurement just no treatment rather just measurement and we see here that the everybody lost the most during the first treatment and then the subsequent treatments have helped to consolidate those results a yellow one here this was number four she actually went on holiday for a week and um i was joked she messed up my graph um she flew somewhere warm so she flew to the canary islands and um even after she'd come back from a week in the sun and uh sort of four hour flight it wasn't as bad as it was at the beginning and it didn't affect her overall result so okay so um right then we consider the so that that's the measurable results and then the next slide considers the impact that this has on people and these are common things that you hear people say it feels lighter no more bulges i feel like i've got my arm back feel good about myself um you know people can go back to wearing a normal sized clothing without having to go up a size to accommodate it not embarrassed to take my cardigan off so we see self-confidence starting to return as well so shoulder no longer hurting pain's gone etcetera i mean i could give many many many examples of those one more slide to share i'm going to swap that back here so this one body image um i look at myself in the mirror now and i can see an actual shape to my arm whereas before it went straight down so carrying on um that quote was actually from the second research study that we did i'm going to tell you a little bit more about the research in a minute um but we can see there that there's a positive impact on people and in the last decade i've made it my mission to reach and teach as many reflexologists around the world as possible because i know the impact rld has and there's this wonderful ripple effect on quality of life and self-confidence so as the swelling reduces self-confidence and quality of life begins to improve again restoring that new normal originally rld was all about breast cancer related lymphedema that that's what i researched and that's what the subsequent research since then has been about too however after a decade of experience and thousands of case studies this method is gaining momentum it also seems to be helping clients with symptoms of non-cancer related inflammatory autoimmune disorders as well as primary lymphedema and lipoedema and it makes perfect sense to me because if to reduce the swelling for a limb with breast cancer related lymphedema we have to get the lymph moving which um which we do we've seen it because we've also done some thermal imaging research so we've seen the the very visual temperature changes and we can see the measurements reducing in size as well and then it makes sense that it's bound to be impacting on our immune system so any autoimmune stuff may well be impacted by this so that whole inflammatory um thing that inflammatory response that gets triggered in autoimmune disorders so i'm going to share some resources with you but i have to say i have oops let's uh just a few more photos first so um this is somebody who was in the second research study when she came the mark on her arm here you can see digging in that's because she took her compression garment off to be measured before we did her treatment so this was photograph was taken before and this one immediately after the treatment you can see um changes in the skin there too and she'd said to us when she came in oh i can't uh get my i can't wear my watch or my rings on this um arm at the moment and then as she was getting dressed again i think i'll just try it and you can see there that you know what joy that was for her it's i always say it's the small things that um seem to make the biggest difference when you can do something again that you weren't able to do before so here we are for some resources um so i have been so fortunate to travel with rld literally from alaska to auckland in new zealand and many wonderful places um in between as a guest speaker at conferences and teaching my method to reflex artists around the world and in that time um i'm proud to say that rld has attracted national and international awards and widespread recognition so we really are gaining momentum because there is a small amount of research and then there are thousands of reflexologists in more than 30 or approximately 30 different countries um so you know you've also got patient voice as well so patients when they go back patients i guess like siobhan who's um tried rld and it's made a difference so word of mouth and patient voice is that word of mouth uh and also mld has only was only first developed in the 1940s so i feel that rld is only 80 years behind so fingers crossed anyway so i'm also the only rld tutor who teaches this method which is now as i said in approximately 30 different countries and every continent except antarctica and whereas travelling before the whole covert pandemic was amazing it's actually been um quite enlightening to be able to take this trading online because it's meant that the reach has been to people in countries that i would be unlikely to go to in person so if you would like more information first of all do like there's a large facebook group it's got almost 9 000 members it's not just reflexologists but you are welcome to join that's a public group and often you it might be a way of connecting with someone who can um do rld in your area if you're interested in reflexology i have a reflexology facebook page so like follow share connect and always like to add on to that enjoy instagram and also a youtube channel where you may find some useful information so the research which i'm going to come on to next i think i'll swap that over just because uh it's up here that i want you to see there's a drop down menu and it gives you a link to the research abstracts that of the papers that have been published including very exciting the most recent one the most recent one at the top there is the thermal imaging which is a pilot study so the other papers have been published in complementary therapies in clinical practice peer review journal but the latest one was published in the british journal of community nursing so do have a look at that you'll find the research abstracts there and a link to the journals where they're available if you decide you want to access the full paper right okay so next um i just want to say that there is um a register of rld reflexologists around the world and this is their logo so you might see this on their website or their social media pages if you're looking for someone who can help you but do check the website because we've got um and here it actually says rld register now not therapist but here there's a drop down menu so if you're in the uk or if you're in europe uh then click on europe here and otherwise uh soon to come to this list is india and italy because two people have recently joined the trading with me and so i always look forward to adding a new country it's just something extra rewarding about it so if you'd like to try try it for yourself do check out the website um swap this back over again now you get the gist of it so if you'd like to connect either through the facebook group um and find someone who's trained with me in rld uh because after the training they do a case study and then after that they go on the register some people just end up doing the work and keep forgetting to get round to write case study so do contact me if you want to double check that somebody has traded me because i do have a list of everyone who's ever attended any of the training it's quite an extensive list now but feel free to message me preferably emails so there's a contact page on the website um social media messages tend to get overlooked you know once you've opened it it's hard to remember to go back to it so just one more slide to finish and it's just i'd just like to say thank you very much for having me and i wish you all the best with the rest of the event thank you siobhan and good luck everyone