How Manual Lymph Drainage relieved my edema and helped me heal.
When I stepped into the shower at the hotel in Scottsdale, Arizona that evening in late February 2021, my feet felt funny. I looked down at them and noticed they were quite puffy and swollen. I was surprised because I had never had problems with edema in my feet. I mentioned it to Karen Slusher (my caregiver at the time who had flown to Arizona with me just two days earlier). “Yes, I started seeing the beginnings of that last night,” she confirmed. “But, they do look worse tonight.” Little did I know that this was just the beginning of a learning journey.
Swollen Feet… then Legs, Hips, & Waist
I’d heard that flying in a plane with cramped seats, air pressure changes, and little chance to move around can cause circulation problems and swelling (edema) in the feet and legs. But, what I had wasn't “ordinary” edema, rather it was "secondary lymphedema" -- a result of my cancer. (You can read that story in my previous article from Feb 2021.)
Over the next few weeks my body swelled tremendously from the waist down. I'm 5'6" tall, and my consistent body weight for years had been about 125 lbs. But, due to the effects of vomiting, dehydration, and cachexia (the medical term for the wasting of the body that happens with severe chronic illness), I had already lost a lot of weight by the time Karen and I flew to Arizona. In the airports I used a wheelchair for the first time due to my weakness. I had become so weak I couldn’t stand up from the toilet without assistance.
So then, as I began treatment for the aggressive and fast-growing neuroendocrine carcinoma tumor in my abdomen, with the lymphedema I started retaining so much water that my weight soared to 162 lbs. at its worst. (See details in this Envita Case Study.) And this wasn’t like soft “comfortable” fat… this water retention made me feel like I was walking with volleyballs between my thighs! With so much extra weight on my body and such muscle loss, I had to use a wheelchair to go just about anywhere. I could walk a short distance (like from my recliner to the bathroom), but I had to be lifted out of the recliner because I didn’t have the strength to get up on my own. Using a toilet riser with arm rails helped me be somewhat independent in that way, thankfully. With an additional 15-20 lbs. of water-weight in each leg, I was barely strong enough to step up the 4 inch threshold into my apartment! It was scary to get "sewing machine leg" muscle-quivering just from the effort of making that small step.
The Edema Learning Curve Begins
It was the Lord's blessing that early-on in my struggle with the edema, Karen saw a business card for Malonie Gabriel of Touch of Healing while she was waiting for me to finish my acupuncture treatment one day. Knowing of my severe and immediate problem, Karen immediately made an appointment for me, and I believe that the Manual Lymph Drainage (MLD) therapy Malonie began on me was instrumental in helping me not only beat the lymphedema, but helped me recover from the cancer and accompanying health complications. I learned a lot from Malonie.
I learned that the buildup of lymph fluid can cause permanent damage to the tissues under the skin. So, getting treatment early is quite important. Typical treatment for edema is diuretics. Specifically, the drug Lasix (Furosemide) is used to quickly reduce water in the body. (In other words you pee a lot!) I was given quite a bit of this when I was hospitalized.
But, such drugs only get rid of the fluid... they don't remove the protein that is part of lymphedema. Lymphedema is different from “ordinary” edema because it is protein-rich. Even “ordinary” edema can become protein-rich if it continues for longer than 3 months. The diuretics get rid of the water, but not the protein. Once the protein is left behind, it can create hard lumps and bumps that are unsightly, and this can lead to life-long cellulitis problems even after the acute edema is resolved.
One way to tell the difference between edema and protein-rich lymphedema is that regular edema is only fluid, but lymphedema feels heavy because of the accumulation of proteins in the affected area. When lymphedema develops because of cancerous tumor obstruction, it is painful. Indeed, the swelling in my feet, ankles, and legs was painful to the touch, and enduring those first therapy sessions required some mettle on my part. (The results were worth it, though!)
Edema is a symptom, while lymphedema is a disease -- technically a chronic, progressive inflammatory lymphostatic disease caused by mechanical failure of the lymphatic system. In my case, the lymph nodes in the abdomen near the tumor were not functioning properly and therefore the lymph from my legs got stuck.
Manual Lymph Drainage to the Rescue
Using her knowledge of Manual Lymph Mapping (MLM), she redirected the lymph to go around the abdomen, thus avoiding the compromised lymph nodes there. She directed the lymph to go up around my hip into my underarms, instead of into my abdomen. I saw an immediate improvement and after a session I would pee almost as much as if I had had a diuretic drug.
In one way, I felt like the MLD therapy Malonie did for me was a miracle treatment. Looking at it another way though, Malonie commented multiple times that it was amazing to see how exceptionally well my body responded to it. The swelling went down easier than Malonie had seen with other patients. Her conclusion was that since I had been eating an organic diet and living a healthy lifestyle before this issue arose, my body didn't have as many toxins in the lymphatic system to clog it up, and therefore it was easier to drain than someone who hasn't been eating a clean diet.
But, beyond just getting rid of the water, Malonie was able to break up the proteins that had already started to solidify in my legs. This is Stage 2 and can be determined by pressing on the swollen area... in the early stages, the area will form a small dent or "pit" when pressed with your finger, but as the disease progresses, the area does not leave a pit when pressed. This indicates the growing seriousness of the disease. (I was particularly annoyed by solid masses on my outer hips that remained even after the basic edema condition improved. They were somewhat hard and made me look a bit disfigured. These were actually just places where the protein molecules had gotten stuck and coagulated. Malonie was able to use her special German-trained technique of removing the stuck proteins, and those masses disappeared! I was so thankful, and amazed!)
Malonie was willing to show my caregivers some basic lymph drainage techniques to help me between visits. This was particularly helpful when I was in the hospital, unable to get MLD, and my legs began to swell. It had become my policy to refuse Lasix if it was just for the edema. So during one hospital stay, I asked my brother (my caregiver at the time) to perform lymph drainage on my feet, ankles, calves and behind the knees as he had learned from Malonie. The immediate improvement in the swelling was amazing.
Not like Deep Tissue Massage
Manual Lymph Drainage (or Lymph Drainage Therapy [LDT] as it is also called) is different from deep tissue massage and other techniques that use a lot of pressure. Not only are some massage methods physically taxing on the therapist, but that rough and forceful work can sometimes damage the lymph vessels. MLD has a light touch -- the pressure is about the weight of a nickel. What works best to move the lymph is gentle pressure that stretches the skin.
What about Cancer Metastasis?
A question that often comes up is, could manual lymph drainage cause cancer to metastasize?
I asked Malonie and she referred me to the work of Michael Földi, MD DSc in his “Textbook of Lymphology: for Physicians and Lymphedema Therapists (German Edition).” He says, “This question is frequently asked and can be answered with a definitive ‘No.’ The biological properties of cancer cells and the condition of the immune system are what are responsible for cancer metastases, not external mechanical factors.”
How the System Works
The lymphatic system is part of the larger circulatory system, but works in an amazing way on its own with lymphatic vessels that carry the lymph fluid around the body without a central “pump”. Instead, it uses a peristalsis-type action. As Malonie describes in one of her brochures, “Lymph is transported by lymph-angions (‘little lymph hearts’) that drive the lymph as a pump does. Lymph fluid is transported through the lymph collectors to the lymph nodes by means of intrinsic contractions of the smooth muscles within the walls of the lymph-angions. They are the cardinal force that moves lymph fluid.” The lymph collectors have valves that keep the lymph moving in only one direction. This process is also known as “Lymphangiomotoricity.”
The lymph angions contract with an average frequency of 6 -10 contractions per minute (but Lymph Drainage Therapy can increase the contracting frequency of the lymph angions to 60 per minute, promoting lymph flow). I understand from Malonie that the rhythm of the flow of lymph can be felt by some practitioners. These contractions are the main force that moves the lymph so it can keep moving even when you are very still. Other things that help it move are 1) Contraction of surrounding skeletal muscle (exercise), 2) Deep breathing (diaphragm movement), 3) Pulsation of arteries (vasomotion), and 4) External compression – Manual Lymph Drainage (or Lymph Drainage Therapy).
So, lymph is constantly on the move (even while sleeping, not just when exercising), and carries white blood cells through the system to reduce infection. It does this through a series of heart-shaped lymph angions that release their fluid when stretched, and then when relaxed are able to fill again. The lymph nodes produce and store white blood cells. More white blood cells are produced when the lymph moves. So, keeping it flowing and uncongested helps maintain a healthy immune system.
As Malonie explains on her website (www.touchofhealing.life), Lymph Drainage Therapy can help to relieve chronic pain, detoxify the body, reduce inflammation, clear sinus congestion, boost blood circulation, improve allergy symptoms, heal injuries faster, increase parasympathetic tone (promoting deep relaxation), reduce the symptoms of chronic fatigue and fibromyalgia, adipose and cellulite tissue, as well as assist in anti-aging since it promotes tissue regeneration. All of this is beyond the main benefit -- resolution of edema and lymphedema.
Finding an MLD or LDT Therapist
According to Steve Norton, founder of the Norton School of Lymphatic Therapy, millions in the US are living with lymphedema from cancer therapy, poor vein health, sedentary living, and unmanaged obesity among other things. That includes a lot of people! In a video on the Norton School website, Steve tells how there is a shortage of trained specialists. I found this to be true as Malonie had a difficult time finding qualified people to join her at her clinic to meet the increasing demand for MLD, and I only found one MLD therapist within a 90 minute drive from my home in rural Oregon. I hope that more people will choose to learn how to do this therapy so many more people can be helped like I was.
Malonie highly recommends Klose Training and the Academy of Lymphatic Studies for learning to treat lymphedema using Complete Decongestive Therapy (CDT) -- which consists of lymph drainage, compression bandaging, therapeutic exercise and skin care. She also recommends the Chikly Health Institute for people to learn Lymph Drainage Therapy (LDT) techniques.
Keeping It Going
Through this learning journey I’ve come to understand just how important the lymph system is for overall health and immunity. I continued the lymph drainage even after the lymphedema was resolved. I believe it helped me regain my health more quickly after cancer treatment and I plan to continue getting this therapy occasionally in my ongoing quest for superior health.