posted Feb 8, 2015, 9:04 PM by Bobby Clark
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updated Feb 13, 2015, 12:03 PM
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Nancy Brown spoke to the Greenville Support Group about her positive experiences with Lymph Node Transfer Surgery with Dr. Marga Massey
Greenville, South Carolina - In January, Nancy Brown discussed her experience with Lymphatic Transfer Surgery at the January Upstate Monarchs Community Meeting. Nancy suffers from Secondary Lymphedema which she developed in 2011 after treatment for Breast Cancer in 2006 and 2007.
She was able to find a medical diagnosis and treatment regiment but the experience, as with many lymphedema patients, was difficult at times. Eventually, Nancy had a good diagnosis and was in a good maintenance state. She maintained that state by wrapping her arm (everyday), wearing garments, and regular visits to her therapist for MLD (Manual Lymph Drainage) treatments. Most patients can control their lymphedema with a good maintenance plan.
This kind of regiment is common for lymphedema patients, because there haven't been good surgical options available to patients for those living in the United States. However, this could be changing for some in the form of Lymph Node Transfer Surgery.
Nancy's hand began getting worse after series of bouts with swelling and arm inflections, referred as cellulitis. Cellulitis is a deep tissue infection, which is painful and dangerous. Repeated cellulitus attacks can further damage a lymphatic system. Nancy was seeing this happen to her hand (see below) and she needed a better option.
While traveling, Nancy saw an advertisement from Dr. Marga Massey, a plastic surgeon, who is one of several US surgeons seeking to pioneer a surgical option for lymphedema patients. Although the option is not for everyone, the promise and results that Nancy has seen have been life changing.
The procedure uses a functioning lymph donor site and transfers lymph vessels and nodes from that site to the site with lymphatic system doesn't function properly. It is for that reason the option is called Lymph Node Transfer and not donation, since the lymphatic ducts are from the own patient's body. In Nancy's case, it was from her neck. The surgery is an option for Primary or Secondary Lymphedema and be on either the arms or legs.
Nancy had several consults with Dr. Massey before electing to move forward with the option, and there were several considerations. Here are few concerns Nancy had to consider.
- First, the surgery is considered an elective procedure in the U.S. and most insurance policies currently don't pay for the treatment.
- Second, there is a real concern for the donor site and a great effort is made to be sure the removal of Lymphatic ducts doesn't leave that site impaired and cause new lymphedema to occur. To avoid this, extensive post treatment is required where the patient is treated and monitored for any problems.
- Before the option can be done, the patient's lymphatic system will need to be assess with Lymphoscintigraphy. Lymphoscintigraphy is the test used to trace your lymph node system using an injected dye. Clinicians use the procedure to map the anatomy of the lymphatic system and determine the exact locations of lymphatic leaks. That helps surgeons to know where to transfer the working ducts for the best result.
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Dr. Marga Massey & Dr. Corrine Becker perform Lymph Node Transfer Surgery in 2013 (video)
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The surgery is considered microsurgery and is usually done by a
pair of surgeons. Nancy had the surgery in Charleston, SC but Dr.
Massey has clinics in several locations in across the country in New Orleans, Chicago, and Salt Lake City. Once is
completed, there is an extensive post-procedure monitoring and therapy a local stay at the local clinic for few weeks with daily bandaging and MLD (Manual Lymph Drainage) treatments. Nancy stayed in Charleston for several weeks.
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Following that, locally with a vascular clinician and lymphedema therapist who conduct regular visits, more MLD treatments and reported back to the surgeon for several weeks. She had MLD Treatment for 5 times a week for several weeks and then dropped down to 3 times a week. All and all, Nancy committed to 3-4 months of post treatment and monitoring.
Despite this, Nancy's results have been very positive thus far. "I would do
the surgery again", said Nancy as she discusses her experiences to date. "I
have been able to reduce wearing my garments from daily use to once every three to four
days with no problems and Dr. Massey's approval". The expectation is that
the results will have the most promise in the first two years of the
surgery.
Lymph Node Transfer option is not for everyone, however in Nancy's case, it was extremely beneficial. Hopefully, Nancy's story is one of many that will start a wider spread acceptance of this surgical option for the right cases.
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