NODE NEWS - SPRING INTO COLOUR - UNDERSTANDING MLD AND SLD CATHERINE KINGSFORD POSITIVE DESPITE ADVERSITY - Lymphoedema Association ...
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NODE NEWS SPRING 2021 UNDERSTANDING MLD AND SLD IN PROFILE: CATHERINE KINGSFORD POSITIVE DESPITE ADVERSITY IMPORTANCE OF THE GUT MICROBIOME SPRING INTO COLOUR Photo credit: Medi Australia. Model wears Mediven flat knit in Blue-jeans with Nature pattern.
CONTENTS
PUBLISHER
Lymphoedema Association of
Queensland
ABN: 13 602 257 202
ANNUAL PUBLICATION DATES
1 December 1 March
1 June 1 September
EDITOR
Pam O’Connor IN THIS ISSUE
Editor Node News
Envelope nodenews@lymph.org.au FEATURE:
SPRING INTO COLOUR 5
DESIGN
Cat Wilkinson FEATURE:
Web and Graphic Design UNDERSTANDING MLD AND SLD 9
GLOBE catwilkinson.com.au
Mobile-Alt 0424 615 611
IN PROFILE:
CATHERINE KINGSFORD 11
ADVERTISING ENQUIRIES
Envelope nodenews@lymph.org.au
HEALTH AND WELLBEING:
CONTACT THE IMPORTANCE OF THE GUT MICROBIOME 13
BUILDING PO Box 3068,
BRACKEN RIDGE Q 4017 MEMBER SPOTLIGHT:
Mobile-Alt 0403 782 795 POSITIVE DESPITE ADVERSITY 19
Envelope info@lymph.org.au
GLOBE www.lymph.org.au DIRECTORY:
PROFESSIONAL PRACTITIONERS DIRECTORY 26
LAQ SECRETARIAT
Kirstyn Marriott
Envelope admin@lymph.org.au
LAQ COMMITTEE MEMBERSHIP - RENEWAL DUE 30 JUNE, 2022
Uff. Hon. Teresa Gambaro GAICD The Lymphoedema Association of Queensland is a membership
President based charity. Membership fees are paid annually and due 1 July
Mary Stewart - Vice President each year. Membership choices and costs are as follows:
Jess Billiau - Secretary • General Membership: $40.00
Brian Browne - Treasurer • Concessional Membership: $30.00
Vacant - Media and Publicity Officer
• Professional Membership: $99.00
Hildegard Reul-Hirche - Education
Officer To join please complete the Online Membership Application on
Robyn Scheer - Education Officer our website visit lymph.org.au/membership/#join
Jennifer Gilbert - Education Officer
Mia Stemm - General Member
Avon Mills - General Member DISCLAIMER - The Lymphoedema Association of Queensland Inc. or its officers are not
Catherine Kingsford - General Member responsible for any copyright infringements of images supplied by writers or advertisers.
Materials and articles in Node News are general information only, not advice. Information
published is believed to be accurate and reliable, but no responsibility is taken for any
GET SOCIAL WITH US opinions expressed or for errors and omissions. Readers should not act on any material
without taking professional advice relating to their particular circumstances. Professional
advice should be sought before any action is taken.
Linkedin FACEBOOK-SQUARE INSTAGRAM
Node News | Lymphoedema Association of Queensland 2
EDITOR´S DESK
to do this is to add some colour to drainage you do yourself –your
our compression garments. lymphoedema therapist will
show you how to do this for your
Sure, I know it’s no fun at all to
individual needs.
wear compression, but we know
the garments help to make our Following on from her article
Pam O'Connor lymphatic system work better. about the dietary management
of lymphoedema, dietitian Eleni
Spring is my favourite time But why stick to boring beige or
Georgiou explains why revitalising
of year. The weather starts basic black when there’s so many
and maintaining a healthy gut
to warm up pleasantly, just on-trend colours and patterns to
microbiome is so important.
before the onslaught of our choose from –you can even add
Queensland summer. Birds some crystal bling! In Medical Matters, Dr Chris
are chirping and I’m picking Lekich explains the types of
Celebrate your individual style and
mulberries from my tree! investigations for the lipoedema
make a statement about who you
patient.
It’s been a tough year so far for are. It’s all about changing your
everyone, but we’re lucky to live in mindset. Read our cover story to Also in this edition of Node
this beautiful state and there are find some colour inspiration. News, follow the inspiring stories
signs to point to a brighter and of member Lini Boyer, mobile
While all these lockdowns haven’t
more free way of living by the end lymphoedema therapist Emily
been easy, they serve as a
of the year. Muldoon and our new General
reminder for all of us to focus on
Committee Member Catherine
Although we’ve still got a way to go our self-care as these uncertain
Kingsford.
before then, we can only try to find times continue.
the positives in the little things to Don’t forget to discover our new
Manual lymphatic drainage (MLD)
lift our mood and be grateful for website, which we launched in July,
is an important component of
the freedoms we have compared and let us know what you think by
lymphoedema management.
to other parts of the world. sending us an email.
Dermal clinician Maisie Hillman
So as the sun starts to shine a little explains the difference between Happy reading and enjoy the
brighter, it’s time to put a bit more MLD and Simple Lymphatic sunshine.
spring into our step –and one way Drainage (SLD), which is lymphatic
COVER GIRLS
The July edition of Lymph pink stripey leg belongs to Pam
Exchange, the Australasian (wearing Sigvaris Microfiber
VOL 22 | ISSUE 2
Lymphology Association’s triennial Patterns from Morris Medical),
July 2021
PUBLICATION OF THE AUSTRALASIAN LYMPHOLOGY ASSOCIATION
publication, featured a couple and the blue/black tie-dye leg
of our LAQ Health Professional belongs to Kaori (wearing Juzo’s
members on the cover –or Batik Collection).
rather, their legs sporting
colourful compression!Brisbane
lymphoedema therapists Pam
O’Connor (right) and Kaori Langley
(left) put their best foot forward
in the photoshoot for the cover
during the ALA Symposium,
held at the Sheraton Mirage on
The Compression Issue
ALA position statement: the use of compression
the Gold Coast in May. In case
in the management of lymphoedema
Are we under (delivering) pressure?
you didn’t recognise them, the
Node News | Lymphoedema Association of Queensland 3
PRESIDENT´S DESK
having the expert advice on hand.
Dr Chris Lekich of Lipoedema
Surgical Solutions was our
guest speaker and gave
attendees an informative talk
Uff. Hon. Teresa Gambaro GAICD about the physical, medical,
and psychological aspects of
Welcome to the Spring Edition
Lipoedema. A disease that affects
of Node News. I hope that you
one in eleven women worldwide.
enjoy this information packed
edition. It has been a busy few Thank you also to all the members
months at the Lymphoedema who renewed their membership
Association of Queensland. As using our new login system. This
Teresa alongside Cr Tracy Davis and
usual we are powering ahead. will allow members to update Cr Sandy Landers at the launch of the
and manage their membership new Lymph Queensland website
July saw the launch of our new
details a lot easier. Your annual
user-friendly website, combined that will help them manage this
contributions allow LAQ to help so
with a successful Trade Day, condition and live their very best
many, who when initially diagnosed
which was held at the Brisbane life ahead.
with Lymphoedema contact us
Bronco’s Club. Special thanks to Covid 19 continues to be a large
frightened and overwhelmed. We
the Website team of Kirstyn, Reid part of our day to day lives. It is
will always continue to support all
and Pauline who did a fabulous because of these uncertainties,
who contact us as well as providing
job, and to all the members and we will be holding this year’s LAQ
the latest information and
health professionals who attended AGM by Zoom on Wednesday the
resources for members.
on the day. The development of 13th October at 7pm. This will allow
the new website and the launch many of our regional members to
day could not have occurred join us and participate for the first
without the generous support of time.
grants obtained from the Lord
Covid 19 has affected all of us at
Mayor’s Community Trust and
some time in the past 18 months,
the Queensland Government’s
and we are thinking of the
Gambling Benefit Fund.
incredible hardships that you are
“ Your annual contri-
butions allow LAQ to
all facing, and we wish you and our
interstate family and friends all the
best for the future.
help so many, who
A special guest speaker will be
when initially diagnose
included in the Program and the
with Lymphoedema
Dr Chris Lekich delivering a speach link will be sent to you via email
contact us frightened
"
about lipoedema at our website launch. shortly. So, Mark the Date! Enjoy
and overwhelmed.
the warmer Spring weather by
So, if you haven’t renewed yet,
getting out and about, exercising
A special mention of thanks must please consider payment of your
and enjoying life. Remember in the
go to our sponsors on the day, much needed membership fees. It
words of Lena Horne "It's not the
Morris Medical Supplies, Essity, is less than a cup of coffee a month
load that breaks you down, it’s the
Impedimed, Medi Australia, for a year and can assist us to do
way you carry it." Enjoy your best
Haddenham Healthcare, The Joint so much. So much is changing
life.
Physiotherapy, Co.as.it. and the and evolving in the treatment of
Zonta Club of Brisbane Sunrise. Lymphoedema and it important
Guests enjoyed the opportunity that our members have access to
of visiting the Trade Displays and current information and research
Node News | Lymphoedema Association of Queensland 4
FEATURE
Medi Mediven Avocado-green
with Dots pattern, Blue-jeans in
Classic pattern, and Mango-yellow
in Nature pattern.
SPRING INTO COLOUR
Author: Pam O’Connor
I
colours – the ever-popular Medi
t’s time to say goodbye
Magenta, Blue-jeans and Grey,
to winter and to welcome
as well as the Standard colours of
the warmer season with a
Navy, Cashmere, Caramel, Sand,
brighter outlook. A perfect
Anthracite and Black.
way to lift our mood is to
brightenour lives with lots of To complement the colours there
colour. So put aside the boring are four new patterns –Nature,
beige and basic black –and Stripes, Dots and Classic.
spring into some colourful Each pattern is available in two
compression. With so many versions – Design-Element with
shades and patterns to a more discreet pattern, or two-
choose from, celebrate your and lipoedema therapy with toned Fashion-Elements that turn
individuality with style ... and fresh new patterns and two new your outfit into a real eye-catcher.
even add some crystal bling! trend colours for both arm and
leg Mediven flat knit garments -
Medi available from October 4.
The most beautiful feeling?
The new Trend colours – Avocado-
According to Medi, it’s simply
green and Mango-yellow – are a
being yourself. Because being true
winning Aussie combination!
to yourself is what makes life truly
free and colourful. Juicy Avocado-green whets the
appetite for new ideas, while
Medi gives you the confidence
radiant Mango-yellow ensures an
to be yourself by bringing more
upbeat mood in any weather.
individuality to lymphoedema Continued on page 6 >
They join the other Trend
Node News | Lymphoedema Association of Queensland 5
For even more individuality, set or keep it soft and flowing with is best suited for tired, restless,
personal accents with motifs warm natural tones. aching legs; travellers,
made of sparkling crystals in occupational health risks,
For a classic look, Cool Grey simply
three designs –Crystal, Pearl and expecting mothers, and a family
goes with everything and is never
Rosegold. Perfect for those who history of chronic vein disease.
boring.
love some added bling!
For women with courage, Deep
Lavender is simply a colour you
cannot miss and adds freshness
and lightness to any outfit.
Sigvaris Trend Colours: www.
sigvaris.com/en-au/campaigns/
trend-colors-20212022
Talk to your lymphoedema
therapist to measure and order
your stylish new garments as the
Mediven flat knit garments are
custom made.
More info:
The Sigvaris Soft Silhouette
www.mediaustralia.com.au
Leggings for women features
The Sigvaris Semitransparent
achic, subtle ribbed design and
Sigvaris range comes in other standard
pairs perfectly with dresses,
Show your colours for a carefree colours and several options: Class
blouses, tunics and shirts.
life full of options, with four new 1 and 2; calf, thigh and maternity;
season Trend Colours in the sizes XXS-XL Plus; 3 lengths; The range comes in the colours of
Sigvaris Semitransparent leg closed and open toe. Midnight Blue, Espresso, Mulberry
compression range. and Black. The advanced soft
For something fun and funky,
stretch microfiber fabric shapes
the Sigvaris Microfiber range of
legs and smooths skin. A foldable,
compression below-knee socks
comfort-stretch waistband
come in Stripe and Argyle patterns
provides a seamless look for
in a variety of colours for both men
all-day wearing comfort, with a
and women.
maternity style also available.
Available in two compression
Available in 15-20mmHg and
grades –15-20mmHg (RRP $49.95)
four size options, the leggings
and 20-30mmHg (RRP $79.95)
are non-latex and best suited for
- and also in three sizes and two
tired, heavy, restless, aching legs;
lengths.
occupational leg health risks; and
The Stripes come in either dark navy a family history of chronic vein
or pink, and the Argyle in purple, disease. RRP $99.
Sun, beach and lemon ice cream graphite, royal blue, and pink.
Sigvaris products are available
– Happy Yellow spreads that The 20-30mmHg compression is from Morris Medical, 6/76
summer feeling and makes your best suited for the management Enoggera Road, Newmarket 4051,
complexion glow. of symptoms related to chronic 07 3356 6995.
For a heavenly style, look to the venous disease, and long-distance www.morrismedical.com.au
skies with True Blue. Combine it travel.
with a bold colour for a daring look, The 15-20mmHg compression Continued on page 7 >
Node News | Lymphoedema Association of Queensland 6
Juzo confidence, lightness and an
eagerness to experiment. Golden
Juzo Trend Colours are sure to
Yellow radiates your personality,
bring more colour into your life
spreading a vibrant sheen and
with the people who mean the
warming aura.
most to you. Embrace freedom and
share your zest for life with friends Contact your lymphoedema
with the colours Blue Love, Violet therapist to order from the Juzo
Truth and Pink Soul. Celebrate range.
friendship and discover your new
Juzo Trend Colours: www.juzo.
favourite shade that makes you
com/en/product-worlds/trend-
feel absolutely amazing.
colours
The Batik Collection turns up
Juzo Batik Collection: www.juzo.
the fashion a notch with tie-dye
com/en/product-worlds/batik-
designs, available in trend and
of optimism and glamour. collection
standard colour blends.
Proud Red represents change, a Juzo Fashion Colours: www.juzo.
The Fashion Colour range celebrates
thirst for action and awakening. com/en/product-worlds/fashion-
the Golden 1920s as a unique era full
Noble Mint reflects self- colours
Quality and Care for your LymphoEdema needs MEDICAL GRADE
At SuperPharmacyPlus Mobility we are dedicated to providing the best quality COMPRESSION
care for customer and therapist alike. Our range of Jobst medical compression
wear is one of the largest in Australia and encompasses circular knit, flat knit,
wrap systems, arm sleeves and gloves as well as a large range of donning and
doffing devices.
SuperPharmacyPlus Mobility staff are ready and able to assist with measuring
and fitting of compression wear and appointments can also be made for
consultation with an Occupational Therapist when required. Our dedicated
mobility staff provide excellent advice on washing and garment care and advice
regarding the best donning and doffing aids.
Available Instore & online:
- Wide range of donning and doffing devices
- Full range of Bella Lite & Bella Strong Armsleeves
- Full range of 20-30mmHg Upper and Lower Limb garments
- Compri2 and Compri2 Lite available
- Trained staff to measure and fit
- We invite referrals from therapists
- Wholesale supply available to clinics and therapists
Lisa - Occupational Therapist
WWW.SUPERPHARMACYPLUS.COM.AU
Open 7am-8pm DAILY
3355 3052 | 621 Stafford Rd, STAFFORD
Node News | Lymphoedema Association of Queensland 7
OUT AND ABOUT
WE HAVE LIFT OFF!
inspiration from our members
living with lymphoedema every day.
It is now a simple task to keep
your information up to date on the
website so you are always in the
loop with the latest information
and developments in the world
Our President Hon Teresa Gambaro of lymphoedema. Our members
Addressing the Audience.
only portal will be updated
On July 10th 2021 we had our with educational and practical
information as time goes on. L - R: Cr Sandy Landers, Hon Teresa
official launch of our new and Gambaro, Dr Chris Lekich, Cr Tracey
improved website. We had Our thanks to our special guest Adams
over 60 members and guests speaker Dr Chris Lekich, Cr Tracey
life members who had worked
join us on the day where we Adams and Cr Sandy Landers
tirelessly to get us to where we are
enjoyed a delightful morning for their ongoing support of our
now today at LAQ.
tea catered for by the Brisbane members. We would also like to
Bronco’s team. Our President express our sincere gratitude If you haven’t been to our new site
the Hon. Teresa Gambaro for the previous efforts from our it is located at www.lymph.org.au
addressed the audience and past and present committee and you will find the latest meeting
highlighted just how far we had schedule where you will be able to
come in making the disease register your interest for an event.
of lymphoedema more widely As we are in uncertain times it is
known and members finding important that you do register so
more resources to support you can be contacted quickly to
them as they navigate through advise of any changed plans.
managing their lymphoedema.
It was wonderful toconnect
We were taken on a tour around the with our suppliers and health
website with a live demonstration professionals on the day, we thank
from the website development them each and every one for taking
team, Kirstyn Marriott, Reid the time to support us on such a
Tregoning and Pauline Longdon. Momentousday for LAQ, and we
L - R: Our Website Development
Showing us the practical Team Reid Tregoning, Kirstyn Marriott, are looking forward to connecting
information and sharing the Pauline Longdon again soon.
Home Care Package Specialists
Social Group Activities + Outings
Cultural and Language Specialists
Domestic Assistance + Personal Care
Node News | Lymphoedema Association of Queensland 8
FEATURE
UNDERSTANDING MLD AND SLD
Author: Maisie Hillman
M
MLD by a professional that those ĠRecent thrombosis – until
anual lymphatic
with lymphoedema can complete anticoagulation is well
drainage (MLD) and independently. Therefore, aims established.
simple lymphatic to: ĠCardiac oedema - a risk of cardiac
drainage (SLD) are important ĠStimulate normal draining overload if the heart if not fully
treatments for lymphoedema. lymphatics. functioning.
These are massage movements ĠEncourage lymph fluid to move Lymphatic drainage massage has
away from congested areas to
that a professional does areas where it can drain more
a particularly valuable role to aid in
where their primary aim is freely. the management of lymphoedema
to improve the functioning ĠImprove the superficial lymph when used in combination with
of the lymphatic system. drainage. other aspects of treatment for
These movements influence Simple lymphatic drainage is thecondition. MLD consists of a
the lymph vessels that then based on the principles of MLD. professional-led treatment that is
transport lymph towards the Hand movements are simplified, mainly used when the swelling is
lymph nodes. In the present and massage is slightly modified complex, then the more simplified
area of lymphoedema, MLD and made easier to those with version SLD, promotes client
is a good treatment when lymphoedema can incorporate it independence and can more be
in combination with other into their daily lives to do at home. used when swelling is milder and
approaches to manage the not as complicated.
swollen limb/s. When MLD and SLD should
NOT be used
MLD aims
These treatments are not
-Increase the activity in the advisable to be done when:
ABOUT MAISIE HILLMAN
normal lymphatics and improve
ĠAcute infection or inflammation
the functioning.-Open the flow of ispresent –can cause discomfort
lymph fluid.-Encouragelymph fluid and toxic substances may be
to flow along alternative drainage moved into the lymph channels
and spread.
routes.-Aid lymphatic drainage
ĠActive and/or untreated
from congested areas.
malignant disease.
USER-MD Dermal Clinician
Ġmay possibly encourage the
SLD aims transport of cancer cells. mobile-alt 0416 331 194
ĠProviding a modified technique of
Node News | Lymphoedema Association of Queensland 9
Because Quality Of Life IS Important!
Niagara Therapy has developed its range of
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devices in Australia since 1969.
Find out for yourself how CVT may be able to
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for more information on how Niagara could help you or book a free
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scan the QR code or call 1800 601 121
www.niagara.com.au
Use only as directed and if symptoms persist see your doctor, always read and follow instructions.
Node News | Lymphoedema Association of Queensland 10IN PROFILE
CATHERINE KINGSFORD
Author: Catherine Kingsford
W
elcome to our newest
committee member
Catherine Kingsford.
Here is a little about Catherine.
Lucy, Catherine's kelpie patrolling the boundary with Mt Lindesay and Mt
Barney in the background.
internationally. This experience occasions about her lymphoedema
opened the door into a whole new experience. Each time whether the
corporate world. audience is a small intimate one or
a large conference one she brings
In 2007 I joined a company called
I have worked in health care for the entire crowd to tears. She is
ImpediMed as their clinical
over 30 years, starting my career an amazing advocate bringing
trials manager. ImpediMed is a
as a cardiac scientist. Working in awareness to lymphoedema
medical device company that
both public and private hospitals around the world.
specialises in the early detection
in Brisbane; Royal Brisbane
of lymphoedema. In the past 14
Hospital, The Prince Charles
years working for the company, I
Hospital and St Andrew’s War
have been fortunate to expand my
Memorial Hospital. In 1992 I
role and am currently responsible
decided to do what many young
for clinical trials and regulatory
Aussies do and move to the UK. I
affairs. In this position I have had
lived in the UK for 3 years working
many interesting experiences
the entire time at the Royal
including travelling to places I
Brompton Hospital in Chelsea.
never thought I would go and Catherine meeting Kathy Bates in
During my career as a cardiac spending 5 years in the United June 2015.
scientist I specialized in States.
I spend my spare time at our
electrophysiology, the study of the
“
property in northern NSW with
heart’s electrical system. This area I am looking forward to
my husband, Don and Kelpie,
of cardiology deals with cutting working with the LAQ
Lucy. With beautiful views of
edge technology that focuses team and using my ex-
Mt Lindesay, Mt Barney and
on pacemakers and implantable perience to help educate
Edinburgh Castle it is a wonderful
cardioverter defibrillators as well and improve aware-
"
place to relax and unwind.
heart arrhythmias. Due to the ness of lymphoedema.
rapidly evolving improvements I am looking forward to working
in the technology, I was lucky While living in the US I had the with the LAQ team and using
enough to be able to contribute opportunity to meet Kathy Bates my experience to help educate
to research and clinical trials that and have had the privilege to and improve awareness of
were performed locally as well as hear her speak on a number of lymphoedema.
Node News | Lymphoedema Association of Queensland 11HOLISTIC COMMUNITY CARE
With over 40 years’ experience before the OT arrived. Immediate
in the provision of community procurement of equipment and
care services, Co.As.It. same-day installation mitigated
Community Services is an the risk of more falls. Aged care is
organisation that supports just that, identifying ways to care,
people to maintain their through an experienced and highly
independence, connect to qualified lens.
community and manage their “Occasionally specialized
health via fully integrated knowledge is required”, says
services. Patricia when asked about treating
A charitable organisation that clients with Lymphoedema.
delivers in-home support services “The Swell Therapies group are
for people that have been experts in treating people with
assessed as requiring support. Co.As.It. occupational therapist lymphoedema” she said. They
Patricia Lapsley.
Services such as domestic duties, provide assessment and ongoing
personal care, clinical and allied the one umbrella means a speedy therapeutic management of
health services including social solution to client needs –the care lymphoedema, scar management
group and individual activitiesare team can collaborate with the allied and joint mobility. “We source
delivered on a weekly basis and as health or clinical teams to find external specialists from time to
often as required. Access to these efficient solutions to client needs. time” says Patricia.
government subsidised services Co.As.It. has a foundation of caring
Co.As.It. has a growing OT team
is facilitated by contacting My for people from diverse cultural
including Patricia Lapsley who
Aged Care if over 65 years of age backgrounds. With particular
was recently nominated for
or contacting Co.As.It if under 65 expertise in servicing clients
LASA (Leading Age Services
years of age. NDIS services that fromCALD backgrounds, Co.As.It.
Australia) Aged Care Employee
focus on individual capabilities employs more than 300 support
Day. The theme #ThanksforCaring
with emphasis on wellness and workers who speak a total of 52
recognises each and every
independence are also easily languages other than English. This
team member involved in
accessible. Co.As.It. has been a means that clients and support
caring for the 1.3 million older
contact point for support for those workers can be matched according
Australians receiving home care
that are from CALD (culturally and to their cultural and linguistic
or residential care services.
linguistically diverse) backgrounds backgrounds and interests.
Lapsley was nominated because
as it is able to meet the cultural
of her willingness to go above In recognition of the number
and language needs of the client.
and beyond to ensure client's of clients who experience
Co.As.It. has a large team of allied safety and independence. lymphoedema, Co.As.It. was
health and clinical specialists Following an urgent OT referral, pleased to acknowledge the work
e.g. occupational therapist, she visited the Co.As.It. client of LAQ by supporting its recent
physiotherapists, podiatrists, three days after she had moved website launch and morning tea at
exercise physiologist, and social into an independent living unit Broncos Leagues Club.
work, counsellors and dementia within a seniors’ complex. The
experts who work together, inthe Find out if you can benefit from
retirement unit had very few
interest of its clients, means Co.As.It.’s services or for more
modifications, and Patricia’s
that support received is more information:
assessment reported the client
comprehensive, holistic service was potentially unsafe and advised phone 07 3624 6100
with the associated benefits of of necessary modifications.
envelope mail@coasit.asn.au
continuity of care. Having qualified Further investigation revealed
specialists all operating under the client had a fall shortly globe www.coasit.asn.au
Node News | Lymphoedema Association of Queensland 12HEALTH AND WELLBEING
IMPORTANCE OF THE GUT MICROBIOME
Author: Eleni Georgiou
I
extract nutrients from them. You hear a lot about fibre and
n the previous edition of
ĠRegulating our immune system bowels, and keeping a healthy
Node News, I talked about
ĠProtecting against other digestive system, and that is
revitalising and maintaining microbes that cause disease absolutely spot on! We need to be
a healthy gut microbiome as ĠProducing vitamins consuming 28g or more of fibre
just one of the key components ĠMaintaining a healthy intestinal each day. How do you do that?
of dietary management with lining
Simple. Consume two serves of
inflammatory conditions such as So, you might be wondering why fruit daily, handful of unsaltednuts
lymphoedema and lipoedema. there are times you experience daily, 3 serves of legumes per
In my practice as a Dietitian, I am bloating, distension, gas, week, always choose wholegrains,
finding that the number of patients abdominal pain, changes in your and consume at least 3 cups of
I see suffering from gut discomfort bowel movements maybe? You vegetables each day, including a
and sensitivities is growing rapidly. are experiencing gut dysbiosis mixture of raw and cooked.
Between a mix of lifestyle factors, which is caused by an imbalance of
Prebiotics and probiotics support
stress, and food sensitivities, our bacteria in your gut, and changes
a healthy gut microbiome.
gut microbiome is in desperate can occur such as losing beneficial
Consuming a balance of both
need of some attention. Let’s set bacteria in your gut, potentially
can increase the diversity of your
the scene. harmful bacteria take over your
gut microbiota, benefiting your
gut, and less diverse bacteria in
The gut microbiome is made up health. Probiotics need prebiotics
your gut. To put it simply, imagine
of trillions of microorganisms and to survive in the gut and to make
your gut is an old warehouse,
their genetic material that live in sure they have enough fuel to do
the tiles are cracked, the roof is
your intestinal tract. It is mainly their job. You wouldn’t go to work
leaking, the windows are broken,
comprised of bacteria that are without any lunch, would you?
all the workers have retired, there
involved in functions critical to Neither should probiotics.
is no one in there getting the job
your health and wellbeing. Our gut
done! We need to get in there and
microbiome is determined way Prebiotics
do some renovations and hire
back to when we were conceived. Prebiotics promote the growth and
some more staff!
Whether we were born naturally, or activity of beneficial gut bacteria
via caesarean, breast fed or formula Gut dysbiosis can be caused by
and are mostly found in plant-
fed, all influences the gut bacteria a variety of factors ranging from
based foods. They are the fibre
we were exposed to and therefore chronic stress, to medication
that passes through the stomach
influences our immune function use such as antibiotics or the
to feed the good bacteria that live
throughout life. contraceptive pill, to stomach
in your large intestine. Their main
bugs, to of course, diet which can
So why do we place such a big food sources include vegetables
include sensitivities or a lack of
emphasis on keeping our gut (especially artichokes, garlic,
fibre consumption.
microbiome in the best possible onion, leek, asparagus), legumes,
shape? The jobs our gut does are wholegrains, nuts and seeds.
Fibre
endless and include:
Where do we start with the diet?
ĠHelping to digest our food to Continued on page 14 >
Let’s start with fibre consumption.
Node News | Lymphoedema Association of Queensland 13HEALTH AND WELLBEING
Probiotics toppings like hummus, avocado approach, our Dietitians at Tree
ĠChopped vegetable sticks with of Life Nutrition are specialists
Probiotics contain the live
tzatziki in gut health and have done an
health-promoting bacteria that
ĠGreek yoghurt with muesli abundance of research that has
is beneficial to maintain a healthy
ĠRoasted chickpeas brought us to create our very own
gut microbiome. They include
So how does this all link to tailored gut fixregime. Speak to us
fermented or aged milk and milk
lymphedema? You need to to learn more!
products, and of course can
picture your gut as the central
also be taken as supplements.
component in a very complex
Examples of food sources include:
mind map, there are connections
feta cheese, natural Greek
everywhere! When we set up a
ABOUT ELENI GEORGIOU
yoghurt, low fat milk and cheese,
well-balancedenvironment in
and Greek olives (fermented in
our gut and when we provide it
brine, not pickled), sourdough
with the appropriate fuel, one of
bread, and sauerkraut.
the main attractions is managing
Gut Friendly Snacks inflammation. Managing the
inflammation in your body protects
ĠCelery sticks with nut butter and USER-MD Dietitian
cinnamon your immune system which is
B.HlthSci (Nut), B.Nut & Diet
ĠSourdough slice with a thick directly related to your lymphatic
APD AN
spread of Greek yoghurt and system, see, connections!
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Tzatziki is a staple in all Greek reduced fat
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great on salads, with pita bread ĠJuice from 1 lemon
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burgers, sandwiches and baked
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potatoes. This quick tzatziki
Mouse-pointer SHARE YOUR RECIPE WITH OUR READERS
Do you have a favourite recipe you would like to share with our readers? Email your recipe to us along with
a photo of yourself with your delicious creation.
Node News | Lymphoedema Association of Queensland 14SPONSOR
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Node News | Lymphoedema Association of Queensland 15MEDICAL MATTERS
INVESTIGATIONS TO AVOID PERIL AND REDUCE THE
BURDEN FOR THE LIPOEDEMA PATIENT
Author: Dr Chris Lekich
L
The deep venous system is also ablation. More recently the use
ast time I wrote for
important to interrogate to of endovenous glue ablation
Node News, I noted that
determine if there is any deep using cyanoacrylate is available.
lipoedema is a clinical
venous incompetence either Endovenous ablation can be
diagnosis which hinges on a
from genetic valvular disease performed in our outpatient's
clear history and examination.
or from a current or past deep procedure rooms, however
I am often asked by patients,
vein thrombosis that would lead inpatient service in our hospital
medical colleagues and
to a swollen limb. Further our allows for a more controlled
therapists what is the best
sonographers use ultrasound to environment with my anaesthetist
investigation to confirm
determine secondary lymphedema providing twilight sedation useful
lipoedema? In short there is
using sub echogenicity grades for complex veins and larger legs.
not one, however there are
(SEG 0-2) whilst performing
important investigations
Chronic Venous Insufficiency
performed day to day using
scans (CVI-studies). This is useful
ultrasound to diagnose and
to determine the lymphatic burden
manage comorbiditiesthat
of the lipoedema.
can impact significantly on
the lipoedema progression,
severity, its conservative and
With modern venous procedures,
surgical management.
stripping is avoided and
Other investigations that are procedures are “walk in walk out”.
useful, however not often ordered, I'm impressed that even patients
that I will not cover in this issue, is with 40 litres plus of lipoedema fat
lymphoscintigraphy, indocyanine in the legs report that they feel “so
green (ICG), MRI and Dexa scans. light” when their venous disease
The Dexa scan is a test that you As seen in these scans this patient is managed. This is not surprising
as MLD therapists would be more shows obvious backward flow as the venous disease compounds
inclined to use in your day-to-day called reflux (in red) occurring inflammation and swelling.
practise and you would be most in the main trunk vein in this A third of the general population
expert with its use. case the greatsaphenous vein suffer from venous disease. This
(GSV) worsened by a refluxing is higher in my experience, up to
Ultrasound perforating vein leading to 50%, of lipoedema patients, due
As a phlebologist, ultrasound phlebo-lipo-lymphoedema). to poor mobility from lipoedema.
is critical for my day-to-day Management of these veins is It is likely that your patient even
assessment to establish the extent critical to avoid progression of without obvious varicose veins will
of any superficial venous disease. disease, pain and swelling as well have coexistent venous disease.
as eliminate the complications of
Treatment of venous disease
the progression of venous disease.
reduces swelling which is
Ultrasound guidance is used important if lipoedema surgery is
in modern phlebology to treat planned to reduce the risk of clots,
venous disease in the legs. These bleeding and further closes off
are minimally invasive approaches
using catheters, endovenous
Continued on page 17 >
laser ablation or radiofrequency
Node News | Lymphoedema Association of Queensland 16MEDICAL MATTERS
large conduit veins to reduce the leg larger than the other. These fog and exercise tolerance. For
risk of fat embolus syndrome or scans are best performed in the me performing lipoedema surgery
paradoxical fat embolism. morning and where the patient on these patients, it reassures
is fasted. These pelvic vein scans me that the patient will not have
Post-surgery ultrasound is very
are different to general pelvic a risk of fat migrating from their
useful to exclude any deep vein
scans of organs in the pelvis and legs during surgery, bypassing
thrombosis and to determine if
are performed by experienced the lungs and passing through a
there are any seromas. Further the
vascular sonographers. Where hole in the heart and ending up in a
ultrasound is used to quickly and
patients have large abdominal small artery in the brain that could
efficiently drain any seromas which
girths, CT venogram is an lead to a stroke. One in four people
may present as “little puddles”
alternative performed in the portal in the community have a hole in the
that are not shifting with MLD.
venous phase will exclude any heart and might not ever be aware
I prime my patients regarding
venous compression or outflow of it. A hole in the heart is the first
seromas. As a therapist if you
obstruction that would cause condition that is investigated when
feel a seroma is present post
swelling in the legs. It is important young people have strokes called
operatively, please feel free to let
todiagnose these conditions cryptogenic stroke.
me know directly and send the
as these can be potentially life
patient our way for drainage. The TCD is an outpatient test that
threatening if missed.
takes approximately 20 minutes
Duplex arterial scans are
Transcranial Doppler (TCD/ with very low risk as a test. it
also important for patients
Bubble Study) is an ultrasound is useful also for patients with
where the sonographers can
modality used in my rooms using significant symptoms pointing
determine that there is no arterial
2 megahertz probes on the right towards a hole in the heart before
compromise before proceeding
and left sides to interrogate the any venous interventions.
to the prescription of flat knit
cerebral arteries worn as a head
compression garments and when In summary the use of ultrasound
piece attached to a doppler box
proceeding to surgery in high-risk is a very important modality
and computer.
patients. This is very important in managing patients with
where there is a history of lipoedema. Portable ultrasounds
cigarette smoking, hypertension that attached to your phone or
or increased lipids. I tend to have your iPad are now available such
a lower threshold to perform this as the Philips Butterfly or Clarius
on my patients as there is difficulty meaning ultrasound will become
in palpating pedal pulses due to ubiquitous in primary care. If you
lipoedema body habitus in the legs have an interest in ultrasound in
and the use of arterial brachial your MLD practice, feel free to
A drip is inserted in the arm or
index (ABI) using a cuff is painful. reach out to us and spend the day
the leg using ultrasound to inject
It is possible to refer patients to with us to learn how to drive the
sterile saline solution with 1 ml of
our clinic for the sonographers machines.
micro-bubble air. These micro-
to perform duplex arterial scans
bubbles dissolve very quickly
for patients. Where as the
therapist you are concerned about
however long enough to count ABOUT DR CHRIS LEKICH
every bubble if there is a hole
compression and arterial disease.
in the heart. When the test is
Pelvic Ultrasound Scans are positive, patients are referred
useful to exclude pelvic venous to an experienced structural
congestion, arterial venous cardiologist that can close
compression syndromes or pelvic these this in 40 minutes with a
or abdominal clots in the deep minimally invasive approach. briefcase Lipoedema Surgical Solution
system that would give rise to When holes in the heart are closed
swollen legs. This is particularly phone 1800 367 534
many patients report significant
important where a patient has one improvement with migraine, brain globe-americas lipoedemasurgicalsolution.com
Node News | Lymphoedema Association of Queensland 17What is lipoedema? What are my options?
Lipoedema is a chronic condition characterised by a painful and abnormal accumulation of fat cells in the hips, thighs, buttocks, legs and
often arms. The legs become swollen, bruise easily, feel tender and uncomfortable.
Sufferers of early stage Lipoedema often have column-shaped legs and as the condition worsens the fat continues to build up and the lower half of
their body becomes heavier. The lipoedemic fat can also build up in the arms. The fat cannot be exercised or dieted away, many patients eat well and
exercise yet continue to develop fat on their lipoedemic areas.
If not diagnosed and managed properly Lipoedema can result in further complications including reduced mobility, lymphoedema (due to scarring of
the lymphatics secondary to the inflammatory nature of the lipoedema tissue); as well as depression, anxiety, body dysmorphia or eating disorders.
Sufferers of Lipoedema typically have two treatment options:
1. Conservative Management through wearing compression garments, diet & lifestyle adjustment & manual lymphatic drainage. This is a mandatory
and a lifelong requirement.
2. Surgical Lipo-extraction to remove the diseased fat aiming to arrest the disease with surgery. Long term, surgical patients are more comfortable
and are less dependent on lifelong compression and manual lymphatic drainage. Refer to our website www.lipoedemasurgicalsolution.com for
case studies with before and after photos.
Surgery with Lipoedema Surgical Solution is:
Minimally Invasive Symmetrical Holistic
No open surgery, small incision points for waterjet Both legs treated at the same time, starting with the lower Diagnosis and treatment are underpinned by ultrasound
assisted treatment, no long scars. legs, to optimise balance, function and form following surgery. for a complete approach to managing the condition.
PH: 1800 FOR LEGS | 1800 367 534
www.lipoedemasurgicalsolution.com
Node News | Lymphoedema Association of Queensland 18MEMBER SPOTLIGHT
POSITIVE DESPITE ADVERSITY
Author: Pam O'Connor
F
Lini has only just recently joined
or Lini Boyer, 1995 was
the LAQ, introduced by one of her
a year she doesn’t want
customers.
to remember. She lost a
baby girl at 19 weeks, and she “I know l probably was told about
was diagnosed with ovarian support groups when l first got
cancer lymphoedema, but at the time
thought l didn’t need it. There have
“My whole world flashed before
been many times I just wanted to
my eyes. I was very lucky as it
cry because you have already dealt
hadn’t spread and didn’t have to
with having cancer but now you
have chemo or radiation. I was
have this as a constant reminder.
very blessed to have a baby girl
12 months later,” Lini said.Years “Being in a group you’re able to
She’s had lymphoedema now for
later she developed lymphoedema share your journey with others
about 10 years and it is just a part
in her right leg, and then ovarian that know exactly how you feel. I
of her daily routine of getting
cancer again another few years like reading about things that help
up and having to put on her
later, this time more aggressive others and about new things that
compression garment.
and requiring chemotherapy. just might make our lives easier.
“A few years ago, l flew to
“I have been extremely lucky to “I have only been able to make one
Melbourne to have a procedure
have amazing doctors throughout morning tea get-together because
done on the lower part of my leg to
my ordeal and I thank my lucky of work but I enjoyed it and hope l’m
give it more of a definition around
stars every day.” able to make it to more in the future.
my ankle. And yes, like us all, wished
“
this procedure would cure it. “I am an identical twin - she never
Being in a group had ovarian cancers but six years
you’re able to share “I work full-time and being on my
ago got breast cancer and suffers
your journey with feet all day, when l come home
with lymphoedema in her right
others that know l can’t wait to take the garment
"
arm. A pigeon pair.
exactly how you feel. off. I massage my leg as well
as use a machine to help take “Even though it’s just turned 15
Lini hates having lymphoedema, out the excess fluid. This helps years, I still have yearly check-ups
and is ticked off that she can’t tremendously and is very relaxing and to me that’s peace of mind."
wear sexy high heels anymore. aswell,” Lini said.
There are times when she is unsure “Other than this, l don’t do any LINI'S TOP TIPS:
about what makes her tick. “I think other treatment - and that’s ĠMoisturise your skin daily
being a mum you just often suck it ĠMassage as often as you can
probably more a time factor than
up and keep going." ĠDrink oodles of water
anything.”
But she is inspired by people who
are much more worse off – and it
is this positive attitude that drives
Mouse-pointer SHARE YOUR STORY WITH OUR READERS
her to get up and get going every We love sharing our Members’ journey with lymphoedema. Their
day to enjoy life surrounded by real-life stories, tips, guidance and sharing of information helps to
her big family, who mean the world create an important resource for LAQ Members while also raising
to her. She tries to see her two awareness.
children and her grandchildren as
much as possible. If you are an LAQ Member and would like to be profiled in the next
issue of Node News please click here to make your submission.
Node News | Lymphoedema Association of Queensland 19THERAPIST SPOTLIGHT
OVERCOME BARRIERS TO LIVE A FULL LIFE
Author: Pam O’Connor
L
would make a better occupational
ymphoedema
therapist than a physiotherapist
occupational therapist
and that I should do my Masters of
Emily Muldoon is
Occupational Therapy,” Emily said.
passionate about helping
people to overcome the “Fast forward a few years and
barriers of their condition so when I was working as a new
they can live life to its fullest. graduate OT at John Flynn
Hospital, I received a referral for a
“I am extremely passionate about
patient with lymphoedema. I asked
the fact disability, disease or
our lymph-trained OT, Tara, if I
condition does not define a person
could shadow the session with her
and everyone should have the
and the patient - both agreed.
opportunity to engage in what
they want,” she said. “I was in awe of how Tara spoke with
this lady and was intrigued about
As the owner of Swell Therapies,
how unique and personalised the Nicole, Anouk andLaila.
a fully mobile business offering
lymphoedema management plan
an in-home service from Brisbane “Since working privately, I feel
was for this lady.
to the Gold Coast, Emily sees my network of lymph-trained
people with a wide presentation of “Fast forward again and I was therapists is ever expanding and
lymphoedema. looking to relocate myself from I am so fortunate now to have a
Gold Coast back to Brisbane for lymphoedema physiotherapist,
“ Everyone should have
the opportunity to
engage in what they
love and I took the big step to start
Swell Therapies.
Marlene, now working with me at
Swell Therapies.
"
“I was quite lucky in the early “It is my goal to continue to offer
want.
stages of Swell Therapies to work in-homelymphoedema support
part-time at both Greenslopes and hopefully expand with more
She describes her journey to
Private Hospital and then at Gold therapists in the future.”
become a lymphoedema therapist
Coast University Hospital, while
as “a little curly”, with her first Emily said she joined the LAQ “to
my business grew.
steps in a health career as an feel more connected to the world of
exercise physiologist working in “I am so thankful for the lymphoedema, both for my clients
spinal cord injury rehabilitation. experience and opportunity and myself as a professional.
provided by GCUH, as well as the
“I was looking to return to study “I believe community therapy
guidance from lymph therapists
when a client convinced me I relies on having supports for both
the client and the therapist.
“I also like to collaborate with
other therapists and learn from
those working in the same field.
Let’s start working together on improving your
health & quality of life Additionally, the lived stories of
• Manual Lymphatic Drainage Massage those with lymphoedema can be so
• Compression bandaging
• Measuring & fitting of compression educational for my understanding
garments as a therapist.”
Book a consultation today to find out how we can
help to restore your health & quality of life through Emily loves sharing education and
better management of lymphoedema
JEANINE MEWBURN Contact me today 0419 022 985
Complex Lymphatic Therapist www.jmlymphoedemaclinic.com.au Continued on page 21 >
Node News | Lymphoedema Association of Queensland 20THERAPIST SPOTLIGHT
knowledge. “Knowledge is power
and it can empower everyone EMILY'S TOP TIPS:
(therapist, clients, family and ĠConsistency is the key. If you think of the lymph system as
supports) to make a positive constantly moving -it needs your help more than “once in a while”.
impact on their lives.” Consistent input will give you more reliable outcomes and help
you work out what is best for your body. For example, wearing your
She said she has met many people compression “every now and then” won’t be as effective as wearing
who have had so many challenges, your compression every day
and is inspired by their ‘never give ĠMake any part of your lymphoedema management part of your
up’ attitude. usual routine. For example, clear your lymph nodes during your
shower or complete some self-lymphatic massage each time you
“There is always a way! It just
get change
might take some extra time or
ĠLive your life! Don’t let your lymphoedema define you. Yes, you will
take a different path to what you
likely need to do something every day with your lymphoedema,
originally thought,” she said. whether it’s massage, compression, pumping, taping, exercise,
Emily embraces life with love, elevation, skin care or a mix of all of the above, but don’t forget to
respect and lots of laughter –she live your life
also loves craft and coffee!
Mouse-pointer SHARE YOUR STORY WITH OUR READERS
We love sharing our Members’ journey with lymphoedema. Their real-life stories, tips, guidance and sharing
of information helps to create an important resource for LAQ Members while also raising awareness.
If you are a lymphoedema treatment provider and would like to be profiled in the next issue of Node News
please click here to make your submission.
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www.morrismedical.com.au FOR STYLE AND FIT
Node News | Lymphoedema Association of Queensland 21IN THE LOOP
ANNUAL GENERAL MEETING 2021
Please register on the following
link or head to our website under
special events.
lymph.org.au/events/special-
events/#!event/2021/10/30/laq-
annual-general-meeting
Allow 10 mins before the event to log
on and get yourself set up.We look
forward to seeing you on the night.
P.S there are phone-in options
as well if the internet connection
is a little weak in your area, once
registered the numbers will be
Grab a cuppa and join us from the zoom. With QLD having such a vast
sent through via email so make
comfort of your home. landscape it is a great opportunity
sure you save the details.
for us all to come together and
With the current turn of events
connect on the evening which is a
nation-wide restricting us meeting
first for LAQ.
in person, we now have the
opportunity to meet with all of our We will have a special guest TICKET-ALT REGISTER NOW
members at once with our AGM via speaker on the night so stay tuned.
THE GIFT OF GIVING
Thank you to the following sponsors who supported us for our website launch
Haddenham Health The Joint Physiotherapy and Allied Plunkett Pharmaceuticals
Health
Morris Medical Coffee Education Network
Essity
Co.As.It Jocelyn’s Provisions
Zonta Brisbane Sunrise
Medi Australia Cr Davis
Creative Flavours
ImpediMed Ltd Cr Landers
And a special thank you to Cr Davis for printing our Node News for those that don't have email.
Australian Distributors
of Bioflect Compression
Garments
Patented design, comfortable and effective
in assisting lymphoedema, lipoedema,
other oedema and lymphatic issues, lactic
acid, aching legs, vascular conditions,
post-surgery and rehabilitation.
Easy sizing & donning
More info at our online shop; Expert back up and service at; 03 97026027
lymphaticaustralia.com.au sales@lymphaticaustralia.com.au
Node News | Lymphoedema Association of Queensland 22SUPPORT
SUPPORT GROUP MEETINGS SEPTEMBER 2021
Date: Wed, 22 September 2021
Time: 10:00am –11:30am
We never want you to feel isolated or alone which is why we Venue: Revolution Espresso -
Caboolture
encourage you to come along to our Support Group Meetings.
Host: Nerida Smith
At these informal gatherings, you will meet others, just like
yourself who are coping with the daily challenges of living with OCTOBER 2021
Lymphoedema. You'll get to share ideas, treatment options and Date: Tue, 5 October 2021
Time: 10:00am – 11:30am
gain insights from the collective experiences. Venue: Luv a Coffee - Beenleigh
Hosted by LAQ Ambassadors our Support Group Meetings are a great Host: Jess Billiau
opportunity to network with members, make new friends and create Date: Mon, 18 October 2021
connections. It's also an opportunity to learn about the support and Time: 10:00am –11:30am
Venue: Cancer Care Centre -
services on offer as part of LAQ Membership. To RSVP or find more
Bundaberg
details about meetings visit our website www.lymph.org.au Host: Olga Beath
If you are interested in being a guest speaker at future LAQ Support
Date: Fri, 29 October 2021
Group Meetings, please call our office on 0403 782 795. Time: 10:00am –11:30am
Venue: Revolution expresso -
LAQ SUPPORT GROUP MEETING Caboolture
Host: Nerida Smith
AMBASSADORS NOVEMBER 2021
Date: Mon, 1 November 2021
Time: 10:00am –11:30am
BRISBANE NORTH MORETON BAY Venue: @Beans - Cannon Hill
Host: Pam O’Connor
user-alt Uff. Hon. Teresa Gambaro user-alt Nerida Smith OAM
Mobile-Alt 0409 849 718 Mobile-Alt 0412 498 106 Date: Mon, 8 November 2021
Time: 10:00am –11:30am
LOGAN GOLD COAST Venue: Chermside Library -
user-alt Jess Billiau user-alt Jess Billiau Chermside
Mobile-Alt 0408 781 914 Mobile-Alt 0408 781 914 Host: Hon Teresa Gambaro
BUNDABERG BRISBANE EAST Date: Fri, 26 November 2021
user-alt Olga Beath user-alt Pam O’Connor Time: 10:00am –11:30am
Mobile-Alt 0429 877 100 Mobile-Alt 0403 683 963 Venue: Revolution Expresso -
Caboolture
Host: Nerida Smith
Node News | Lymphoedema Association of Queensland 23You can also read
