The second day was always going to be full … I was to attend the Smith and Nephew hosted breakfast session – breakfast at 7.30 and a talk at 8, followed by the full schedule of talks from 9am to 5.15pm, followed by the Conference Dinner at the War Memorial from 7pm till 11pm. But it started slightly differently – I woke up and thought, “wow, it’s much lighter than yesterday” then looked at the clock and saw it was 7.35am! Not a good start. I did manage to get to the start of the Smith and Nephew talk, well, it was 8.03 and I had only missed the introduction. I thought that was a pretty heroic effort.
The talk was pretty much the launch of the JOBST Elvarex Plus, the latest innovation in compression. The garments are made using 3D knitting techniques and are seamless and the edges have been improved so there is no unravelling. We were shown some of the machinery that was designed specifically to test the hardiness of the material. They look pretty impressive, the fingers and toes have no ridging or seams and they seem to be exceptionally well designed, click here for more information. At the moment they are only available in custom-made garments.
There were a number of presentations on studies that morning, I’ll give the titles of the talks and the conclusions in brackets – The prevalence of LE following gynaecological cancer (one-third of women have swelling by 12 months post surgery, three-quarters by 24 months); incidence and risk factors for LE at 18 months following surgery for early breast cancer (at 18 months, 10% had swelling, mainly in women who had node dissection); generalised oedema post taxane-based chemo in women with early breast cancer (incidence of LE in the arm on affected side increased at 6 months after completion of taxane-based chemo); Improving the way we measure bilateral upper- and lower-limb lymphoedema (Bioimpedance spectroscopy (BIS) is an effective diagnostic tool for measuring lymphoedema).
I attended a Kinesio taping workshop that has inspired me to go off and do the course. We used it on a muscular level, as we didn’t have guinea pigs with lymphoedema to experiment on, but we saw instant improvements in the range of motion in a number of people with shoulder issues, pretty amazing. I’ve already sent off for details of the next course!
Kinesio tape
The afternoon session had talks on: the feasibility of night-time compression systems for breast cancer related lymphoedema (early results suggest use of night-time compression is not significantly better than standard care, however, they are preferred due to their comfort and convenience in application); Review of the evidence of lymphoedema treatment effect (reviews consistently concluded that complex physical therapy is effective at reducing limb volume. Reductions were also recorded using compression garments, manual lymphatic drainage and compression pumps. Insufficient evidence to support these treatments as stand-alone strategies); low-level laser therapy (LLLT) for lymphoedema (this was a review of a number of studies, which concluded that there is an emerging and reliable evidence base for the positive effectiveness of LLLT for lymphoedema); LLLT for fibrosis, capsular contracture of post-mastectomy breast implants (this study was done on mice, placing silicone implants subcutaneously on mice then irradiating the site to induce fibrosis. Results – no capsular contracture in either group, but the implants receiving LLLT had tissue that was better “organised” and had less inflammation.); Do women with breast cancer-related LE need to wear compression during resistance-exercise? (no change in L-Dex readings were observed for either compression or non-compression control groups, immediately post-exercise and 24 hours post-exercise); The acceptability and perceived effectiveness of treatments prescribed for the management of LE (this was a survey sent out to members of the LA Associations of Victoria and Queensland – outcome was – understanding patients’ perceived acceptability and effectiveness of treatments is necessary to determine whether treatment strategies proven clinically effective are feasible in the real-world settings); Imaging in LE in clinical practice (Dr Keely talked about Venous Duplex Scans, Ultrasound of soft tissue and Echocardiography).
A lot of the talks were very evidence-based and statistical which is why I chose to list them out with their conclusions. The ones that made an impact on me were: the studies on using the Low Level Laser, these showed benefits to using LLLT and I felt justified in purchasing one last year; and the study on wearing compression during exercise – I would have expected there to be a difference, but I think the take away message was that it’s a personal choice, wearing the sleeve will not do harm (of course there’s always the odd person who’ll prove that wrong!) and for some there may be an improvement, but try it and see.
Then there was the conference dinner. It was held at the beautiful War Memorial.
We walked through parts of the Museum to get to the event but it wasn’t really long enough to have a proper look at the exhibits unfortunately. There was an opening ceremony with Maori dancers performing a number of dances, culminating of course with the Hakka, always an awe-inspiring event. Literally as we finished the main course a DJ started to crank up the music and in an instant the dance floor was filled with women – I’ve never seen so many women dancing in one spot in my life. I asked one of the guys the next day if he found it odd – he really did! And we boogied until after 11 (I was dragged onto the dance floor by those who shall remain nameless … Kelly!!!!!).
All in all a very full day.
If you’d like info on any of the talks, please message me.
Day 3, coming up!