eNews Online - November 1998 Edition

eNews Online
November 1998 Edition


This Lymphedema eNews is being generated through your request from our website.



Reconstruction and Lymphedema

Recently one of our readers asked whether breast reconstruction after some way to grow new lymphatic channels to overcome the blockage that exists due to surgery and radiation. There is promise in current research on a protein called VEGF-C; however, it is still in the research stage.

The use of growth factors has become more common in medicine. In oncology we commonly use growth factors to stimulate the growth of the infection fighting white blood cells after treatment with chemotherapy. In the area of neurology, scientist have been working with nerve growth factor to find ways to regenerate nerves. Several years ago a protein that is made by the body that stimulates the growth of the vessels was identified. This was called Vascular Endothelial Growth Factor or VEGF. Recently, a member of the VEGF family that stimulates the growth of the lymphatics was identified. This has been called VEGF-C. The discovery of VEGF-C opens up the possibility that sometime in the future we may be able to stimulate the growth of the patientís own lymphatic system to make new lymphatic channels. This technology is in the early development stages and is not yet ready for human trials. Nevertheless, it is an exciting and promising discovery, one that offers the hope of effective treatment for patientís who su ffer from lymphedema. There are several research papers on this subject and I have included the references for these at the end of the letter.


Tony Reid MD Ph.D

Lymboussaki , Expression of the vascular endothelial growth factor C receptor VEGFR-3 in lymphatic endothelium of the skin and in vascular tumors. Am J Pathol 1998 Aug;153(2):395-403.

Witzenbichler B, Vascular endothelial growth factor-C (VEGF-C/VEGF-2) promotes angiogenesis in the setting of tissue ischemia. Am J Pathol 1998 Aug;153(2):381-94.

Jeltsch M, Hyperplasia of lymphatic vessels in VEGF-C transgenic mice. Science 1997 May 30;276(5317):1423-5.



Case of the Month

Our Case of the Month for this eNews involves a patient who has been faithfully wearing her ReidSleeve for several months. A week ago, she called our toll free customer support number to discuss her lack of reduction. She was working with a therapist on a very limited schedule and had missed her last appointment.

It didn't take long to discover the challenge that she had been experiencing. The compression level had not been adjusted since her initial fitting. Fortunately,she had her own gauge she increased the pressure from 15mmHg's to 20mmHg.

She called a week later with great news. Her body was now responding rapidly with the increase in pressure. She now had reduction of up to 2 1/2 inches in her upper arm, and the lower arm was also responding well. She is very pleased with these results and sorry that she missed her appointment with her therapist for follow up.

We recommend that you wear your ReidSleeve at the lowest pressure that still provides good results. If you are currently not experiencing reduction, please work with your therapist or doctor to find the compression level that is appropriate for you. We also offer customer service and a Patient Support Program to anyone needing additional support with their ReidSleeve. While this service doesn't replace your need to be under the clinical supervision of your therapist or doctor, it can be very beneficial in conjunction with your therapist in optomizing the fitting of the ReidSleeve.



Insurance Billing

Most Insurance companies are reimbursing for the ReidSleeve. The following is a partial list of insurance companies that have paid. Blue Cross/Blue Shield of the following states; California, New York, Vermont, Alabama, Mississippi, Wisconsin, and Washington. Other companies are; Aetna, The Guardian, Cigna, Prudential, United Healthcare, and the Veteran's Administration in California, Hawaii and Canada. There are many other insurance companies that we have dealt with, and at no obligation we offer insuranc e verification for coverage. If you would like us to check on your policy provisions for durable medical equipment coverage, please call Stacey @ 800-293-3362, ext. 202.

* DEDUCTIBLES *

This is the time of year we like to remind patients that annual deductibles renew on January 1st. If you are considering treatment and/or the purchase of durable medical equipment, have your insurance benefits checked out by Stacey to see if you should try and get a claim processed before January 1st.

* MEDICARE update *

There continues to be cuts in Medicare coverage for patients seeking treatment for lymphedema. Along with the help of several advocates, we are pushing forth the ReidSleeve with our government officials for consideration of future coverage. We'll keep you updated on our progress.